Stanford University

Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

CESP senior fellows receive funding from the Presidential Fund to support the launch of the new program on Food Security and the Environment

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"Feeding the World in the 21st Century: Exploring the Connections Between Food Production, Health, Enviromental Resources and International Security," was one of eight projects to be be awarded.

Eight research projects led by multidisciplinary-faculty teams have jointly received $1.05 million in the first round of awards made by Stanford's new $3 million Presidential Fund for Innovation in International Studies.

Coit D. Blacker, director of the Freeman Spogli Institute for International Studies, said the fund is the first program launched by the university's International Initiative, which seeks to encourage collaborative, cross-disciplinary approaches to address the global challenges of pursuing peace and security, improving governance and advancing human well-being.

The multi-year projects, selected by the International Initiative's executive committee from 37 proposals, will bring together faculty from fields that traditionally do not collaborate to produce new courses, symposia, conferences and research papers. Blacker, who chairs the executive committee, said additional awards totaling about $2 million will be made in 2007 and 2008.

President John Hennessy said he supports the research projects. "The world does not come to us as neat disciplinary problems, but as complex interdisciplinary challenges," he said. "The collaborative proposals we have selected for this first round of funding offer great potential to help shed light on some of the most persistent and pressing political issues on the global agenda today."

Projects in the first round of funding include:

Governance under Authoritarian Rule. Stephen Haber and Beatriz Magaloni, political science; Ian Morris, classics, history; and Jennifer Trimble, classics. The researchers will examine the political economy of authoritarian systems and determine why some authoritarian governments are able to make the transition to democracy, stable growth and functioning institutions, while others prove predatory and unstable.

Addressing Institutional and Interest Conflicts: Project Governance Structures for Global Infrastructure Development. Raymond Levitt, civil and environmental engineering; Doug McAdam and W. Richard Scott, sociology. The project will analyze the challenges of creating efficient and effective public/private institutions for the provision of low-cost, distributed and durable infrastructure services in emerging economies.

Combating HIV/AIDS in Southern Africa: The Treatment Revolution and Its Impact on Health, Well-Being and Governance. David Katzenstein, infectious diseases; and Jeremy Weinstein, political science. Based on the 2005 Group of 8's commitment to put 10 million people infected with HIV/AIDS on treatment within five years, this project will research the impact of this treatment revolution on health, well-being and governance in sub-Saharan Africa.

Evaluating Institutional Responses to Market Liberalization: Why Latin America Was Left Behind. Judith Goldstein, political science; Avner Greif, economics; Steven Haber, political science; Herb Klein, history; H. Grant Miller, Freeman Spogli Institute (FSI)/medicine; and Barry Weingast, political science. The project will research the interaction between inequality and Latin American institutions in explaining the poor economic performance of countries in the region during the past two decades, examining why reforms such as trade liberalization have failed to yield expected results.

Feeding the World in the 21st Century: Exploring the Connections Between Food Production, Health, Environmental Resources and International Security. Rosamond L. Naylor, FSI/economics; Stephen J. Stedman, FSI/political science; Peter Vitousek, biological sciences; and Gary Schoolnik, medicine, microbiology and immunology. The group will launch a new research and teaching program, titled "Food Security and the Environment," with an initial priority on determining linkages between food security, health and international security, and globalization, agricultural trade and the environment.

The Political Economy of Cultural Diversity. James D. Fearon, political science; and Romain Wacziarg, Graduate School of Business. The researchers will assess the impact of ethnic, linguistic and religious diversity on economic growth, trade and capital flows, governance, development of democracy and political stability.

In addition, two grants to plan forthcoming research projects have received $25,000:

Global Health by Design. Geoffrey Gurtner, plastic and reconstructive surgery; David Kelley, mechanical engineering; Thomas Krummel, surgery; Julie Parsonnet, medicine, health research and policy; and Paul Yock, medicine, bioengineering. The group will design a project to examine how new technology can be used to develop effective, affordable and sustainable methods and devices to prevent disease in the world's poorest countries.

Ecological Sanitation in Rural Haiti: An Interdisciplinary Approach to Sanitation and Soil Fertility. Ralph Greco, surgery; and Rodolfo Dirzo, biological sciences. The researchers will develop a plan to test the efficacy of ecological sanitation in decreasing disease and enhancing soil fertility in rural Haiti.

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Cancer Risk Following Exposure to Low Level Radiation

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For the past five years, the Committee on the Biological Effects of Ionizing Radiation (BEIR VII) of the National Academy of Science has reviewed and analyzed the health risks from exposure to low levels of radiation (X-rays and gamma rays.) This re-assessment followed a period of rich accumulation of biologic and epidemiologic data from 1990 on, the year of the last previous study (BEIR V.)

The scientific evidence showed that even low doses of radiation may pose a risk of cancer, and that there was no threshold below which exposure may be viewed as harmless. Lifetime excess risks were determined for 12 relatively common cancers. While the over-all risk of cancer at low radiation levels is small, the mortality in women is higher than in men, and infants are at greater risk than adults. The presentation will review the conclusions of the 700-page report.

Herbert L. Abrams, M.D., Professor Emeritus of Radiology at Stanford, was formerly Philip H. Cook Professor and Chairman of Radiology at Harvard, and has been a CISAC Member-in-Residence since 1985. He served as one of the two physicians on the BEIR VII committee, the other members, representing radiation biology, cancer biology, physics, epidemiology and genetics. The 1st edition of his three volume work, Abrams Angiography: Vascular and Interventional Radiology, was published in 1961, the fifth edition in 2005. He is the author or co-author of six other books on Congenital Heart Disease, Coronary Arteriography, Diagnostic Decision Making, Diagnostic Technology Assessment, and Presidential Disability and of over 200 refereed papers on cardiovascular disease, health policy, disabled leadership, human instability in the nuclear forces, and inadvertent nuclear war. A member of the Institute of Medicine of the National Academy of Sciences, he was also the founding Vice-President of International Physicians for the Prevention of Nuclear War (IPPNW), recipient of the 1985 Nobel Peace Prize.

Reuben W. Hills Conference Room

Herbert L. Abrams Professor of Radiology, Emeritus Speaker CISAC
Seminars

New Presidential Fund for Innovation in International Studies awards eight grants totaling $1.05 million

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Stanford, CA - The Office of the President and the Stanford International Initiative announced today that eight new interdisciplinary research grants totaling $1.05 million have been awarded to Stanford faculty. The grants are the first to be awarded from Stanford's new $3 million Presidential Fund for Innovation in International Studies (PFIIS), created to support interdisciplinary research and teaching on three overarching global challenges: pursuing peace and security, improving governance, and advancing human well-being.

"The world does not come to us as neat disciplinary problems, but as complex interdisciplinary challenges," said Stanford President John Hennessy. "The collaborative proposals we have selected for this first round of funding offer great potential to help shed light on some of the most persistent and pressing political issues on the global agenda today - issues acutely important to our common future," he stated.

The research projects qualifying for first round funding of $1.025 million are:

  • Governance under Authoritarian Rule. Stephen Haber and Beatriz Magaloni, Political Science. Ian Morris, Classics, History and Jennifer Trimble, Classics. Will examine the political economy of authoritarian systems and determine why some authoritarian governments are able to transition to democracy, stable growth and functioning institutions, while others prove predatory and unstable.
  • Addressing Institutional and Interest Conflicts: Project Governance Structures for Global Infrastructure Development. Raymond Levitt, Civil & Environmental Engineering, Doug McAdam and W. Richard Scott, Sociology. Will analyze the challenges of creating efficient and effective structures for the provision of low cost, distributed and durable infrastructure services in emerging economies.
  • Combating HIV/AIDS in Southern Africa: The Treatment Revolution and its Impact on Health, Well-Being and Governance. David Katzenstein, Infectious Diseases, and Jeremy Weinstein, Political Science. Based on the 2005 Group of 8 commitment to put 10 million people infected with HIV/AIDS on treatment within five years, will research the impact of this treatment revolution on health, well-being and governance in Sub-Saharan Africa.
  • Evaluating Institutional Responses to Market Liberalization: Why Latin America Was Left Behind. Judith Goldstein, Political Science, Avner Greif, Economics, Stephen Haber, Political Science, Herb Klein, History, H.Grant Miller, FSI/Medicine, and Barry Weingast, Political Science. Will research the interaction between inequality and Latin American institutions in explaining the poor economic performance of Latin American countries in the past two decades, examining why reforms such as trade liberalization have failed to yield expected results.
  • Feeding the World in the 21st Century: Exploring the Connections Between Food Production, Health, Environmental Resources, and International Security. Rosamond Naylor, FSI/Economics, Stephen Stedman, FSI/Political Science, Peter Vitousek, Biological Sciences, and Gary Schoolnik, Medicine, Microbiology & Immunology. Launches new research and teaching program on "Food Security and the Environment," with an initial priority on determining linkages between Food Security, Health and International Security, and Globalization, Agricultural Trade and the Environment.
  • The Political Economy of Cultural Diversity. James D. Fearon, Political Science, and Romain Wacziarg, Graduate School of Business. Will assess the impact of ethnic, linguistic and religious diversity on economic growth, trade and capital flows, governance, development of democracy and political stability.

Two planning grants were also awarded:

  • Global Health by Design. Geoffrey Gurtner, Plastic & Reconstructive Surgery, David Kelley, Mechanical Engineering, Thomas Krummel, Surgery, Julie Parsonnet, Medicine, Health Research & Policy, and Paul Yock, Medicine, Bioengineering. Will design a project to examine how new technology can be used to develop effective, affordable and sustainable methods and devices to prevent disease in the world's poorest countries.
  • Ecological Sanitation in Rural Haiti: An Interdisciplinary Approach to Sanitation & Soil Fertility. Ralph Greco, Surgery, and Rodolfo Dirzo, Biological Sciences. Will develop a plan to test the efficacy of ecological sanitation in decreasing disease and enhancing soil fertility in rural Haiti.

"Addressing some of the most significant problems of our day, in the fields of security, governance and human well-being, will require imaginative thinking, bold approaches, and interdisciplinary collaboration," stated Coit D. Blacker, Director of the Freeman Spogli Institute and Chair of the International Initiative's Executive Committee. "The Executive Committee was encouraged to receive more than 35 proposals of an impressive caliber, and after careful review, to award these first grants," Blacker said.

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Age Differences in the Processing of Health Care Information

This study seeks to extend evidence for preservation of emotional processes relative to a decline in cognitive processes among older adults to the healthcare domain, in order to improve the presentation of healthcare information for older adults. Younger and older samples will be given descriptions of health care plans with increasing information across trials. In the cognitive condition, participants will be asked to recall facts, and in the emotional condition, participants will be asked about their feelings pertaining to a specific statement.

Health Insurance among the Elderly in Colombia

Relative to other age groups, the elderly are disproportionately likely to become seriously ill and to face burdensome medical expenditures.  Many middle-income countries like Colombia have begun experimenting with targeted public-sector health insurance.  By exploiting discontinuities in eligibility formulas for health insurance subsidies, this project evaluated the consequences of a large targeted health insurance program for the well-being of the elderly in Colombia.  The investigator presented his findings at a Research in Progress seminar in April 2008, and at the Univer

Effects of Obesity on Employer-sponsored Health Insurance

Drs. Bundorf and Bhattacharya received an RO1 grant (RO1-AG028236) from the National Institute on Health (NIH) to extend their work to look at the external costs of obesity through large public health insurance programs, including Medicare and Medicaid.  Results from the seed have been presented at four national meetings.  A paper entitled, “The Incidence of the Health Care Costs of Obesity,” was published in Journal of Health Economics.

National Trends and Practice Patterns of Detection and Treatment of Hypertension During Ambulatory Visits in the United States

Using pre-existing data sets, this study will evaluate changes from 1994-2004 in the detection, diagnosis and treatment of hypertension and will identify contributors (clinical and non-clinical) to disparities in the detection and treatment of hypertension, looking at comorbidities, age, sex, race/ethnicity, medical insurance coverage and physician specialty. Statistical analyses will be performed to quantify the extent to which treatment goals were achieved with various classes of anti-hypertensive medications.

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