From Local to Global— Taking Child Development and Community Health to a New Level

Sheila Gahagan, MD, MPH 

San Diego, January 12, 2010 - Current national controversies rage regarding obesity, healthy eating, and healthcare reform, all of which affect the nation’s children.  In response to these robust debates, UC San Diego’s Department of Pediatrics has emerged with renewed passion and commitment towards research that ensures health, happiness, and academic success among kids.

The Department recently created the Division of Child Development and Community Health, appointing Sheila Gahagan, MD, MPH as the new Division Chief. Recruited from the University of Michigan, Dr. Gahagan is the Martin T. Stein Endowed Chair Holder in Developmental-Behavioral Pediatrics and Professor of Pediatrics at UC San Diego.

The Division comprises a clinical section, Developmental-Behavioral Pediatrics at Rady Children’s Hospital and a research division, the Pediatric Center for Community Health. Based in City Heights, San Diego, the Pediatric Center for Community Health focused on the health disparities gap long before these issues emerged on Capitol Hill. Given the nation’s currently struggling economy and consequent effects including restricted community resources, overburdened schools, increased family stressors, and poorer nutrition, child development and health in San Diego remain more vulnerable than ever before, especially in underserved areas.

But due to the pioneering work of Dr. Martin Stein, Dr.Community outreach by the Children's hospital faculty Phil Nader, and others in developmental-behavioral pediatrics and community pediatrics, the new division boasts a robust foundation of clinical service and community health that impacts youth and families well beyond the border. Under the leadership of Dr. Gahagan, the understanding and amelioration of health disparities serves as the fundamental theme of the division — a theme that resonates personally for Gahagan herself.

“During the 60’s, I grew up in Detroit in a family that was conscious of the economic and social justice gaps between races,” Gahagan shared. “Years later I completed my Master’s Degree in Public Health with a focus on health disparities. Since then, I’ve developed a more complex view of disparities.”  What determines a child’s nutrition, weight, height, or ability to grow? According to Gahagan, genetic determinants are important but we have to look at factors beyond genetics. “Community resources, the family’s wealth, the mother’s stress level — these all contribute to children’s health, development, and educational outcomes.”

With a balance of compassion, leadership, and scientific rigor, Dr. Gahagan has devoted her lifelong career towards the investigation of health disparity determinants such as socioeconomic status, ethnicity, family relationships, and early life conditions. Possessing extensive clinical expertise, she is an international expert on child growth, childhood obesity, infant neurodevelopment, and fetal alcohol syndrome. She has worked with various ethnic groups in the U.S. including Navajo populations (1984-1989), urban Mexican-American immigrants (1989-1995), and urban African Americans (1995 – 2008). Continually funded by the NIH since 2001, Dr. Gahagan received a mentored patient-oriented Career Development Award, followed by an independent investigator award for the study of early socioeconomic and psychosocial risk factors related to child and adolescent obesity in Chile.

At present, Gahagan’s work on early childhood risk factors is based on an understanding of the development of self-regulation and dynamic transactional processes. She is interested in the methods by which children achieve self-regulation of eating, sleeping, and activity behaviors, as well as in the interaction of biological risk factors within social contexts.

The overall research focus of the Division of Child Development and Community Health is to improve understanding regarding trends and determinants that affect local, national, and global disparities in child health and development.  In addition, the Division is currently working on interventions that will address health gaps in child well-being. A true example of ‘going local to global,’ the division utilizes a multidisciplinary team of pediatricians, nutritionists, statisticians, psychologists, health educators, physical educators, and other professionals, from countries as diverse as Chile, Mexico, France, Italy and the United States. Under the overarching umbrella of health disparities, the Division addresses disparities in adolescent pregnancy, teen dating violence, and STIs including HIV/AIDS as well as the reduction of health-science workforce disparities and the promotion of increased numbers of minorities pursuing health science careers.

While the Division has made great strides in the past decade, much still remains to be accomplished.  Gahagan’s goal for the Pediatric Center for Community Health is for the center to become the preeminent research unit on child health disparities in the country.  The faculty and staff are working together towards the development of an NIH-funded Program Project, or a University of California designated Organized Research Unit.  Gahagan also notes that the Clinical Developmental-Behavioral section needs to increase its capacity to evaluate children with developmental-behavioral problems. “Our vision is to have a full-service Developmental-Behavioral Pediatric Clinic at Rady Children’s Hospital, with satellite clinics in underserved areas,” she said. The division also hopes to increase clinic space and faculty members in order to accept the growing amount of referrals from other specialists.

“There is a big demand for what we do,” Gahagan emphasized. “Our research center is situated in City Heights, so we work at the most local level. But we are also working on the U.S./Mexico border, in Chile, France and in Italy. We can learn so much from our international colleagues, and we also have a great deal to contribute to their work.  In this division, we’ve got it all: clinical excellence and creative, compassionate investigators.  We are so fortunate.”

WRITTEN BY: Shivani Singh, Sr. Writer, UC San Diego, Pediatrics

COMMENTS: Dr. Sheila Gahagan, Division Chief of Child Development and Community Health, UC San Diego Pediatrics