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Department of Social Medicine
Our department takes an interdisciplinary epidemiological approach to examine the role of the fetal and early life environment in influencing health status in childhood and adolescence/adulthood. We aim to further our understanding of the determinants of disease and suffering in children and their families and use this knowledge to advocate for an environment that is optimal for childbearing and childrearing.
The collective expertise of this department’s permanent staff, represented by a broad range of ongoing research, includes epidemiology, biostatistics, sociology, molecular genetics, mental health, nutrition, pediatrics, perinatal medicine, and childhood cognitive, behavioral, and social development. We utilize various methodological approaches, ranging from linkage of large national demographic and clinical databases to field-based work that involves population recruitment, biological sample collection and qualitative research strategies.
In our department, we believe epidemiological research thrives through collaboration which is essential for a continuous pursuit towards enhancing the quality and representativeness of our studies.
Our current research (as of June, 2017) addresses the following themes:
Childhood Hematological Cancers
- Genetic susceptibility to childhood acute lymphoblastic leukemia
In collaboration with a large network of Tokyo Children’s Cancer Study Group hospitals and clinicians, DNA from saliva has been collected from childhood ALL patients and underwent whole genome microarray SNP genotyping. Case-control genome-wide association study (GWAS) analyses are being conducted to identify genetic variants associated childhood ALL risk in Japanese.
- Epidemiological Study of Hematological Cancers in Children (EPI-HCC)
This case-control study aims to evaluate the role of pregnancy-related factors, fetal environment, and early postnatal exposures in the risk of childhood leukemia and lymphoma. DNA samples are also collected from children and their parents to examine the effect of gene-environment interactions, as well as possible maternal genetic effects on the risk of leukemia in the child.
- The effect of inherited genetic variation on treatment-related outcomes in childhood ALL patients
Various follow-up clinical data on prognostic indictors and major treatment-related clinical manifestations have been collected and is being linked to the patients’ data on inherited genetic variation. Identification of genetic variants associated with these clinical outcomes can contribute to understanding biological mechanisms and personalized genomic medicine strategies.
NCCHD Maternal-Child Cohort
As members of the NCCHD Maternal-Child Cohort research group, we are pursuing projects to understand how nutritional factors, eating habits and behavior during pregnancy and childhood influence maternal and child health. Outcomes currently under examination include, growth, cognitive development and metabolic functions. As a broader object of this cohort, we expect to pursue additional themes related to the “developmental origins of health and disease” concept.
Effect of the Social Environment in Maternal and Child Health
- A collaborative study with the local government on the effect of socioeconomic disadvantage on child health and development.
Working with the city of Adachi and the Tokyo Medical and Dental University, we are examining the effects of socio-economic adversities on child health and development among students in public elementary and middle schools. We also utilize the collected data to evaluate policies and programs aimed at supporting socio-economically disadvantaged families and children.
- Motivational interviewing techniques as an intervention to prevent birth defects and child maltreatment.
We are conducting intervention studies with local governments to promote the normal development of infants and to evaluate infant abuse preventive measures. In particular, we are examining the effect of motivational interviewing strategies in those who show reluctance to receiving social support.
- Intervention and Observational Studies Related to Childhood Obesity
Working with the city of Setagaya, we are conducting a randomized controlled trial evaluating the effect of a family intervention program with focus on the paternal role in childhood obesity. In addition, we are pursuing data analysis related to preventive screening of childhood diseases based on data taken at the children’s health check-up visits.
Longitudinal Population Health Survey Research in Maternal and Child Health
- Government-sponsored Longitudinal Survey of Newborns in the 21st Century
Utilizing data from these national population health surveys, we evaluate issues surrounding Japanese children and families to help us understand what are the most beneficial childbearing and childrearing environment. Some topics of interest include benefits of breastfeeding and risks of unintentional injuries , early childhood dental caries, and poor adjustment to school environment.
- Government-sponsored Healthy Parents and Children 21 National Survey
In collaboration with Yamanashi University and The University of Tokyo, we are utilizing existing survey data to examine the effect of municipal-sponsored programs in reducing childhood unintentional injury and parenting difficulties. The intention of these programs is to help promote normal development of the infants and prevent infant abuse.
- Government-sponsored Japan Environment and Children’s Study
In collaboration with Kyushu University, we are utilizing existing survey data from this national birth cohort to examine the long term effects of nutritional and behavioral exposures during pregnancy on the child’s growth, development, and metabolic and endocrinological functions.
Clinical Epidemiology Studies of Pediatric Diseases
In collaboration with The University of Tokyo, we are utilizing data from the Nation-wide Diagnosis Procedure Database, to assess treatment outcomes and cost effectiveness of various drugs, procedures and treatment regimen for pediatric diseases. Examples of recent analyses undertaken include the effect of obesity on acute asthma exacerbation as well as recent treatment trends and cost-effective analyses between different treatment regimens in common pediatric disorders, including pediatric anaphylaxis, Kawasaki Disease, immune thrombocytopenia, and influenza-related respiratory disorder.
“Big data” Linkage Projects in Maternal and Child Health
We utilize data-linkage techniques to build comprehensive datasets, promote collaborative utilization of these databases, and obtain high-quality results that would not have been possible from analyzing them separately. In addition, these linkage techniques can assist in validating coverage and accuracy of individual databases, and contribute to future research infrastructure. Several of these projects are being pursued with international collaborators to compare results between countries and/or conduct pooled analyses.
Databases currently in use include nation-wide registries run by the Japan Society of Obstetrics and Gynecology, Japan Society of Pediatrics, Japan Society for Neonatal Health and Development, and maternal and child health related registries and surveys conducted by the Ministry of Health, Labour and Welfare.
Tsuguhiko Kato (Chief, Division of Behavioral Science)
Naho Morisaki (Chief, Division of Life Course Epidemiology)