IN THIS ISSUE
New nursing programs p.7 Research at Wadsworth p.20 Promoting health equity p. 36
Defining experiences in public health Winter 2023 magazine
Contents 3
SCHOOL UPDATES • About the School (page 4) • New faculty (page 6) • Nursing programs (page 7) • Full scholarship program (page 8)
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COMMUNITY • Day of service (page 10) • Police response alternatives (page 12) • Access to healthy food (page 14) • First artificial sky in a nursing home (page 16)
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STUDENTS • Research in Antarctica (page 18) • Lizards and Lyme disease (page 20) • Climate change (page 22) • Food systems (page 24) • Student spotlights (page 26) • Disease patterns (page 29)
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GLOBAL HEALTH • Sexual health in West Africa (page 30) • Going “glocal” (page 32) • Epidemiolocal capacity (page 33) • Research in the Amazon (page 34)
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RESEARCH • People with disabilities (page 35) • Health equity (page 36) • Oral health workforce (page 38) • Artificial intelligence (page 39) • PFAS (page 40) • Embryo and placenta development (page 41) • Climate and air quality (page 42) • Breastfeeding disparities (page 44) • Mental health (page 46) • Food pantry donations (page 47)
PAGE 12
UAlbany researchers evaluated alternatives to police response for mental health crises.
PAGE 26
Students conduct research and intern with faculty and our local, national and global partners.
PAGE 34
At UAlbany’s Cancer Research Center, experts tackle the genetic and environmental causes of cancer.
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University at Albany School of Public Health
SPH UPDATES
Friends and colleagues, At the University at Albany School of Public Health, we care deeply about our communities and this is reflected in our teaching, research and practice. We strive to eliminate health disparities and improve the health and wellbeing of all people. Public health, and the solutions we can offer, is needed now more than ever, as our world faces the devastating impacts of climate change, poverty, unjust systems, food insecurity, violence and trauma. Since 1985, we’ve proudly collaborated with the New York State Department of Health (NYSDOH) to train the next generation of public health researchers and professionals. This unique approach to education, housed at the intersection of government and academia, brings together expert minds with the fresh perspective of our students, enhancing the community engaged public health research that we do. Whether we’re examining the biological basis of disease and infection, understanding the risk factors for chronic diseases, improving maternal and child health, establishing new health policies, or researching climate change and environmental contamination, we stay focused on the larger picture: to prioritize health and wellness for all members of our community. To do this work, we collaborate with our NYSDOH, government agency, and non-profit partners, many of whom are located here in New York’s Capital Region. Our students gain in-depth knowledge and mentorship through these partnerships, and in fact, over 34 percent of our students receive job offers from their internships. The skills they learn, both in and out of the classroom, are applicable to real world work in public health, making them highly sought-after graduates.
including the recently launched AI Plus initiative, a holistic approach to integrating teaching and learning about AI across our academic and research programs to ensure every graduate is prepared to live and work in a world radically changed by technology. Our faculty also lead important initiatives and programs at the University, including the Center for the Elimination of Minority Health Disparities, led by Associate Professor Elizabeth Vásquez, and the newly formed Institute for Social and Health Equity, led by Empire Innovation Professor Paul L. Morgan. Our researchers are also involved in the Healthy Aging Research Initiative and the AI and Global Mental Health Initiative. These Universitywide programs emphasize the interdiscipinary nature of our work and how public health touches all areas of our lives. In the following pages, I invite you to learn more about some of our work. We are poised to make an even greater impact on public health as we work to improve lives, increase access to care, and promote social justice through the elimination of health disparities, and I look forward to your involvement in our efforts. We have big plans and exciting announcements coming soon - stay tuned!
Erin Bell Interim Dean, UAlbany School of Public Health Professor, Department of Environmental Health Sciences
As interim dean, words truly cannot convey how proud I am of our students. They come to class ready to create the change they wish to see in the world, often on top of multiple obligations. Some of them work full-time jobs and are raising children. Others are caretakers for their partners and also volunteer at non-profits in their spare time. Others are learning here at UAlbany in their second or third language, which is an impressive feat by itself. And, of course, many of our students are first generation students, both at the undergraduate and the graduate level. We are grateful to our community partners, alumni, and our many colleagues and friends who support our students and our school. The generosity of our network truly changes students’ lives and strengthens the public health workforce for years to come. I speak on behalf of all faculty, staff, and students at the School of Public Health when I say we’re proud to be a part of the University at Albany, which has an unwavering commitment to being one of the nation’s most diverse and inclusive Research I institutions and a nationally recognized engine of opportunity and social mobility. We are embedded in many University-wide initiatives, Winter 2023 Magazine
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About the School
38 YEARS
ACADEMICS
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5
academic programs
online programs
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2
academic departments
new nursing programs launched in 2023
in partnership with the New York State Department of Health (NYSDOH)
HANDS-ON WORK
75+ 720
partners provide student internship opportunities each academic year
internship hours completed by MPH students
59% 20+ of faculty hold primary appointments at the NYSDOH and other organizations
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global partners and collaborators for research and applied public health
ocated in New York’s capital city, the University at Albany School of Public Health was created in partnership with the New York State Department of Health (NYSDOH) and is strategically positioned at the intersection of academia and government. Our location in the capital provides real advantages. As the seat of government for one of America’s largest and most diverse states, the city of Albany and its surrounding communities provide many opportunities for us to work with policy makers, public health professionals, non-profit organizations, and clinicians - and for students, this provides outstanding internships, field placements, and vast job opportunities. For faculty, our location also allows connections with research partners, access to culturally and economically diverse populations, and partnerships with community-based organizations.
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University at Albany School of Public Health
SPH UPDATES
CENTERS & RESEARCH Research is conducted within our four academic departments, the labs of our NYSDOH partners (including the Wadsworth Center), and several of our research centers and institutes: • • • • • • • • •
Cancer Research Center Capital Region Medical Research Institute Cardiac Quality Improvement Initiative Center for Aging and Policy Studies Center for Collaborative HIV Research in Policy and Practice Center for Global Health Center for Health Workforce Studies Center for Public Health Continuing Education Center for Public Health Preparedness
$36M for research (2022-2023)
STUDENTS
97%
152
of recent BS graduates are employed or continuing their education*
undergraduate students
260
99% of recent MPH graduates are employed or continuing their education*
masters students
129 doctoral students
100% of recent MS, PhD, and DrPH graduates are employed or continuing their education*
*Based on our fall 2023 survey of recent graduates
PUBLIC HEALTH LEADERS OF TOMORROW PROGRAM
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he Public Health Leaders of Tomorrow (PHLOT) program offers tuition assistance for state and local health department employees to take academic coursework at the UAlbany School of Public Health and promotes leadership development activities for students preparing for public health careers in state government. As the first program of its kind in the nation, PHLOT has provided public health professionals with the applied knowledge to carry out their jobs more effectively. Continued support of the PHLOT program from the Governor's Executive Budget, the New York State Senate, the New York State Department of Health and the University at Albany helps ensure that the public health needs of New York residents are addressed and protected by a highly trained and competent public health workforce.
$1.6M awarded to public health professionals across New York for their graduate-level coursework tuition since 2006
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public health directors from across 28 counties in New York have taken coursework through PHLOT
Winter 2023 Magazine
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Expanding our expertise Faculty study critical areas of public health, with an emphasis on reducing health disparities and building health equity. Experts at the NYSDOH hold faculty appointments, collaborate with full-time faculty on a wide array of research projects, and mentor students in their labs. This provides our students with extensive networking and applied learning opportunities alongside their academic coursework, enabling them to contribute to innovative public health initiatives that directly impact the health of New Yorkers. As our school continues to grow, new faculty join our ranks to provide guidance and mentorship to our students. Six full-time faculty joined the School of Public Health in Fall 2023 under UAlbany’s AI Plus initiative (a strategic cluster hire of new faculty with a focus on AI in multiple disciplines), with the creation of UAlbany’s Institute for Social and Health Equity, and with the launch of the nursing programs.
Fall 2023 New Faculty:
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Jessica Castner Director of Nursing
Chanup Jeung Assistant Professor
Muntasir Masum Assistant Professor
Paul L. Morgan Empire Innovation Professor
Melonie Walcott Assistant Professor
Xin Wang Assistant Professor
University at Albany School of Public Health
SPH UPDATES
New nursing programs Our school’s strategic programs fill a need to enhance the public health workforce, and pull on our long-standing and successful relationship with the New York State Department of Health to train skilled leaders.
U
Albany recently launched two new nursing degrees — a Bachelor of Science in Nursing (BSN) completion program and a Master of Science in Population Health Nursing — to help meet the significant demand for qualified health care providers in New York. Between October 2021 and October 2022, nearly 30,000 registered nurse positions requiring a bachelor’s degree were posted throughout New York State alone. That demand comes amid a growing call for the nursing workforce to have a strong understanding of the social determinants of health and health equity, including training with an eye toward addressing patients from historically minoritized and low-income communities as well as those with complex health needs. As one of the most diverse public research institutions in the country, UAlbany and its School of Public Health are uniquely positioned to fill this unmet demand. In addition, the new BSN program meets the needs of registered nurses throughout the state who are soon to be impacted by the “BSN in 10” law. Passed in 2017, the law requires all nurses practicing in New York to obtain a baccalaureate degree in nursing within 10 years of obtaining their initial licensure. As 2027 approaches, which would mark 10 years since ‘BSN in 10’ was passed, it is expected that there will be a surge in demand for degree-completion options for nurses who will be affected by the law. UAlbany's BSN completion program — the only program of its kind in the Capital Region that incorporates important public health coursework essential for the nursing workforce of the future — provides a critical pipeline for registered nurses to obtain the degree required to maintain licensure in New York.
The new nursing programs are led by Director and Professor Jessica Castner, an international expert in emergency nursing who comes to UAlbany following a year-long residency as the Distinguished Nurse Scholar-in-Residence at the National Academy of Medicine, where she developed health policy related to climate change and disasters, environmental health, clinician wellbeing and applications of artificial intelligence in health care. “Demand for health care workers is soaring, yet in 2021, nursing schools across the country turned away over 90,000 qualified applicants from baccalaureate and graduate nursing programs due to a shortage of faculty and other resources to accommodate them,” says Castner. “This shows that while demand for such programs is growing, our capacity to train nurses, as a nation, is insufficient. At UAlbany, we are helping to fill this gap.” Through coursework and clinical learning experiences, students enrolled in the School of Public Health’s nursing programs will have the opportunity to advance their skills in health assessment and evidence-based practice, preparing them to succeed in a variety of health care settings — from traditional venues like hospitals and private practice clinics to community-based organizations such as public health agencies, telenursing centers and home visiting services. Due to the School of Public Health’s deep existing partnership with the New York State Department of Health, nursing students have access to unique clinical placement opportunities related to public health and population health that will help advance their careers. The first nursing students enrolled for the Fall 2023 semester. Winter 2023 Magazine
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Strengthening the public health workforce
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he Strengthening the Public Health Workforce Scholarship Program (SPHWSP) is a 3-year initiative at UAlbany that provides students with a scholarship that covers full tuition and fees. SPHWSP recruits diverse candidates to enhance the public health workforce, with a special focus on preparing individuals to address health disparities and social determinants of health, especially in underserved populations. Currently, a group of 38 students are enrolled in SPHWSP. They are taking courses towards their MPH, and are also required to complete a graduate certificate in either health disparities or maternal and child health to equip them with further knowledge to address social determinants of health. “Receiving this scholarship was the best news of my collegiate career,” says Daniela Sanclemente, a second-year MPH student and SPHWSP scholar. “Continuing education as a lower income student can be a huge feat. It gave me a sense of comfort because I can focus on my academics knowing that my tuition is paid for. Having paid my way through undergrad by acquiring student loans, continuing education can be a very scary investment. However, this scholarship took that anxiety away and ensured that I had made the right decision when it came to my future.”
SPHWSP students also attend seminars that focus on providing them with practical field skills that have been highlighted by the COVID-19 pandemic as essential for the public health workforce. “I felt so lucky to not only have received the scholarship but to also be included in a seminar series where I can hear the unique perspectives of public health officials from the New York State Department of Health,” says Alexander Losey, a first-year MPH student. “I am most excited to hear about culturally and linguistically appropriate services in healthcare, as this is a health need that I hope to address in my career.” Along with the MPH and their graduate certificate, the students are required to complete two internships—one with the New York State Department of Health or a local health department and the other in a community-based organization. Funding for the program— $1.5 million—came in 2022 from the Health Resources and Services Administration.
38 STUDENTS have received the Strengthening the Public Health Workforce Scholarship
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University at Albany School of Public Health
Meet scholarship recipient Theodore Alexander
SPH UPDATES
“Growing up in a low-income home and neighborhood has been challenging,” says MPH student Theodore Alexander. “I have observed my mother struggling to pay rent to maintain a roof over our heads and have seen firsthand the detrimental effects of our perplexing healthcare system on my loved ones' health outcomes.” This influenced Alexander’s decision to earn an MPH, as he hopes to spearhead initiatives to enhance the well-being of people, regardless of their background or experiences. Long term, he wants to lead his own public health consulting firm after working for several years to improve mental health programs and policy. “Becoming a leader is a notion that has consistently increased my drive toward the end of my college education. I would love to manage and lead a team of public health and healthcare professionals to create projects and programs to counteract health inequities and advance health equities,” he explains. “In addition, I want to foster policy changes geared toward improving outcomes for all members of society.” Alexander is passionate about mental health, LGBTQ+ health, and health policy—and through the Strengthening the Public Health Workforce Scholarship, he is earning his master’s degree and a graduate certificate in health disparities to help reach his professional goals. “Receiving the scholarship meant everything and more to me,” he says. “Because of this opportunity, I no longer worry about applying for additional loans as I continue my education, which is a very liberating feeling.” Alexander has also worked as a direct support professional at an emergency shelter in Albany for the past two years, where he helps to facilitate the admissions process for new shelter residents, implements de-escalation and crisis intervention techniques, manages interpersonal conflicts, distributes food, linens, and hygiene products, and more. “This work experience has been eye-opening and humbling and taught me so much about myself. I have learned to be more patient, resourceful, compassionate, and resilient; every resident I have encountered had their own story that led them to the point of seeking refuge at the emergency shelter, and it is my responsibility to make them feel welcomed as well as supporting them in every aspect, whether that be physical or emotional,” he says. As he works towards his professional goals, Alexander is also working towards achieving financial freedom and building deeper connections with his family, friends and professional network. He will also be interning in the spring to fulfill the MPH program’s 720-hour internship component.
“I’m excited to see what the future has in store for me post-graduation. When I graduate, I know I’ll have in-depth knowledge and competencies to ensure I can direct, lead, and facilitate projects and programs crucial for population health.” -Theodore Alexander Winter 2023 Magazine
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Serving our community
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s University at Albany Great Danes, we take pride in being a part of our local community. At the start of the academic year, faculty, staff and students from the School of Public Health came together for a day of service. One of the school’s community partners, the Food Pantries of the Capital District, organized the day of service at the Salvation Army in Troy, where over 75 faculty, staff, and students sorted donations, cleaned stairwells, painted the food pantry, removed carpet and ceiling tiles, and more. personal convictions ultimately motivated me to pursue an MPH degree and embark on a career in public health.” “Every person tofrom addTogo value toNigeria, their community andher to interest Having grown up was with born parents and Akindele credits contribute to the needs of their generation— this gives one true purpose no matter what one is doing. While volunteering at the day of service, I used my time and energy to meet a need in my sphere. In addition, I made friendships that I hope can last beyond my graduate studies.” - Blender Muzvondiwa, DrPH student
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University at Albany School of Public Health
COMMUNITY
Winter 2023 Magazine
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Evaluating alternatives to police response for behavioral health crises A study by UAlbany’s Schools of Public Health and Social Welfare aids with reducing social and health disparities in rural communities
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University at Albany School of Public Health
COMMUNITY
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joint study by UAlbany’s Schools of Public Health and Social Welfare is helping Albany County officials evaluate the success of a new program designed to reduce law enforcement involvement in nonviolent emergency calls – and inform the program’s expansion.
During the year-long pilot, 325 crisis interventions and 218 follow-up services were provided by the ACCORD team to 191 people, the vast majority of whom had never used services provided by the Department of Mental Health before.
Known as ACCORD— short for Albany County Crisis Officials Responding and Diverting — the program launched in 2021 in rural areas of the county to reduce unnecessary interactions between law enforcement and people with mental or behavioral health issues. The goal is to decrease unnecessary arrests while increasing access to mental health services.
“For people in the towns of Berne, Knox, Rensselaerville, and Westerlo, it can take nearly an hour to get to Albany, depending on where they are located,” Tomoko Udo of the School of Public Health explains. “This is where most behavioral health resources reside, so this distance alone is a barrier to accessing mental health services.”
The program relies on a collaboration between the Albany County Sheriff’s Office, its emergency medical services and the Albany County Department of Mental Health. Under the protocol, once dispatchers from the sheriff’s office determine a call is nonviolent and related to behavioral health, the ACCORD team is called to the scene. The team is comprised of an EMT and a licensed behavioral health counselor who travel in a dedicated unmarked vehicle rather than a police car or ambulance.
The evaluation led by Udo (School of Public Health) and Carmen Morano (School of Social Welfare) found that ACCORD helps to fill this important service gap, and that the ACCORD team typically arrived more quickly to the crisis scene than mobile crisis teams coming from the city of Albany. 57 percent of crisis cases responded to by ACCORD were resolved on the scene by addressing the patient’s immediate needs, such as providing a safety plan, service recommendations and treatment plans. The evaluation also found that as the program grows it may need to increase and standardize staff training and improve public awareness. “We did find that law enforcement tended to still be on scene, mostly for backup and not to directly interact with the patients. This may mean that more buy-in and trust from dispatchers and officers, along with pre-launch training, would help to bring a stronger partnership between law enforcement and teams like ACCORD in the future,” Udo says, and notes that trust was developed over time as officers became more familiar with ACCORD and the team’s ability to respond to crises. Udo and Morano received additional funding from the New York State Health Foundation to help other communities more easily mimic what Albany County is doing without reinventing the wheel. Udo and Morano’s team has developed data collection tools and continue with their evaluation study to identify barriers, best strategies to grow and sustain the program and investigate the efficacy of the program. “Programs that provide a mental health response to mental health crises are important in many ways, and overall can help reduce social and health disparities, particularly in underserved and under-resourced areas,” Udo says. “I applaud the ACCORD program as it works to build response capacity in our communities.”
Winter 2023 Magazine
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Increasing access to healthy food
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he Food Pantries for the Capital District is a coalition of over 65 local food pantries serving the capital region. Kathryn Connell, an MPH student with a concentration in Social Behavior and Community Health, recently interned with their Food as Medicine program, which provides medically tailored meals and groceries to individuals with chronic health conditions who are also facing nutrition insecurity. Food as Medicine interventions advance health equity by improving access to affordable, healthy foods and by bringing local residents, health care institutions, countyand community-based organizations, and the private sector together to enhance food security. The Food as Medicine internship program at The Food Pantries was especially appealing to Connell because of her long history of community volunteer work. “I grew up in Albany and I did a lot of volunteering in food pantries and soup kitchens with my family,” explains Connell. “I saw firsthand how vital it is to have access to good nutrition. Food insecurity work grows more vital every day, especially when considered alongside the burdens of chronic disease. In communities with no or little access to food, such as the South End of Albany where my family is from, we need buy-in and social support from the government as well as the community to work towards increasing food access, affordability, and cultural competency in food access.” 14
University at Albany School of Public Health
As an intern, Connell was responsible for establishing working relationships with three member pantries and helping them to reorganize and deliver services to their Food as Medicine clients. Her daily work ranged from face-to-face client services, produce pickup at the food bank, and helping to on-board new client choice systems. During her office hours, she conducted research for the focus groups that she was responsible for, and attended operational meetings on Food as Medicine and food pantry needs. “After I ran all five focus groups and performed some data analysis I provided two recommendation reports to the organization, one on member pantry staff feedback and one on program participant feedback,” says Connell. But her favorite part of the internship was riding along with the delivery drivers. “I met pantry staff from pantries I wasn’t placed in and got to see a different side of the charitable food system than I had before,” she explains. “One thing I learned that surprised me was how much of the system is kept running by volunteers. Roughly half of the food pantries in the Food Pantries for the Capital District network are entirely volunteer-run, and for those that have staff, volunteers still play a significant role in the day-to-day operations. So go volunteer at your local food pantry, you can make a real difference!” Connell says that she also enjoyed meeting such a wide variety of people and building relationships with the pantry
COMMUNITY
staff at Trinity Alliance Albany, Salvation Army Albany, and LifeWorks Community Action. “Everyone was welcoming and helpful, I couldn’t have asked for a better team for my first internship in the MPH program!” Since completing her internship with The Food Pantries, Connell has begun a fellowship with the New York State Public Health Corps. She now works at the Cornell Cooperative Extension in Schenectady County, where her time is split between working in emergency preparedness and continuing her work on improving food security. “I am so grateful for the funding I received for my internship, because it made it possible for me to gain professional experience in the area that I am most interested in,” Connell says. “Now, I will get to take that work even further.”
Funding for Connell’s internship was provided through the Dean’s Fellowship for Community Engagement, established with the generosity of Bill Kelly, ‘95.
Winter 2023 Magazine
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Online student brings the first artificial sky to Capital Region nursing home
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ecently, a skilled nursing facility in Guilderland, New York, became the first facility of its kind in the U.S. to install an artificial sky in one of its patient care wings. For her MPH internship, Alexandra Smith oversaw its installation and conducted research to evaluate its impact on the residents. Born and raised in Albany, New York, Smith always knew that she wanted to work in the health care field. After receiving a master’s degree in health care administration and becoming a certified dementia practitioner, Smith decided to take her education even further. In the midst of the pandemic, Smith enrolled in UAlbany’s online MPH program. 16
University at Albany School of Public Health
As the U.S. population ages, the health care industry increasingly looks to technology to better serve geriatric patients. UAlbany faculty and students are exploring the impact of artificial intelligence on communities, the public health workforce, and more.
“I chose to pursue an MPH because I wanted to learn more about policy development in hopes of one day enacting meaningful, substantive change on behalf of the geriatric population, specifically those with memory impairment and cognitive health disorders. The online MPH program worked best with my full-time career as a nursing home executive director,” Smith says. Before she began the MPH program, Smith had applied for a grant to install an artificial sky at Our Lady of Mercy Life Center (OLOM), where she had previously been employed.
COMMUNITY The artificial sky is a series of seamless panels that use high-level luminance lighting to create an imitation blue sky and sunlight. It uses AI technology to display images that correspond to the time of day. It can display birds, clouds, and even sunsets. “The reason we decided this would benefit those with dementia, especially those on OLOM’s memory care unit, has to do with the way in which the building was designed,” Smith explains. “The memory care unit is on the lower level of the building which unfortunately does not get much natural light. Because dementia also impacts the circadian rhythm, the combined effects can lead to the exacerbation of a lot of the behavioral symptoms of dementia such as depression, anxiety, agitation, and aggression.”
Online Programs The UAlbany School of Public Health has offered online courses since the late 1990s. Today, students come from four countries and 13 states to learn online from our faculty experts. Many of our online students are working professionals from a wide range of fields who bring their own experiences to the online course discussions, enriching the learning environment for all and providing tremendous networking opportunities.
Smith believed the artificial sky could potentially alleviate some of these symptoms in her patients. The grant was awarded, but the onset of the pandemic delayed the project. By the time the funding for the artificial sky had become available, Smith had moved on to a new position. However, the MPH internship requirement allowed her the opportunity to see the project through for academic credit. “When it came time to do my internship it seemed like a good reason to go back to see my residents and help OLOM finish up the proof of concept of this project. I worked closely with the interdisciplinary team at OLOM to collect data pre- and post-sky installation. We wanted to see the impact the sky had on number of falls, antipsychotic usage, resident activity participation, sleep cycles, and overall staff satisfaction. We did this using the data that is already collected in the electronic medical records and through surveys and collection tools that I helped develop during the internship.” So far, the data have shown that the artificial sky is having a positive impact on residents. “During the study period, there were fewer falls in the area where the sky is installed, better sleep cycles, and improved staff satisfaction compared to the other unit on the ground floor, which does not have a sky,” Smith says. “However, not enough data was collected to establish an association between the installation of the sky and the usage of antipsychotic medication or between the sky and specific behaviors of the residents. But OLOM is still collecting data and they are working on answering those questions.” After completing her internship, Smith says she would recommend the artificial sky to other skilled nursing centers. “It's cool knowing that we were the first to do it in the U.S. I think it's an important intervention for any resident living in a health care facility that was not designed with the environment or natural conditions that humans need in mind.”
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fully online programs at UAlbany SPH
38%
of all UAlbany SPH graduate students are enrolled in a fully online program
54% of all MPH students are completing their degree online
Winter 2023 Magazine
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Conducting research in Antarctica
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s a doctoral student, recent graduate Amanda Andreas performed research at McMurdo Station, the primary Antarctic research base for American scientists, in 2015 and 2016. She was there on a mission to collect specimens of tiny but important single-celled aquatic organisms known as foraminifera. “Most people probably don’t know much about foraminifera, or forams for short, but they are globally important organisms that help protect and maintain the stability of our oceans, which, as we know, directly affects our global climate,” Andreas explains. “Forams have been called ‘nature’s masons’ because of their beautiful and intricate shells.” But foraminifera aren’t just living works of art—they’re also important for another reason. Andreas and her mentor, Professor Sam Bowser, are interested in a particular species of foraminifera that lives in McMurdo Sound and produces a powerful bio-adhesive that composes its outer shell. Andreas collected specimens from the frigid Antarctic waters with the goal of gaining a better understanding of this bio-adhesive and characterizing how exposure to two common heavy metal pollutants, lead and cadmium, affects their ability to produce it. “The primary goal of my research was to isolate and characterize this bio-adhesive and to determine if it binds lead or cadmium from the seawater. I found that both heavy metals
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University at Albany School of Public Health
negatively affect shell formation. I also determined that the bio-adhesive accumulates lead from the seawater, but not cadmium. This finding is useful from a public health perspective in that this unique bio-adhesive could potentially be used for bioremediation purposes to filter lead-contaminated seawater in areas of known heavy-metal pollution. Lead exposure is a global concern as is it toxic to humans (and marine organisms), and negatively affects human growth and development,” says Andreas. But doing research in one of the most extreme environments on earth can be daunting. Just getting there can take several days. Researchers must first fly to New Zealand, where they are issued special cold weather gear and other special equipment. Then, weather permitting, it is another eight hours by military cargo plane to finally reach McMurdo Station. Before they can begin their work, Antarctic researchers must first spend about a week orienting themselves to the station and to their new environment: “We learned things like how to use a GPS device and hand-held radios, how to safely maneuver on sea ice, how to survive in cold weather/extreme situations, and how to operate a snow mobile. The SCUBA divers must also go through a series of dive safety checks with the dive masters on station.” Only once they have passed safety checks and are adequately prepared for life in the Antarctic can the researchers then travel by helicopter to the site of their field work. For Andreas and her team, this was a location called Explorers
SPH STUDENTS
Cove, approximately 30 miles across the ice shelf from McMurdo Station. “Our days were spent making dive holes through meters-thick sea ice, diving to collect sediment, sorting and identifying foraminifera specimens, maintaining scientific gear, and performing experiments that can be done in the field. We also occasionally get to explore some of the incredible sights Antarctica - it’s like being on another planet. One day it was a complete whiteout and the next it was sunny and blue skies with the whitest snow blanketing everything as far as the eye could see. It was a magical sight. And yes, we had a snowball fight! Oh, and another highlight was seeing penguins in the wild – they’re one of the few animals we see above the ice.” Once her research concluded, Andreas had one more challenge ahead of her: getting the foraminifera back to Albany alive and well. “Transporting cold-adapted organisms across the world – and keeping them cold – was a challenging and stressful experience! But I’m happy to report that both the forams and I made it safely back to New York.” Today, Andreas is living in Montana and working as an adjunct faculty member at the University of Montana. “I have only just begun to identify the usefulness of this species and I hope to expand my research, so my ultimate goal is to one day return to Antarctica.” Winter 2023 Magazine
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Lizards and Lyme disease
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n the Lin Laboratory at the Wadsworth Center, which researches the ways in which Lyme disease bacteria and other tickborne pathogens survive in distinct host environments, biomedical sciences PhD candidate Tristan Nowak studies the ways in which wildlife reservoirs can maintain and proliferate the spread of this troubling disease. We sat down with Tristan to learn more about his work. What drew you to a career in biomedical sciences and to Lyme disease research? “My father completed his own PhD at SUNY-ESF in forest resource management when I was a kid. In the years that followed, we spent countless hours visiting research plots in various forested properties, often assisting in data collection. While I didn’t necessarily develop a passion for forest biology and silviculture, the groundwork for a lifelong interest in scientific research was well established. Beyond my childhood, my interest in microbiology and infectious diseases flourished while performing routine analysis as an industry microbiologist. The work included bacterial culturing and maintenance, sequencing of thousands of recovered microbial species, and drafting procedures or investigational studies when necessary. During this time, I reflected on my childhood in northwestern Pennsylvania and upstate New York and recognized the changing landscape of Lyme disease now impacting these regions. Lyme disease is the most widely transmitted vector-borne disease in North America and Europe. Early prevention of 20
University at Albany School of Public Health
serious complications is possible, yet cases continue to rise due to poor diagnostic tools, inconsistent tick deterrent strategies, and a lack of viable vaccines. The biomedical sciences PhD program at UAlbany offered a unique opportunity to work with Wadsworth Center faculty and to research the bacteria that causes Lyme disease.” Your recent work has focused on fence lizards and their role in the spread of Lyme disease. How did you end up working on this project? “Arthropods began feeding on vertebrates about 200 million years ago, taking bloodmeals from ancient reptiles. Today, ticks continue to feed on lizards and a diverse array of vertebrates, some of which can serve as reservoirs for tickborne pathogens. In North America, limited studies have explored the ability of lizards to harbor and subsequently transmit Lyme disease. We set out to repeat experiments conducted on lizard species from the west coast with the goal of evaluating their eastern counterparts (eastern fence lizards). As the habitat of the eastern fence lizard continues to expand northward, overlapping with Lyme endemic areas, lizards may serve as novel reservoirs for specific variants. Exploring the role of this lizard and adjacent migrating reptile tick
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hosts is critical for effective field eradication strategies. It is important that we investigate the role of our changing ecology alongside public health authorities as the climate continues to shift and Lyme disease prevalence increases.” What should the public know about Lyme disease and the results of your research? “I think we are still in need of additional public service announcements to raise awareness of areas with high circulating Lyme prevalence and continue to disseminate appropriate tick exposure mitigation strategies. We live in a Lyme endemic area and the public is at risk even in manicured areas during certain times of the year. Our work reveals that lizard migration may enhance tick populations and amplify Lyme prevalence, leading to an increase in human cases.” What was your favorite part of conducting this research? “Synthesizing field research into our experiments, celebrating a ‘field to bench to bedside’ paradigm, while also harnessing my experience as an industry microbiologist. While this was rewarding, it was also the most challenging aspect of my PhD experience. Adjusting from the rigors of the pharmaceutical industry to basic research was a trip to the wild west of benchwork. The field collections were also formidable and fraught with difficulty capturing lizards the size of your pinky finger, by hand, for 8 hours straight. Bringing lizards into our research facilities and caring for them through the course of our subsequent studies was intensive, but very gratifying and informative. Eventually, I will bring my knowledge back to the pharmaceutical industry, where I hope to continue working on finding ways to treat and prevent emerging infectious diseases, including Lyme.” Winter 2023 Magazine
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Climate change and vector-borne disease
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iomedical sciences PhD student Rachel Fay had an interest in infectious diseases from an early age, particularly ones that are transmitted by insects.
“I grew up in Chatham, New York. Early on, we were taught as children to tuck our pants into our socks and the importance of tick checks every time we participated in outdoor activities. So I was always aware that insects spread disease, and I found that both frightening and fascinating,” she says. Today, Fay works in the New York State Arbovirus Lab run by Alex Ciota, which is a part of the Wadsworth Center at the New York State Department of Health. This lab combines research and diagnostic testing, conducting surveillance and clinical testing for both mosquito and tick-borne viruses across New York. Fay explains, “The research projects carried out in the Arbovirus Lab are diverse, but they share a concern with the ways in which pathogens evolve and how unique interactions between viruses/bacteria, vectors, and environment influence the transmission of disease. Due to the nature of this work, we utilize both biosafety level-2 and level-3 labs. These are labs with higher level safety protocols that reflect the seriousness of the diseases we study. We also have an insectary where we rear our own mosquitoes to study virus interactions. In collaboration with our county health department partners, we are able to utilize surveillance samples and field mosquitoes to investigate vector-virus interactions and determine current risk.” 22
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Fay’s doctoral research investigates West Nile virus, which transmits to humans via mosquito bites that can cause flu-like illness and, in some people, can become neuroinvasive and fatal. “West Nile virus emerged in 1999 in New York and since then, we have seen it spread across the Americas. As global temperatures rise as a consequence of climate change, researchers expect this temperature shift to have a significant effect on vector-borne diseases,” Fay explains. “I have spent the majority of my graduate work assessing West Nile virus transmission risk using numerous genetic variants across a wide temperature range in the laboratory. The purpose is to obtain more empirical data to update existing infectious disease models to improve West Nile virus predictions across New York.” West Nile virus is one of many pathogens that is predicted to become more prevalent in New York as climate change results in warmer, wetter weather patterns. But Fay also cautions that predicting how climate change will affect transmission patterns of diseases transmitted by insects is not an easy task. “Although temperature is important, it is not the only environmental factor in play here; precipitation, humidity, and drought can also influence transmissibility. These can difficult patterns to predict.” In order to model these changes, it is important to understand how the pathogen, host, and vector interact with each other.
SPH STUDENTS
Genetics also play a major role. Fay’s research shows that mosquito populations across New York differ in their thermal sensitivity, resulting in different peak transmission temperatures. “I’ve also assessed how different strains of West Nile virus differ in their thermal sensitivity. And whenever a new strain of West Nile emerges, there is potential to see changes in disease transmission. I am currently working on assessing the transmissibility of different strains across temperature in the hopes of utilizing this data to predict disease risk more accurately,” she says. Researchers hypothesize increased temperature may allow for both a prolonged transmission season as well as the introduction of new mosquito species into regions where they were not previously present. Fay believes that public health surveillance will play a key role in keeping New Yorkers safe from West Nile and other vector-borne diseases. “By retaining robust surveillance programs and generating more accurate regional transmission models with finer resolution across the state, we can identify when environmental factors are most favorable to transmission and inform county health departments that they should be preparing their mosquito control measures. Better models could help stop an outbreak before it starts by implementing proper vector control measures during the immature life stage of the mosquito,” Fay says.
Winter 2023 Magazine
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Food systems and sustainability
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hD student Mariana Torres conducts research on food sustainability. She says that she has always been fascinated by everything to do with food: “When I was a child, I wanted to learn how to grow my own produce, so I planted a bean in my backyard. I spent every day watching that little bean plant—I was so focused on it that I was even able to observe the slow movement of the leaves as they followed the sunlight. That was such a discovery for me—I thought to myself, wow, plants are so much more incredible than we realize!” Growing up in Guadalajara, Mexico exposed Torres to a very different food culture. “Food was always very much a part of our social life,” she explains. “I spent a lot of my time learning to cook traditional meals from my grandmother, working in the community garden with my friends, and spending time in the marketplace where we bought our fresh produce. Food was always a part of the social fabric of my world.” Her interests eventually led her to pursue an undergraduate degree in food engineering and later a master’s in human ecology with a focus on food systems. During her master’s program, Torres began studying the effects of ultra-processed foods on nutrition. 24
University at Albany School of Public Health
“That was the ‘aha!’ moment for me where I realized that what I am really interested in is how food contributes to our health and wellbeing. From then on, I knew that I wanted to study food in a public health context, so I began searching for a PhD program where there were research groups that focused on food systems. My search eventually led me to join the environmental health sciences doctoral program and the FRESH research group at UAlbany, led by Drs. Feingold and Romeiko. Joining this program allowed me to combine my interests in food, food systems, integrative approaches, environmental sustainability, and public health.” When Torres arrived in Albany, she was surprised by some of the differences between American and Mexican food culture. “The structures of the food systems are very different. For example, here there are farmers markets, which are wonderful places to find locally produced foods. But they are so expensive that most people cannot rely on them as their primary food source. Instead, everything comes from a supermarket. I remember when I first learned that food insecurity is in part measured according to the proximity of supermarkets in the U.S., I was very confused. I thought, where are the local outdoor markets like we have at home?”
SPH STUDENTS
Torres’ research has a strong social justice current running through it, tackling issues like food and nutrition security and food waste. “As a member of Capital Region FRESH, I actively participated in several projects that studied the recovery and redistribution of fresh fruits and vegetables in our area. This group has been profoundly supportive, creating an inclusive and encouraging environment.” In addition to her work with FRESH, Torres has also collaborated with the National Food Access and COVID Research Team on a project assessing the impact of the pandemic on food security in the capital region. She is also a member of Multiscale RECIPES, a research network aiming to reduce waste within food systems, which has offered her “the opportunity to enhance and foster collaborations with other researchers in the network. Additionally, being part of the student and postdoc cluster within the RECIPES team has provided a safe space to share ideas and research in a fun and enthusiastic manner, where I always feel encouraged and supported.” Part of Torres’ doctoral research has involved creating a model to simulate the impact of food policies on fruit and vegetable recovery and redistribution. “The co-production of knowledge between academic and community partners within this project has been one of the most rewarding and exciting experiences throughout my doctoral program,” Torres says. “This work has gained recognition from several audiences, including the New York State Council on Hunger and Food Policy. In the summer of 2022, I was awarded the Barry Richmond Scholarship which gave me the opportunity to present results from our model in Frankfurt, Germany at the International System Dynamics Conference. The experience of sharing my research, trying different foods, and experiencing a new culture was truly fulfilling as it allowed me to combine my academic and personal passions.”
Pictured above: Torres at the awards ceremony for the Barry Richmond Scholarship to attend the International System Dynamics Conference. After she completes her doctoral degree, Torres plans to continue developing her food systems research. “In the long run, I envision myself as a professor leading my own research group, making transformative contributions to food systems. As the very foundation of our existence is at stake, I aim to contribute towards creating more sustainable, healthy, resilient, and equitable food systems.” Pictured below: (Left) Torres serving on a panel for the Local Government Lab, an annual one-day gathering of local government researchers, practitioners, and policymakers, and (right) conducting field work in Mexico.
Winter 2023 Magazine
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Defining experiences in public hea
Undergraduate Student
Marilin Broncano interned at Koinonia Primary Care, where she planned and executed health education activities for the Albany community. She helped discuss patient concerns and generate activities during the weekly barbecues held at Koinonia.
DrPH Student
Andrei Chell evaluated high-profile health campaign integrations in Honduras, Colombia, and Guyana related to three neglected infectious diseases through a practicum with the Health Campaign Effectiveness Coalition. This work may help countries in Latin America and the Caribbean to better understand how integrated health campaigns could curb the spread of disease.
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MPH Student
Gabby Mayers works at the NYSDOH Workforce Innovation Center, where they help to develop and propose programs that aim to reduce the health care workforce shortage in the state. This includes assisting with grant proposals, speaking with stakeholders, and collecting data to inform the programs.
Undergraduate Student
Jonas Barkevich spent the summer at the NYSDOH AIDS Institute conducting a literature review “Barriers and facilitators of access to timely Antiretroviral Therapy Initiation” and supporting program evaluation through cleaning, organizing, and summarizing sexual health data.
University at Albany School of Public Health
PhD Student
Recent graduate Thoin Begum’s PhD resulted in 11 peer-reviewed publications on health impacts of contaminants. Her dissertation examined the physiological and social consequences among Akwesasne Mohawks resulting from significant and prolonged exposure to environmental chemical toxicants from nearby superfund sites.
MPH Student
Evelyne Nehama interned at the Prolepsis Institute in Athens, Greece. She worked on a variety of public health projects for specific populations and environmental issues, including two projects working on research, literature reviews, and in-the-field with Roma communities.
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SPH STUDENTS
Learn more about some of our current students and recent graduates, who conducted research and interned with UAlbanybased faculty, our NYSDOH colleagues, and other external partners to gain hands-on experience in the public health field.
MPH Student
Daniela Sanclemente interned at the Cancer Registry at NYSDOH, where she helped with the RESPOND study, which focuses on understanding factors related to disproportionately high diagnoses of aggressive prostate cancer in African American men.
PhD Student
In the Paczkowski lab at the Wadsworth Center, Kayla Simanek helps identify genetic mutations that make bacterial strains isolated from hospital patients more pathogenic. Hospital-acquired infections cause thousands of deaths each year, and a better understanding of how these clinical bacterial strains evolve will help scientists prevent, and treat, these types of infections.
DrPH Student
Mamun Rahman developed Promoting Mental Health of Asian American, Native Hawaiian, and Pacific Islander Communities— now an 18-person unit at the NYC Dept. of Health and Mental Hygiene—that partners with community- and faith-based organizations to reduce stigma around mental health and share mental wellbeing and resilience best practices.
MPH Student
JC Guzman worked with the NYSDOH Office of Public Health Practice on the 2023 New York State Health Equity Report. The results of the report help to drive health equity policies and interventions in New York State.
Undergraduate Student
Working as a part of Team Cluster Buster for the NYSDOH Bureau of Communicable Disease Control, Izzy D’Ambro learned how to speak with patients to obtain information needed by the health department and to empower them to make more informed decisions in their everyday lives to limit the spread of disease.
MPH Student
Saima Hannan helped Stacy Pettigrew from Albany College of Pharmacy on a narrative case study covering five decades of social justice advocacy surrounding the Ezra Prentice complex in Albany. Saima presented initial findings at the American Public Health Association annual conference, where she won second place for the student poster award.
Winter 2023 Magazine
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Undergraduate Student
Christina Rust, who is now an MPH student, interned with the state legislature while completing her public health major. She worked on a range of legislative tasks, including preliminary research and bill tracking. Her work focused on public health issues like K-12 health education reform and the 988 mental health hotline.
PhD Student
Ayesha Tahir studies the differences in expression of various isoforms of a tyrosine kinase in solid tumors at UAlbany’s Cancer Research Center. Her team found that one isoform of this tyrosine kinase, which was also identified as a top breast cancer cell survival factor, is highly upregulated in solid form tumors.
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MPH Student
Hamidat Adeyi works as a family planning intern at the Division of Family Health at the NYSDOH. She works on the ‘Community Voices, Family Planning’ program campaign, which provides comprehensive family planning and reproductive health services for low income, uninsured, and underinsured individuals.
Undergraduate Student
For an extra credit assignment, Gillian Belarmino worked on a project on solar UV radiation and its effects on occupational health, focusing on skin cancer and cataracts in outdoor workers. She was supervised by an adjunct assistant professor and presented her work at UAlbany’s Showcase Day.
University at Albany School of Public Health
Undergraduate Student
Nick Ortega Preciado interned with NYSTEC, where he identified coding defects and devised resolution strategies on a project for the New York State Medicaid Health Home Program, which aims to get people the services they need and reduce trips to the emergency room and less time spent in hospitals.
PhD Student
Mirza Ishrat Noor is a research support specialist at the UAlbany Center for the Elimination of Minority Health Disparities, which works to identify community health concerns and sources of disparities, plans strategies to alleviate them, and tests their effectiveness.
SPH STUDENTS
Uncovering disease patterns through modeling
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roadly speaking, biostatistics is the application of statistical methods to the study of living things. PhD student John Angles’ research focuses on applying these methods to research on infectious disease, disease surveillance, and the social determinants of health. “Recent events have highlighted not only the importance of disease surveillance and the challenges we face in managing infectious disease outbreaks but also how people are impacted differently by these outbreaks,” Angles explains. “I think that by working to better understand infectious disease data we can work to make our public health systems better and more equitable.” One major project that Angles has worked on is the Coalition for Applied Modeling for Prevention, or CAMP. This research group is dedicated to creating models that improve public health decisionmaking at the national, state, and local levels. CAMP uses statistical and economic models alongside epidemic simulation to uncover new disease patterns and inform prevention policies in five areas: HIV, viral hepatitis, sexually transmitted infections, tuberculosis, and school/adolescent health. Modeling offers a ways of understanding data when researchers do not have a full picture of what is happening, which according to Angles is “almost always the case when working with public health data. There are so many different factors that can impact health, that it's usually impossible to collect information on everything.” When data is incomplete, modeling uses what is already known to make an educated guess as to what the data is telling researchers about the object of study. “There's a famous quote often attributed to George Box which says, ‘All models are wrong, but some are useful.’ It's important to remember that no model will ever be perfect, but a ‘useful’ model will still help us understand our observations,” says Angles. During his time as a project collaborator for CAMP, Angles has focused primarily on sexually transmitted infections. He works on aberration detection, which “is basically about finding outliers (very unusual datapoints) in a given dataset. Once a potential anomaly has been found, further exploration can help point to a cause, and ideally a fix for the aberration.” Aberration detection is particularly important for disease surveillance, where anomalies can signal that a disease is behaving in new or unexpected ways. “While our collaborators at CDC already engage in multiple activities to identify data aberrations, the modeling tool we're working on at CAMP will help to improve these existing activities and broaden the types of aberrations they are able to find,” Angles explains. Through CAMP, he has collaborated not only with experts in epidemiology and biostatistics but people with expertise in a wide variety of fields including public policy and law. Winter 2023 Magazine
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Improving sexual and reproductive health in West Africa A global internship experience facilitated by the Center for Global Health
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icha Akindele always wanted a career that would allow her to combine her interest in science with her love of cultural studies. With some encouragement from her undergraduate mentor, Akindele decided that public health was the ideal avenue to apply her knowledge and passion to make a meaningful difference in the health and well-being of communities. After receiving her BS in biology and African American studies in 2021, she decided to pursue an MPH at UAlbany. “Public health appealed to me because it is so interdisciplinary. It is a platform that lets me blend my scientific knowledge from biology with the sociocultural insights I gained from African American Studies. During my undergraduate years, I began to recognize the profound impact that public health initiatives can have on communities, particularly underserved populations,” says Akindele. “This alignment of my academic pursuits and personal convictions ultimately motivated me to pursue an MPH degree and embark on a career in public health.” Having grown up with parents from Togo and Nigeria, Akindele credits her interest in health disparities, particularly the challenges facing maternal and child health in low-resource settings, to her early life experiences.
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University at Albany School of Public Health
“My upbringing instilled in me a deep sense of responsibility to contribute towards improving the health and well-being of vulnerable populations. Later, my academic studies gave me a broader perspective on health disparities, social determinants of health, and the historical and cultural contexts shaping maternal and child health outcomes,” she says. When Akindele was presented with an opportunity to intern with the United Nations Population Fund (UNPFA) in Lomé, the capital of Togo, she knew that her personal and academic background and her interest in women’s sexual and reproductive health would make her an excellent match for the position: “My passion for maternal and child health and the unique learning and impact opportunities presented by the UNFPA internship in Togo made it ideal. I knew it would allow me to apply my knowledge and skills to address critical health challenges and contribute to improving the lives of women, children, and families in Togo.” After identifying UNFPA Togo as a site where she wanted to intern, Akindele connected with John Justino, director of the UAlbany School of Public Health’s Center for Global Health, to determine next steps for developing a global internship.
GLOBAL HEALTH “I was thrilled to learn that John had a prior connection with the former country representative for UNFPA Togo, Josiane Yaguibou, which enabled us to use the power of networking to connect with UNFPA Togo and secure an internship,” she says. Akindele applied epidemiologic methods learned during her MPH coursework to carry out tasks required of her while abroad. Of note, she conducted a series of analyses on family planning initiatives spanning from 2019 to 2022, and used data analysis techniques to examine trends, patterns, and outcomes related to family planning in different regions of Togo. This included calculating rates, identifying disparities, and assessing the impact of various interventions. These reports aimed to provide evidence-based insights for program improvement and resource allocation. Knowing that her work had the potential to make a real impact on the lives of women and children living in Togo kept Akindele motivated throughout her time in West Africa. Being able to work in the field and meet the people she was helping was even more rewarding. “We spend a lot of time behind computer screens in epidemiology, so it was exciting to witness firsthand the tangible impact of our work,” she says. “Meeting the people who benefit from the programs and initiatives we were supporting added a deeply fulfilling dimension to the work.” She returned to the U.S. with new insights to apply to her future work in public health. One lesson is that collaboration is key: “I was pleasantly surprised by the dedication of the team and the diverse stakeholders involved in advancing sexual and reproductive health in Togo. It highlighted the importance of collective efforts in achieving meaningful and sustainable change in public health.” When it comes to maternal and child health specifically, Akindele believes that “a sense of community can be a powerful asset in promoting maternal and child health outcomes in the United States. Building stronger support networks and emphasizing the importance of community involvement in public health initiatives can help address some of the challenges we face in this area.”
Pictured left: Aicha Akindele (front) with UNFPA Togo staff and Olga Sankara, Togo UNFPA Representative a.i. Pictured above: (top) Aicha Akindele with a group of interns from Orange Space, which assists with the achievement and development of young people in Togo, and (bottom) the UNFPA Togo building.
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‘Glocal’: From global to local
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he COVID-19 pandemic created challenges handson experience in global health. But despite travel restrictions, it was crucial that students gained skills and knowledge that will help them excel in a global environment. This led to the development of the Glocal Initiative, a pilot program at the school that enables students to apply global health expertise to local activities, in a method coined as “glocal”— short for “global to local”. The initiative, led by the Center for Global Health in collaboration with the Office of Internships and Career Services, engages students in public health interventions in domestic settings, working with target audiences such as refugees, immigrants, and migrant workers from abroad. Projects that are often applied in global health work— such as vaccination programs and humanitarian assistance— can be applied within these communities, and the glocal initiative develops programs, places students in internships, and organizes activities to assist students who want to gain cultural competency and work with diverse populations. “I love that this initiative allows students to interact with and learn about another culture without traveling abroad, something I love but do not always have the resources to do. This initiative also highlights and celebrates the diversity that exists right here in the Capital Region,” says Maeve McCullouch, a recent MPH graduate who helped to plan glocal initiative activities and events during her last semester. Through the Glocal Initiative, two students recently interned at the West Hill Refugee Welcome Center in Albany, where they worked to help improve the health and nutrition of Afghan, Sudanese and Burmese refugees. Since 2005, over 4,500 refugees have settled in New York’s capital region, and the West Hill Refugee Welcome Center helps with welcoming those settling in the West Hill community, connecting them with support services, resources and safe housing. Samantha Guerra, who recently graduated with her bachelor’s degree, completed 108 internship hours at West Hill, working on various projects. “I got to know the families on a personal basis while applying concepts I was learning in the classroom,” explains Guerra. “It was exciting—yet sometimes challenging—to connect with the families past the language barrier. Many are still 32
University at Albany School of Public Health
learning English and so trying to come up with programs that took this into account meant that we had to get creative. One time I was helping one of the little boys that came from Burma with his homework at the center. I had been working there for two months at the time and thought that I had a good grasp of each family, where they came from, and some of their experiences. However, as I was helping with his homework, the boy started telling me how much he missed living in Indiana, and before that Chicago, and before that Burma. He was only eight years old, and to have moved around that many times really put into perspective how difficult it can be for refugees—particularly children.” Guerra notes that the experience was very eye-opening and enabled her to work with global populations she is interested in serving—without having to go abroad. Her internship also prepared her for her current role in Peru, where she currently serves as a community health facilitator with the Peace Corps.
GLOBAL HEALTH
Building epidemiological research capacity
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ith a grant from the National Institute of Allergy and Infectious Diseases, Associate Professor Mark Kuniholm recently traveled to Kigali, Rwanda to lead a two-week training in population-based research with international partners from Albert Einstein College of Medicine. 20 professionals with backgrounds in nursing, medicine, social research, microbiology and data science attended the training, focusing on three core skillsets for populationbased research: epidemiology, biostatistics and computer programming, and data management. “The goal is to increase capacity in Central Africa to tackle major public health problems of people living with and affected by HIV/AIDS, and other common conditions like tuberculosis, cancer, liver disease and post-traumatic stress disorder," Kuniholm explains, noting that UAlbany researchers are open to future collaborations and exchanges of people and ideas. “Such collaborations have the potential to benefit both the UAlbany community and to make a demonstrable difference in the health and wellbeing of everyday people living in Central Africa.” Pictured above: Trainees with certificates of completion Pictured right (top): Kuniholm with trainees from Cameroon Pictured right (bottom): Kuniholm with research study coordinator Dr. Fabienne Shumbusho
Winter 2023 Magazine
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Closing gaps in environmental health research in the Peruvian Amazon
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ssociate Professor Beth Feingold was selected as one of 16 inaugural scholars to participate in Fulbright Amazonia, a new initiative to support cutting-edge research and cross-sector collaboration on Amazon Basin issues. The Fulbright program brings together researchers from Brazil, Bolivia, Colombia, Ecuador, Guyana, Peru, Suriname, the United States and Venezuela to collaborate on action-oriented research with the goal of securing a sustainable Amazon Basin. Working in interdisciplinary and multinational research teams, the Fulbright Amazonia scholars are exploring socially relevant research questions and participating in group seminars to recommend actionable policies that directly improve the quality of life of communities throughout the Amazon Basin. A program of the U.S. Department of State, Fulbright Amazonia is supported in collaboration with the Fulbright Commission in Brazil and other Fulbright partners in the region. Feingold leads longstanding projects investigating environmental health risks in the Peruvian Amazon. Her research addresses relationships between the food system, the environment and population health. “My Fulbright analyses build on my 12 years of environmental health research in the southern Peruvian Amazon region of Madre de Dios,” Feingold explains. “The overarching goal of this research is to provide some of the first longitudinal data on effects of anthropogenic activity in the Amazon on children’s health risks.” Feingold’s work aims to better understand the impact of mercury exposure on children’s development, and how access to 34
University at Albany School of Public Health
the interoceanic highway has impacted the dual burden of childhood malnutrition between 2011 when it was constructed and now. “I hope that my findings will help fill important gaps in policy-relevant children’s environmental health research in Peru and across the Amazon.” While in Peru, Feingold was hosted by Universidad Peruana Cayetano Heredia’s CRONICAS Center of Excellence in Chronic Diseases, with whom she is also working on her NIH-funded research. “Integral to my work in Peru are the relationships I have fostered over the years with CRONICAS, the Madre de Dios Regional Health Directorate, and many others. I am grateful to the Fulbright Program for this opportunity to continue to strengthen these partnerships, and I am honored to have been selected to participate in this inaugural Fulbright Amazonia cohort." Fulbright Amazonia activities began in June 2023 with a meeting in Belem, Brazil, that included Amazon stakeholders. Fulbright Amazonia scholars will convene in Leticia, Colombia in April 2024 and in Washington, D.C. in December 2024 to present their final policy recommendations.
SPH RESEARCH
Making health information easier to understand and access for people with disabilities
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ccording to the CDC, one in four adults in the U.S. has some sort of disability, with the number changing to one in three when looking at rural communities. For children, about one in six have a mental or physical disability.
People with disabilities often experience health disparities or worse health outcomes compared to people without disabilities. They can face various challenges that make it more difficult to participate in their communities and access services due to inadequate accessibility, complicated paperwork, and lack of information about where to go for which services. They also have to navigate one of the most complex healthcare systems in the world—a system that frequently faces shortages and changing needs, as evidenced by research from UAlbany’s Center for Health Workforce Studies. “When someone has a disability or a rare disease, they may need more health care or may need to interact with other systems to get education accommodations or disability services,” UAlbany’s Professor Jennifer Manganello explains. “Thinking about ways we can improve the ease of navigating these systems and educate people about how to access and utilize needed services is important.”
Pictured: Jennifer Manganello
Manganello’s work focuses on health literacy, health information, and the use of media and technology. She applies her personal and professional experiences, to think about ways to help improve access to health care and supports and make health information easier to understand and more accessible. “Many times, people with disabilities or their family members have multiple health care providers and systems they have to navigate for services,” Manganello says. “I have family members who have disabilities and rare diseases so I know from personal experience how time consuming and challenging it can be to navigate health care and other systems.” Manganello has been working with various groups to support efforts to improve information about services, including the NYS Office of Mental Health System of Care program and NYSDOH Early Hearing Detection and Intervention program. “It is great to see so many different agencies and organizations focused on improving access and accessibility of information and services.” Manganello also serves on the New York State Rare Disease Workgroup as part of the parent and caregiver support subgroup. For this work, she helps to identify best practices that could improve the awareness of rare diseases and ways to provide information and resources to parents and caregivers who support people with rare diseases. “We are lucky to be in New York State. There is a lot of great work being done to ensure programs are available and successful at providing supports to people with disabilities. However, many times, the general public is not sure about what services and supports are out there, or how to access them. I enjoy applying my expertise in health communication to help think through the best way to present and distribute information to state residents.” An expert on social media and health communication, Manganello has conducted several studies recently related to media and disabilities. To name a few, she’s looked at important issues related to mental health—such as social media use and mental health among young adults with disabilities—along with how children with disabilities use media differently from their siblings. "With the growth of social media and digital technology, we have many ways to create and provide information to people about heath care and other services. It is my goal, through research and practice, to find creative ways to use these digital tools to provide accessible and clear information to people with disabilities and their families.” Winter 2023 Magazine 35
Promoting health equity in Black families
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n the United States, Black mothers and infants experience disproportionately worse pregnancy-related outcomes.
“Black women are 1.5 to 4 times more likely to die within a year of giving birth compared to other racial groups," Allison Appleton, associate professor in the Department of Epidemiology and Biostatistics explains. “Black infants are also 2-3 times more likely be born prematurely, have low birth weight, and to die within their first year of life than their non-Black peers.” Pregnancy-related morbidity and mortality often manifest in the form of complications such as hypertension, cardiomyopathy, preeclampsia and gestational diabetes. “These numbers and statistics do not capture the full impact, and it’s possible these health disparities may have serious implications for longevity and well-being of future generations of women and children,” says Betty Lin, assistant professor in UAlbany’s Department of Psychology. To better understand the factors that affect child and family health and well-being in Black families from pregnancy to adulthood, a team of researchers led by Lin are conducting the Birth and Beyond Study—called the BABY Study for short. The study, funded by the National Institute of Child Health and Human Development (NICHD) brings together researchers from UAlbany (within the Department of Psychology, the Department of Epidemiology and Biostatistics, and the Department of Environmental Health Sciences), Boston College, and Albany Medical Center to better understand the social and environmental determinants of racial disparities in birth outcomes in Black/African American families, along with factors that help to counter negative effects. “Researchers evaluating the social and environmental determinants of health disparities have historically worked in parallel with little crossover despite a common goal of promoting and safeguarding human health," Appleton, who serves as a researcher on the project, explains. “Social and environmental risks do not exist in isolation but rather co-occur and disproportionately affect populations experiencing health disparities. As such, traditional siloed research likely underestimates the joint effects of social and environmental exposures on health.”
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The BABY study team blends expertise from psychology, epidemiology, environmental health sciences, and clinical medicine to better specify and understand the synergistic health effects of a range of exposures that can accumulate and drive disparities over the life course and across generations. Now in year two of the project, the research team is enrolling Black women who are pregnant and will give birth at Albany Medical Center into the study. The participants will complete short activities and an interview three times: during the third trimester of pregnancy, when their babies are six months old, and when their babies are a year old. Fathers or romantic partners are also invited to participate. MPH student Dayo Ogundimu is assisting with the BABY Study and will be helping to interview the fathers or romantic partners. “This is a vital project with the potential to contribute significantly to our understanding of the role of fathers/ partners in maternal and child health,” he says. “I am enthusiastic about being a part of this initiative and helping with the interviews. This work not only furthers my academic and professional development but also has the potential to positively impact families and healthcare practices.” The interview sessions with the participants have started, and families are continuing to enroll in the study. Tentatively, the study will complete in 2027. "Through this work, we will identify what stress exposures are most important to intervene in, when in the life course they should be targeted, and how best to do so,” says Lin. "Knowledge gleaned from this research will help to promote health across generations of Black U.S. families.”
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Oral health workers are burned out too
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he COVID-19 pandemic heightened issues of burnout for health workers, especially those providing patient care. For the oral health workforce in particular, the chance of COVID-19 infection was considered high due to potential contact with respiratory aerosols and spatter during dental procedures. A recent report by the Oral Health Workforce Research Center at UAlbany’s Center for Health Workforce Studies (CHWS) explored the prevalence and effects of burnout and stress among the oral health workforce in safety-net dental organizations during the COVID-19 pandemic. Researchers worked with the Health Choice Network to analyze its 2021 online survey of clinicians working in 25 community health centers across the U.S. The survey showed that oral health providers reported high levels of burnout, at rates similar to other medical providers involved in patient care. Of the oral health providers surveyed, 79.3% reported burnout; this is compared to 80.1% of surveyed primary care providers and of 76.2% of mental/ behavioral health providers.
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Burnout is a prevalent problem for the health workforce, associated with employee turnover, absenteeism and depression. Burnout has also been shown to increase risk of medical errors and raises concerns about patient safety.
The researchers also conducted key-informant interviews with individuals in various positions at safety-net dental organizations throughout the U.S. in 2022. The goals of the interviews were to collect information about the impact of COVID-19-related stressors on dental staffs’ stress and anxiety levels and to determine if burnout and stress affected employee recruitment and retention. “It’s not only important to be aware of burnout, but to understand the reasons why health workers are experiencing it,” says CHWS Director Jean Moore. “Once specific stressors have been identified, then strategies to address them at both organizational and personal levels can be implemented to reduce burnout for these providers.” To address these stressors, organizations implemented various strategies to support work-life-balance among their staff, including more time off, extra pay, more breaktime for staff and increased work-schedule flexibility for parents. About the Center: CHWS provides timely, accurate information and conducts policy-relevant research about the health workforce. The center’s work assists health, professional, and educational organizations, policy makers, planners, and other stakeholders to understand issues related to the supply, demand, distribution, and use of health workers.
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The future of artificial intelligence in public health An interview with Assistant Professor Xin Wang
Your career started in computer science. What made you decide to pursue public health? “The intersection of computer science and public health is fascinating. I was drawn to public health from computer science due to the potential for AI technologies to impact global health issues positively. For example, AI can read diagnostic images better than human beings can in many cases. Providing primary care physicians access to this type of technology would expand access to these services substantially, potentially helping to alleviate health care deserts. Leveraging AI techniques can lead to innovative solutions for complex health challenges.” There is a lot of public interest (and concern) about artificial intelligence right now. How do you see AI impacting the field of public health? “AI has tremendous potential in the field of public health. From disease outbreak prediction to analyzing vast amounts of data for research to precision medicine and personalized healthcare recommendations, AI can streamline existing processes and offer insights that were previously out of reach. However, with this potential comes the responsibility to ensure that AI applications are ethically transparent and do not inadvertently introduce or perpetuate biases. It is important to remember that AI is ultimately authored by humans and can be embedded with the prejudices and internal biases of those humans. As a discipline, we have to think critically about what AI is doing and why, and to what extent that is consistent with what we are trying to accomplish as public health professionals.” You mentioned precision medicine. Could you say a little bit about that and how AI is involved?
analyzing vast patient data, recognizing patterns, and making predictions or recommendations tailored to individual patients. This can lead to more effective treatments and interventions, potentially reducing costs and improving outcomes at the same time. Anything that both improves health care and saves money is highly desirable, particularly in the U.S. health care system which is one of the most expensive in the world.” Do you think the anxieties that are often expressed in the media about AI are warranted? Are there any specific health-related concerns that you have about the future of AI? “While I don't have personal anxieties, it is understandable that there are concerns about AI, especially given its growing influence, like the Generative AI and Large Language Models. These are responsible for programs like ChatGPT, which seems to be very popular in the media right now. Some people have concerns about the ethics and accuracy of using AI for composing articles, essays, and other communications. For example, some schools are now using “AI detectors” on student writing to try to catch potential plagiarists. Other concerns often revolve around privacy, data security, the potential misuse of biodata, and the ethical implications of decision-making by AI in the context of health care. And also in the health sector, there's the added complexity of ensuring that AI doesn't inadvertently cause harm through misdiagnosis, biased algorithms, or other unintended consequences. A balanced approach to AI adoption, which weighs benefits against potential risks and involves multidisciplinary expertise, such as that of my colleagues in the school, is crucial.”
“Precision medicine aims to tailor medical treatment to each patient's individual characteristics, needs, and preferences. I mainly use AI for medical image analysis, but it can serve other functions as well. AI can play a critical role by Winter 2023 Magazine
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Exposure to PFAS in drinking water
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Albany and the NYSDOH, with support from the CDC’s Agency for Toxic Substance and Disease Registry, are studying the exposures of residents living in communities with drinking water contaminated with per-and polyfluoroalkyl substances (PFAS). As one of seven sites nationally selected for funding in 2019, New York’s study includes participants from the Hoosick Falls and Newburgh areas, two communities affected by PFAS contamination. As the first national study to look at exposure to multiple PFAS at multiple sites, the goal of the study is to better understand the relationship between PFAS exposure and health outcomes in differing populations. The information will benefit all communities faced with the challenges of PFAS drinking water exposures and protecting public health. The New York project is led by UAlbany’s Erin Bell and Elizabeth Lewis-Michl, director of the Division of Environmental Health Assessment at NYSDOH’s Center for Environmental Health. They are recruiting a total of 1,000 adults and 300 children from the Hoosick and Newburgh areas, communities impacted by legacy industrial sources and firefighting foams used by the military and others. This effort will build upon the extensive information about PFAS exposures already collected by the NYSDOH through its PFAS blood testing programs and extensive public water system and private well testing. “What makes this project unique is that we’re heavily focused on community engagement,” Bell explains. “We have worked closely with community partners and have also spent significant time in each community, walking the streets with their local leaders, talking with people and getting to know them. We also incorporate what we learn from our community advisors to ensure this study benefits the community.” Currently, the research team is conducting evaluations to assess each individual’s exposure along with the observed associations with the clinical markers for all participants. When the assessments are complete, each participant will receive their individual results on PFAS contamination and health in addition to the full report and results on the impact of PFAS in their communities. 40
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Early embryo and placenta development Research from UAlbany’s Cancer Research Center
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n his lab at the Cancer Research Center, Assistant Professor BK Lee studies gene regulations in the early embryo and placenta development in humans. His work to better understand the placenta may help to treat cancer. After a sperm meets an egg and becomes an embryo, the fertilized embryo undergoes several rounds of cell divisions and forms a blastocyst that has two distinct compartments— the inner cell mass (ICM) and the trophectoderm (TE). The ICM develops into the baby and the TE becomes the placenta, an essential organ that supports the growth of the baby by promoting the exchange of oxygen and carbon dioxide, nutrient uptake, waste elimination, hormone production and secretion, and immunological protection.
So how does this relate to cancer? One of the cell types Lee is studying, extravillous trophoblasts— or EVTs— can invade the mother’s uterus during early placenta development. This invasion shows considerable similarities to how metastatic malignant cancers spread. The key distinction lies in the controlled invasion of EVTs into the mother’s uterus, as opposed to the uncontrolled invasion characteristic of cancer. Lee’s work aims to identify common and distinct molecular pathways and transcriptional networks between cancer metastasis and placenta invasion — ultimately with the goal of treating metastatic cancer with relatively low toxicity.
If the placenta does not develop or function properly, this can lead to pernicious outcomes such as miscarriage and other pregnancy complications. These complications not only immediately endanger both the mother and baby, but can also affect their lifelong health. Despite the crucial role of the placenta, large knowledge gaps exist in understanding factors and the mechanisms underlying the placenta development and placenta-related disorders. Currently, Lee is focused on identifying novel factors that play important roles in placenta development and deciphering the underlying mechanisms of development. For this work, his lab is using trophoblast stem cells derived from TEs. Lee’s lab has identified multiple putative candidate genes that may play important roles in placenta development, and is closely examining the molecular functions of these genes. In particular, he is unraveling the molecular functions of two major specialized cell types in the placenta to help pave the way to develop therapeutics for placenta-related pregnancy complications. Additionally, he is studying the impact of environmental pollutants on placental development using human trophoblast stem cells. Pictured: BK Lee in his lab at the Cancer Research Center.
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Using NASA satellite data to assess impacts of climate and air quality
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wo faculty based at the NYSDOH, who are also alumni of UAlbany’s School of Public Health, received funding from NASA to perform research that has helped modify warnings for heat-related illness in New York State and continues to provide data that informs public health policy and practice.
project that used satellite data in conjunction with modeled temperature reanalysis data from the North American Land Data Assimilation System (NLDAS). With funding from the NASA Applied Sciences Program, the multidisciplinary team downscaled the satellite data from a 12-kilometer gridded product to 1 kilometer.
Temilayo Adeyeye, research scientist at the Bureau of Environmental and Occupational Epidemiology, and Tabassum Insaf, director of the Bureau of Cancer Epidemiology, have used state-of-the-art tools— including satellite data from NASA— to assess the impact of climate and air quality in communities where air monitoring does not take place.
“With NLDAS, you’re looking at heat in sections of 12 kilometers. Essentially, what we did was downscale to look at grids of one kilometer to see the variation based on a smaller area,” Insaf explains. “We know that heat is not experienced the same way across the state and that local features play an impact. ‘Zooming in’ on this data allowed us to better understand how our local communities are impacted by heat.”
For years, temperature data has been collected by physical monitoring stations located in counties across New York State, but relying only on this data means that heat trends are not captured in communities without a station. While the number of observation stations has expanded through UAlbany’s New York State Mesonet—a network of 126 stations across the State— additional data from satellites can enable a closer look at temperature within individual communities. “Using satellite data, we can examine more closely how people are affected by heat and use this information to better inform the public on when they need to take action by hydrating, staying inside, and taking other measures,” Adeyeye explains. Insaf was principal investigator on a NASA ROSES (Research Opportunities in Space and Earth Sciences)
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This research has led to modifications that benefit programs for heat-related illness to help better assist communities that face extreme heat. Insaf and Adeyeye’s team also worked with the regional offices of the National Weather Service to evaluate whether heat advisories were issued appropriately to protect the health of New Yorkers. In 2016, they found that the threshold for heat advisories in New York State was too high when issued at 100 degrees Fahrenheit, a threshold developed based on national data. Using New York data taken from satellites, this work led the heat advisory criteria in the State to be lowered by five degrees (to 95 degrees Fahrenheit) in 2018.
SPH RESEARCH “This adjustment is significant enough to make a difference and reduce hospitalizations, but not too low that people feel heat warning fatigue from receiving too many messages about staying indoors,” Adeyeye says. This work also led to the development of tools and infographics by NYSDOH for each county in New York State to aid climate health surveillance and mitigation efforts. The data provided was locationspecific, making the messaging more helpful for local communities. Adeyeye and Insaf also played a key role in developing an interactive map for New York State on extreme heat and health, which displays information on climate change, heat related illness, risk factors, and steps to take to reduce the risk of heat-related illness. They have also worked with NASA’s Health and Air Quality Applied Sciences team to study the joint effects of air pollution and climate in the context of climate policy initiatives in the state. Insaf was named a HAQAST ambassador in recognition of her work to promote the use of satellite data among stakeholders in the field of environmental health. “Whether we’re providing input on climate action plans, working with climate impact assessment advisory groups, or creating tools for countries across New York, our research using satellite data directly informs policy and practice,” says Insaf. “It has been rewarding work.”
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UAlbany and Department of Health examine breastfeeding disparities in New York
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tudies show breastfeeding is beneficial for the health of the baby and the breastfeeding individual, and the World Health Organization recommends that infants be exclusively breastfed for six months after birth, with continued breastfeeding through 2 years. In 2020, 85.3 percent of infants in New York (83.1 percent in the U.S.) initiated breastfeeding, but continuation drops off rapidly.
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Christine Bozlak, associate professor and co-director of UAlbany’s Maternal and Child Health program, explains that there are many communities in New York that have lower breastfeeding rates and greater breastfeeding disparities, including certain racial and ethnic groups, groups that have been economically/socially marginalized and, in general, individuals in communities that have historically
SPH RESEARCH experienced systemic barriers to accessing health care services or supports.
UAlbany’s Maternal and Child Health Program
Bozlak, Lindsay Ruland, and Britnee Eskew from UAlbany’s Center for Public Health Continuing Education (CPHCE) collaborated with Maureen Spence and Dr. Barbara Dennison at the NYSDOH to better understand breastfeeding disparities. Findings were included in a report that is being prepared by the NYSDOH for the legislature. These findings included recommendations to improve access to prenatal and postpartum health care services, reduce breastfeeding barriers, and increase breastfeeding success.
Founded in 2015, the Maternal and Child Health (MCH) Program seeks to strengthen the capacity of emerging public health professionals to support MCH populations. The program provides a wide range of academic and professional development opportunities for students, faculty, staff, and community partners. We offer MCH-related courses, fund student practica and internships, host brown bag seminars and networking events, and support students and faculty participation in MCH conferences locally and nationally. Some program highlights include:
“For 38 years, our School of Public Health has conducted timely academic work alongside our Department of Health colleagues,” says Bozlak. “Our close relationship enables us to provide critical support on important maternal and child health issues like breastfeeding. Together, we compile and examine the data needed to develop strategies to reduce barriers, improve access, increase breastfeeding rates, and reduce disparities to ultimately build healthier communities in New York.” The UAlbany team led the study, and the NYSDOH provided recommendations for national and state experts to participate in UAlbany’s work, identifying regions across the state with low breastfeeding rates where particular focus should be placed. The UAlbany team interviewed and surveyed individuals with expertise in breastfeeding promotion and breastfeeding disparities, including health care professionals, lactation consultants, health educators, community leaders, and minority health advocates. “Our primary focus was to reach individuals, stakeholders, advocates, and organizations who interact directly with the groups with the lowest breastfeeding rates, so we could obtain their perspectives and expertise on how to best address the disparities in their communities,” says Ruland, project manager for the study. In addition to the study report provided to the NYSDOH, a webinar presentation and a summary of findings from UAlbany’s report was shared with study participants, providing them with insights that may inform their work to address breastfeeding disparities in their own communities. The study and findings were also presented at the 2023 American Society for Nutrition Conference in Boston. Recommendations from the study include reducing return to work barriers for breastfeeding individuals, increasing access to breastfeeding education, offering mental health support, expanding community services, training health care providers to deliver culturally appropriate care, and expanding insurance coverage for breastfeeding support services.
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Secured $1.65 million in funding for the program from federal, state, and community partners. This includes a second five-year commitment (20202025) from the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau Developed and launched a graduate certificate in MCH in January 2020. Secured 34 MCH-related student internship and practicum opportunities in community settings, and another 37 at the NYSDOH
UAlbany’s Center for Public Health Continuing Education The UAlbany School of Public Health Center for Public Health Continuing Education (CPHCE) provides exemplary education for the public health and health care workforce. The Center is nationally recognized for online training, including the award-winning Public Health Live! webcast series and numerous interactive, self-paced online courses. Most training programs provide the following free or affordable continuing education credits: • • • •
Nursing contact hours Continuing medical education credits Certified in Public Health renewal credits Continuing education contact hours in health education
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Mental health in rural New York
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ural communities face many challenges around mental health, including limited access to care as well as risk factors associated with isolation. In New York, the suicide rate in rural areas (15.2 per 100,000 people) is significantly higher than in urban areas (7.5 per 100,000 people). It is also accelerating more quickly. Between 2004 and 2020, the suicide rate in rural New York increased by 83.1 percent, while urban New York saw a 27.9 percent rise.
participants spoke about the effects of social isolation on mental health, pros and cons of living in close-knit communities, barriers around delivering and accessing mental health services, and how tenets of rural culture contribute to stigma around mental health issues and seeking help.
The work, which is the first of its kind in the state, took the form of a “listening tour” comprised of 32 group interview sessions that engaged 289 participants representing 16 rural counties. It includes key insights from participants, with recommendations for strategies to improve mental health in rural areas in New York and beyond.
Many of the issues commonly raised by the mental health professionals centered on state-level policies that limit access to care. For example, the state allocates funding for mental health services to communities based on population size. Areas with smaller populations receive less funding, making it harder to implement mental health programs. There are also limitations around how the funds can be used, with approved services favoring treatment instead of prevention. Finally, professional participants explained that they must treat a certain number of patients in order to secure funding. There is no shortage of demand. Yet, without adequate funds to support programs and staff, it is difficult to meet these quotas.
“Rural communities, especially those most isolated that lack access to public transportation and internet services, often contend with deep-rooted issues that impact residents’ mental health,” says Harris. “These can include things like poverty, economic and employment challenges, substance use, domestic violence, child abuse and neglect, a lack of affordable housing and homelessness.
“The constant discussion around restrictive regulations and funding algorithms was surprising and unexpected,” Harris explains. “As an exploratory study, we were looking to identify missing elements in our efforts to prevent suicide. We thought this issue may come up once or twice, but it came up in most, if not all, of the listening sessions with professionals. Adjusting these state-level policies could help providers more effectively serve their communities.”
“In 2019, the New York State Suicide Prevention Task Force issued recommendations for addressing mental health and suicide in New York, with special attention to several priority populations. Yet, the report did not address rural communities — which are distinctly vulnerable to mental health challenges, have limited care options and are home to nearly 20 percent of all New Yorkers. We undertook this study to address this critical gap.”
“In order to alleviate growing mental health concerns in rural New York, we first need a clear understanding of the challenges on the ground,” Harris says. “Learning from residents and mental health professionals living and working in these communities sheds much needed light on the ways that rural living can at times support, yet often impede, residents’ mental health.”
Clinical Associate Professor Brett Harris released a report detailing the results of an 18-month study on mental health in rural New York.
The research team invited community members from 16 rural counties in New York to share their perspectives and experiences concerning the local accessibility and utilization of mental health services during group interviews called “listening sessions.” They held two listening sessions for each county — one for residents 18 years of age and older, and one for professionals who play a role in community mental health. These were conducted first in person, then via Zoom, between March 2020 and September 2021. Through these conversations, a number of common themes emerged. For example, many 46
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Working in collaboration with study participants, the team developed recommendations to help improve mental health and access to supportive resources in rural communities. These include goals like increasing community cohesion, expanding access to transportation and broadband services, improving and sustaining workforce capacity and increasing awareness of the mental health and suicide prevention programs that are available. “The ultimate purpose of this listening tour was to effect policy change,” Harris said. “We disseminated this report to policymakers, and we are working with community partners to put our findings to work.”
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Assessing food pantry donation strategies
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n the United States, 40 percent of all food produced is never eaten, resulting in lost resources, economic costs to businesses and households, decreased food security and negative climate impacts. A team at UAlbany is conducting work as a part of a multiscale research network called RECIPES—the first national academic research network on wasted food in the United States—to make the food system sustainable, equitable and resilient. The network is deepening the understanding of how the causes of wasted food are interconnected and how they intersect with other regional systems beyond food. It is a $15 million, five-year project funded by the U.S. National Science Foundation that engages communities in various locations around the United States. The UAlbany team —led by Associate Professor Xiaobo Xue Romeiko— is collecting system-level datasets and developing quantitative models for quantifying environmental health impacts of wasted food and for assessing benefits and effects of management strategies. Additionally, the team is investigating potential impacts of policies, technological and behavioral interventions on the amount of food rescued or distributed and the associated effects on health and the environment. They are also assessing how the food donation systems responded to changes due to the COVID-19 pandemic, and are identifying strategies capable of improving the resilience of food systems. Currently, the team is working with Feeding New York State to assess an emerging donation strategy in which pantries directly pick up food surplus from retail donors. “Less than one percent of surplus food was donated in 2021, with the greatest portion coming from grocery retail,” Romeiko explains. “Essentially, we’re looking to understand if optimizing strategies for picking up donated food can enlarge the donation amount so that more food can get to those who need it.” Romeiko's team is examining what drives retail stores across New York to donate fresh produce— and in the Capital Region, the team is determining optimal strategies for pantries to directly pick up the produce. “The model we’re creating and associated outputs will provide scientific basis for supporting Feeding NYS to implement the retail pick-up interventions and will aid Feeding New York State in maximizing the rescued amount by strategically allocating limited resources,” Romeiko says. Winter 2023 Magazine
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