2020 Fellows

2020 Yusuf Hamied Fellows: Columbia Mailman School of Public Health

Building Capacity for Studies of Child Development in the Slum Environment

Pam Factor-Litvak, PhD
Professor of Epidemiology
Vice Chair for Research, Department of Epidemiology
Associate Dean for Research Resources

ONE HEALTH focuses on the interrelationships between humans, animals and the broader environment to determine health status, especially among children under the age of 5 years. Much of the ONE HEALTH work focuses on infectious disease, a large public health problem in urban slum environments.  However, little attention is given to neurodevelopmental outcomes in children, outcomes that are crucial for the development of human capital in low- and middle- income countries. Building on work already begun in Jaipur, India, in conjunction with the international Child Health, Infections and Pollution (CHIP) consortium, this project will expand preliminary work to develop large multi-site studies across India relating conditions of the slum environments to pre-school readiness and behavioral assessments in young children and to develop methods to obtain and store appropriate biological specimens to measure pollutants.  Further, as citizen science is one of the hallmarks of the CHIP consortium, Dr. Factor-Litvak will continue to develop relationships with non-governmental agencies to perform field studies.

Dr. Pam Factor-Litvak is professor of epidemiology, vice chair of the Department of Epidemiology for Research and Associate Dean of Research Resources at the Mailman School of Public Health.  She has had over 30 years of experience studying the effects of early life exposures to toxic metals, toxic chemicals and environmental stress and developmental outcomes in children, including lead, arsenic, pesticides and plasticizing chemicals.  Much of this work has been performed in international settings, and has, in part, informed several US policies regarding allowable limits for these agents.    

Investigating Modifiable Lifestyle Drivers of Cancer Risk in Indian Populations

Jeanine M. Genkinger, PhD, MHS
Associate Professor of Epidemiology
Department of Environmental Health Sciences

The World Cancer Research Fund (WCRF) estimates that healthy weight is the second most important factor, besides not smoking, for cancer prevention, and recommends individuals “be a healthy weight.” Yet, questions still exist about the role of obesity in carcinogenesis. Also, we have no data to make substantiated recommendations on whether, when, and how weight change can reduce the risk of cancer among those who are overweight or obese. Cancer is believed to be a disease of multifactorial origins; therefore, it is critical to understand risk in the context of multiple, simultaneous dietary and lifestyle factors, including nutrients, additives, and contaminants found in foods. India is one of the largest populations in the world, with approximately 1.2 billion individuals. Its population experiences the co-occurrence of infectious and non-communicable diseases, unique dietary consumption patterns, high rates of both obesity and underweight, exposure to critical environmental factors (e.g., pesticides, arsenic, drinking water contaminants, and cooking and processing of food). It is important to understand how these factors may drive cancer risk in this population. 

To develop a research platform and network in India around modifiable lifestyle factors, Dr. Genkinger will partner with Dr. Rajesh Dikshit, at the Tata Memorial Centre and examine the Barshi Cohort of 200,000 individuals. 

Dr. Genkinger is a cancer epidemiologist focused on how modifiable factors, molecular pathways, and related biomarkers may impact cancer risk and progression, particularly for rare but highly fatal cancers. Her area of methodological specialty is in nutritional epidemiology, longitudinal design, and complex pooled and meta-analytic techniques. She has conducted her research in large scale international consortia, namely the Pooling Project of Prospective Studies of Diet and Cancer and the NCI Cohort Consortium, and she has conducted research in numerous cohort studies, such as the Breast Cancer Family Registry.

Impact of diet, inflammation and microbiome on risk of cardiometabolic disease in India

Rupak Shivakoti, PhD
Assistant Professor
Department of Epidemiology

Unresolved inflammation is associated with a variety of adverse health outcomes including higher risk for cardiometabolic disease (CMD). This project will focus on the relationship of dietary intake and gut microbiota with inflammation and CMD risk in India. The goal of this project is to identify potential dietary or microbial interventions to reduce inflammation and CMD risk. This has great public health significance in the context of India, as CMD is the leading cause of mortality in India with over a quarter of all mortality attributable to CMD. Dr. Shivakoti will partner with Public Health Foundation of India (PHFI) and Columbia Global Centers | Mumbai to conduct this research and lay the groundwork for future observational and interventional collaborative studies.

Dr. Shivakoti, Assistant Professor of Epidemiology, has formal training in immunology and epidemiology. His research is focused on the role of inflammation in infectious and chronic disease outcomes. Dr. Shivakoti is also investigating the relationship of nutrition and microbiome with inflammation and health outcomes.

2019 Yusuf Hamied Fellows: India

Continuum of care for dementia in older persons: Family, Community and Health services

Rama V. Baru, PhD
Professor
Centre of Social Medicine and Community Health
School of Social Sciences, Jawaharlal Nehru University
New Delhi, India

As societies age there is a rise in the incidence of cognitive decline among older persons. Dementia is an umbrella term that captures different symptoms of cognitive decline.  Often dementia occurs along with other morbidities and is, therefore, a complex problem that requires lifelong care. The arrangements for its management pose a challenge for the individual, the family, the immediate community, and for institutionalized health care. This “continuum of care” is further complicated by the intersection of class, gender and race that produces inequities in access to medical care and support to different sections of the population.  This work will review the evolution of the concept of “continuum of care” and its relevance for the care of dementia in developed and developing countries.

Rama V. Baru is Professor, Centre for Social Medicine and Community Health, Jawaharlal Nehru University, India; and Hon. Professor, India Studies Centre, Central China Normal University, Wuhan, China. She is a member of several committees of the All India Institute of Medical Sciences and the Indian Council of Medical Research. Her publications include Private Health Care in India (Sage) and Commercialisation of Medical Care in China (Routledge).

Assessment of occupational Lead exposure and health hazards among Bronze sculptors and their families in Southern India

Rajan Patil, PhD
Senior Epidemiologist
Associate Professor and Founding Faculty
School of Public Health
SRM University
Chennai, India 

About 2000 people in the Swamimalai region of the Tanjavore district in Tamil Nadu, India, are involved in bronze metal sculpting, unknowingly involved in highly hazardous processes that expose themselves to toxic fumes and chemicals, such as lead. The clinical diagnosis of lead poisoning can be difficult because poisoned individuals can be asymptomatic, and signs and symptoms, when they are present, are relatively nonspecific. Laboratory investigations are the only reliable way to diagnose lead-exposed individuals. They, therefore, play an essential role in the identification and management of lead poisoning and the assessment of occupational and environmental lead exposure. 

The study will be a multi-disciplinary research initiative in conjunction with other faculty members from the School of Public Health, Department of Physiology, and Research Institute at SRM University to highlight the magnitude of hazardous occupational exposures involved in sculpting work, as well as health hazards and outcomes in children. Dr. Patil’s research focuses on assessing the morbidity and respiratory status of sculptors continuously exposed to smoke and fumes in Tamil Nadu, India. 

Dr. Rajan Patil is a senior epidemiologist and a distinguished founding faculty member of the School of Public Health at SRM University in Chennai, India. He is a prolific writer on public health issues with research interests that include infectious disease epidemiology, immunization policy, and climate change. He has also served as a consultant to the WHO, UNDP, and UNICEF. 

Investigating Environmental factors for breast and gall bladder cancer risk in India

Krithiga Shridhar, MDS, MSc
Epidemiologist
Fellow, Centre for Environmental Health
Public Health Foundation of India
Gurugram, Haryana, India

Environmental risk exposures for carcinogenesis are chronic and insidious over which individuals have limited personal control. In India, cancer burden and the pattern of occurrence mirror unique risk exposures, pertaining to air, water and soil pollution, affecting young women and men. High incidence of triple negative breast cancers, gallbladder cancers - a lethal digestive tract cancer commonly affecting women but very rare in other parts of the world - and increasing trend of lung adenocarcinoma among women are being investigated for potential causative role of certain environmental risk factors. However, quantification of these exposures and investigating true associations, amidst a myriad of other established risk factors, are highly challenging yet critical for developing relevant and adequate interventions. 

This proposal aims to develop and validate ‘exposure intensity algorithm’ in Indian population for environmental exposure to pesticides, including occupational exposure, using existing questionnaire and biochemical data of completed and ongoing cancer studies at the Public Health Foundation of India; and investigate whether the exposure is independently associated with breast (among women) and gallbladder (women and men) cancer risk. Further, it aims to explore how the association is mediated and/or confounded by total estrogen exposure and other important reproductive risk factors among Indian women (pre- and post-menopausal) for these cancer sites.  

Dr. Shridhar is an epidemiologist focusing on cancer prevention and control in India. To date, her work in descriptive, biological and implementation research, in collaboration with premier academic and research institutions across the globe, has resulted in high quality peer-reviewed publications of regional and global importance. Through current research, she aims to understand the role of environmental factors for cancer risk that are relevant and impactful for Indian population. In addition to specific analysis and manuscript writing, during her time at Columbia Mailman School, she hopes to interact with contemporaries and experienced leaders; share knowledge on recent trends and evidence; and initiate long term research network for cancer prevention and control.