InSight Fall 2022

THE POWER OF STORIES

The University of Iowa College of Public Health

FROM THE

DEAN

We all love a good story. Beyond entertainment, stories can offer valuable lessons, new insights, different perspectives, and helpful information. In public health, we often collaborate with communities to gather people’s stories and experiences to help inform research and planning efforts. Public health also uses stories to help relay health information in a more relatable or approachable way. In this issue, we talk with several College of Public Health researchers who embrace aspects of storytelling in their work.

We also check in with the college’s relatively new undergraduate program, which welcomed its first cohort of students in 2016. Those pioneering students have since graduated and moved into careers or continued their education, and we catch up with several alumni and review the growth of the program.

Students are also at the heart of two other exciting projects based in the college—a volunteer effort called the CPH Student Strikeforce and a student-run podcast called “From the Front Row.”

Finally, the multicountry outbreak of monkeypox earlier this year again tested the public health system’s ability to respond to an infectious disease. We talked with Christine Petersen, CPH professor of epidemiology, about current zoonotic threats and the role of One Health in addressing emerging infectious diseases.

Looking back at the fall semester, I’m pleased that we were able to host many in-person events such as our annual homecoming lunch as well as our alumni reception at the American Public Health Association Meeting and Expo in Boston. It’s been wonderful to reconnect with friends and former students, as well as give our current students opportunities to present their research and network with the wider public health community.

Whether we gather in-person, virtually, or in a hybrid manner, I’m continually impressed and energized by the dedication and collaborative spirit found in our faculty, students, staff, and alumni. I look forward to another great year of accomplishments and learning.

InSight is published twice a year for alumni and friends of the University of Iowa College of Public Health.

Director of Communications and External Relations Dan McMillan, daniel-mcmillan@uiowa.edu

Editor Debra Venzke

Designer Leigh Bradford

Marketing and Community Outreach Coordinator Mitch Overton

Alumni and Constituent Relations Coordinator Tara McKee Webmaster Patrick Riepe Creative Media Specialist Joey Loboda

Correspondence, including requests to be added to or removed from the mailing list, should be directed to:

Debra Venzke

University of Iowa College of Public Health 145 N. Riverside Dr. 100 College of Public Health Bldg., Rm S257 Iowa City, Iowa 52242-2007 debra-venzke@uiowa.edu

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Edith Parker

2 THE POWER OF STORIES

The use of stories to inform public health planning, understand peoples’ experiences, and share information is gaining traction.

6 SIX THINGS TO KNOW ABOUT THE PUBLIC HEALTH STRIKE FORCE

A team of student volunteers is assisting health departments and non-profit organizations with public health-related activities, events, and emergency situations.

8 UNDERGRADUATE UPDATE

Graduates of the college’s new undergraduate program are now starting their careers in public health.

12 PODCAST HIGHLIGHTS PUBLIC HEALTH

The “From the Front Row” podcast gives students an opportunity to hone their communication skills, meet thought leaders in the field, and educate the public.

14 WATCHING FOR SPILLOVERS

Professor Christine Petersen and her colleagues study ways to track and prevent emerging infectious diseases, particularly those that spread between animals and people.

17 A GENEROUS GIFT SUPPORTS STUDENTS

The Wu-Yang Family College of Public Health Scholarship will support aspiring public health students.

The Power of Stories

BY JENNIFER NEW

Educational psychologist

Jerome Bruner spent his career studying the ways in which stories are formed and how they impact our understanding of the world. “We are storytelling creatures,” he wrote, arguing that our minds are not made to absorb or share information in a linear way but through stories.

Public health, long dominated by quantitative research, is warming to the ways in which storytelling can be used both to collect and share information. Several College of Public Health faculty members have long seen the value in storytelling and rely on narrative to anchor their work in human experience.

COMMUNITY COLLABORATION

One researcher who embraces stories is Sarah Nash, assistant professor of epidemiology. Nash blends data science with community engagement to understand and address cancer health disparities, particularly among Indigenous and rural communities. She maintains a relationship with the Alaska Native Tribal Health Consortium where she’s particularly focused on colorectal cancers in Alaskan Indigenous peoples.

When the Iowa Cancer Registry’s 2021 Cancer in Iowa report was released, she was among the investigators whose interest was piqued by the racial disparities expressed in the data. Black Iowans are contracting and dying from cancer at a far greater rate than white Iowans. She conceived of a research project that explores the causes of this gap.

“I come from a cancer prevention background,” she says, “so I was thinking, ‘Let’s try to understand cancer prevention behaviors in this population.’” If she could better understand why the differences were occurring, she could devise solutions to prevent it.

Nash was committed to collaborating with the community. “I have a real passion for communityengaged research,” says Nash. “I totally believe in the adage ‘Nothing about us without us.’” She reached out to Angela Van Arsdale, a patient service coordinator at UnityPoint Health in Waterloo, telling her that she wanted to hear the community’s needs and concerns. The information that came back via Van Arsdale was loud and clear: African American community members in eastern Iowa were interested in the racism that exists in the health care system and how it affects people’s desire to access care.

“We flipped the script,” says Nash, who brought Van Arsdale on board as a co-investigator and added Ashley Williams, a graduate student in community and behavioral health, to the team. Instead of focusing on outcomes, they devised an interview guide that focused on people’s experience of racism and its relationship to cancer prevention and screening.

Interviews were administered by Van Arsdale and Williams, both African American. It was important to Nash that she wasn’t present at the interviews. Capturing people’s stories necessitates trust and comfort in a situation, and, she said, it would have been “highly inappropriate for a white professor” to be there while gathering stories from Black residents of Waterloo.

GAINING BETTER UNDERSTANDING

Nash’s team has completed 20 interviews and is now applying for a grant to do related work that will combine forces with another CPH researcher, Whitney Zahnd. An assistant professor of health management and policy, Zahnd’s current research project was also sparked by the disparities highlighted in the Cancer Registry’s report.

The use of stories to inform public health planning, understand peoples’ experiences, and share information is gaining traction.

“The registry has a lot of quantitative data that describe cancer disparities,” Zahnd says, “but we wanted to get a better understanding of how cancer is impacting Black Iowans. Let’s take it a step further and talk to survivors about their experiences of learning they had cancer and of the treatment they received and their experiences in the health care system.”

Funded by the Holden Comprehensive Cancer Center, Zahnd is working with Gawain Williams, a graduate student in health management and policy, to perform interviews. She suspects that the stories they collect will surface experiences of inequities and racism in the health care system.

“We want to identify ways to make cancer patients’ experiences better,” she says. “After we listen to these stories and find similarities, we’ll return to the community and say, ‘This is what we heard. Now, what should we do?’” It’s this next step of moving toward improving the system that she and Nash hope to do together.

SHARING EXPERIENCES

Another CPH scholar who puts storytelling at the center of their work is Rima Afifi, professor of community and behavioral health, who says, “All of my work is storytelling in one form or another.”

Steeped in community participatory approaches to public health, Afifi says opening space for people to share their stories substantiates their lived experiences, while amplifying their stories allows others to strengthen understanding and empathy.

One of Afifi’s current projects is related to health care workers and the pandemic. In partnership with the Iowa Public Health Association, the study “Harnessing Knowledge/Elevated Learnings: Iowa’s Experience Mitigating COVID-19” asks statewide public health professionals to share their experience of working on the front lines during the pandemic. An online platform gives participants the option to write or record their story. The study is intended to assess and understand lessons about effective action and areas that need improvement for future crises.

“This assessment is really an emergency preparedness initiative, uplifting both the incredible strengths and assets in our public health system and areas of challenge,” Afifi says, noting that of the

more than 100 people who have submitted stories so far, many have said the experience of doing so was therapeutic.

STORYTELLING SKILLS

Amanda Sursely, a PhD student in epidemiology, is working with Afifi on the study. As someone who has already honed a lot of experience in quantitative methods, Sursely says she appreciates the ways in which qualitative methods can help to parse the meaning behind the numbers. “Dr. Afifi has taught me to look across stories for themes and to find the broader picture of what the stories tell you when they’re all put together,” she says.

Student Ashley Williams credits the interviewing she’s performed for Nash’s study as a major learning experience in working effectively and ethically. “Some of the stories were really difficult. I’ve learned [from Nash] to give people time. To say, ‘Hey, if there’s anything you don’t want to share, that’s fine. If you want to talk again later, that’s fine.’”

While many of the faculty members say they received little to no training in how to do storytelling well, they are mindful of passing these skills on to their students. Zahnd provides some of the basics

Afifi says opening space for people to share their stories substantiates their lived experiences, while amplifying their stories allows others to strengthen understanding and empathy.

she teaches in her classes: “Be collaborative with the community you’re interviewing. Don’t helicopter in and extract information and then leave. Recognize that relationship building takes time; you can’t rush.”

Brandi Janssen, clinical associate professor of occupational and environmental health, comes from an anthropology background. She jokes that she was hired because she was able “to speak farmer.” Janssen is dedicated to sharing information with rural agricultural workers in ways that will matter to them. She writes a regular column on safety and health for Iowa Farmer Today, a major trade newspaper that gets distributed across the Midwest. Her writing is aimed at structural change and prevention, but she’s well aware that her readers are going to be more receptive to the words of their peers than those of a university professor.

Which is where storytelling comes in. In articles that have focused on how to work after a shoulder surgery or how to manage diabetes, Janssen cultivates and shares the experiences and words of farmers who have gone through it. She’s found that “stories are generative,” so that after publishing a piece, she’ll hear from others about a similar experience.

BEYOND THE NUMBERS

Janssen believes that public health is beginning to embrace storytelling and other qualitative methods more readily. In her field, she says, “We’re having a conversation about what is evidence. It’s usually deemed quantitative, such as exposure data and levels of contamination. My questions are, how do people reflect on their environment, how do they act in it?” She says that coming to an understanding that data is more than numbers is a slow change.

Afifi also believes the field is opening to more qualitative methods. “The reckoning that’s come from COVID and racial disparities, the stories that have been under the surface are now coming out,” she says of the moment.

Nash sums up their efforts with an important reminder: “Behind every single data point is a story.”

Things to Know About the Public Health STRIKE FORCE

What is the Strike Force?

The Public Health Strike Force is a team of student volunteers from the University of Iowa College of Public Health. The students provide support to health organizations and non-profit organizations throughout Iowa by assisting with public health-related activities, events, and emergency situations.   Organizations and agencies benefit from the engagement of skilled, enthusiastic students to assist with carrying out goals and objectives, while students build on their education and training, more effectively preparing them to enter the workforce and contribute to the strength and sustainability of Iowa’s public health infrastructure.

Who oversees it?

Two staff members, Bonnie Rubin (faculty sponsor) and Tricia Kitzmann (program coordinator) provide day-to-day support and direction for the Strike Force. The UI College of Public Health received funding through a contract with the Iowa Department of Health and Human Services to design and deliver a public health workforce development initiative, of which the Public Health Strike Force is one activity. The project is funded by the American Rescue Plan Act of 2021.

How many students are involved?

Since its formation, 47 students have participated in the Strike Force, with 39 active team members in fall 2022. The Strike Force is approved as a zero-credit course for those students who wish to have their participation recorded on their official transcript.

“During the summer, I helped with the Johnson County CASPER Survey. The questions revolved around how families handle exposure and response to extreme heat. We partnered with Johnson County Public Health, and we went door-to-door to randomly selected houses to administer the survey. It was a really great time, and we got to connect with each other, because we went out in pairs. We had some great conversations with locals about public health, and many were really excited to see college students helping out in the community. This survey will provide valuable information to the local health department so they can understand how to best respond if there is an emergent event with extreme heat.”

McKenna Deaton, second-year MPH student

in epidemiology

volunteering

“The Strike Force has really helped solidify my understanding that public health is not just science, but it’s really looking at how your community functions and how you can support the different organizations within it. I’m excited to learn more about that and to see that public health has a million different components. This is just a great organization to explore those different aspects of it.”

Mitchell Wisniewski, second-year MS student in epidemiology

“The Strike Force is an opportunity for College of Public Health students to get real-life, hands-on experience, especially in emergency or large event activities. We’re designed to assist public health departments or any sort of public health-related organization when they need more hands, or when there’s an event that needs a lot more people to accomplish what they want to do. We’re there to help with both emergent and non-emergent events.”

Bonnie Rubin, faculty sponsor

What projects have students worked on?

Team members have worked on 23 projects with nine different organizations around the state as of fall 2022. Students have:

ƒ Received and processed COVID-19 test kits at the State Hygienic Laboratory and assembled sample collection kits for distribution when cases of COVID-19 surged in early 2022.

ƒ Helped Dickinson County Health Department assess how its seasonal tourism population impacts public health strategies through literature and best practice reviews focusing on dental health, transportation, and mental health to be used for the community health assessment.

ƒ Conducted door-to-door Community Assessment for Public Health Emergency Response (CASPER) surveys in Johnson County.

ƒ Collected lake water samples and learned the importance of integrating public and environmental health at the Iowa Lakeside Laboratory.

ƒ

Gathered survey data for the Fayette County Community Needs Assessment during the Fayette County Fair.

ƒ

Assisted community members with filling out the Johnson County Community Health Assessment.

How do students join the Strike Force?

Students must be in good academic standing and fill out an application. They are required to complete training consisting of three incident command courses and a HIPAA compliance course. Once they have finished the training, students receive a Strike Force T-shirt and business cards to help identify their role. They are matched with projects based on interests and availability.

“I think it’s a great opportunity when we can give students hands-on experience and some of the training that’s going to be required when they go out into the workforce, outside of the things that they learn through their academics.”

Tricia Kitzmann, program coordinator

How does an organization request help from the student Strike Force?

ƒ

Completed Stop the Bleed training with plans for CPR and Violent Incident Survival Training in the future.

Organizations and agencies can involve public health students in a variety of projects. Students may assist with large-scale campaigns, assessments, or activities or respond to emergent situations. More information and a request form are available at www.public-health.uiowa.edu/ workforce-development-student-opportunities/

Undergraduate Update

Graduates of the college’s new undergraduate program are now starting their careers in public health.

BY DEBRA VENZKE

When Laura Eckles started her college

journey, public health wasn’t on her radar. Once she discovered it, however, she knew she’d found her niche.

“I happened to stumble upon this schooling,” she says of the BA in public health she earned from the University of Iowa College of Public Health in 2019. “My first declared major was biochemistry, but I had signed up for an introductory course in public health. I will never forget that class since it propelled me into the public health sector. I always knew I wanted to help others, and this course just confirmed that instead of focusing on treatment, I wanted to help prevent, mitigate, and promote overall health and well-being.”

Morgan Jessie (22BA) shares a similar story. “I started out knowing that I wanted to be in the health field in some capacity,” she says. “I realized that lab work and medicine were too technical for what I wanted to get out of my career. I then found public health and it just clicked.”

A GROWING PROGRAM

As a home to well-established graduate programs, the College of Public Health expanded to include an undergraduate program offering both BA and BS degrees in public health. The college welcomed its first class of bachelor’s degree students in August 2016.

The undergraduate program was formed in part to respond to an increasing national need for public health workers. An aging workforce means many public health practitioners are set to retire in the next few years, with the stresses of the pandemic hastening the departure of many others.

“Our undergraduate program prepares students with a lot of important skills in project development and management, data collection, preparedness, and evaluation—they are well positioned to fill a number of public health roles,” says Brandi Janssen, director of the CPH undergraduate program and clinical associate professor of occupational and environmental health.

Laura Brooke Morgan

The undergraduate program has grown steadily since its establishment, with 185 students enrolled in fall 2022. Almost a third of these students identify as underrepresented racial minorities, and nearly 1 out of 5 students are first-generation college students.

“There are so many benefits to having diverse teams within a workplace as well as in public health as a whole,” says Janssen. “In a work setting, diversity in perspective and experience can help solve complex problems that one person couldn’t address alone. More broadly, public health professionals have to build trust with the communities they serve, and a workforce that reflects those communities is going to be better able to develop productive relationships.”

ALUMNI AT WORK

Following graduation, many students pursue graduate studies, while others enter the workforce.

Laura Eckles, the student who switched from a biochemistry major to public health, now works as a city planner for the City of Mount Vernon, Iowa.

“This career path has multiple similarities to other jobs in public health,” she says. “My role in the planning and zoning department aids in preventing adverse impacts on not only the built environment, but the community as a whole. I’m not just working in the present, but I’m also looking into the future at what can be done to protect and promote the health of citizens and visitors of the city.”

Eckles enjoys the variety her job entails and working with the public. “I love that I can make a positive impact on the community, whether that be through listening to an individual’s story and concerns, reviewing new project development, or creating or amending legislative language—all are significant!”

Morgan Jessie, the recent graduate, wears many hats in her role as a secretary at Des Moines County Public Health in Burlington, Iowa. She has helped conduct a social determinants of health survey for the county, analyzed data, and works with the public to answer questions about public health topics. “The best part is that my job is always evolving,” she says. “We have a small department of only around 11 people, so this means that I get to do more than would be expected as a secretarial role.”

She adds, “I’m excited to get the opportunity to learn what public health looks like both in times of crisis and in the mundane day-to-day of it all. This position, with the help of the director of the department, has

presented the opportunity to meet so many people within the community and opportunities that will help me to further my career goals and learn from others.”

Brooke Zibell graduated with a BS in public health from Iowa in 2021. She continued on to a graduate program and earned an MHS degree in environmental health from Johns Hopkins University in 2022. She’s now employed as a pollution control analyst with the Baltimore County Government in White Marsh, Maryland.

Zibell also found public health to be a perfect fit. “Coming into college, I was really stuck between a career in health care and a career in the environmental sciences,” she says. “After doing some research, I found public health to be the perfect field at the intersection of both my passions for health and the environment.”

Her work as a pollution control analyst involves a variety of tasks. “There is always something different to be done, from taking groundwater samples, measuring landfill gas concentrations, ensuring compliance and safety, conducting stormwater inspections, writing reports, monitoring leachate patterns, working with consultants and other governmental jurisdictions, and so on,” she says. “What excites me most about my job is knowing that I’m making a difference in the public’s health and the surrounding environment.”

SUCCESSFUL OUTCOMES

Janssen sees a bright future for the undergraduate public health program and its alumni. “I think we will see steady growth, especially as students continue to chart their unique paths after graduation,” she says. “We anticipate that many will move into traditional public health roles, but many are also finding success outside of public health. We hear that their public health training has provided important skills that contribute to their success no matter where they are. I think these outcomes are especially exciting and show how a public health perspective is valuable in many different career settings.”

Students also appreciate what they gain beyond book learning at Iowa. “I value the connections and experiences that I had both in and out of the classroom,” Jessie says. “I grew so much at Iowa. The atmosphere is like nowhere else, and the College of Public Health really is full of professors and other faculty who genuinely care about this field and want to do as much as they can to prepare students for their futures in public health.”

98%

A Workforce in Demand

22% of the government public health workforce was planning to retire by 2023, and 24% was considering leaving for other reasons, according to a 2017 survey.

According to a national analysis, state and local health departments need to hire a minimum of 80,000 more full-time equivalent positions (FTEs) — an increase of nearly 80% — to provide adequate infrastructure and a minimum package of public health services.

An FY20 survey of Iowa’s local public health systems found that 98% of directors identify as white 90% of directors are female 40% of directors are 55+ years of age

job/grad school placement rate for Iowa public health undergraduates

PODCAST HIGHLIGHTS Public Health

The “From the Front Row” podcast allows CPH students an opportunity to hone their communication skills, meet thought leaders in the field, and educate the public on important topics.

BY EMILY NELSON

While Stevland Sonnier was

considering graduate schools for public health, several colleagues suggested he look at the University of Iowa. While researching the UI College of Public Health, he discovered the student-produced From the Front Row podcast.

“I listened to a few of the episodes, and one was with Mona Hanna-Attisha, a pediatrician who was really at the heart of exposing the Flint, Michigan, water crisis,” Sonnier says. “I thought, ‘Wow, they are talking to one of the key practitioners of the key public health principles at the issue of this crisis. This is a very important conversation that this person gets to have and learn from as a student.’ I wanted to be a part of that.”

Learning Communication Skills

Sonnier joined the podcast team shortly after starting at Iowa and became the executive producer his second year. He received an MPH with an emphasis in policy in 2021 and now works as a federal policy analyst at MITRE, where he says he uses many of the skills that he gained while working on From the Front Row.

“I advise the federal government on health care solutions, and a big part of that is engaging with community members, talking with them, listening to what their needs are, and then translating them into effective recommendations,” Sonnier says.

“Working on the podcast really helped me figure out what effective public health messaging looks like. Science changes, it’s very complicated, etc., but how do you quickly, concisely, and clearly communicate a message to folks from different backgrounds with different viewpoints? That was a critical element that we engaged with in every podcast.”

The podcast began in 2018, and there have been new episodes almost every week since, covering topics ranging from the connection between food production and rural and immigrant health, dealing with the opioid epidemic, delivering mental health and counseling services on a college campus, newborn screening programs, intimate partner violence, and, of course, navigating COVID-19.

“The podcast has been an impressive student-run initiative from the beginning,” says Lexie Just, associate director of admissions and recruitment in the College of Public Health. “Ian Buchta was the first producer and he set the tone on day one. Ian turned the reins over to Steve Sonnier, then Alexis Clark, and now to our current producer, Anya Morozov. They’ve led podcast teams that have put out engaging and informative public health content every week.”

Introducing Public Health

Morozov, From the Front Row’s current executive producer, also discovered the podcast while trying to decide on graduate schools. And while the school’s strong sense of community is what ultimately swayed her, the podcast didn’t hurt.

“I thought it must be a pretty cool school of public health if they were able to keep a podcast going for so long,” says the second-year epidemiology student.

While the podcast aims to introduce public health topics to the general public, there is another important audience: students and potential students.

It serves as an introduction to the UI College of Public Health—as Sonnier and Morozov know firsthand—but also to the field of public health.

“Why is this an interesting field to get into? Why should you look at this versus any other number of careers?” Sonnier says. “Or, how does it relate to other careers? Other fields are very influenced by public health, so getting exposure to that was a critical driving force for me when we were considering what the vision was for the podcast structure.”

Building Skills

From the Front Row introduces students to more than the technical aspects of producing a podcast— although they get a crash course in that, too.

“Working on the podcast has created many opportunities for students to engage with both local and national public health experts and has allowed them an opportunity to gain invaluable skills, including leadership, interviewing, and networking,” Just says.

Morozov says she’s interested in going into public health at a local, state, or federal governmental level, and, as in any public health field, excellent communication skills are important.

“Whether you’re the public relations officer who’s actually communicating about the topic, or you’re working in a clinic, or you’re doing bootson-the-ground public health work, being able to communicate your work and its value is really important,” Morozov says. “This podcast gives people a unique opportunity to practice that.”

Sonnier agrees. “Meeting people is essential for many different reasons,” he says. “Networking is great, but you also get to know thought leaders in your field. They help shape your perspective of who you want to be and where you want to be as a professional in the public health field. The podcast broadened my horizons as to what public health means and what public health can do.”

Find all the episodes at www.public-health.uiowa. edu/from-the-front-row/

From left: Podcasters Anya Morozov, Radha Velamuri, Eric Ramos, and Logan Schmidt. Photo by Joey Loboda

Watching for Spillovers

BY DEBRA VENZKE

Professor Christine Petersen and her colleagues study ways to track and prevent emerging infectious diseases, particularly those that spread between animals and people.

MONKEYPOX IS THE

latest

infectious disease to capture global attention, joining an increasingly lengthy list of worrisome pathogens such as Ebola, Zika virus, and, of course, SARS-CoV-2. While humans have always had to contend with diseases, new threats seem to be popping up with increasing frequency around the globe.

Christine Petersen, CPH professor of epidemiology, studies zoonotic diseases—infections that spread between people and animals. She also directs the Center for Emerging Infectious Diseases (CEID), where interdisciplinary teams focus on research and training in cross-cutting emerging infectious diseases, particularly those that are zoonotic. The center is operated by faculty from the University of Iowa and the Veterinary College at Iowa State University.

The CEID has earned a national reputation for excellence in zoonotic disease research in the areas of vector-borne disease (disease spread by insects such as mosquitos and ticks); anti-microbial resistance; and environmental, occupational, and wildlife exposures to infectious diseases.

Petersen and the CEID apply the idea of One Health in their work. One Health is a collaborative, transdisciplinary approach with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.

A GLOBAL CONCERN

With so many new health threats in the headlines, are there more emerging infectious diseases affecting humans than in the past, or is the discovery of new diseases the result of better surveillance?

“The number of emerging and zoonotic infections has been increasing throughout the last couple of decades,” Petersen confirms. “I think there are a lot of reasons for it, and, honestly, better surveillance is not the main one.”

One major factor is global travel and commerce. “Humans are moving around the globe much faster and more frequently than we ever have,” she says. “Our trade is much more global, so we have planes, ships, and cargo containers that can easily transport mosquitos, small rodents, or bats from other places. We are trading various creatures that can carry the infections.”

Petersen also points to the effects of climate change on emerging infections, particularly vectorborne diseases. Warming temperatures and milder winters make it easier for West Nile virus, Lyme disease, and other infectious diseases to expand into new locations and infect more people.

Drought, flooding, and loss of habitat forces wildlife to move into closer contact with humans. Likewise, as people leave their homes due to natural disasters, civil unrest, or urbanization, they may push into uninhabited land, increasing the risk of cross-species transmission. Poor water quality and increased stress can also increase people’s susceptibility to infections.

“All of these factors are setting up the possibility of a spillover of an animal disease into people that much more,” Petersen says.

SHIFTS IN SURVEILLANCE

Despite the increasing threat of spillovers, global disease surveillance programs have undergone significant reshuffling.

PREDICT, a project of USAID’s Emerging Pandemic Threats program, was formed in 2009 to strengthen global capacity for detection of viruses with pandemic potential that can move between animals and people. PREDICT initiated One Health Surveillance, “a transdisciplinary collaborative approach to understanding infectious disease risk at the animal-human interface,” according to its web site. However, in early 2020, PREDICT was closed by the Trump administration.

In August 2020, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National

Institutes of Health, announced the establishment of the Centers for Research in Emerging Infectious Diseases (CREID). NIAID intends to provide the global network approximately $82 million of support over five years.

“Although there are some partners on the veterinary side, it’s going back to our traditional human-focused disease surveillance needs. So that’s what’s disappointing,” says Petersen about the switch to CREID. “We’re having pandemics and infections coming from animals, but we’re not really thinking in new ways about how to reach across the health fields to do this in a true One Health way.”

MIDWEST MONITORING

Closer to home, a number of diseases are being monitored in the Midwest. As a top producer of hogs and poultry, Iowa is especially alert to influenza. “Flu is a real interest because it affects all those animals and they can spread it from themselves to people,” says Petersen. The flu of most concern is called highly pathogenic avian influenza, she says, adding that this form of influenza “kills poultry quite readily, but doesn’t do as well in people.”

But, in a worst-case scenario, “it just needs a couple of mutations, and it could go from something that doesn’t infect people well into something that can, so that’s why we have surveillance happening at all times,” she says.

Another disease being watched in the Midwest is chronic wasting disease (CWD). “This disease is in deer in Michigan and Wisconsin, so we are finding some infected deer in northeast Iowa,” Petersen explains. “It’s not a virus, but a prion.”

Prion diseases, such as CWD and Mad Cow Disease, can affect both animals and humans. Prions are pathogenic agents that can cause abnormal folding

of specific proteins in the brain. The abnormal folding leads to brain damage and neurologic changes. To date, there have been no reported cases of CWD infection in people, but in areas where CWD is known to be present, the CDC recommends that hunters take precautions.

FIGHTING LYME DISEASE

disease, a tick-borne illness caused by the bacterium  Borrelia burgdorferi , is found in the eastern United States and Upper Midwest. Although it’s difficult to know exactly how many people get Lyme disease, one estimate based on insurance records suggests that each year approximately 476,000 Americans are diagnosed and treated for Lyme disease.

Petersen is a co-investigator on a NIH-funded study of a Lyme disease intervention.

“I’m working with a collaborator at the University of Tennessee, Professor Maria Gomes-Solecki,” she says. “She has developed an oral bait vaccine that basically uses the ecology of Lyme disease to get rid of it. When mice eat this oral bait, they make antibodies against one of the outer surface proteins of Borrelia . Then when a tick feeds on that mouse, those antibodies bind to the Borrelia that cause Lyme disease and gets rid of it. We’re basically getting the Lyme disease out of the ticks. That means you can still get a tick bite, but it isn’t going to give you Lyme disease.”

The researchers are using dogs as stand-ins for human exposure to infected ticks, since both dogs and people are similarly active outdoors.

“We’re asking people to walk their dogs in a specific area where we put out the bait,” Petersen explains. “We want to see if, by doing this intervention in those ticks, dogs get less disease.”

Grant Brown and Jacob Oleson, both faculty from the UI Department of Biostatistics, are providing data support for the five-year study, now in its third year.

The oral bait vaccine—which is inexpensive and easily distributable—could have a huge impact on reducing the burden of Lyme disease in people and animals. And since Lyme disease is the most common vector-borne disease in the United States, that’s welcome news.

Christine Petersen (left) and students look for ticks in a wooded area.

A Generous Gift Supports Aspiring Public Health Students

EARLIER THIS YEAR, Dr. David Wu, Una Yang, and Austin Wu (21 MPH, 20BA) designated a generous gift to establish the Wu-Yang Family College of Public Health Scholarship in the University of Iowa College of Public Health.

The family’s support will help future College of Public Health students achieve their academic goals at Iowa. “Our family comes from a long line of educators and professionals who value higher education,” says Una Yang. “Providing opportunities for the next generation of aspiring students who may not be as fortunate in a financial sense is our primary motivation.”

The family maintains a strong connection to the University of Iowa. “Our family spent over 20 years in Iowa; these were very important years in our family’s development,” Yang says. “Right off the bat, we became fans of Hawkeye athletics, which continues to this day. After Dave’s retirement from corporate life, he taught in an adjunct capacity at the Colleges of Business and Engineering.”

Austin Wu’s years as an undergraduate and graduate student at the College of Public Health were rewarding in many respects. The college felt like a second home on campus to him, he says, and he has fond memories of lunches at the Spotlight lectures and many other events. The college provided opportunities to engage with the state of Iowa and the wider public health world, such

as attending a state legislative breakfast in Des Moines and providing financial support to attend the American Public Health Association’s annual national meeting, he adds.

After graduating with a Master of Public Health degree in 2021, Austin held positions as a research assistant at the University of British Columbia’s School of Population and Public Health in Vancouver, Canada, and as a policy analyst at the League of American Bicyclists with a focus on road safety. He recently started the Centers for Disease Control and Prevention’s Public Health Associate Program, a competitive two-year paid training program where associates are assigned to state, tribal, local, and territorial public health organizations across the U.S. He has been assigned to the Center for Public Health Practice within the Minnesota Department of Health.

“We’re so grateful to the Wu-Yang family for their gift to the college,” says Edith Parker, dean of the College of the Public Health. “This new scholarship will support students as they pursue the education and skills they need to launch successful careers in public health.”

“The university environment provides many avenues for growth—academic, social, artistic, athletic, etc.,” Yang says. “We encourage prospective students to fully explore what the University of Iowa has to offer in and out of classrooms. Go Hawks!”

Austin Wu (center) with Dr. David Wu and Una Yang.

HAPPENINGS

Christine Petersen elected to the National Academy of Medicine

Christine Petersen, professor of epidemiology and director of the Center for Emerging Infectious Diseases at the University of Iowa, has been elected to the National Academy of Medicine (NAM).

Election to the academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service. Petersen is one of 100 new members elected in 2022.

Petersen is internationally known for her work on the recognition and prevention of zoonotic diseases, or infections that spread between people and animals. Her work has focused particularly on visceral leishmaniasis, a neglected tropical parasitic disease that kills 20,000-40,000 people every year, and tick-borne diseases, particularly Lyme disease. In addition, she collaboratively works on malaria, Brucella canis, influenza, and other diseases. She teaches joint medical, veterinary, and global public health coursework related to the diagnosis, treatment, and prevention of zoonotic diseases within all populations.

New toolkit helps pharmacists increase access to COVID-19 vaccinations

The University of Iowa Prevention Research Center for Rural Health has developed an online toolkit, “Pharmacists’ Guide to Increasing Equitable Access to COVID-19 Vaccines.” The toolkit gives vaccine providers the knowledge, strategies, and resources needed to address the factors inhibiting vaccine access and confidence. It can be used by pharmacists and other vaccine providers, administrative staff, public health departments, or anyone else supporting the effort for vaccine equity. Find the toolkit at https://prc.public-health.uiowa.edu

Motorcycle fatality rates are increasing, and impaired driving is a major contributing factor. University of Iowa public health researchers say law enforcement officials aiming to reduce drunk driving have an effective tool at their disposal: ‘Throw the book at ’em.’

A new study of alcohol-involved motorcycle crashes in Iowa suggests that applying all relevant charges at the time of the crash leads to increased convictions, says Cara Hamann, CPH assistant professor of epidemiology, who led the research.

“Traffic stops and the issuance of traffic charges are important tools law enforcement officers have available to discourage unsafe driving,” says Hamann. “Understanding the effectiveness of impaired driving laws, in terms of charge and conviction outcomes, is important for informing prevention efforts.”

The study looked at 480 alcohol-influenced drivers (428 motorcyclists and 52 other vehicle drivers) involved in motorcycle crashes between 2011 and 2018. After adjusting for blood alcohol content, drivers with a combination of alcohol, administrative, and moving violation charges had more than 3 times the odds of conviction of any charge compared to drivers with alcohol-only charges.

“Our results showed convictions were more likely when the impaired driver was charged with multiple types of offenses than with a single offense,” says Hamann.

PETER THORNE named University of Iowa Distinguished Chair

Peter Thorne, professor of occupational and environmental health in the College of Public Health, has been named a recipient of the 2022 University of Iowa Distinguished Chair. The award is one of the highest bestowed on Iowa faculty. It recognizes tenured scholars of national and international distinction who are making a significant positive impact within the university, state of Iowa, and beyond through teaching, research, and/or scholarship.

Thorne’s pioneering research is focused on environmental risk factors for inflammatory lung diseases, the toxicity of engineered nanomaterials and persistent chemical pollutants, and the health effects of climate change.

Research suggests increasing charge types results in more convictions for alcohol-related motorcycle crashes

Health equity pioneer David R. Williams receives Hansen Leadership Award

The University of Iowa College of Public Health selected David R. Williams, the Florence and Laura Norman Professor of Public Health and chair of social and behavioral sciences at the Harvard T.H. Chan School of Public Health, as the 2022 recipient of the Richard and Barbara Hansen Leadership Award. Dr. Williams visited the College of Public Health in November to engage with students and deliver the Hansen Lecture, titled “Understanding and Effectively Addressing Inequities in Health.” View the lecture at www.public-health.uiowa.edu/hansen-award/

IOWA’S PUBLIC HEALTH TRAINING CENTER RECEIVES $3.1M FUNDING RENEWAL

The Midwestern Public Health Training Center (MPHTC) at the University of Iowa College of Public Health has been selected as one of ten regional public health training centers to be refunded by the Health Resources and Services Administration (HRSA), an agency within the U.S. Department of Health and Human Services.

MPHTC covers the four-state region of Iowa, Kansas, Missouri, and Nebraska. The four-year grant continuation of over $3.1 million will allow MPHTC to continue to help improve public health by strengthening the technical, scientific, managerial, and leadership competencies of the public health workforce.

HAPPENINGS 3.1

Public health researchers lead international study of young adults in humanitarian settings

A new grant awarded to an international team of researchers, co-led by investigators in the University of Iowa College of Public Health, will study whether engaging young adults as community mental health workers in humanitarian settings helps not only to support those communities in crisis, but protects the well-being of the young workers as well.

The collaborative research team is co-led by Rima Afifi, CPH professor of community and behavioral health. Other investigators include Grant Brown, CPH assistant professor of biostatistics, as well as researchers from George Mason University, American University of Beirut, and Yale University. The research team is also partnering with the non-governmental organization Multi-Aid Projects (MAPs) that will guide field activities.

The project, funded by a three-year, $450,000 grant from the National Institute of Mental Health, is focused on Syrian young adults living in Lebanon, a nation that currently hosts about 1.5 million Syrians displaced by war in their home country.

“Humanitarian crises increase mental health disorders,” says Afifi. “Yet, in humanitarian settings, human resources for health are often insufficient to meet needs. Understanding how young adults can support communities in the context of disasters is an important area of research.”

The overall goal of the new study is to evaluate whether being a young adult community mental health worker (CMHW) impacts the young adults’ well-being, coping, and stress levels. The research also aims to measure how and why the CMHW role may be a protective factor for these young adults.

Madeline Kerr Named Director of Development

The College of Public Health is pleased to welcome Madeline Kerr as director of development for the college. She began her new role in November 2022. She has been with the University of Iowa Center for Advancement since July 2018, most recently serving as the associate director of development with the Holden Comprehensive Cancer Center team. Madeline can be reached at Madeline.Kerr@foriowa.org .

Study explores the ‘boyfriend loophole’ and intimate partner homicides

A new study co-authored by Hannah Rochford, a PhD student in health management and policy, and colleagues Mark Berg and Corinne Peek-Asa, examined intimate partner homicides and what’s known as the “boyfriend loophole.” Intimate partner homicides (IPH) are a risk in relationships with a history of violence. Policies intending to reduce IPHs by limiting firearm access for those with a history of intimate partner violence (IPV) have been enacted in certain states. However, some states fail to extend IPV-related firearm related protections to dating partners, which is referred to as the “boyfriend loophole,” or “partner loophole” in this study.

By examining trends in the National Violent Death Reporting System data, the study assessed the relationship between intimate partner homicides among unmarried victims and state partner loopholes. Some of the findings included noticeable differences in the age and racial compositions of the groups when victim demographics were compared to their vulnerability to the partner loophole. Closing a partner loophole was associated with significantly fewer expected IPHs amongst unmarried white victims. However, this relationship was not observed for unmarried victims of color, suggesting that closing partner loopholes may offer important protections, but may not reduce IPHs equitably. The study was published in the Journal of Prevention .

LEHMLER LEADS TEAM ADDRESSING CLIMATE, ENVIRONMENT, AND HEALTH

With $500,000 in funding from the OVPR Interdisciplinary Scholars awards program, an interdisciplinary team will start work on a new project at the intersection of climate, the environment, and health. The award is sponsored by the UI Research Development Office within the Office of the Vice President for Research.

The project is led by Hans-Joachim Lehmler, CPH professor of occupational and environmental health and director of the Environmental Health Sciences Research Center. The team includes researchers from the College of Public Health, Carver College of Medicine, and College of Liberal Arts and Sciences. The researchers will investigate the effect of the diverse environmental stressors affected by climate change on the unique health challenges of rural people.

HAPPENINGS

Alcohol-involved deaths are on the rise in Iowa

A report from the Iowa Department of Health and Human Services in collaboration with a group of researchers and community partners examines the significant increase of alcohol-involved deaths in Iowa since 2008 and offers recommendations and strategies to help address the issue at the state and community levels.

IDHHS’s Bureau of Substance Abuse established the Alcohol-Involved Deaths Workgroup in 2019 to better understand a concerning 10-year trend in alcohol-involved deaths among Iowans aged 45 and older. The workgroup included Paul Gilbert, associate professor of community and behavioral health in the UI College of Public Health. According to the report, alcohol-involved deaths increased by more than 73% in Iowa between 2008 and 2019 and men aged 45+ are 2 times more likely to die an alcohol involved death than women. Gilbert says that there are likely many things contributing to this trend.

“Research has shown that people respond to stressful situations by increasing alcohol use,” he says. “We know that people have increased their alcohol use during the pandemic and combined with isolation and ease of access, it has had a major impact on people’s drinking habits, making the drinking trends even more worrisome.”

The report also highlights several evidence-based strategies that have proven to be effective in reducing excessive alcohol use, and in turn could reduce alcoholrelated deaths. These include limiting alcohol outlet density, strengthening compliance monitoring, increasing alcohol prices, increasing public health surveillance, implementing problematic use screenings, and continuing public education.

Did you know?

The Clinical Trials Statistical and Data Management Center is a renowned national leader in multicenter clinical trials. Continuously funded for more than 30 years, the center has collaborated with more than 100 academic institutions to design, implement, and analyze clinical trials.

CLASS NOTES

Samira Abdalla (22MPH, 21BA) is a community resources navigator for the City of Coralville in Coralville, Iowa.

Olu Afolayan (12MPH) is a solution associate at McKinsey & Company in Kalamazoo, Michigan.

Matthew Carr (17MPH) is the medical director at Mission Veterinary Partners in Gladstone, Missouri.

Bryant Conkling (14MPH) is the associate director of public policy at Gilead Sciences, a biopharmaceutical manufacturer, in Washington, DC.

Bryce Damman (22MS) is a biostatistician at Mayo Clinic in Rochester, Minnesota.

Pramod Dwivedi (98MS) has been named president-elect of the National Association of County and City Health Officials Board of Directors, which represents the country’s nearly 3,000 local health departments. Dwivedi will become board president in July 2023 and currently serves as health director of Linn County Public Health in Cedar Rapids, Iowa.

Eric Hawkins (09MS) is the state epidemiologist at the Indiana Department of Health in Indianapolis, Indiana.

Mallory Holub (21BS) is a community health assistant at Jones County Public Health in Central City, Iowa.

Emil Kalloor (16MHA) is an operational reporting analyst at JPS Health Network in Fort Worth, Texas.

Kristen Kidd Donovan (02MPH) is an infection control practitioner at HCA Healthcare in Richmond, Virginia.

Jared Lesher (15MHA) is the chief operating officer at TriStar Greenview Regional Hospital in Bowling Green, Kentucky.

Emily Loya (22BA) is a clinical data analyst specialist at UI Health in Chicago, Illinois.

Adriana Maldonado (21PhD) is a postdoctoral research associate at University of Arizona Mel and Enid Zuckerman College of Public Health in Tucson, Arizona.

Abigail McCarthy (21BA) is a clinical research associate at Medpace in Denver, Colorado.

Mikaela Mikkelsen (20MPH, 19BS) is a public health data analyst at Southern New Jersey Perinatal Cooperative in Oak Park, Illinois.

Norma Miller (07MPH) is a biological threat coordinator/biosafety officer at the State Hygienic Laboratory at the University of Iowa in Coralville, Iowa.

Olivia Moran (22MHA, 20BA) is an administrative resident at SCA Health in Portland, Oregon.

Laurel Mueller (12MPH) is an internal medicine physician at MedStar Washington Hospital Center in Washington, DC.

Francisco Olalde (22MHA) is the executive liaison to the chief quality officer at University of Iowa Health Care in Iowa City, Iowa.

Abby Olson (22MPH, 22CER) is an associate health scientist II at CTEH in Denver, Colorado.

Lauren Pinney (22MHA) is an administrative fellow at NorthShore University Health System Evanston Hospital in Evanston, Illinois.

Joe Promes (22MHA) is a consultant at Deloitte in Chicago, Illinois.

Homa Sadeghi (22PhD) is a postdoctoral research fellow at USC Norris Comprehensive Cancer Center in Los Angeles, California.

Melissa Jay Smith (22PhD, 19MS) is an assistant professor of biostatistics at UAB in Birmingham, Alabama.

Wade Swenson (04MPH) is an oncologist at Lakewood Health System in Staples, Minnesota.

Wenquan Wang (03PhD) is senior director at Pfizer in Collegeville, Pennsylvania.

Jamie Weber (09MHA) is an attorney at Tschetter and Adams P.C. in Sioux Falls, South Dakota.

Hannah White (22MS, 22CER) is an industrial hygiene specialist at RPS in Austin, Texas.

Clare Willey (22MPH, 20BA) is a safety and ergonomics analyst at John Deere in Waterloo, Iowa.

Brooke Zibell (21BS) is a pollution control analyst at Baltimore County Department of Public Works, Bureau of Solid Waste Management, in White Marsh, Maryland.

IN MEMORY

Phillip

Cline (87MA) of Eden Prairie, Minnesota, on Sept. 15, 2022. James Cooney (57MA) of Charlotte, North Carolina, on July 2, 2022. R. William “Bill” Field (94PhD) , University of Iowa professor emeritus of occupational and environmental health, of Iowa City, Iowa, on Nov. 4, 2022. Ann Garvey (03MPH) of Norwalk, Iowa, on Nov. 1, 2022. Paul Guptill (72MA) of Charlotte, North Carolina, on May 22, 2022. Mark Shellmyer (01MHA) of Winter Park, Florida, on May 26, 2022.

Developing the Next Generation of Biostatisticians

BY EMILY NELSON

THE IOWA SUMMER INSTITUTE in Biostatistics (ISIB) is a seven-week program hosted by the UI College of Public Health that provides biostatistical research education and research opportunities to undergraduates and graduates with an interest in the field.

Gideon Zamba, ISIB director and CPH professor of biostatistics, says the program was designed to provide students an entry point to the growing field and encourage them to consider graduate programs related to biostatistics and data science. ISIB began in 2008 with a pilot trial and is funded by the National Institutes of Health and the National Heart, Lung, and Blood Institute.

ISIB students come from across the United States. The summer 2022 students traveled from as far as California and Massachusetts and are majoring in a range of disciplines, including mathematics, biology, computer science, and physics.

“Our students don’t have the same backgrounds or majors, but we think they all have the tools to be the next generation of biostatisticians and data scientists,” Zamba says.

Alumna Keyla Pagán-Rivera knows firsthand the opportunities that biostatistics can offer—and how the ISIB can affect a person’s career trajectory. While studying applied mathematics at the University of Puerto Rico, she traveled to Iowa to become part of

PHOTO BY JOEY LOBODA

the second ISIB group in 2009. She was curious about the field of biostatistics, but she planned to become a math teacher.

“Little did I know that it would change my career entirely,” Pagán-Rivera says. “I realized I would rather be analyzing data and doing stats than teaching, and it was like a domino effect from there.”

Pagán-Rivera returned to Iowa to get a master’s degree and PhD in biostatistics. She now works as a research staff member for the nonprofit Institute for Defense Analyses outside Washington, D.C. And while she’s not working in the health care industry, she says her education prepared her well to apply statistical methods to a different field.

Pagán-Rivera never thought when she left Puerto Rico it would be for Iowa, but she’s glad she did.

“Deciding where you go for a PhD program is not a trivial thing,” she says. “I had never lived outside the island before coming to Iowa. But feeling welcomed and liking what you do and liking the people around you make a difference. The support that I found at the University of Iowa, both during the program and during grad school, was amazing. For some people, it might be the first time that they’re away from home, and knowing you’re going to have support is important.”

Learn more about ISIB at www.public-health.uiowa. edu/isib/

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The University of Iowa College of Public Health has generated more than $207 million in research funding over the last 5 fiscal years.

The College of Public Health is a national leader in our multidisciplinary, collaborative approach to addressing public health challenges and training the next generation of public health leaders, educators, and researchers.

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