Uncharted territory

What do a geospatial scientist with an economics background and a medical anthropologist have in common? At UT Southwestern, both are in the new Department of Population and Data Sciences and are examples of the institution’s reach into less traditional fields of study.

Drs. Amy Hughes (left) and Simon Craddock Lee

Dr. Amy Hughes, the geospatial expert, was working toward a doctorate at UT Dallas, thinking she would probably become a stock analyst. That’s when a UT Southwestern researcher looking for someone trained in a special kind of analysis opened her eyes to a different career path.

For Dr. Simon Craddock Lee, who wanted to be an art curator before opting to be a medical anthropologist, having one of the nation’s premier public medical institutions – Parkland Memorial Hospital – nearby was the draw.

The expertise of researchers like Drs. Hughes and Lee allows UT Southwestern to expand into new areas of study and contribute to the growing dialogue about how best to address community health problems and cancer care disparities, says Dr. Carlos Arteaga, Director of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern.

“Physicians must be mindful of and work to reduce risk factors that affect not one, but many of their patients and those at risk of developing cancer.”

Dr. Carlos Arteaga

“Public health issues will play an increasingly important role in our national health care and funding discussion,” says Dr. Arteaga, Associate Dean of Oncology Programs and Professor of Internal Medicine. “Astounding advancements are bringing new cures for many once-fatal cancers, and those advancements must be made available to all. Physicians must be mindful of and work to reduce risk factors that affect not one, but many of their patients and those at risk of developing cancer.” 

Change of outlook, venue

Dr. Hughes was in the process of switching from a doctoral program in economics to geospatial information sciences – which uses technology to collect and analyze geographical data – when Dr. Sandi Pruitt approached her for help with a study.

Dr. Pruitt, Associate Professor of Population and Data Sciences and the first population scientist recruited to a UT institution with an award from the Cancer Prevention and Research Institute of Texas (CPRIT), needed a geospatial scientist to study how the location of patients’ homes and other factors affected whether they got cancer screening.

“I frequently say it’s the best thing that ever happened to me,” says Dr. Hughes, who arrived at UT Southwestern as a Research Assistant in 2012 and joined the faculty as an Assistant Professor of Population and Data Sciences in December after earning a Ph.D. in geospatial information sciences from UTD.

Life expectancy by ZIP code in Texas interactive map

Now, instead of economics research, Dr. Hughes pulls together patient treatment and address information from electronic health records and combines that with U.S. Census and other neighborhood data to study what geographical factors affect a patient’s health care.

In one recent project, she teamed up with Dr. Pruitt again to create an interactive map showing life expectancy in Texas by ZIP code, broken down by race and sex.

Last year, Dr. Hughes became the first nonclinical scientist chosen as a Texas Health Resources Clinical Scholar at UT Southwestern. The honor comes with $750,000 over three years to advance her research, which Dr. Hughes is using to look at neighborhood and local environmental risk factors for diabetes and for poorly controlled asthma that results in repeat hospitalizations. She also plans to study how frequent household moves and health insurance gaps affect patients dealing with two or more chronic diseases – known as comorbidities.

Good neighbors

Location came into play in a big way for Dr. Lee as he considered coming to UT Southwestern – specifically having one of the nation’s top public safety-net hospitals nearby.

Dr. Lee, an Associate Professor of Population and Data Sciences, earned his master’s in public health from the University of California, Berkeley before getting his doctorate in medical anthropology from a joint program at that institution and UC San Francisco.

As UT Southwestern’s only medical anthropologist, Dr. Lee focuses on the delivery of health care to low-income patients like those served by Dallas County’s Parkland Health & Hospital System.

Dr. Lee is a social scientist who uses qualitative research methods – gathering information via patient and provider interviews, focus groups, and clinical and community observations – to study patients and the communities where they live.

“The outcome of your research should be more than a journal article. The outcome of your research should be a positive change in the world based on that new knowledge.”
Dr. Simon Craddock Lee

His field has gained prominence in recent years as researchers have uncovered differences in cancer survival rates associated with race and access to health care, a particular problem for people in rural areas. He now co-leads the Harold C. Simmons Comprehensive Cancer Center’s Population Science and Cancer Control Program.

Digging for knowledge

Dr. Lee uses his knowledge as a medical anthropologist, his training in public health, and his time as a postdoctoral fellow at the National Cancer Institute to analyze and improve how cancer care is delivered.

UT Southwestern mobile mammography unit

In one project underway, Dr. Lee studies how UT Southwestern oncologists and Parkland physicians coordinate cancer treatment and primary care to make sure cancer patients’ other health problems don’t get overlooked as they undergo chemotherapy and radiation. The study will determine if strategies being tested improve medical outcomes and patient experiences.

In another effort, Dr. Lee’s team evaluated a new model for delivering breast cancer screening to underinsured women in rural Texas counties lacking public health systems like Parkland. The program has evolved from mobile mammography units on specially designed 18-wheeler trucks to also include a network of community clinics and hospitals to help women receive screening and follow-up care.

With support from CPRIT and other state funding, the program now covers 35 North Texas counties. Using geospatial data, Dr. Lee is working with Dr. Hughes to broaden the program’s reach by calculating whether to contract with local facilities or schedule mobile mammography in a given community.

Outreach efforts target 35 North Texas counties.

Using science to improve delivery of care is important, Dr. Lee says. UT Southwestern is trying to help its physician partners think not just about the patient in front of them, but also the whole panel of patients they take care of, and then the communities those patients come from as well, he says.

Translating medical research findings into benefits for patient care faster is another of his goals.

“The outcome of your research should be more than a journal article,” Dr. Lee says. “The outcome of your research should be a positive change in the world based on that new knowledge.”                  

Dr. Arteaga holds The Lisa K. Simmons Distinguished Chair in Comprehensive Oncology.