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Late in November, Mary-Elizabeth Vachon visited Central Harlem's Bradhurst section, the area from 139th to 155th Streets between Edgecombe Avenue and Adam Clayton Powell Jr. Boulevard. The second-year student in the Mailman School of Public Health and Columbia School of Social Work went to Central Harlem to create a map of its supermarkets, delicatessens, and corner grocery stores. Why? To help design a study of healthy food choices available to neighborhood residents.

Recent research has underlined the importance of food availability for public health. A paper in the November American Journal of Public Health, co-authored by Dr. Ana Diez-Roux, assistant professor of medicine at P&S and epidemiology at Mailman, found that lack of supermarkets in two predominantly black areas of North Carolina and Mississippi restricted the amount of fruits and vegetables in residents' diets.

Ms. Vachon's project is just one example of the importance of community-based research efforts undertaken by students at Mailman. While other Mailman classes address community projects, In Vivo caught up with Ms. Vachon and eight other students attending a seminar, History of Public Health Decline in Harlem from 1950 to 1990, taught by Dr. Beverly Xaviera Watkins, assistant professor of clinical public health. The class is one of the core courses for a new track in the master of public health program in Mailman's Department of Sociomedical Sciences. The track, called Urbanism and Community Health, began in fall 2002.

The course requires each student to design and conduct an independent research project. The students also must write multiple, progressively longer drafts of a paper about the research that results in a 30-page paper of publishable quality. Besides the food choice study, the student projects included studies of the history of public housing, prostitution, homicide, HIV/AIDS, and art in Harlem.

Dr. Watkins teaches students how to plan a study and do historical research using archives, municipal databases, vital statistics, and census data. "In public health, you have to be able to design and conduct research projects, write grants, meet deadlines, and publish," Dr. Watkins says. The course runs the gamut and in so doing prepares students for the world of work.

"The objective is to foster independent thinking and broaden students" perspective on public health," she says. "Students learn to go beyond the individual level to the community level. We're exploring the connections between behavioral, social, cultural, economic and environmental determinants of health."

To demonstrate the importance of historical research techniques in public health and show students the actual neighborhood of Harlem, Dr. Watkins takes the class on walking tours. Field trips, which include a visit to the Schomburg Center for Research in Black Culture (part of the New York Public Library), also take the students to other research facilities around the city, including the Municipal Archives of the City of New York, the New-York Historical Society, and the Columbia University libraries. "Doing community health from an 'armchair' doesn't work," Dr. Watkins says.

Each student works on a research paper throughout the semester, revising and expanding the document with Dr. Watkins' guidance. Students rewrite the papers based upon Dr. Watkins' comments and their continuing research findings. "By the end of the class, they know how to marshal evidence and build an argument," Dr. Watkins says. "They develop confidence in their abilities to do research and overcome obstacles."

Even though the course finished at the end of the fall semester, Dr. Watkins continues to advise many of the students, including Ms. Vachon, in spring semester tutorials about how to improve the papers for publication. Ms. Vachon, for example, is modifying the survey she started in November with elements from a 1991 healthy-food availability study done by researchers at the University of Washington.

Classmate Sonia Gonzalez, a second-year Mailman student, researched prostitution in Harlem from 1940 to 1969. She used archival materials to track how the local economy, unemployment, the Civil Rights movement, and the increased use of heroin in the 1960s affected prostitution. Largely due to the dearth of historical information about Harlem, Ms. Gonzalez found the research to be the most challenging project she has ever worked on.

"The class heightened my critical thinking skills and provided me with an in-depth understanding of the history of Harlem, the players involved, and the policies that impacted what Harlem looks like today," Ms. Gonzalez says.

"Understanding the history and lifeways of a community is vital to understanding public health issues—you need to study people and places simultaneously," Dr. Watkins says. "This course aims to give students skills that will help them as they enter professional life."


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