Photos: Hoag Levins Marie Christelle Mabeu, University of Ottawa PhD Candidate, presents her findings during the Methodological Advances in Population Health Sciences portion of the Fourth Annual Population Health Science Research Workshop convened at the University of Pennsylvania. The two-day event was sponsored by the Leonard Davis Institute of Health Economics (LDI) and the Penn Center for Health Incentives and Behavioral Economics (CHIBE).
Academic scientists from Penn and two dozen other universities including Harvard, Yale, Princeton and Brown attended the Fourth Annual Population Health Science Workshop, December 5-6, 2019 at the University of Pennsylvania. Topics discussed were the broad decline in health across the U.S.; links between social isolation and health; sleep and health in low-income communities; gender disparities among health care professionals and their impact on patients; deploying genetics in population health research; hospital consolidation’s impact on community costs and care; and other areas of inquiry including how the stress of Donald Trump’s presidential campaign may have physically affected the health of pregnant Latina women and their babies.
The Population Health Science Workshop was organized four years ago by research colleagues (above) Atheendar Venkataramani, MD, PhD, of Penn; Jacob Bor, ScD, SM, of Boston University; and Willa Friedman, PhD, of University of Houston. All are Assistant Professors at their respective schools. Venkataramani’s research focuses on life-course origins of health and socioeconomic inequality; Bor’s focuses on the study of population health, especially on HIV treatment and prevention in southern Africa; and Friedman’s focuses on health, education, political economy and behavioral economics.
“When we began this, the three of us could see the increasing national focus on matters of population health, but we couldn’t see a clear definition of what that term actually meant.” said Venkataramani, a faculty member at the Penn Department of Medical Ethics and Health Policy and an LDI Senior Fellow.”
‘Coalescing thread’
“Provider organizations have their own ideas, which involve caring for a large group of people and optimizing certain activities like medical screening,” Venkataramani said. “But then on the economics and epidemiology side, there is a sense that social factors and policy could shape the health of large populations. And other fields, like demography and sociology, are working hard to describe trends in health outcomes for different groups of people. Across these fields, we saw scholars interested in reaching across disciplinary boundaries to generate new insights. However, there was no interdisciplinary space for these people — many of whom are young researchers — to meet and build novel collaborations. That’s what the Workshop idea was all about — to build a coalescing thread across disciplines that defines the cutting edge of population health science.”
“A goal of the Workshop is to redefine the science, especially because we are realizing that health systems are probably not the biggest determinant of population health anymore,” continued Venkataramani. “The larger context of this is that the U.S. has fallen off the trend of other industrialized countries in mortality and life expectancy since about 1980 and we have even reversed some of the health gains achieved over the last century.”
An expanding Penn perspective
“I also think it’s important to point out that this conference would not have happened this year if it weren’t for the Leonard Davis Institute of Health Economics (LDI) and the Center for Health Incentives and Behavioral Economics (CHIBE) stepping in to sponsor it,” said Venkataramani. “This again demonstrates how Penn and its research centers has consistently focused on what’s next for health systems, providers, insurers, and the economic and behavioral side of patient care. Now, groups like the Population Studies Center at Penn’s School of Arts & Science and the Center for Public Health Initiatives are growing out a broader population perspective about how societal events, structural forces and public policies influence and shape health outcomes here and across the globe.”
Ishani Ganguli MD, MPH, an Assistant Professor of Medicine at Harvard’s Brigham and Women’s Hospital, presented on her study, Association Between Physician Revenue, Work, and Gender in Primary Care. It found female primary care physicians (PCPs) are paid less because they tend to spend more time with patients in a physician payment model based on the number of patients seen daily. Ganguli found that even accounting for factors such as specialty and age, female PCPs generated nearly 13% less annual revenue than male PCPs — driven entirely by the difference in visit volume. At every level of analysis female PCPs were found to have spent more time with patients than male PCPs. “One big takeaway from this,” Ganguli said, “is that if we want to make primary care work for population health, we have to reconfigure how we pay all PCPs.”
Alison Gemmill, PhD, MPH, Assistant Professor of Population, Family and Reproductive Health at Johns Hopkins University, discussed the Increase in Preterm Births at the Limits of Viability Among Latina Women Associated with the 2016 Presidential Election. Her research concluded that periviable — or very early — births of the sort that account for the majority of neonatal deaths, increased among pregnant Latina women exposed to Trump campaign election rhetoric while the rate did not increase among white pregnant women during the same period.
In her “Sleepless in Chennai: The Consequences of Increasing Sleep among the Urban Poor,” Heather Schofield, PhD, Assistant Professor in the Department of Medical Ethics and Health Policy and LDI Senior Fellow, spoke of her six years of sleep-related studies in India.
Harsha Thirumurthy, PhD, Associate Professor in the Department of Medical Ethics and Health Policy, and LDI Senior Fellow, was the discussant on a presentation about the use of temporary voucher systems to provide food and household items during humanitarian assistance programs in the wake of population catastrophes.
In a presentation related to her poster, LDI Associate Fellow Ellen Moscoe, PhD, MA, a Postdoctoral Researcher in the Department of Medical Ethics and Health Policy, spoke of her study that used information and education strategies to mitigate transactional sex encounters in areas of high HIV risk.
LDI Senior Fellow and Professor of Demography at the School of Arts & Sciences, Hans-Peter Kohler, PhD, was the discussant on a study about the difference in contemporary fertility levels in African countries previously ruled by Britain and France. The work focused on the continuing impact of former Colonial Reproductive Laws on today’s birth rates.
The Population Health Workshop featured a two-day expo of 30 posters related to a wide variety of population health topics. Above, left (from left to right) perusing the works are Lauren Schmitz, PhD, MS, Assistant Professor at University of Wisconsin-Madison Center for Demography of Health and Aging; Yarine Fawaz, PhD, MSc, a faculty member at the Bank of Spain’s Center for Monetary and Financial Studies in Madrid; and Saravana Ravindran, PhD, M.Phil, Postdoctoral Fellow in International Development and Policy Outreach, Department of Public Policy, UCLA.
A view of one section of the poster aisle displays.
Explaining her poster, “Economics of Gender Roles and Gender Discrimination,” is Jocelyn Finlay, PhD, Senior Research Scientist in the Department of Global Health and Population at Harvard’s T.H. Chan School of Public Health.
In discussions are Engy Ziedan, PhD, Assistant Professor of Economics at Tulane University; Kelly Hyde, a PhD student in the Department of Economics at the University of Pittsburgh; Aryn Phillips, PhD, MS, Graduate Student Researcher at the University of California, Berkeley’s Center for Healthcare Organization & Innovation Research; and Joseph Nwadiuko, MD, MPH, MSHP Student at Penn’s Perelman School of Medicine and LDI Associate Fellow.
