Identifying the Health Impacts of Dynamic Inequities

Research Summary

Francisco Alejandro “Alex” Montiel Ishino, Ph.D., M.P.H., C.P.H., leads the NIEHS SocioEnvironmental and Ecological Disparities (SeEDs) Group. His team studies socioenvironmental and socioecological factors — such as acculturative stress, discrimination, and neighborhood cohesion — that affect the health and disease processes of underserved, underrepresented, and hard-to-reach subpopulations. Of particular interest to the SeEDs Group is syndemic risk. That term refers to the cooccurring and synergizing social, environmental, and ecological determinants of health that can exacerbate observed and latent chronic health disparities among at-risk groups.

Although research on health disparities has been growing, there remains a need to assess how inequities in dynamic environments can affect cardiometabolic risk among diverse populations experiencing demographic shifts. Those shifts can occur because of global events such as migration due to climate change; war; and sociopolitical conflict. As such, risk will vary between individuals, communities, and societies.

The SeEDs Group combines approaches from ethnographic, participatory action, community-based participatory, and epidemiologic research. The goal is to understand how contextual factors affect health disparities measured through cardiometabolic risk biomarkers and novel biomarkers of stress and accelerated aging, such as telomere length and DNA methylation. Those factors will be examined in populations including, but not limited to, immigrant and refugee groups such as the Bhutanese residing in the U.S.

To this end, the SeEDs Group uses advanced quantitative and qualitative methods, including mixed methods, to not only understand syndemic risk but also identify the most efficient and effective interventions. The research processes and outputs from the SeEDs Group will fill critical gaps in public health needs and enhance strategies to further strengthen epidemiological research through the inclusion of diverse community organizations, study participants, and trainees.

Major Areas of Research

  • Syndemic risk of cardiometabolic diseases.
  • Effects of dynamic acculturation, social vulnerability, and resilience on telomere length.
  • Epidemiological innovation in modeling risk in underserved, underrepresented, and hard-to-reach populations.

Current Projects

  • Epidemiological (biobehavioral and environmental) assessment of cardiometabolic disease and associated climate-induced health risks in the Bhutanese Community of Central Ohio Health Study.
  • Identifying novel biomarkers of acculturative stress and cardiometabolic disease.
  • Examining the time-varying effects of acculturation stress on telomere length.

Montiel Ishino earned a Ph.D. in Health and Kinesiology in 2019 with a specialization in Health Education from the College of Education and Human Development at Texas A&M University. He holds an M.P.H. in Sociobehavioral Health Sciences with a Biocultural Medical Anthropology concentration from the University of South Florida. He obtained his B.S. in Anthropological Sciences from The Ohio State University. He is also Certified in Public Health (C.P.H.) from the National Board of Public Health Examiners; a Ford Foundation Fellow; and Sloan Scholar. The pilot work for the Bhutanese Community of Central Ohio Health Study was supported by a National Institute on Minority Health and Health Disparities (NIMHD) William G. Coleman Jr., Ph.D., Minority Health and Health Disparities Research Innovation Award. After completing a postdoctoral fellowship in the Division of Intramural Research at NIMHD, he was awarded a position in the NIH Independent Research Scholars Program within the Epidemiology Branch of NIEHS in 2022.


Please see Montiel Ishino’s full bibliography.