MCH

Department of Community Health Sciences
Scholarship is the cornerstone of our department. The faculty has diverse interests, reflected in their scholarly areas of interest and expertise. These scholarly areas are reflected in our research, our teaching, and our community service and interactions. We apply common skills to all content, in the following areas:assessment, intervention, communication, community-based research and practice, system change/translation/dissemination, policy change/advocacy, and evaluation.

Overarching areas that are applied across the department:

Health and social disparities
Most of today's health problems are complex in nature, involving medical, social, and cultural issues. Premature mortality and morbidity, once mostly an issue of infectious disease rates, now include chronic and preventable noncommunicable diseases, as well as urban problems and public health issues of poverty. Disparities exist in health outcomes for most of these health problems. Here we define disparities as differences among subgroups in health outcomes that have in part putative social justice rationales.

How, then, can we prevent mortality, and reduce morbidity and improve quality of life, by reducing health disparities adversely affecting these disparate populations? Any new strategy for cancer control must recognize that human behavior is a major determinant of incidence and outcomes. A recent IOM report estimates that lifestyle changes account for considerable preventable deaths, and a recent position paper by the CDC called for action to reduce the burden of chronic disease through lifestyle changes. Tobacco is the leading preventable cause of death worldwide, and obesity-related cancers account for 32% of cancer deaths. Alcohol and other dietary factors play a role in several cancers. Social and behavioral science research is critical to cancer prevention and control because translating knowledge into practice at the population level requires new methods for promoting social and behavioral change (including identifying cultural barriers to change), improved cancer communications, and continuous evaluation of the outcomes of cancer interventions. The recent focus on the social and structural causes of negative health outcomes also calls for increased research and training on the social epidemiology of health problems and societal interventions to reduce disparities.

Gender and sexuality
One area of scholarship in the Department of Community Health Sciences is the emphasis on gender and sexual orientation and its implications for public health. Our faculty's gender-based perspective in research, teaching, health policies and programs recognizes that the differences between men and women, girls and boys, are not exclusively driven by biology, rather social and cultural factors contribute and compound gender-based differences in health. In the past, scholarship on gender and health was often interpreted as a focus on the health problems of women. Instead our aim is broader in that we focus on ways that gender, as a social construction, affects the health of men and women, also recognizing the emerging complexity of transgender individuals health. Our scholarship seeks to increase knowledge and understanding about gender inequality such as women's longer life expectancy or men's greater experience of life-threatening diseases and risky health behaviors. In addition to the well-known unequal power relations by gender, in most societies, power inequity exists also with respect to sexual orientation. Generally, sexual minority individuals, that is lesbian, gay, or bisexuals have lower social status than heterosexuals, which impacts health and health behaviors in multiple ways. Our scholarship of sexual orientation recognizes inequality due to sexual orientation in relation to individuals' treatment by and participation in health and medical care systems, differences in needs for health information and knowledge to increase individuals and communities ability to promote prevention and achieve the best possible level of health and well-being.

Urban health
Urban health is an important area of focus for the Community Health Sciences Department. Faculty work in urban health addresses issues relevant to the most disadvantaged and under-served urban populations, and addresses topics such as food insecurity, homelessness, community violence, and access to medical care. Additional areas of focus include immigrant health, the health of public housing residents, substance use and abuse, community violence, child and adolescent health, community-based participatory research, and intimate partner violence. Students have rich opportunities to obtain training in urban health through coursework, research assistantships, and internships. They are taught how to assess population health in urban environments using existing data sources and community surveys; many conduct intervention practica within the City of Boston.

Importantly, the Department has close connections and collaborations with local municipal agencies, community health centers, and community-based organizations, including Boston Public Health Commission, Boston Housing Authority . These academic-community partnerships facilitate opportunities for research, practice and training in urban health. As an example, several Department faculty are associated with The Partners in Health and Housing Prevention Research Center , a collaboration with a mission to engage public housing residents in community-centered research programs and activities that improve their health and well-being.

Family and community health systems
The Departments research agenda in family and community health systems represents a dynamic blend of research on public health practice, application of evidence to practice and fully integrated partnerships with professional agencies, local community organizations, and colleagues within BUMC and SPH. This effort focuses on three areas: (1) Innovative community health practice, such as Screening for maternal depression in a pediatric setting and Follow-up after a suspicious mammogram; (2) Knowledge to practice, including Examination of long term impacts of Assisted Reproductive Technologies and The impact of multiple cesarean sections on maternal and infant health, and (3) Health Disparities, including projects on Reducing Disparities in Birth Outcomes: Does the Boston Healthy Start Initiative Make a Difference and Access to Primary Care for Residents of Boston's Housing Developments: A Peer Education Model. The diversity of these projects reflect the interdisciplinary nature of field oriented public health research that is at the heart of the Departments research in family and community health systems.