University of Washington School of Public Health
Q&A with Shirley A.A. Beresford
Professor Shirley A.A. Beresford (Epi, HServ) will deliver the Winter 2012 Distinguished Faculty Lecture on March 12 at 3:30 p.m. in Health Sciences Building Room T-733: Socioeconomic Status: Mediator, Moderator, or Cause?
Beresford, a professor of epidemiology and adjunct professor of health services, will provide one perspective on some of her key findings over more than 40 years of research in public health. She began her career as a mathematical statistician in the UK and earned a PhD in epidemiology at the University of London before moving to the United States.
Beresford has been principal investigator on numerous studies focusing on dietary intake and chronic disease prevention. She is well known for her worksite randomized trials in behavior change, most recently in obesity prevention. She jointly created the course "nutritional epidemiology" in 1989 and has been teaching and directing it ever since.
Q (SPH): Is obesity the nation's number one health problem?
A (Beresford): Yes, prevalence of obesity has been increasing in all age groups for some time, and very few intervention studies have suggested a way to halt this trend.
Q: What are some of your most significant findings?
A: One of our successes was in our intervention program to increase fruit and vegetable dietary intake in working adults. That's held for both high socioeconomic status and blue-collar work sites. Even more important is that we've been able to demonstrate long-term effects of our interventions – for five years after initiation of a program. This kind of program is just one step in a whole host of things that we need to do in order to improve public health. It turns out that people who eat lots of fruits and vegetables are also less obese.
Q: How were you able to achieve those results?
A: We partnered with the work site. We help it to create an employee advisory board, which is a committee we work with throughout the whole intervention. I should emphasize that all of my intervention work is collaborative with behavioral and social scientists. Ultimately, we want the work sites to make changes in policy. We also rely on self-help manuals that every employee at the work site receives, and provide posters and fliers at the work site in the common areas, and help put on work site-wide events. We can include taste tests, potlucks. There's a "lunch on us." The whole phased intervention takes 12 to 15 months to implement. We evaluate at the two-year anniversary.
Q: What is the message of your Distinguished Faculty Lecture?
A: I'm going to try to highlight a thread that has woven through my career (in the background) that relates to the search for an understanding of why socioeconomic status affects health. Knowing that socioeconomic status may affect behavioral choices, we need to focus on the lower end of the socioeconomic scale as much as possible in attempts to improve public health.
Reflecting on socioeconomic status as a mediator, moderator or cause, we can observe a web of inter-related effects. People may be working in industrial occupations and maybe they're living in poorer areas of the city. Maybe the low socioeconomic opportunities dictate the kind of housing they have, and the kind of housing they have may in turn affect their health. The economic opportunities may also impact dietary choices either because of cost (and there are other colleagues here at the university who pursue that line of research) or because of associated education level and therefore they may lack knowledge of the extent to which their eating choices might affect their health.
Q: How did you get interested in nutritional epidemiology?
A: When I moved to the States, I was part of a team working on blood pressure and adherence to treatment. It became pretty clear it would be ever so much better if we could prevent high blood pressure in the first place. Likely behavioral factors, including physical activity and healthy eating choices, were the main modifiable factors. Given some of the work of colleagues in London, I wondered: how do you measure dietary intake in a reliable way? These forces together led me into nutritional epidemiology.
Q: What do you do for fun?
A: I sing alto with Seattle Pro Musica. We perform a range of classical, mainly a cappella, choral works. We give seven or eight concerts a year, as well as perform outreach concerts for the community.