Medical researchers must work together across disciplines to provide better health care to those who need it most, according to panelists at Stanford Medicine’s Annual Population Health Sciences Colloquium.

The symposium, hosted by the Stanford Center for Population Health Sciences, brought together working groups from across the Stanford campus to showcase the latest findings in population health research.

“Population health science at Stanford is likely to make the most important contributions when we cross traditional intellectual expertise disciplines,” said Paul H. Wise, a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research (CHP/PCOR).

Many of the scholars at the daylong conference on Tuesday stressed that an interdisciplinary approach to health care is crucial to understanding and aiding underserved populations.

“To deal with life-course questions we need to create-life course observational windows,” said Mark Cullen, chief of the Division of General Medical Disciplines and director of the Stanford Center for Population Health Sciences.

Instead of trying to create an all-encompassing care plan for the human population as a whole, panelists demonstrated that studying the needs of particular groups, or smaller populations, can better serve individuals within populations that may not receive the best care.

Douglas K. Owens, director of CHP/PCOR, said the U.S.  Preventive Services Task Force, of which he is a member, has “often faced a real paucity of data trying to develop prediction guidelines for both the very young and the old.”

The Task Force, a panel of experts that makes recommendations for medical prevention services, is generally able to make guidelines for large populations like adults, but suggestions for specialized groups like children and the elderly are more challenging. Though Stanford researchers like Wise are working to improve care for particular sectors like children, more study is needed.

Several speakers at the conference said the underserved population of poor children could benefit from research targeted toward their population group.

“We don’t really understand the biology of the life-course, why things taking place in gestation and early life actually affect healthy aging and adult onset disease,” said Wise, adding, “We have a very poor understanding of how to translate this understanding into effective interventions for communities in need.”

Panelists agreed that big data can help them understand smaller, poorly served populations, such as young children in impoverished communities. By collecting large amounts of data from the general population, researchers will increase the amount of data available for more specific groups. This allows researchers to study these populations more closely and help create better outcomes.

Abby King, a professor of health research and policy and of medicine, and Jason Wang, director of the Center for Policy, Outcomes and Prevention (CPOP) and a CHP/PCOR core faculty member, believe life-course digital applications can provide individualized care while collecting data on a large-scale.

According to King, a life-course app, or a device to track health and provide care throughout one’s life, would grow with the user and help them through important developmental stages.

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Health-care techniques using mobile devices, known as mHealth, could be particularly useful in underserved populations. King notes that even low-income populations have cell phones, so using phones as health-care tools could help decrease the gap between higher- and lower-income populations.

“I think for us one of the major challenges of the century is to really close that health-disparities gap and mHealth can help.”

However, each app must be tailored to the user.

“There’s no reason to believe that an African-American 16-year-old is going to be motivated the same way as a 45-year-old white man,” said Wang. “You need to involve patients in the design of the app.” When the app fits the specific patient’s needs, they are more likely to use it regularly, and knowing the needs of their population helps determine their preferences.

As the world continues to become more connected, the panelists said that reaching across disciplines and incorporating technology may hold the key to effective health care in the 21^st century.

The new European Security Initiative at Stanford will examine the long-term policy issues and trends in Europe's changing geopolitical landscape, especially given Russia's growing aggression in the region.

First, it was the 2014 annexation of Crimea. Then, it was the intervention in eastern Ukraine. Most recently, airstrikes and naval cruise missiles are hitting targets in Syria.

What, many are wondering, is Russian President Vladimir Putin up to?

Russia's spate of aggressive tactics has thrust Europe into a new era of uncertainty and has raised pertinent policy questions that Stanford scholars have set out to explore more deeply with the launch this fall of a new European Security Initiative (ESI).

The working group of a dozen senior faculty members – whose breadth of expertise in Russian and Eurasian affairs spans multiple administrations – portrays Russia's actions as constituting the greatest challenge to European security and stability since the end of the Cold War. At the same time, Russia's own unstable economy and political landscape complicate the matter; policy changes moving forward will be high-stakes decisions, as Russia and the West step into a period of sustained competition.

Stanford, with its heavyweight lineup, is poised to play a role. The European Security Initiative – formed by the Freeman Spogli Institute for International Studies (FSI), the Europe Center, the Hoover Institution and other university partners – will serve as the collaborative framework for the policy research.

"Policymakers in Washington have to react immediately to events in the world, making it difficult to develop longer-term strategies for dealing with ongoing challenges," said FSI's director, Michael McFaul. "At Stanford, we have the luxury of being able to think about longer trends and then recommend more enduring strategies to our colleagues in government.

"We also have deep expertise on Russia and Europe, which assigns us a special responsibility to tackle these new challenges to European security."

The initial group of Stanford faculty involved in the initiative includes: McFaul, former U.S. ambassador to Russia and a professor of political science; Condoleezza Rice, former U.S. secretary of state and a professor of political science; international studies Professor Coit Blacker, former special assistant to President Bill Clinton and director for Russian, Ukrainian and Eurasian Affairs on the National Security Council; David Holloway, professor of history and of political science, and one of the world's leading authorities on Russia's nuclear weapons program and defense policies; and Kathryn Stoner, an expert on Russia's governance and political economy and a senior fellow at FSI. 

Analyzing Russia's actions

One of the first objectives of the initiative is to understand the nature of the conflicts at hand and develop theories on Russia's domestic and international intentions.

For example, is Putin trying to re-establish Russian dominance over former Soviet states? Is he trying to distract internal constituencies from an array of domestic problems? Depending on the answers, the initiative's faculty members say the United States would have to pursue different policy options.

Working group discussions and a series of public events featuring key figures in U.S.-Russian and European policy will facilitate the Stanford-based dialogue and help broaden the academic discussion among students.

In September, for instance, ESI launched the new academic year with a talk at the Europe Center by Anders Fogh Rasmussen, who was at the center of European and global politics as the former secretary-general of NATO.

Other fall quarter ESI events, past and upcoming, include an Oct. 14 talk by Sergey Aleksashenko, a former deputy chairman of the Russian Central Bank; a Nov. 2 visit by Vladimir Milov, the former Russian deputy minister of energy; and a Nov. 9 visit by General Philip M. Breedlove, supreme allied commander, Europe. 

Students, scholarship

In addition, Stanford students are showing a growing interest in Putin's actions and the unfolding refugee crisis in Europe. Applications for new student fellowships on European issues in Brussels this past summer far outstripped the six spaces available. To capitalize on this renewed interest, the initiative will involve students through events, new fellowships and a new seminar.

The initiative aims to rebuild scholarship in an area of academic interest that waned as the Cold War ended.

"At the end of the Cold War, many thought that we no longer needed to study Russia. I myself even stopped teaching courses on Russia and Eastern Europe," McFaul said. "That was a mistake." He noted that Stanford is ideally positioned to seed a new generation of expertise on Russia and Europe.

FSI provided the startup money to create the initiative, but it will be looking for funds to sustain the program.

This article was originally published in The Stanford Report on October 28, 2015.