Why Social Determinants of Health Matter: A conversation with Sally Vernon, PhD and Kayo Fujimoto, PhD

Sally W. Vernon, PhD, professor, and holder of the Blair Justice, PhD Professorship in Mind-Body Medicine and Public Health and Kayo Fujimoto, PhD, the first recipient of the Sally W. Vernon, PhD, Distinguished Professorship in Social Determinants of Health, talk about why studying social determinants—where we live, work and play—matters more than ever to our health and well-being.

Why are you interested in social determinants of health?

Dr. Vernon:

Kayo Fujimoto, PhD, holder of The Sally W. Vernon Distinguished Professorship in Social Determinants of Health was established in 2017

I became interested in social determinants when I was in my doctoral program and studying the work of John Cassel, who did a lot of writing on the subject. We called it social epidemiology at the time. It emphasizes the external environmental, social and physical conditions in which people live.

What appealed to me was that the theory went beyond just biology and people's biological determinants to their social environment. Public health started with basic things like cleaning up the air and the water. Now there's a lot of talk about income inequality, which has many social factors that play into that. It's looking at important factors that affect people's wellbeing.

Dr. Fujimoto:

Being a social network methodologist, I am particularly interested in studying the impact of social networks among people and organizations on diffusing health information and group norms, influencing people’s health behaviors, and influencing organizations' decisions on adopting evidence-based interventions. Social networks often are identified as a driver for generating health inequities.

How is your work making an impact?

Sally Vernon, PhD, holder of the Blair Justice, Ph.D. Professorship in Mind-Body Medicine and Public Health

Dr. Vernon:

The project I’m most proud of is the one I'm working on now on HPV (human papillomavirus) vaccination. Since 2006, several national organizations have recommended the HPV vaccine for boys and girls starting at age 11 or 12. We worked with the Texas Children's Pediatrics Clinic network in Houston to change the way the vaccine is introduced to patients by physicians and medical staff in the clinic. We've been able to increase initiation rates from about 40% five years ago to over 60%. In spite of the evidence that the HPV vaccine is safe and effective, there is resistance from some parents who are vaccine deniers.

Dr. Fujimoto:

I am the principal investigator for The Young Men’s Affiliation Project, which investigates how social networks among young men who have sex with men, places and spaces important to them, and collaborations and competitions among these places in a community, impact people’s sexual health behavior.

We’re learning more about how sexually transmitted diseases are transmitted within this population, and in particular, HIV, syphilis and HPV. We’ve found that social network contexts matter for disease transmission, and for an individual’s risk-taking and preventive behavior, especially for young men who have sex with men, who are members of racial/ethnic minorities. With this in mind, we are designing network-informed interventions that will help increase the uptake of pre-exposure prophylaxis (or PrEP) – a daily pill to prevent HIV– and catch-up HPV vaccinations for this most at-risk population.

What do you hope this professorship will accomplish?

Dr. Vernon:

I established the professorship because I wanted to give back to the school. I earned my doctorate here in 1980 and joined the faculty that same year. I have had a very productive career and made many friends and colleagues here.

My hope is for Dr. Fujimoto to build on her successful research and I'm confident that's going to happen. She has a multidisciplinary perspective that's so important in population health. And she’s done some great research on HIV. We've made a lot of progress from HIV being a deadly disease to being containable so it's treatable. It's not curable, but it can be treated effectively. However, HIV still affects many people and underserved populations particularly.

Dr. Fujimoto

My team and I are deeply grateful for Dr. Vernon establishing this endowment and the opportunities it provides. Our research will examine health inequalities among the most at-risk populations and environments that surround them.

Specifically, we will undertake population health research with an eye towards turning our network research into applied products based on artificial intelligence to enhance delivery of tailored or customized interventions, building an innovative technological infrastructure, such as blockchain, to facilitate coordination among health service agencies within the local health care delivery system.

Together, these endeavors will help us mobilize collective community efforts and empower local communities to provide improved health services to underserved populations.