Califf Hopes Duke Data Effort Creates "Better Map" for Those Lacking Healthcare

For the first time in 99 years, national life expectancy is falling, and former FDA Commissioner Robert Califf, MD, wants to understand why.

Now back at Duke University, where he has spent much of his career as a clinical investigator, Califf has a new role with Verily Life Sciences, a branch of Google, and on Monday he offered a blog post on how this fits with his new role at Duke: vice chancellor for Health Data Science.

The new Center for Health Data Science seeks to “draw a better map,” in Califf’s words, for both North Carolina and the rest of the Southern States that always seem to flow from burnt orange to brick red on county-level maps that highlight rates of obesity, diabetes, and, most troubling, inequities of life expectancy.

It troubles Califf that the inequities in income, education, and healthcare are growing, despite advances in medicine and computing powers that have never been better.

Califf cited recent papers in JAMA and JAMA Internal Medicine that point out these realities—as well as the groundbreaking work by Princeton University economists Anne Case and Angus Deaton—that tabulate the “deaths of despair,” including those from the opioid crisis that are plaguing Americans who are increasingly left behind. Califf wants to work with Verily and use the powers and expertise of the Duke Center, as well as the campus’ considerable brain trust, to come up with ideas to fix this.

But this is not an ivory tower exercise. “How do we move beyond ‘academic analyses’ and produce compelling knowledge that can be acted upon by patients/consumers and health systems, ultimately leading to better health?" he asked. "How do we develop tools and systems that serve both individuals and populations?”

To those who saw Califf’s appearances among his colleagues at the 2 most recent gatherings of the American College of Cardiology (ACC), these announcements are not a surprise. In 2016, fresh off his FDA confirmation, Califf spoke about the need to harness big data, both to find patients for clinical trials and then to locate patients appropriate for life-saving therapies, perhaps cutting out millions in unnecessary costs that make life-saving drugs so expensive.

More recently, Califf took part in a half-day ACC intensive on health equity, where he offered a “to do” list for health systems seeking to act locally to prevent rollbacks in funding and access.

The Duke center was in the planning stages before Califf departed for FDA, and he says it will cut across disciplines—social sciences, clinical research, delivery systems—all with the goal “of developing powerful approaches to turning data into useful information and knowledge and acting on that knowledge to improve health and healthcare.”