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Family Medicine in the News.....
May 10, 2011
School of Medicine Signs Research Agreement with Shanghai Zhabei District Health Bureau
Case Western Reserve University School of Medicine has signed an unprecedented 10-year research agreement with the Shanghai Zhabei District Health Bureau to study how an increasingly westernized diet and a less active lifestyle are affecting the health of China’s residents.
Under terms of the agreement, researchers from the School of Medicine and Zhabei Health Bureau will track the health information of 48,000 children and adults in the Zhabei district over 10 years. They will study the prevalence of disease across multiple generations and the impact of environmental and genetic factors.
“This is among the largest community-based cohort studies ever and embodies a meaningful collaboration in an important part of the world,” said Pamela B. Davis, dean of the School of Medicine and vice president for medical affairs at Case Western Reserve. “What we learn will provide a critical understanding of how genetics, lifestyle, and environmental factors can adversely impact overall health, expanding our knowledge of many diseases, and how they evolve.”
The baseline data for the research are surveys of lifestyle and health information that have been collected from 48,000 Zhabei residents of all ages, together with blood and DNA samples from 23,000 participants ages 35 and older. Every two years, the data, which is linked electronically to health care centers throughout the district, will be updated to identify patterns that emerge, including common risk factors for disease.
In China, rapid economic development has brought about drastic lifestyle changes that are altering the disease spectrum in that country. Increased fast food intake, overeating and the adoption of more sedentary lifestyles have contributed to a rise in obesity, diabetes, heart disease, and cancer.
“The knowledge gained from the collaboration with the Zhabei Health Bureau will help identify potential risk factors for common diseases like cancer and will further our understanding of disease origins, in China, and across other countries and cultures,” said Li Li, associate professor of family medicine, epidemiology and biostatistics at Case Western Reserve School of Medicine; family medicine physician at University Hospitals Case Medical Center; and the study’s principal investigator. “Population studies like this establish a basis for future disease prevention and intervention initiatives.”
The newly signed research agreement expands the scope of a six-year collaboration that has existed between the Bureau and the School of Medicine around the education and training of family medicine physicians, a medical discipline that did not exist in China until recently.
Since 2005, School of Medicine faculty members have traveled to China several times a year to provide family medicine education and training. Physicians and researchers from Zhabei have likewise traveled to Case Western Reserve to participate in observational training. An annual family medicine/community health symposia held alternately in Cleveland and Shanghai has provided physicians and researchers from both countries the additional opportunity to understand and compare the U.S. and Chinese health care systems.
The Chinese Ministry of Health in 2009 designated the Zhabei District community health system as a model for identifying community health needs and developing health care delivery models. It was in this context that the director of the Zhabei Health Bureau, Guangrong Wang began working with the School of Medicine to develop a long-term strategic plan for the health bureau and establish a framework for large, population-based studies and delivery of family medicine services in China.
Between February and October 2009, the international research team completed the random survey of 48,000 permanent Zhabei residents, going door-to-door to gather information on their health histories. The survey was conceptualized and designed by Li and other researchers from Case Western Reserve, who collaborated with researchers from Zhabei and Fudan University, one of China’s oldest and most prestigious universities.
The information collected information on lifestyle and risk behaviors such as smoking, and incorporated data from physical exams, including weight and body mass index. Aside from a research tool, the resulting database serves as a baseline for the Chinese government’s policy making.
“The database is a gold mine of basic science and epidemiological information," said George Kikano, Dorothy Jones Weatherhead Professor of Medicine at the School of Medicine and chair of the Department of Family Medicine at the School of Medicine and University Hospitals Case Medical Center. “The research opportunities are enormous.”
In addition, the School of Medicine has signed a memorandum of understanding to establish a student exchange program with Fudan University School of Public Health and, Zhejiang University School of Medicine, a top notch research institution located in Hangzhou. The program will allow medical and public health students from the Chinese universities to come to the School of Medicine for observational training. Students from Case Western Reserve School of Medicine will likewise have the opportunity to travel to China to learn firsthand about the community health research initiatives underway.
The exchange program will be an important part of forging ongoing partnerships in Shanghai and Hangzhou for research, training of community-based primary care physicians, and student education, Li said.
The first group of Chinese students arrives in July.
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