Epidemiology is a branch of medicine that deals with the causes, frequency and pattern of diseases in a population. It examines how diseases can be tracked, predicted and prevented. Epidemiology is considered the foundation of public health.
James Blanchard is an epidemiologist and director of the U of M’s Institute for Global and Public Health.
He was first trained as a physician, practicing for two years in the U of M’s northern medical unit with rural and Indigenous populations. He later completed a PhD in epidemiology at Johns Hopkins University.
“It was a bit of a circuitous route to working in global health, but I guess it started when I was still working in clinical practice,” Blanchard said. “I wanted to focus more on public and population health.”
Partnering with the government of Uttar Pradesh, India, Blanchard led a research team aiming to decrease maternal and neonatal mortality rates in the region. At the project’s inception in 2014, more than 45 out of every 1,000 newborn babies died under one month of age.
According to the World Health Organization (WHO), three-quarters of neonatal deaths occur in the first week of life. Birth complications, such as trauma and suffocation, infections and birth defects are among the leading causes of death. The vast majority of these deaths occur in developing countries as poverty increases maternal risk factors and reduces access to care.
To ensure better health outcomes, the WHO recommends that all babies receive thermal protection (often through skin-to-skin contact with a parent), umbilical cord and skin care, a breastmilk-only diet early in life, examination for health problems and preventative treatments such as vaccinations.
Blanchard’s project involved deploying a team of over 1,100 healthcare providers across the state, district and village levels. The team also developed systems such as human resources planning, supply chain management, training and mentorship to help healthcare providers offer accessible, high quality patient care.
During the COVID-19 pandemic, Blanchard’s team also tracked COVID-19 tests, allowing the government to collect data that could help track outbreaks and respond to emerging public health crises. Following the success of the system, it was expanded to collect data on twelve other diseases, including malaria, which causes an estimated 20,000 deaths in India annually.
The project has since proven successful.
Over the past 15 years, neonatal mortality rates in Utter Pradesh have decreased by 40 per cent, saving approximately 99,000 infant lives annually. Home births have decreased from 80 per cent to 11 per cent. Thirty-eight per cent more women now access healthcare services during pregnancy.
Currently, Blanchard is involved in a project examining the barriers faced by underserved communities in accessing family planning services and maternal, newborn and child health. The project is funded by a US$12.5 million grant from the Bill and Melinda Gates Foundation to the U of M’s Institute for Global and Public Health.
“The research is really focused on systematically trying to understand what the gaps are and what the opportunities are,” he said. “We’ll be taking those analyses and working with local government public health programs and other health service delivery organizations to help them map out ways they can improve the coverage and availability of those services.”
Blanchard emphasized that the work focuses on urban environments, where gaps in service availability for underserved and excluded populations are rampant.
“I think this project is an example of how the U of M has made a commitment to orient our research, as well as our service and our clinical services, to really provide better services for underserved populations around the world,” Blanchard said.
“It’s been a priority for the university for a long time now, and I think it’s a terrific part of the U of M.”
