Dr. Shikhar Agarwal is the author of more than a hundred scholarly papers. The 2015 Social Mood Conference speaker and Cleveland Clinic cardiologist has received honors from the American Heart Association, American College of Cardiologists of Indian Origin and the Society of Critical Care Medicine, among others. He was named the American College of Cardiology’s ELITE FIT Rising Star in 2012 and best graduating resident at the Cleveland Clinic.
So how did he do it? In this interview with the Socionomics Foundation’s Alexandra Lienhard, recorded before the conference, Dr. Agarwal reveals some of his insights about the publishing process and also discusses his recent paper on the link between trends in the stock market and firearms-related hospitalizations.
Click the play button to listen to the interview, or read the transcript below.
Socionomics Foundation: So to start off, can you tell me a little bit about your background and what attracted you to a career in medicine?
Shikhar Agarwal: I was really fascinated with human biology during high school, so that’s why I chose to do medicine and went to med school in India. After that, I decided to learn a little bit about public health and international health, so I went to Johns Hopkins for a Master of Public Health. After that, I came to Cleveland and did internal medicine residency, then cardiology and now interventional cardiology.
SF: You’ve published numerous papers. One which really piqued our interest was published in the American Journal of Medicine. It found a relationship between stock market fluctuations and the incidence of firearms-related hospitalizations. What did you find in particular, and what inspired you to compare the two?
Shikhar Agarwal: The reason I did this was because firearms have been in the news so much, and there is so much controversy about what should be done about firearms-related mandates in the United States. I didn’t grow up here, so I was intrigued by what it was that drives firearms-related injuries. I had some experience working with the Nationwide Inpatient Sample, and I realized that firearms-related hospitalizations carry unique diagnosis-related codes which are generally used to identify a particular diagnosis when a patient gets admitted to the hospital. I went on to kind of understand the trend that has been prevalent in the United States across the past two decades and found that there were peaks in the incidence during 2003-2004 and then later in 2009-2010. It was interesting in the sense that there have not been any major changes to firearms federal mandates or anything. But if one asks what could be the potential reasons, one of the major reasons that comes to mind is stock market crashes just preceding these two time periods. I went ahead and obtained the monthly indices from the Dow Jones Industrial Average and subsequently correlated them to find this beautiful correlation. Intuitively speaking, it makes sense that economic insecurities drive crime, and probably that is kind of the underpinning of firearms-related hospitalizations in our country, too.
SF: Are there any other linkages you see between stocks and health beyond this paper that you published?
Shikhar Agarwal: It is a new field, and people are starting to look into it. There is a study from Duke that was published in 2012 that looked at the association between the stock market and acute myocardial infarctions. They looked at the specific time period from 2008-2010 and showed that during the stock market crash that happened during that time, there was a higher incidence of people coming with heart attacks. I think there are certainly several chronic diseases that one can see as being correlated with the stock market. In fact, I was actually reading a very interesting paper, which I will show when I present my study at the conference, that looks at what could be the potential reasons as to why this happens. It has to do with anxiety-related molecules that may go up in the body and immune system reactions and so on and so forth. There is a new understanding of why the stock market affects health, especially chronic diseases.
SF: In reviewing your resume, it looks like you have had more than a hundred publications in leading journals. What have you found to be some of the tools of the trade to become a widely published researcher?
Shikhar Agarwal: I would give a lot of the credit to my training at Johns Hopkins because I think that was very important in terms of providing me with background training in statistics and epidemiology, which I think is all critical. But one thing I would like to mention is that a lot of researchers who are starting out kind of get carried away with the statistical aspects. They want to present sophisticated statistics and things that are kind of advanced. I don’t think that is actually necessary. I feel it is more important to get the message right. It is more important to interpret your statistics. For most of the medical journals, the audience is doctors who have very basic knowledge of statistics and know very little. Most of us, especially in medicine, are just looking for things that make intuitive sense and are easily understandable. One of the biggest messages is to do things in the perspective of the context that you are studying. If you look at my paper on firearms-related hospitalizations, it doesn’t have anything advanced in terms of statistics. It’s very basic. It draws qualitative correlations and leaves it up to the reader to look at these graphs, inspect them and look at the correlations. That is something very critical. One more feature that I think is very important in research is collaboration. I couldn’t stress that enough. For several of our papers, we have collaborated with other institutions and people of different departments. Everybody brings a different kind of expertise. We are now working on a paper where we are trying to improve the institution-wide efficiency. We are collaborating with the nurses. We are collaborating with the administrators. I think collaboration is also a key in research.
SF: The last question I have for you today is: Why are you most excited to present your work at the Social Mood Conference?
Shikhar Agarwal: I am most excited because I have never done this before. It’s a new experience for me, which is certainly welcome. Also, I am always open to interacting with people from different walks of life and different specialties, so I think it will be very interesting to get that platform to interact with different people. And thirdly, and most importantly, I have very basic knowledge of the stock market and how this affects health, so I am looking forward to meeting some of the financial analytical experts to get a better understanding and maybe some ideas for further research, and maybe build some more collaborations.
SF: Thanks for taking the time to chat with me. I know we are looking forward to your presentation. I’m excited to get to meet you in person in April.
Shikhar Agarwal: Absolutely, Alexandra. Thank you very much.