UAlbany School of Public Health Magazine 2019

DEFINING EXPERIENCES IN PUBLIC HEALTH

TACKLING CLIMATE CHANGE. IMPROVING ACCESS TO CARE. REDUCING HEALTH DISPARITIES. STUDYING INFECTIOUS DISEASES. ASSISTING THE STATE. TRAINING THE FUTURE LEADERS OF PUBLIC HEALTH. CREATING MEANINGFUL CHANGE. ADDRESSING FOOD STUDENT INSECURITY.SUCCESS PROMOTING DIVERSITY AND INCLUSION. IMPACTING COMMUNITIES LOCALLY AND 2 Hands-on Learning 3 THE Strengthening Public Health Workforce AROUND WORLD.theUNLEASHING GREATNESS. 4 Bachelor of Science COMBATTING LONELINESS 5 Influencing Policy AND AGING. PARTNERING 15 Students onAROUND the Forefront Discovery TACKLING WITH COUNTRIES THEof WORLD. 19 From Mentee to Mentor CLIMATE CHANGE. IMPROVING ACCESS TO CARE. 31 The Power of Student Scholarships REDUCING HEALTH DISPARITIES. STUDYING INFECTIOUS DISEASES. ASSISTING THE STATE. RESEARCH EXCELLENCE TRAINING THE FUTURE LEADERS OF PUBLIC HEALTH. 10 In the News CREATING MEANINGFUL CHANGE. ADDRESSING 14 Candida Auris Partners in Maternal & Child Health FOOD 16 INSECURITY. PROMOTING DIVERSITY AND 17 Albany Infant & Mother Study INCLUSION. IMPACTING COMMUNITIES LOCALLY AND 17 Upstate KIDS Study 18 THE UPSIDE Study UNLEASHING GREATNESS. AROUND WORLD. 20 How do Dietary Factors Influence Cancer?

COMBATTING LONELINESS AND AGING. PARTNERING 23 Loneliness & Aging WITH COUNTRIES AROUND 25 Latinx Physical Activity THE WORLD. MAKING 26 The IN Impact of Climate Change STRIDES CANCER RESEARCH. TACKLING 27 Air Pollution CLIMATE IMPROVING 28 CHANGE. Research & Training CentersACCESS TO CARE. 30 Reducing HIV Incidence REDUCING HEALTH DISPARITIES. STUDYING INFECTIOUS DISEASES. ASSISTING THE STATE. DIVERSITY INCLUSION TRAINING THE FUTURE & LEADERS OF PUBLIC HEALTH. 12 An MEANINGFUL Unwavering Commitment CREATING CHANGE. ADDRESSING 24 Eliminating Health Disparities FOOD INSECURITY. PROMOTING DIVERSITY AND INCLUSION. IMPACTING COMMUNITIES LOCALLY AND INTERNATIONALIZATION AROUND THE WORLD. UNLEASHING GREATNESS. 6 MeetLONELINESS Jeancarlo COMBATTING AND AGING. PARTNERING 7 A Global Approach WITH COUNTRIES AROUND THE WORLD. TACKLING 8 A Global Impact 9 Partnership CLIMATE CHANGE. Countries IMPROVING ACCESS TO CARE. REDUCING HEALTH DISPARITIES. STUDYING ENGAGEMENT & SERVICE INFECTIOUS DISEASES. ASSISTING THE STATE. 13 THE Community Engagement TRAINING FUTURE LEADERS OF PUBLIC HEALTH. 22 Food insecurity CREATING MEANINGFUL CHANGE. ADDRESSING FOOD INSECURITY. PROMOTING DIVERSITY AND

IN THIS ISSUE

A FOCUS ON THE FUTURE DEAR FRIENDS & FAMILY OF THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH: Welcome to our amazing school! We are a community of teachers, scholars, researchers, and advocates working together to improve the health and well-being of all people. Our School was created 34 years ago as a visionary partnership between the New York State Department of Health and the University at Albany. Experts at the Department of Health hold faculty appointments, collaborate with full-time faculty members on a wide array of basic and applied research projects, and mentor students in their labs, including the renowned Wadsworth Center.

Our location in the capital of New York 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.

As public health challenges arise, it is uplifting to see the passion from and collaboration between our faculty, students, and community partners as they come together to find solutions, disseminate information, and influence policy. We are nationally known for our commitment to experiential learning, which means our students are equipped to truly make a difference, accelerate their careers, and be sought after by employers. Our MPH program requires more internship hours - 720, to be precise - than any other program in the nation.

And our MS, PhD, and DrPH students also gain extensive

hands-on experience with our faculty researchers, who focus on high-impact areas such as climate change, vector-borne illness, maternal and child health, and social determinants of health, to name a few. We are very grateful to family and friends who support this work. Of note, we recently received an anonymous $1,000,000 donation pledge to further our school’s mission.

As we work towards creating big change, it’s also important to remember that small steps in the right direction can have a ripple effect. Here at the school, we have embraced changes that encourage our community to make healthy decisions.

We’ve hosted several Meatless Monday lunches (great for us - and for the environment, too!) and on #MoveItMonday, you can find many faculty, staff, and students taking group strolls down our walking route on campus. It is through actions like these that teamwork can create long-lasting change... literally one step at a time.

Thanks to the talent and dedication of our students, staff, and faculty and the support of our community partners, donors, and alumni, we are poised to make an even greater impact as we pursue excellence and work to save lives and promote social justice. We hope you enjoy reading our new magazine structured around the five pillars of the University at Albany’s “Authoring Our Success” strategic plan, and we hope to partner with you in the future!

David Holtgrave, Ph.D

Dean, School of Public Health SUNY Empire Innovation Professor University at Albany

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HANDS-ON LEARNING

abrielle (Gabby) Gregoire is ready to enter the public health field with a wealth of knowledge and the experience necessary to make an impact. After interning, volunteering, researching, and completing the Master of Public Health (MPH) degree, Gabby is prepared to help communities thrive.

Gabby completed her undergraduate studies in chemistry at UAlbany.

Passionate about science, but unsure of which route to take in the field, she came across public health at a tabling event and picked up the 18-credit minor during the second semester of her junior year. “I’ve always loved science,” she says. “But public health seemed like the ‘Gabby’ way to apply this passion to people and really make a difference.”

She decided to pursue an MPH. “I was blessed to get into all the programs I applied to,” Gabby exclaims, “But what pushed me to stay at UAlbany was that the program is heavily internship based, and I learn better from doing.”

According to Gabby, her MPH courses enabled her to flourish. She gained a strong understanding of the fundamentals during her first year, and then in her second year she applied

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this knowledge to real-world issues through her internships.

“A huge applause to whoever structured the program,” laughs Gabby. “It’s very strategic. Each class has a benefit, and you might not realize it fully until you’re completing the internship component.

That’s when everything just clicks and you’re thankful for each class – even Program Development and Evaluation, which ended up being the most relevant class for my second internship, even though at the time I didn’t quite understand its importance.”

Gabby interned with Albany Med’s Division of Community Outreach during the first semester of her second year. She helped integrate public health knowledge into the medical students’ curriculum and facilitated community engagement activities to connect med students to populations they may serve as future doctors. “It’s important that doctors are really listening to their patients and understanding where they’re coming from, rather than falling back on stereotypes,” Gabby explains. “It’s great to see that Albany Medical Center is placing a huge emphasis on learning public health alongside medicine.”

Gabby also became a certified application counselor (CAC) for New York State through her internship and was sent out into the community to help people enroll in health insurance.

“It was an eye-opening experience,” Gabby reflects, stating that she truly saw how socioeconomic status impacted people’s health and access to healthcare.

“It was so rewarding to help empower people. In public health we need to become partners with community members rather than just teach them, as this will help them make decisions to better their own health for years to come.”

Gabby completed her second internship with the New York State Department of Health (NYSDOH) Campus Sexual Assault Prevention Unit (CSAP) in the Bureau of Women, Infant, and Adolescent Health. She assisted with the development of a Student Outreach and Engagement Toolkit for the NYSDOH Enough is Enough-funded rape crisis and sexual violence programs to use on campuses in their work to assist colleges and universities with preventing and responding to sexual violence. (Continued on next page)

(Continued from previous page)

“Working with the team at the NYSDOH was so much fun and I learned so much from everyone around me,” Gabby says. “Right from day one, I was in group meetings, conference calls, and even getting asked my opinion. They really made me feel like a part of the team rather than an intern.”

Gabby received important mentorship at the NYSDOH. “Each week, my supervisor would meet with me and go through everything that happened. And I literally mean everything. She’d ask me what I understood, what I didn’t understand, and really facilitated my learning.

She was constantly sending me things that she thought I could learn from – articles, webinars, news stories, anything.”

As a new graduate, Gabby hopes to work on health literacy projects in the near future or secure a position in healthcare administration. “With 720 internship hours under my belt, I feel confident that I’ll be successful in any area of public health. It’s one of the biggest pluses of the UAlbany program.”

Gabby Gregoire (pictured left) Programs: MPH and Health Disparities Certificate Hometown: Brooklyn, NY Graduation: May 2019

720

internship hours are required for each MPH student

STRENGTHENING THE PUBLIC HEALTH WORKFORCE The Public Health Leaders of Tomorrow program, made possible through funding in the New York State Governor’s Executive Budget, strengthens the public health infrastructure of New York State by providing academic, practical, and leadership training opportunities at the University at Albany School of Public Health for the state public health workforce.

$1.8 M

has been provided to 418 graduate students to complete internship projects

225

public health professionals have received tuition awards to attend UAlbany

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County Public Health Directors have completed public health coursework at UAlbany 3

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NEW BACHELOR OF SCIENCE DEGREE

he University at Albany School of Public Health recently received approval from the New York State Department of Education to offer a Bachelor of Science degree in Public Health.

This new major, accredited by the Council on Education for Public Health (CEPH), replaced the former Interdisciplinary Studies concentration in Public Health established in 2007.

As one of the first Public Health Bachelor of Science degrees in the State University of New York (SUNY) system, this program will prepare students for graduate study in public health and related disciplines as well as for entry-level positions in the public health workforce.

Meet Mmutaka Mmutaka Ajulu-Okeke, a rising senior at UAlbany, is completing a Bachelor’s degree in Public Health. She plans on combining public health with medicine and returning to her home country, Nigeria, to open a notfor-profit to improve the health of the Nigerian people. Mmutaka grew up in Belgium, Nigeria, Brazil, South Africa, and the Bronx— giving her a wellrounded, global perspective and exposure to different cultures.

“At first, I wanted to do medicine,” says Mmutaka. “But when I discovered public health, I realized that this major is extremely practical and useful. If people in Nigeria, especially in villages, had access and resources, it would make a huge difference in the overall population health. But since that is not the case in many villages back home, education on simple public health approaches such as boiling your water, sterilizing your tools, and proper waste disposal could go a very long way in prolonging life and maintaining a healthier population.”

Mmutaka fell in love with public health after taking her first introductory course, where she learned how public health is connected to almost all areas of our lives. In particular, she was drawn to the field’s focus on preventative measures rather than cures.

“I realized that there are so many more ways to help people than just being a doctor,” says Mmutaka. “I can help to educate people on resources and healthy choices, and this can make a big difference in the overall health of the population.”

Mmutaka plans on attending graduate school to complete an MPH. The medical field is still on her mind, as she may combine this with a degree in nursing before she returns to Nigeria. “This way, I’ll get the best of both worlds and can approach problems from multiple perspectives,” she says.

As she works toward her goals, Mmutaka takes advantage of the many opportunities on campus. She is a University tour guide, a mentor to a young student through the Big Brothers Big Sisters program, a Resident Assistant, a member of Alpha Kappa Alpha Sorority, an organic chemistry tutor, and a research assistant for Dr. Christine Bozlak at the School of Public Health.

Mmutaka Ajulu-Okeke Public Health Major

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“Through all of these experiences, I’ve learned so much,” Mmutaka says.

“But most importantly, I’ve learned that I can have a big impact through educating others to make better choices for their health. A healthier nation is a wealthier nation, for sure!”

STUDENTS INFLUENCING POLICY Students and faculty at the University at Albany School of Public Health are committed to fighting fearlessly for human rights, equality, and health for all populations.

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athryn Mishkin, a DrPH candidate in the Health Policy, Management, and Behavior department, worked with a diverse, international six-person team to develop a policy for the American Public Health Association (APHA) - a not-for-profit widely regarded as the only public health organization that influences federal policy in the U.S. The new policy, aimed at curbing childhood diarrhea, was adopted by APHA’s Governing Council and was officially released in January 2019.

Mishkin conducted this work in conjunction with her work as a 20172018 national Maternal and Child Health (MCH) Student Fellow with the MCH Section of APHA. Upon commencing the Fellowship, she joined the international MCH committee of the MCH Section along with the Global Maternal and Child Health Network (GMCHN).

Mishkin and colleagues from the GMCHN wrote the policy intended to reduce child mortality rates by increasing access to oral rehydrating and zinc treatments in order to reduce diarrhea, which, according to the Centers for Disease Control & Prevention (CDC), kills 2,195 children

Meet Kathryn every day – “more than AIDS, malaria, and measles combined. Experts worldwide agree that deaths caused by diarrhea are preventable, so it’s astonishing that so many children are still dying from it,” says Mishkin.

“It’s also widely known that oral rehydration salts and zinc treatments, which are affordable and can be administered at home, can serve as an effective treatment option that requires minimal care directly from health care providers.”

The policy calls on federal officials to appoint an individual referred to as the “Children’s Champion” to coordinate U.S. activities to reduce diarrhearelated mortality and serve as a global voice for children’s health. It also encourages global health programs in the U.S. to improve the supply of oral rehydration salts and zinc treatments, train providers in treatment guidelines, and increase public-private partnerships to scale up oral rehydration salts and zinc treatment by 30 percent within three years.

When APHA publishes a policy, leaders take notice, says Mishkin. “APHA has connections to many different sectors and a lot of influence on medical communication, public health

communication, and social work communication. When they push a policy out, other organizations such as the UN use them to strategically tackle issues.” Mishkin represented the team by presenting the statement at the APHA Public Hearings in November 2018, and afterwards the team received word that it would be adopted by APHA. As a current co-chair of the GMCHN and the international MCH committee and a Senior MCH Fellow, Mishkin is now leading the development of an APHA policy on advocating for investment in maternal mental health, a topic on which she has experience through previous work at the CDC and the New York State Department of Health, among other organizations.

“While APHA has policies that touch upon the importance of maternal mental health, currently, no policies exist that focus in-depth on the topic,” Mishkin says. “Many organizations including the World Health Organization are increasingly recognizing the importance of mental health and maternal mental health in particular. Women’s health matters because women matter.”

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MEET JEANCARLO

CELEBRATING

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years of partnership with the University of Costa Rica

His public health courses exposed him to new career paths that would allow him to combine education and health, aspects that had initially drawn him to physical education.

“I loved teaching people what exercises could help them with their health, whether it was for blood pressure, diabetes, or other health issues,” says Jeancarlo, who at the time was playing soccer for the University of Costa Rica and teaching fitness classes. “Earning a degree through the School of Public Health meant that I could take this love and use it to help people in a broader way.”

Jeancarlo Cordoba, a clinical professor at the University of Costa Rica School of Public Health, is a dedicated public health professional. Now, he is also a DrPH student at the University at Albany, chosen by his home University to receive an international doctoral degree.

When asked about his decision to apply to UAlbany, Jeancarlo emphasized that the School of Public Health was uniquely positioned to help him reach his goal to give back to the people of Costa Rica.

“I wanted to select a university that would give me training that could be directly turned into actions at home. I knew UAlbany— and its strong connection to the NYSDOH— would give me the experience to truly give back to my community.”

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Originally enrolled in college for physical education, Jeancarlo switched careers after taking undergraduate stat here courses at the University of Costa Rica School of Public Health about social determinants of health, health literacy, and other aspects of the field.

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After completing his Bachelor’s degree in Physical Education and Sport Sciences, Jeancarlo was encouraged to pursue his Master’s degree by the Director of the School of Public Health, Dr. Ileana Vargas. He started the program in 2011 and began working at the school, as well, as a Coordinator of Fieldwork for a project on parasites in one of the local indigenous communities. In this new role, Jeancarlo organized various aspects of the parasite intervention in the community, from meeting with community members to arranging transportation for researchers, alongside a team of dedicated public health professionals.

“The project was so interesting that I ended up working much longer than what I actually got paid for,” laughs Jeancarlo. “I just wanted to learn as much as I could and get as much experience as possible so that I could best serve my people.” He then continued on to other areas of focus for his research and projects, including prevention of tobacco use.

And now, Jeancarlo’s desire to learn as much as he can to help his community has brought him to UAlbany. He aims to complete the 5-year DrPH program and will return to his home university, where he will continue to teach while working to improve his country’s health. Jeancarlo notes that the University at Albany’s connection to the NYSDOH is particularly useful for him to learn more about tobacco prevention in New York. He is eager to examine another country’s approach to tobacco prevention, since his home country places a strong focus on this public health issue.

“It’s amazing learning here at UAlbany,” says Jeancarlo.

“And not just in terms of public health. It’s great to learn surrounded by so many accents and dialects of English.

There are so many different accents within one classroom at UAlbany, yet we’re all speaking the same language and are passionate about helping those around us.”

A GLOBAL APPROACH TO PUBLIC HEALTH Each year, UAlbany School of Public Health students fly to Costa Rica through our faculty-led study abroad program that compares the healthcare systems of the United States and Costa Rica, examining national histories, philosophies, and cultural influences.

LEARNING THROUGH EXPEREINCE

CREATING CULTURALLY AWARE PROFESSIONALS

“We travelled to the Ministry of Health, public and private hospitals, and other facilities to view how they function. Employees from each place took the time to talk with us, give us a tour, and show us the pride that they have for their jobs as well as for their country. It was interesting to see how different healthcare measures and regulations are between Costa Rica and the United States.”

“In the United States, you’re going to meet people from different places no matter where you go or where you work, which makes it important to understand other cultures’ views on healthcare.

In Costa Rica, they have a family-oriented culture and this is reflected in their healthcare system. They care for every individual, even strangers. Seeing a different way of approaching healthcare was a great experience.”

- Kim Thompson, MPH student

- Brittany Pysadee, MPH student

“This trip fired up my desire to make sure that we focus on prevention. If we teach our children things like how to eat healthy, be active, and brush their teeth properly, we can make a big impact on public health.”

- Lisa Montgomery, MPH student

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hrough UAlbany’s Center for Global Health and its international partnerships, students are conducting research around the globe and finding results that could help to improve the well-being of local communities.

Their work has a global impact, too— appearing in academic journals for the wider public health community to access.

MPH student Namratha Gurram secured a position at the Sun Yat-sen University (SYSU) School of Public Health in Guangzhou, China, this past summer. She assisted Dr. Guang-Hui Dong, Assistant Dean and Professor of Environmental Health, and his research team to assess the effect of environmental exposures on lung function in Chinese children.

Despite the language barrier between Namratha and her new colleagues, she worked successfully as a part of the research team, learning to analyze data and helping to prepare manuscripts for publication. The project led to multiple manuscripts accepted for publication in journals such as Indoor Air, Toxicology, Environmental Research, Chemosphere, and Environment International— some of which are top environmental health journals. In one study, the team looked at how home renovation, including new carpets and different building materials,

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affects children’s lung function.

“A lot of this work is the first time that these topics are being explored,” says Namratha. “I’m hoping that the study on home renovation will be looked at by the Chinese government and will change home renovation policy or lead to certain protections for children.”

The research has more than just an impact on the public health community— it also helps the students as they look to advance their careers.

“It’s very important to have hands-on research experience in the public health field, and publications are one of the first things employers look at when they evaluate you,” says Dr. Yi Lu, who conducted research in Romania and Pakistan while completing her PhD in Environmental Health Sciences at UAlbany. “Participating in research abroad made me a very strong candidate. In fact, I already have a job secured.”

With guidance from UAlbany’s Dr. Lin and Drs. Gurzau and Neamtiu from the Environmental Health Center in Cluj-Napoca, Romania, Dr. Lu helped analyze data collected in Romania as part of the Schools Indoor Pollution and Health: Observatory Network in Europe project. Dr. Lu and her

Romanian colleagues used this data to better understand the association between a range of home characteristics and respiratory health in school-aged children. Their findings showed that nearly half of the Romanian children studied were exposed to environmental tobacco smoke at home— this rate is double the typical exposure reported in the U.S. and was strongly associated with asthma-like symptoms in children.

The study was recently published in Science of the Total Environment.

“Conducting research abroad is an amazing experience,” says Dr. Lu. “I love exploring new cultures. And when you’re there for research you really have to dive deep into the culture and talk to the people to help understand the cultural aspects of your results.”

Through a range of strategic partnerships around the world, more students are choosing to participate in research projects abroad each year with support from the Center for Global Health and are making valuable contributions to public health knowledge. The UAlbany School of Public Health is pleased to partner with international institutions and places a strong emphasis on providing students with opportunities to understand public health from a global perspective.

“Promoting and ensuring good health is vital not just to the growth and stability of individuals and families, but to the economic growth and social stability of nations and the world as a whole. In today’s increasingly interconnected world, an outbreak of infectious disease in one country can become a global health threat within a matter of days or even hours. Working to address global health problems is clearly no longer a matter of just helping to improve the lives of people in faraway lands; it helps us all.”

- John Justino, Director of the Center for Global Health, UAlbany

The University at Albany School of Public Health partners with schools and organizations in: Brazil China Colombia Costa Rica Dominican Republic Georgia Haiti Honduras

India Japan Kazakhstan Liberia Malawi Mongolia Pakistan Peru

Romania Russia Saudi Arabia Sweden Turkey Uganda Ukraine Vietnam 9

IN THE NEWS...

In 2019, the work of UAlbany School of Public Health students and faculty has been featured on various news outlets, including CNN, ABC News, CBS News, NBC News, Buzzfeed, WebMD, The Washington Post, TIME, The Guardian, Smithsonian Online, U.S. News, Daily Mail, and the New York Post.

Dr. Eli Rosenberg and Dr. David Holtgrave’s research on Hepatitis C and HIV received 35 pieces of media coverage in publications with an estimated online readership of 1.26 billion. Online views of the coverage is estimated at 1.3 million.

Dr. Shao Lin’s research on climate change received 127 pieces of media coverage in publications with an estimated online readership of 306 million. Online views of the coverage is estimated at 593,000.

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In addition to making national headlines, expertise at the School of Public Health is coveted by New York. Dr. Julia F. Hastings helps to advise the NYSDOH on issues pertaining to tobacco use and prevention as a member of the Tobacco Use Prevention and Control Advisory Board, and Dr. Holtgrave holds a seat on the 28-member Hepatitis C elimination task force comprised of experts and representatives in public health, healthcare, criminal justice, HIV/AIDS research, and more.

Dr. Eli Rosenberg serves on a subgroup of the task force focused on surveillance, data, and metrics.

BY THE NUMBERS...

FACULTY UAlbany School of Public Health faculty embrace each pillar of the University’s strategic plan: student success, research excellence, diversity and inclusion, internationalization, and engagement and service. They incorporate diverse perspectives into the classroom and contribute to research projects that drive entrepreneurship, publicprivate partnership, and translational application. School of Public Health faculty also facilitate productive, mutually beneficial synergies between the University and regional, state, national, and international partners, positioning the School as a highly engaged, impactful institution ready to tackle public health issues with an interdisciplinary, community-focused approach.

100%

of faculty participate in publicly engaged scholarship and research

500+

unique publications produced by faculty in 2018

75%

of faculty hold primary appointments at the New York State Department of Health

STUDENTS UAlbany School of Public Health students bring diverse perspectives into our physical and virtual classrooms, where they learn from each other and experts in the field. A focus on experiential learning leads to successful outcomes for our students, including many promotions for public health practitioners who pursue a program at UAlbany to further their careers. Students take advanced in-person and online programs that balance the emerging demands of students, employers, and society. Students can complete a Bachelor of Science, a Master of Public Health, a Master of Science, a Doctor of Philosophy, or a Doctor of Public Health at the school.

Graduate-level certificates and dual degrees (MSW/MPH, MD/MPH, and JD/MPH) are also offered.

100%

of doctoral graduates are employed within 6 months of graduation (2018)

93%

of MPH graduates are employed or continuing their education within 6 months of graduation (2018)

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AN UNWAVERING COMMITMENT S

By Dr. David Holtgrave Dean of the School of Public Health, UAlbany

ocial injustice, sadly, is to be found in so many domains of public health. For instance, HIV most heavily and disproportionately impacts AfricanAmerican and Latinx communities, unstably housed persons, the southern United States and particularly, young gay men of color. Further, life expectancy varies widely even across very short geographic distances: when living in Baltimore City, the life expectancy near my house was almost 20 years longer than the life expectancy at my office five miles away at Johns Hopkins University.

In public health, we must not only improve the health of populations, but also work tirelessly to ensure that communities have equity in access to health care and in the actual achievement of health outcomes.

Further, we in public health hold as a core principle the ideals of parity, inclusion and representation. I had the privilege of helping to establish HIV prevention community planning when I

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worked at CDC. These planning groups across the U.S. were meant to bring together persons living with or at risk of acquiring HIV, community leaders, front-line service providers, scientists and health department officials. Central to their planning efforts were ensuring that all disproportionately impacted parties were included, the persons at the table were strong representatives of their community and all voices had parity in the discussions. The first step in any public health effort is not proclamation, it is listening.

Therefore, at the University at Albany School of Public Health, we are thrilled that the University’s strategic plan “Authoring our Success” holds up diversity and inclusion as a core pillar.

In our school’s alignment planning, we warmly embraced this pillar, and developed a number of alignment strategies to ensure that diversity, inclusion, and equity are reflected in our research, teaching, service, and policy activities. This means, in part, conducting research that not only

measures levels of disease, but also aims to understand which communities are most disproportionately impacted.

We also must not stop identifying health disparities; we are obligated to develop and evaluate interventions that actually address these disparities and build equity.

Our school is committed to even further expanding the diversity of our student body, staff, and faculty, and warrantying that all of our events show our commitment to diversity broadly defined. Additionally, we feel an obligation to hearing community voices to guide our efforts, and the principles of parity, inclusion, and representation are core to our work. The School of Public Health is incredibly excited to play a collaborative role at the University at Albany to making real the promise of the diversity and inclusion pillar in our strategic plan. It is only in this way that we can successfully advance our mission to promote health and health equity in Albany, New York and across the world.

COMMUNITY ENGAGEMENT I

By Dr. Janine Jurkowski Associate Dean for Public Health Practice, UAlbany

t is critical to engage communities in public health practice and research.

Communities that experience health and social inequities are often marginalized from program and policy development— and historically, public health research did not study social realities, limiting its ability to improve the health and well-being of those most burdened by poor health.

At the UAlbany School of Public Health, we emphasize communityengaged public health, which aims to incorporate the voices of those historically marginalized— and the organizations that serve them— to improve the health and well-being of society while advancing education and science. We work closely with communities, nonprofits, and government organizations to provide our students the opportunity to learn through community-based internships and courses that collaborate with organizations to meet a current need or gap. This approach to public health education is meaningful for all

involved: Students who participate in these experiences apply their knowledge and gain skills in critical thinking and social responsibility, while the communities and organizations benefit from projects that move their public health work forward.

But it’s not just our students who are actively engaging with the community; our faculty researchers conduct innovative community-engaged public health research that incorporates the perspective of those impacted by the research while addressing an important public health challenge. Many impactful projects, including Drs. Beth Feingold and Xiaobo Xue Romeiko’s work on food insecurity (see page 22), are a result of our focus on communitybased partnerships.

We see the true impact of engaging communities in public health during our annual National Public Health Week PhotoVoice Project, when we invite community, local, and state government organizations and practitioners to share

on-the-ground stories and pictures of public health in action to address health inequities. We host a photo gallery (pictured above) followed by an open panel discussion led by participants who share the stories of their work and the people’s lives they touch. This project serves as a strong reminder to students, researchers, and all organizations involved that the greatest impact is made through working with communities. Engaging with communities leads to more effective solutions and helps our students and professors to be innovative practitioners on the forefront of current public health efforts; therefore, true progress can be made in public health through bringing all voices, experiences, and populations to the table.

We invite you to join us for our next PhotoVoice gallery and panel discussion during National Public Health Week 2020 to view the incredible community-engaged work happening in New York’s Capital Region. We hope to see you there!

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WHAT IS CANDIDA AURIS?

By Dr. Magdia De Jesus Assistant Professor of Biomedical Sciences Recently, the fungus Candida auris (C. auris) was found on surfaces such as call buttons, drains, linens, and curtains in several hospital rooms— and some patients died of C. auris infections. Although it is important to inform the public about new, emerging organisms, C. auris has become sensationalized as it is being called a superbug.

We still have the echinocandin class of antifungals that are still effective to combat this fungus and there are ways to prevent its spread in hospitals and nursing homes.

The earliest known strain of C. auris dates back to 1996 in South Korea. It began gaining attention about a decade ago in 2009, when it was identified from the ear of a Japanese patient. It was given the name auris which comes from the word “aural”, meaning “ear” or “hearing”.

What makes C. auris so interesting is that although it has no known origin, it independently and simultaneously emerged in different parts of the world.

Using whole genome sequencing technology, scientists have categorized C. auris into clades based on the area of the world in which it emerged. Currently, there are four clades: South Asian, South African, South American, and East Asian.

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C. auris has been on the public health community’s radar for several reasons: 1) It is multidrug resistant. We currently have a limited arsenal of antifungals. The three major classes are the azoles, polyenes, and the echinochandins. C. auris has shown resistance to the azoles and polyenes, and in some parts of the world, there have been isolated samples of C. auris that are showing resistance to all three classes of antifungals. However, in the U.S. and many other places, C. auris is still responsive to echinocandins.

2) Not too long ago, C. auris was difficult to identify and most technologies were identifying it as Candida haemulonii. At the time, Matrix-assisted laser desorption/ ionization (MALDI-TOF) was able to identify C. auris, but this technology was expensive and not easily available in healthcare settings. This led to a big push to develop rapid diagnostics and we now have technology that is less costly and can rapidly identify C. auris.

3) C. auris is a skin colonizer, meaning that it can become resident on the skin’s surface and it is transmissible. Some studies have shown that skin contact within a few hours or days is enough to transmit it, allowing outbreaks to occur.

4) C. auris is known to live on surfaces for about a month and can cause outbreaks in nursing homes and hospital settings due to skin-to-skin contact and inadequate disinfection practices.

5) C. auris infections in blood have a high mortality of 30-60 percent. Populations at risk include cancer patients, diabetics, patients on long-term antibiotics, and patients with catheters or those who are intubated. However, healthy patients can be colonized with C. auris on the skin, and when these patients have blood drawn or a catheter inserted, C. auris can go from the skin into the bloodstream.

My laboratory recently published a paper in the Journal of Occupational and Environmental Hygiene that demonstrates four simple rules to prevent the spread of C. auris when working with animals that are applicable to healthcare settings. These four rules are: Proper personal protective equipment (double gown, double gloves, double booties, face mask), a buddy system (to help bring awareness to surfaces that may have been touched), proper disinfection (using 10 percent bleach for five minutes followed by 70 percent ethanol), and biomonitoring (swabbing surfaces in the room and testing for C. auris DNA).

When it comes to drug resistant microbes, fungi have not received as much attention from the public and the scientific community as other kinds of microbes. However, with the recent development of more C. auris infections, I am hopeful that there will be more funding to study them and to develop antifungals to fight infections. With certain antifungals available, new research, and protocols for dealing with C. auris, there is hope for combatting this— and other — fungi.

STUDENTS ON THE FOREFRONT OF DISCOVERY S

tudents gain unique insight into public health in action through the University at Albany’s connection to the NYSDOH. The resources, expertise, and mentorship provided by NYSDOH researchers enable students to pursue meaningful projects with a real-world application.

Dr. Magdia De Jesus, a leading expert on Candida auris in the NYSDOH Wadsworth Center Labs, believes that mentorship is extremely important.

With several mentors of her own who helped push her to where she is today, she’s eager to work with current students to help them find their passion.

Currently, students in Dr. De Jesus’ lab are assisting with her groundbreaking work.

Meet Steven After receiving a Bachelor of Science in biology from SUNY Potsdam, Steven Torres had a strong passion to save lives. He applied to the University at Albany School of Public Health to pursue a Master’s degree in biomedical sciences, as this degree would enable him to do just that through important health research.

“I chose to attend UAlbany because of its unique affiliation with the Wadsworth Center Labs, which provide students the ability to perform innovative research within a well-established and nationally known facility,” says Steven.

UAlbany faculty member and Wadsworth researcher Dr. Magdia De Jesus brought Steven into her lab in February 2018 to study the fungi Candida auris.

He was intrigued to learn more about Candida auris, which Dr. De Jesus had mentioned to him was multidrug resistant before he was offered the research assistant position in her lab. After reading the available literature on the fungi, Steven felt as though this was a great opportunity for him to learn more about planning, designing, and executing experiments under the mentorship of an accomplished public health professional.

“It’s interesting to study Candida auris because there are so many discoveries to be made. There is not an abundance of information on it, which inspires me to learn more and fill in the gaps in knowledge,” explains Steven.

Steven completed his thesis project in Dr. De Jesus’ lab, assisting her on a project to determine how to safely work with Candida auris in a lab setting without the risk of accidental exposure. A second part to his project included the development of models to study the progression of Candida auris infections— a study of high significance due to the recent outbreaks of Candida auris.

“It is quite the experience learning from Dr. De Jesus,” says Steven. “Her passion for science is what fuels me to work hard. She is very ambitious and is always thinking about the next step we need to take for the project.”

Steven Torres Program: MS in Biomedical Sciences

With his degree from the University at Albany, Steven will apply techniques learned in Dr. De Jesus’ lab to an industry setting. His work in the Wadsworth Center has exposed him to the necessary steps to ensure the safety of all personnel working with a highly transmissible pathogen, making him a strong addition to various scientific teams.

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MATERNAL & CHILD HEALTH PARTNERS IN MATERNAL & CHILD HEALTH YMCAs throughout New York are implementing interventions to promote children’s health and well-being thanks to an ongoing partnership with UAlbany School of Public Health’s Dr. Christine Bozlak. Since 2012, Dr. Bozlak has collaborated with the Alliance of New York State YMCAs, a nonprofit organization that represents and advocates on behalf of the 39 individually incorporated YMCAs in New York, and the New York State YMCA Foundation, a 501(c)(3) that shares a management agreement with the Alliance to provide staffing and other support to fulfill its mission. Together their team has worked to promote healthier vending machine options and Healthy Eating and Physical Activity (HEPA) standards for childcare programs in all of New York’s YMCAs. As part of this effort, Dr. Bozlak’s previous research found that while YMCAs saw tremendous success in healthier eating and engaging children in physical activity, more could be accomplished in all areas— especially in supporting the HEPA infant feeding standard and its emphasis on breastfeeding promotion. She offered the example of a mother supervising her child swimming at the YMCA, but who also has a nursing infant.

“Mothers run into situations where they need to breastfeed their child, but there’s no practical and private way to do so,” Dr. Bozlak said. “Although it is still being determined exactly how breastfeeding contributes to a decreased risk of childhood obesity, the evidence suggests that breastfeeding is a protective factor for childhood obesity and many other childhood conditions and diseases.”

When the New York State YMCA Foundation began planning for its 2019 Healthy Eating and Physical Activity initiative focused on infant feeding, they asked Dr. Bozlak to help them. In 2019, Dr. Bozlak and the Foundation began a pilot intervention research study to determine which resources can help YMCAs implement the HEPA infant feeding standard that includes breastfeeding promotion.

The 18-month project uses data from the previous studies conducted by the team and incorporates best practices used elsewhere to create organizational interventions for a sample of four YMCA Associations in New York. Four additional YMCAs are serving as a control group and will receive no intervention until the conclusion of the study.

“Due to the presence and mission of YMCAs within many of our communities, they are essential to community health promotion, especially family health promotion. The New York State YMCAs have the opportunity to be leaders in demonstrating how organizations can support breastfeeding mothers within our communities. It is our hope that the current pilot study will help them work to achieve this goal,” said Bozlak.

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ALBANY INFANT & MOTHER STUDY

UPSTATE KIDS STUDY

Childhood adversity such as neglect, abuse, and household dysfunction can negatively affect women’s health— including pregnancy health and birth outcomes. However, studies have shown that social support during pregnancy can promote healthy birth outcomes. School of Public Health Drs. Allison Appleton and Lawrence Schell recently studied social support during pregnancy to examine how this support may mitigate the impact of adverse childhood experiences (ACEs) on infant birth size, providing the first evidence that social support can provide some buffer against the impacts of ACEs.

Research led by Dr. Erin Bell found that a pregnant mother’s exposure to certain chemicals doesn’t negatively impact birth outcomes – a conclusion reached by way of analyzing dried blood spots taken from newborns years prior. With parental permission, Bell’s team used samples from routinely-taken newborn blood spots for analyses. Their study was part of the larger Upstate KIDS Study, which tracks the ongoing growth, motor, and social development of more than 6,000 babies born between 2008 and 2010 in upstate New York.

Data were taken from the Albany Infant and Mother Study (AIMS), which examined pregnant women aged 18-40 and their infants born at Albany Med in Albany, New York.

Clinical information was recorded about the women’s exposures, health, and delivery and the infants’ birth size and characteristics. ACEs were assessed with a questionnaire about experiences prior to age 18 and social support was determined using a survey that measured social resources and relationships.

The research team found that higher ACEs were associated with higher cephalization scores, a marker of asymmetric fetal growth, whereas higher social support was associated with lower cephalization scores. Tangible and emotional support, but not informational support, contributed to these associations.

As one of the first studies to test whether social support during pregnancy can mitigate the risk associated with ACEs and promote healthy fetal growth, these results show that further examination of ACES— particularly how they may become biologically embedded during childhood— may help to provide useful insight into the impact on birth outcomes.

Using both “singleton” infants and twins, they measured the babies’ characteristics while looking at the blood spots for exposure to bisphenol A (BPA, commonly found in plastic), perfluorooctanesulfonic acid (PFOS, commonly found in stain repellents and cookware) and perfluorooctanoic acid (PFOA, also found in cookware). From their analysis, they concluded that for “singleton” babies, exposure to these chemicals was not associated with potentially dangerous characteristics, such as low birth weight or abnormally small head circumference.

The only association observed was for BPA and gestational age and birthweight among twins, but Bell cautions that this is more likely to be a result of twins having a greater opportunity for exposure.

“Twins are often delivered prematurely and/or may have low birthweight, both factors that may warrant admission to the NICU. Given that these chemicals are often found in plastic, it is possible that exposure may occur after delivery for these infants,” said Bell.

In addition to confirming that the chemicals don’t negatively impact the babies in this study, the team has confirmed that dried blood samples can be used for ongoing research even years down the line.

“Maternal and child health (MCH) continues to be an essential sub-field of public health. There is an increasing need to address the health challenges faced by mothers, fathers, children and youth, and their families, but the MCH workforce is not large enough to meet this need. Our rapidly growing MCH Program is training students to fill this gap, and our network of MCH students, faculty, alumni, and local partners is essential to ensure the health and well-being of the MCH population.”

- Dr. Christine Bozlak and Dr. Rachel de Long, Co-Directors of UAlbany’s Maternal and Child Health Program

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UPSIDE STUDY I

n response to the medical breakthroughs rendering Hepatitis C (HCV) curable, state and local governments across the country are taking steps to drastically lower the prevalence of the disease – and New York is leading the charge with the nation’s first state-level strategy to eliminate it. As part of this initiative, Governor Cuomo created a task force to guide the work and turned to expertise at the UAlbany School of Public Health. Dean David Holtgrave serves on a 28-member HCV task force comprised of experts in public health, healthcare, criminal justice, and research – and Dr. Eli Rosenberg serves on a subgroup of the task force focused on surveillance, data, and metrics. At the outset of the initiative in late 2018, Dr. Rosenberg worked with the NYSDOH to refine the New York HCV prevalence estimate with additional local information.

Now, the UAlbany School of Public Health is taking its work on HCV even further by conducting the UPSIDE study.

Funded by the NYSDOH, this study aims to better understand HCV and related issues among persons who inject drugs (PWID) in Upstate New York. Because HCV is most commonly transmitted by drug injection, a behavior which has been increasing as part of the drug epidemic in the U.S. and New York, the spread of HCV has been increasing. Although PWID are the priority group to study in order to better understand the ongoing spread of HCV, few research studies have been conducted on this population in upstate New York.

Principal investigators Dr. Tomoko Udo and Dr. Eli Rosenberg are leading the UPSIDE study, in partnership with syringe exchange programs run by Catholic Charities Care Coordination Services in the Capital Region, the Alliance for Positive Health in Plattsburgh, and the Southern Tier AIDS Program in Norwich. Participants are recruited from those seeking services from the partner organizations. Once recruited, they complete a survey about themselves and their medical history, experience with drug use, and history with harm reduction services and medical care. Participants also receive free testing for HCV and HIV and are linked to care if they have a positive result. UPSIDE aims to also recruit PWID from wider communities by using respondent-driven sampling, where participants can refer peers who inject drugs to the study in multiple ways, including providing a unique code via a coupon, phone call, text, email, or social media.

“UPSIDE will help guide the development of programs and policy to prevent the spread of HCV and better connect PWID with HCV to treatment,” says Dr. Udo. “Historically, this population has been difficult to study. Due to New York’s commitment to eliminating HCV, we are able to utilize syringe exchange programs that are already in place to find out more about this population. From there, we’re working with our study population to refer more individuals to UPSIDE to get a better understanding of PWID, particularly in rural communities.”

In addition to UPSIDE, in summer 2019 Dr. Udo will begin a five-year evaluation of a NYSDOH program to study three innovative HCV care models designed specifically for substance users to improve access to HCV treatment. “We want to reduce the barriers this population faces when it comes to care,” says Dr. Udo. “If it’s easier to receive treatment, we can further our momentum towards elimination.”

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Recent MPH graduate Sarah Bitley Shufelt steps into a new role as UPSIDE Project Coordinator

S

arah Bitley Shufelt completed a Bachelor’s degree in musical theatre at Russell Sage College. As a coloratura soprano, she focused on classical and liturgical music alongside courses in stagecraft, literature, and theatre in education. Now, she’s working as Project Coordinator for UPSIDE after completing an MPH at the UAlbany School of Public Health— quite different from her previous work in musical theatre. So how did Sarah land a position on a hepatitis C research project?

After years of performing, Sarah noticed her body was becoming increasingly tired. In addition, her back and joints were suffering under the stress of obesity. After losing a considerable amount of weight in a healthy way, Sarah decided she wanted to become a dietitian and focus on addressing the stigma that those who are overweight face. She completed a health coaching certificate and realized she wanted to be able to have an even larger impact— and turned to public health.

“Entering the scientific world with an existing career in the performing arts was intimidating, but to my surprise, UAlbany’s MPH program fit me perfectly,” Sarah says. “It pushed me beyond what I thought was possible while nurturing me with its intimacy.

The professors and administrators at the school are truly outstanding.”

Sarah completed an independent project with Dr. Tomoko Udo on the age of onset of depression and lifetime binge eating disorder diagnosis, and speaks fondly of her her now former professor. “I found a mentor who shares the same interests and reasons for doing this important work,” she says.

Although Sarah’s initial desire to work in obesity research waned, she chose to put her skills and knowledge in working with people who face stigma to use, securing a position as the Project Coordinator for UPSIDE, which focuses on persons who inject drugs.

As Project Coordinator, Sarah manages finances and general procedures, monitors data and workflow, and supervises the MPH interns— giving her the opportunity to step into the mentor role that was so important to her own success.

“As a recent student myself, I am more connected to the challenges interns may face and I can assign tasks and advise through this lens,” Sarah says. “Going through UAlbany’s MPH program made me feel prepared to not only serve as project coordinator for a large research project, but to help others find their public health passion, too.”

Sarah Bitley Shufelt UPSIDE Project Coordinator “Going from mentee to mentor felt natural, since the MPH program at UAlbany enables you to act as a professional and a colleague through selfdirected learning. When I learned I would be mentoring the interns for UPSIDE, I felt excited to help them gain confidence and develop their skills through creative problem solving.”

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HOW DO

DIETARY FACTORS

INFLUENCE CANCER? A significant amount of information shows that diet influences cancer risk; it is estimated that around 40 percent of human cancers are related to dietary factors. Since diet is extremely complex, the challenge for scientists is identifying the factors within a diet that are related to cancer and how these factors operate to increase or decrease the risk of disease. Since we all must eat to survive, this is a critical area of study.

Dr. JoEllen Welsh of UAlbany’s Cancer Research Center studies vitamins in relation to cancer, and is internationally recognized as an expert on nutrition and breast cancer with over 100 publications, reviews, and chapters. She has extensively studied Vitamin D and chronic disease since 1984. In addition to researching and teaching at the University at Albany, Dr. Welsh also holds the position of Chief Financial Officer for the Vitamin D Workshop, an international non-profit organization that sponsors research conferences that bring together Vitamin D researchers to communicate, share ideas, and present their work.

Vitamin D is found in a few natural foods such as fatty fish and egg yolk, but is also produced in our skin through exposure to sunlight. While Vitamin D has traditionally been known as important for bone health, further study of the compound has shown that it is important for almost every tissue in the body and may protect cells from becoming cancerous. However, the impact of Vitamin D on our health is complex as new research indicates that our genes contribute to our ability to make and utilize Vitamin D. Combining these factors— the sun, our food, supplements, and genetics— makes it difficult to determine Vitamin D’s role in combatting disease. In fact, even experts disagree about the optimum level of Vitamin D for disease prevention in humans, although studies have shown that the risk of many cancers goes down as the amount of Vitamin D in serum goes up.

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“Epidemiologic studies of cancer and Vitamin D are difficult to run,” says Dr. Welsh. “It’s hard to estimate the effects and interactions of genetics, diet, and skin production. And, of course, studies that examine the development of cancer have to extend over a long time period and include many people. The incidence of cancer is only about 200 per 100,000 in the general population.

For these reasons, not all studies on Vitamin D and cancer are conclusive, but the majority have found that low levels of Vitamin D increase risk of various types of cancers.”

Consistent with these population studies, “when breast cancer cells are exposed to Vitamin D in the lab, they undergo a cell death process,” says Dr. Welsh. “The Vitamin D treated cancer cells also behave differently from untreated cancer cells. Our studies suggest that Vitamin D reduces the hallmark behaviors of cancer cells, reverting them to act more like normal cells. My lab is working to identify the processes that Vitamin D trigger to alter cancer cell behavior.”

Funded since 1995 by the National Institutes of Health (NIH), Dr. Welsh has extensively characterized the impact of Vitamin D and the Vitamin D receptor, a protein found within most cells, on breast cancer development and progression. The Welsh Lab at the University at Albany includes post-doctoral fellows, graduate students, and undergraduate students completing projects related to this work. Scientists from around the world have visited the Welsh Lab to collaborate and learn techniques to study Vitamin D and cancer.

Dr. Welsh’s current five-year project funded by the NIH is studying Vitamin D and triple negative breast cancer, an aggressive subtype of the disease that is missing the three common targets for the drugs typically used to battle other types of breast cancer. This means that there are fewer specific drugs for triple negative breast cancers, and standard treatments like radiation and chemotherapy are largely ineffective.

“Our research is studying ways to fight this kind of cancer, since it is missing the receptors that many drugs target,” says Dr. Welsh. “We have found that triple negative breast cancers retain the Vitamin D receptor, and that these cancer cells can be regulated by Vitamin D. We have identified some pathways that cause these cancers to be more aggressive, and we’ve found that Vitamin D blocks the activity of these pathways. Now we’re trying to understand the specific Vitamin D targets in these cancer cells to help optimize future treatments.”

Further studies on Vitamin D actions in the Welsh Lab could help to better understand the complex connection between Vitamin D and cancer— and provide a better understanding of how our diet and time in the sun may help us to reduce our risk of disease.

“Our project on Vitamin D is just one example of the critical work conducted by the University at Albany faculty at the Cancer Research Center aimed at identifying novel ways of diagnosing, preventing, and treating human cancers.”

- Dr. JoEllen Welsh Empire Innovation Professor

ABOUT THE CANCER RESEARCH CENTER The University at Albany’s Cancer Research Center (pictured above) is dedicated solely to cancer research. The core group of faculty researchers includes cancer biologists and scientists with expertise in functional genomics, DNA damage and repair, posttranscriptional regulatory mechanisms, apoptosis, and bioinformatics.

What makes the Cancer Research Center unique is its strong ties to the School of Public Health. Faculty at the Cancer Research Center are dedicated to providing a collaborative research environment within the University at Albany School of Public Health and its affiliated Wadsworth Center Labs of the New York State Department of Health to foster the training of graduate students and postdoctoral fellows in cancer biology.

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FOOD INSECURITY AND THE ENVIRONMENT E ach year in the United States, approximately 62.5 million pounds of wasted food is left unharvested on farms or ends up in landfills. When food like this gets wasted, it produces greenhouse gases that contribute to climate change— but there’s an alternative option that allows us to provide healthier food to food-insecure communities while reducing the environmental impact of our food system.

Across the U.S., many programs and strategies have been developed through efforts to have less wasted food and fewer food-insecure citizens. However, few of these programs have been evaluated for their effectiveness and for their potential joint impacts on environmental and human health. Research led by Dr. Beth Feingold and Dr. Xiaobo Xue Romeiko addresses this gap, working to identify inefficiencies, barriers, and opportunities for growth in the produce recovery and redistribution system— and also to quantify the impacts of current and future policies and interventions on greenhouse gas emissions, access to fresh produce, and subsequent health benefits in the Capital Region of New York.

This interdisciplinary research will produce estimates on how local, state, and national food system policies and interventions, such as tax incentives for farmers and date-labeling education, might influence produce recovery strategies, donations, quality, and access.

In the first year of the project, the team has worked closely with their community partner organizations to compile and collect necessary data on the recovery and redistribution arm of the local food system and identify best practice strategies for modeling the food flow throughout it and associated environmental health impacts.

Now in year two, the team anticipates completing an initial model to estimate both environmental and health impacts of current and forthcoming food policies, such as the New York State Farm to Food Bank Tax Incentive and the forthcoming Food Donation and Food Scraps Recycling Act. The model will also evaluate a date-labeling education program within the Capital Region.

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LONELINESS & AGING

I

t is estimated that 30-40 percent of older adults are lonely; however, a lack of consistency in the definition of loneliness and the way it is measured means this percentage could be much higher. Research shows that loneliness is linked with several serious chronic health conditions as well as with shortened life expectancies. Moreover, the prevalence of loneliness has doubled since the 1980s, making it a topic of growing concern for public health practitioners.

outcomes over the life course— and how these relationships and their health impacts may change as people age.

“Social isolation is the biggest contributor to loneliness, and older adults are at a heightened risk for this,” says Dr. Benjamin Shaw, Professor and Associate Dean for Research at the School of Public Health. “They may experience health problems that impact their access to others, family members and friends might move away or pass away, and they may have less energy to devote to social networks, meaning that their peripheral relationships could be reduced in comparison to their younger years— increasing their risk for isolation.”

Currently, Drs. Shaw and Gallant are working to understand how home-delivered meal programs can be enhanced to reduce loneliness among the recipients. Studies show that recipients of home-delivered meals experience less loneliness than their counterparts who do not receive delivered meals, even though they are at high risk for loneliness due to social isolation. Working with delivery programs in the Adirondack region of Upstate New York and four county Offices for the Aging, the team will analyze what practices are working best, while also identifying other ways that meal delivery programs could reduce loneliness.

Dr. Shaw and his colleague Dr. Mary Gallant have vast experience researching how social support and social relationships influence chronic illness management and broader health

“It’s important to understand how social networks contribute to health outcomes,” notes Dr. Gallant, Professor and Senior Associate Dean for Academic Affairs. “This way, we can create meaningful intervention programs that enhance social connections and ultimately increase quality of life and improve health.”

“In addition to training delivery workers to understand and address

social isolation and loneliness, meal delivery programs pose a unique opportunity for us for a few reasons,” says Dr. Shaw. “The service already exists for a purpose— satisfying the nutritional needs of vulnerable older adults. We simply want to optimize the social benefits of these programs. Most people are accustomed to mealtimes being not just a nutritional experience, but also a social and emotional one. For this reason, eating alone may trigger loneliness, but we think that we can reduce this by training delivery staff, and through the implementation of even more innovative practices that aim to create a sense of ‘togetherness’ at mealtime in non-traditional ways.”

The project will also examine the effectiveness of connecting recipients of meals to each other to reduce loneliness, particularly in rural areas.

Possibilities include technology to enable recipients to virtually share meals and community newsletters delivered alongside the food.

“This project isn’t solely focused on reducing loneliness among our older adult populations, although that is our main goal,” says Dr. Gallant. “It’s about creating community that really makes a difference.”

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ELIMINATING HEALTH DISPARITIES

I remember a meeting I had in a Māori indigenous community in New Zealand, where a woman was discussing her experiences with racism and discriminatory policies.

She paused, looked at me and my colleagues (we are all black), and expressed that from what she sees on the news, black people have it just as bad in the U.S. When examining statistics, this seems correct: in New York City, black men have approximately a 50% higher rate of premature mortality compared to white men.

When identifying solutions, it is evident that collaboration with other societal sectors is necessary to address how discriminatory policies shape patterns of disease. My experience abroad with vulnerable populations stressed the importance of conducting public health research among underserved and underrepresented populations— specifically, why it is important to apply this research towards developing evidence-based public health policies that aim to provide equitable health resources for historically marginalized groups.

By Wayne Lawrence DrPH Candidate

Throughout my academic training, I have continuously asked myself, “How can I contribute towards reducing preventable diseases and premature mortality among marginalized populations?”

My search for an answer took me to Australia and New Zealand for a fellowship, where I conducted epidemiological research and assessed health disparities among indigenous populations. More specifically, I examined how colonization, forced removal from land, intergenerational poverty, and racism created a perfect storm for premature mortality. Between Australia’s indigenous and non-indigenous populations, the differences in life expectancy are greater than ten years. Communicating with indigenous communities, I learned how barriers to adequate care, lack of access to nutritional foods, and the loss of ancestral land had a generational impact on their health, such as elevated risk for cardiovascular disease.

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This year, I had the opportunity to apply what I learned in the classroom at UAlbany when I was selected by the American Association for Cancer Research to participate in Early-Career Scientist Hill Day and the Alliance for Childhood Cancer Hill Day on Capitol Hill in Washington D.C. Alongside other scientists, I met with Senators and Representatives to educate them on the importance of robust, sustainable, and predictable funding for the National Institutes of Health. More specifically, we discussed how research can help address health disparities and improve the nation’s overall health. While speaking with congressional members and their staff about pediatric cancer research, I realized it was just as important for me to listen and provide the opportunity for those who are directly impacted— such as childhood cancer survivors and mothers who have children diagnosed with cancer— to share their stories and show elected officials the true human impact of their decisions.

As public health students enter the workforce, it is important that they are aware of the pervasiveness of inequities across the continuum of care, and the need to understand these health inequalities is crucial for developing polices aimed at resolving them. Public health practitioners must be aware of their own personal biases and how this bias can impact public health practice.

It is also critical that the current public health workforce takes a stronger effort to promote and support diversity, as well as inclusion within the work environment, especially as the U.S. population is becoming majority-minority with respect to race and ethnicity. Additionally, increasing cultural inclusiveness in the workforce will heighten cultural awareness, particularly when developing interventions for minority populations. Speaking with public health students across the U.S., I have learned that most selected the field due to a strong moral obligation to improve the health of populations. For this reason, we must advocate, encourage critical dialogue, and act to provide equitable health resources for the underserved and underrepresented.

LATINX PHYSICAL ACTIVITY N

ational physical activity guidelines recommend partaking in 150 minutes of moderate-intensity aerobic activity per week or 75 minutes of vigorous physical activity.

Dr. Elizabeth Vásquez has studied physical activity and how different populations, particularly Latinxs, meet these exercise recommendations. Her findings emphasize that culture, along with other factors, must be considered when examining how people might or might not meet exercise guidelines and what may influence healthy behaviors such as walking.

Working with a team of researchers from across the U.S., one of Dr. Vásquez’s studies took an in-depth look at the relationship between ethnicity, nativity status, and the likelihood of meeting national physical activity guidelines. The team found that the type of physical activity considered may impact the ability to meet recommendations.

According to Dr. Vásquez, there are multiple types of physical activity that should be considered to create a better understanding of how different populations may exercise. Many studies show that the U.S. Latinx population is less likely to meet physical activity guidelines than whites, but these studies focus primarily on leisure-time physical activity. “Transportation physical activity—walking or bicycling as a means of getting somewhere— and

occupational physical activity such as carrying loads, digging, and chores, must be examined among the Latinx population, as well as other populations,” says Dr. Vásquez. “These activities can increase the ability to meet recommended physical activity guidelines, particularly for foreign-born Latinxs who may come to the U.S. for labor-intensive roles. A focus on leisure-time physical activity excludes individuals who could be exercising or meeting physical activity guidelines in other ways.”

ence both health and health behaviors.”

Using data from the National Health and Nutrition Examination Survey conducted between 2007 and 2012, the team analyzed a national sample of Latinxs and whites. They found that Latinxs were much more likely to meet physical activity recommendations through transportation physical activity compared to Whites. In addition, including occupational physical activity led to a 40-50 percent increase in the proportion of Latinx individuals that met the national physical activity guidelines.

Another study by Dr. Vásquez took a closer look at the impact of culture, examining the association between neighborhood social cohesion and walking limitations among ethnically diverse older Latinxs in the U.S. Using data from the 2013 to 2016 National Health Interview Survey. Dr. Vásquez and her colleagues analyzed 3,716 adults over 60 years old on their walking limitation (measured by self-reported walking difficulty) and social cohesion (measured by 4 questions about their neighborhoods).

The participants were categorized into five major groups: Mexican/ Mexican American, Puerto Rican, Cuban, Dominican, and Central/ South American. Those with high neighborhood social cohesion reported lower prevalence of walking limitations compared to participants living in neighborhoods with low social cohesion. When broken down by Hispanic sub-group, only the Mexican American group was less affected by a lack of social cohesion.

“It’s important to note the heavy influence of nativity and ethnicity on occupation, culture, and socioeconomic status,” says Dr. Vásquez. “When we study populations for physical activity, we must take this into account. Even within the Latinx population, there is an array of cultural backgrounds and distinct immigration histories that influ-

“Social cohesion can represent a key factor in older adult’s lives that can influence disability outcomes,” says Dr. Vásquez. “It’s important that we look at social, occupational, and cultural aspects of physical activity within populations, as this will provide us with further insight into the development of health behaviors and overall health.”

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CLIMATE CHANGE & HEART DEFECTS According to research by Dr. Shao Lin and her postdoctoral fellow Wangjian Zhang, climate change could increase the number of infants in the United States born with congenital heart defects. Their findings were published in the Journal of the American Heart Association and made national headlines.

The research team, comprised of interdisciplinary experts across the United States and China, caution that continually rising temperatures will exacerbate pregnant women’s exposure to extreme maternal heat and result in as many as 7,000 additional congenital heart defect cases from 2025-2035.

The greatest percentage of increase in congenital heart defects is expected in the Midwest, followed by the Northeast and the South. The authors caution that the projected increase will pose greater demand on the medical community caring for these patients not just during their infancy, but potentially throughout their lifetime.

Previous research uncovered a link between maternal heat exposure and the risk of heart defects. While the

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precise cause remains unclear, experts believe that heat causes fetal cell death or interferes with heat-sensitive proteins that play a critical role in fetal development, particularly during the first trimester.

The research team used climate change forecasts from NASA and the Goddard Institute for Space Studies.

They improved the spatial and temporal resolutions of the forecasts, simulated changes in daily maximum temperatures by geographic region, and calculated the anticipated maternal heat exposure per region for spring and summer.

“Our findings underscore the alarming impact of climate change on human health and highlight the need for improved preparedness to deal with the anticipated rise in a complex condition that often requires lifelong care and follow-up,” says Dr. Lin, who holds a medical degree and a PhD in epidemiology. “It is important for clinicians to counsel pregnant women and those planning to become pregnant on the importance of avoiding extreme heat, particularly during the 3-8 weeks post conception.”

CLIMATE CHANGE & VECTOR-BORNE ILLNESS

AIR POLLUTION

Lyme disease, spread by the blacklegged tick, may become an even larger public health problem due to changes in climate that are enabling this tick to thrive.

A team of researchers including Drs. Shao Lin and Bryon Backenson investigated the relationship between weather and Lyme disease incidence and tick encounters from 1991-2006 to determine the impact of weather pattern on Lyme disease in New York.

Information on Lyme disease cases and tick density and infectivity was taken from NYSDOH human and vector surveillance activities, which includes demographic data on cases of Lyme disease and data from routine tick collections across the state. Weather data were obtained from the U.S. Historical Climate Network and the National Climatic Data Center. These three datasets were linked and analyzed.

The research team found that Lyme disease incidence has increased from 1991, when it was concentrated in the coastal area to the southern Hudson Valley. The disease has spread steadily northward and westward over time in the state.

Summer Lyme disease incidence was positively associated with warm winter temperature and extended spring days, which foster the early activity of ticks.

Lyme disease can have debilitating symptoms such as severe headaches, arthritis, nerve pain, and problems with short-term memory, making it especially important that further study takes place to determine the full impact climate change may have on the spread of this vector-borne illness.

“While more frequent and severe extreme weather events are expected due to climate change, most of these increased morbidities are potentially preventable, which provides the opportunity to reinforce community prevention and education. Our findings are important for public health and forecast agencies to create targeted interventions and issue early warnings to the general public.”

- Dr. Shao Lin

Climate change is impacting our air quality: According to Dr. Michael S. Bloom, the public health community expects the adverse health impacts of poor air quality to become more pronounced over time as our global climate warms.

Although it has improved in recent years, the air pollution concentrations in China routinely exceed World Health Organization guidelines. Dr. Bloom and his colleagues are conducting research that helps to further clarify the effects of high air pollutant levels on chronic disease and chronic disease precursors in Chinese adults and children.

Dr. Bloom’s work has not only identified associations between the prevalence of type 2 diabetes, atherogenic lipid profiles, and blood pressure changes in adults and children; it also suggests that effects may be strongest in younger people, that obesity may exacerbate the effects, and that breastfeeding may mitigate some of the adverse effects of poor air quality.

With the results of this work, organizations, governments, and individuals can better understand the impact air quality has on health, and work to find ways to reduce the public health impact of our environment.

HOW CAN YOU HELP OUR AIR QUALITY?

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Research shows that humans play a significant role in our world’s air quality. Fuel emissions from vehicles are one way that humans contribute to pollution.

“Maximizing motor vehicle fuel efficiency by employing high mileage, hybrid,stat andhere electric vehicles powered by renewable energy sources, and carpooling or ideally using public transportation are individuallevel efforts in the right direction!” says Dr. Bloom.

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CENTER FOR GLOBAL HEALTH UAlbany’s Center for Global Health proactively engages with a wide range of partners around the world to create educational programs, collaborative research initiatives, and health promotion interventions to help solve today’s most critical global health problems. The Center also plays a vital role in helping the school’s numerous international students as they integrate into life here at the University and into their new communities.

140+ students, faculty, and health professionals have

participated on study programs in Costa Rica, the Dominican Republic, and India

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50+

students have enrolled in the Global Health Studies Certificate Program

55+

students have completed international internships and/or Peace Corps Service with their graduate study

CENTER FOR HEALTH WORKFORCE STUDIES The Center for Health Workforce Studies (CHWS) at UAlbany’s School of Public Health provides timely, accurate data and conducts policy-relevant research about the health workforce. CHWS has established itself as a national leader in the field of health workforce studies, with key areas of focus in researching oral health, providing technical assistance, and monitoring the health workforce in New York.

In the past 5 years, CHWS has released 72 reports and research briefs, published 11 articles in peer reviewed journals, and conducted 123 presentations at national and international conferences.

CARDIAC SERVICES PROGRAM The Cardiac Services Program is a collaboration with the NYSDOH that promotes quality improvement and research surrounding cardiac surgery and percutaneous coronary interventions (PCI) in New York.

Recently, the program developed a report on outcomes for Acute Myocardial Infarction (heart attack) patients in New York. This report, which will be released annually, was the first of its kind in the state and will foster quality improvement at the hospital level while providing valuable information on outcomes for patients who suffer heart attacks.

CENTER FOR PUBLIC HEALTH CONTINUING EDUCATION The Center for Public Health Continuing Education (CPHCE) provides exemplary education for the public health and health care workforce and is nationally recognized for distance learning training, including the awardwinning Public Health Live! webcast. These programs, as well as in-person trainings, webinars, and webcasts, provide free or affordable nursing contact hours, continuing medical education credits, Certified in Public Health renewal credits, continuing education contact hours in health education, lactation continuing education recognition points, and social work continuing education hours. This year, as the Center celebrates 20 years of educating the public health workforce, CPHCE won its 9th national award for video production excellence for the Public Health Live! entitled “Combating the Opioid Crisis: Addressing Stigma”.

30,000+ Continuing Education (CE) credits offered

70,000+ hours of training provided per year

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D

uring the 2019 State of the Union address, the federal administration announced a plan to reduce HIV incidence by 90 percent during the next ten years. A study by the University at Albany School of Public Health and Georgia State shows that this target is likely unachievable— but with a carefully implemented plan, HIV incidence could be reduced significantly.

From 2013-2017, approximately 40,000 people were diagnosed each year with HIV, and many of these infections were disproportionately concentrated within a few communities of people— men who have sex with men, persons living in the south, and African Americans.

With an increase in prevalence of HIV from 2008-2015 despite some decrease in the number of new infections, it is clear that there has been inadequate progress in addressing the HIV epidemic in the United States.

In order to provide realistic evaluations of how the HIV burden can be reduced, the researchers analyzed the latest HIV surveillance data from the CDC to develop a model to project the HIV

epidemic in the United States. They examined several different scenarios of care and prevention goal achievement.

The results showed that we could reduce new HIV infections by 67 percent in the next decade, and begin to see a decline in prevalence, if the United States meets internationally accepted targets for HIV diagnosis and care by 2025 and prevents an additional 20 percent of transmissions through targeted interventions such as pre-exposure prophylaxis (PrEP), a medication that individuals can take before coming into contact with HIV to reduce their risk of infection.

Even this level of impact would require the percentage of individuals who are living with HIV and are receiving care to increase to 95 percent in only six years. This would in turn mean addressing underlying barriers to care such as poverty, homelessness, and food insecurity.

effective and targeted but are responsive to community needs and locally implementable,” says Dr. Eli Rosenberg, one of the co-authors along with Dr. David Holtgrave. “This means that it’s especially important for groups representing populations most affected by the epidemic to help create goals and develop implementation plans, so that the approach is effective for each community.”

With the stagnation of progress towards eliminating HIV in the United States, this research presents a realistic look at how the epidemic can be addressed— and can be used to guide estimates of the investments needed to achieve improvements.

“We need more than just political commitment to reduce HIV infections in the next decade— realistic goals, adequate resources, and a flexible implementation strategy are crucial to meet this goal,” says Dr. Rosenberg.

“To significantly reduce HIV infections, we need innovative models for delivering HIV care along with prevention interventions that are

Introducing CCHRPP: The School of Public Health’s New Research Center The Center for Collaborative HIV Research in Practice & Policy (CCHRPP) will leverage the unique partnership between the University at Albany and the New York State Department of Health (NYSDOH) AIDS Institute to expand collaborations to address social justice and public health challenges of persons at risk for or living with HIV and related diseases. Taking a life-course view of prevention and treatment of interrelated epidemics, the center will work to create meaningful research, develop and evaluate policy, identify best practices, build health equity across diverse communities, and train public health professionals. University approval for CCHRPP is expected in fall 2019.

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THE POWER OF STUDENT SCHOLARSHIPS David Axelrod Fellowship recipient Monroe Marshall with Jonathan Axelrod and Janet Axelrod

Our students reach their full potential thanks in part to the generosity of our scholarship donors, and they’re eager to pay it forward by helping the communities around them.

A

fter following disease outbreaks in the news as a child, Monroe Marshall (pictured top right) is rigorously working toward a career addressing health disparities and is now entering his second year in UAlbany’s MPH program. Once he graduates, he plans to focus on LGBTQ health, HIV prevention, and opioid use in New York City.

William Randolph Hearst Fellowship recipient Christina Hatten with George R. Hearst III, Publisher and CEO, Times Union, and President, University at Albany Foundation

“My goal is to work at Callen Lorde, an organization that provides programming and services pertaining to behavioral health, HIV, and transgender health,” says Monroe. “The experiences I’m gaining here at the University are propelling me toward this end result.

Although I’m concentrating in epidemiology, I’m also exploring other areas of public health through electives, internships, and volunteer opportunities. All of these experiences will help me to better serve marginalized populations.”

Over the course of his academic training, Monroe has taken on leadership roles in various clubs, organizations, and societies, and has worked at Community Access, an organization that provides resources to those with HIV and persons who misuse drugs. He even created presentations about opioid use and its impact on the brain, which were shown to high school students in the IMAX theatre at the Cradle of Aviation Museum in Long Island, New York.

CDPHP Scholars Program students Emma Geyer, Kim Thompson, Amanda Kocienski with Dr. John Bennett, President and CEO, CDPHP

Due to his passion for increasing the health of populations, Monroe received the David Axelrod Fellowship in 2018, which has allowed him to dedicate more time to his studies. This summer, Monroe is interning at the New York State Office of Mental Health and Suicide Prevention.

“Every opportunity to apply my learning is worthwhile,” says Monroe. “Immersing myself in various opportunities will make me a well-rounded public health professional— and more capable of making strides in LGBTQ health, HIV prevention, and opioid use in New York City.”

Adell Y. Smith HANYS Healthcare Leadership Scholarship recipients Elizabeth Stephenson and Caryl 31 English pictured with Adell Y. Smith

CORPORATE DETERMINANTS OF HEALTH W

ith the generosity and support of the Hogarty family, the University at Albany School of Public Health and its friends enjoyed a presentation in April 2019 from Dr. Cheryl Healton entitled Combatting the Tobacco Epidemic: Impact and implications for other major health risk factors associated with cancer.

Pictured: Dr. Cheryl Healton, Dean of the College of Global Public Health at NYU and Professor of Public Health Policy and Management with Dr. David Holtgrave, Dean of the School of Public Health at UAlbany, and Fardin Sanai, Vice President for University Advancement and Executive Director of the University at Albany Foundation.

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Through this presentation, Dr. Healton, who serves as the Dean of the College of Global Public Health at NYU, introduced the concept of “corporate determinants of health.” Industries produce some products that result in death and disease and she says we must hold them accountable for their actions and the effects. Corporations whose products cause varying degrees of illness and death among their consumers include the sugar industry, tobacco companies, fast food chains, the gun industry, alcohol companies, and fossil fuel giants.

Dr. Healton held corporations responsible by taking on the tobacco industry. She served as the founding President and CEO of Legacy, a leading organization that developed the national youth tobacco prevention counter-marketing campaign, truth®, which has saved between 1.9 and 5.4 billion dollars in medical costs for society by encouraging youth to reject tobacco.

In 2020, we will celebrate the 10th anniversary of the Hogarty Family Foundation Lecture and hope that you will join us for this marvelous event made possible thanks to the Hogarty family (more information to come).

A DONOR’S IMPACT “I was so honored to receive the Adell Y. Smith HANYS Healthcare Leadership Scholarship! Meeting Ms. Adell was remarkable. She has inspired me to one day pay it forward and establish a scholarship so that I can give back to students, too. Receiving the scholarship motivated me to maintain a high GPA and take in all that the School of Public Health has to offer. Recently, I’ve accepted an internship position at a health clinic in Uganda! I can’t wait to go abroad and receive a truly hands-on approach to global health.

Thank you Adell for this scholarship and for helping me reach my public health goals!”

- Elizabeth Stephenson, UAlbany MPH student & recipient of the Adell Y. Smith HANYS Healthcare Leadership Scholarship

TACKLING CLIMATE CHANGE. IMPROVING ACCESS TO CARE. REDUCING HEALTH DISPARITIES. STUDYING INFECTIOUS DISEASES. ASSISTING THE STATE. TRAINING THE FUTURE LEADERS OF PUBLIC HEALTH. Your generosity enables us to make significant improvements to the health of CREATING MEANINGFUL CHANGE. ADDRESSING FOOD INSECURITY. PROMOTING DIVERSITY AND INCLUSION populations locally, nationally, and globally. Thank you to all our scholarship IMPACTING COMMUNITIES LOCALLY AND AROUND THE WORLD. UNLEASHING COMBATTING donors, campaign donors, and friends who continually show GREATNESS. their support.

LONELINESS AND AGING. PARTNERING WITH COUNTRIES AROUND THE WORLD. TAKING A GLOBAL APPROACH TO PUBLIC HEALTH. PROVIDING HANDS-ON EXPERIENCES FOR STUDENTS.

It only takes a minute to make the gift that lasts a lifetime.

albany.edu/sph/give

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1 University Place Rensselaer, NY 12144 (518) 402-0283 ualbanysph@albany.edu

THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH: DEFINING EXPERIENCES IN PUBLIC HEALTH