Welcome back to Introduction to Translational Science. In this segment, T4 research will be covered, Translation to Communities and Population Health. The goal of T4 research is to provide communities with the optimal intervention or relationship and result in a true benefit to society. T4 research studies factors and interventions that influence the health of entire populations, not just individuals, not just communities, but larger populations across many different boundaries, geographies, and areas. The findings from T4 research aim to improve global health conditions. Now, T4 research is often conducted through a variety of different types of studies. We're going to talk about population-level prevention and outcome studies, mass screenings and outcome studies, health policy studies, and studies of the social determinants of health, a very important and underappreciated aspect of health. You might think that a large proportion of your health depends on access to health care, that turns out to be about 15 percent of the total determinants of health. Social determinants of health are 40 percent or more of health outcomes and something that is often neglected at earlier levels of translational research. Moving through the translational spectrum, we see that translation to population health occurs after translation into practice and it asks, once we put these methods into practice, how large a group are they going to affect? What are the variations across groups? How can we improve that? How can we reach groups that are much harder to reach and make sure that they receive the benefits of research? And that we know more about how those groups respond to therapies, and what types of interventions they may need so we can feed back to earlier parts of the translational spectrum? Let's talk about population-level prevention and outcome studies. These studies look to characterize, and explain, and sometimes influence the levels and distributions of health across populations. These might be large scale vaccine studies, screening for high blood pressure, interventions that look at the availability of mental health, and look for ways of effecting the health of an entire population. The end result of these studies can include: better functioning within your community, a better quality of life for both individuals, and improved interactions with their community and lower rates of death from specific diseases within a large population. The studies provide evidence for the value of specific medical treatments or interventions or diagnostic methods that can be used to make better decisions for an entire population. Mass screenings are part of this type of studies and those involve looking at how many individuals can we pick up with a particular condition using the latest interventions for screening. In these types of studies, Mass screening is provided to everybody regardless of their risk factor. And one of the things that these types of studies do, is to look at whether it's worthwhile to screen everybody without risk factors and whether that type of test has benefits that outweigh the risk. Some types of mass screenings are often used in the medical community to screen for cancers, like breast and prostate cancers, to screen for asthma, allergic diseases, celiac disease, and also to screen for infectious diseases and medical conditions like high blood pressure or diabetes. The outcome studies of mass screenings look to compare how people did mortality and burden of disease before and after the screening. The idea is once we know somebody screens positive for a particular condition, we can then go out and treat it and we can develop methods of treating it, and feedback on the T3 and T4 levels of translational research. Also included in the types of T4 studies are health policy studies. These studies look to see if a public health policy has a great impact on the health of populations and on public health. There are studies to look at processes to understand the likelihood that a policy will be adopted. What are the barriers to adopting a policy? What are the potential outcomes of policy adoption? And looking at what's happened after policies have been implemented. For example, studying the effect of lowering the speed limit on automobile accidents is a type of policy study that has been undertaken. And, in the medical realm, studying the incidence of breast cancer and how early it can be detected is, after implementing policy recommendations in a medical system, is another type of health policy study. The social determinants of health, as I mentioned, social determinants of health are incredibly important and often the social barriers to implementing new therapies and new diagnostics are the main reason that populations do not benefit from these incredible new discoveries, therapies, devices, and methods. Social determinants of health include where somebody was born, where they live, where they work, where they play, their worship, their age, and these can affect a variety of perceptions of risk and the actual risk of poor health outcomes. Studies of social determinants of health ask both: What are these determinants? And how can we intervene in context of where people live, work, learn, in order to improve the health of populations? You're going to hear from two amazing researchers at the University of Rochester. Dr. Stephen Dewhurst, who studies HIV and interventions to improve the population health of individuals with HIV infection and to prevent progression to AIDS. And he leads a large research center dedicated to this type of work. In addition, you're going to hear from Dr. Cullen. Dr. John Cullen is a Research Associate professor in the Clinical and Translational Science Institute at the University of Rochester. And Dr. Cullen's work in T4 seeks to provide recognition and a voice for people who are often not empowered to speak on their own behalf or to seek health interventions in these hidden populations because of stigma, shame, or fear of reprisal. These types of individuals include victims of intimate partner violence and their communities. This kind of work makes hidden populations visible and helps researchers, and clinicians, and policymakers address the needs and concerns of populations that are often very underserved. I hope you enjoy their stories.
