Faculty Spotlight - Rafael Meza

Rafael Meza, PhD, is assistant professor in the Department of Epidemiology. Dr. Meza's research interests lie at the interface of epidemiology, biostatistics and biomathematics. In particular, he is interested in cancer risk assessment, the analysis of cancer epidemiology data using mechanistic models of carcinogenesis, and the mathematical modeling of infectious disease dynamics and its applications in public health policy design.

What has been your career path in global health up until now?

I am from Mexico, so I started by leaving my country to study in the United States and then to work in Canada, before coming here to the University of Michigan. Now that I’m outside of Mexico, the work I do back home is “international” from this perspective. Because I was not trained inside the public health community in Mexico, I’ve had to learn how the system works there. I received my PhD at the University of Washington in Applied Mathematics and conducted research at the Fred Hutchinson Cancer Research Center in cancer epidemiology. I also completed a post-doc as a research scientist at Fred Hutchinson and held a research scientist position at the British Columbia Center for Disease Control, which is a provincial regulatory agency. There, I found that working in a government institution was very helpful for building the type of collaborations that would allow me to do research in Mexico and elsewhere.

Back in 2009, my research group developed an interest in the H1N1 outbreak, so I started to build connections in Mexico to get a sense of what we could do that would allow us to help. This eventually led to a collaboration between my institution and the Mexico City Ministry of Public Health. After I came to the University of Michigan and met other researchers interested in Latin America, my existing connections led to more opportunities. In particular, I started collaborating with Dr. Tonatiuh Barrientos from the Mexico National Institute of Public Health, who was here as a postdoctoral fellow working with Professor Ana Diez-Roux. For about two years now, we’ve been working in a variety of projects relating to diabetes, estimating the impacts of the tax on sugar drinks on diabetes rates, and expanding that work to look at prevention strategies on cancer and some infectious disease risks in Mexico.

My background is mathematical modeling of public health issues. I’m very interested in prevention of disease and using modeling to forecast the effect of different prevention strategies. That’s why my work spans across the universes of chronic diseases and infectious diseases.

Since coming here, a variety of opportunities to do research in Thailand have also come up. I currently have two projects there. One is jointly with Laura Rozek in Environmental Health Sciences, working with Dr. Hutcha Sriplung from the Epidemiology Unit at Prince Songkla University in Hat-Tai, a leading cancer epidemiologist in Thailand, to look at cancer trends there. This has been really wonderful and productive, and has given us the opportunity both to send students there, as well as to work remotely with Dr. Sriplung. For example, we have a biweekly conference call where students are able to present their progress and gain insight from our collaborators in Thailand. This is going very well and will hopefully continue for many years.

The other project is in collaboration with Marisa Eisenberg in Epidemiology, examining cholera transmission in a refugee camp on the Thailand-Burma border. This was initiated by an international health epidemiology student, Josh Havumaki, who was interested in mathematical modeling and cholera epidemics, and did his summer internship in Thailand. This past summer, Josh, Marisa, and I visited the U.S. CDC office in Bangkok and  the refugee camp where we connected with the two main NGOs working in the camp, as well as gained firsthand experience of the living conditions, as they are very relevant to the transmission to cholera and other infectious diseases. This is critical for developing models that are both realistic and able to address relevant questions.

What did you find especially helpful about working for a government institution?

It gives you exposure to issues that matter from a public health policy perspective. I was able to see the process of public health decision-making - should we vaccinate against HPV? Should we vaccinate boys or girls? How should we go about doing it? That allowed me to identify the areas where someone with my expertise could be helpful. Being in a government center and getting to know who the key players were and how to engage them was a great experience that has been really useful when trying to establish new collaborations with people from all over the world.

What advice do you have for students who’d like to get involved in global public health work or research?

To put their minds to it and do it! There are a lot of opportunities, and there is a huge need for people to do research and work in global health, as well as public health in general.  Talk to as many people as possible who are doing international work, not just mentors and advisors. If they’re here in Michigan, they should take advantage of being able to meet with the many researchers here working in global health, as well as the large number of visiting speakers and lecturers that come through our doors. Ask what they’re doing, how they’re doing it, and learn about what is relevant.

Many times, global health can be mistaken by people thinking it’s cool to go and travel overseas, but it’s a lot more than that. There are many challenges to doing work internationally. Be aware that it’s not a vacation. Most of the time, it is far more challenging than doing work domestically.

If you’re interested in global health, try to do an internship abroad. In addition, for students interested in coming here for International Health in Epidemiology, the most competitive applicants are those who have already done international work; Peace Corps, volunteering, or research overseas is very helpful, as it shows interest and commitment.

What skills should students prioritize to prepare them for future work?

For students with an interest in international health, we offer a large variety of courses to prepare you to for international research. Students should learn how to communicate when they aren’t in the United States. A big part of successful overseas collaborations is being able to communicate properly with people in different countries and in different situations. More than how wonderful your research is, success is determined by how receptive you are to others’ needs, awareness of cultural protocols, and being respectful of those rules. Research skills are important, but to do international work, you need to conduct yourself sensitively as an international ambassador.

Are there more opportunities for students to engage in your projects, currently or in the future? What skills would they need, and what could they expect to learn?

Absolutely. In Mexico, we are building stronger links both with the National Institute of Public Health and with other public health institutions. There are opportunities to work on diabetes risks and trends in Mexico, which is a major issue, as obesity rates and diabetes rates are increasing dramatically. There are also opportunities for students who would like to work on cancer in Thailand, as well as on disease transmission not only of cholera, but of other diseases relevant to settings like refugee camps. What we need now, besides funding, is manpower. So there are definitely opportunities.

As far as skills, these projects cover a wide range of possibilities. For example, students can use mathematical modeling and epidemiological studies to characterize risk, or conduct field studies to collect data or field samples to study disease transmission. Health behavior/health education students could look toward the end of the spectrum – now that we have this knowledge, how can it be used? And at the end of the day, many of these issues are policy decisions. For instance, we’ve been in discussions with the Thailand Ministry of Health about vaccination against cholera. So a variety of disciplines and approaches can work.

Learn more about Professor Meza’s work:

Written: February 12, 2014