Health Care Epidemiology Research


Program in Health Care Epidemiology

Health care epidemiology and outcomes research rest on the theoretical formulation that the distributions of health states (good health, disease, disability, and death) in populations are not random. They are determined by many factors that are found in the host, agent, or environment including biological, social, and environmental factors. One important determinant of the health of populations is the accessibility and use of health services.

Since its inception, the Department of Epidemiology at UNC-CH has been among the few departments in this discipline throughout the world with a recognized program area emphasis in the application of epidemiological theory and methods to the study of problems and issues related to the delivery of personal health services. The Department’s faculty took the lead in the training of the first generation of American epidemiologists who had a substantial concern for the measurement of the impact of several variables on the distribution of illness in human populations and the factors that either enabled or impeded the use of personal health care services.

The Training Program in Health Care Epidemiology is primarily housed in the Department of Epidemiology, but the full array of activities is spread throughout the university. The program involves faculty and students from the other Health Affairs Schools, including Medicine, Dentistry, Pharmacy and Nursing, as well as the Cecil G. Sheps Center for Health Services Research. Most students in this content area come from other programs in the School of Medicine, such as the K30 Clinical Research Curriculum and Preventive Medicine Residency Program, with only a few students primarily based in the Department. Because most departmental programs have an application aspect that relates to health care, clinical research, or policy, there is inevitable, but desirable, overlap and duplication of resources: faculty, students, research projects, and courses.

A wide array of Health Care Epidemiology research is being conducted across the UNC campus. For example, the Program in Health Care Epidemiology has strong relationships with the

In addition, individual faculty members have links to research area specific centers, such as the

The Program has also enjoyed strong ties with


Learning Objectives:

The mission of the Program in Health Care Epidemiology is to train competent and innovative investigators who will improve the health of the population and to contribute to this field through research and service. We define health care epidemiology broadly to include clinical research, outcomes research, and the juncture between epidemiology and health policy.

Specific learning objectives of the program include the following:

  • Discuss the interrelated nature of clinical, administrative, and policy processes and their impact on health outcomes of populations;
  • Discuss the role of the population-based perspective in the delivery of healthcare services;
  • Discuss the origins and development, including changing perspectives, of the discipline of healthcare epidemiology;
  • Discuss and account for the relationship between traditional etiologic epidemiology and healthcare epidemiology;
  • Effectively participate in interdisciplinary approaches to studying issues of the impact of the healthcare system;
  • Evaluate the impact of healthcare programs (e.g. disease management programs) and specific interventions/treatments (e.g. pharmaceuticals or clinical procedures) on the health outcomes;
  • Effectively communicate the results of research and evaluation efforts to the variety of stakeholders in the healthcare system (e.g. different types of healthcare professionals, researchers, policy makers, insurers, and the public);
  • Consult with clinicians, administrators, and policy makers about the implementation of population-based programs designed to improve the delivery of healthcare services;
  • Critically review the scientific literature relating to the epidemiology of healthcare delivery for both methodological quality and potential applicability;
  • Understand the benefits and risks of medication use, including drug safety and risk management;
  • Design and conduct an epidemiological study related to the impact of healthcare, together with biological, social, behavioral, and/or environmental factors on the health outcomes of populations.



Advisors in the healthcare epidemiology program work in conjunction with individual students to identify courses in the Department of Epidemiology and on the rest of the UNC campus that will enhance skills that are necessary for working in specific areas of healthcare epidemiology. Examples of such courses include health economics, clinical trials, prevention methodology, survey research techniques, scale development, and medical geography. Faculty advisors in the program work also with students to identify internship opportunities for gaining first-hand experience in health care delivery and its potential impact on health outcomes. Sites include managed care organizations, pharmaceutical companies, governmental, and international agencies.

Additional Courses (MPH Students)

Students in the MPH program also typically participate in key courses within the Translational & Clinical Research Curriculum, supported, in part, by the Program in Health Care Epidemiology. These courses include EPID 896, Clinical Research Seminar, and the year long sequence EPID 805/806, Clinical Epidemiology and Clinical Research Methods (805) and Clinical Research Skills (806). These courses are not typically available to doctoral students.

Program Area Leader

William Miller, MD, PhD, MPH, Assistant Professor

Dr. Miller is the Director of the Program in Health Care Epidemiology and Pharmacoepidemiology. He also serves as the University’s Clinical Research Training Coordinator. He is a core faculty member for the K30 Clinical Research Curriculum and the Roadmap K12 Program. His research interests relate to the intersection between infectious diseases, specifically HIV and sexually transmitted infections, and health care. His work in screening for chlamydial infection has been internationally recognized. He also has substantial expertise in diagnostic test evaluation, especially in the area of infectious diseases.

Affiliated Faculty

Sara Huston, PhD, Research Assistant Professor

Wayne Rosamond, PhD, Professor

Kathryn Rose, PhD, Research Associate Professor

Sonia Napravnik, PhD, Research Assistant Professor

David Margolis, MD, Professor of Medicine

Graduate Student Research Assistantships

Research assistantships (RAs) offer students an opportunity to gain research-related experience, develop close working relationships with faculty, and sometimes earn CO-authorship on peer-reviewed publications. Information on the type of assistantships available and how to locate them is available from Student Services. A small number of RA positions are generally available in the Health Care Epidemiology program. Students interested in an assistantship should submit an application form (available from Student Services), and should discuss this interest with their advisors.

Departmental Training Grants

Because the Health Care Epidemiology program has strong ties with other epidemiology program areas, such as Cancer, Cardiovascular, Infectious Disease and Pharmacoepidemiology, students are sometimes able to secure funding through training grants that offered in each of these program areas. Please visit the Cancer, Cardiovascular, Infectious Disease, and Pharmacoepidemiology program area pages for further information about training grant options for Health Care Epidemiology students.

External funding

Students are sometimes able to secure funding from sources that are external to the University. For example, GlaxoSmithKlein has provided funding for pre- and post-doctoral trainees in Pharmacoepidemiology, and for graduate research assistants in both Pharmacoepidemiology and other substantive Epidemiology research areas.