Faculty Spotlight: Ziming Xuan.

Collaborative work is key to developing sustainable public health solutions and improving population health outcomes. This weekly series spotlights one SPH faculty member who advances public health through collaborations within the field and across sectors.

As a social epidemiologist, can you provide a brief overview of your extensive research in gun violence prevention and alcohol use?

As a trained social epidemiologist and a faculty member of the Injury Prevention Center at Boston Medical Center, I am interested in assessing the long-term impacts of socio-contextual determinants, particularly health policies, on substance use and related injuries among vulnerable populations such as youth. Given the substantial public health burdens of gun violence and alcohol misuse in our society, I have always been intrigued about discovering the effects of intervention strategies including various policies that may reduce these harms. I am also interested in developing and applying more rigorous methodologies to get better answers to these complex questions.

My research on gun violence focuses on the impact of firearm policies, which vary substantially across US states and have changed considerably in the past several decades. My early work demonstrated that youth living in states with an overall restrictive firearm policy environment are much less likely to carry guns, and that is in part due to reduced adult gun ownership in these states. While understanding the overall policy environment is helpful, it does not tell us which specific policy is more effective or less effective, therefore limiting our dissemination efforts to become more targeted towards key policies. So, to bridge this gap, I was very fortunate to collaborate with Professor Michael Siegel and other firearm researchers, and developed a comprehensive and longitudinal panel data of state firearm policies over the last several decades. With the establishment of this database, we have examined the relative impacts of specific firearm policies (i.e., universal background check) in reducing gun violence, overall and by subpopulations such as age groups, and also by types of violence. It has been a very fulfilling experience for me to be able to advance the field and shed new light on gun violence research.

Interestingly, my research on alcohol evolved in a similar vein. Over the last 10 years, we have created and validated Alcohol Policy Scale, a robust measure that characterizes the stringency of alcohol policy control environment based on the presence or absence of 29 state-level alcohol policies (i.e., alcohol taxation, retail sales restrictions, state monopoly, outlet density regulations) for each US state-year since 1999 after weighting each policy based on its relative efficacy and degree of implementation in states.  Funded by the National Institutes of Health, our studies found that a more restrictive alcohol policy environment (i.e., higher APS scores) was strongly inversely related to the odds of subsequent adult binge drinking, youth drinking and binge drinking, adult and youth drinking and driving, and lower levels of alcoholic cirrhosis mortality, alcohol-related suicide and homicide, and alcohol involvement in fatal vehicle crashes.

With the advancement of measuring alcohol policy environment, we further assessed relative impacts of key individual alcohol policies (i.e., alcohol taxation) in reducing excessive consumption. For example, I have led several studies to develop tax measures that combined both volume-based taxes and value-based taxes as levied by US states. Compared with volume-based tax measures, combined tax measures (e.g., those incorporating volume-based tax and value-based taxes) yield substantial improvement in model goodness-of-fit and find more negative price elasticity in predicting binge drinking in US states.  Over the years, we have enhanced our research methodologies, and gained insights on how these alcohol policies can shape the distribution of these harmful outcomes. These experiences can be valuable for countries (i.e., India and China) that also experience rising problems of excessive alcohol consumption and related alcohol harms.

How is collaborative research integral to your work, and can you discuss one or two collaborations that have been most meaningful to you? 

Collaborations and partnerships are essential in what I do. The problems we are tackling, such as gun violence and alcohol misuse, are immensely complex, therefore they really require interdisciplinary expertise.

Also, collaborations help get better work done, promote team science, strengthen research ideas, add diversity, innovations and eventually productivity. I believe in “together we go far.” There are so many collaborations that I really enjoy, current or in the past, gun violence, alcohol or other substance, US-based or in other countries such as Brazil, India, Japan, China and so on.

Probably one of the most meaningful collaborations is my work on gun violence research with experts in the fields, including Professors Michael Siegel and David Hemenway. This collaboration is particularly meaningful because there are extremely limited resources for gun violence research, in contrast to the tremendous amount of harms that gun violence has burdened our communities and numerous individuals. We are collaborating because we believe that our work will provide meaningful evidence in saving lives from gun violence, improve population health, and eventually make a difference. It is a path less traveled by many, but it has been a meaningful journey for me. In order to promote better and sustained research on gun violence that is commensurate with societal impacts similar to other major health conditions, there should be, in my opinion, a 28^th NIH institute that is committed to advancing the science of firearm research, and reducing gun violence.

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“Professor Xuan contributes substantially and favorably to teaching our students, leading our Health Communications certificate, and always shows up to be a part of the academic life of our department. He is making a significant impact on the health of the public by reducing the harms of alcohol, drugs, firearms, suicide and risky behaviors in general and particularly among youth, and discovering the policy determinants of health in vulnerable populations.”

Richard Saitz, chair and professor in the Department of Community Health Sciences