Dean’s Initiative Sets Sights on Obesity Prevention
As BMIs near and far continue their upward trajectory, there has never been greater urgency for public health answers to what is now a global pandemic.
That point was driven home this past spring as Dean Linda P. Fried hosted the kick-off meeting of the School’s new working group on obesity. On the agenda: map out the obstacles and the opportunities for more effective prevention.
Right away, the group’s discussion underscored the complexity of the problem and just how many questions remain unanswered. Why has obesity started to decline in some areas and not others? And in some locations, like Mississippi, why are rates down but disparities up? How do we address hunger and obesity at the same time? And what lessons do public health successes with smoking, occupational exposures and HIV/AIDS, for example, have for this new battle?
Interdisciplinary Action
In the summer of 2012, Y. Claire Wang, MD, ScD, assistant professor of Health Policy and Management, and Andrew Rundle, DrPH, associate professor of Epidemiology, met with the Dean Fried to present the idea of a coordinated, School-wide push on obesity.
The Dean agreed that how to prevent the world’s obesity pandemic was a key area of need to public health science. And she saw this area as a central focus of the School’s ongoing chronic disease prevention effort—and one where faculty at the Mailman School were especially well situated to offer leadership.
“It is our responsibility to use innovative scientific thinking to chart a way forward to prevent this huge driver of chronic diseases, morbidity, and disability,” Dean Fried told the group.
While any number of public health schools is grappling with obesity, the Mailman initiative is unique in putting a special emphasis on prevention and engaging with faculty from all corners of the School. This multidisciplinary and programmatic approach presents new opportunities for junior and mid-level faculty to work with each other across traditional scholarly silos.
“Asking the really big questions is what we all need to do. But doing this can be intimidating to individual researchers working on their own,” said Dean Fried. “This interdisciplinary team gives you the chance to learn the body of evidence on obesity together—and find the opportunities for prevention that may lie at the intersection between fields.”
Along with Drs. Rundle and Wang, who lead the effort, the group is made up of Jeffrey Goldsmith, PhD, assistant professor in Biostatistics; Rachel Shelton, ScD, assistant professor in Sociomedical Sciences; and Shakira Suglia, ScD, assistant professor in Epidemiology. A faculty representative from Environmental Health Sciences is expected to join the group in coming weeks. Amber Hsiao, MPH, serves as the initiative’s coordinator.
All are engaged in obesity issues ranging from the effectiveness of policies and interventions to the role of social networks and the built environment on physical activity.
Filling in the Gaps
The coming year will be busy as the group’s members dedicate at least one day a week to obesity issues. Several times monthly, they will gather to share ideas and lay the groundwork for research collaborations.
“One of the most important items on our to-do list is making the case for the primacy of prevention in obesity, acknowledging that the data on treatment is more solid and readily available than the data on prevention,” said Dr. Rundle. Added Dr. Wang, “A related question is what is the best metric to demonstrate the value of prevention.”
By poring through scholarly literature, the group will identify gaps in what’s known about the epidemic. The landmark Foresight Report, for instance, created a spaghetti-like chart showing the interplay of dozens of factors behind obesity—physical activity, social psychology, food production, etc.—but it does not address the relative importance of these factors, or which are the critical levers.
At the end of a year, the goal is to produce several jointly-authored position papers and a vision for more effective directions, and possibly host a seminar series.
Senior faculty advisors will periodically join meetings to bring perspective and offer guidance. They include Dean Fried, Jeremiah Barondess, MD, professor of Epidemiology; Sally Findley, PhD, professor of Population and Family Health and Sociomedical Sciences; Tiffany Gary-Webb, PhD, professor of Epidemiology; Bruce Link, PhD, professor of Epidemiology; Peter Muennig, MD, associate professor in Health Policy and Management; Michael Rosenbaum, MD, professor of Medicine and Pediatrics; and Renée Wilson-Simmons, DrPH, professor of Health Policy and Management and director of the National Center for Children in Poverty.
“Oftentimes our research is very proscribed: Is X related to Y outcome? This obesity initiative is our opportunity to ask the larger questions,” Dr. Wang said. “Be wild. Even if it’s not fundable or publishable—yet."