Our faculty solve some of the most pressing health problems in North Carolina and around the world by conducting novel, innovative research that changes public health practice, influences policy and improves the quality of people’s lives. Last year, our faculty received $154.1 million in research grants and contracts related to these pressing health problems.
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Currently making an impact…
In North Carolina, non-Hispanic black men are more than twice as likely to have advanced prostate cancer than men of other races and ethnicities. Advanced prostate cancer causes significant pain and fatigue. Antonia Bennett, PhD, is looking at the prevalence of pain, how it changes over time, who is most affected, and the best ways to survey older patients about the pain they experience from advanced prostate cancer. This information is important for the development of new treatments that reduce pain better than current treatments. In addition, what is learned about the best ways to conduct symptom assessment in men with advanced prostate cancer, including African-American men, will inform the design of symptom assessment in clinical trials and long term outcome studies in other advanced cancers and diseases experienced by older patients. By improving symptom assessment methods, we will be better able to evaluate new treatments by their effect on pain and other symptoms that impact the quality of life of severely ill patients.
Nutrition assistant professor, Patrick Bradshaw studies long-term health outcomes in cancer survivors, primarily in the 2.5 million women who are survivors of breast cancer. Motivated at an early age by several family members who died from cancer, and a mother who is a cancer survivor, Bradshaw is applying his advanced training in biostatistics and epidemiology to identify the impact of risk factors like obesity, diet and physical inactivity coupled with cancer treatments on survivorship. His recent work has shown that women with breast cancer are more likely to die from cardiovascular disease than women without breast cancer, but the increase in risk is only evident seven years after breast cancer diagnosis. Including cancer survivors from the beginning of their diagnosis will allow Dr. Bradshaw to identify the lifestyle changes cancer survivors undergo and how their clinicians may treat them most effectively.
What is implementation science? If science is on one bank of a great river and improved population health on the other bank, then we might view Implementation Science as building the bridge across that river. Epidemiology assistant professor Daniel Westreich’s work focuses on this bridge building.
Epidemiology is often interested in information about causal effect: whether an exposure causes a change in an outcome. But in recent years epidemiologists have increasingly focused on contrasts of effects which are of limited utility in public health policy making. For example, epidemiologists have reported that those with tuberculosis as well as HIV are much more likely to die (a piece of information perhaps most useful to an individual patient), but often don’t go on to calculate how many deaths might be avoided by reducing the prevalence of tuberculosis with realistic interventions (a piece of information more useful to policy planners). Dr. Westreich’s work in domestic and international HIV epidemiology uses new methods and tools to build bridges from clinical results to population health results: from effects of exposures, to effects of interventions. In the latter case, his work strives to understand and predict how many poor health outcomes or deaths can be eliminated through specific interventions aimed at specific populations or subpopulations. Thus, Dr. Westreich’s work helps show the role that epidemiology can play in the larger field of implementation science, and is helping optimize the relevance of epidemiology to policy making.
On April 20, 2010, the oil drilling rig Deepwater Horizon exploded, killing 11 workers and injuring 17 others. Nearly three years later, researchers have enrolled almost 33,000 participants in what is the largest and most comprehensive health effects study of its kind ever conducted among oil spill clean-up workers and volunteers. Epidemiologist Larry Engel, PhD, is one of the lead investigators for The GuLF STUDY (Gulf Long-Term Follow-Up Study) funded by the National Institutes of Health and led by the National Institute of Environmental Health Sciences. In addition to investigating health effects among the clean-up workers from the clean-up efforts, this long-term study will aid in the evaluation of federal worker safety training measures for disaster responders that were revised in the aftermath of the 9/11 World Trade Center attack response and is informing preparedness and policy for health research in future disasters. “The GuLF STUDY will be invaluable in improving our very limited understanding of the short- and long-term human health effects of oil spills and our responses to them” says Dr. Engel. “Such knowledge is critical not only in regard to this disaster, but so that we can better prepare for such disasters and their health consequences in the future.”
For details about the study, click here
Mental health for African-American men is negatively affected by subtle everyday racism. “The slings and arrows of everyday racism still exist, and we need to find targeted ways to help men defend against them while also working to address the policy structures that project them,” says Dr. Wizdom Powell Hammond, PhD, Health Behavior assistant professor.
Epidemiology professor Til Stürmer, MD, PhD, is set to begin leading an interdisciplinary team in examining methodologies for comparing the effectiveness of treatments used in elderly patients’ treatment after myocardial infarction. This research aims to improve patient-centered research by providing patients, caregivers and clinicians the information and tools they need every day.
After completing one of the largest genome sequencing studies to date (14,002 people), biostatisticians from UNC, GlaxoSmithKline and other universities found that rare genetic variants associated with common human diseases are actually not so rare.
Climate researchers including J. Jason West, PhD, environmental sciences and engineering assistant professor, estimate 400,000 ozone-related deaths could be avoided by 2030 by reducing emissions of short-living pollutants like soot and methane. “There are cost-effective ways to reduce methane sources,” West says, “and when we monetized health benefits, we found that they outweigh the cost of emission reduction.”
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