Chronic Disease Epidemiology

The Chronic Disease Unit is the largest unit within the Department of Epidemiology with an overarching goal to extend healthspan and lifespan and to reduce the chronic disease burden and associated disparities locally, nationally, and internationally. Research in the Chronic Disease Epidemiology Unit addresses the etiology, distribution, natural history, prevention, progression, and treatment of the following chronic diseases:

  • Cardiovascular disease
  • Cancer
  • Diabetes
  • Hypertension
  • Obesity
  • Alzheimer’s Disease and Dementia
  • Gastrointestinal and Respiratory Diseases
  • Psychological Conditions

Our faculty’s research programs encompass both observational and interventional studies. These studies extend from our local Northern Manhattan community to the broader five boroughs of New York City, and from the United States to international settings. Our interdisciplinary research studies integrate chronic disease epidemiology with lifecourse epidemiology, social epidemiology, clinical epidemiology, lifestyle medicine, behavioral medicine, and implementation science. Given that chronic disease encompasses a spectrum of communicable and non-communicable conditions with shared sociocultural, behavioral, and environmental risk factors, our faculty members collaborate extensively with other departmental units to elucidate innovative solutions for tackling complex public health challenges.

Our unit maintains and continues to expand impactful and collaborative research and training programs. Primary Columbia collaborators include the Herbert Irving Comprehensive Cancer Center; the Center for Behavioral Cardiovascular Health, the Robert N. Butler Columbia Aging Center, the Columbia Population Research Center, the Columbia University Diabetes Research Center, and the Departments of Environmental Health Sciences, Sociomedical Sciences, Biostatistics, Medicine, Neurology, Urology, and Psychology. We benefit greatly by drawing on expertise from many of our faculty members in the unit who hold appointments in various departments across Columbia University Irving Medical Center.

Selected Projects

Breast Cancer Studies

The Metropolitan Breast Cancer Study (https://www.metronyregistry.org/) is a family-based cohort study that has followed over 1,400 high-risk families in the greater Metropolitan New York area since 1995 and is part of a six-site NIH study, the Breast Cancer Family Registry (www.bcfamilyregistry.org). The study has collected DNA and cancer data on over 4,000 individuals and is now part of a prospective family cohort that includes over 30,000 women worldwide. The family-based registry continues to be used for genetic, epigenetic and other biomarker studies including nested case-control, sibling studies and intergenerational designs.

Our unit faculty have been at the forefront of leading large-scale studies within local mammography screening cohorts and national cancer cohorts, investigating breast biomarkers from imaging and other modalities, including studies aimed at the integration of mammographic breast density into breast cancer risk stratification, screening and chemoprevention. Additional research in this area involves U.S. birth cohorts and children and adolescent cohort studies, focusing on early life exposures and gene-environment interactions in relation to intermediate markers of breast cancer risk. This includes the prospective LEGACY Girls Study (www.legacygirlsstudy.org) of over 1000 girls with extensive data on growth, development, diet and lifestyle factors and the Breast Cancer and Environment Research, a consortium investigating environmental exposures and windows of susceptibility in the etiology of breast cancer (https://bcerp.org/).

Multi-level and Multi-generational Interventions to Address CVD and Cancer Inequities

The New York City COMMUNITY Center is 1 of 11 NIMHD-funded Health Equity Action Network Centers across the United States. The mission of the COMMUNITY Center is to reduce disparities in multiple chronic diseases in the New York City region, focusing on cardiometabolic disease and cancer, as the leading causes of death and premature mortality. The Center’s research encompasses projects focused on multidimensional sleep health for cardiovascular health equity promotion (The DREAM Study), the integration of sleep health into ongoing lifestyle change programs focused on diet and physical activity for improving health behaviors and cardiometabolic risk factors (The SLEE2BWELL Study), CVD medication adherence among cancer survivors (The IMPACT Study), and expanding colorectal cancer screening uptake and promoting healthy diet among African Americans (The CHURCH Study). To learn more about the COMMUNITY Center visit: www.health4allnyc.org

Lifestyle Medicine Studies

Our faculty lead evidence-based behavioral interventions grounded in the pillars of lifestyle medicine (healthy diet, sufficient restorative sleep, physical activity, stress reduction and social connectedness) to prevent, treat and manage multiple chronic diseases. For example, we are conducting the first-of-its-kind randomized clinical trial to evaluate how Food is Medicine approaches, particularly medically tailored meals and groceries, could improve type 2 diabetes and hypertension outcomes among New Yorkers living with multiple cardiometabolic morbidities and how to identify novel approaches to enhance the effectiveness and expand the reach of these programs.

Studies of Health Behaviors, Cardiometabolic Risk Factors, and Chronic Disease

Our faculty leverage big data approaches to understand the interplay of diet, sleep, and physical activity in chronic disease etiology and risk modeling within population-based cohort studies and national and international consortia. Examples include studies of dietary patterns and cancer risk, studies of multidimensional sleep and circadian health and cardiovascular risk modeling, and studies of the determinants of sedentary lifestyles and the role of physical activity in reducing obesity and diabetes risk across the lifecourse. In addition, our Unit’s research portfolio encompasses seminal studies to elucidate the intersection of health behaviors and cardiometabolic indicators in the pathogenesis of age-related chronic diseases such as cardiovascular disease, cancer, Alzheimer’s disease and related dementias.

The Multi-Ethnic Study of Atherosclerosis (MESA)

The Multi-Ethnic Study of Atherosclerosis (MESA) is a medical research study involving more than 6,000 males and females from six communities across the United States, including a field center in New York City at Columbia University. This cohort of middle aged to older Asian, Black, Hispanic, and White adults, was designed to study the characteristics of subclinical cardiovascular disease and has contributed extensively to our knowledge of the risk factors that predict progression from subclinical and overt cardiovascular disease, risk factors for stroke and other chronic conditions, and the interplay between cardiovascular risk factors and aging outcomes.

Affiliated Centers and Programs

Training Opportunities

The unit sponsors a highly popular certificate in Chronic Disease Epidemiology for MPH students. The Certificate in the Epidemiology of Chronic Disease provides a comprehensive foundation in etiology, distribution, risk factors, and epidemiologic methodologies to better understand and address complex chronic diseases. Students learn to describe the historical epidemiological transition and its impact on the global chronic disease burden, identify authoritative sources of chronic disease data, understand environmental, behavioral, and structural factors influencing multiple chronic diseases, and critique published research, focusing on study design, analytic methods, interpretation, and public health and policy implications. Faculty teach several courses within the Department, including Chronic Disease Epidemiology, Cancer Epidemiology, Cardiovascular Disease Epidemiology, among others.

Our faculty are nationally and internationally recognized experts who mentor graduate students and postdoctoral trainees in various subdisciplines of Chronic Disease Epidemiology to train the next generation of scientists and public health leaders. Faculty mentor doctoral students through Graduate Research Assistant positions and as part of the Department’s interdisciplinary training programs in Environmental Epidemiology, Psychiatric Epidemiology, and others. In addition to holding monthly seminars and collaborative meetings, the unit hosts an annual social event for faculty and trainees.

Unit Faculty

For more information about the chronic disease epidemiology unit contact Drs. Nour Makarem or Parisa Tehranifar.