When Dr. Alan Villarreal Rizzo was a medical student at UTMB, he sought opportunities to apply his epidemiology background to meaningful health research. Through collaborations with faculty mentors across campus—including School of Public and Population Health (SPPH) Dean Dr. Kristen Peek and Associate Professor Dr. Brian Downer—he developed research skills that have now culminated in significant published findings.
New Insights on Arthritis and Hospitalization in Mexico
The study, published in the Journal of Aging and Health, reveals that arthritis is associated with a higher risk of hospitalization among middle-aged and older adults in Mexico. Lead author Dr. Alan Villarreal Rizzo, who graduated with his MD from UTMB's John Sealy School of Medicine in 2024 and is now completing his Internal Medicine residency at Mayo Clinic, worked closely with SPPH faculty throughout his medical school journey.
Using data from the Mexican Health and Aging Study (MHAS), the research team analyzed information from over 12,000 participants aged 50 and older across multiple waves of the nationally representative longitudinal study. This comprehensive dataset allowed the researchers to examine the complex relationship between arthritis, its symptoms, and healthcare utilization over a six-year follow-up period.
The findings fill an important gap in understanding the impact of arthritis in low and middle-income countries, where the condition is prevalent but understudied. The research showed that arthritis was associated with 23% higher odds of hospitalization, with even higher risks for those experiencing joint pain, using medication, or facing physical limitations due to their arthritis.
Most notably, participants whose arthritis limited their daily activities had 48% higher odds of hospitalization compared to those without arthritis. The study also revealed that while arthritis initially appeared to be linked with increased mortality in unadjusted analyses, this association disappeared after accounting for demographic and health characteristics—suggesting that coexisting conditions rather than arthritis itself may drive the mortality risk.
The research paper notes that osteoarthritis is the most common type of arthritis in Mexico, with an estimated prevalence of 20-25% among adults aged 40 and older. This high prevalence stems from multiple factors, including obesity, chronic health conditions, and physically demanding occupations that many adults have worked in throughout their lives.
These findings have significant implications for public health systems in Mexico and potentially other middle-income countries, suggesting that interventions targeting physical limitations from arthritis could help reduce hospitalization rates and healthcare utilization.
Faculty-Student Collaboration Across UTMB Schools
The publication represents the culmination of years of mentorship and collaborative research that began during Dr. Villarreal Rizzo's medical studies at UTMB. Prior to medical school, he had completed an MPH in Epidemiology from the UT School of Public Health, providing him with valuable epidemiological training that he applied to this research.
"During medical school, I participated in the MSTAR program, the scholarly concentration in translational research, and the medical student honors thesis program," explains Dr. Villarreal Rizzo. "For all these programs, I worked with Dr. Brian Downer who was an outstanding research mentor. He helped me use the knowledge I learned in my MPH and apply it to longitudinal cohort studies such as the HEPESE and the MHAS."
Dr. Downer, reflecting on the experience, notes that student mentorship is among the most rewarding aspects of his role. "Mentoring students is one of the most rewarding parts of my job as an SPPH faculty member," he shares.
"Students often approach me with a research question they are interested in studying, but they are unsure of where to begin their research. I greatly enjoy helping students identify a data source that matches their research question, design the study, complete the data analysis, interpret the results, and write the manuscript."
Building Research Skills for Future Health Leaders
The research collaboration yielded impressive results beyond this single publication. "In total, we were able to publish five manuscripts in the past 4 years," Dr. Villarreal Rizzo notes, highlighting the productivity of the mentoring relationship.
This success story exemplifies UTMB's commitment to training well-rounded clinicians and researchers. Dr. Villarreal Rizzo is now pursuing a career in cardiology and academic medicine at Mayo Clinic, carrying forward the research skills developed during his time at UTMB.
For current SPPH students hoping to follow a similar path, Dr. Villarreal Rizzo offers clear advice: "I would recommend current SPPH students to find a mentor with research interests that align to your own, or a mentor who is willing to support your research ideas."
He adds that mastering statistical software is crucial: "Learning how to use STATA was a long process for me, but I am proud to have published papers in which I did the entire analysis."
SPPH: A Supportive Environment for Research Development
Dr. Downer emphasizes that SPPH provides exceptional resources to support student research endeavors. "SPPH has fantastic resources to support students' research. We have access to many data sources for studying population health and aging. Students can also access statistical software to do data analysis. Finally, SPPH provides many opportunities for students to present their research and get valuable feedback before submitting a paper for peer review."
The publication of this research highlights UTMB's commitment to fostering collaborative relationships between faculty and students across schools, preparing graduates who can make meaningful contributions to public health knowledge and practice.
Find the full publication “Hospitalization and Mortality Among Mexican Adults With Arthritis: Findings From the Mexican Health and Aging Study” in Journal of Aging and Health.
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