Karen Edwards shares why epidemiology’s disease detectives are needed now more than ever

There’s a reason why epidemiologists are known as disease detectives.

Years ago, Karen Edwards, professor of epidemiology at the University of Washington (UW), received a call from a research team in Croatia. They wanted to know if she could help them figure out what was causing a mysterious illness amongst people living in the Balkan Peninsula. The illness caused end-stage kidney disease and was known as Balkan endemic nephropathy. The disease progressed slowly, and people would develop different symptoms, from copper discoloration on their hands to tumors in their urinary tract.

Scientists narrowed down their list of suspects. Was the illness caused by something in the water or soil? Was it something people were eating? Edwards and the research team studied population surveys of people who had the disease. They also looked at whether long-term residents suffered from the disease more or less compared to immigrants who had recently moved to the region.

Their years of research led them to uncover the answer. There was in fact a nutritional cause for the disease: flour that had been contaminated with aristolochic acid, which came from weeds growing in wheat fields. People making and eating bread with this flour were unknowingly ingesting this acid. But the researchers uncovered that there was also a genetic risk at play in whether people would develop this illness. People whose lineage extended for a long time in the region had an increased likelihood of being affected by the disease.

Edwards recalls that being able to work with the research team to uncover the causes behind the illness was one of the most exciting and rewarding moments of her career. 

“Epidemiology encompasses everything I love doing, which is working with data and thinking about complex problems that could be useful for improving the health of populations,” Edwards said. 

Epidemiology disease detectives play an important role in solving the world’s public health crises, and Edwards will be helping lead this work in a new way. Starting in March, Edwards was appointed chair of the Department of Epidemiology at the UW School of Public Health. In this role, she will support the work of a department recognized for its excellence in research, education and service. She will also help shape the education of epidemiology’s future leaders. 

“I want to support our training of the next generation of students to go out and tackle the pressing public health challenges of our time,” Edwards said. “I also want to make sure that the impact of our research is recognized outside of our community and that we can highlight the important role of epidemiology and our department in helping to make populations healthier, not just here, but around the world.” 

Edwards is returning to the UW after working for a decade as an epidemiology professor at University of California, Irvine, where she held leadership roles across disease prevention, population health, cancer care, and equity and inclusion. Before that, Edwards was an epidemiology faculty member at the UW for 15 years, and served as director of the Institute for Public Health Genetics. Her research has been focused on understanding how the interactions between genetics and the environment influence disease. Her genetic epidemiology research covers a broad range of conditions, including diabetes, metabolic syndrome, cardiovascular disease, melanoma and Parkinson’s Disease. 

Edwards was an epidemiologist before she even knew what the word meant. As a master’s student, she used surveys to understand the relationship between diet and diabetes. “You know the work you’re doing is essentially epidemiology?” a mentor once told her. That conversation led her to pursue a doctorate in epidemiology at the UW. In Seattle, her interest in understanding nutrition’s role in disease expanded to understanding how genetics also factor in. 

As chair, Edwards wants to encourage communicating the impact of epidemiologists’ work to communities. During the pandemic, she recognized just how important it was to give timely and factual information to people about their risk for COVID-19 and how to protect themselves.  

“Epidemiologists are not trained to talk to the media or more general audiences, but it is something that we need to be able to do,” Edwards said. “This will likely become increasingly important as public health and research are under threat.” 

Beyond responding to pandemics, people can forget that epidemiologists are critical to working behind the scenes to keep populations healthy, from monitoring the nation’s food and water supply to prevent the spread of illnesses, to mapping and containing disease outbreaks around the world. As funding for epidemiology research is cut and the public health work force is reduced, that means fewer epidemiologists are able to conduct work that helps keep people healthy and can ultimately save lives.

“Epidemiologists’ work may not always be visible, but the work we do is essential—we provide the data and evidence that shape life-saving decisions,” Edwards said. “When major areas of research and funding are cut, we risk losing the critical momentum we have had in understanding the causes of disease—and in developing the interventions and the policies we can put in place to help people be healthier.” 

Edwards acknowledges that this can be an anxious time for students who feel uncertain about the future of epidemiology. During her second day as chair, Edwards attended the School’s Prospective Student Day, where she talked with future students about how important the work of epidemiologists will continue to be. 

“My ray of hope is understanding that this is a challenging time right now, but it won’t always be this way,” Edwards said. “We have gone through challenging times in public health before. Historically, there have been many times where political factors influence what we do or don’t do, and we have always been able to rise to the occasion and figure out how to do the work we all believe in.”