Ohio State's College of Public Health Magazine, Summer 2015

Global Significance. Local Impact.

OHIO STATE

SUMMER 2015

COLLEGE OF PUBLIC HEALTH

IN THIS ISSUE

Supply vs. Demand A New Day for the War on Drugs

No Tobacco ‘til 21 First College MOOC From Columbus to Malawi Mirror Lake Study

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The Ohio State University College of Public Health

TABLE OF CONTENTS MESSAGE FROM THE DEAN

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COVER STORY Supply vs. demand Research documents important favorable outcomes of treatment

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F E AT U R E S No tobacco ‘til 21 Hosting the leaders of today College of Public Health’s first MOOCs From Columbus to Malawi

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NEWS Global projects Dr. Nagaraja’s retirement Research and news briefs National Public Health Week Student achievements Alumni class notes

STAY CONNECTED

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Editorial Staff Tessie Pollock, Director of External Relations Colleen Herr, Communications Coordinator Olivia Hamilton, Communications Student Intern Steve Barrish, Alumni Affairs and Outreach Coordinator K2Studios, LLC, Lisa Klancher Photo Credits André Lui Bernardo, page 2 Laura Thomas, page 3 mcdermottography, page 12 Administration William J. Martin II, MD Dean for the College of Public Health Michael Bisesi, PhD Senior Associate Dean for Academic Affairs Pamela Salsberry, PhD Associate Dean for Outreach and Engagement Christopher Weghorst, PhD Associate Dean for Research Ann Florentine Assistant Dean for Finance and Administration Qinghua Sun, MD, PhD Assistant Dean for Global Public Health Division Chairs Biostatistics: Rodney Sturdivant, PhD (interim) Environmental Health Sciences: Michael Bisesi, PhD (interim) Epidemiology: Phyllis Pirie, PhD (interim) Health Behavior and Health Promotion: Phyllis Pirie, PhD Health Services Management and Policy: Thomas Wickizer, PhD

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Message

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What a year. The Ohio State University College of Public Health has had a parade of national leaders, including visits from the U.S. Surgeon General, Region V Health Administrator for U.S. Health and Human Services, the executive leadership from the International Medical Corps and President Obama’s drug czar.

We respect the great work that they are doing in public health and they have clearly been enthusiastic and supportive of the fine work that our faculty, alumni, students and staff are doing from Columbus to Malawi.

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alth Admi

The outstanding work was also recognized in the latest rankings by U.S. News and World Report. Rankings for the best graduate programs across the country were released earlier this year and both programs in the College of Public Health moved up the ladder. ni

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We are proud to share the exciting news that the College of Public Health’s Master of Health Administration program is now recognized as one of the top 10 in the nation for Health Care Management. The Public Health program moved up to the 19th best overall for Public Health graduate programs. When you consider just public universities, this ranking places us at 11th nationally. These recognitions reflect what we all know – we have great graduate programs in the College of Public Health and we are training the next generation of public health leaders.

We have also had a terrific year for recruiting new faculty to the College with seven new faculty joining us in September. With these new faculty, we are building strengths that will allow us to address the major public health problems in Ohio such as reducing infant mortality, preventing cancer and understanding how to protect the environment to improve human health.

We appreciate that our current success was built on decades of hard work by the students, alumni, faculty, staff and friends of the College of Public Health. We are committed to extending this legacy to improve public health in Ohio for future decades.

Thank you for your ongoing commitment and generosity in support of the College. “It takes a village” to improve public health.

William J. Martin II, MD Dean and Professor College of Public Health

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Supply vs. Demand A new day in the war on drugs has national leaders looking at supply and demand less as codependent variables and more as individual battles that must be won before the country can even think about an overall victory.

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rug policy is shifting focus from law enforcement crackdowns on illegal suppliers to the reasons demand exists in our society. It turns out those are the same determinants that impact our country’s poor health outcomes like chronic disease.

important work that we do, but now we’re really focusing on public health strategies and demand reduction issues as opposed to supply reduction issues,” Botticelli told faculty during his May visit to The Ohio State University College of Public Health.

“During my time in public health, I never really had much interaction with the Office of National Drug Control Policy (ONDCP),” said Michael Botticelli, the director of the White House’s ONDCP, informally known as the drug czar. “It was largely law enforcement: supply reduction, interdiction. It’s still

Director Botticelli was the featured speaker at the college’s 2015 precommencement graduation ceremony.

During his visit, he also sat down with faculty who are focused on public health approaches to substance use looking at it from diverse perspectives and areas of specializations. Ultimately,

that’s the only way this crisis can be solved.

“Addressing drug abuse in our society is a complicated matter,” said Randi Love, PhD, who teaches a course on alcohol and other drug prevention as an associate professor in the Division of Health Behavior and Health Promotion.

“We are barraged with media promoting psychoactive substances at every turn. We have a love/hate relationship with drugs and alcohol.

Issues include supply v. demand; legal v. illegal; abstinence v. harm reduction;

“Prevention programs should address youth, adolescents and adults, tailored to address risks specific to the population, reach people in multiple settings and be research based. Treatment should be readily available, matched to an individual’s problems and needs and incorporate the multiple needs of the individual, not just aimed at his or her drug abuse.”

Randi Love, PhD Associate Professor - Practice Health Behavior and Health Promotion

help v. harm. Clearly such a complex issue warrants a thoughtful response.”

The Lightning Rod Over the last ten years a drug epidemic has emerged that indeed requires a different and more thoughtful response.

Enter prescription pain killers. Created with good intentions to address pain as the fifth vital sign, the use and prescribing rates quickly skyrocketed.

According to the Centers for Disease Control and Prevention (CDC), health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills. CDC data shows that deaths from prescription painkillers quadrupled since 1999, killing more than 16,000 people in the U.S. in 2013. Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013, the latest year that data are available.

“The opioid epidemic crisis that we have going is a lightning rod for all the things

we’ve known have been problematic.

Yes we want pain treated, but the prescription drug issue has been driven by the vast over prescribing of pain medication,” said Botticelli.

Ohio is not immune to the epidemic. The Buckeye state has the seventh highest overdose rate, and it’s been a unique demographic. It’s the perfect nexus between availability and youth and affordability.

On To the Next One Just as states like Ohio put into place new policies to educate prescribers and health system administrators to stop people from “doctor shopping” to get their prescription opioids, the number of deadly heroin overdoses began to rise.

CDC cites two things that appear to be driving the increase in heroin overdoses: (1) widespread prescription opioid exposure and increasing rates of opioid addiction; and (2) increased heroin supply. While the majority

of prescription opioid users do not become heroin users, previous research found that approximately three out of four new heroin users report having abused prescription opioids prior to using heroin. This relationship between prescription opioid abuse and heroin is not surprising; heroin is an opioid, and both drugs act on the same receptors in the brain to produce similar effects.

Heroin often costs less than prescription opioids and is increasingly available says the CDC. Reflecting a continuing national trend, unintentional drug overdoses caused 2,110 deaths of Ohio residents in 2013.

Ohio Department of Health (ODH) data shows there were about 196 more deaths in 2013 compared to 2012.

Opiates, which include heroin and prescription painkillers, were culpable in more than 70 percent of overdose deaths. Heroin-related deaths increased in 2013, significantly surpassing prescription opiates among unintentional overdose deaths. Heroin overdose 3

deaths rose from 697 in 2012 to 983 in 2013. Prescription opiates remained a significant contributor to drug overdose deaths, increasing from 680 in 2012 to 726 in 2013.

Michael Botticelli Director of National Drug Control Policy Prior to joining ONDCP he served as Director of the Bureau of Substance Abuse Services at the Massachusetts Department of Public Health.

Mr. Botticelli has more than two decades of experience supporting Americans who have been affected by substance use disorders.

Randi Love, PhD

Associate Professor - Practice Health Behavior and Health Promotion Dr. Love serves on the Prevention Think Tank for Ohio and on the board of Amethyst Inc, a residential treatment program for women. She also served as a counselor and educator for a National Institute on Drug Abuse sponsored HIV study with injection drug users.

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“It’s untreated addiction that causes people to move to heroin. So rather than a physician just cutting off a medication, what are the intervention opportunities?

There are lots of programs that have shown that you can use specially-trained peers and other physician extenders to really do some of that work,” Botticelli said.

is the number of medications that can be administered within a primary care setting. Now someone with a substance use disorder can walk into a primary care practice, indistinguishable from anybody else who is going in to seek care. But, Botticelli says, there is a huge cultural divide among primary care physicians in their interest to treat addiction. There aren’t a huge number of physicians who want to get trained to do this work.

“Campaigns to reduce the stigma associated with substance abuse disorders can reduce discrimination Shedding the Stigma and the reluctance to seek treatment,” Out of the rampant number of said Love. She advocates for substantial prescription pain killer and heroin change which necessitates crossing overdose stories, there could be disciplines in collaboration with some positive movement. The face government agencies and health care of substance users is changing and systems.“Effective drug abuse efforts catching the attention of those who had are dependent on research-based once dismissed the drug policy, a closer problem. examination of the “An initiative that has had criminal justice system an immediate impact is the “The opioid epidemic and a reevaluation of a expanded availability and use of has a much more drug control budget that naloxone, a lifesaving drug that vocal efficacy focuses on prevention has the potential to reverse drug community. We’ve and treatment. Harm overdoses. In a Lorain County been doing outreach reduction measures pilot for the year 2013, naloxone for a lot of these such as syringe saved 63 lives. Naloxone was parent groups that exchange and naloxone administered by Ohio EMS have sprung up across distribution should be personnel 12,256 times in 2013 the country. There more widely accessible and 15,493 times in 2014. is opportunity in for those who continue – Ohio Department of Health crises. It’s engaging to use.” people who would have never before “We’re trying to look been interested in at better integration drug policies. I feel of care so you don’t optimistic that out of have these siloed all of this adversity, systems with behavioral we’re going to healthcare over here see some kind of and medical care over significant change in there,” said Botticelli. both policy and practice as it relates to “Part of the work we’ve always done as these issues,” said Botticelli. public health practitioners has been to empower people impacted by this to help One of the things that has changed us make the change that we need to do. dramatically and helped with the stigma That’s what we’re trying to accomplish.”

Research documents important favorable outcomes of treatment

Substance Abuse Costs

$977

per person

Substance Abuse Treatment Reduced Medicaid Expenses

$385 per person

Thomas Wickizer, PhD Chair and Stephen F. Loebs Professor in the Division of Health Services Management and Policy. Dr. Wickizer has spent more than 15 years studying substance misuse and the effects of treatment.

Substance misuse does represent a national public health problem that exacts an enormous cost on individuals, families and society, but substance abuse treatment does work. Studies conducted by Tom Wickizer, PhD have estimated the costs of substance abuse treatment and have documented the positive outcomes of treatment. Wickizer estimated the cost of substance abuse in Washington state for 2012 was $6.1 billion, or $977 per person. Substance abuse accounted for 3,224 deaths in 2005 (7 percent of all deaths),

representing 89,000 years of productive life lost. Drug law violations accounted for 46 percent of all state correctional facility costs. But research shows these costs can be reduced by effective treatment and related interventions.

In published articles, Wickizer’s research has documented important favorable outcomes of treatment, including reduced health care costs, improved employment and earnings and decreased criminal activity. One of his more recent (2012) studies showed that substance abuse treatment reduced Medicaid expenditures by up to $385 per patient per month and also decreased criminal activity (felonies) by a substantial degree.

The public health challenge is to develop effective preventive strategies and to maintain a treatment system that affords timely access to care for those who need specialized treatment services. There is little question that in the case of substance misuse prevention and treatment more than pay for themselves.

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No Tobacco

‘til 21 I

n a new white paper released this spring, Ohio State University public health experts detail how raising the minimum tobacco sales age would be effective in improving health and note the economic consequences to retailers would be minimal.

The white paper focuses on Ohio, but the results would be the same for any region that raises the minimum sales age, the authors say.

“The key point is that if people get through adolescence without smoking, it is highly unlikely they will ever start,” said Micah Berman, assistant professor of public health and law at Ohio State. “The flip side of that is if they do start smoking in adolescence, everything we have learned about teen brain development shows that it will be much harder for them to quit later.”

Berman co-authored the white paper, published by Ohio State’s College of Public Health, with Rob Crane, clinical associate professor of family medicine, and Natalie Hemmerich, an attorney and postdoctoral fellow in public health.

Though this is the first report that examines raising the minimum tobacco sales age in Ohio, the idea

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Raising the minimum age to buy cigarettes from 18 to 21 would save lives by preventing adolescents from ever taking up smoking, a new report suggests. is catching on nationally. More than 80 municipalities in the United States, recently including Upper Arlington and Bexley, Ohio, have adopted this policy and at least eight states have proposals pending in their legislatures.

In Ohio, the tobacco industry spends more than $1 million every day marketing its products. Meanwhile, Ohio spends less than nearly any other state on the delivery of messages that counter tobacco advertising.

Berman, Crane and Hemmerich cite dozens of studies to support their conclusions. For example, previous research has suggested:

Adult smokers have nothing to fear if the minimum sales age changes, said Berman, also a researcher in Ohio State’s Center of Excellence in Regulatory Tobacco Science.

> Nicotine’s effect on brain development leads adolescents to heavier daily tobacco use, a stronger nicotine addiction and more trouble with quitting later in life. > Raising the minimum sales age to 21 puts legal purchasers outside the social circle of most high-school students. Most people supplying cigarettes to teens are 18 to 20, and many of them are still in high school.

“This has no impact on anyone who’s over the age of 21,” he said. “It’s really about preventing the next generation from starting to smoke.”

Berman, Crane and Hemmerich did not receive funding from any tobacco-control organizations to produce this publication.

> Raising the legal drinking age to 21 reduced alcohol use, daily drinking and binge drinking by more than a third among high-school seniors.

“The percentage of cigarettes sold to people who are underage or even people who are 18, 19 and 20 is pretty small. But smoking at those ages sets them up for lifelong addiction,” Berman said.

The tobacco industry is sure to dislike this national movement because it knows that recruiting new “replacement smokers” is key to its survival, the authors wrote.

Micah Berman, JD

holds a joint appointment with The Ohio State University Moritz College of Law and the College of Public Health

Hosting the leaders of today and preparing the leaders of tomorrow Ohio State’s College of Public Health played host to statewide and national leaders in the last few months.

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.S. Surgeon General Vivek Murthy chose Ohio State’s College of Public Health as the site for his central Ohio stop in a national tour. He met with community leaders from across Ohio to talk prevention and the impact of the Affordable Care Act. Region V Director Falk and Regional Administrator Lando from U.S. Health and Human Services joined him for the tour and listening sessions.

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irector of National Drug Control Policy Michael Botticelli was the featured speaker at the 2015 precommencement graduation ceremony for the College of Public Health. He also met with faculty and students working with substance misuse policy in Cunz Hall.

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hio State Senator Charleta B. Tavares spoke to students, faculty and community members at the student-organized Diversity in Public Health Summit during National Public Health Week.

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mbassador William J. Garvelink is Senior Advisor for Global Strategy accepted the college’s Thompson Public Health Award on behalf of International Medical Corps during National Public Health Week. During his visit, he also met with student wellness ambassadors and led a Voices from the Community lecture sharing incredible stories about the organization’s efforts to fight Ebola in West Africa.

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MOOC

College of Public Health’s First MOOCs

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he College of Public Health joined a small but growing group of Massive Open Online Courses (MOOC) offered in partnership with The Ohio State University. Stanley Lemeshow, PhD, MSPH, and a professor in the Division of Biostatistics, was the first in the college, and one of the first at the university, to develop and complete MOOCs.

methods to reach their potential. The idea that, through access to the internet, these people can take life-changing courses offered by great universities and great professors, is truly exciting.”

Villermé for Public Health Paris-Berlin, a bi-national center of the Université Sorbonne Paris Cité and Charité – Universitätsmedizin Berlin. All taping and editing was carried out, at the Université

Coursera, the platform that hosted Lemeshow’s MOOCs, provided analytics detailing attendance. For example, 8792 students signed up for the Applied Logistic Regression MOOC. Of these, 5827 actually visited the course at some point in time. Students signed in from 151 different countries. Thirty seven percent of the students were from emerging economies. At the time of registration, 823 students indicated that they were not even familiar with The Ohio State University as a learning institution.

Paris, Descartes that also belongs to the community of Université Sorbonne Paris Cité.

The first, Applied Regression Analysis, went live at the end of March and stayed live for six weeks. The second, Applied Logistic Regression, just wrapped up an eight-week run that started in May. Ohio State hopes MOOCs will play a huge part in the mission to provide quality open resources for use in higher education. The aim is to not only directly affect students and instructors at Ohio State, but also give people around the world the opportunity to experience Ohio State courses for free.

“I believe that those of us who have had the opportunity to go to universities, obtain degrees, attend workshops and learn skills that can lead to happy and productive lives are incredibly fortunate,” said Lemeshow, who was also founding dean of the College of Public Health. “There are, however, many people on this planet who, due to no fault of their own, are born into social and economic conditions that make educational achievement virtually impossible. With the costs of higher education rising so dramatically and so quickly, the goal of getting educated is becoming increasingly remote for many people. Some of these people are brilliant but cannot rely on traditional 8

Both courses were developed during Lemeshow’s sabbatical leave in 2014 in Paris, France. These were done in partnership with the Centre Virchow-

The concept is brilliant. I love the idea of it,” said Lemeshow.

“Somehow without knowing it, I might be contributing to the future of someone in Bangladesh or in Haiti or in Afghanistan who is desperately striving to learn and to excel.

This is very exciting to me and I’m very proud to be part of this effort.

From Columbus to Malawi

A Robust Health Research Program Grows

By University Communications

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hen Alison Norris came to The Ohio State University four years ago for a joint appointment as an assistant professor in the Division of Epidemiology, College of Public Health and the Division of Infectious Diseases, College of Medicine, it didn’t take her long to find the resources she needed to initiate what has grown into a robust, multi-disciplinary reproductive health research program in Southeast Africa.

“Despite the public health problems, Malawi is a very stable place, a very peaceful place, and we’ve been able to establish a very productive working relationship,” says Norris, who studied in a medical scientist training program at Yale University where she received a PhD in public health and an MD. As a postdoctoral fellow at Johns Hopkins, she did research that informed the direction of her work at Ohio State.

The work is based in Malawi, one of the poorest nations in the world, with a low life expectancy, high incidence of HIV/AIDS and high infant and maternal mortality rates.

A multi-method study she conducted in northern Tanzania looked at the risks of sexually transmitted infections (STIs) among the residents of a large sugar plantation, while work she did on the island of Zanzibar

off the coast of Tanzania expanded beyond sexual health into reproductive health.

“When I came to Ohio State,” says Norris, “I had become convinced that we didn’t need to have sexual health and sexually transmitted infections live in one world and reproductive health and fertility live a separate world, because in people’s lived experiences these two things overlap.”

The program, Umoyo wa Thanzi (UTHA, Health for Life), began in Malawi in 2012 when Norris began talking with Child Legacy International which had established a wind and solar health facility. A collaboration was developed between Ohio State, Child Legacy, the University of Malawi and the 9

Baylor College of Medicine. In 2013, Ohio State faculty and graduate students began conducting qualitative research about contraceptive decision-making in the region, and in 2014, a research team carried out the first-wave of a cohort study, enrolling 1,030 women and 442 of their male partners.

Due to the extremely high rates of cervical cancer in Malawi, another Ohio State faculty member, Abby Norris Turner, led an educational intervention with 243 women using an interactive program on a tablet computer with a pre- and post-test. “[UTHA] has been a platform to try out several ideas, and we’re continuing to get new ideas from our preliminary data and have new partners from around the university that say ‘I have an idea that I think might be really applicable in this context,’” says Norris.

relationship between female genital schistosomiasis—a parasitic infection that can damage the reproductive tract—and an increased risk of HIV and infertility.

Another clinic-based study, led by Ohio State’s Jesse Kwiek and Jordi Torrelles will evaluate the accuracy of an inexpensive test for tuberculosis. A second wave of the cohort study is also being prepared, in which biological samples will be collected from the existing participants and tested for STIs and other infectious diseases.

“There’s been a lot of work done in the U.S. context around decision competencies— characteristics people have that make them more or less able to make a complicated decision. One predictor of being able to make complicated decisions is numeracy – how good you are with numbers. There are some data to show that people who are more numerate are better able to make complicated decisions,” says Norris. “We’ll be looking at whether people who are more numerate are more likely to have had an HIV test, to have received treatment for infection they are found to have, to have used contraception when they don’t want to have a pregnancy.” Depending upon the study’s results, interventions to improve numeracy may be introduced with the goal of improving outcomes.

Norris says that even though she had heard that Ohio State had a collaborative environment, she wasn’t expecting what she found here.

This year, Abby Norris Turner conducted a clinic-based study investigating the 10

“In some places, certain diseases or certain countries are kind of owned by particular faculty members and anyone who wants to work on those things has to be part of that empire,” she says. “There are so many extremely ambitious and successful people here at Ohio State, but the way to win is not to beat the other guy—it is to collaborate.

I had heard that before I came but I’m still surprised by how true it is.”

Part of the cultural push toward collaboration comes from the funding mechanisms.

Faculty are more likely to be successful in receiving internal grants when they have an interdisciplinary team.

UTHA has thus far been funded by Ohio State grants, including monies from the Institute for Population Research, Public Health Preparedness for Infectious Diseases, the Center for Clinical and Translational Science, the Office of International Affairs, the College of Public Health’s Dean’s Discovery Fund, and the Department of Women’s, Gender and Sexuality Studies. The preliminary findings of the cohort’s first wave are being used to apply for NIH funding, but in the meantime, the second wave has been funded by Ohio State.

The other aspect of Ohio State’s infrastructure that facilitates collaboration is its breadth and depth, says Norris. The technology and laboratory resources are immense, for starters, but especially the human resources. “A truism about Ohio State is that it is such a big place with so many faculty and seven health sciences colleges right here on our campus that there is somebody working on whatever you are interested in.”

All of this leads to hearty collaborations that will only increase through the university’s introduction of Discovery Themes. “The Discovery Themes faculty will be crossdisciplinary in nature, and administratively will be located in more than one college. This will help to create an environment where multi-disciplinary action is going to be very fruitful.”

CPH Global Projects Our mission: Develop new approaches to critical health challenges domestically and internationally by utilizing the extensive expertise and resources of The Ohio State University and its College of Public Health together with partners and collaborators worldwide to promote research, education and services in global public health.

Bonn, Germany Cultural influence on determinants of marital satisfaction Dr. Amy K. Ferketich

Democratic Republic of Congo Central Africa IeDEA Dr. Marcel Yotebieng

Kinshasa, Democratic Republic of Congo Conditional cash transfers to increase uptake of and retention of PMTCT services Dr. Marcel Yotebieng

Malawi Umoyo wa Thanzi (UTHA, Health for Life) Dr. Alison H. Norris

Victoria, Australia International, prospective study of the association between exposure data and childhood cancer Dr. Stanley A. Lemeshow

Reflection Upon Retirement Developing the first public health study abroad course ranks at the top of the list when it comes to Haikady Nagaraja’s favorite Ohio State memories.

“It is the most exciting activity I have pursued as an educator in the past 35 years at Ohio State. This choice is not intended to diminish many other interesting academic activities that I have enjoyed here. I always loved and still love teaching and training, and the Ohio State campus has provided me with a splendid opportunity to carry out this endeavor over the years,” said Nagaraja.

Nagaraja, or Raj as he is called by many of his

colleagues, retired from his position as chair of the Division of Biostatistics at the College of Public Health in June 2015.

Throughout his Ohio State career, he taught more than two dozen different courses at all levels and trained 20 PhD students in statistics and biostatistics. After spending 30 years as a faculty member in the Department of Statistics, Nagaraja moved to the College of Public Health in autumn 2010 when he accepted an invitation to join the Division of Biostatistics.

“Biostatistics is where I decided to learn and explore opportunities in a totally new area global public health,” said Nagaraja. “During my visit to India in December 2010, I stopped by the campus of Manipal University, a major private university known for health sciences, to learn about their public health activities.”

In spring 2011, the Ohio State Office of International Affairs announced a study abroad seed grant competition seeking faculty involvement and leadership to develop and

implement four-week study abroad programs.

Supported by this grant, Nagaraja was able to develop the curriculum for the course Field Experience in Global Public Health: India and cultivate a hospitable relationship with Manipal University over a period of nearly two years.

“After two offerings, with 17 students in May 2013 and 19 in May 2014, along with the most recent trip with 20 students, the experience still excites and at the same time challenges me,” said Nagaraja. “As a Buckeye with roots in that region of India, it was a very memorable moment of my life.”

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Taking the Plunge A word of advice to Ohio State students who want to continue the Mirror Lake Jump tradition during Beat Michigan Week: go early and get out quickly.

CPH Names First Public Health Associate Dean of Community Outreach and Engagement

A recently-published study CPH looked at the levels of E. coli and other contaminants before, during and after the university tradition. During the evening, as many as 575 people jumped at midnight in the campus pond while researchers took hourly water samples.

Marcel Yotebieng, MD, PhD, and assistant professor of epidemiology, recently published, “CD4+ gain percentile curves for monitoring response to antiretroviral therapy in HIV-infected adults,” and was honored when the research was selected as the free distribution to all International AIDS Society members.

The Ohio State University College of Public Health (CPH) is pleased to announce its first appointment to a new position. Dr. Pamela Salsberry is assuming a new role as the college’s first associate dean of community outreach and engagement.

In this capacity, she will facilitate the development, implementation and evaluation of college-related community and outreach activities. She will be the college representative to the Ohio State Office of Outreach and Engagement and will be the point person for important new initiatives and partnerships to improve public health across Ohio.

Further, the Center for Health Outcomes, Policy and Evaluation Studies (HOPES) will also report to Dr. Salsberry in her new role.

Dr. Salsberry joined the College of Public Health as a professor in the Division of Health Behavior and Health Promotion last year last year from Ohio State’s College of Nursing. She has had a stellar career in research and research training, focused on major communityand population-based topics of urgent public health importance such as health disparities in early life development. She is Co-PI of an NIH/NINR study “Poverty, low birth weight and obesity across the life course” as well as co-principal investigator (co-PI) of an NIH/NINR T32 training grant. Dr. Salsberry is also associate director of the NIH/ NICHD-funded Institute for Population Research at Ohio State.

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HIV Research Featured

“We found that fecal contamination measured by fecal indicator bacterial peaked during the highest number of bathers and the source of contamination is correlated with human-associated fecal contamination,” said Jiyoung Lee, PhD, associate professor of environmental microbiology at CPH. “In addition, resuspension of fecal indicator bacteria and antibiotic resistant bacteria likely occurred during the jump and bather’s jump was the factor.”

The study was published in Water Quality, Exposure and Health journal in March 2015 and was authored by Jason Marion, PhD ’11; Vanessa Burrowes, BSPH ’12; and Chang Soo Lee, PhD, former postdoctoral researcher in addition to Dr. Jiyoung Lee.

“It’s a true honor to see the journal with the highest impact of all AIDS-related journals decide that the findings of our research is worth making it immediately accessible to members of the world’s largest association of HIV professionals,” said Yotebieng, “We believe this is a testimony of the potential impact that our results may have on clinical practice.”

In the article Yotebieng and his coauthors present a simple tool for healthcare workers in low-resource settings to monitor response to antiretroviral treatment, which is more informative and more accurate than the current World Health Organization (WHO) criteria for deciding when a patient is no longer responding to his/her treatment regimen.

They have also proposed a similar tool for children in another paper that was also published in the Journal of the International AIDS Society this past January. Their hope is to be able to refine it a little bit with data from a more representative population and to see the WHO adopt it in its future guidelines.

Harris Publishes 2nd Book

Leaders in Tobacco Research

Randy Harris MD, PhD, and professor of epidemiology and director of the Center of Molecular Epidemiology and Environmental Health, recently authored his second book, “Global Epidemiology of Cancer.”

“This book is an excellent resource for medical, public health and epidemiology students,” said Harris. “It is easily understandable and provides great imagery to compliment the text.”

Global Epidemiology of Cancer provides a basic overview of common cancers and provides worldwide information to address the global landscape of cancer.

Additionally, the book offers clear, concise descriptions of each specific type of cancer as well as its epidemiology, etiology, risk and preventive factors.

Studying the Scores Robert Ashmead, PhD ‘14, presented his work at the 2015 Joint Statistical Meetings, the largest gathering of statisticians in North America this August after winning the Health Policy Statistics Section of the American Statistical Association Student Paper Competition.

Ashmead’s paper titled “Health Care Policy Evaluation Using Propensity Score Matching: A Study of Care Consistent with a Patient-Centered Medical Home Using a Large Population Survey” is a joint work with his advisor, Bo Lu, PhD, associate professor of biostatistics. In the paper, Ashmead reports that care consistent with a patient-centered medical home (PCMH) is less than expected, given Ohio’s provider capacity.

“It’s really great to get positive feedback like this on the research that I worked on during my time at Ohio State. I’m hopeful that presenting my work at the meeting will provide me with additional opportunities to collaborate with other researchers interested in similar topics,” said Ashmead.

Ashmead currently works for the Center for Statistical Research and Methodology where he conducts research for the Census Bureau’s data collection, analysis and dissemination programs.

More than 20 faculty and staff members from CPH attended the 2015 annual meeting of the Society for Research on Nicotine and Tobacco (SRNT) in Philadelphia. The SRNT is the leading association focused on this special area of research.

“It was thrilling to see the significant Ohio State College of Public Health presence at the meeting,” said Mary Ellen Wewers, emeritus professor, Health Behavior and Health Promotion.

“Our faculty investigators were highly visible. It was especially gratifying to see our postdoctoral fellows and students, graduate and undergraduate, involved in research presentations. I was able to witness first-hand the sparks of curiosity ignite as they attended paper and poster presentations. Being able to expose them to world-class tobacco research and experts was special.”

Among the Ohio State attendees were Abby Evans, a Center of Excellence in Regulatory Tobacco Science (CERTS) post-doc whose current work focuses on how attitudes form and change in health related contexts; Ling Wang, PhD student, who presented a poster titled “Would a cigarette by any other name taste as good in China?”; and Micah Berman, JD, assistant professor in the Health Services Management and Policy division.

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#NPHWOSU

MONDAY Public Health Boot Camp: hands-on experiences that demonstrated the multidisciplinary nature of public health

WEDNESDAY “The Anonymous People” Movie Screening with The Ohio State Campus Recovery Community

FRIDAY Public Health Photo Contest with the Diversity and Inclusion Committee

SATURDAY NSPIRE 5k: College of Nursing & College of Public Health

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National Public Health Week 2015 The Healthiest Nation in One Generation

TUESDAY Thompson Public Health Award Presented to International Medical Corps

THURSDAY Farm [to Cart] to Table Luncheon and Local Vendor Fair

SATURDAY Diversity in Public Health Summit Hosted by Multicultural Public Health Student Association

>>> The College of Public Health celebrated National Public Health Week April 6-11 partnering with public health champions across the community and across the globe.

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Connecting though Technology So often technology is blamed for replacing face to face communication, but College of Public Health (CPH) undergraduate student Mushtaq Dualeh is using a new app to bring people together.

Dualeh, along with eight other Ohio State students and alumni, created a mobile app with the purpose of connecting Muslims to one another, finding the nearest location to congregate for prayer and tracking individual prayer patterns. The students named the app Pillar because they hope it will serve as a support system and provide a way for Muslims to connect with one another. Prayer is also one of the five pillars of Islam, the framework of the Muslim lifestyle.

Dualeh, along with eight other Ohio State students and alumni, created a mobile app with the purpose of connecting Muslims to one another.

Dualeh was nominated by her peers to present her new app at the 2015 TEDxOhioStateUniversity talk. Her talk, “The Beauty of Connectivity” is based on the idea that everyone is connected regardless of the social constructs and divisions that individuals create amongst themselves.

“During my talk, I spoke about identity and how we carry these long-drawn-out hyphenated identities, like Somali Muslim American women, but we often forget that these are just social constructs, and that above all else, we’re all human,” said Dualeh.

Dualeh graduated with a BSPH last semester. While at Ohio State, she was a VanderMolen Scholar and national Benjamin A. Gilman Scholar. She also took part in study abroad trips to India and China with CPH where she is specializied in public health sociology. Dualeh continues her career as a Fulbright Scholar.

The Pillar app is available for download for both Apple and Android devices.

Public Health Undergrads Recognized at Denman Research Forum

Congratulations to the public health undergraduate students who were recognized at the 20th Annual Denman Undergraduate Research Forum this spring. More than 600 students in all disciplines presented posters on their research and creative activity projects on March 25 at the RPAC. Research on national social fraternities’ and sororities’ tobacco policies and perceptions won Paul Zivich, BSPH ’15 and public health graduate student, first place in the Social and Behavioral Sciences category.

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Zivich’s research focused on the perceptions of tobacco policies among national social fraternities and sororities.

He designed a web-based survey to assess if any social fraternities or sororities had tobacco-control policies and what their perceptions of these policies were.

Public health undergraduate students Dajzsa McDaniel and Sarah Newman’s research was also recognized at the forum, both receiving honorable mentions.

McDaniel’s research focused on how National Cancer Institute

designated comprehensive cancer centers are marketing their breast cancer screening services post Affordable Care Act and how these centers are differentiating themselves from other centers.

Newman presented her research on family meal frequency and home food availability among U.S. adults in multi-person households using data collected in the National Health and Nutrition Examination Survey, 2007-2010.

Sexual Violence

Top Concern for Ohio State Student Government A

s an advocate for more than 51,000 students, Celia Wright, Ohio State student body president (2014-2015 academic year) and public health student, took on a variety of challenges while in office.

One of the most important issues: sexual violence among college students.

Wright, along with a task force made up of both community and university leaders, created a report to inform the campus community about sexual violence at Ohio State, the university’s response to this problem and continued awareness.

The task force is looking for solutions that address this issue both proactively and reactively in nature.

By approaching the issue this way, they hope to prevent sexual violence

in the future while also determining the resources needed for sexual violence survivors.

Celia Wright receiving the Ohio Public Health Association’s Undergraduate Student of Merit award from Amy Ferketich, PhD, professor of epidemiology and co-director of CPH’s Public Health Honors Program

Wright says sexual assault is a threat to physical, social and emotional health. “This issue has become a hot topic nationally, as we become more attuned to the prevalence and impact of sexual violence on college campuses,” said Wright, a fourth year public health honors student minoring in Spanish and International Studies.

“I majored in public health in large part due to an interest in living conditions and health consequences of poverty in developing areas. I seem to be drawn to the greatest or most severe needs of a population and the physical and mental wellness of our students is a major priority for our USG administration,” said Wright.

This issue has become a hot topic nationally, as we become more attuned to the prevalence and impact of sexual violence on college campuses.

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Fulbright Scholars Chineze Okpalaoka

Making Their Case Students from seven health administration programs around the country came together in April for the third annual Ohio State Health Care Management Case Competition hosted

by The Ohio State University College of Public Health Master of Health Administration program and the Association of Future Healthcare Executives (AFHE).

- global public health minor PROJECT: high school English teaching assistant LOCATION: South Africa Okpalaoka serves as vice president of the African Youth League, and secretary of Model African Union at Ohio State. She is also a peer leader for Advising in Scholarship Service and a program facilitator for the local, non-profit organization, 1girl. Okpalaoka spent a summer in Africa volunteering at the TB/HIV Care Association.

Mushtaq Dualeh

- undergraduate public health student PROJECT: teaching English LOCATION: Malaysia Dualeh is a VanderMolen Scholar and national Benjamin A. Gilman Scholar. She holds a variety of leadership roles at Ohio State including secretary of the Mortar Board Senior Honor Society, co-president of the Muslim Students Association and chief networking officer for Pillar, a mobile app intended to unite the Muslim community (see story on page 16). Following her teaching experience, she plans on applying to graduate school to acquire her MPH in epidemiology and global health.

Albert Schweitzer Fellows Meghan O’Brien This year’s case study was written by David Miller, MHA ’80 and partner at Healthcare Strategy Group.

“The case study was based on a client project completed by my firm and focused on its challenges with managed care contracts, community perception and making a shift to high-quality, value-based care,” said Miller. “I really enjoyed working with the students on this project. They were insightful and had a good understanding of the challenges and potential solutions for the case.”

The Case Competition is designed to bring together healthcare management students and community professionals for discussion about leadership development and serve as a networking opportunity for healthcare leaders and students.

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- graduate public health student PROJECT: address nutrition and wellness of underserved residents at Gladden Community House.

Brynne Presser

- graduate public health student PROJECT: address teen health literacy at the Barack Community Recreation Center by facilitating weekly workshops and producing health-related segments

OSU-Research Scholar Award Mariah E. Charette

- undergraduate public health student PROJECT: study abroad working with women and children’s health promoters.

Charette first began her career at Ohio State pursuing a biology degree. She decided to change her major to public health after environmental health science courses caught her attention. She also felt the BSPH curriculum gave her added flexibility in choosing a career path.

Recent Awards

Harry S. Truman Scholarship David Danesh

- global public health minor A Morrill Excellence Scholar and member of the Honors Collegium, Danesh is conducting research in the College of Public Health under Dr. Amy Ferketich, studying the effectiveness of tobacco cessation education in U.S. dental schools. He is a co-founder and president of Promoting the Advancement of Childhood Education, a student organization mentoring local middle and high school students.

In addition, he serves as the chair of the American Student Dental Association’s National Predental Advisory Committee, volunteers at Columbus’s KidsSMILES dental clinic, and interned at the Center for Population Health and Health Disparities. David plans to obtain a DDS and a Master of Public Health before pursuing a career in dental public health, advocating for increased access to quality dental care to all Ohio citizens, especially those currently underserved in urban and Appalachian regions.

Benjamin A. Gilman International Scholarship sponsored by the U.S. Department of State

Sarah Anderson

NIDDK R21, “Epidemiology of Parenting and Childhood Obesity”

Stanley Lemeshow

Ambassador Software, “Modeling Patient Satisfaction Using Variables Included in the OSUMC Electronic Medical Records.”

Randi Love

OSU-AHEC, “Public Health in Action: Leading Students Toward an Understanding of the Social Determinants of Health.”

Bo Lu

Cincinnati Children’s Hospital Medical Center (PCORI), “Propensity score-based methods for CER using multilevel data: What works best when.”

Annie-Laurie McRee

Assistant professor in the Division of Health Behavior and Health Promotion, and Paul Reiter of the College of Medicine, received an award from National Cancer Institute for a project titled “Increasing HPV Vaccine Coverage among Young Adult Gay and Bisexual Men.”

Grzegorz Rempala

National Science Foundation, “RAPID: Stochastic Ebola Modeling on Dynamic Contact Networks.”

Pam Salsberry Siham Abdi

- undergraduate public health student PROJECT: study global public health at Manipal University/College of Public Health study abroad program. (see more on page 11) LOCATION: Karnataka, India

OSU-CCTS, “A community approach to lowering the risk for type 2 diabetes in high risk women with a history of GDM.”

Wendy Xu

AcademyHealth, “Evaluation of the Utilization and Distributional Effects of Expanding Medicare Coverage of Preventive Cancer Screening under the Affordable Care Act.”

Michael Bisesi

Allen County Combined Health District, “Workforce Development Consultation” and University of Illinois, “Region V Public Health Training Center Collaborative” Seneca County Health Department, “Seneca County Health Department QI” Putnam County Health Department, “Workforce Development Consultation” ; and Williams County, “Williams County Health District QI”; and Perry County, “Perry County Health Department QI.” University of Illinois, “Mid America Regional Public Health Leadership Institute Mentor Training Webinars.”

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College of Public Health

Travel Awards The College of Public Health was proud to provide its students with $7,900 in travel awards for the autumn 2014 and spring 2015 semesters. Students conducted research, participated in field practice placements, and took part in service learning opportunities, all focused on global public health.

At a glance...

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travel awards have been given out for the autumn 2014 and spring 2015 semesters

graduate students received travel awards

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“My study abroad experience has allowed me to bring my public health degree full circle. This experience embraces the importance of culture and will make me a better care provider in the future.”

Leesha Bolton Undergraduate Public Health Student

undergraduate student received a travel award Connetticut

1

PhD student received a travel award

Guatemala

Alabama

“This experience taught me the importance of presenting my research to colleagues within the discipline of cancer prevention. Not only were they able provide valuable feedback, but they helped me to consider future directions for my work that I never considered previously.”

Brittany Brewer PhD Candidate

Costa Rica (4 students)

Support students and faculty engaged in global public health by investing in the Global Health Travel Fund (#314259).

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Homecoming Tailgate Voices from the Community is a lecture series offered by the College of Public Health that explores the multiple dimensions of public health.

Join Us

Presenters include researchers, practitioners, students and faculty who are actively engaged in the doing of public health with the expressed purpose to improve population health.

ClassNotes

Chris Clinton, MHA ’05 featured in “Forty Under 40” in Columbus Business First magazine. Clinton currently serves as Vice President of Neuroscience/Heart & Vascular for OhioHealth Riverside Memorial Hospital.

William Considine, MHA ’71

featured in Ohio State Alumni magazine May-June 2015 issue. Considine is the longest-running CEO of a children’s hospital (35 years at Akron Children’s Hospital).

Katie Seward, MPH ’10

became Health Commissioner of Tuscarawas County General Health District.

Hear about exciting projects!

Please join us to hear about exciting projects and creative approaches at the local, state, national and international level that are improving public health across the community. All lectures are free and open to the public.

For event details regarding the 2015-16 Voices from the Community Lectures please visit

cph.osu.edu/phvoices

Keith Alexander, MHA ’88

appointed as Regional President of Memorial Hermann Health System in Houston, Texas.

Lee Hilling, MHA ’74 chronicles his time spent at a children’s hospital in Kabul, Afghanistan in his latest publication, “A Place of Miracles: the Story of a Children’s Hospital in Kabul and the People Whose Lives Have Been Changed by It.” Kim Rieman, MPH-PEP ’14

was hired by Putnam County Health Department as their new Health Commissioner. Previously she had worked with Allen County Public Health for over 20 years.

If you have news to share, please contact Steve Barrish, alumni affairs and outreach coordinator at Barrish.2@osu.edu or 614-292-0297.

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College of Public Health The Ohio State University 250 Cunz Hall 1841 Neil Ave. Columbus, OH 43210

Invest locally. Impact globally.

From Columbus to Malawi, in both urban and rural communities, our faculty and students are helping to develop solutions to current and emerging public health problems through a combination of innovative interdisciplinary research, community outreach and engagement, and delivery of exceptional educational programming.

Please partner with us as we prepare the public health leaders and change makers of tomorrow by making a gift in support of the College today!

cph.osu.edu/support