Graduates of UCLA's public health school have taken a leading role in research into veterans' health, from lung disease and cancer to homelessness and mental health, through a partnership with the Department of Veterans Affairs in Los Angeles that dates back more than six decades.
Faculty and alumni of the UCLA Fielding School of Public Health coauthored at least 32 peer-reviewed studies with a veterans' health element published so far this year, according to a Nov. 2 announcement. Topics ranged from lung cancer screening and treatment for chronic obstructive pulmonary disease to diabetes prevention, insomnia, PTSD and housing for homeless veterans.
For veterans, the goal is better care, said Dr. Elizabeth Yano, who directs the VA's Center for the Study of Healthcare Innovation, Implementation & Policy at the VA Greater Los Angeles Healthcare System and earned a doctorate at UCLA Fielding.
"Most VA researchers also deliver care to veterans, so they often use problems they observe and that veterans experience to drive their ideas for change, whether that's new treatments or new ways of delivering their care to make it easier to access and better quality," Yano said. "So bottom line, it's to improve care at the VA and veterans' health outcomes. It's everything from immediate care needs for mental health crises to healthy aging and everything in between."
The school has worked with VA researchers and health care providers in Los Angeles since its founding in 1961. The VA Greater Los Angeles Healthcare System serves more than 84,000 veterans. About 200,000 veterans are known to live in Los Angeles County, according to VA records, and roughly 1.4 million live in Southern California, according to state and federal estimates.
"Almost all our researchers at the VA in Los Angeles have their academic appointments at UCLA in the schools of medicine, public health, or both," Yano said.
Researchers tied to the school lead work in primary care, mental health, specialty care and women's health, she said. They also study homelessness and social factors that make it harder for veterans to get services.
"I'd say the single most important thing that this body of research does is ensure focused attention and resources to discovery of new treatments tailored to their needs and testing new solutions to challenges they may face in their care," Yano said.
One example cited was integrating mental health into primary care clinics "so it's faster and easier to get needed care." Another was building electronic health record tools that help VA doctors meet or exceed national standards, "which is one reason why VA care continues to be the same and often better than care outside the VA," she said. Others included preventing diabetes, lowering heart disease risk and improving sleep care.
Federal law requires the VA to prioritize research directly relevant to veterans' care, said Dr. Isomi Miake-Lye, a VA researcher for more than 15 years who also earned her doctorate at the school.
"So it shouldn't come as a surprise that some of the top priority areas include military exposures, traumatic brain injury, suicide prevention, and chronic pain, as some examples," she said.
Physicians who split their time between UCLA and the VA said veterans make willing research partners.
"Veterans are some of the most engaged patients and research participants I work with; many see joining a study as another way to serve, because it helps the veterans who come after them," said Dr. Russell Buhr, a pulmonary and critical care physician. "They're also refreshingly direct about what is and isn't working, which makes our research better."
Dr. Fola May, a colorectal cancer physician who treats patients at the VA medical center in Westwood and conducts research at UCLA Health's Jonsson Comprehensive Cancer Center, agreed.
"They are some of the most grateful patients I have been privileged to provide care for, and they also have a very strong sense of service, community, and purpose in research," May said.
Buhr's VA-funded research examines whether veterans with asthma and COPD receive treatments recommended by national guidelines. His team uses the VA's nationwide electronic health record to track how quickly new recommendations reach patients.
"Asthma and COPD affect tens of millions of Americans, so what we learn about turning evidence into everyday practice applies well beyond the VA," he said.
Dr. Carlos Oronce, an internal medicine physician at UCLA and a VA researcher, said his training at the school shapes the projects he takes on.
"One of the most valuable lessons I learned at Fielding was to always ask, 'Why does this matter?'" Oronce said. "Regardless of how sophisticated the research methods are, the work must be relevant to improving health and healthcare."
The studies were supported in part by the VA and the Veterans Health Administration, along with other federal agencies and philanthropic and academic sources.