HAPPENINGS

New Center Addresses Trauma and Resiliency in Native American Children and Families

College of Public Health researchers have been awarded a $3 million grant over five years by the Substance Abuse and Mental Health Services Administration to establish and support a new center, the National American Indian and Alaska Native Trauma and Service Adaptation Center (TSA). The goals of the TSA are to increase the national infrastructure and workforce capacity to prevent, reduce, and treat trauma as well as to increase wellness and resilience among American Indian and Alaska Native children, adolescents, and their families.

The TSA will be housed within the Native Center for Behavioral Health, which is a research center in the Department of Community and Behavioral Health at the UI College of Public Health committed to developing programs to support the behavioral health workforce in Native American and Alaska Native communities across the country.

“Importantly, our efforts will not endorse the inevitability of adverse outcomes,” says Anne Helene Skinstad, director of the Native Center for Behavioral Health and the program director for the new center. “The center will prioritize identification and dissemination of programs and approaches that seize the opportunities presented in early childhood and adolescence as an optimal time for prevention and intervention to mitigate trauma and promote resilience.”

Campaign Encourages COVID-19 Vaccinations in Iowa Communities

The University of Iowa Prevention Research Center for Rural Health (UI PRC), Iowa Public Health Association, and Iowa Immunizes have collaborated on a new “mini-campaign” to increase COVID-19 vaccinations. The campaign was developed in response to the rise of the Delta variant that is making some unvaccinated people reconsider vaccination against the virus.

The campaign was created by a team at the UI College of Public Health that specializes in health communication for behavior change. It was informed by conversations with local public health leaders, youth-serving organizations, small businesses, faith leaders, and other community representatives. The messages and images, like the one below, were also tested with a review panel that included members from Iowa communities.

“The campaign is not intended to move hesitant folks, but motivate those that ‘just haven’t gotten around’ to getting the vaccine,” says Natoshia Askelson, deputy director and co-principal investigator of the UI PRC.

The messages have been placed in movie theaters, paid social media, newspapers, and free papers in Iowa micropolitan areas—urban areas with a population of at least 10,000 but fewer than 50,000 people. The UI PRC is also freely sharing the campaign materials via social media and with community partners in micropolitan areas.

Healthier Workforce Center of the Midwest Awarded Renewed Funding

The Healthier Workforce Center of the Midwest, based in the University of Iowa College of Public Health, has received renewed funding from the National Institute for Occupational Safety and Health (NIOSH) to continue researching the evolving connections between work and health. The federal grant is expected to total more than $6 million over five years.

Directed by Diane Rohlman, professor of occupational and environmental health, the center focuses not only on changes at the individual worker level, but also policies and programs to change work climate and culture. The Healthier Workforce Center addresses emerging issues and high-risk, high-need populations in employers of all sizes in the predominately rural Federal Region VII (Iowa, Kansas, Nebraska, and Missouri). It is one of 10 NIOSH-funded Centers of Excellence for Total Worker Health. The Total Worker Health® approach collectively addresses workplace hazards to create a safer and healthier workplace and reduces the impact of injury and illness on businesses and communities.

The center is a regional collaboration among the University of Iowa, Washington University in St. Louis, the University of Kansas Medical Center, WorkWell Kansas, and two NIOSH Total Worker Health Affiliates: the Nebraska Safety Council and the St. Louis Area Business Health Coalition.

Rural Americans Are Dying of COVID at Higher Rates than Their Urban Counterparts

Rural Americans are dying of COVID-19 at higher rates than their urban counterparts—a divide that health experts say is likely to widen as access to medical care shrinks for a population that tends to be older, sicker, heavier, poorer, and less vaccinated.

While the initial surge of COVID-19 deaths skipped over much of rural America, where roughly 15% of Americans live, nonmetropolitan mortality rates quickly started to outpace those of metropolitan areas as the virus spread nationwide before vaccinations became available, according to a report from the RUPRI Center for Rural Health Policy Analysis. Keith Mueller, director of the center, and Fred Ullrich, research analyst with the center, co-author the regularly updated report.

The earliest surge in the pandemic (spring 2020) largely took place in metropolitan areas (both incidence and mortality), according to the report. The second surge (summer 2020) saw increases in incidence and mortality in both metropolitan and nonmetropolitan areas. However, it was at that time that nonmetropolitan incidence and mortality rates surpassed those in metropolitan areas. Both rates were higher in nonmetropolitan areas during the third surge until its peak in January 2021.

Following that peak, metropolitan and nonmetropolitan rates declined in similar fashion with incidence rates (for both geographies) levelling off in the spring and then declining until July 2021. At that time incidence rates started rising sharply with mortality rates following suit in August. Although that surge appears to have peaked in late September, incidence and mortality rates remain much higher in nonmetropolitan counties than those in metropolitan counties, according the report published Nov. 1, 2021.

Hospital closures and shortages of health care providers may contribute to the high mortality rates from COVID-19 in rural areas. “We know that around the country since 2010, over 130 rural hospitals have closed,” Mueller told the Daily Iowan. “In many places, that was the cornerstone of care in the community.” The latest report can be found at https://rupri. public-health.uiowa.edu/.

GPCAH Launches New FarmSafe Podcast

The Great Plains Center for Agricultural Health has launched a new podcast, FarmSafe. During each episode, agricultural workers and public health experts share firsthand stories and real-life tips for making safer and healthier decisions while on the farm. Topics have included a series on ATV safety and the importance of sleep. Find the podcast episodes at https://gpcah.publichealth.uiowa.edu/ farmsafe/.

IOWA RESEARCH TEAM LAUNCHES HEALTH EQUITY PROJECTS

Martha Carvour, assistant professor of infectious diseases in the University of Iowa Carver College of Medicine, has received a three-year, $758,000 grant from the UI’s Strategic Initiatives Fund (UISIF) to begin a series of campus- and community-wide projects aimed at improving equity in health science and practice (E-HSP). Funds in the UISIF are generated from the publicprivate partnership Iowa established in 2019 and are to be used for goals aligned with the institution’s strategic plan, which includes diversity, equity, and inclusion, as well as engagement.

In addition to Carvour, the E-HSP will be led by Ebonee Johnson, assistant professor in the College of Public Health, and Kimberly Dukes, research assistant professor in general internal medicine. The E-HSP project aims to alleviate longstanding imbalances in health care affecting patients who identify as members of a minoritized racial or ethnic group and/or who live in rural settings.

The researchers initially will focus in part on interventions for people with COVID-19 and diabetes, two diseases that have disproportionately affected minoritized groups. The team will also establish structures and methodology—such as a reliance on community partnerships—that can be replicated in future projects.

Study Examines Rural Cancer Control Plans to Address Disparities

A study from researchers at the University of Iowa College of Public Health and the Arnold School of Public Health at the University of South Carolina (UofSC) found that only about one-third of U.S. states, territories, and tribal organizations have made plans to address rural cancer mortality disparities through their required comprehensive cancer control plans.

In 2019, the National Advisory Committee on Rural Health and Social Services released a set of recommendations on rural cancer control that included a recommendation to address these disparities and provide rural-specific strategies as part of their comprehensive cancer control planning. However, there was not any baseline data on whether these plans already included this data. This new study sought to provide a baseline assessment of rural inclusion in these plans.

The analysis and paper were led by Sydney Evans, an MPH student at the University of Iowa, and Cathryn Murphy, an undergraduate student at the University of South Carolina. Jan Eberth at UofSC and Natoshia Askelson and Whitney Zahnd at Iowa were also involved in the study. The team reviewed the Comprehensive Cancer Control Plans for all U.S. states, territories, and tribal organizations to see if they included rural-specific data, like cancer rates, or developed rural-specific goals, objectives, or strategies. The research team found that about two-thirds of these groups considered “rural” in their plans and only about one-third of plans included a rural-specific strategy.

“As rural populations have higher cancer mortality rates, higher incidence rates for some of the more preventable cancers, and lower cancer screening rates, it is important that they are appropriately considered,” Zahnd says. “Our study helps provide information on how these plans include rural as one way of using research to facilitate public health changes.”

SURVEY HIGHLIGHTS PANDEMIC’S IMPACT IN IOWA’S SMALL TOWNS

The pandemic has taken a steep toll on mental health in many of Iowa’s rural communities, according to survey data gathered by an Iowa State University rural sociologist and University of Iowa researchers.

The pandemic strained the mental health and personal relationships of many rural Iowans, while residents in larger towns tended to report physical health and economic challenges with greater frequency, according to the survey data collected between December 2020 and February 2021.

The results illustrate how the pandemic impacted communities in different ways and can inform how public policies are constructed to address these challenges, said David Peters, professor of sociology at Iowa State University who led the survey effort. Nicole Novak, research assistant professor of community and behavioral health at the University of Iowa College of Public Health, and Mark Berg, associate professor of sociology at the University of Iowa, also contributed to the project.

The survey asked respondents in 73 Iowa communities to evaluate how the pandemic has affected various aspects of their lives, including their physical and mental health as well as their financial situation. The survey found respondents in the smallest towns were more likely to report worsening mental health and relationships as a result of the pandemic than they were to report worsening physical health. Economic impacts were relatively less widespread in the smallest communities, according to the survey. In larger communities and in towns with meatpacking facilities, however, more respondents said their physical health and economic situation took a toll as a result of the pandemic.

The results, including an overall report and statistics for individual communities, are available at https:// smalltowns.soc.iastate.edu/covid19/.