People-Centered Science

These statistics represent individual lives that can be changed. For researchers like Monti, a new strategy for recovering from alcohol use disorder could mean a family that isn’t missing a parent. It could mean a spouse that isn’t gone too soon. And as our understanding of alcohol dependence advances, it is translated into work that helps scientists better treat other forms of addiction—like to tobacco or opioids—leading to impact at an even wider scale. 

That kind of reach touches individual lives, changes entire communities and is the type of people-centered mindset that flows through all of the research at Brown’s School of Public Health, said Jennifer Tidey, associate dean for research. “It’s hardwired into our ethos.”

The Research Landscape

Identifying solutions to perplexing public health challenges is a labor-intensive endeavor. Health recommendations and approaches need to be backed by rigorous evidence, with data that has been thoroughly reviewed, analyzed, critiqued and refined. To that end, Brown’s public health faculty and research staff dedicate over 600,000 hours to research endeavors over the course of a single year, amounting to over 1,000 studies published in peer-reviewed journals annually. 

That level of research investment is funded by a mix of institutional funding, gifts from individuals and foundations, and state and federal grants. Federal grants, primarily from the National Institutes of Health, have traditionally made up most of the School of Public Health’s research funding. It has been part of the federal government’s decades-long investment in life-saving science in medicine, safety and technology—a model, born from the urgency of World War II, that became a central pillar of American progress, prosperity and global leadership.

“The United States made a deliberate choice in the second half of the 20th century to back science and welcome talent from around the world,” said Dr. Ashish K. Jha, dean of the School of Public Health. “That decision built industries, made America the world’s technological and economic powerhouse and improved the health of millions.”

Today, that model is under pressure, both from the federal government and from Americans who question the value of academic research. A 2023 Pew Research Center survey found that only 57% of Americans say science has a mostly positive effect on society, down from 73% in 2019. That lack of confidence extends to higher education as well. Fewer than half of Americans have “a great deal” or “quite a lot” of confidence in higher education, with 23% having little or no confidence, according to Gallup.

Following a series of presidential executive orders and federal agency actions, public health and biomedical researchers across the country—and here at Brown—have faced grant terminations, funding freezes and proposed cuts to indirect costs that support the ongoing research enterprise. Vital projects have been delayed, downsized or cut altogether. While the University reached a voluntary agreement with the federal government in July to reinstate funding for federally-sponsored health and medical research, the justifications for the disruptions were particularly painful for many of the scientists affected.

“What cut deep was reading the words in the termination notice that suggested my work wasn’t real scientific inquiry,” said Katie Biello, professor and chair of epidemiology. Biello, who studies HIV prevention strategies, had two grant projects cancelled—one a pilot study in Brazil to help people stick to their HIV medications, and another a large multi-site trial examining stimulant use and HIV risk among youth—before they were later restored through court order.

Now, as Congress weighs proposed cuts to NIH funding and continued threats of cuts to universities’ indirect research costs, collective uncertainty hangs over the future. Some researchers express concerns about the setbacks delays could have on results, while others worry about the types of studies that will or won’t be funded.

But even as uncertainty lingers, conversations with several Brown researchers reveal deep resilience anchored in the same purpose that drew them to public health in the first place—to confront urgent health challenges and ultimately improve lives.

“Periods of uncertainty test any research enterprise,” Jha said. “But they also sharpen our focus and remind us why the work we do matters and who it’s meant to serve.”

Research at Scale

The work of Brown’s public health researchers can be felt in homes, hospitals, federal halls and international organizations around the world. Their scholarship has guided new policies, informed public debate and expanded understanding of how complex health challenges—from addiction to environmental hazards—impact communities, societies and people’s lives today and in the future.

Take the New England Family Study. Now led by Brown epidemiologist Stephen Buka, the project has been following families across three generations to study how late-life health traces back to what happened in the womb. The one-of-a-kind project has advanced scientific understanding of the development and treatment of cancer, heart disease, depression, schizophrenia and substance abuse. It is also directly contributing to the development of new diagnostic tools and therapies on conditions ranging from depression to the risk for Alzheimer’s disease that affect millions of Americans across the country. 

A more recent project by health policy researcher and biostatistician Alyssa Bilinski exposed major gaps in drug trial data for pregnant people. Another study she led revealed how flawed data collection masked the pandemic’s true toll on maternal mortality. New work from health economist Irene Papanicolas shows how the richest Americans live only as long as the poorest Europeans. These studies sparked new discussion about our nation’s healthcare system.

Researchers in the Center for Alcohol and Addiction Studies have devoted decades to expanding our understanding of not only alcohol, but nicotine use, which contributes to hundreds of thousands of deaths in the U.S. each year. One study looked at smokers who switched to very low-nicotine cigarettes, showing they not only smoked less but reported fewer cravings and were more likely to try quitting. These findings helped lay the evidence for a policy proposal the FDA introduced to reduce nicotine levels in cigarettes, and are a reminder that this type of impact often builds over long periods of time, said Tidey, who helped lead the work.

“The value of public health is its ability to improve health at scale,” Tidey said. “It’s why many of the protections we take for granted—vaccines, smoke-free spaces, clean water—come from decades of public health research. Even if they go unnoticed, these changes don’t just happen. They are built on strong evidence that is used to shape policy that protects health and saves lives.”

Research that Responds to the Moment

Public health research often involves a simple question: What is hindering people’s ability to live long and healthy lives and how can evidence improve it?

When federal policymakers wanted a clearer picture of how the Trump Administration's new federal tax and spending bill could affect nursing homes across the country, they turned to Vincent Mor, the Florence Pirce Grant University Professor of Health Services, Policy and Practice. 

His team’s analysis found that the bill would likely make more than 600 nursing homes nationwide at risk of closure. The report added urgency to national debates about long-term care and helped translate how budget decisions directly impact people’s lives. “That’s 600 places caring for grandparents, stroke survivors and adults with disabilities,” Mor said.

“We have people at Brown doing these types of translational studies all the time,” added Mor, the former director of the Center for Gerontology and Healthcare Research. “The value of a sustained research infrastructure is the ability to answer pressing questions that matter to people’s lives in real time.”

This ability to quickly pivot, to take on emerging questions and turn them into actionable research, is a hallmark of Brown’s School of Public Health. Over the past five years, that adaptability has led to the development of several new research centers designed to respond rapidly to pressing public health challenges.

At the start of the Trump administration when government data sources on infectious disease were scaled back, Pandemic Center researchers expanded their reporting efforts on a weekly Tracking Report newsletter that provides free, timely updates on outbreaks worldwide. The newsletter, now with over 10,000 subscribers, has become a trusted resource for local health departments and policymakers because it not only aggregates data, but interprets it.

Amidst a rapidly shifting health policy landscape, and the critical challenges of health care coverage, spending and access, faculty in the Center for Health Policy through Research, have helped reshape the national conversation. Through their research, and by providing expert testimony to state and federal policymakers, Brown scholars have impacted debate on topics including saving Medicare, private equity’s growing role in healthcare, telemedicine and the healthcare affordability crisis.

Last spring, the school launched the Center for Climate, Environment and Health, a new hub uniting researchers from across disciplines at Brown to study how environmental stressors like noise pollution, changing urban landscapes, extreme heat, and air pollution impact human health. This work includes studying how clean air laws reduce asthma attacks in children and how exposure to everyday products can have harmful health effects.

“Our research tackles everything from overdose prevention to the health impacts of extreme weather—driven by a commitment to turn data into decisions that improve lives, whether across the street or across the globe,” said Francesca Beaudoin, academic dean and professor of epidemiology and emergency medicine. “The health and well-being of our communities is the most authentic measure of how healthy we are as a society.”

For the Community, with the Community

Contrary to the image of scientists stuck in a lab or behind a computer, research at Brown is increasingly out in the community. It also doesn’t stop when the data is collected or the paper is published.

For Erica Walker, assistant professor of epidemiology and founder of the Community Noise Lab, that’s how community-based research should always be done. Her current work includes monitoring noise pollution and air quality levels in Providence and across Mississippi and Alabama. Her projects, she says, go beyond measuring the environment and are really about aiding local communities. Walker is building infrastructure that will outlast her initial research and ensuring the data is publicly available so residents can make informed decisions about the air they breathe and noise around them.

“Researchers have to come in, not with an agenda, but with an attitude of service,” she said. “What can we do for you? We have all of these tools. We have all of this expertise. We have all of this knowledge. How can we leverage these resources to work on a problem that's meaningful for you? A lot of times, community studies unearth some sort of problem and then just leave, but we have to be there for the long haul.”

Researchers from the school’s People, Place and Health Collective (PPHC) share a similar approach. They are helping to prevent overdoses and improve recovery outcomes in Rhode Island and shaping evidence-based public health policy nationwide. They have led efforts testing street drugs for dangerous substances like fentanyl, mapped overdose hotspots to help first responders target aid and studied treatment approaches that could improve a person’s chances of staying in recovery. Most recently, they've been evaluating the country’s first state-sanctioned overdose prevention center in Providence. 

Importantly, the PPHC shares its findings publicly, through websites and social media, with those who can use it most.

“This is information for first responders, friends and family of people who are affected by overdose, and for people who use drugs themselves,” said Brandon Marshall, professor of epidemiology who founded the collective in 2021.

This community-based mindset extends far beyond Rhode Island. The chair of Brown’s Department of Biostatistics, Professor Joseph Hogan, for example, works with colleagues in Kenya to train local experts in collecting and using health data to strengthen African HIV prevention and treatment programs. For over two decades the partnership has empowered Kenyans to lead their own public health solutions. That kind of research, that remains rooted in communities, builds something deeper, more durable and more impactful to the people that it serves and touches. 

“Our research isn't just about communities; it's done with them,” Marshall said.

Staying Power

For Dean Jha, true progress in public health is driven and measured by the goal of improving people’s lives. That can take months, years, even decades, which is why public health demands steady, persistent effort. Boots on the ground. Researchers in the field and in the lab. Data and evidence gathered to generate insights that help people live healthier lives. 

“That commitment—is everything,” Jha said. “That kind of persistence is how progress happens. It’s how we make sure our research reaches the people and communities who need it most and leads to decisions that will save lives."