The University of Michigan Thursday announced a three-year, $1.4 million federal grant to establish the UM School of Public Health Children’s Environmental Health and Disease Prevention Center, and a $2.25 million dollar federal grant to expand its preventive medicine residency to help combat an estimated 35,000 shortfall of primary care physicians expected within 10 years.
The children’s center will study exposure to certain toxins, or so-called obesogens, during pregnancy to determine if and how these toxins contribute to child obesity or change the timing of puberty.
The center has an engagement plan both in Michgian and Mexico. Obesity is a problem in both regions. A 2009 report by Trust for America’s Health and the Robert Wood Foundation deemed Michigan the home to the ninth highest percentage of obese adults in the country.
The study of obesogens is not new, but the SPH study is one of the only few that will have data tracking the effects of toxins on the same children from birth into school years and adolescence. Obesogens are chemicals that are thought to contribute to obesity by disrupting normal processes in the body, and this long-term perspective is critical to see how obesogens may affect the risk of a child developing obesity, diabetes, and other chronic diseases later in life, said Karen Peterson, principal investigator of the new center and director of UM SPH’s Human Nutrition Program.
Specifically, researchers will examine the effects of early exposure to lead, bisphenol A, and phthalates on children’s weight gain, BMI, development of obesity during pre-school and school years, and on pubertal timing. Using animal and human studies, researchers also will explore epigenetic mechanisms that could shed light on how toxins may influence child growth and maturation. The term epigenetics refers to heritable changes in gene expression — for example, genes associated with physical growth — which are caused by something outside the gene, such as toxins or nutrients.
Peterson said the community engagement portion of the plan aims to educate and inform study participants, policy makers and public health decision makers on children’s environmental health exposures.
The physician training grant, meanwhile, was the largest in the country.
“I consider this new funding as a validation of our program as one of the best nationally, and will permit us to expand to a full complement of 12 physician residents over the next three years,” said Matthew Boulton, director, Preventive Medicine Residency program and professor in the School of Public Health. Boulton also has an appointment in the UM medical school.
At 41 years old, the UM SPH houses one of the oldest preventive medicine residency programs in the country. Its mission is to train physicians for careers in public health, clinical preventive medicine, medical epidemiology and health administration.
“Generating an adequate number of primary care physicians is a problem nationwide and Michigan is no exception,” Boulton said. One of the aspects of the SPH grant proposal that resonated with Health and Human Services’ Health Resources and Services Administration, which administers the grants, was having residents rotate through HRSA funded Community Health Centers in Lansing, Jackson and Detroit, which provide care to poor and underserved residents. We committed our residents to spending at least three months of their training providing primary care services in those settings. HRSA really liked the idea and we are excited to embark on this new partnership with the CHCs.”
Boulton said physicians interested in board specialization in general preventive medicine and public health should consider the SPH two-year residency, which has available MPH tracks in epidemiology, health behavior/education, health management/policy, and environmental health sciences.
The money will fund 82 accredited primary care residency training programs to increase the number of residents trained in general pediatrics, general internal medicine, and family medicine. Grant recipients will use the 5-year grant to provide stipend support for new enrollees in 3-year primary care residency training programs. By 2015, the program will support the training of 889 new primary care residents over the number currently being trained and more than 500 of these residents will have completed their training.
The money is part of $320 million in awards announced in September by HHS Secretary Kathleen Sebelius to strengthen the health care work force. Of that, $253 million will go to improve and expand the primary care workforce under the Prevention and Public Health Fund of the Affordable Care Act. Another $67 million in Health Profession Opportunity Grants will provide low-income individuals with education, training and supportive services that will help them prepare to enter and advance in careers in the health care sector.
For more on the Residency Program in General Preventive Medicine and Public Health: http://practice.sph.umich.edu/practice/pmr.php.
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