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.

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In the face of population aging, policymakers throughout the Asia-Pacific are seeking ways to improve health service provision for older individuals. The InterRAI (International Resident Assessment Instrument) is a comprehensive assessment tool for older people, and is used as a de facto assessment tool for the care needs of older people in many countries, including New Zealand (see http://www.interrai.org). Part of the full InterRAI assessment is a home care assessment, which provides the data we use in this study, including three main outcome measures: (1) CHESS (Changes in Health, End-stage Disease, Signs, and Symptoms); (2) MAPLe (Method of Assigning Priority Levels); and (3) the ADL (Activities of Daily Living) hierarchy. Specifically, we use data on over 8000 assessments in the Waikato region of New Zealand over the period 2013-2016.

In this seminar, Professor Cameron discusses the relationship between the three outcome measures and a range of clinical and operational outcomes within 90 days of the assessment, including hospital admissions; dementia admissions; number of bed days; and mortality. The CHESS outcome measure offers the greatest predictive validity of the three measures, with a one unit increase in CHESS score (interpreted as a higher risk of serious decline in health status) associated with 26 percent higher odds of hospital admission within 90 days of assessment, 18 percent more bed days, and 30 percent higher odds of mortality. Finally, Cameron discusses how these results are being used by the Waikato District Health Board to improve the services provided to older people in the region.

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Dr. Michael Cameron is an associate professor in economics at the University of Waikato (New Zealand). He is also a research fellow in the National Institute of Demographic and Economic Analysis (NIDEA). He was a PGDA Visiting Fellow at the Harvard T.H. Chan School of Public Health at Harvard University from 2015-16.

Dr. Cameron gained his PhD from University of Waikato in 2007, with a thesis titled "The Relationship between Poverty and HIV/AIDS in Rural Thailand". His current research interests include population, health and development issues (including the social impacts of liquor outlet density, the economics of communicable diseases especially HIV/AIDS, health applications of non-market valuation, and health and development project monitoring and evaluation), population modelling and stochastic modelling, financial literacy and economics education.

He also blogs regularly at Sex, Drugs and Economics (http://sex-drugs-economics.blogspot.com/).

 

Michael P. Cameron National Institute of Demographic and Economic Analysis (NIDEA), University of Waikato, New Zealand
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Using agricultural and economic characteristics in African nations as test cases, new research by David Lobell and Marshall Burke demonstrates the use of satellite data to address the long-standing problem of accurate data collection in developing countries. An often cited challenge in achieving development goals aimed at poverty and hunger reduction is the lack of reliable on-the-ground data. Limited or insuffiient data makes it difficult to establish baseline conditions and to assess effectiveness of various aid programs. In the past, researchers and policymakers had to rely on ground surveys, which are expensive, time-consuming, and rarely conducted. This has led to large data gaps in mapping sustainable development goal progress, such as in agricultural and poverty statistics.
 
This brief is based on findings from the papers “Satellite-based assessment of yield variation and its determinants in smallholder African systems,” published in Proceedings of the National Academy of Sciences in 2017 and “Combining satellite imagery and machine learning to predict poverty,” published in Science in 2016.
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For forty years, the Tuskegee Study of Untreated Syphilis in the Negro Male passively monitored hundreds of adult black males with syphilis despite the availability of effective treatment. The study's methods have become synonymous with exploitation and mistreatment by the medical community. We find that the historical disclosure of the study in 1972 is correlated with increases in medical mistrust and mortality and decreases in both outpatient and inpatient physician interactions for older black men. Our estimates imply life expectancy at age 45 for black men fell by up to 1.4 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men.

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On July 21, SCPKU was the site of a seminar entitled “Medical Big Data Application Assessment and Safeguards.”  Co-sponsored by the Chinese Health Information Association (CHIA) and the China National Health Development Research Center of the People’s Republic of China (NHDRC), this event was the group’s second seminar focused on this topic which gathered over 80 participants including leaders from CHIA, NHDRC, local members of the Health and Family Planning Commission, and academic representatives from universities, medical institutes and pharmaceutical companies. The seminar concentrated on the fusion of medical big data and health care services, decision outcomes, as well as deployment by the State Council and National Health and Family Planning Commission of the People’s Republic of China (NHFPC).

 

Following NHDRC Director Wei Fu’s opening remarks, Xuefeng Ling, SCPKU Faculty Fellow, Principal Investigator of the Translational Medical Program at Stanford University and co-founder of HBI Solutions, gave a talk on the application of medical big data in decision support. Dr. Ling introduced big data based business intelligent solutions for health management platforms that hold electronic medical records as structured data. Big data based business intelligent solutions have been shown to yield better performance than traditional unstructured solutions in numerous cases including situational awareness, population approach, and risk information.

 

University of California-Riverside Bioengineering Associate Professor Jiayu Liao followed with a presentation on Chinese medicine and its contribution to medical big data. Dr. Liao cited the latest clinically validated immunosuppressant inspired by Chinese medicine which is cheaper and more effective than its predecessors.  He also highlighted the first reported Non-peptide GLP-1R Agonist with in vivo efficacy and a new fluorescence resonance energy transfer technique, both of which are based on Chinese medicine.

 

Harvard Professor of Statistics and Director of Graduate Studies Jun Liu, West China Hospital Vice President and Professor Wei Zhang, and Taizhou Pharmaceutical High-Tech District Health Bureau Director Tao Zhang separately presented on medical big data applications in medical management and service, medical service evaluation and applications based on diagnosis related groups, and Taizhou’s demand and practices.  NHFPC Associate Director and CHIA Chairman Xiaotao Jin and Chinese Academy of Chinese Medical Sciences (CACMS) and Academicians of Chinese Academy of Engineering (CAE) Dean Boli Zhang also presented.

 

Dr. Ling and Health and Development Center Professor Long Cheng closed the seminar with a discussion focused on early investigations into a medical big data application evaluation index system and an international medical big data human resources development cooperation plan. 

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Experts discuss medical big data application assessment and safeguards at SCPKU, July 21, 2017.
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The Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in conjunction with The Next World Program, is soliciting papers for a workshop, “Inequality & Aging,” held at the University of Hohenheim from May 4-5, 2018. The workshop will result in a special issue of the Journal of the Economics of Ageing, and aims to address topics such as:

  • Population dynamics and income distribution
  • The evolution of inequality over time and with respect to age
  • Health inequality in old age
  • The effects of social security systems and pension schemes on inequality
  • Policies to cope with demographic challenges and the challenges posed by inequality
  • Family backgrounds and equality of opportunities
  • Demographically induced poverty traps
  • Effects of automation and the digital economy in ageing societies
  • Flexible working time and careers, and their long-term implications
  • The dynamics of inheritances, etc.

Researchers who seek to attend the workshop are invited to submit a full paper or at least a 1-page extended abstract directly to Klaus Prettner and Alfonso Sousa-Poza by Sept. 30, 2017.

Authors of accepted papers will be notified by the end of October and completed draft papers will be expected by Jan. 31, 2018. Economy airfare and accommodation will be provided to one author associated with each accepted paper. A selection of the presented papers will be published in the special issue; the best paper by an author below the age of 35 will receive an award and be made available online as a working paper.

Researchers who do not seek to attend the workshop are also invited to submit papers for the special issue. Those papers can be submitted directly online under “SI Inequality & Ageing” by May 31, 2018.

For complete details, please click on the link below to view the PDF.

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Stanford’s Center for Innovative Study Design, with co-sponsors including the Stanford Center at Peking University (SCPKU), the International Society for Biopharmaceutical Statistics and Tsinghua University’s Center for Hospital Management, held a Forum on Regulatory Science and Biomedical Innovations at SCPKU on March 22, 2017. The event gathered more than 60 leaders from the Chinese Food and Drug Administrations (CFDA), Chinese Association of Preventive Medical (CAPM), universities, professional organizations, and R&D experts from domestic and international biopharmaceutical companies.

Over the last decade, significant progress has been made in medical research, disease treatment and general health and well-being.  The Chinese government has called out innovation as a major national strategy to achieve sustainable growth.  At the same time, to address public health and safety, the country’s regulatory agencies are tasked with implementing relevant laws to ensure the safety and efficacy of new products and services before they’re available to the public. The ability of regulatory agencies, laws and regulations to promote innovation while protecting public health is an important research question.  This forum at SCPKU was designed to facilitate a high-level discussion on this topic by scholars from academia from both China and the US, CFDA leaders, and R&D experts from biomedical industries.

The forum was structured with four keynote talks and two panel discussions. Dr. Ruiyi He, the Chief Scientist at the Center for Drug Evaluation of CFDA, delivered a speech on CFDA’s plan to enhance regulations on drug evaluation to promote the development of new drugs. He highlighted some major initiatives to align with ICH (International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use).  In June 2017, China became a member of ICH. Dr. Dechao Yu, founder and CEO of the Innovent Biologics, Inc., gave a talk on opportunities and challenges in innovative biologics in China. He shared his experience in developing Oncorine and Conbercept in China and the needs for regulation reform for innovative new drug applications. Professor Jiqian Fang from Sun Yat-Sen University reviewed the development of the CFDA in the past two decades and called for open, transparent and academic participation in innovative development of drug review and approval regulations. Professor Baoyan Liu, Vice President of the Chinese Academy of Chinese Medicine Sciences, presented innovations in Chinese medicine (CM) using clinical trials and big data, and the regulatory needs tailored for the sciences of CM.

The two panel discussions were focused on the challenges and opportunities in evaluating the safety and efficacy of innovative biomedical products and collaboration in biomedical innovations. Panelists included a CFDA division director, CFDA biostatisticians, several members of the CFDA advisory committee, a vice president of CAPM, and CEOs of several biomedical startups in China.

Attendees were able to exchange ideas in an open and fair environment and many expressed interest in joining future SCPKU-based forums and workshops on this topic.  Forum participants drew the following conclusions:

 

·   Regulatory science plays an important role in promoting and supporting biomedical innovations.

·   Regulatory reforms should be open, transparent, science-driven, and in alignment with international standards.

·   Low-quality generic drugs should not be supported.

·   Regulatory agencies, academics, and the biopharmaceutical industry should work together on developing science-based policies to make effective, safe and affordable drugs for Chinese patients.

 

The Center for Innovative Study Design also held a Workshop on Innovative Statistical Methods in Precision Medicine and Big Data at SCPKU on March 23, 2017. Twelve statisticians from the Chinese FDA, Chinese universities and US universities presented their research on advanced clinical trial design, statistical innovations in big data, and applications of machine learning in biomedical data science. More than 60 attendees from local universities (both faculty and graduate students), government, and pharmaceutical companies joined the workshop and had many insightful discussions.

 

 

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Dr. Jie Chen, International Society for Biopharmaceutical Statistics (L), and Ying Lu, Professor of Biomedical Data Science and Co-Director of the Center for Innovative Study Design at Stanford University (R), speak during SCPKU forum March 2017.
Dr. Jie Chen, International Society for Biopharmaceutical Statistics
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Sergio Rebeles, the first student to graduate with a Global Studies minor in European Studies, received his B.S. in Biology in June.

One of Sergio's earliest impetuses towards a global focus for his education was becoming aware of the Sinjar massacre of Yazidis in northern Iraq in 2014. At Stanford, Sergio's native Spanish-speaking abilities led him to volunteer as a medical Spanish Interpreter at free clinics at Stanford and in San Jose. This solidified his desire to attend medical school in the future.

Sergio's interest in international affairs led him to study abroad with Stanford's Bing Overseas Studies Program in Madrid and Paris. After considering both the French and International Relations minors, Sergio ultimately chose the European Studies minor because of its "flexibility and interdisciplinary/comparative focus." Sergio's favorite class of those specifically taken for the minor was History of the International System (INTNLREL 102), taught by Norman Naimark.

In Madrid, Sergio interned at a Catholic school where he gave English lessons to first graders. In France he enjoyed a French art history class that included trips to the Louvre and Musee d'Orsay. While abroad he also "treasured the time I spent with my host family, which included two young boys, and thus very stimulating dinners."

Sergio is confident that studying both science and the humanities at Stanford helped to make him a well-rounded graduate. "There’s certainly a difference in personality type between the ‘hard’ and ‘soft’ sciences, and it was refreshing to experience both during my time on the Farm. Believe it or not, I would even describe it as cathartic to work on an essay between bouts of memorizing biochemical pathways or practicing genetic crosses."

Sergio's one regret is that, because the minor program was new, he was not able to take the introductory courses (Global 101 and International Relations 122) before his study abroad, and he found that what he learned in them would have been useful in framing his European experience. In planning his studies, Sergio appreciated the guidance of advisors Ken Scheve, director of The Europe Center (TEC), and Christophe Crombez.

Sergio's immediate plans include studying for the MCAT and working for two years as a high school math teacher in Miami for Teach For America. We wish him the best of luck in his future endeavors!


Learn more about the Global Studies Minor with a Specialization in European Studies.

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Sergio Rebeles and friends in Toledo, Spain
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The new United States administration’s first budget proposal, previewed in March and released in May, 2017, includes deep cuts to foreign aid, cycling this thorny issue back into the American limelight. The stated reasons for the cuts are that “the United States currently pays more than its fair share,” and to ensure that “foreign aid supports American interests and values.” The budget proposal is not specific on which types of development assistance will undergo the largest budget cuts but, at 20% of all US foreign aid, the health sector may undergo substantial changes if the budget is implemented.

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Eran Bendavid
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The global financial crisis starting in 2007 prompted national governments around the world, and notably many within the European Union, to implement austerity measures. Similar to structural adjustment programs (SAPs) implemented throughout the developing world since the 1980s, much of the pressure to adopt and enforce austerity measures has been levied by global financial institutions such as the IMF. Despite original claims that these measures were intended as ostensibly “short-term” solutions, slow economic recovery or worsening economic conditions in many of the countries impacted by financial crisis has led to an increased number and stringency of measures.

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The CISAC Fellowship Program is training and educating the next generation of thought leaders and policy makers in international security.

Our fellows spend the academic year engaged in research and writing, and participate in seminars and collaborate with faculty and researchers. Every summer, many complete their fellowships and move on to new career endeavors. For the 2016-17 academic year, CISAC hosted 21 fellows (the center has 399 former fellows).

Some of our fellows, in their own words, explain what they will be doing next:

Andreas Lutsch

Having spent two years as a nuclear security postdoctoral fellow at CISAC, I return to my home institution, the Julius-Maximilians-University of Würzburg, Germany. As a historian of late modern history, I do so in great gratitude for an excellent and abundantly rich scholarly experience at Stanford. Once I am back in Germany, I will publish my first book early next year, the manuscript of which I finalized at CISAC. I will also proceed to publish the manuscript of my second book, which I wrote entirely at Stanford. And I will move towards the pursuit of the so-called “habilitation,” which is required (in Germany) to qualify for a position as a full professor in my home country. 

It is not easy to put into a few words how much my CISAC experience has helped me with making progress at a crucial juncture of my career. CISAC fellowships offered me a transformative opportunity to make my research more rigorous, to think more creatively and more carefully, to appreciate interdisciplinary approaches in addressing complex problems, to improve my teaching abilities, and to establish relationships with leading scholars and specialists, which I hope will be long-lasting ties to communities at CISAC, Stanford, and the U.S.

Anna Péczeli

I have a tenured position at my institute in Hungary so I will move home in August and get back to teaching and research.

My CISAC experience was amazing, from the beginning I felt that I was part of a community here. I got much useful feedback on my research, and I really feel that my work improved in quality and I became a better researcher. I learned a lot about how to present my ideas so that it would be relevant for policy makers, and my fellowship opened new doors for me. I am grateful for this opportunity, and I am certain that I will continue to be an active member of the CISAC community wherever I go.

Eric Min

During the 2017-2018 academic year, I will remain at CISAC. As a social sciences postdoctoral fellow, I will study how international actors and third parties utilize diplomacy to manage and resolve interstate conflicts. This builds upon my broader research agenda, which uses new quantitative data and statistical methods to analyze the strategic logic of negotiations during war. 

Given that I came from a predominantly social science background, my year at CISAC was invaluable in helping me to understand the policymaking world and how my research could more effectively communicate the technicalities of my research to a broader informed yet general audience. I also learned about what kinds of pressing questions concern policymakers, which I will use to shape my future work. I look forward to meeting another group of diverse and knowledgeable individuals next year. 

Jennifer L. Erickson

This fall, I will return to my regular life at Boston College, where I am an associate professor of political science and international studies. In the upcoming academic year, I will continue to work on the research I worked on at CISAC on new weapons and the laws and norms of war and the nuclear weapons portion of my project in particular. I will also teach two sections of the Introduction to International Studies for BC undergraduates and the Field Seminar in International Politics for BC graduate students. In the fall, I also look forward to being affiliated with the Security Studies Program at MIT. 

CISAC has been a tremendous source of academic support for my research. Not only has it given me time and resources to do research and write, but it has also introduced me to new colleagues, who have generously provided insights and expertise that have improved that research. It also made it possible for me to attend events like a conference on New Dilemmas in Ethics, Technology, and War at the Air Force Academy in April 2017, the Military Immersion Map Exercise at RAND in May 2017, and the UN Conference to Negotiate a Legally Binding Instrument to Prohibit Nuclear Weapons in June 2017.

These experiences, as well as all of the opportunities to attend events and meet people at CISAC itself, will continue to shape how I think about my research and teaching and have helped me build new professional networks for the long term.

Cameron Tracy

In the next academic year, I will be a postdoc in Stanford’s Department of Geological Sciences. There, I will continue my work on the role of geologic disposal (burial) of weapons plutonium in the global arms control and disarmament regimes. I will also conduct scientific research on the manner in which nuclear materials change in response to their environments. For example, I am currently starting a project in which I attempt to determine the conditions in which uranium-bearing materials have been stored by studying the oxidation and hydration of their surfaces. This could help to determine the provenance of smuggled uranium that has been interdicted by law enforcement or security authorities. 

My fellowship at CISAC has allowed me to translate my scientific skills to the policy realm, and to greatly expand the impact of my work. I have long been interested in science policy, but lacked the resources, connections, and experience necessary to effectively analyze critical issues and to communicate the results to both scholarly and governmental audiences. Through interactions with CISAC’s resident policy experts, I learned about the role that technical analysis can play in the policymaking process.

While my transition to policy-relevant work is ongoing, my efforts have already yielded some impact on international policy, with an Australian Royal Commission report citing my work on quantifying the long-term risks associated with the burial of nuclear materials. I expect that the valuable experience and mentorship I received over the course of my CISAC fellowship will continue to inform and enhance my work at the interface of nuclear science and policy.

Jooeun Kim

I will become the Jill Hopper Memorial Fellow at Georgetown University and will be teaching a course, the History and Politics of Nuclear Proliferation, in spring 2018. From August this year, I will be a visiting scholar at the Institute for Security and Conflict Studies at George Washington University. CISAC provided me with amazing resources. I loved my intellectually stimulating meetings with my mentor Scott Sagan and other amazing scholars who opened their office doors to me. CISAC is an ‘intellectual candy store.’ I am grateful to everyone there for creating such a special environment.

Andrea Gilli

Starting July 1, I will be a postdoctoral fellow at Harvard University's Belfer Center for Science and International Affairs where I will keep working on my research about technology and international security.

The CISAC experience helped my career in three main ways. First, CISAC is a fantastic academic environment where young researchers can deal with leading scholars in a plurality of fields: the constant interactions between different views and expertise represent a unique source of intellectual growth that has helped me develop new ideas and identify new questions in my field.

Second, CISAC's activities and professional growth initiatives help fellows gain the skills and acquire the knowledge to succeed not only as an academic but also, more broadly, as public intellectual. CISAC has helped me improve my understanding of policy dynamics as well as my capacity to present to non-experts the findings of my research. Third, CISAC's "be-good" motto combined with its strong mentorship provides fellows with a perfect working environment.

Eva C. Uribe

This fall, I will be starting my position as a systems research analyst at Sandia National Lab. For my research here at CISAC, I have taken a broad, holistic look at the proliferation impact of the thorium fuel cycle. Therefore, CISAC has given me valuable experience in thinking through difficult problems using a systematic, top-down approach, which is a skill that I will take with me to my next position.

Accepting a postdoctoral fellowship with CISAC was an unconventional career move for me, personally. I got my doctorate in chemistry from UC Berkeley in 2016. Most of my peers in the chemistry department went on to conduct postdoctoral research at another university, a national lab, or in industry. A few made the leap into science policy fellowships in Washington, D.C. For me, CISAC provided a happy compromise between these two options. It allowed me the freedom to continue conducting technical research (albeit outside the chemistry lab), while still exploring the policy implications of my research.

My experience at CISAC helped my career progression in two ways. First, through targeted workshops, reading groups, and less formal daily interactions, CISAC provided me with the opportunity to view my research and interests from a different lens, that of the policymaker.  It was interesting to see my fellow fellows, of all academic backgrounds, struggling with how to translate the finer points of their academic research into policy-relevant media. I learned a lot from their experiences and challenges. The second way that CISAC has helped my career progression was through exposure to others who have done this transition successfully. This was achieved through fantastic seminar series, as well as through daily interaction with faculty and fellows here at CISAC. Speaking with people who have worked at high levels in Washington, D.C. made me realize that I would prefer to continue doing policy-relevant academic and technical research in nuclear science, rather than to transition to policy completely.

Fellowship information

Current fellowship opportunities at CISAC include: 

•  Social Sciences or Humanities International Security Fellowship

•  Natural Sciences or Engineering International Security Fellowship

•  Cybersecurity and International Security Fellowship

•  Law and International Security Fellowship

•  Nuclear Security Fellowship

•  William J. Perry Fellowship in International Security

For more information about CISAC fellowships, email cisacfellowship@stanford.edu.

 

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Fellows at the Center for International Security and Cooperation participated in a January 2017 seminar with Air Force Gen. John Hyten, commander of the U.S. Strategic Command. The talk was titled, “U.S. Strategic Command Perspectives on Deterrence and Assurance.”
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