The Q&A: Eric Boerwinkle

With each issue, Trib+Health brings you an interview with experts on issues related to health care. Here is this week's subject:

Eric Boerwinkle is set to take over as the new dean of the University of Texas Health Science Center at Houston School of Public Health at the start of the New Year. He previously served as the professor and chair of the Department of Epidemiology, Human Genetics and Environmental Health at the School of Public Health. He also conducts research in the field of genetics and directed the Human Genetics Center at the School of Public Health and the Brown Foundation Institute for Molecular Medicine for the Prevention of Human Diseases.

Editor's note: This interview has been edited for length and clarity.

Trib+Health: What are your goals for the School of Public Health, once you start as dean in January?

Eric Boerwinkle: First, it's a great honor to be the dean of the School of Public Health. The school offers advanced degrees in very diverse fields across the spectrum of public health. We have students and faculty in behavioral sciences, genetics, health care statistics, so it really is a very diverse group.

And I'm happy to say that our graduates lead population health programs in universities, in companies. They have government positions in Texas. And, really, all of them are spread throughout the country.

But the key is that we can do better, and we will do better.

So we need to challenge ourselves and challenge our research and educational programs to meet the growing demands in the workforce, especially the public health workforce in Texas and expand our repertoire of both research and education, so we can maintain a leadership role in the ever changing nature of health care.

It's not a secret that health care in the United States, especially in Texas, is changing rapidly.

The key is that research is really the engine that drives advanced graduate education and modern health care. And so I'll make sure that we continue to build our research program going forward.

And then my own personal goal, for myself and for the school, is to be the premier hub of population health in Texas and across the United States. I'm looking forward to building and solidifying the so-called third coast, the Gulf Coast, as a leader in advanced biotech and health care and in population sciences.

Trib+Health: In what ways are you seeing public health change in Texas, and how do you plan to address the changes?

Boerwinkle: I think first it's important for all of us to stand back, and particularly for the readers and listeners of the Texas Tribune to stand back, and ask themselves, "What is public health?"

Public health is a science, first and foremost, that works with people and entire communities to keep them healthy, focusing on prevention and ensuring better health care outcomes, if unfortunately they do get sick.

Public health is also a profession. We're a professional school, and we're here to improve health, especially the health of Texas and Texans. We're doing that both through our research programs, education and also public health service.

The difference between public health and traditional medicine is that traditional medicine works on one patient at a time. Public health focuses on the health of entire communities, entire groups of individuals.

Frankly, we can't afford — we as a country and particularly the state of Texas — we can't afford business as usual. If we just take kidney disease as a result of hypertension diabetes, the state of Texas cannot afford the current increase in chronic kidney disease. So we need to focus our attention, in addition to treating those with disease, to preventing the onset of that disease.

We're doing this by research and practice: to get young people to eat healthier, to find new ways to prevent diabetes and treat diabetes.

A lot of people don't realize what happens within schools of public health. We have an enormous group in the UTHealth School of Public Health identifying the genes that contribute to chronic diseases, such as diabetes and heart disease. So we're using the latest technologies to be able to identify who's at high risk, so those individuals can take more rigorous prevention steps.

Trib+Health: What are some of the biggest challenges facing the field of public health?

Boerwinkle: I think the greatest challenge is a lot of people don't understand what public health is in 2015. They have public health very, very narrowly defined, and I think one of the things that I'm looking forward to as dean and also working with all of the faculty, staff and students in the UT Health School of Public Health … to get out and educate the population and all individuals on what modern public health is.

As I just mentioned, we have campuses in Houston. We have campuses in Austin, San Antonio, Brownsville, Dallas and El Paso. So we really span the state, from east to west and north to south, and I'm looking forward to us getting out and talking to the citizens of Texas and educating them on what modern public health is all about.

Another challenge, on the research side of our mission, is declining real research dollars.

Research dollars with the National Institute of Health or the Center for Disease Control have not kept up with inflation, and we need to again work with state and federal governments to make sure that the United States, and Texas in particular, maintains its excellence in research.

We've done so historically, and I worry a little bit that we're slipping behind, that we have taken our success, frankly, for granted, and we can't do that. So we'll need to redouble efforts in that area.

In a very practical setting, we're going to need to, I think, redouble our efforts in attacking childhood obesity. If we don't do something to stem the tide of childhood obesity, we're going to be paying the individual, the family and the population price for that for years and years to come.

Trib+Health: Going back to research, what plans do you have to have to try and get more research funding?

Boerwinkle: One is to diversify our research portfolio and make sure we stay contemporary. You know, the research that was done 10 years ago is not the research we should be doing today. And making sure we as a school do that.

The second is to recruit and retain the best and the brightest population and public health scientists into our school. And, again, we are doing that.

The third is I work very hard at the state and national level to educate our legislators on the importance of research, both within the state and across the country. And make sure they realize that it's important that we stay a leader, and make sure they realize the business opportunities that are created and how [for] every dollar ... spent in research, we have multiple dollars leveraged and brought back with improved health care and new businesses that are created.

So it's really a good investment for governments to invest in research, but we need to make our case. We, frankly, in academia don't. Often either we're shy, or we don't think that's our role. And it's important that we step out, and we educate the public and we educate the legislators of the importance of our educational research mission.

Trib+Health: You've touched on a lot of public health issues in the state, but is there an issue that you think is most prevalent in the state?

Boerwinkle: We all need … to be vigilant about preventing the onset of childhood obesity and then preventing other risk factors that give rise to diabetes. The state of Texas, in particular, needs to really have an all out war on diabetes and the clinical outcomes that come from diabetes. They can be stroke. They can be eye disease, heart disease, kidney disease, your legs — so-called peripheral vascular disease.

Both for the well being of the people and the health of our economy, we really need to have an all out war on diabetes, beginning with childhood obesity, and then diabetes itself and then the clinical outcomes of diabetes.