Heritage College welcomes population health cluster faculty focused on social determinants of health

Ohio University’s Heritage College of Osteopathic Medicine has welcomed three new faculty members as part of a new population health cluster hire focused on researching social determinants of health.

The new hires are Graciela Muniz-Terrera, Ph.D., Osteopathic Heritage Foundation Ralph S. Licklider, D.O. Endowed Professor in Health and Aging and a professor of social medicine; Allyson Hughes, Ph.D., assistant professor of primary care; and Ángela Gutiérrez, Ph.D., MPH, assistant professor of social medicine. Each new faculty member brings a different type of experience and research focus to the Heritage College, all with the same ultimate goal – to conduct research on ways to help members of society who often get overlooked in health care.

The three faculty members hired in as a cluster – the third cluster hire the University has completed – and – will work with the Ohio Musculoskeletal and Neurological Institute (OMNI) and the Diabetes Institute.

“Population health research is interdisciplinary, meaning it touches a lot of fields and is a complement to the University’s health-oriented research institutes,” Darlene Berryman, associate dean for research and innovation and professor of biomedical sciences, said. “For that reason, and also because this type of research generally concentrates on health outcomes, we saw potential for the researchers to be a bridge between the college’s strong research program in basic sciences and our efforts to look after the health and well-being of the communities we serve.”

Muniz-Terrera’s research focuses on aging and brain health, including dementia, as well as studying the modifiable risk factors for cognitive and physical decline in older adults.

After she started studying mathematics and statistics in Uruguay, she realized that what she enjoyed most was solving real life problems through the analysis of data. She earned her Ph.D. in statistics from the University of Cambridge. While working on her doctorate, Muniz-Terrera focused on trying to understand healthy aging and what can be done to help support healthy aging. She also wanted to understand and tailor recommendations to improve health based on an individual’s situation and lived experience.

“To me, the way forward in this field is through evidence-based research and the continued development and use of improved methods of investigation,” Muniz-Terrera said. “So to have a background in statistics and be able to look at results is integral to the research we do and will do together.”

Prior to coming to OHIO, Muniz-Terrera served as a senior lecturer in biostatistics and epidemiology at the Centre for Dementia Prevention at the University of Edinburgh, where she worked with others to research aging and brain health initiatives across the university and Europe. She co-led the Integrative Analysis of Longitudinal Studies of Aging, a project involving an extensive network of international collaborators, and is currently involved in BrainLat, a new initiative investigating brain health in Latin America.

Before working in Edinburgh, she was also a lecturer at University College London (UCL) and a program leader at the MRC Lifelong Health and Ageing Unit at UCL. She also worked for several years in Cambridge with the MRC Biostatistics Unit.

Muniz-Terrera wanted to be a part of this cluster hire for the chance to work with other experts on aging but also to be a part of the Athens community.

“It was nice to get here and already have people who I could talk with about research,” said Muniz-Terrera.

One of her ongoing projects includes studying how an individual’s personality traits may make them more likely to engage in behaviors that could affect their risk of dementia later in life. For example, people who enjoy playing contact sports may have an increased risk of dementia later in life due to a sports-related traumatic brain injury. However, people with personality traits that make them more prone to engage in healthy behaviors, such as healthy eating and regular exercise, can have a lower risk of dementia.

While working in Scotland, Muniz-Terrera gave public lectures in rural areas to help people understand ways they can stay healthy and is hoping to bring this idea to the Athens community too.

Her research has been supported by the Medical Research Council, the Alzheimer's Society, the National Institutes of Health and various other funding organizations.

Hughes is a behavioral medicine expert who has worked in academia and for nonprofit organizations and has partnered with pharmaceutical companies to understand patient perspectives of post market drugs and disease management. Her research in diabetes and behavioral medicine focuses on the psychosocial challenges of diabetes management, including health equity regarding severe hypoglycemia, diabetes distress, diabetes complications and disability. She also advocates for health policies that give people with diabetes and their families a voice and more accessibility to care.

Hughes’ interest in disease management piqued when she was diagnosed with type 1 diabetes at an early age.

“What I noticed was that not all of us were thriving despite having the same resources,” Hughes said. Her goal is to apply her lived experience, the data she collects, and best clinical practices to transform the health care experiences of others.

Before coming to OHIO, Hughes worked for a non-profit in Boston, collecting data from people with diabetes. She has also done advocacy work that addresses how people with blindness and diabetes handle diabetes self-management, what health care provider relationships look like, and has examined data from children’s hospitals to determine if diabetes prevention used there is evidence-based. She received a master’s degree in clinical psychology and a doctorate in health psychology at the University of Texas at El Paso.

Hughes’ current research looks at aging populations with diabetes as well as the language health care providers use when treating people with diabetes.

She is currently building her lab and a team for the summer, as well as mentoring students who are interested in health policy and advocacy and providing resources and opportunities for students to conduct research. She says she wants to help students understand what chronic disease looks like. She feels that OHIO has created a caring environment focused on ensuring students are successful both at school and after they graduate.

“Coming here and working in that type of environment has been a positive experience,” Hughes said. “It’s been really cool to work with the students.”

Gutiérrez’s research focuses on improving health outcomes and quality of life among racial and ethnic minoritized populations – populations that have been forcibly marginalized, devalued or mistreated and typically have less access to resources, relative to other groups. She is interested in risk and resilience among older Latinxs and other racial and ethnic minoritized groups with chronic health conditions; community-based and culturally informed research among under-resourced communities in Mexico, California and Ohio; and workforce diversity in health-related sectors.

“I’m looking at the direct factors contributing to wellbeing among these populations, mental health and physical health outcomes, and measuring accelerated aging over the lifespan,” said Gutiérrez, who completed her doctoral training in community health sciences at the University of California, Los Angeles Fielding School of Public Health and has formal training in public health policy, sociology and education.

She previously worked in rural Mexico implementing and evaluating a diabetes self-management program. More recently, she explored promotoras’ (subset of community health workers) experiences as members of the public health workforce. She is also investigating recruitment science in Alzheimer’s disease and related dementias and cognitive function among Latinxs. For example, in a study published in “Gerontology and Geriatric Medicine,” she recently documented the role of the digital divide in widening disparities in recruitment of Latinxs for dementia research.

Gutiérrez was introduced to these lines of research after majoring in sociology and taking a social stratification course that opened her eyes to patterns that she had seen growing up, where some individuals tend to experience a higher burden of chronic health and other disadvantages. The course gave her the knowledge and skills to systematically explore health disparities, now the foundation for her research, which she plans to continue in collaboration with her fellow cluster hires.

“I’ve made the argument before that cluster hires are important for enhancing diversity and social support, so I’m truly gratefully to be a part of this cluster hire and to begin working with Drs. Muniz-Terrera and Hughes on projects focused on aging,” she added.

Currently, Gutiérrez is collaborating with fellow Heritage College professor Berkeley Franz, Ph.D., an associate professor and Osteopathic Heritage Foundation Ralph S. Licklider, D.O., Endowed Faculty Fellow in Population Health Science, on a paper that documents strategies hospitals use for diabetes prevention outreach. They are looking at whether these strategies use evidence-based approaches and whether they are focused on individual-level or community-level factors.

“So far Ohio University and HCOM have been very welcoming and collaborative, which makes HCOM stand out, relative to other places. I’m excited for the support provided and the infrastructure already in place to help us succeed,” Gutiérrez said.