The Accomplishments of the Divisions for the School’s First academic year – ’20-’21.
When the Herbert Wertheim School of Public Health and Human Longevity Science was established on Sept. 19, 2019, programs were categorized into five divisions. While these divisions may focus on a particular discipline, the range of academic programs are multidisciplinary. Here we highlight the accomplishments of the divisions for the school’s first academic year – ’20-’21.
T he faculty of the Division of Behavioral Medicine have been highly productive, contributing meaningfully with advancing research, education and providing needed services and support for communities. Among the many areas of research, in the ’20-’21 academic year the team focused on: health disparities and health equity; ethical, legal and social implications of research; digital health; brain, behavior, immunity, mental health as a public health topic; implementation science; refugee health; physical activity; community engagement and empowerment; social justice; public advocacy; social relationships and health behaviors; the built environment and health; yoga; multilevel interventions; cancer prevention; childhood obesity; and childhood health, anxiety and trauma care; and health promotion in integrative settings.
The Division of Behavioral Medicine was involved in a wide range of meaningful service to the community during the COVID-19 pandemic. Among the programs was the UC San Diego RELINK (Re-Entry Community Linkages) which supports re-entry of young adults after incarceration, human-centered design of CA Notify, and support in the creation of the UC San Diego Return to Learn program. The group received a wide range of federal, foundation and NGO funding to support research and education, such as the development and implementation of new Master’s in Public Health programs.
F aculty in the Division of Biostatistics thrive on, indeed require, collaborative research. The hallmark of an outstanding academic biostatistician is a dual research focus, with one foot in an area of collaborative specialization and the other in an area of related statistical methods research. Because of this collaborative focus, they are natural drivers of connections and outreach, and this is reflected in a broad research portfolio of the division’s 13 faculty members whose focus ranges from cancer, to climate change, to Alzheimer’s Disease, to genome-wide association studies (GWAS); from tobacco control policy to obesity, diabetes, kidney disease and stroke. Founded in 2001, the division is thriving as it completes its 20th year. The first cohort of doctoral students just graduated in May 2021 with promising new jobs. For the new academic year, the division has 46 graduate students, including its first two cohorts of master’s students.
The division and Herbert Wertheim School of Public Health are benefitting from the energy, enthusiasm, and strong quantitative skills of these new cohorts of future biostatisticians. From the inception, the division has had a strong emphasis on recruiting diverse students, including from a wide variety of economic and social back grounds. The group is developing feeder networks with the California State University system, and planning for a summer biostatistics institute focused on undergraduate recruitment to the data sciences. Future plans are to continue to grow the academic reputation of its faculty and graduate programs, and at the same time continue to grow the diversity of the graduate student body.
F aculty in the Division of Epidemiology conduct research on a wide range of health issues across the life course, from birth outcomes to exceptional longevity. The faculty also support training in epidemiologic methods in the school’s education programs. During the global COVID-19 pandemic, Richard Garfein, Ph.D., M.P.H., John Bellettiere, Ph.D., M.P.H., and Nancy Binkin, M.D., M.P.H., served in advisory and managerial positions supporting the UC San Diego Return To Learn public health and outbreak investigation teams. Garfein also participated in a binational effort to estimate the prevalence of SARS-CoV-2 infection in Baja California. A major focus of the division is healthy aging and human longevity science. Aladdin Shadyab, Ph.D., M.P.H., was awarded a $3.2 million R01 grant from the National Institute on Aging (NIA) for “Epigenetic Aging Biomarkers of Mild Cognitive Impairment, Alzheimer’s Disease and Related Dementias (ADRD), and Brain Aging.” Andrea LaCroix, Ph.D., M.P.H., was awarded a NIA U19 grant as multiple PI expected to total $55.6 million to continue and expand the Adult Changes in Thought study, a long-term prospective study designed to advance the understanding of Alzheimer’s.
In addition, new findings from the Rancho Bernardo Study were published by Gail Laughlin, Ph.D., and Linda McEvoy, Ph.D., showing that older adults with impairments in both hearing and vision showed the greatest declines in cognitive function over time; and Donna Kritz-Silverstein, Ph.D., presented new findings at the American Geriatrics Society showing that egg consumption was not associated with any adverse changes in cognitive function over time. Several new large grants were submitted investigating genetic and behavior risk factors for ADRD.
Division faculty have also assumed influential national and international leadership positions including Garfein’s co-chairmanship of San Diego County’s TB Elimination Initiative and his service as member of the World Health Organization’s Digital Health Roster of Experts. While LaCroix was appointed to serve on the NIA Board of Scientific Counselors and is now serving as committee chair. In addition, a fruit-bearing tree will be planted in Mentorship Grove commemorating LaCroix’s 2021 receipt of the Health Sciences Faculty Excellence in Mentoring Award.
T his year has made it clearer than ever how interconnected the world is. The Division of Global Health is dedicated to addressing public health challenges, wherever they may arise. Faculty made great strides in global environmental health, with research led by Jose Ricardo Suarez, M.D., Ph.D., M.P.H, Harvey Checkoway, Ph.D., M.P.H, Georgia Kayser, Ph.D., studying pesticide exposures and neurobehavioral function among Ecuadoran children; Checkoway’s study in manganese-related motor and cognitive impairment among professional welders; and advocacy for climate change awareness by Wael Al-Delaimy, M.D., Ph.D. Gender-based violence and HIV is another focus of the division, including a study on child marriage and adolescent fertility in Niger by Holly B. Shakya, Ph.D., research on the struggles of indigenous men who have sex with men in Guatemala by Kimberly Brouwer, Ph.D., and an investigation into structural drivers of HIV and gender-based violence in sub-Saharan Africa by Rebecca Fielding-Miller, Ph.D., M.S.P.H.
Global Health faculty, including Michael Pratt, M.D., M.P.H., also spearheaded publication of the largest policy inventory on physical activity to date in 2020, with 76 countries represented. Lockdowns and travel restrictions this past year paused most field data collection, so faculty applied their skills more locally to community-based, infectious disease research by exploring the social impacts of COVID-19 and studying and advising safe ways to reopen schools and keep communities safe. The coming year brings with it the hope that field activities will resume and that the Division of Global Health will continue to make a positive impact on public health equity, locally and globally.
F aculty in the Division of Health Policy are focused on the development, implementation and evaluation of health policies and programs that impact public health. Richard Kronick, Ph.D., worked on implementation of the Affordable Care Act and served as director of the Agency for Healthcare Research and Quality. Sara McMenamin, Ph.D., M.P.H, serves as a vice chair for the California Health Benefits Review Program, providing analysis of health insurance legislation to the California State Legislature. Cinnamon Bloss, Ph.D., conducts research on the impacts and implications of new biomedical and public health innovations and their policy implications; she serves as the chair of the National Institutes of Health Novel and Exceptional Technology and Research Advisory Committee. Cynthia Schairer, Ph.D., is a qualitative methodologist with a long-standing interest in topics related to medicine, ethics and disability.
The division has a significant focus on tobacco use. Dennis Trinidad, Ph.D., M.P.H., studies race and ethnic disparities in tobacco control. Eric Leas, Ph.D., M.P.H., considers the social and health implications of legal substance use including cannabis and tobacco use. The division also has a strong emphasis on community-based research. Todd Gilmer, Ph.D., focuses on the evaluation of community-based programs to improve health equity. Borsika Rabin, Ph.D., Pharm.D, M.P.H., applies dissemination and implementation science models and methods to address public health challenges across diverse populations. Kanya Long, Ph.D., focuses on climate change and health. Ana Navarro, Ph.D., underlines a long-term commitment to the development, nurturing, and growth of community-centered partnerships and health equity initiatives.
Epigenetic Aging Biomarkers
A higher epigenetic age relative to chronological age, described as epigenetic age acceleration (EAA), indicates that an individual is biologically older than their years. EAA is associated with lower cognitive function (e.g., episodic memory, phonemic fluency) and lower white matter and total brain volumes, supporting a role of EAA in cognitive and brain health. Yet, while age is the strongest risk factor for Alzheimer’s disease and related dementias (ADRD), the association of EAA with mild cognitive impairment (MCI), ADRD, and brain aging is vastly understudied.
Aladdin Shadyab, Ph.D., M.P.H., received a National Institute on Aging (NIA) RO1 grant to identify blood-based epigenetic aging biomarkers predicting risk of MCI, ADRD and brain aging. These biomarkers can be used to identify older adults early in the ADRD disease course to potentially prevent irreversible cognitive and functional decline. The proposed research will support NIA’s public health mission by addressing the NIA 2020-2025 Strategic Directions for Research goals of understanding how “molecular bases of changes associated with aging contribute to the development and course of age-related dementia” and identifying “biological and clinical markers for early detection of cognitive decline, MCI, and AD.”
ESPINA: Secondary Pesticide Exposures among Children and Adolescents
In Moncayo County, Ecuador, is one of the greatest concentrations of rose plantations in the Americas. Among this beauty lies an unseen danger. Pesticides used in floriculture can seep into groundwater. In 2008, Jose Ricardo Suarez, M.D., Ph.D., M.P.H., responded to this potential threat by developing ESPINA – or ‘thorn’ in Spanish – a prospective cohort study funded by the National Institute of Environmental Health Sciences to increase understanding of the effect of pesticide exposure on development of children in agricultural settings.
For the study, 623 boys and girls have been examined and followed over time. With a bio-repository of 16,000 samples, this is the largest study of children to assess short-term effects of pesticide exposures. It is also among the largest investigation assessing the long-term effects of pesticide exposures on child development.
Since coming to UC San Diego in 2013, Suarez has welcomed involvement of students and other global health faculty in this study, including Harvey Checkoway, Ph.D., M.P.H., who specializes in cognitive and motor effects of chemical exposures, and Georgia Kayser, Ph.D., who received a K01 career award from the National Institute of Environmental Health Sciences to explore geospatial determinants of neurobehavioral performance and outcomes in the ESPINA cohort.
Developing Trauma Resilient Communities through Community Capacity Building
T rauma is a significant public health issue, negatively impacting a range of health outcomes that disproportionately impact vulnerable populations. Mental health providers and administrators recognize the widespread experience of trauma in their communities, as well as their limited ability to address community-wide trauma within community mental health centers. In response, the Los Angeles County Department of Mental Health funded nine regionally based community partnerships to build capacity to address trauma within their communities. Community capacity building identifies and strengthens existing assets within a community, establishing new collaborations to address emerging issues, and leveraging existing resources in a sustainable manner.
The Division of Health Policy is conducting a longitudinal, mixed methods evaluation of this capacity building initiative. Quantitative data is being used to quantify the capacity building efforts by partnerships and examine their impact on the community. Qualitative data from interviews and focus groups with partnership and community members will examine the implementation of trauma-informed capacity building, its impact on the community, and the sustainability of the initiative. Our initial findings show that community-based partnerships demonstrated effective capacity building strategies. Despite the pandemic, community members did not report reduced stress tolerance, instead demonstrating gains in external help-seeking (use of emotional and instrumental supports) and perception of community connectedness.