Professor of Epidemiology, Mailman School of Public Health
Professor of Psychiatry, College of Physicians and Surgeons and New York State Psychiatric Institute
Director, The Imprints Center for Genetic and Environmental Lifecourse Studies, Mailman School of Public Health and New York State Psychiatric Institute
Co-Director, Global Mental Health Program, Mailman School of Public Health
Past Research: Much of Professor Susser’s past research focused on the inter-relationships between sociocultural conditions and mental illness. This work included international studies (with WHO) of the incidence and course of psychotic disorders in differing contexts; studies of the relationships between mental illness and homelessness, as well as the broader contextual factors related to homelessness; and studies of the intersection of mental illness, homelessness and HIV infection. Extending to experimental studies, he developed the Critical Time Intervention to prevent recurrence of homelessness among individuals with mental illness; this intervention proved successful in several studies and is now being adapted and tested in a variety of settings. He also developed and tested an intervention to reduce sexual risk behaviors among homeless mentally ill men. A second focus of Susser’s past work was on the early origins of schizophrenia and other mental illnesses. He showed that early prenatal exposure to the Dutch Hunger Winter of 1944-45 was linked with an increased risk of schizophrenia in adulthood, a finding that has since been replicated in two studies based on the Chinese famine of 1959-61. He also established the Prenatal Determinants of Schizophrenia study, based in the Child Health and Development Study cohort born 1959-67 in Oakland, in which archived maternal sera (as well as a rich array of other prenatal and childhood information) can be used to examine prenatal influences on schizophrenia. One of several notable findings from this study was that prenatal exposure to influenza, measured by antibodies in maternal sera, was related to the risk of schizophrenia in adulthood.
Present Research: In recent years, Susser has extended his work in several ways. In particular, he has developed a network of birth cohort studies which examine not only severe psychiatric disorders such as autism and schizophrenia, but also a broader set of health domains including cancer, obesity, health behaviors, cardiovascular disease, and common mental disorders such as depression and anxiety. The extension to a broader set of health domains is exemplified by the NIA-funded multi-site collaborative project he leads, entitled “Early Determinants of Adult Health.” It is also evident in the Imprints Center, which he established to bring together a network of scholars at Columbia to investigate how health conditions evolve over the life course. A general theme in these studies is to integrate investigation of social and biological (including genetic and epigenetic) influences on health. Susser’s most recent work has focused on documenting an increased risk of schizophrenia among ethnic minorities in Western Europe and among African Americans in the United States. He has begun to explore potential explanations, which include socioeconomic status, racial discrimination and neighborhood characteristics. A particularly intriguing finding is that in Holland and the United Kingdom, the increased risk of schizophrenia among immigrant ethnic minorities is most evident in persons living in neighborhoods of low ethnic density (i.e., few others of same ethnic group). This finding strongly implicates social experience in the etiology of schizophrenia, balancing the emphasis on genetic factors and prenatal insults which has characterized recent research on schizophrenia.
Future Research: Susser is developing new work in two directions. One is to use the established birth cohort data to understand how health inequalities develop over the life course, a likely focus for a renewal of the “Early Determinants of Adult Health” project. Another is to discover the link between prenatal famine and schizophrenia, which can be approached by studying the very large numbers of persons who were exposed and developed schizophrenia in China, including applying new technologies from genomics and epigenetics.
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