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Epidemiology: Now Is the Time

Studying the patterns and spread of disease has never been more important than during the time of the COVID-19 pandemic. Public health professionals across the globe have been essential in tracking the spread, projecting increases in cases, and communicating to the public about how to protect themselves from the novel coronavirus.

Even before COVID-19, the field of epidemiology—the study of patterns and causes of health-related events in populations—has been growing in scope and importance in recent decades. With increasing concerns about emerging infectious diseases, environmental hazards, and global health disparities, epidemiologists are playing key roles in developing policies and interventions to protect and improve the health of populations.

The Boston University School of Public Health Department of Epidemiology unites around two parallel passions: the desire to serve the greater good of healthy populations, and dedication to the teaching of epidemiology.

Even though the department is relatively small—consisting of 19 full and part-time faculty members, 3 and half administrative staff, and 12 research staff—Martha Werler, professor and chair of epidemiology, says the collaboration and mutual trust between faculty and staff makes the department feel like a big family.

“Faculty in epidemiology have expertise in a wide variety of research areas, including reproductive, perinatal, environmental, and mental health, and in infectious and chronic diseases,” she says.

“But for most of us, our first identities are as epidemiologists. We share a passion for epidemiologic concepts, theory, methods, and applications; we love employing epidemiology tools to any of a range of research topics, even when outside our specific areas of research, as a way to stretch our learning and teaching.”

One of the largest research projects within the department involves internet-based recruitment, enrollment, and data collection of couples seeking pregnancy. Professors Lauren Wise, Elizabeth Hatch, Ken Rothman, and Amelia Wesselink are conducing parallel studies in Denmark (Snart Foraeldre) and North America (PRESTO) that have collected data from over 20,000 couples from pre-conception through pregnancy and into early years of parenting, with questionnaires, semen and blood samples, and linkages to birth certificates and medical records. Recent studies answer questions like how do seasons play a role in conception and when does fertility return after using most forms of contraception.

Werler believes that projects like these will help the department accomplish new things in the future.

“We are leveraging our areas of expertise and data resources to broaden our research portfolios in two ways: to encompass both individual-level and macro-level exposures and to consider these multi-level factors across the full life course,” she says. “For example, studies with primary data collection on behaviors, exposures, and experiences are linking to data sources on macro level factors, such as pollution, healthcare services, and affordable housing over time.”

Other research projects in the department include using machine learning to identify predictors of suicide, how air pollution and racial inequities affect cognitive decline, HPV vaccine uptake among HIV-exposed adolescents, gun violence, and emerging public health threats such as COVID-19 and vaping.

Originally established in 1981 as the Epidemiology and Biostatistics Department, the two areas separated in 1999. The doctoral program was the first offered at BUSPH, initially conferring a doctorate of science (DSc), and then changing to doctorate of philosophy (PhD) in 2009. As of 2020, 119 students have received a doctoral degree in Epidemiology from BUSPH.

“These alumni have gone on to practice epidemiology in academia, government agencies, and the private sector, including 56 professors (including 4 chairs or deans), 16 leaders in government agencies (including World Health Organization, Centers for Disease Control and Prevention, U.S. Food & Drug Administration, Department of Defense, Massachusetts Department of Public Health), 12 leaders at health institutes, and 23 senior program directors in the pharmaceutical industry. Seven of our most recent graduates hold post-doctoral fellowships. Five of our alumni have written textbooks in epidemiology,” Werler says.

Epidemiology has always been one of the most popular tracks at BUSPH, and Werler says the department is proud of the more than 2,600 public health professionals across the US and the globe that received a doctorate, MS in Epidemiology, or MPH degree, with a certificate in Epidemiology and Biostatistics or Chronic and Non-Communicative Diseases.

As the department looks to the future, Werler says they are acutely aware of the pervasive health disparities along racial and ethnic lines, currently thrown into sharp relief with the COVID-19 pandemic. She says they plan on spending critical time evaluating how epidemiologists can highlight and address the ways racism harms health. At the end of this month, the School is hosting a Public Health Conversation on this very topic, “Epidemiology and Race: Why and How We Study Racial Health Disparities”.

“We in the Epidemiology Department are committed to examining how we as epidemiologists address race and ethnicity in our studies. We seek to better understand and articulate our conceptualizations of race, racialization, ethnicity, and racism through all steps of epidemiology research – from developing research questions, measurement, analysis, and interpretation all the way to implementation,” Werler says. “By looking at our epidemiology studies with a new lens on fundamental race, racialization, ethnicity, and racism, we hope to move the needle to health equity.”