For our faculty, investigating women's health is more than just another day at the office; it’s a calling.
For more than 20 years, scientific findings have clearly demonstrated that sex-based differences in physiology and disease development go far beyond the reproductive system. Among these differences are rates of illness, causes of death, ways that medications are metabolized, lifestyle-related health issues, use of health services, and experience of disease.
Lewis H. Kuller, MD, DrPH, Distinguished University Professor of Public Health and former chair of the Department of Epidemiology, is nationally recognized for his contributions to the study of cardiovascular disease and the use of non-invasive technologies like ultrasound to detect early heart disease before symptoms appear. Much of what is known about heart disease risk factors—particularly among women going through menopause—can be attributed to Kuller's work over the past 30 years. Begun in 1983, the Healthy Women Study has led to the evaluation of new imaging techniques, psychosocial factors, hormones, and development of cardiovascular risk from pre- to post-menopause. The study has identified key determinants for prevention of heart disease among women.
In January 2010, a research team led by Kuller also reported that high blood pressure—a significant cardiovascular disease risk factor—may put women at greater risk for dementia later in life by increasing white matter abnormalities in the brain. The study, reported online in the Journal of Clinical Hypertension, is part of the multisite Women’s Health Initiative Memory Study, an ancillary study of the national and long-term Women’s Health Initiative (WHI), in which Kuller's research team has also been involved.
WHI studies are credited with dramatically changing attitudes toward routine use of hormone-replacement therapy (HRT) for treatment of menopausal symptoms. In 2002, reports associated HRT with increased risks for breast cancer, stroke, and heart attack. As a result, guidelines now advise women undergoing normal, non-surgical menopause to use the lowest effective dose of HRT for the shortest period of time possible.
At Pitt Public Health, however, expertise in sex-based research encompasses a lifespan of women’s health concerns. Jane A. Cauley, DrPH, professor of epidemiology and vice chair for research, is a principal investigator of Pitt's component of the National Children’s Study, an ambitious multi-year research project examining environmental influences on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. In late 2010, the study is expected to begin recruiting participants in Westmoreland County.
“Pitt Public Health is really in front not only with the breadth of research, but also with the novel research questions being investigated in women’s health,” said Cauley, who is internationally known and frequently sought for her expertise in osteoporosis and bone health.
Pitt Public Helath faculty members also have made significant contributions to the National Surgical Adjuvant Breast and Bowel Project (NSABP), with which the school has long been affiliated. For example, among many women’s health improvements discovered through NSABP, the anti-estrogen drug tamoxifen is now routinely used to help prevent breast cancer recurrence because of NSABP studies, notes Joseph P. Costantino, DrPH, professor of biostatics and director of the NSABP Biostatistical Center. The drug has also been approved by the Food and Drug Administration for use to help prevent breast cancer in women who are at high risk for developing the disease.
Several Pitt Public Health investigators have been supported through the highly competitive National Institutes of Health-funded Building Interdisciplinary Careers in Women’s Health program, including Lisa Bodnar, PhD, MPH, RD, assistant professor of epidemiology. Bodnar’s current projects seek to quantify links between maternal nutritional status—particularly vitamin D levels—and birth outcomes.
Other notable Pitt Public Health investigators examining women’s health include:
- Catherine L. Haggerty, PhD, MPH, assistant professor of epidemiology, is principal investigator of four National Institute of Allergy and Infectious Diseases-funded projects examining the role of infection and inflammation in adverse reproductive and pregnancy outcomes. Her research could shape future screening and treatment for women at high risk for pelvic inflammatory disease.
- Anne B. Newman, MD, MPH, chair of the Department of Epidemiology and director of the Center for Aging and Population Health, has research interests in many areas of health and aging, including the epidemiology of cardiovascular disease and the associations of subclinical atherosclerosis with aging, disability, and frailty.