Faculty Profiles

Yuanli Liu
Heather Nelson
Stephen Buka
Barbara Burleigh
Eric Rimm
Karen Kuntz

Department &
Center Highlights

Annual Report Home

If we are to be the greatest institution for research and training in public health, then attracting the most creative faculty and preparing outstanding younger faculty for leadership in their fields must remain a high priority. It is essential that we build our endowment in order to attract, retain, and nurture extraordinarily creative and dedicated people.

Complex problems in public health cannot be solved by one outstanding scientist working in his or her laboratory day and night. Clearly, multidisciplinary solutions are required. We have made it a priority to create new opportunities for faculty from multiple disciplines to come together to address urgent, complex challenges, from AIDS to health care reform to violence prevention and vaccine development. In the course of strategic planning, our faculty has identified three issues they believe are pivotal to the future of public health and merit greater investment: global health, health disparities, and gene-environment interactions. These issues cut across all of the major disciplines and, we believe, will generate significant ideas and energy through our collaborations in the years ahead.

While health gains of the past half century have been remarkable, yawning gaps in life expectancy--of as many as 40 years--persist between groups and nations today. Infant mortality rates vary by a factor of almost 50. Illnesses that are readily preventable or curable, including diarrheal diseases and cholera, take millions of lives each year. Disparities like these pose huge threats to social, political, and economic progress and stability.

If we are to get our arms around this challenge, we must begin by deconstructing it, in hope of achieving four aims: First, to develop a deeper understanding of the burden, severity, and cost of current and anticipated global health problems, in both human and economic terms. Second, to articulate a case for new investments by wealthy nations in global health to reduce health gaps between rich and poor. Third, to formulate and test hypotheses concerning the root causes of health problems we hope to change, from the biological, chemical, ecological, and environmental forces at work to the social, economic, and political. And fourth, to delineate our options for intervention--medical interventions, such as vaccines and drugs; non-medical strategies, such as strengthening health systems and prevention programs, improving nutrition, and expanding access to clean water and sanitation; and non-health-related endeavors, such as improving roads and communication, expanding education, and easing poverty. We must then carry out studies and trials with collaborators to learn what works best.

The health disparities that abound in our world are inextricably interwoven with economic ones. Life expectancy in Japan is 81 years, while in Sierra Leone it is just 34.

Some 1.2 billion people subsist on $1 per day, while 2.8 billion live on $2. The U.S. is arguably home to the world's most overweight people, yet 11.5 million households go hungry. While one-on-one interactions between doctors and patients will never solve such problems, population-based health interventions focused on prevention have been proven to narrow disparities. In 2003, our faculty formed a cross-departmental team to identify new ways of bringing together experts from the School, the University, and beyond to focus on these issues. Recently School researchers, partnering with Florida A&M University, received a $6 million grant to address leading causes of excess mortality in minority communities within Boston's Roxbury neighborhood and rural Gadsden County, Florida. Throughout the School's departments and centers, a commitment to reducing health disparities is the thread that runs through everything we do and binds us together.

Complex diseases such as cancer, diabetes, asthma, and infectious diseases result from the interplay of our environment and our genes. While scientists may identify genes with established functions within a biochemical pathway that is altered in individuals affected by a particular disease, often the correlation with disease is not absolute, since both environmental influences and other genes determine susceptibility or resistance. And while epidemiological studies may identify a toxic exposure or pathogen that seems to increase disease risk within a given population, why exposures affect some individuals and not others remains unclear. The challenge is to move from identifying a statistically significant association uncovered in an epidemiological study--or a gene identified in a laboratory--to defining the mechanisms underlying a particular disease, factoring in all of the genetic and environmental influences that must be present for it to develop. It is with this comprehensive knowledge that we can best devise targeted therapies and prevention strategies.

In 2003, the School established a new interdisciplinary department, Genetics and Complex Diseases, to study how diseases arise when genes, proteins, and biological pathways within organisms respond to environmental forces. Its researchers, together with others throughout the School and University, will explore the adaptations and responses of biological networks to environmental stresses, with the ultimate goal of preventing multi-factorial diseases such as diabetes and cancer.

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