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The Bridge

Public Health Newsletter

Spring 2014, Volume 4

The Bridge is a public health newsletter written and produced by Hofstra University students and faculty devoted to bridging the gaps in our health care system and improving the health of our communities.

Recap: “Health Care Reform 2014 and Beyond The Impact of Obamacare” By Ronald Sanchez, MPH, ’14 John McDonough, DrPH, MPA, director of the Center for Public Health Leadership at Harvard University School of Public Health and a former advisor to the U.S. Senate on health care reform, presented a special public lecture at the Leo A. Guthart Cultural Center Theater on “Health Care Reform 2014 and Beyond: The Impact of Obamacare.” Dr. McDonough offered incredible insight into the planning, execution and the future of the health reform law.

Why Health Reform? “Obamacare” is the common term used for the Patient Protection and Affordable Care Act (ACA), the federal law enacted in 2010. The need for reform to the U.S. health system has been in contention for decades. In 2009 there were more than 50 million uninsured or underinsured non-elderly residents, with a U.S. health care bill of $3 trillion – approximately $8,000 per person, representing 17.4 percent of the country’s gross domestic product. Health care expenditures have been steadily increasing globally, but in the U.S. there has been a substantial spike in costs since the 1980s. Compared to highly developed health systems in other countries, the U.S. spends much more. For example, the next most expensive per capita health system is Norway, at about $5,300 per person. In other words, for every dollar the U.S. spends, Norway spends only $0.67. Dr. McDonough made clear that greater health care spending does not equate to better health outcomes or improved quality of care. We spend twice as much as France ($3,978 per capita), and they rank No. 1 globally. The U.S. ranks No. 37 worldwide. A variety of health disparities and inequalities has been pushing the nation’s health system into disaster – enter the Affordable Care Act.

The ACA The Public Health Care and Education Act amended the Patient Protection and Affordable Care Act to formalize the Affordable Care Act (ACA). The ACA is a robust law with 10 titles that focuses on all sectors of health care – consumers, providers, security systems, payers, hospitals, pharmaceuticals, biomedicine, payment and revenue systems, delivery systems, prevention and wellness, technology, the workforce and education. Currently, the provisions of the law that have garnered the most attention and have had the greatest impact thus far are the first two

titles: (1) Affordable and Available Coverage and (2) Medicaid and Child Health Insurance Plan (CHIP). Title I passed immediate reforms, such as coverage for children under 26; ban on lifetime and annual limits; medical loss ratios (in which insurance companies must spend at least 80 percent of their revenue on health care or provide rebates to enrollees); and closing of the Medicare Part D prescription drug “donut hole.” Dr. McDonough described these changes as “the most substantive changes to health care in the U.S. since the passing of Medicare and Medicaid.” Title I also establishes consumers guaranteed issues of coverage, removal of the possibility of being denied for pre-existing conditions, individual responsibilities in the form of tax penalties, and insurance premium and cost sharing subsidies. Title II establishes the option to expand the Medicaid and Child Health Plus programs for low-income individuals and families. continued on page 8

Inside From the Director................................................................2 Health Care Reform 2014 and Beyond............ front cover Love Shouldn’t Hurt......................................................... 3 Campus-Wide Health Promotion Campaign.................. 4 Dental Public Health........................................................ 5 Public Health Film Festival.............................................. 5 Progress on Millennium Development Goals................. 6 Nassau County Minority Health Conference.................. 7 Interdisciplinary Student Case Competition on Childhood Obesity........................................................... 8 Industry Leaders Discuss Changes in Health Care................................................................ 10 How Nurses Can Help Save Health Reform.................. 10 Radiation Safety............................................................. 11 Run or Dye 5K................................................................ 12 Shouldn’t Everyone Have a Right to a Healthy Life?................................................................ 12 Women’s Health Fair...................................................... 13 Health Equity Symposium............................................. 14 For More Information.................................................... 14

From the Director

Corinne Kyriacou, PhD, MPH Associate Professor and Director MPH and MSCH Programs Department of Health Professions Hofstra University As the blooming Hofstra campus celebrates spring and says goodbye to a particularly long and challenging winter, we in the public health program are also simultaneously celebrating and saying goodbye to our graduating students. Although we are sad to see them go, we are filled with pride and optimism over their growth and achievement, and for their developing public health careers. Transitioning from student to public health professional will be a fairly simple process for these graduating students, who have been actively engaged in public health initiatives throughout their academic training. Indeed, many of these graduates held positions on our student leadership board of the Society of Public Health Advocates (SOPHA), took part in our 2014 National Public Health Week event series and other community-based events we hosted, and worked in the global or local community on research, advocacy or policy projects. The graduates, together with their classmates, are an impressive group of young professionals who care deeply about the most vulnerable among us and who are working toward solutions to the most complicated public health challenges (see article by AnMarie Freeman for one example). This issue of The Bridge will provide a glimpse into some of their outstanding work. Once again it’s been a busy semester. In addition to implementing several new courses, establishing a number of new internship placements, and working with students on their culminating research projects, the public health program played a central role in numerous professional development and community awareness activities. In February our students helped organize and run Heart Health Week, presented by Hofstra’s Labor Studies Program. On March 12, a graduating MPH student, Johanna Andrews, spearheaded 2

the first Health Equity Symposium and Networking Lunch (see Health Equity article), and on March 26, an MPH faculty member, Dr. Joshua Moskovitz, gave a special field report on the national emergency care environment report card (see article by Meghan Hickey-Pace). We held three journal club discussions with MPH faculty: Dr. Sarah Novak reviewed articles on her research on weight and relationships; Dr. Andrzej Kozikowski discussed research on diabetes and self-efficacy; and Dr. Martin Lesser reviewed research on vitamin E and prostate cancer risk. We also held a number of skillbuilding methods workshops on synthesizing literature, building Qualtrics surveys, and using SAS. In April we also organized Hofstra’s 2014 National Public Health Week (NPHW) event series, an exciting, action-packed initiative that was further galvanized by the early spring announcement that Hofstra’s MPH is now a candidate for accreditation with the Council on Education in Public Health. For nearly 20 years, with the American Public Health Association’s leadership, the first full week of April has been dedicated to recognizing the contributions of public health professionals and highlighting issues that are important to improving our nation. This year, Hofstra University’s School of Health Sciences and Human Services, led by the Master of Public Health Program and the Society of Public Health Advocates (SOPHA) celebrated its second annual NPHW from April 6-12, 2014 with more than a dozen free events addressing some of the most pressing challenges facing public health professionals today. The event series, which brought together students, faculty, local and national policy experts, practitioners, communitybased organizations and the public, featured a campus-wide health promotion campaign, two health fairs, panel discussions, film screenings, and a 5K run. A wide range of topics were addressed, including progress on the Millennium Development Goals (see article by Sophia Noel), oral public health (see article by Danielle Spitaleri), radiation safety (see article by Amy Singh), dating violence (see article by Anu Anish), the evolving role of nurses (see article by Vanessa Williams), and the changing health care environment (see article by Nathalie Jean Baptiste and Hope Zewou).

Among the many exciting events were the first Nassau County Minority Health Conference, which included an expert panel discussing strategies for building health equity, a health fair with high school students and a film screening of Soul Food Junkies with the film’s producer, Byron Hurt (see article by Nina Scollo); a Women’s Health Fair (see article by Johanna Andrews); an interdisciplinary student case competition looking at ways to tackle childhood obesity (see article by Pascale Frederique and photo collage by Thalia Stewart); a public health film festival where students led a discussion about the social determinants of health (see article by Amanda Dugan); and a special lecture on the impact of the Affordable Care Act, given by Dr. John McDonough, director of Harvard University’s Center for Public Health Leadership and a former senior advisor to the U.S. Senate on health reform (watch it live on Hofstra’s YouTube channel; see article by Ronald Sanchez). The SOPHA-run health promotion campaign incorporated the national theme of “Public Health, Start Here” and included an interactive information table in Hofstra’s Mack Student Center and creative campus exhibits, lawn signs and sidewalk chalk messages about such issues as the dangers of drinking and driving, the high toll of smoking, and the importance of recycling. Student volunteers staged a “flash mob/drop dead dance” to highlight startling statistics about the state of health in the United States (see article by Nuzhat Quaderi). To wrap up the weeklong public awareness campaign, a SOPHA-led team of students ran in the Run or Dye 5K to celebrate fitness (see article by Anu Anish). Hofstra’s NPHW 2014 was an informationrich, dynamic celebration of public health and a call to action. The most rewarding element was watching the students take part in the planning and implementation of the series: they truly functioned as scholar-advocates by sharing data about the dangers of poor personal or policy decisions, highlighting the value of investing in public health, and engaging their community in serious discussions about how to improve health. The 15 student accounts published here are as interesting and enlightening as the students themselves. Happy reading!

How Did the US Receive a D+ and How Can We Improve It? Hofstra Special Report with Joshua Moskovitz, MD, MPH, MBA, FACEP

Dr. Joshua Moskovitz is busy; in addition to being a board certified emergency physician working overnights in NSUH Emergency Departments (EDs), he is also the EMS liaison for NSUH, an assistant professor at the Hofstra North Shore-LIJ School of Medicine, an adjunct assistant professor in the MPH program, and was a member of the American College of Emergency Physicians’ Task Force on America’s Emergency Care Environment. On March 26th, his “How Did the US Receive a D+ and How Can We Improve It?” presentation was overwhelmingly hailed as eye-opening and thought-provoking by attendees. Hospital administrators, EMS supervisors, general and specialty doctors, attorneys, professors, and students from the New York metropolitan area learned about “The Evolving Role of Emergency Departments in the United States” by the RAND Corporation, which segued into “The National Report Card on the State of Emergency Medicine” by The American College of Emergency Physicians (ACEP). (RAND is a non-partisan, non-profit outfit specializing in helping policy makers make pertinent decisions through independent research and analysis [www.RAND.org].) The RAND study revealed that 50 percent of all hospital admissions come through the emergency department first, and only 11% of all ED visits were considered non-emergent or non-urgent. Of that eleven percent, nearly 80% occurred because patients had no better place to receive their care, half because their physician’s officers were not open. Further, when a patient called their primary

By Meghan Hickey-Pace, MPH, ’14

care doctor, four out of five patients were instructed to go straight to the emergency department. In 2010 there were a startling 130 million ED visits, 37.9 million of which were injury-related (Public Health students, take heed); 43 out of 100 people had been seen in the ED, and ED visits were up by 34% from 1995-2010. It is disquieting to note that despite these large numbers, only 4.2% of practicing MDs/DOs are emergency physicians and the costs associated with emergency visits are only 2% of every dollar spent on health. RAND concluded that PCPs are utilizing EDs to assess more patients so that intricate, complicated workups can be performed in a more efficient manner. ED visits also increased due to the fast and sharp increase of hospitalizations of a growing Medicare population. EDs are being challenged with treating more patients because of hospital closures and facing burgeoning liability in an increasingly litigious environment. EDs are being forced to handle these increased challenges, while having decreasing numbers of available hospital beds, staff, and resources. To raise awareness of the challenges confronting EDs nationwide, the ACEP’s Report Card on Emergency Medicine was born (www. emreportcard.org for the full reports). Three report cards were completed in 2006, 2009, and 2014. The grades were calculated as follows: access to emergency care (30%); quality/patient safety (20%), medical liability environment (20%), public health/injury prevention (15%), and disaster preparedness (15%). The components were averaged for the overall grades for the 50 states and Washington, D.C and each state

was ranked and given a grade. First place went to D.C., followed by Massachusetts, Maine, Nebraska, and Colorado. The worst rankings went to Wyoming, followed by Arkansas, New Mexico, Montana, and Kentucky. I was surprised that New York didn’t fare better in the disaster preparedness (we moved up to #4, but the grade dropped to a B from an A-). Overall we scored a C, mainly because of New York’s hostile medical liability environment, which scored an abysmal F (#49). NY is experiencing a ‘brain drain’ as physicians don’t want to be forced to practice expensive defensive medicine. Texas is the recipient of many of our doctors because of its successful tort reform. Dr. Moskovitz explained that if he apologizes to a patient, just a simple “I’m sorry” can be admissible as evidence in a malpractice case in New York; ironically, most patients in lawsuits admit that if the doctor had simply said “I’m sorry”, they wouldn’t have sued. The report cards were done to highlight topics that need attention. Many states have used past report cards to improve their ability to provide high quality emergency care. States like Oklahoma improved its disaster preparedness substantially going from a D- (#45) to a B- (#6) which saved countless numbers of lives during its EF Category Five 2013 Newcastle-Moore tornado. Public health programs can decrease the number of injuries, and tort reform will allow doctors to treat their patients to prevent diseases, rather than to prevent lawsuits. Listen to Dr. Moskovitz on the Brian Lehrer Show (www.wnyc.org/story/er-report-card/). I highly recommend taking his course in Critical Decisions in Public Health: MPH 280C. *Updated May 2014

Love Shouldn’t Hurt: Know the Signs and What to Do About Dating Violence By Anu Anish, MPH, ’14

Knowledge is power, but what you do with that knowledge is what makes the difference. Data show that more than 25 percent of young people have experienced unhealthy, abusive or violent relationships. Nearly 1 in 3 college women say they have been in abusive relationships, and most sexual abuse takes place between partners. The effects of violence and assault on an individual can be damaging to their personal and professional

growth and can put communities at risk. Facts alone are not enough; action must be taken. The session “Love Shouldn’t Hurt: Know the Signs and What to Do About Dating Violence,” was part of Hofstra’s 2014 National Public Health Week. Hofstra’s MPH program wanted to raise awareness about domestic violence and empower students to take action. Three professionals

addressed the audience: Dr. Amy Weintraub, formerly of Harlem Hospital Center and Freedom House; Anthony Zenkus, director of education at the Safe Center of LI; and Kaitlyn Pickford, assistant director of education at the Safe Center of LI. The panelists shared their expertise and knowledge of this area and engaged the attendees in a challenging manner. continued on page 4

SOPHA’s Spring 2014 Campus-Wide Health Promotion Campaign By Nuzhat Quaderi, MSCH, ’14 During the week of April 6, 2014, Hofstra’s Master of Public Health Program and the Society of Public Health Advocates (SOPHA) presented the second annual event series for National Public Health Week (NPHW). As a part of the event series, SOPHA members implemented a studentrun, campus-wide public health campaign that reflected this year’s APHA theme, “Public Health: Start Here.” The campaign included a multitude of engaging displays and sessions that addressed public health issues such as nutrition, alcohol awareness, and driving safety. With multiple showcases across campus, students were reminded throughout the week of ways to maintain personal health as well as improve overall community health with small but meaningful changes. Public health messages, which emphasized health statistics, healthy lifestyle behaviors, and public safety, were written in chalk on sidewalks. Lawn signs along campus pathways also reflected public health statistics and offered tips for maintaining good health and preventing illness. In addition, SOPHA was able to put together three on-campus displays, one reflecting the devastating statistics on the effects of second-hand smoke, one highlighting environmental awareness, and one emphasizing responsible decision making with regard to drinking and driving. Nearly 100 pairs of shoes were donated and then showcased outdoors on the South Campus. The pairs of shoes represented a fraction of the 49,000 Americans killed every year from second-hand smoke. These shoes were then donated for distribution to the community. Garbage cans were displayed to represent the amount of trash an individual generates that could be recycled,

Dating Violence

For each day of NPHW, SOPHA set up a public health awareness table in the Mack Student Center, offering free condoms, hand sanitizers, and pamphlets on topics such as sex education and heart health. In collaboration with students from Hofstra’s Health and Wellness Club, the table also displayed engaging and interactive trifold boards regarding public health topics. Guests, including the Red Cross, NutrishMish, and Felicia Schneberg from the Nassau County Department of Human Services, joined SOPHA at the table, offering information and an interesting demonstration with Fatal Vision goggles (simulated impairment goggles). Last, but certainly not least, students put together a flash mob at the Mack Student Center stressing the importance of exercise, and a “drop dead” campaign highlighting alarming public health statistics. Overall, with a variety of activities, displays, and sessions, the student-run campaign caught the attention of the Hofstra community and emphasized that public health truly encompasses everything around us.

Student Campaign

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Anthony Zenkus challenged us to change the way we think about violent acts. Rather than ask, “why does she [the victim] go back to him [the abuser],” we should ask, “why does he [the abuser] beat her?” Hearing that statement made me realize that to end this pattern of abuse, we can’t only focus on victims, but also on 4

and a half-taxi/half-police car displayed the words “You Choose Your Ride,” reminding passersby that drinking and driving is a choice that can be avoided.

the abuser. What causes them to act this way? What can we do to stop this? It is important to remember that many times the abuser may have been a victim at some point. Domestic violence is an issue that impacts the most immediate to extended networks of the individual involved, be it male, female, young or old. This session

reminded us to be aware, sensitive and ultimately bold and to speak out and stand strong. If you see something, say something. If you are a victim of abuse, it’s never too late to get help. Love shouldn’t hurt; it should make you strong. Know when enough is enough.

Dental Public Health: Politics, Policy and Practice By Danielle Spitaleri, RDH; BS; MPH, ’15

Dental health is closely tied with one’s overall health. The field of dental public health is still growing and is rapidly becoming even more important in public health policy and practice. Having good oral health promotes improved quality of life and overall well-being and should be considered an essential health benefit for all Americans. And yet, this is still not the case. Many populations, especially those in lower socioeconomic areas and seniors, are truly struggling with the costs, access to care, and quality of care that’s available to them. Many Americans don’t have dental insurance, which is a fringe benefit often not included in many employers’ incentives, and are not equipped with the adequate amount of knowledge to understand the importance of dental health and how to prevent dental disease. The value of “preventive dentistry,” the current medical and dental link in the hospital setting, and the ethics involved with this debate were reviewed by four expert panelists during an event that was part of Hofstra’s 2014 National Public Health Week. Gerard Meuchner, chief global communications officer at Henry Schein Inc., served as the panel moderator. Francine Raxenberg, DDS, MPH, a dentist in Syosset, NY, discussed dentistry across the lifespan. She explored the dental issues faced during different ages and health status. During pregnancy, oral health is a huge concern as hormones affect the mother’s oral health and conversely affect the growing fetus in utero. In childhood, early childhood caries is on the rise due to poor diets linked to our nation’s obesity epidemic, lack of dental sealant placement, lack of proper fluoride use, and lack of knowledge on the

importance of baby teeth to permanent adult teeth. Adolescents encounter issues with the need for proper mouth guard protection in sports, orthodontic needs for alignment and spacing of permanent teeth, and, in some, the negative effects of eating disorders and drug use on dental health. Adulthood brings a slew of very common dental diseases, such as gingivitis, periodontal disease, and oral cancers, and is affected by diabetes, heart disease, and smoking. Seniors face dry mouth issues associated with multiple prescription medication use, tooth loss and denture care, and limitations of care with Alzheimer’s disease and physical mobility and dexterity issues. Hicksville dentist Thomas Wilkens, DDS, discussed the role of dental health in oral cancer prevention. He stressed the importance of having a proper head and neck and intraoral cancer exams at every dental visit to check for signs and symptoms of oral cancer. Common signs and symptoms associated with oral cancers include a mouth sore that fails to heal or that bleeds easily; a white or red patch in the mouth that will not go away; a lump or thickening or soreness in the mouth, throat, or tongue; and difficulty chewing or swallowing food. The common risk factors associated with oral cancer are tobacco use (tobacco chewing), excessive alcohol consumption, viral infections (HPV), immunodeficiency, poor nutrition and poor hygiene, and excessive exposure to ultraviolet light (especially in lip cancer). When discovered early, oral cancer is treatable, even when no pain is present, but in latter phases oral cancer is very aggressive and destructive.

Ron Burakoff, DMD, MPH, chair of the department of dental medicine at the Hofstra North Shore-LIJ School of Medicine, discussed dentistry in the hospital setting. He explored the difficulties in the role of integrating dental care and medicine in hospitals and the struggle to get dental education incorporated in the medical school curriculum, which is currently being done successfully at the Hofstra North ShoreLIJ School of Medicine, thanks in part to his efforts. Current issues in this discipline include the increase in people admitted to emergency departments for non-traumatic dental conditions due to lack of care and the difficulties of getting clearance for patients with systemic conditions that impede necessary dental treatment. Lastly, Janet Dolgin, JD, PhD, professor of law at the Maurice A. Deane School of Law, discussed the ethics behind the insufficient attention to dental coverage in America. Over the years, we have struggled as a nation with our essential health care rights and benefits – with dental health coverage being neglected – while other countries are making strides. Legal action and lobbying for policy changes to include dental care coverage in health care reform is both ethically and fundamentally needed. A lively Q-and-A followed the panel, with several members of the audience proposing solutions to the challenges addressed, including the expansion of the role of the dental hygienist, an underutilized preventive change agent, and possible solutions to access to care.

Public Health Film Festival By Amanda Dugan, MPH, ’14 Today, the top 1 percent of Americans own more wealth than the bottom 90 percent combined, and 1 out of every 5 children in the United States lives in poverty. Economic inequality is greater than at any time since the 1920s. Compared to other countries, the United States has the greatest income inequality – and the worst health.

In Sickness and In Wealth is part of a sevenepisode PBS series that explores how social conditions affect population health and how some communities are extending their lives. This provocative film examines the connections between healthy bodies, healthy bank accounts and skin color, taking the viewers to Louisville, Kentucky, not to explore whether medical care cures us but to see why we get sick in the first

place, and why patterns of health and illness reflect underlying patterns of class and racial inequities. This film depicts the lives of a CEO, a lab supervisor, a janitor, and an unemployed mother, which illustrates how class shapes opportunities for good health. Those on the top have the most access to power, resources and opportunity – and thus the best health. Those on the bottom are faced with more stressors – continued on page 6

Film Festival

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unpaid bills, jobs that don’t pay enough, unsafe living conditions, exposure to environmental hazards, lack of control over work and schedule, worries over children – and the fewest resources available to help them cope. After showing In Sickness and In Wealth during National Public Health Week, two of my fellow graduate MPH students, Alicia Colangelo and Lindsey Myers, and I engaged the audience in a discussion of the important themes portrayed in the film. Having viewed the film for the first time exactly one year prior, I can honestly say my views have changed drastically; initially I thought it was a ridiculous notion that a hospital CEO might in fact suffer less health effects from stress than a hospital janitor. However, now I understand how devastating the effect of “cumulative stress” can be. While I still believe we all have different kinds of stressors and coping mechanisms, there are definitely some “luxuries” that the upper class takes for granted (e.g., having flexibility and control in the workplace) and the middle/lower classes

struggle with every day (e.g., being at risk for losing a job if one needs to take time off to care for a sick child). In the last year working in a hospital, I have been able to see and experience stress at all levels in employees but also in patients who might lack proper access to care, resources, even something as simple as transportation to and from appointments. Lindsey commented on an example from the film that regards the connection between one’s ZIP code and one’s health. For example the “rich guy” has the stress of worrying about hitting a deer while driving home from work, and the guy in the low income neighborhood is constantly stressed about being shot while walking home or whether there is going to be enough food on the table. Environment and neighborhood affect disease greatly. Lindsey also referenced a study that took people from low-income neighborhoods in NYC and moved them to higher income neighborhoods and measured health outcomes of parents and children three years later. Both the parents and children in the treatment group had much better

self-reported health outcomes than those in the control group, proving that where people live can affect health outcomes. Alicia also addressed the issues associated with ZIP code and health. The film spoke about how this health/wealth relationship becomes a vicious cycle – that you are more likely to live in a neighborhood similar to the one you grew up in, further perpetuating the negative health effects. She spoke about how a child born into poverty is starting off at a disadvantage when considering health. We need to figure out how to break the cycle and improve the most vulnerable neighborhoods by building healthier and safer environments. Other films shown during the Public Health Film Festival included The Waiting Room, a film about the challenges of overcrowding at America’s emergency departments, and Pearls of Wisdom, a documentary about how the Nassau County Department of Health protects the public’s health.

Millennium Development Goals: Where Do We Stand and Where Do We Go From Here? By Sophia Noel, MPH, ’14

On April 8, 2014, in the Teaching Center Conference Room of Long Island Jewish Medical Center, two global health leaders addressed a room filled with public health students, medical residents and fellows, and local providers. David Hipgrave, MBBS, PhD (Melb) senior health specialist, UNICEF’s Health Section, and Ranu Dhillon, MD, senior health advisor, Earth Institute, Columbia University, shared their assessment on the state of the Millennium Development Goals using current data and personal stories. 6

In 2000 the United Nations outlined eight Millennium Development Goals (MDGs) for the world to be met by 2015. In this penultimate year, the speakers addressed the achievements, challenges and sustainability of the MDGs. Dr. Hipgrave focused his discussion on goals 5 and 6, which address reducing child mortality rates and increasing maternal health. He noted that UNICEF has taken the lead in reporting on child mortality through its publications Committing to Child Survival: A Promise Renewed – Progress Report 2013 and Levels and Trends in Child Mortality, Report 2013. He went on to say that although 90 million lives have been saved and there has been a nearly 50 percent reduction in child mortality since 1990, there were still 216 million deaths reported between 1990 and 2012. Twenty-five of the high-mortality countries have reduced mortality rates of children under 5 by at least 50 percent, and most regions have reduced health disparities with the exception of SubSaharan Africa. This region is not expected to achieve the MDGs until 2027. The major causes of preventable deaths in the

children under five population continue to be pneumonia, diarrhea and malaria. Progress made is due in part to the availability of free and low-cost vaccines and bed nets. The presence of skilled birth attendants has increased significantly but has had no effect on mortality rates in children under 5. Dr. Hipgrave concluded that after 2015 the MDG targets for health will continue, with emphasis on over- and under-nutrition, mental health, overall health and health as a human right. Dr. Dhillon shared a story about an experience in India that demonstrated how the caste system and culture affect access to care. His presentation also addressed MDGs 4 and 5 as well as 6, which seeks to combat HIV/AIDS, malaria and other infectious diseases. He pointed out that as access to antiviral medication has increased, new HIV infections and death have leveled off. There has been a dramatic decrease in malaria deaths, but child mortality remains a persistent burden, with 6 to 9 million deaths per continued on page 7

Nassau County Minority Health Conference By Nina Scollo, MPH, ’14 In the first conference of its kind, the Nassau County Minority Health Bureau, in conjunction with Hofstra’s School of Health Sciences and Human Services, conducted the Minority Health Conference on Wednesday, April 9, 2014. As part of Hofstra’s National Public Health Week, this event focused on health equity among minority populations in Nassau County. An esteemed panel of professionals gave a series of thoughtprovoking presentations on the topic. Dr. Lawrence Eisenstein, commissioner of the Nassau County Department of Health, introduced the newly developed Minority Health Bureau and explained its purpose to promote health education and outreach in target communities in Nassau County. Dr. Martine Hackett, assistant professor at the School of Health Science and Human Services, gave a presentation on “The ‘What, How and Why’s’ of Minority Health.” Clearly outlining the issue and motivating stakeholders to collaborate, Dr. Hackett inspired action on this important matter. Andrea Gatewood, director of the Nassau County Women-Infant-Children (WIC) program, discussed how her communitybased program delivers essential services to minority communities by providing supplemental food, nutrition counseling, referrals, and breastfeeding support to individuals found to be at nutritional risk. The final speaker, Dr. Adam Aponte, assistant dean in the office of diversity and inclusion at the Hofstra North Shore-LIJ School of Medicine, presented some jarring statistics on health care delivery and minority health. He also spoke about diversity, inclusion, and health literacy as an important factor of minority health. The audience of students, community members, organizations and health providers were grateful for the enlightening information presented.

Development Goals

Following the panel discussion, official county awards were given to three community advocates: Dr. Chuck Madu of Freeport Medical Supply, Ms. Leisa Dent of LL Dent Southern Restaurant; and Mr. Byron Hurt, director of the film Soul Food Junkies. As the award ceremony ended, high school students flooded the Multipurpose Room at the Mack Student Center for the next two events, the Health Fair and viewing of the film Social Food Junkies. Students enjoyed a number of free screenings, including blood pressure, dental, and hearing screenings provided by North Shore-LIJ Health System, Henry Schein Inc., and Hofstra’s SpeechLanguage-Hearing Clinic, respectively. A healthful food demonstration and tasting provided delicious smoothie samples along with valuable nutrition information. Other vendors present at the fair included Planned Parenthood, NS-LIJ Tobacco Control, Office of Mental Health, and Hofstra’s Career Center and Graduate Admissions. Students appreciated the array of interactive health information provided.

Minority Health Conference and Fair

As the Health Fair concluded, students grabbed a complimentary nutritious bagged lunch and headed into the theater for the screening of the documentary film Soul Food Junkies. In the film, director and producer Byron Hurt offers his personal experiences around soul food traditions and cultural identity. Hurt examines both the positive and negative consequences of this culinary tradition and explores the socioeconomic conditions that influence them and ways to adopt healthier eating behaviors. Byron took time after the film to discuss the topic with audience members and high school students and to answer questions. Overall, the audience felt they could relate to the film and gained some knowledge to bring back to their families and communities.

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year from preventable disease. Dr. Dhillon defined the framework of sustainability as synthesis, scale and engagement. He defined synthesis as creating interventions across lifecycles and determining how to put it all together and deliver consistently, ordering the system so that it always works the same

way. He described scale as determining how to tailor the system so that it works in larger populations with varying geographic characteristics. In the post-2015 era, Dr. Dhillon sees universal health coverage versus universal health care delivery, human rights, social justice and global health

equity as important concerns. The noncommunicable disease (NCD) epidemic will also be in the forefront of any health care discussion. Of greatest importance will be designing sustainable health systems amid complex political and social systems.

The Impact of Obamacare

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Dr. John McDonough (speaker); Senator Kemp Hannon; Dean Ronald Bloom; Dr. Larry Eisenstein (Nassau County Health Commissioner); MPH Director Corinne Kyriacou

Health professionals and government officials are swiftly rolling out the other nine titles of the ACA. The ACA aims to reduce health care costs, improve health outcomes, and reduce disparities and inequalities.

Current Success and the Future of the U.S. Health Care System The rollout of the online health marketplaces allowed consumers to purchase commercial health plans through their state or the federal

government. These plans offer subsidies that reduce the total amount a family pays per month and annual out-of-pocket costs. States that agreed to build their own marketplaces received additional federal dollars. For the most part, these are the same states that agreed to expand Medicaid. Eligibility for government-sponsored health programs are determined based on family size and annual income. Data from the rollout of the ACA is growing and changing daily, but it is being labeled as a success. As of March 31, 2014, more than 7 million non-elderly residents have enrolled in marketplaces, of which 82 percent are getting subsidies to help pay for their health care costs. Eliminating pre-existing condition clauses has protected more than 129 million children, and more than 3 million young adults are insured through their parents’ plan. The Congressional Budget Office reports that by the end of 2014, more than 13 million non-elderly residents will have enrolled in Medicaid, due to expanded eligibility. Innovative health care models are being developed and deployed focusing on prevention and access, so much so, that preventive care is available to more than 71 million people who did not have prior access to preventive care. Overall, there is a net reduction in the national cost to the health system, such as the $5 billion in savings from the medical loss ratio. However, there is plenty of work still to be done to effectively implement and improve the ACA. Many states have not expanded Medicaid or opted to create their own marketplace; medical models and technology infrastructure must be fine-tuned; payment and revenue systems must be re-evaluated; the workforce must be incentivized; and U.S. health care beliefs (national sociocultural norms) must acknowledge and support placing a priority on highquality access and coverage as well as low-cost health care to all.

Interdisciplinary Student Case Competition on Childhood Obesity By Pascale Frederique, MPH, ’15; photo collage by Thalia Stewart, MSCH, ’15

During this year’s National Public Health Week, the first Interdisciplinary Student Case competition gave testament to the caliber of students here at Hofstra University. Hosted by Hofstra’s Master of Public Health program and co-sponsored by the School of Health Sciences and Human Services and the National Center for Suburban Studies at Hofstra University, the event was an example of how collaboration is crucial to resolving societal problems. Twenty-three students from eight different programs across campus (undergraduate and graduate) were assigned to five teams and given the task of proposing innovative solutions to the high rates of childhood obesity in Roosevelt, Long Island. Having 8

prepared for more than a month, teams presented solutions ranging from after-school programs to a mobile food bus to internship opportunities. After each presentation, teams were subject to questioning by a panel of expert judges, including Clara Guillens Eromosele, director of the Roosevelt Community Revitalization Group; Vanessa Farrell, program associate at the Robert Wood Johnson Foundation; Lawrence Levy, executive dean for the National Center for Suburban Studies at Hofstra University; and Dr. Charles Schleien, department chair of pediatrics at Cohen’s Children’s Medical Center, part of the North Shore-LIJ Health System.

Teams were judged on creativity, feasibility, comprehensiveness and sustainability. Program plans had to build on existing evidence, and students were required to report on secondary research. First and second place winners were chosen, with members of the first place team receiving $250 each and members of the second place team receiving $100 each. Overall, it was a fun, competitive event that attracted media attention and an audience of more than 100 students and faculty. A small committee of students and faculty is planning to continue the work started by these ambitious students and seeks external funding to implement a multidisciplinary program to reduce childhood obesity in Roosevelt, NY.

Managing Care, Cost and Quality in an Era of Unprecedented Health System Change: A Conversation With Industry Leaders on Long Island By Nathalie Jean Baptiste, MPH, ’14, and Hope Zewou, MPH, ’14

On Monday, April 7, 2014, as part of National Public Health Week, two student-led organizations, the Society of Public Health Advocates (SOPHA) and Future Healthcare Leaders of Hofstra University (FHL) sponsored a panel discussion on “Managing Care, Cost, and Quality in an Era of Unprecedented Health System Change.” Local industry leaders on this panel included Martine Hackett, PhD, assistant professor in the Department of Health Professions in Hofstra’s School of Health Sciences and Human Services; Jeffrey Kraut, senior vice president of strategy at the North Shore-LIJ Health System, assistant professor of science education at the Hofstra North Shore-LIJ School of Medicine, and adjunct faculty in Hofstra’s MHA and MPH programs; Walter Markowitz, EdD, director, Office of Strategic Planning and Program Development at the North Shore-LIJ Health System and adjunct faculty in Hofstra’s Department of Health Professions; and Jane Greenko, an epidemiologist at the New York State Department of Health and adjunct faculty in Hofstra’s Department of Health Professions. Michael Gatto, associate executive director of ambulatory care services at Harlem Hospital Center, adjunct faculty and director of Hofstra’s MHA program, served as moderator. This distinguished panel discussed how the shift from episodic, reactive, and individual-level care to continuous, proactive population health has changed the way health care is managed for different patient populations. The panelists emphasized quality across the spectrum of care while addressing cost. Students attended this

techniques to address issues such as diabetes and cardiovascular disease, which are major drivers of high health care costs. Also, increasing the transparency about the true cost of health expenditures such as emergency room visits is expected to increase patient awareness and potentially reduce unnecessary cost.

panel discussion hoping to gain knowledge on leadership development, mentorship and a perspective on public health from the invited health care leaders. Before the event began, students had the opportunity to network with other students, as well as with faculty and health care professionals in attendance. The discussion delved right into some of the critical topics in managing health care, including the allocation of scarce resources for improving health, access to high-quality medical care and public health. The panelists discussed the role of technology and the importance in addressing health disparities. The impact of technology is critical in managing health care. With greater interconnectivity among the providers through electronic medical records, the continuum and the quality of care can improve. Other technological examples cited were innovative opportunities such as telemedicine and increased communication with physicians through the use of mobile devices. Public health is an important aspect in managing care, cost and quality. Public health professionals use patient awareness and engagement

Professor Gatto asked the panelists to share some of the major challenges facing health care leaders and to identify the leadership skills necessary for effective management in these difficult times. Panelists discussed provider reluctance to adopt electronic health records and the importance of having leaders who can motivate staff to see change as an opportunity. The Affordable Care Act, one of the major catalysts for health system change in the United States, was also discussed. We have already begun to see shifts in care, cost and quality since its implementation in 2010. An example of this is to incentivize providers on health outcomes through reimbursement rather than the number of activities performed. Panelists also discussed new initiatives to address population health concerns on Long Island such as childhood obesity and health disparities. The audience had the opportunity to pose questions to the panelists, and a lively discussion continued on technology and the need for more innovations and creativity in health promotion and public health. Students were reminded that public health starts in our homes, classrooms and communities, and that as tomorrow’s leaders, we need to be ready to embrace change.

How Nurses Can Help Save Health Reform By Vanessa Williams, MSCH, ’15 The last day of Hofstra’s 2014 Public Health Week, April 11, ended with a panel presentation and luncheon sponsored by BAYADA Home Health Care. The title of the panel presentation was “How Nurses Can Help Save Health Reform.” On the panel were four nurses with extensive expertise in hospital care, home care, nursing education 10

and nursing research. The speakers were Kathy Skarka, MSN, RN, CAN, executive vice president and chief nursing officer, Nassau University Medical Center; Carol Bishop, RN, CRRN, clinical support specialist, BAYADA Home Health Care; Jeannine Muldoon, PhD, RN, dean, Nursing Division, Molloy College; and Catherine

Besthoff, RN, MHA, director, Loss Prevention and Safety, MCIC Vermont, Inc. The moderator was Maureen Houck, DNP, FNP, APRN-BC, director of Hofstra’s Health and Wellness Center. All were gifted, informative and thought-provoking speakers. After each speaker, there were many questions asked by the audience.

Save Health Reform

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President Obama signed into law two groundbreaking pieces of health reform legislation, the Affordable Care Act and the Health Care Education and Reconciliation Act of 2010. The American Academy of Nursing, along with many other nursing organizations, has strongly supported the Obama administration’s efforts to reform health care, recognizing the potential to expand access to cost-effective, high-quality care, and to help shift the U.S. health system toward a greater emphasis on primary and preventive care. The new health care legislation is promising basic health care for millions, which will require

more primary care practitioners – a gap that nurse practitioners are ready to fill. One way to encourage nurse practitioners to enter primary care is to remove unnecessary legal barriers for nurse practitioners to practice.

among inpatient, outpatient, rehab, home health organizations and other providers. New interventions based on case management models are being implemented with nurses as the central component.

Another area where nurses are playing a pivotal role is in increasing continuity of care. Hospitals are now putting together transition teams to keep patients out of the hospitals or to make sure that, once discharged, patients are cared for comprehensively in the community. This involves a team of multidisciplinary staff and collaborations

Health care reform offers a new opportunity for nurses to take leadership roles health care. Nurses are best positioned to engage patients as active participants in their health care and, more importantly, in their overall health. I thank the speakers on the panel for their optimism and enthusiasm.

Radiation Safety: How Exposed Are You? “Be aware. Be educated. Be engaged!” By Amy J. Singh, MPH, ‘14 Stacey Funt, MD, radiology consultant, enlightened students from various disciplines at Hofstra University at a presentation on April 8, 2014, on radiation safety. Dr. Funt has an extensive background in medicine and in helping hospitals and other providers take steps toward reducing radiation exposure in their practice. We often question, “Does increased cancer risk greatly outweigh the benefits of the examination?” Dr. Funt explained that high levels of radiation exposure can cause injury to the cells and living tissue leading to cell death, tissue failure and chromosomal damage, and causing mutations in the human genome (DNA). Additionally, an apparent explosion in medical imaging technology was seen with a shift of 3 million computerized tomography (CT) scans ordered in 1980 to 70 million CT scans ordered in 2007. Dr. Funt relays that CT scans, mammography, fluoroscopy and dental radiography are tests that have ionizing radiation exposure. On the contrary, ultrasound and magnetic resonance imaging (MRI) tests do use not use ionizing radiation exposure. To implement preventive measures, we must pay special attention to statistical estimates. A study done by National Cancer Institute researchers found that the cumulative radiation dose from two to three head CT scans could triple the risk of developing brain tumors. Another finding was that five to 10 head CT scans could triple the risk of developing

leukemia. Regardless of radiation exposure, the risk of getting cancer is 38.2 percent in females and 44.8 percent in males. The risk of cancer death is 19.4 percent in females and 23.1 percent in males. With relevance to specific tests, 1 in 10,000 persons will suffer from exposure associated with a head CT scan, 1 in 84,000 persons will suffer from exposure associated with a chest X-radiation, 1 in 4,000 persons will suffer from exposure from a pelvic scan, and 1 in 125,000 persons will suffer from exposure from mammography. As a point of comparison, 1 in 10,000 persons are at risk of dying from a bicycle accident, and 1 in 100 persons are at risk of dying in a car accident. As practitioners, we need to make sure that CT scans are appropriately ordered. For example, to eliminate duplication of tests, physicians need to refrain from ordering CT scans when other tests show that the CT is unnecessary (e.g., a woman with a negative reading on a Plasma D-Dimer measurement probably does not need a CT to diagnose a pulmonary embolism). Dr. Funt claims that by having more practitioners trained with subspecialties, this equates to fewer follow-up examinations and X-radiation (X-ray) orders. “Choosing Wisely,” an initiative of the American Board of Internal Medicine, relates evidencebased recommendations to be discussed by the practitioner and patient. Another great resource is “Image Wisely,” which addresses concerns of the surge of public exposure to ionizing radiation from medical imaging and

offers information to radiologists, medical physicists, and patients. Dr. Funt’s recommendations to the general public include:

• Know the options available to you. • Know why you are having an exam and how it affects your treatment.

• Use physicians as consultants. • Be aware of the benefits and risks of any procedure.

• Keep track of your history. Before an examination is performed, patients should ask their physician the following questions: • “Are you an American College of Radiology-accredited facility with a radiation reduction program?” • “How will the results of this exam affect my care? • “Do the benefits exceed the risks?” • “Do you have the appropriate history from my doctor?” • “Do you have a pulse fluoroscopy unit which emits half the radiation exposure?” • “Do you have radiation reduction software?” • “Should I be wearing a shield over my body parts?” Lastly, to better track the amount of radiation, the amount of contrast, technologies and instructions from your practitioner, you should consider downloading Dr. Stacey Funt’s free mobile app, “My Imaging Records,” where you can both track your radiation exposure and learn more about the tests and procedures that may put you at risk. 11

Run or Dye 5K By Anu Anish, MPH, ’14 The Run or Dye 5K is deemed “one of the world’s most colorful runs” and is a variant of the well-known Color Runs that take place nationally. Hosted all over the United States, the Run or Dye 5K aims to celebrate “life, friendship, fitness and fun.” All proceeds are donated to a local nonprofit organization. For the Nassau County Run or Dye 5K held on April 12, 2014, the proceeds were donated to the Boys and Girls Club of Hicksville. The April 12 5K took place at the nearby Nassau Coliseum at the conclusion of National Public Health Week. This untimed race allows participants to run, walk, jog, skip or even dance (for the brave hearted) to the end. Throughout the course, volunteers at different dye stations flood participants with color and words of encouragement. The run leads to a color festival, where all participants are given packets of color to throw at friends and other runners. The atmosphere is one of pure fun and excitement. The team, formed under the name of the Society of Public Health Advocates (SOPHA), consisted of graduate students, undergraduate students and administrators from across campus. Joanne Snapp, director of admissions for the Hofstra North Shore-LIJ School of Medicine, saw this experience as “a great day to just relax and join the Hofstra community

Run or Dye Team: List names?

in a fun fitness event.” Ronald Sanchez, MPH, ’14, felt the Run or Dye 5K “exemplified public health – a community focused on our health and happiness.” The Run or Dye event was definitely a memorable experience and one that I hope will be carried on by the

Hofstra community. In a world as busy and complex as ours, events like these help us remember what’s important: sharing life, love and fun in a healthy and happy way! Be well, Hofstra University!

Shouldn’t Everyone Have a Right to a Healthy Life? By AnMarie Freeman, MSCH, ’15 Seven days a week, three times a day, 12 people are lined up at a door waiting; some are in wheelchairs, some are holding onto walkers, others are leaning against a wall, and still others can be seen responding to internal auditory stimuli. As they wait for the door to open, negative behaviors – shouting, fighting, insults and profanity – often occur, especially if the person who has the key to open the door is one minute late. Who are these people who are waiting so anxiously, and what are they waiting for? They are residents of a private facility who have some type of severe mental illness, and they are waiting to enter a designated room to smoke. 12

The scenario above might be a shock for some, but for others, like me, who work in these types of facilities, this is routine. Many of the residents I work with are elderly and, despite their mental incapacitation, and for many their comorbidities and overall poor health, I am constantly reminded that it is their “right to smoke” … THEIR RIGHT. Many of these residents have no family members or next of kin and the state or the facility will act as proxy on behalf of the resident. I worry daily about these residents’ health. As mentioned, many are suffering with other major health diseases such as diabetes, AIDS, and cancer – to name a few

– and most are on multiple medications. Yet when I voice my concern about how smoking may worsen their condition or minimize the effectiveness of their treatment, the response is not about the impact on their health but rather that I cannot do anything to prevent them from smoking. However, these residents are living in this facility because they cannot function on their own in the community. They lack comprehensive skills to make decisions for themselves, so a team of social workers, physicians and administrators become their voices. However, finding ways to help the residents stop smoking does not seem to be a priority. The right to smoke appears to trump the right to a healthy life.

A healthy life

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When the monthly allowance that the residents are given by the state goes into their account, the No. 1 concern is to make sure that they have cigarettes for the month. Outside the facility, the Centers for Disease Control and Prevention, along with the state of New York, are ensuring

that the public is aware of how dangerous cigarette smoking is for one’s health. Inside the facility we do not offer smoking cessation programs or nonsmoking alternatives but rather advocate for the residents’ right to harm themselves even more and endanger the lives

of nonsmoking residents and staff with secondhand smoke. We need to think about these vulnerable residents’ rights differently. We need to find ways to respect their autonomy while also respecting their right to a healthy life.

Women’s Health Fair By Johanna Andrews, MPH, ’14 care, also took place at the Women’s Health Fair. Trained survey administrators who spoke both English and Spanish administered the survey. We were very pleased to receive a high response rate and were truly appreciative of how receptive mothers were when we asked them to complete the survey. We are now analyzing the data and looking forward to distributing additional surveys in other settings. A major hurdle in getting people to come check out the Health Fair as they passed by on the street was the misconception that we were trying to sell them health insurance. However, after our volunteers explained that we were providing free clinical services, they were inclined to take advantage of the resources that were available. As a result, large numbers of local residents benefited from the services and were very pleased with the assistance they received.

Zumba Workout Session at Women’s Health Fair

The Women’s Health Fair kicked off Hofstra University’s 2014 National Public Health Week event series. This free community event, presented by the Gitenstein Institute for Health Law and Policy at Hofstra’s Maurice A. Deane School of Law and Hofstra’s Master of Public Health (MPH) program, took place on Sunday, April 6, from 9 a.m. to 3 p.m. at the United Healthcare Auditorium in Hempstead, New York. The mission of the Women’s Health Fair was to provide community members with the services and resources they need to raise happy, healthy babies. These services included information on child care, health care enrollment, healthy eating, maintaining a healthy lifestyle, legal rights, self-care, medical screenings, and mental health care.

Thirty-eight organizations were in attendance to teach more than 150 community members how to keep themselves, their babies and their families healthy from head to toe. It was a fun and productive day filled with children’s activities, raffles, cooking demonstrations, health screenings, information sessions and an invigorating Zumba workout session! A DJ from Studio 44 pumped vibrant tunes in the parking lot as the sun beamed and a celebration of public health filled the air. The official launch of the Postpartum Healthcare Survey, a research project aimed at identifying challenges and opportunities to improve quality and access to postpartum health

The collaboration between the Law School and the MPH program was definitely a fruitful one! The combination of our goals, visions, and skill sets offered the community an enlightening day filled with health promotion activities as well as with critical information about legal rights and resources. We look forward to working together again soon to benefit the community and enhance our educational experiences. The law and public health students had the opportunity to apply skills learned in the classroom in a setting where we all hope to serve similar populations in our professional careers. Hempstead was a great location, and we have now presented ourselves as serious community partners. We are committed to creating and participating in similar events in order to address the critical needs of the community.

Hofstra’s First Health Equity Symposium The School of Health Sciences and Human Services’ Master of Public Health program hosted a Health Equity Symposium on March 12, 2014, to examine why differences in health outcomes and other critical aspects such as living conditions, environmental risks and food security exist in certain populations and what can be done to close the gaps. Eliminating disparities and improving the health of all groups is an overarching goal for Healthy People 2020 (www.healthypeople.gov) and a top priority for the Centers for Disease Control and Prevention. Event presenters included Martine Hackett, PhD, MPH, assistant professor in Hofstra’s MPH program; Jalonne White-Newsome, PhD, federal policy analyst with community group WE ACT for Environmental Justice; and Katie Martin, PhD, director of the public health program and assistant professor in the department of nutrition and public health at the University of Saint Joseph. Second-year MPH student Johanna Andrews, under the supervision of MPH Program Director Dr. Corinne Kyriacou, planned and implemented the event, and served as panel moderator. The speakers inspired students to think about what they can do as future professionals to minimize disparities, said Andrews. “It’s important to understand that these disparities do exist and to learn from the work that others have done to build health equity in their fields. These success stories serve as motivation and evidence that building health equity is not an impossible task.”

Held at the Lowenfeld Exhibition Hall of Axinn Library, the event attracted more than 125 public health professionals, community representatives, educators, and students, and featured a networking luncheon where participants exchanged ideas on building greater health equity in their communities.

This symposium was a fine example of how the MPH program operationalizes the school’s mission of improving health equity due to its focus, but just as importantly due to the fact that Johanna Andrews, MPH, ’14, conceptualized, organized and facilitated the event. Johanna embodies all the ideals our school strives to promote: she excels academically; she is engaged in research to build evidence that can inform policy and practice; and she is translating her learning and research into action to improve the health of communities.

For more information: To learn more about Hofstra’s MPH and MS in Community Health programs and to find out about upcoming events and view archived webinars, please visit hofstra.edu/Academics/Colleges/healthscienceshumanservices. You can also email Corinne Kyriacou, PhD, MPH, associate professor and director, MPH and MS in Community Health programs, at corinne.m.kyriacou@hofstra.edu.

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