By Camille Mojica-Rey
Population studies estimate that more people die because of the way they live than from diseases preprogrammed in their genes.
So, while some scientists continue to look to improve the treatment of heart disease, for example, by understanding the molecular mechanisms behind it, others are charting new territory in community health. UCSF's Center for Health and Community
(CHC) is among the programs leading the way in this interdisciplinary approach to improving health care and preventing disease.
"For eight years, we have been fostering education, research and service aimed at understanding how health impacts the community and how society impacts an individual's health," says Nancy Adler, CHC's director, a professor of medical psychology and vice chair of the Department of Psychiatry.
A community approach to health care requires experts from diverse fields to communicate and work closely with one another, Adler points out. "The idea is to work across disciplines, so that people can address the broader range of issues that affect the conditions of people's lives and, ultimately, their health," she says.
The CHC is located on the Laurel Heights campus, providing a centralized organization and physical location to meet and coordinate collaborations. Over the years, it has focused on community health education, research and service, Adler notes. In 2003, CHC partnered with UC Berkeley's School of Public Health as a participating site in the Robert Wood Johnson Health & Society Scholars Program (RWJHSS).
The program site, based at CHC, is one of six nationwide chosen by RWJHSS to train and recruit experts from fields as diverse as economics, medicine and anthropology to work together on population health issues. The UCSF-UC Berkeley program just received its second five-year, $5 million grant from RWJHSS.
Scholars spend half of their two-year fellowship at UCSF and the remainder of their time at UC Berkeley. The core of the program is a seminar on health and society in which both the scholars and the entire CHC faculty participate. "These are lively sessions," Adler says. "We are really debating what population health means."
Past participants of the two-year program have included a former health adviser to Senator Joseph Lieberman who held MD and PhD degrees in molecular immunology, as well as an assistant professor from Northwestern University's business school who is now pioneering the field of neuroeconomics, the study of the brain's response while making financial decisions. "We look for people who have already broken boundaries," Adler says.
In addition to training, the RWJHSS grant has allowed CHC to foster several research initiatives through pilot study grants. Several of those grants have gone to faculty of the Center for Obesity Assessment, Study and Treatment (COAST). The center was created two years ago to bring together basic and behavioral researchers to address this increasingly pervasive problem.
"While there is plenty of research on rare disorders at UCSF, there is only a tiny fraction of research devoted to obesity, one of the most common disorders," says Elissa Epel, COAST's director of research and an assistant professor of psychiatry.
CHC sponsors COAST's monthly grand rounds, which are seminars devoted to topics in obesity research. These seminars keep the research community tightly knit, Epel explains. "We hope that COAST will continue on to develop into a cohesive research community that is dedicated to both prevention and treatment of obesity," she adds.
One of the COAST studies that began as an RWJHSS-funded pilot project included faculty from psychiatry, neuroscience and physiology. It examined whether stress-induced cravings for high-fat, sweet foods is mediated by opioids - chemical messengers that activate the pleasure centers of the brain.
In a second pilot study, Jeanne Tschann, adjunct professor of psychiatry, looked at family environment and obesity among Latino children. Focus groups with Latino mothers and fathers, respectively, looked at the role of food in family dynamics.
CHC researchers also are looking at a host of issues related to health disparities, including a project to develop new ways to measure experiences of racism and social disadvantage led by RWJ Health & Society Scholar Amani Nuru-Jeter and Paula Braveman, professor of family and community medicine.
According to Adler, the CHC research initiatives aim to result in changes in policy, treatment and community conditions.
"We are working with members of the community to improve a variety of factors that impact health," she said. "That's what it's all about."
To find scheduled COAST grand rounds, visit here
Center for Health and Community (CHC)
Center for Obesity Assessment, Study & Treatment (COAST)