For Xue Zhang, assistant professor of biobehavioral health at Penn State, prevention begins long before a crisis occurs.

As a new affiliate of the Edna Bennett Prevention Research Center, Zhang brings an interdisciplinary perspective to understanding how places and people affect how individuals live and work, and shape health and well-being. Her research uses a social-ecological framework to examine how individual, interpersonal, community and policy-level factors interact and how they can limit opportunities to achieving better health.

Zhang’s journey began at Cornell, where she received her Ph.D. in regional science and then completed a postdoctoral training in urban planning, where she examined how zoning policies and local government influence health outcomes. A second postdoctoral experience at a population center allowed her to explore health across multiple levels, from individual and interpersonal to the neighborhoods and communities where people spend their time.

Across her experiences, one theme has remained constant: health is shaped by more than individual choices.

“I’m always passionate about how people, relationships, community and environment around them can shape the health—not only health, but opportunity to achieve better health,” Zhang said.

She has observed a gap in research, one that focuses on identifying risk factors after the problem has already emerged. Zhang finds the river metaphor helpful in explaining how prevention should be viewed.

“If a man is fishing in the river and the man sees that people are drowning, he’ll drag people out of the river but will eventually get exhausted. That reflects the healthcare system. We have a financial shortage, a shortage of workforce, all those financial drains that exhaust the healthcare system,” Zhang said. “But there’s another community that has a better drainage system, has good infrastructure, so there’s no one going into the river.

This upstream approach is important in rural communities, where health disparities are significant. Rural areas experience lower life expectancy and higher mortality rates. Zhang focuses on the social determinants that contribute to those disparities, including income, education, access to healthcare and food access. Addressing the underlying conditions that may affect individual health can help improve specific health outcomes, while reducing the pressure on an already stretched healthcare system.

This upstream approach is important in rural communities, where health disparities are significant. Rural areas experience lower life expectancy and higher mortality rates. Zhang focuses on the social determinants that contribute to those disparities, including income, education, access to healthcare and food access.

A project that Zhang is currently involved in examines school-based health centers in rural communities. These centers address multiple barriers at once by bringing health services directly into school, reducing transportation challenges and lowering costs. She said that collaboration plays a vital role in achieving her goals.

“It took almost two decades to build the center. We didn’t really have many resources to build, but were able to collaborate with a senator and local government to get the money they needed to build,” Zhang said. “Research definitely plays a very important role in translating the research, providing evidence and enacting change.”

The collaborative environment was one aspect of what drew her to the Prevention Research Center.

“I want to find people like me,” Zhang said. “Which center can do my research the best?”

As Zhang begins her work at Penn State, she hopes her connections to colleagues will lead to new projects. Her goal remains straightforward: create conditions in which people will have the opportunity to live healthier lives, regardless of age, class, gender, sex or other circumstance out of their control.

“I think that’s the best thing you can do as a researcher, focus on preventing the problem,” Zhang said.