HAPPENINGS

Injured Farmers Take Longer to Get Trauma Care

A University of Iowa College of Public Health study shows that farmers who suffer an on-the-job injury take more time to arrive at a hospital that provides the specialized trauma care they need than workers in other industries.

The study found that median time to care was one hour longer for farmers than other workers. It took farmers 2 hours and 46 minutes to arrive at a definitive trauma care center, compared to 1 hour 48 minutes for people who suffer rural, non-farm work injuries. However, that difference came in the first two hours after the injury was reported. For injuries that took longer than two hours to reach definitive trauma care, differences in farm and rural non-farm injuries had similar times to access care.

Corinne Peek-Asa, professor of occupational and environmental health and study co-author, says the differences were primarily due to the time it takes to discover the injury and for medical personnel to reach the injured person. Once paramedics arrive, the time to provide care and begin transport was similar for all injuries. Peek-Asa says that extra time can often make a difference in a person’s recovery time, or even life or death.

The study was published in the journal Injury Epidemiology. It was co-authored by James Torner, UI professor of epidemiology, and Amanda Swanton of Dartmouth College.

Peek-Asa Elected to the National Academy of Medicine

Corinne Peek-Asa, associate dean for research and professor of occupational and environmental health in the University of Iowa College of Public Health, has been elected to the National Academy of Medicine. Election to the academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.

Peek-Asa is internationally renowned for her research in injury and violence prevention. Her work includes studies of global roadtraffic safety, interpersonal violence, workplace safety, traumatic brain injury, and adverse childhood experiences and trauma. Her research has inspired national legislation, and she helped develop injury and violence data collection systems in five countries.

“Dr. Peek-Asa’s valuable contributions to the field of injury prevention have helped improve the health and safety of people all over the world,” says Edith Parker, dean of the College of Public Health. “We’re very proud of her accomplishments and this welldeserved recognition from the National Academy of Medicine.”

Modeling the Spread of Health Care-Associated Infections

More than two million patients each year contract hospital-borne infections such as C. difficile, E. coli, and now COVID-19. A multi-disciplinary group of University of Iowa researchers is studying how to protect hospital patients from these types of diseases. The project involves faculty, students, and staff from four UI colleges, including assistant professors Aaron Miller and Dan Sewell from the College of Public Health.

The researchers comprise the UI Computational Epidemiology Research Group— commonly known as CompEpi—which recently received a $3.3 million grant from the CDC to continue tracking the spread of health care-associated infections, or HAIs. One of six centers in the CDC’s Modeling Infectious Diseases in the Healthcare Network, the UI group uses computational modeling and simulation to study HAI transmission in relation to hospital layout and hospital-based interventions. “The overarching theme of this project is to overcome existing barriers for modeling the spread of HAIs,” said Alberto Maria Segre, professor and chair of the Department of Computer Science and the Gerard P. Weeg Faculty Scholar in Informatics. “Simulations based on our models can be used to compare alternative interventions and provide effective and practical guidance for how to reduce the transmission of multidrug resistant organisms and other pathogens capable of causing HAIs.”

In response to the COVID-19 pandemic, the CompEpi group has also received two supplemental grants from the CDC. These grants, which total $850,000, will allow CompEpi to apply modeling techniques to COVID-19 transmission in health care facilities as part of a larger consortium of CDC-funded modeling centers.

Sue Curry: Legacy of Leadership

Following more than a decade of transformational leadership, College of Public Health Dean Emerita Sue Curry this fall capped her distinguished career at the University of Iowa. Curry has been appointed professor emerita in health management and policy. “Sue’s outstanding leadership positioned our college to meet the urgent public health challenges before us today,” says Edith Parker, dean of the College of Public Health. “I’m delighted that she will maintain ties to our college through this faculty appointment, and I look forward to her continued national leadership as an elected member of the National Academy of Medicine and other affiliations

Curry stepped down as College of Public Health dean in 2017 to serve as University of Iowa interim executive vice president and provost, a position she held until 2019. She then served as a part-time administrative fellow in the Office of the President until 2020. She continues her national service as a member of the governing council of the National Academy of Medicine, a member of the governing board of the National Research Council, and a visiting scientist in the Office of Disease Prevention at the National Institutes of Health.

During her tenure as CPH dean from 2008 to 2017, Curry oversaw several major milestones and elevated the college as a national leader in public health education, research, and community engagement. Notably, she nurtured a dramatic expansion of undergraduate educational offerings for UI students and the launch of the college’s thriving undergraduate public health degree programs—the first such baccalaureate programs in the Iowa Regents system. In addition, under her leadership, the college forged innovative partnerships with business and community leaders across Iowa, and brought prominent public health and other national leaders to campus through a visiting scholar program and residencies for business leaders and journalists.

Marian Wright Edelman Selected as 2020 Hansen Award Recipient

The College of Public Health selected Marian Wright Edelman, founder and president emerita of the Children’s Defense Fund, to receive the 2020 Richard and Barbara Hansen Leadership Award and Distinguished Lectureship. Wright Edelman, who has been an advocate for disadvantaged Americans for her entire professional life, delivered her lecture on “Closing the Cradle-to-Prison Pipeline: Why America Needs to Invest in Children.” A recording of her presentation is available at cph.uiowa.edu/hansen-award/.

The Hansen Award, established in 2001 thanks to a generous gift from Richard and Barbara Hansen of Iowa City, honors persons who have demonstrated exemplary leadership in the public health field.

Iowa Researchers Receive $2.5M to Study Immunization-Related Issues

A team of University of Iowa researchers has been awarded a five-year, $2.5 million grant from the Centers for Disease Control and Prevention to survey primary care providers and the general public every three to four months on various immunization-related issues.

Co-investigators from the UI College of Public Health are Christine Petersen, professor of epidemiology and director of the UI’s Center for Emerging Infectious Diseases, and Natoshia Askelson, assistant professor of community and behavioral health. Aaron Scherer, associate professor of Internal Medicine in the UI Carver College of Medicine, is the principal investigator.

The information obtained from the surveys will help researchers identify and address patient and health care provider barriers to a variety of immunization-related issues and could help inform future immunization-related recommendations and policies.

The research team also includes Courtney Gidengil and Andrew Parker from the RAND Corp. and will receive survey and statistical support from the Iowa Social Science Research Center.

Researchers Find Concerns Related to Medicaid Managed Care in Iowa

A growing number of states are turning to managed care arrangements to provide care to senior and disabled Medicaid beneficiaries. Despite their complex care needs, very little is known about the experience of these individuals in managed care. A study from the UI College of Public Health published in Disability and Health Journal suggests that there are serious and persistent concerns related to access and quality of care under managed care for at least some participants in Iowa.

Medicaid managed care (MMC) was introduced in Iowa in 2016. A team of researchers led by Kanika Arora, assistant professor of health management and policy, wanted to assess the experiences of senior and disabled beneficiaries and see if they changed over time as the program stabilized and took root in the state.

The researchers conducted telephone survey interviews among 49 senior and disabled beneficiaries in 2017 and then again in 2019. According to Arora, not all beneficiaries completed both rounds of interviews, but among those who did participate in both waves, the frequency of concerns in all categories appeared to grow over time.

The open-ended survey questions across both rounds revealed issues centered on seven distinct themes: system navigation, service approvals, provider relations, customer service, case management, perception of Iowa’s transition

Arora says the results of the study underscore the need for a comprehensive evaluation of the program, particularly with reference to beneficiaries with complex care needs. “The study really raises important questions relating to how managed care can support the goals of rebalancing—shift away from delivery of long-term care in institutions to home and community-based settings,” she says. “It’s important to consider how managed care can improve access to home and community-based services, how it can improve beneficiary experience and quality of life, all the while improving budget predictability and potentially better managing costs.”

Brian Kaskie and Hannah Rochford of the Department of Health Management and Policy at the University of Iowa and Kelli Todd of the Iowa Chiropractic Society co-authored the study.

Gerr Presents 2020 Distinguished Faculty Lecture

Fredric Gerr, professor emeritus of occupational and environmental health, presented the College of Public Health 2020 Distinguished Faculty Lecture in early December. His presentation, “Meat Packing Plant Workers: A Case Study of a Precarious Workforce,” provided an overview of historical and current occupational injury and illnesses, including COVID-19, among meat packing plant workers as a case study of systemic disenfranchisement of precarious workers. to MMC, and oversight. Concerns with service approvals was the most frequently reported theme.

Expanding the Definition of Those Most at Risk for COVID-19

Seeking to enhance health equity and social justice, a commentary co-authored by University of Iowa College of Public Health researchers argues that the definition of people most at risk for COVID-19 illness and death should be expanded beyond biological factors to include social factors.

Definitions for those most at risk for COVID-19 typically focus on biological factors such as age and pre-existing chronic health conditions, despite evidence of health disparities linked to social, economic, and political factors. Inequitable social conditions have been found to play a significant part in COVID-19 infections and outcomes, as they have with all other health outcomes, state the authors who include College of Public Health researchers Rima Afifi, Nicole Novak, and Paul Gilbert. The commentary was published in Preventive Medicine.

Inequitable social conditions have been found to play a significant part in COVID-19 infections and outcomes.

COVID-19 prevention strategies, such as hand washing, physical distancing, sheltering-in-place, and self-isolation when sick, are most accessible to privileged individuals— those with secure housing, financial resources, social support, access to medical care, and white-collar professions that easily transition to remote work. Access to these resources is limited or unavailable to groups that are disadvantaged based on gender, race, ethnicity, social position, education, class, physical and cognitive ability, sexual orientation, and citizen status.

The authors call for the collection of data on social factors as part of the analysis of COVID-19 morbidity and mortality, as well as including social factors in decision-making to identify risks and plan strategies for COVID-19 and all other health outcomes. Additionally, when a coronavirus vaccine becomes available, the authors advocate “that vaccines become rapidly accessible to those most at risk as a result of both biological and social vulnerabilities.”

The co-authors include Bernadette Pauly, University of Victoria School of Nursing; Sawsan Abdulrahim, American University of Beirut; Sabina Faiz Rashid, BRAC University; Fernando Ortega, Universidad San Francisco de Quito; and Rashida A. Ferrand, London School of Hygiene and Tropical Medicine.

Vakkalanka Awarded American College of Epidemiology’s Annual Student Paper Prize

Priyanka Vakkalanka, a PhD student in epidemiology and occupational epidemiology trainee with the UI’s Heartland Center for Occupational Health and Safety, was selected as the 2020 recipient of the American College of Epidemiology’s Annual Student Paper Prize.

Vakkalanka’s paper examines the effectiveness of treating opioid use dependence (OUD) in veterans with buprenorphine, an opioid agonist medication. Her research team conducted a study to determine whether treatment with buprenorphine was associated with mortality, and to determine whether risk of mortality varied by length of time from last known treatment.

The study found that those who were not on buprenorphine were over four times more likely to die by suicide/overdose compared to those on treatment on any given day, and this risk did not significantly vary by time since last treatment. “This study adds to the growing body of evidence that buprenorphine treatment works and may have long-term beneficial health impacts,” says Vakkalanka.

Study Explores How Societal Development Affects Disease Transmission

A research team led by University of Iowa College of Public Health investigators has received a $2.5 million grant over five years to study how societal development affects the transmission of diarrheal disease among infants in urban Kenya. The funding comes from the Fogarty International Center, part of the U.S. National Institutes of Health.

Enteric (intestinal) infections remain the second leading cause of diarrheal illness and death globally in children, despite significant improvements in access to latrines and safe water sources in countries with high rates of diarrheal disease.

“Our study is focused on tracking how ongoing rises in the middle class in low-income countries induces a collapse in infectious diarrheal pathogen transmission and disease in infants,” says Kelly Baker, co-principal investigator of the study and assistant professor of occupational and environmental health.

“Our statistical developments will allow us to understand points of vulnerability for children susceptible to enteric infections, teasing apart the different pathways of infection,” adds co-principal investigator Dan Sewell, assistant professor of biostatistics.

The statistical and modeling tools developed through this project in urban Kenya will be widely applicable to studying multi-pathogen infectious disease transmission dynamics in other low- to middle-income countries, and will address global needs for evidence to prioritize urban development interventions. Additional co-investigators include Sriram Pemmaraju with the UI Department of Computer Science, and Blessing Mberu, Sheillah Simiyu, and Abdhalah Ziraba with the African Population Health Research Center.