World Health Day 2025: Q&A with Prof Andrew Williams

Andrew D. Williams, PhD MPH, is an assistant professor in the Department of Population Health at the University of North Dakota School of Medicine & Health Sciences and Associate Editor for Reproductive Health. Dr. Williams is a perinatal epidemiologist with an interest in structural inequalities and obstetric and pediatric health outcomes with consequences across the life span. Currently he is leading the Stress and Health in American Indian Pregnancies study, investigating associations between Adverse Childhood Experiences, historic trauma, stress, and infant growth among American Indian women in North Dakota. Dr. Williams was recently awarded an NIH Loan Repayment Program for Health Disparities Research award for his work investigating telehealth use and pregnancy outcomes in North Dakota. As Executive Director of the North and South Dakota Perinatal Quality Collaborative, Dr. Williams has secured over $2 million from the Centers for Disease Control and Prevention and the Health Resources and Services Administration to implement quality improvement projects at prenatal care sites in the region.  

How does your research relate to the SDGs?

My research directly addresses SDG 10's focus on reducing inequality, particularly through my work examining health disparities in maternal and child health. My studies on ethnic enclaves and pregnancy outcomes among Asian/Pacific Islander women, racial residential segregation and stillbirth disparities, and the impact of environmental factors on gestational diabetes all highlight how social determinants affect health inequitably. My current work with the "Stress and Health in American Indian Pregnancies (SHAIP) Study" specifically targets health inequities faced by American Indian women in North Dakota, examining how adverse childhood experiences affect maternal and infant outcomes in this historically marginalized population.

Why did you decide to go into your field of research?

My career path reveals a consistent commitment to addressing health disparities. Beginning with my work at the North Dakota Fetal Alcohol Syndrome Center and research in the Republic of Congo on prenatal alcohol exposure, I've consistently focused on vulnerable populations. My transition to studying broader determinants of maternal health outcomes reflects my recognition that addressing upstream social and environmental factors is essential for meaningful change. The geographic progression of my work—from international settings to rural American populations—demonstrates my commitment to applying epidemiological methods to understand and address health inequities across diverse contexts.

How has the knowledge of maternal health developed over the course of your career?

The evolution of my research publications shows how maternal health knowledge has expanded from individual risk factors to a more complex understanding of multilevel influences. My early work focused on specific exposures like prenatal alcohol, but has expanded to incorporate environmental pollutants, neighborhood characteristics, racial segregation, and psychosocial factors like stress and adverse childhood experiences. My recent publications examining telehealth access, COVID-19 impacts, and interpersonal violence demonstrate how the field increasingly recognizes the intersection of social, environmental, and healthcare system factors in maternal health outcomes.

What challenges do vulnerable populations in particular face?

My research highlights several key challenges facing vulnerable populations:

1. Disparities in healthcare access: My work on early prenatal care barriers among American Indian women in North Dakota reveals significant obstacles.
2. Historical trauma: My current SHAIP study examines how adverse childhood experiences and historical trauma affect pregnancy outcomes in American Indian women.
3. Systemic barriers: My work with the North Dakota Perinatal Quality Collaborative addresses systemic issues in rural healthcare delivery, including urban-rural disparities in interpersonal violence screening.
4. Limited representation: My publications on ethnic enclaves highlight how cultural isolation and marginalization affect health outcomes.

What are your hopes for progress in the future?

My current grant activities and research trajectory suggest several aspirations for future progress:

1. Strengthening rural healthcare systems: My leadership of the North Dakota Perinatal Quality Collaborative demonstrates commitment to improving maternal healthcare in underserved rural areas.
2. Cultural responsiveness: My focus on American Indian maternal health indicates dedication to culturally appropriate interventions that respect indigenous knowledge.
3. Multi-level interventions: My research increasingly examines both individual and structural factors, suggesting a commitment to comprehensive approaches.
4. Data-driven policy: My work producing reports on American Indian women and children for the North Dakota Department of Health shows commitment to translating research into policy action.

Throughout my career, I've maintained focus on using epidemiological methods to illuminate and address health disparities, particularly those affecting maternal and child health in vulnerable populations. This work directly supports SDG 10's aim of reducing inequalities and ensuring no one is left behind.

World Health Day, celebrated on 7 April each year, aims to promote wellbeing and health. Organised by the World Health Organisation, the 2025 campaign, titled "Healthy beginnings, hopeful futures", will urge governments and the health community to ramp up efforts to end preventable maternal and newborn deaths, and to prioritise women’s longer-term health and wellbeing, supporting Sustainable Development Goal 3. 

For more content on World Health Day 2025, please check out our research highlights blog here.