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Dr J. Jaime Miranda

J. Jaime Miranda MD, MSc, PhD, FFPH (born 25th February 1976) is a Peruvian medical epidemiologist, global public health researcher and professor. He currently holds a number of academic positions as Professor and Head of School of the Sydney School of Public Health at the University of Sydney's Faculty of Medicine and Health.[1]

Prior to his move to Australia, Miranda was a Full Professor at the Department of Medicine, School of Medicine, and was founding Director of the CRONICAS Center of Excellence in Chronic Diseases,[2] both at Universidad Peruana Cayetano Heredia (UPCH) in Lima, Peru, where he maintains active projects in his role as Professor in the School of Medicine.[3]

Miranda's body of academic work[4] brings together aspects of public health policy and epidemiology relating to chronic, non-communicable diseases - namely diabetes, hypertension, obesity, dementia and mental health - in low- and middle-income countries. His main lines of research include analysis of the patterns of chronic disease, adapting public health solutions to local contexts, evaluating health systems and scientific communication and outreach.[5] Miranda is active in several international working groups on non-communicable diseases, including the United Nations, the World Health Organization (WHO), the World Heart Federation (WHF), and the International Epidemiology Association (IEA), and participates in the Global Alliance for Chronic Diseases (GACD). In 2025, he became a Fellow of the UK Academy of Medical Sciences.[6]

Miranda has authored over 500 scientific publications[7] and is a current member of the editorial committee of several international biomedical journals, including the British Medical Journal, Cities & Health,[8] Global Heart,[9] Lancet Global Health, Revista Brasileira de Epidemiologia,[10] Revista Peruana de Medicina Experimental y Salud Pública[11]and Salud Pública de México[12]. He has been an active member of the WHO Technical Advisory Group on Research and Innovation (TAG/RI) for NCDs[13] since 2021, contributed to the Lancet Commission on Migration and Health,[14] the Lancet NCDI Poverty Commission[15] and the Lancet Commission on Racism and Child Health.[16] He received the Wakely Prize[17] in 2003 for his essay on tuberculosis entitled 'TB and you and me... personal reflection'.[18]

In 2014, Miranda was listed among the 30 under-40 researchers redefining science in Latin America[19][20]and is the only Latin American to be appointed by the United Nations to be part of the Independent Scientists Group responsible for preparing the 2023 Global Sustainable Development Report.[21]

In the public health space, Miranda is known for leading teams in developing initiatives for strengthening health systems and the impact of public health interventions through the lens of primordial, primary and/or secondary prevention. His research projects and study design bring the issues of geographical variation, politics, socioeconomics and cultural and religious tradition to the global health discourse. He is known for implementing grass roots interventions and study models that focus on both the individual and population outcomes of these interventions. Miranda has described himself as a 'doctor for populations'.[22]

Early life and education

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Miranda was born and raised in the port city of Chimbote on the coast of northern Peru, known for its fishing industry, particularly anchovy production, and is a notable hub of transportation and trade. He has discussed at length his early life exposure to an economically and ethnically diverse population in Chimbote as influencing his focus on diverse health needs within populations and the importance of community research and intervention.[23][24][25][26][27][28]

Miranda relocated to Lima, Peru, at the age of 15, where he obtained a Bachelor of Medicine (MB) and Doctorate of Medicine (MD) at Universidad Peruana Cayetano Heredia's medical school and met his now-wife, Claudia Lema. He credits her studies in psychology and later work with Health Poverty Action[29](formerly Health Unlimited) in minimising deaths in childbirth in Peruvian indigenous communities[30] for influencing his early interdisciplinary focus and resistance to medical specialisation. He joined her in working for Health Unlimited in rural Andrean communities in Ayacucho, the origin place of the Shining Path , the far-left Peruvian communist terrorist group. He credits his resulting social justice activism for honing a professional focus on marginalisation and human rights in public health.[31][32][33][34] Miranda has said, 'Inequities matter. Inequities kill people. Inequities kill our opportunities to thrive'.[35]

At age 20, Miranda studied English to enable him to read international medical journals like The Lancet and Nature. In 2002, Miranda and Lema relocated to London where he completed his Masters of Science (MSc) and Doctor of Philosophy (PhD) in epidemiology at the London School of Hygiene and Tropical Medicine, University of London. He went on to become a Fellow at the Faculty of Public Health, Royal College of Physicians of the United Kingdom in 2012. Miranda has also completed a certificate in planning and management of development projects, and intensives in health and human rights at the Harvard School of Public Health and tropical medicine at the Johns Hopkins Bloomberg School of Public Health.

Public health approach

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Miranda credits a discussion paper by epidemiologist Geoffrey Rose as influencing his 'whole distribution' approach to public health.[36] The popular paper, titled 'Sick individuals and sick populations', appeared in the International Journal of Epidemiology in 1985 and discusses individual disease susceptibility within the population approach, which leads to the importance of cause of disease incidences- the 'causes of the causes' -which must therefore centre non-communicable diseases.

Miranda's subsequent focus on cause of incidence and consideration of cultural, political and socioeconomic factors in public health centres the shared risk factors of non-communicable diseases, which includes diabetes, obesity, depression, cognitive decline, physical inactivity and poor nutrition. He has also initiated global discussion on the importance of separating public health population averages in countries with diverse settings. This includes his native Peru, which has notable geographical and socioeconomical diversity. Miranda has identified a need to consider 'four Peru's' as separated regions in data collection and informing global data pool aggregation efforts[xxvi] [xxvii] [xxviii] and human migrations.[xxix]

The CRONICAS Center of Excellence in Chronic Diseases at Universidad Peruana Cayetano Heredia (CRONICAS)

[edit]

Miranda's 2009 PhD thesis on cardiovascular outcomes in rural-to-urban migration provided material for a grant submission to the US National Institutes of Health for the establishment of an academic centre of excellence in non-communicable diseases. On being awarded the initial grant, Miranda founded the CRONICAS Center of Excellence in Chronic Diseases at Universidad Peruana Cayetano Heredia and held the role of Director from 2009-2023. As a health research center, the organisation appointed experts in an array of disciplines including anthropology, sociology, biostatistics, communications, economics, education, physiotherapy, engineering, physics, medicine, nutrition and psychology to a public health research space. CRONICAS evolved into one of Latin America's leading research centres on non-communicable diseases and was described in Nature Magazine as 'a model of interdisciplinary research that is scarce in any part of the world'.[37] CRONICAS has become known for implementing projects across multiple settings and designing intervention models for maximum population impacts within public health. Miranda has emphasised that the organisation was founded on the values of generosity, innovation, integrity and quality as decided by an initial founding member think tank.

COVID-19

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Having relocated to Australia in 2020, Miranda was not residing in Peru for the inception and progression of the COVID-19 pandemic. The pandemic resulted in 4,526,977 confirmed cases and 220,975  deaths in Peru[38][39]and Miranda has referred to the virus being akin to 'an abrasive that removed the cataract, forcing the country to see its systemic weaknesses'[40] at a public health level and as highlighting the divorce between the health system and community. The inclusion of socioeconomic and cultural factors in Miranda's work involved him in critical discussions in both non-communicable disease and community adherence to public health measures throughout the lock down periods.[41]

Notable research

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Miranda has authored over 500 scientific publications[7] in indexed journals and participates in other project teams on further publications.[42][ He was included in the 2014 list of top 30 researchers under 40 who were redefining science in the Latin American region compiled by LatinAmericanScience.org.[19] His notable research studies include:

Salt substitution project

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In response to the hypertension crisis in Peru, where 1 in 5 people have elevated blood pressure, Miranda initiated research on population determinants and potentials for 'shifting the curve'. From here, his team developed and implemented a stepped-wedge cluster randomised controlled trial, substituting regular salt with a sodium-reduced and potassium-enriched substitute across all households in six villages in Tumbes, Peru.[43] In a total of 2,376 participants, an overall average of 1.29 mm Hg systolic and 0.76 mm Hg diastolic blood pressure was seen, representing an entire shift of the curve over the study population.[44] Further, among those without hypertension at baseline, the risk of developing hypertension was decreased by 51% compared to the control group.[45] The social marketing methodology used in this study was determined by the communal dining culture in Peru, where substituting salt for hypertensive candidates alone would have isolated them from their families and community and likely resulted in poor compliance and, therefore, outcomes.

Miranda presented a TED Talk on the results and impact of this study in 2021[46] and has been consulted for comment in media on the impact of sodium in the diet.[47]

Fruit purchasing and store visibility

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In an experimental study, Miranda's team developed a methodology for measuring the impact of changing the visibility and lowering the cost of fresh fruit at a university cafeteria in Lima, Peru. The 2015 study had three phases of three weeks each; fruit being displayed 3m from point of purchase, fruit moved close to point of purchase with health information displayed and finally a price reduction applied. Over the three phases, fruit purchasing doubled overall, with the highest increases seen in young females.[48]

Priest-led health interventions

[edit]

Miranda's focus on cultural factors includes acknowledgement of the importance of faith and church service to many people in Peru and how this could potentially assist in population health interventions. He developed a cluster-randomised trial in 2017, to examine the impact of a simple, short message, delivered in mass by the priest, on the importance of protecting one's health as it relates to one's faith. Six parishes served as study groups and delivered the message during mass, and a further six control groups received a normal service with no intervention. Parishioners were offered a choice of soda or water immediately after the service. Across the parishes, it was found that the proportion of mass attendees choosing water over soda after the service increased in total by 8-11% in the study groups compared to the control groups, supporting the proof-of-concept that a brief priest-led intervention can decrease sugary drink choice. With Latin America ranking among those regions with the highest level of intake of sugary beverages in the world, this study highlighted the potential impact of the church on population health choices[49] and the impacts of retail display, education and financial accessibility on healthy food choices.

Mental health and technology

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Miranda led a set of two clinical trials designed to explore the impact of a 6-week digital intervention program on patients with depression and comorbid diabetes or hypertension in Brazil and Peru respectively. In both studies, participants who received the digital intervention – a smart-phone based behavioural action app supported by nursing assistants – showed greater improvement in depression symptoms compared to those who did not receive the intervention. Further, sustained improvement in depressive symptoms was noted as significant at 3 month follow up.[50]

Miranda also led the academic team who developed the Allillanchu Project, a technology based mental health screening program designed to streamline early detection, referral and access to treatment for those attending primary health care services in Lima, Peru. Throughout the 9-week trial, 21.7% of the 733 patients enrolled in the study screened positively, triggering advice to seek specialised care. This resulted in 72.4% of the group following through with seeking specialised care and 55.1% having attended at least one specialist appointment.[51]

The use of a screening app supported by training and supervision is feasible and uncovers a high prevalence of unidentified psychological symptoms in primary care. To increase its sustainability and utility, this procedure can be incorporated into the routine practices of existing health care services, following tailoring to the resources and features of each service. The early detection of psychological symptoms by a primary health care practitioner within a regular consultation, followed by adequate advice and support, can lead to a significant percentage of patients accessing specialised care and reducing the treatment gap of mental disorders.

Each of these studies highlighted the potential for significant improvement in both mental health services and outcomes through the use of technological intervention.

Health impacts of urban environments in South America

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In a study that incorporated data from more than 200 South American cities, Miranda and his academic team examined the associations between urban environmental characteristics and population body mass index, obesity and diabetes. Unlike the Anglo-Saxon studies that affirm that the walkability of urban settings, measured largely via the number of traffic intersections and pedestrian access, has significant corresponding health benefits, Miranda's team found that high density intersections in South America were associated with a higher BMI and increased risk of obesity and diabetes. Similarly, where Anglo-Saxon literature links higher population density with increased physical activity, and therefore reduced rates of obesity in the population, these links were not found in the South American data.[52][xliii]

This study specifically serves to support Miranda's assertion that Western data does not necessarily align with Latin American metrics.

References

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  39. ^ Msemburi, William; Karlinsky, Ariel; Knutson, Victoria; Aleshin-Guendel, Serge; Chatterji, Somnath; Wakefield, Jon (2023-01-05). "The WHO estimates of excess mortality associated with the COVID-19 pandemic". Nature. 613 (7942): 130–137. Bibcode:2023Natur.613..130M. doi:10.1038/s41586-022-05522-2. ISSN 0028-0836. PMC 9812776. PMID 36517599.
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  44. ^ Dalton, Angus (2024-04-09). "The tiny dietary tweak with a giant health impact". The Sydney Morning Herald. Retrieved 2025-07-18.
  45. ^ Bernabe-Ortiz, Antonio; Sal y Rosas, Víctor G.; Ponce-Lucero, Vilarmina; Cárdenas, María K.; Carrillo-Larco, Rodrigo M.; Diez-Canseco, Francisco; Pesantes, M. Amalia; Sacksteder, Katherine A.; Gilman, Robert H.; Miranda, J. Jaime (2020-02-17). "Effect of salt substitution on community-wide blood pressure and hypertension incidence". Nature Medicine. 26 (3): 374–378. doi:10.1038/s41591-020-0754-2. ISSN 1078-8956. PMC 7613083. PMID 32066973.
  46. ^ Miranda, Jaime (2022-02-17). Let's talk about the salt you consume. Retrieved 2025-05-14 – via www.ted.com.
  47. ^ Callahan, Alice (2024-03-19). "Are You Eating Too Much Salt?". The New York Times. ISSN 0362-4331. Retrieved 2025-07-18.
  48. ^ Cárdenas, María Kathia; Benziger, Catherine P; Pillay, Timesh D; Miranda, J Jaime (2014-12-01). "The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru". Public Health Nutrition. 18 (15): 2742–2749. doi:10.1017/s1368980014002730. ISSN 1368-9800. PMC 5454487. PMID 25434293.
  49. ^ Miranda, Jaime; Taype, Alvaro; Bazalar, Janina; Bernabe, Antonio; Ariely, Dan (2017-05-08). "Priests' sermon and sugar-sweetened beverage choices in Catholic parishes". doi:10.1186/isrctn24676734.
  50. ^ Araya, Ricardo; Menezes, Paulo Rossi; Claro, Heloísa Garcia; Brandt, Lena R.; Daley, Kate L.; Quayle, Julieta; Diez-Canseco, Francisco; Peters, Tim J.; Vera Cruz, Daniela; Toyama, Mauricio; Aschar, Suzana; Hidalgo-Padilla, Liliana; Martins, Hellen; Cavero, Victoria; Rocha, Thais (2021-05-11). "Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru: Two Randomized Clinical Trials". JAMA. 325 (18): 1852–1862. doi:10.1001/jama.2021.4348. ISSN 0098-7484. PMC 8114139. PMID 33974019.
  51. ^ Diez-Canseco, Francisco; Toyama, Mauricio; Ipince, Alessandra; Perez-Leon, Silvana; Cavero, Victoria; Araya, Ricardo; Miranda, J Jaime (2018-03-27). "Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation". Journal of Medical Internet Research. 20 (3): e100. doi:10.2196/jmir.9208. ISSN 1438-8871. PMC 5893885. PMID 29588272.
  52. ^ Anza-Ramirez, Cecilia; Lazo, Mariana; Zafra-Tanaka, Jessica Hanae; Avila-Palencia, Ione; Bilal, Usama; Hernández-Vásquez, Akram; Knoll, Carolyn; Lopez-Olmedo, Nancy; Mazariegos, Mónica; Moore, Kari; Rodriguez, Daniel A.; Sarmiento, Olga L.; Stern, Dalia; Tumas, Natalia; Miranda, J. Jaime (2022-12-29). "The urban built environment and adult BMI, obesity, and diabetes in Latin American cities". Nature Communications. 13 (1): 7977. Bibcode:2022NatCo..13.7977A. doi:10.1038/s41467-022-35648-w. ISSN 2041-1723. PMC 9800402. PMID 36581636.