Research Activities in the Department of Public Health Medicine
With the help of the burden of disease methodology it is possible to assess the global and regional burden of disease (morbidity and mortality) using Summary Measures of Population Health. A frequently used measure is DALY (Disability Adjusted Life Years) which represents the sum of Years of Life Lost (YLL) as measure of premature mortality and Years Lived with Disability (YLD) as measure of morbidity-related burden of disease. Through a sophisticated classification of disabilities that takes into account several dysfunctions (physical, mental, social), it is possible to weigh and score the specific disability that is relevant for a defined disease and its stage. The disease burden varies substantially between developed and developing countries with a much higher disease burden in the Global South. It was noticed that diseases that per se do not necessarily lead to death such as neuropsychiatric diseases (e.g. major depression) have a high impact on the disease burden of populations. Moreover it is possible to predict the future burden of disease for the world and its regions and evaluate intervention scenarios. The Department of Public Health Medicine will contribute to further development of the burden of disease methodology, e.g. in the field of infectious disease epidemiology which has been one of our longstanding interests.
In addition to other public health and epidemiological methods the burden of disease approach represents a major methodological tool for populations’ health assessments in various life worlds (settings, livelihoods) in research projects of the Department of Public Health Medicine (see figure). We will continue our work in the university setting with a focus on university students’ health (particularly mental health). Here we aim to extend our research further internationally beyond the European context in comparative studies including Asian university settings. Methodologically we increasingly use online tools for individualised health consultation and monitoring. Online tools are also used for occupational health promotion in settings like production and service industries. We will continue our work in the urban setting where we have assessed the health of populations in Asian megacities including slum populations in Dhaka, Bangladesh, and Chinese migrant workers. The impact of environmental risks such as air pollution on excess mortality and morbidity will be further evaluated, but also health promoting dimensions such as urban “green” and “blue” spaces will continue to play a major role in our research. Lately we are addressing nursing needs in North Rhine-Westphalian cities and regions in relation to socioeconomical clusters and current and future morbidity spectra. Comparative epidemiological studies focus on the increasingly important effect of interpersonal violence on health. Here we evaluate the impact of domestic violence on reproductive health as well as youth violence in advantaged versus disadvantaged settings. Under the assumption that climate change represents a growing challenge for public health, future research of the Department of Public Health Medicine will address the impact of climate change effects on health. This challenge goes far beyond the typical public health disciplines and includes cooperation with other disciplines such as climatology, geography, economics, engineering and others. We will continue to evaluate the impact of thermal stress on city populations as well as that of flooding on vulnerable coastal populations. A major geographical focus will be South Asia, namely Bangladesh, which is known to be one of the “hot spots” of climate change. Existing and potential cooperation with other departments of our school are listed in the figure. See also the attached list of recent publications, representing the main research fields and (international) collaborations of Department 2.
In summary, we want to contribute to comparative public health studies in a variety of settings and life worlds using the burden of disease approach. In a globalising world we assume that an international perspective can best result in new and deeper insights into public health dynamics. Global challenges of public health research such as climate change go beyond the expertise of the public health disciplines, why we cooperate with neighbouring academic fields.