Epidemiology Research.

The Epidemiology Department at BU School of Health takes an inclusive view of the field of epidemiology as the study of the distribution of health and disease across populations, and the determinants of population patterns of health and disease.

Pursuing the goals of methodologic rigor and innovation alongside the emphasis on social and structural determinants of health (SSDOH) are woven throughout our research. In the broader field of epidemiology and public health, these emphases are sometimes perceived to be in conflict. Here, they are recognized to be highly complementary. We also place a strong emphasis on translational research, i.e., evidence that can be used to guide decision-making.

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Methodology: Measurement, Recruitment, Sampling, Study Design, and Analyses

Faculty Lead

Faculty active in cluster


Research methods are central to epidemiology and methodology is the largest research cluster within the department, with the majority of faculty tackling one or more methodologic challenges in their work. Epidemiologic methods are a long-standing strength of the department, with two of the leading textbooks in the field authored by our faculty (Aschengrau, Rothman) and many additional textbook chapters authored by faculty. Dr. Fox is among the preeminent scholars in measurement error and quantitative bias analysis and has published two editions of a textbook on these methods. Two cohorts led or co-led by departmental faculty (PRESTO and the BWHS) have established field-standards for novel recruitment methods. These recruitment methods address two of the most important challenges in field epidemiology: increasing sample size of individuals when there is no sampling frame, and recruiting individuals underrepresented in research. Research in PRESTO was complemented by systematic evaluation of potential biases introduced by the recruitment approach and further research to enhance the types of data that could be collected. For example, in a particularly innovative set of projects, PRESTO embedded randomized trials within the observational cohort. Measurement innovations are drawing on high-density data flows such as ongoing blood pressure monitors, electronic health record data, online panel data fielded for measurement harmonization, and spatial data, linked to outcomes assessed in cohorts or in administrative data. Machine learning approaches are being used to identify strong predictors of health outcome, particularly in mental health. Study design innovations include evidence triangulation across econometric approaches (e.g., instrumental variables, regression discontinuity designs), innovative approaches to conventional epidemiologic studies (e.g., novel confounder control methods like G-methods and marginal structural models) and integration of randomization into long-term observational studies. As the field moves to more computationally intensive and data-driven analytic approaches, department faculty are advancing methods in both causal inference and machine learning (Gradus, Murray, Rosellini, Shiba).

Health Equity: Structural and Social Determinants of Health

Faculty Lead

Faculty active in cluster

Social inequalities affect nearly every health outcome, and department faculty are considering both individual and structural social determinants of health. Half of the primary faculty in the department incorporate health equity as a component of their research. Research considers health equity along socioeconomic status, geography, and racial/ethnic identity and most importantly social policies. Social and structural determinants of health shape the distribution of many other exposures, including environmental risk factors, behavioral patterns, stress, and access to health care. Specific projects related to health equity include work on social inequalities in the perinatal period (Ncube, Parker, Wise, Wesselink), social and structural determinants of fertility (Ncube, Wesselink, Willis, Wise), major chronic conditions in adulthood (Cozier, Shiba), and healthy aging (Glymour, Jimenez, Shiba, Weuve). A distinctive feature of our Social and Structural Determinants cluster is the emphasis on rigorous research methods applied to health equity problems. By bringing the strongest methodologic approaches to our questions about health equity, we aim to deliver evidence that is most likely to translate to health improvements.

Environmental Determinants of Health

Faculty Lead

Faculty active in cluster




The physical environment and community infrastructure influence health via many pathways, and as the environment changes, so too do the consequences for health. The complexity of environmental exposures poses many epidemiologic challenges related to study design, data collection, and causal inference. Our faculty are leaders on methods to characterize exposures in the physical environment, including drinking water pollution (Aschengrau), traffic patterns (Willis), noise (Weuve), air pollution (Weuve, Wesselink), heat (Wesselink), greenspace (Jimenez), energy use (Willis), consumer product chemicals (Wesselink, Wise), infrastructure change (Jimenez, Willis), and occupational exposures (Weuve). Population growth, migration, and climate change will all drive new patterns of environmental exposure and therefore have important consequences for health. Faculty in this research cluster collaborate extensively with the Department of Environmental Health, and the Center for Climate and Health.

Stress, Trauma, and Mental Health

Faculty Lead

Faculty active in cluster




This research cluster includes both psychosocial exposures and psychiatric outcomes. The creation of the Center for Trauma and Mental Health crystallized the department’s strength in these areas. Our scholarship encompasses challenging conventional narrow definitions of trauma and mental health (i.e., extending beyond DSM/ICD diagnostic codes), understanding the myriad health effects of individual and mass trauma, and evaluating how social and psychosocial adversity, including exposure to racism and other stressors, influences mental and physical health outcomes. The department’s faculty use exceptional data sets and collaborative efforts to conduct work that would not otherwise be possible, such as understanding the health consequences of having a family member die by suicide.

Infectious Disease Research

Faculty Lead

Faculty active in cluster


The department has cutting edge research in tuberculosis, HIV, and COVID and faculty collaborate on critical epidemiologic modeling projects to predict the trajectory of epidemics and generate resources for allocating resources to mitigate the impacts. Much of the research focuses on HIV as this has been a leading cause of infectious disease morbidity and mortality for the last thirty years. Dr. Fox’s work in South Africa seeks to use novel observational datasets and clinical trials to identify ways to improve outcomes on and access to HIV treatment. Tuberculosis, which accounts for roughly 1.5 million deaths globally each year and is a major contributor to antimicrobial resistance, is another area of strength within the department. Dr. Martinez focuses much of his work on the strong intersection between social vulnerability and infectious diseases, for example among incarcerated populations who are especially adversely impacted by infection. Dr. Martinez works on TB control in incarcerated and other high-risk populations, optimizing screening programs, developing core infrastructure and research tools to monitor changes in population burden of TB, and on evaluating the long term adverse effects of TB infections in children. This research directly informs policies to reduce TB burden and inequalities. Department faculty have been heavily involved in epidemiologic research around the COVID epidemic. Dr. Murray worked on a highly influential paper in the New England Journal of Medicine on the effects of lifting universal masking mandates in schools on COVID transmission and demonstrated increased transmission associated with the change using novel methods for causal inference.

Aging and Chronic Diseases Research

Faculty Lead (interim)

Faculty active in cluster

Via strong links with the Framingham Heart Study and other studies, the department has historically been a leader in cardiovascular disease and stroke (Hwang). Additional work centering the experiences of Black women and seeking to fill the historical gap in research on the drivers of health in Black women draws on the Black Women’s Health Study to evaluate risk factors for cancer, sarcoidosis, inflammatory bowel disease, and myriad other chronic conditions (Cozier, Healey). Several outstanding research projects related to Alzheimer’s Disease and dementia are also housed in the department, with faculty including Drs. Jimenez (environmental exposome and dementia), Hwang (novel measurements of dementia risk, and behavioral risk factors for dementia), and Weuve (noise and dementia, research methods and dementia). Research into the causes of kidney disease occurring among young agricultural and other manual laborers throughout Central America focuses on both environmental and genetic contributors (Brooks).

Reproductive, Perinatal, Gynecologic, & Developmental Epi

Faculty Lead

Faculty active in cluster


The department hosts field-leading research on fertility (notably via the PRESTO study and considering both male and female contributions); women’s health (the SELF cohort focusing on uterine fibroids, research on menstruation and menopause); adverse birth outcomes (eclampsia, birth defects, stillbirths); gynecologic outcomes (e.g., vulvodynia); and determinants of health and flourishing of individuals with developmental disorders, e.g., Down Syndrome. In the past year, department faculty have published extremely important work about the effects of COVID-19 vaccines on fertility and miscarriages, while continuing their ongoing work on diverse determinants of fertility. Department faculty (Rubenstein, Weuve) are also using Medicaid data to better understand the health needs of people living with Down Syndrome and, in collaboration with a co-research team of individuals with and without Down Syndrome, are delivering critical evidence on the long-term health of individuals with Down Syndrome.

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