Research

Urban Health Services & Systems Delivery

Research in Action

Many countries once beset by dire poverty have advanced economically. Half of mankind now lives in cities and this number will approach 75 percent by 2050. Most cities are ill equipped to manage this demographic transition. UChicago Urban is an emerging community of scholars and community members that aims to spur innovation in the study of urban processes and to encourage interdisciplinary discourse in urban research, theory, and policy. CGH and its global partners are collaborating to build self-sufficient local health service delivery systems and long-term research partnerships in pursuit of improved health services for urban populations. Multidisciplinary teams from Chicago, including student research fellows, are working with universities in Ibadan, Lagos, Kumasi, Cape Town, Hyderabad, Tegucigalpa, Sao Paulo, Santiago, Wuhan, and others. They also collaborate with non-governmental organizations such as the AORTIC, Project Gaia, HLF, FASUL, Project HOPE and with urban medical centers. Their aims are to assess health services, develop improvement plans and training programs, train local health care workers, put in place evaluation and continuous improvement systems, and establish collaborative research agendas concerning such issues as the comparative (cost) effectiveness of methods of providing health care. These projects provide opportunities for collaboration between CGH and Booth, Harris and SSA.

CGH has collaborated with UChicago Urban Health Initiative to develop community partnerships to reduce food deserts, map locations of health centers, and tackle common health challenges on the Southside of Chicago. We have partnered with the Chicago Council on Global Affairs to study global health services and systems delivery. The Drs. Olopade have leadership roles on the Council, which provides educational and internship opportunities for UChicago students. Our commitment to urban health issues is exemplified by partnerships in Bangladesh, China, Chile, Eastern Europe, Ghana, India, Johannesburg, Nigeria, Tanzania, Uganda, and others. Booth, Harris, SSA and departments of Anthropology and Sociology are committed to partnering in this endeavor. Areas of engagement by CGH-affiliated faculty include:

Medical Education Reform in China

Dr. Renslow Sherer is a founding member of the CGH Steering Committee. His work in China on improving primary care has received almost $10 million in grant funding since 2008. This work stems from the national mandate to provide expanded primary care capacity in Hubei Province, China, to 67 million people. Dr. Sherer and other University of Chicago researchers from the Section of Infectious Diseases and Global Health collaborated with Wuhan University and the Hubei Province Centers for Disease Control (CDC) on the Hubei Medical Education Reform Project, an effort to modernize medical training with a special emphasis on infectious diseases and public health (hivelimination.uchicago.edu). The Pozen Family Center for Human Rights was a partner in this initiative. Dr. Sherer has continued this work as the leader of Wuhan University Medical Education Reform (WUMER). A modified curriculum from UChicago was adopted for use in China. UChicago continues to send teams regularly to Wuhan University both to teach and to provide feedback and suggestions for clinical practice.

Health Care Financing and Management in India

In 2013, Professor Anup Malani founded the International Innovation Corps, a social service program that sends teams of UChicago and foreign university graduates to work on innovative development projects with government officials in India and Brazil. Malani is a professor in both the Law School and the Pritzker School of Medicine (PSOM). Malani is Principal Investigator on the India Health Insurance Experiment, an 11,000-household randomized controlled trial of universal health insurance in Karnataka, India. An International Innovation Corps team is supporting the implementation of this project using team member experience in policy, data analytics, strategy consulting, and project management (iic.uchicago.edu). 

Governance and Health Sector in the Global South

From Panama to Chile to Peru and Brazil, CGH supports faculty interested in collaborations to advance health and well-being among LatinX populations. SSA has hired several new faculty members involved in developing global health solutions or reducing health disparities among immigrants, refugees and people of color, including Alan Zarychta, Miwa Yasui, and Angela Garcia. Alan Zarychta, Center for Health Administration Studies (CHAS), is an Assistant Professor whose research focuses on the politics of social services in Central and South America, especially in the areas of public health and environmental policy. Professor Zarychta is part of an interdisciplinary team working in collaboration with the Honduran Ministry of Health to study the effects of decentralized governance on the performance of local health systems in that country (chas.uchicago.edu). He is now initiating related projects on health sector reform in Guatemala and Nicaragua, supported by the National Science Foundation and the Social Science Research Council.

Global Surgery in China

The University of Chicago has had a relationship with Peking Union Medical College (PUMC) for over a century. Then president of the University, Harry Pratt Judson, helped to establish the China Medical Board, which included Dr. Franklin C. McLean, the first Dean of PUMC. One of the earliest successes in UChicago global health services and systems delivery was the work of Dr. Michael Millis to transform Chinese transplant policies in collaboration with Transplant Surgeons at PUMC and the Chinese Academy of Medical Sciences (surgery.uchicago.edu). Millis, Professor of Surgery and Vice Chair, Global Surgery, is a founding member of the CGH Steering Committee and an expert in adult and pediatric transplant surgery who has pioneered new techniques of operating on the liver. Since 2005, Dr. Millis has been assisting the Chinese government in overhauling its approach to organ donation. The Chinese Ministry of Health has cut by two thirds the number of facilities allowed to offer transplants, created a donor registry, established tougher standards for transplants, and launched educational programs to encourage volunteer donation. Changes also have been made to the justice system to discourage prisoner executions at will, which had produced a steady supply of organs.

Global Mental Health and Neurosciences

Depression affects over 322 million people and is ranked as the largest contributor to global burden of disease. Chronic diseases like breast cancer also confer an elevated risk for major depression as they expose women to stress, medical trauma, and stigma associated with mastectomy. In Nigeria, as in most low-to-middle income countries (LMICs), the psychological sequelae of breast cancer diagnosis go largely unrecognized. Untreated, depression independently contributes to poor outcomes in this population. Mobile phones, used by over 84% of Nigeria’s almost 200 million people, have been important tools for improving Nigerian economic outcomes, enabling widespread access to communication, banking, and internet services. Drs. Beiser, Gibbons, Seeba Anam and Olopade are working with partners in Nigeria to develop a culturally-validated mobile mental health (mMHealth) platform to improve breast cancer outcomes through increased access to mental health screening, diagnosis, education, and treatment. By developing and establishing the clinical feasibility of a novel mMHealth assessment platform within an established psycho-oncology care program at University College Hospital in Ibadan, Nigeria, we will gain insights, develop a technical platform, and enhance professional relationships that can form the basis for developing mobile mental health assessment and intervention tools aimed at dramatically raising the scale and precision of mental health measurement in Nigerian and other countries with unmet clinical needs. Other investigators across the University in pediatrics, SSA, Anthropology and sociology have programs in this area.