In public health, our focus is upstream prevention — we work to stop illnesses before they start. Nowhere is this more important than with chronic diseases. Our school investigates every possible risk factor to keep chronic illnesses from taking hold in people and populations.

Our long-running ARIC (Atherosclerosis Risk in Communities) and CARDIA (Coronary Artery Risk Development in Young Adults) studies provide data to make cardiovascular disease less of a threat for future generations and continue the work of one of the founding research specialties of our school, heart disease.

We explore risk factors before birth — like the association between a pregnant woman’s frequent consumption of artificially sweetened beverages and her infant being overweight at one year — and those later in life — analyses of two longitudinal studies show that severe obstructive sleep apnea is associated with greater risk of type 2 diabetes.

A recent SPH study showed that “epigenetic age” predicts mortality from all causes, including deaths from chronic diseases, better than chronological age and traditional risk factors.

We are breaking new ground by exploring what messages resonate with the public in order to forge more effective and acceptable chronic disease prevention policies.

For example, two recent studies involving chronic disease risk factors found that 1) believing that parents are responsible for reducing childhood obesity does not universally undermine support for broader policy action, and 2) if certain foods are found to be addictive, framing them as such may increase obesity-related policy support.

Our research never loses sight of the disproportionate impact chronic diseases have on people with low-incomes. Finding interventions accessible to and affordable for all people could prevent or delay 40 million cases of chronic illness per year.

We are exploring established and novel ways to create a future where all people can be healthy, such as the availability of nutritious food, strategies to increase activity, and the effectiveness of the cheapest and most widely available drug in the world — aspirin.

(* asterisk marks SPH student, post-doc, or researcher at time of study)

• Effect of a Whole-Person Model of Care on Patient Experience in Patients With Complex Chronic Illness in Late Life. (American Journal of Hospice and Palliative Medicine). Nathan D. Shippee, Tetyana P. Shippee, Patrick D. Mobley, Karl M.Fernstrom, Heather R. Britt. This study examined the effects of LifeCourse, a team-based, whole-person care intervention, and found improved patient experience from the sum effect of small improvements across different domains/aspects of care, such as relationships with and work by the care team.
• Aspirin Use and the Incidence of Breast, Colon, Ovarian, and Pancreatic Cancers in Elderly Women in the Iowa Women’s Health Study. (Cancer Causes & Control) Lisa E. Vaughan*, Anna Prizment, Cindy K. Blair, William Thomas, Kristin E. Anderson. Findings from this study suggest that aspirin use may prevent incident breast, colon, pancreatic, and ovarian cancer in elderly women.
• ​Association Between Indoor Tanning and Melanoma in Younger Men and Women. (​JAMA Dermatology). DeAnn Lazovich, Rachel Isaksson Vogel*, Martin A. Weinstock, Heather H. Nelson, Rehana L. Ahmed, Marianne Berwick. This study found that indoor tanning is a likely factor for the steeper increase in melanoma rates in the United States among younger women compared with men.
• Hospitalized Infection as a Trigger for Acute Ischemic Stroke: The Atherosclerosis Risk in Communities Study. (Stroke). Logan T. Cowan*, Alvaro Alonso, James S. Pankow, Aaron R. Folsom, Wayne D. Rosamond, Rebecca F. Gottesman, Kamakshi Lakshminarayan. Study findings support the hypothesis that hospitalized infection is a trigger of ischemic stroke and may explain some cryptogenic strokes.
• Reducing nicotine exposure results in weight gain in smokers randomised to very low nicotine content cigarettes. (Tobacco Control). Laura E. Rupprecht, Joseph S. Koopmeiners, Sarah S. Dermody, Jason A. Oliver, Mustafa al’Absi, Neal L. Benowitz, Rachel Denlinger-Apte, David J. Drobes, Dorothy Hatsukami, F. Joseph McClernon, Lauren R. Pacek, Tracy T. Smith, Alan F. Sved, Jennifer Tidey, Ryan Vandrey, Eric C. Donny. Men and women in this study who were compliant in the lowest nicotine content cigarette conditions gained 1.2 kg over 6 weeks, indicating weight gain is a likely consequence of reduced exposure to nicotine.

• Timothy Church: 2013–2017, Stanford University, “Colon Cancer Family Registry Cohort,” Principal Investigator
• Lisa Peterson and Silvia Balbo, 2016–2021, NIH National Cancer Institute, “Mechanisms of Ethnic/Racial Differences in Lung Cancer Due to Cigarette Smoking,” Co-Investigators
• Rachel Widome and Deb Hennrikus: 2014-2017, Clearway Minnesota “Impact of Smoke-Free Policy Implementation on Public Housing Buildings,” Co-Principal Investigators
• Aaron Folsom: 2016–2021, NIH NHLBI, “Atherosclerosis Risk in Communities Study,” Principal Investigator; Pamela Lutsey, James Pankow, Weihong Tang, Pamela Schreiner, Lyn Steffen, Ellen Demerath, Co-Investigators
• Lynn Eberly: 2014–2019, NIH, “Identifying the Brain Substrates of Hypoglycemia Unawareness in Type 1 Diabetes,” Co-Investigator

• Risk of Intraoperative Hypotension in Cystic Fibrosis (Clinical Research)
• Venous thromboembolism: Lifetime risk and novel risk factors (Epidemiology)
• Hepatitis C: Hepatocellular carcinoma, mortality, and the impact (Health Services Research, Policy and Administration)
• Lean mass in survivors of childhood acute lymphobastic leukemia (Epidemiology)
• Relation of Coagulation Factor XI with Incident Coronary Heart Disease and Stroke (Epidemiology)