Our epidemiology research team in NYU Langone’s Department of Psychiatry conducts large-scale, cross-sectional, and longitudinal cohort studies that investigate behavioral health, including mental illness and substance use. Our researchers assess the related social and structural determinants that perpetuate disparities in clinical and service outcomes across the life course.

Our research group, led by Kerstin E. Pahl, PhD, and Crystal F. Lewis, PhD, uses quantitative, qualitative, and mixed-method epidemiological approaches to data collection and overall study design. These approaches allow for the most innovative and effective interventions in rural and urban community settings. Our research efforts include examining the social, structural, and cultural factors—including stigma and discrimination, housing instability, transportation, social networks, and social support—that shape mental health and substance use outcomes.

Epidemiological Studies

Our current research includes the following studies.

Longitudinal Effects of Socioeconomic Disadvantage and Racial Discrimination on Health Among African Americans and Puerto Ricans

Dr. Pahl is conducting a longitudinal study of African American and Puerto Rican adults at the threshold of midlife who have been followed since adolescence. The study evaluates the ways in which social determinants, such as racial discrimination and socioeconomic disadvantage, impact mental health and allostatic load. Allostatic load is a biologic multi-system index of stress, including measures such as systolic and diastolic blood pressure, glycosylated hemoglobin, waist-to-hip ratio, as well as multiple biomarkers (e.g., interleukin-6, C-reactive protein, and cortisol). Researchers are collecting biological specimens from longitudinal participants for the first time, including saliva, hair, and dried blood spots. The study’s hypothesis is that participants who have experienced higher levels of racial discrimination and are more socioeconomically disadvantaged likely have higher levels of allostatic load in their forties, potentially demonstrated through increased inflammatory markers, hemoglobin A1C, and dysregulated cortisol reactivity.

As part of this research, Dr. Pahl is also examining whether resilience resources such as ethnic-racial identity and critical consciousness may be protective against racial discrimination.

Post-Exposure Prophylaxis Among Intravenous Drug Users Syringe Customers—Pharmacy Pilot Intervention

Dr. Lewis is leading a pharmacy-based structural intervention providing direct access to non-occupational post-exposure prophylaxis (PEP) to help prevent HIV for persons who inject drugs and their peers. Intervention pharmacies are in low-income Black and Latinx communities where the HIV burden is high with the goal of reducing disparities in HIV/AIDS. The study is comparing injection drug user syringe customers who agree to pharmacy-based PEP and education in the event of an accidental exposure to those who decline. Researchers are determining whether syringe customers who agree to the intervention have increased and accurate knowledge of PEP as an HIV prevention strategy and whether they share this information with peers. Researchers are also assessing side effects of PEP, adherence to the program, risk behavior, social networks, and attitudes and opinions about PEP.

Exploratory Study of Drug User Health-Related Internet and Mobile Technology Use

Dr. Lewis is conducting research to assess utility and usability of public health prevention and treatment information via web and text messaging. Researchers are targeting New York City neighborhoods with high drug activity and enrolling persons who use street-marketed drugs.

The study’s goals are to determine (1) the prevalence of internet and mobile technology use among this vulnerable population, and among those reporting regular drug use, (2) for what purposes participants are using the technology, and, finally, (3) what proportion of participants access and use information delivered via the intervention’s interactive behavioral health-focused website, including weekly text messages on prevention and treatment for substance use, mental illness, HIV, and other sexually transmitted infections. Researchers anticipate that the study can help with the development of internet or mobile technology-based interventions to improve the health of persons with heavy substance use involvement and disengaged from care.

Other Pilot Research and Evaluation Studies

As director of the Center for Research on Cultural and Structural Equity in Behavioral Health (CCASE), a Center of Excellence funded by the New York State Office of Mental Health, Dr. Lewis oversees several pilot research and evaluation studies among communities experiencing the greatest disparities in treatment and recovery outcomes related to mental health and substance use. CCASE disparities–focused research centers around social, cultural, and structural determinants of health including stigma and discrimination, impact of living in rural communities, substance use, and access and engagement in services for children and adults.

Current Grants

Our researchers receive grant funding from the National Institutes of Health and other organizations.

National Institute on Minority Health and Health Disparities

Longitudinal Effects of Socioeconomic Disadvantage and Racial Discrimination on Health Among African Americans and Puerto Ricans; 5R01MD012248-02

National Institute on Drug Abuse

Post-Exposure Prophylaxis Among IDU Syringe Customers—Pharmacy Pilot Intervention; 5R01DA030253-05

Exploratory Study of Drug User Health-Related Internet and Mobile Technology Use; 5R21DA034841

New York State Office of Mental Health

NYS Center of Excellence—Center for Research on Cultural and Structural Equity in Behavioral Health (C-CASE) (2007–2019)

Research Faculty

Our faculty are experts in epidemiological psychiatry research.

Crystal F. Lewis, PhD
Kerstin E. Pahl, PhD
Jung Yeon Lee, PhD
Helen-Maria Lekas, PhD
Ricardo M. Osorio, MD

Recent Publications

Our epidemiology research faculty frequently publish in peer-reviewed journals. Here is a selection of recent publications.