? Despite an emerging consensus that many diseases are influenced by multiple gene-gene and gene-environment interactions, little is known about how genetic and environmental factors interact to influence outcomes in children. In addition, although psychosocial theory focuses on how socio-economic characteristics influence the health status of children, we have little information about how social factors interact with genetic and environmental factors to affect child well-being. Thus, methods to address the simultaneous and combined influence of social, environmental, and genetic factors are imperative. The mission of Duke's Center for Geospatial Medicine is to develop systematic, spatially-based methods for analyzing the pathways through which the environment, genetic, and psychosocial domains jointly shape child health and well-being. Specific goals of this Center are to: 1) develop an interdisciplinary center that supports research on how genetic, environmental, and social aspects of vulnerability combine to affect children's health and well-being; 2) promote interdisciplinary research interactions among programs in biomedicine, environmental health, statistics, and social sciences; 3) advance new methodologies for incorporating innovative spatial analysis into health research; 4) develop new and creative analytic approaches that address spatial/temporal variation, multiple comparisons, confounding, and effect modification; 5) train young scholars in the resulting methods. We will leverage active partnerships among the Nicholas School of the Environment, the Duke University Medical Center, and Trinity College of Arts and Sciences. We will link social, environmental, and genetic vulnerability using advanced spatial statistical approaches in combination with techniques from genetics and genomics. Using neural tube defects as a prototype health endpoint, we will develop a generalized framework for applying these methods to a wide variety of health endpoints, including autism, asthma, ADHD, and obesity. ? ?
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