The University of Iowa College of Public Health
FALL 2023
WILDFIRE SMOKE: IS THIS THE NEW NORMAL?
FROM THE
DEAN
It’s often been said that disasters know no borders, and this year’s heavy rains, floods, record-breaking heat, and unprecedented wildfires around the globe certainly prove that point. This summer, smoke from Canadian wildfires affected not only that country, but also large swaths of the United States, including Iowa and the Midwest. In this issue, several air quality experts examine the increasing impact of wildfire smoke on human health and what we can do to prepare for and help mitigate smoky days. Unfortunately, the researchers note that “Computer simulations of the future in a warming climate show more smoky days, higher smoke concentrations, larger burned areas, and higher emissions—which further fuel climate change.” As climate change leads to more extreme weather events, being prepared for natural disasters and other emergencies is increasingly important, especially for older adults and other vulnerable populations. One of our stories takes a closer look at a program called Disaster PrepWise, which helps individuals and families develop a personalized disaster management plan. Another story examines the alarming increase in mental health disorders among young people. Schools can play an important support role, and you’ll learn more about one program that aims to increase the number of school-based mental health services professionals in Iowa.
InSight is published twice a year for alumni and friends of the University of Iowa College of Public Health. Director of Communications and External Relations Dan McMillan, daniel-mcmillan@uiowa.edu Editor Debra Venzke Designer Leigh Bradford Marketing and Community Outreach Coordinator Mitch Overton Alumni and Constituent Relations Coordinator Tara McKee Webmaster Patrick Riepe Creative Media Specialist Joey Loboda Correspondence, including requests to be added to or removed from the mailing list, should be directed to: Debra Venzke University of Iowa College of Public Health 145 N. Riverside Dr. 100 College of Public Health Bldg., Rm S257 Iowa City, Iowa 52242-2007 debra-venzke@uiowa.edu Visit our website cph.uiowa.edu
Follow us
We also celebrate our highly ranked Master of Health Administration program and hear from faculty, students, and alumni about how it prepares future health care leaders to enter the profession. I’m also excited to let you know about the University of Iowa’s Together Hawkeyes campaign, the largest fundraising and alumni engagement effort in the history of the state of Iowa. The College of Public Health’s efforts will focus on securing gifts to support student success and experiential learning, enhance research excellence and discovery, and bolster diversity in all its forms. In a world filled with numerous challenges, crises, and conflicts, the work of public health is more important than ever. I thank our collegiate community for all that you do and wish you a happy and healthy New Year.
Edith Parker FALL 2023 INSIGHT
The University of Iowa prohibits discrimination in employment, educational programs, and activities on the basis of race, creed, color, religion, national origin, age, sex, pregnancy, disability, genetic information, status as a U.S. veteran, service in the U.S. military, sexual orientation, gender identity, associational preferences, or any other classification that deprives the person of consideration as an individual. The university also affirms its commitment to providing equal opportunities and equal access to university facilities. For additional information on nondiscrimination policies, contact the Director, Office of Institutional Equity, the University of Iowa, 202 Jessup Hall, Iowa City, IA 52242-1316, 319335-0705, oie-ui@uiowa.edu.
CONTENTS
18
8 4
2 QUICK TAKES 4 NORTH AMERICA’S SUMMER OF WILDFIRE SMOKE: 2023 WAS ONLY THE BEGINNING
12
Air quality experts weigh in on the health hazards of wildfire smoke and what the future might hold.
8 SUPPORTING KIDS’ MENTAL HEALTH Young people are facing an unprecedented increase in mental health disorders.
12 OLDER, WISER, AND PREPARED FOR DISASTERS The Disaster PrepWise program helps older adults create a personalized disaster management plan.
15 IOWA’S MHA PROGRAM PREPARES FUTURE HEALTH CARE LEADERS
21 HAPPENINGS News and research findings. 24 CLASS NOTES Alumni news and notes. 25 GALLERY Student Ragan Martin’s internship led to the creation of a resource guide for childcare centers. 26 SPARK
18 TOGETHER HAWKEYES COMPREHENSIVE CAMPAIGN COVER ART: Adobe Stock
INSIGHT FALL 2023
1
QUICK TAKES
“
Quoted
People riding [electric scooters] on the sidewalk is a major concern because they can travel pretty fast. On an e-scooter, you can get up to 30 miles per hour, something that really should be ridden on the road, not on the sidewalk. That kind of speed mismatch between someone walking and someone on an e-scooter can lead to major injuries if there is a collision.
”
PHOTO: ALLIE HOLLOWAY
– Cara Hamann, associate professor of epidemiology, discussing the benefits and risks of electric bikes, e-scooters, and e-skateboards on Radio Iowa
HANSEN AWARD
The College of Public Health honored Peggy Shepard, co-founder and executive director of WE ACT for Environmental Justice, as the 2023 recipient of the Richard and Barbara Hansen Leadership Award and Distinguished Lectureship. She delivered the Hansen Lecture, “Advancing Environmental Health Through Justice and Equity.”
43= 2
FALL 2023 INSIGHT
amount of external research funding the college received in FY23
The College of Public Health’s Undergraduate Mentorship Program
is a new initiative that connects first- and second-year undergraduate public health students with third- and fourth-year undergraduate mentors to provide a layer of connection between public health students, help ease the college transition, expand access to resources, and allow students to build strong networks.
In August, incoming first-year MHA students spent a morning getting to know one another, building confidence, and creating bonds by participating in teambuilding activities at the UI Adventure Challenge Course.
DID YOU
KNOW? The University of Iowa is one of 71 members of the elite Association of American Universities, an organization that recognizes institutions for their research and discovery.
THE COLLEGE HOSTED 285 ALUMNI, STUDENTS, FACULTY, STAFF, AND FRIENDS AT ITS ANNUAL HOMECOMING LUNCH IN OCTOBER. INSIGHT FALL 2023
3
4
FALL 2023 INSIGHT
NORTH AMERICA’S SUMMER OF WILDFIRE SMOKE: 2023 WAS ONLY THE BEGINNING BY CHARLES O. STANIER, GREGORY CARMICHAEL, AND PETER S. THORNE
Canada’s seemingly endless wildfires in 2023 introduced millions of people across North America to the health hazards of wildfire smoke. While Western states have contended with smoky fire seasons for years, the air quality alerts across the U.S. Midwest and Northeast this summer reached levels never seen there before.
INSIGHT FALL 2023
5
The smoke left the air so unhealthy in Philadelphia on June 7, 2023, that the Phillies-Detroit Tigers Major League Baseball game was postponed. That same week, New York City residents hunkered down indoors for several days as a smoky haze hung over the city, turning the skies orange and exposing millions of people to the worst air quality in the world. Smoke also drifted into the Midwest, triggering the highest air quality index levels in the Chicago area in at least 24 years, forcing the cancellation of numerous summer activities and leaving residents with raspy voices. In several states, people woke up to smoky skies day after day. The pressing question on many people’s minds: “Is this the new normal?” From our perspective as air quality scientists, we think the answer is likely “yes.”
The U.S. has an extensive air quality monitoring and forecasting system to help provide some early warning.
In short, people will need to learn to live with wildfire smoke. It won’t be every year, but we’re likely to see summers like 2023 more often. Fortunately, there are several tools and strategies for managing a smokier future.
GLOBAL WARMING MEANS MORE FIRES
The wildfire smoke of 2023 highlights an emerging air quality trend. The U.S. had seen decades of falling levels of fine particulate matter pollution, PM2.5, thanks to environmental regulations and cleaner engines, factories, and power plants. But wildfires’ contribution to air pollution is increasing again, resulting in flat or rising levels of air pollution in much of the country. Climate models predicted this reality as global temperatures rise. Hotter, drier conditions, coupled with dry grasses and underbrush that accumulated over decades of fire suppression, have made large wildfires more common. Computer simulations of the future in a warming climate show more smoky days, higher smoke concentrations, larger burned areas, and higher emissions—which further fuel climate change. While prescribed fire and forest thinning can help reduce the number and intensity of fire outbreaks, smoke exposure is still likely to increase because of the increases in burned area anticipated as a result of large-scale shifts in temperature and moisture. 6
FALL 2023 INSIGHT
PREPARING FOR SMOKY DAYS
Managing the risk of wildfire smoke starts with making smart personal choices. Think of smoke waves like heat waves: They’re easier to face if you’re prepared and know they’re coming. That means paying attention to forecasts and having face masks, air monitors, and clean-air shelters available. Inhaling PM2.5 and the chemicals in wildfire smoke can exacerbate asthma, worsen existing respiratory and cardiac problems, and leave people more susceptible to respiratory infection. People caring for individuals sensitive to smoke, such as young children and older adults, will need to plan for their needs in particular. To prepare, read up on the risks and warning signs from public health professionals. Living with wildfire smoke may mean using air filtration devices, wearing N95 or KN95 masks on bad air days, modifying outdoor commuting patterns and activity schedules, and changing household ventilation choices.
WHAT SCHOOLS AND COMMUNITIES CAN DO
Living with smoke will also require changes to how schools, businesses, apartment buildings, and government buildings operate. Schools can start with setting a threshold for canceling outdoor activities and making sure staff are ready to meet the needs of kids with asthma. Building managers may need to rethink air filtration and ventilation and deploy air quality sensors. Communities will also need contingency plans for festivals and recreation venues, as well as rules for business to protect outdoor workers. Decisions on how to deal with smoke can be complicated. For example, selecting an air purifier can be a daunting task, with over 900 products on the market. The effectiveness of different smoke management interventions is not well known and can vary depending on small implementation details, such as how a mask fits the wearer’s face, whether exterior doors and windows seal tightly, and whether filters are installed properly and are replaced often enough. IMPROVING SMOKE MONITORING AND FORECASTING
The U.S. has an extensive air quality monitoring and forecasting system to help provide some early warning. It uses ground-based air quality monitors, satellite remote sensing systems to detect smoke and fires, and computer systems that tie observations together with wind, chemistry, and weather. These are supplemented by expert guidance from meteorologists. However, for average people trying to make decisions about the safety of outdoor activities, the current forecasting system is wanting. This is especially true when smoke blows in from fires far away, or when rapidly changing smoke emission rates and complex wind patterns lead to conflicting forecasts and advisories. A few key improvements would go a long way for practical decision making around wildfire smoke, like whether to delay the start of soccer practice: Knowledge of how fires evolve hour by hour can improve the smoke estimates going into the forecast models. Providing smoke forecasts at neighborhood scale can better inform individuals and cities of pending risks.
Merging seasonal weather forecasts of precipitation, humidity, and winds with satellite assessments of fuel conditions could enhance emergency planning for firefighters to help anticipate which regions and periods present the highest risks of fire and smoke. Maintaining a strong air quality monitoring network is also important. State and local government agencies have reduced the number of ground monitors by about 10% from its peak in 2001. Smoke estimates from satellites and low-cost portable sensors can help, but they work best when they can be cross-calibrated to a wellmaintained network of high-accuracy monitors. WE STILL HAVE A LOT TO LEARN
More effective adaptations to smoke will require more research to better understand the factors that make some people more vulnerable to harm from smoke, the effects of cumulative impacts of exposures to environmental stressors and smoke over the life span, and the efficacy and costeffectiveness of adaptations. For example, clean-air shelters—the equivalent to a cooling center during extreme heat—are gaining attention, but there is only limited guidance on what constitutes a clean-air shelter and where and when they would be used. A 2023 Government Accountability Office report called for better coordination to help target resources where they can be most effective. Living with smoke is emerging as a new reality. Next-generation tools need to be both clear and resilient to the compound hazards that develop when smoke hits simultaneously with other challenges, such as extreme heat. Charles O. Stanier, Professor of Chemical and Biochemical Engineering, University of Iowa Gregory Carmichael, Professor of Chemical and Biochemical Engineering, University of Iowa Peter S. Thorne, University of Iowa Distinguished Chair, Professor of Environmental Health, University of Iowa This article was originally published on The Conversation.
More accurate 10-day forecasts would allow communities to plan. INSIGHT FALL 2023
7
Supporting Kids’ Mental Health Young people are facing an unprecedented increase in mental health disorders. BY DEBRA VENZKE
8
FALL 2023 INSIGHT
The journey to adulthood
is often a turbulent one, but recent research shows that today’s adolescents are struggling with dramatic increases in mental distress. In 2019, more than 1 in 3 U.S. high school students said they had experienced persistent feelings of sadness or hopelessness, a 40% increase since 2009, according to the Centers for Disease Control and Prevention. Reports also show significant increases in youth mental health disorders, including depression, anxiety, and suicide ideation. The COVID-19 pandemic intensified this crisis, prompting the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association to declare a national emergency in child and adolescent mental health in autumn 2021. U.S. Surgeon General Vivek Murthy also issued the Protecting Youth Mental Health advisory in 2021, which called for “an all-of society effort, including policy, institutional, and individual changes in how we view and prioritize mental health.” “[T]he challenges today’s generation of young people face are unprecedented and uniquely hard to navigate,” Murthy wrote. “And the effect these challenges have had on their mental health is devastating.”
Worsening Mental Health of Girls
Mental health is affected by biological factors, including genes and brain chemistry, and environmental factors, including life experiences and larger social forces. Globally, it’s estimated that one in seven 10- to 19-year-olds experiences a mental disorder, according to the World Health Organization, and adolescent mental health conditions are increasing in many countries worldwide. Research has also shown that these increases are greatest in female adolescents. “Across clinical and community settings and measured with various instruments, girls and women are more likely than boys and men to experience a range of internalizing conditions and symptoms, including depression, psychological distress, anxiety, and suicidal ideation,” says Jonathan Platt, assistant professor of epidemiology in the University of Iowa College of Public Health.
INSIGHT FALL 2023
9
Platt, along with Katherine Keyes from the Columbia University Mailman School of Public Health, co-authored a paper that reviews and summarizes studies published since 2010 from around the world to understand trends, causes, and consequences of gender differences in internalizing conditions—mental health symptoms that individuals express inwardly, such as anxiety, sadness, worthlessness, and withdrawal. The paper, which appeared in the Journal of Child Psychology and Psychiatry, closely examines several potential causes of increasing mental health symptoms in youth. The authors then present a framework to evaluate whether these risk factors could plausibly explain the increased concentration of symptom rates among female adolescents. The authors found that potential factors in the worsening mental health of girls are trends in cyberbullying, education-related pressures, and earlier onset of puberty. Other potential risk factors that require more research include climate anxiety, social media use, and global economic and political instability. The short- and long-term consequences of the COVID-19 pandemic will also be “a critical part of mental health surveillance for years to come,” the authors write. Platt and Keyes stress that “there are no simple stories for the increase” in youth mental health conditions. They call for additional research and training to continue to unpack the underlying reasons so that evidence-based solutions can be developed. They also note the urgent need for studies that include more expansive measures of gender expression beyond the male/female classification. “The science is woefully behind on moving beyond binary measures of gender,” Keyes says. “Not only is binary gender inaccurate, but without assessing internalizing symptoms across a broader spectrum of gender, we miss important disparities.”
The Latest Youth Risk Behavior Survey
The CDC’s Youth Risk Behavior Survey, which examines health behaviors and experiences among U.S. high school students, further illuminates the struggles of girls and marginalized groups. Data collected in fall 2021 and released in early 2023 revealed that teen girls are experiencing the highest levels of sexual violence, sadness, and hopelessness they have ever reported. Three in five girls felt 10 FALL 2023 INSIGHT
potential factors in the worsening mental health of girls are trends in cyber-bullying, educationrelated pressures, and earlier onset of puberty
persistently sad and hopeless in 2021—double that of boys and the highest level reported over the past decade. The same report also confirms ongoing and extreme distress among teens who identify as lesbian, gay, bisexual, or questioning (LGBQ+). More than half (52%) of LGBQ+ students had recently experienced poor mental health and more than 1 in 5 (22%) had attempted suicide in the past year. Findings by race and ethnicity also show high and worsening levels of persistent sadness or hopelessness across all racial and ethnic groups, and that reported suicide attempts increased among Black youth and white youth.
Working with Schools
Helping young people navigate these challenges requires a full range of support from families, policies, and institutions. School personnel and educators are key partners in the effort, given that children spend so much time in school. “With the right programs and services in place, schools have the unique ability to help our youth flourish,” Kathleen Ethier, director of the CDC Division of Adolescent and School Health, said in a press release. One project that aims to increase the number of school-based mental health services professionals (MHSPs) is called MPath—Multidisciplinary Pathways to Recruit, Train, and Retain School Mental Health Providers in Iowa. The MPath project focuses on developing a multidisciplinary training model to increase the number of highly qualified school-based MHSPs serving high need areas of Iowa. With a grant from the U.S. Department of Education, MPath will fund 72 graduate students in school psychology, school counseling, school social work, and public health over the next five years. Special emphasis will be focused on increasing the number of MHSPs from underrepresented, nontraditional, and minoritized backgrounds. The graduate students will receive practicum supervision from credentialed professionals in their respective degree programs. They’ll acquire the expertise and practical experience necessary to address the broad range of mental health concerns encountered by high-need local education agencies. Two Master of Public Health students,
Jaron Jones and Ngonyo Mungara, are currently enrolled in the program. Ann Santos, clinical associate professor in school psychology, serves as the project director. Ebonee Johnson, assistant professor of community and behavioral health in the College of Public Health, is a co-project director, along with Enedina Vazquez, clinical professor of school psychology, Gerta Bardhoshi, professor of school counseling and Scanlan Center for School Mental Health Director of Research and Training, and Sarah Witry, clinical assistant professor of social work. “MPATH will make a significant and positive impact on school mental health workforce expansion in the state of Iowa,” says Johnson. “By partnering closely with Keystone and Mississippi Bend Area Education Agencies, students will receive their clinical training in high-need schools and districts. Students will also receive Iowa-based job placement support as they matriculate to ensure we’re retaining a workforce that is committed to addressing the mental health needs of Iowa’s youth. “Working as a part of this multidisciplinary team has been so rewarding, and I’m excited to see the long-term impact of this work,” Johnson says.
What’s Next
There are no quick fixes for solving the mental health challenges facing youth. However, improving awareness, support, and policies can lead to better prevention and treatment of mental health conditions. “Everyone has a role in addressing the mental health of our youth: families, teachers and staff, clinicians, and researchers,” advises Platt. “Only through cooperation and sustained commitment can we work together to identify who is struggling and why, in order to get kids the help that they need and reverse the crisis we face today.”
INSIGHT FALL 2023 11
Older, Wiser, and Prepared for Disasters The Disaster PrepWise program helps older adults create a personalized disaster management plan. BY DEBRA VENZKE
12 FALL 2023 INSIGHT
THE AUGUST 2020 DERECHO
—the powerful windstorm that swept through parts of Iowa and the Midwest—left thousands of residents without electricity, cellular service, or internet access. Homes were damaged and roads were blocked with downed power lines and trees. For older adults and those with disabilities, these conditions can be especially challenging or even life-threatening. To help this population and their families prepare before an emergency happens, researchers at the University of Iowa have developed a program called Disaster PrepWise. Led by Sato Ashida, associate professor of community and behavioral health, the program guides individuals through the process of developing a personalized disaster management plan for an emergency in their home or community.
Supporting Older Adults This program started about a decade ago when Ashida was inspired by a tool called PrepKids, a disaster preparedness program designed for rural families with children with special needs. “We really needed something like this specifically for older adults,” Ashida says. “They are vulnerable, and they need support in preparing.” Ashida’s team conducted an extensive review of the literature on older adult preparedness and sought input from service providers. “We took this information and made it fit the needs of older Iowa adults,” she says of the program. Disaster PrepWise has been tested and refined over the years to its current form. The program is offered free of charge and is delivered by trained interventionists who guide participants through five steps of planning, with the goal of being prepared to care for themselves for up to three days.
The five steps are: 1) complete a personal and household assessment; 2) develop a personal emergency network (identify three people outside of the household you can go to for assistance); 3) gather emergency information and important documents; 4) keep a 3-5 day supply of medications/ medical supplies; 5) build two emergency supply kits (one for home, one “to-go”). “We’ve published a couple of research papers showing that people’s preparedness behavior increased and their support systems were enhanced after they participated in the program,” Ashida says.
A Tool for Planning Ashida and her team have collaborated with numerous state and community partners to develop and deliver Disaster PrepWise. One of its longtime partners is the Heritage Area Agency on Aging (HAAA), which serves older adults, adults living with disability, and caregivers in east-central Iowa. “Some of the biggest considerations for older adults and people with special needs in an emergency are power, caregivers, evacuation and transportation, medications, and any required medical machines,” says Kellie Elliott-Kapparos, HAAA’s integrated services director. “These families need to have some extra conversations and planning, and PrepWise is a great tool for doing that.” “PrepWise is right in line with our mission of helping people remain independent and remain in their home for as long as they can,” adds Harrison March, HAAA’s community engagement coordinator. “If there’s a disaster but you’re not ready for it, a house or living setup that was safe might not be safe for you anymore. But if you’re prepared for that disaster, you can remain in that home longer than if you weren’t ready.”
Working with Partners As Disaster PrepWise has evolved over the years, it has received a variety of grant support, with the most recent grant from AmeriCorps. The grant provides the Disaster PrepWise program with 13 AmeriCorps members (8 this fall and 5 next summer), most of whom are college students. “We train them to do Disaster PrepWise interventions, presentations, and education, then INSIGHT FALL 2023 13
we send them to our partner agency host sites,” says Ashida. “We’ve established new partnerships with local public health agencies, county emergency management agencies, and HAAA.” Tiffany Wunderlich, a first-year Master of Health Administration student in the College of Public Health, is an AmeriCorps member who has worked with Disaster PrepWise since summer 2021. She’s currently a graduate research assistant for the program. “That first summer my role was to be an interventionist for the program. I would go to participants’ houses, maybe the community library, anywhere that participant wanted to meet, and I would set up a personalized disaster plan with them,” she says. Most of her visits have taken place within a 90-minute drive of Iowa City. “It’s all done online. By the end of the session, we can download their plan and put it on a flash drive, PDF, or print or email it to friends, family, or neighbors,” she says. Wunderlich says the feedback from the individuals she’s worked with has been positive. “Having Disaster PrepWise provide a location for gathering all their information in one place is really helpful,” she says. “Ensuring that we’ve set them up with an adequate support system is one of the bigger aspects I would highlight within the program.”
Reaching Different Populations The Disaster PrepWise program has been modified in several ways to meet the needs of different populations. The materials have been translated into Spanish, with plans to add more languages in the future, Ashida says. As part of her dissertation, Lena Thompson (14MPH, 23 PhD) helped outline cultural adaption needs for the Sac & Fox Tribe of the Mississippi in Iowa, also known as the Meskwaki Nation. “Through conversations with Meskwaki organizations and with Elders, we made a list of 25 specific adaptations that we would like to implement in Disaster PrepWise for the Meskwaki 14 FALL 2023 INSIGHT
“ENSURING THAT WE’VE SET THEM UP WITH AN ADEQUATE SUPPORT SYSTEM IS ONE OF THE BIGGER ASPECTS I WOULD HIGHLIGHT WITHIN THE PROGRAM.” community,” Thompson says. “Some of these adaptations were cultural adaptations, others were tribal-specific additions, and we also found ways to make the program more user-friendly. We hope to use this list as a guide in writing a grant proposal to fund future work on this project.” Ashida also has a grant from the National Institutes of Health for a study called Disaster PrepWise: Caregiving. This adaptation is geared to caregivers of individuals who have been diagnosed with dementia. The goal of the research is to better understand how having a disaster plan impacts participants’ stress, resilience, preparedness, and social support in preparation for a disaster. “It’s really about keeping the care going,” Ashida explains. “If a disaster hits, your home health care may not be able to come, your meals may not be delivered, or the electricity might be out for a while. All of those things can have a huge impact on the caregiver and the person receiving the care.” Because of its comprehensive nature, the Disaster PrepWise program can serve as a valuable planning tool for every household. “I would encourage anybody to look at Disaster PrepWise. Unfortunately, we’re very experienced in our area with emergencies and disasters,” says HAAA’s Elliott-Kapparos, referring to the derecho, past floods, and other emergencies. “We’ve seen time and time again, the more prepared anyone is, especially anyone with special needs, it really makes a world of difference in their ability to cope, but even more so, in their recovery. Somebody who has a plan recovers faster and more completely than someone who doesn’t.” Learn more about Disaster PrepWise at cph.uiowa. edu/prepwise/
Most highly ranked
Iowa’s MHA Program Prepares Future Health Care Leaders Iowa’s Master of Health Administration program is powered by an active network of alumni, faculty, and staff invested in students’ success. BY JENNIFER NEW
graduate programs have something that sets them apart. This unique quality is what differentiates an exceptional program from the pack of great ones. For the University of Iowa’s Master of Health Administration (MHA) program, that element is its alumni network. Iowa’s MHA program, one of the oldest in the country, holds a top place in annual rankings of health care management programs. It is distinguished by former students who are deeply invested in the growth and success of current and prospective students. “The availability of the alumni network is unparalleled in the MHA world,” says John Corbeil (12MHA), chief executive officer of HCA Houston Healthcare Kingwood. His words are echoed by Kristin Wilson, director of the MHA program: “One generation mentors the next. Students don’t become great in a vacuum. They get incredible support from our alumni, faculty, and staff. It’s a whole team effort.” TIGHTKNIT FROM THE START
One student currently reaping the rewards of this tightknit and generous alumni community is Maddie Huinker. “The alumni are very engaged with every aspect of the program,” says the Iowa City native. “I met alums during my application process, as guest speakers, and doing mock job interviews and resume reviews.” During her two years as an MHA student, Huinker enjoyed being taught directly by professionals at University of Iowa Health Care. She was a graduate research assistant for UIHC’s chief growth officer and worked on projects ranging from predictive modeling to pediatric physician supply and demand assessment. Over the summer, she interned in INSIGHT FALL 2023 15
Wisconsin and experienced the bond that links past and current program members. “I arrived in Eau Claire and right away a UI MHA alum reached out to welcome me to the community!” AN ARRAY OF MHA CAREERS
Like Huinker, who is currently in a two-year fellowship that will allow her to rotate through different areas of the Mayo Clinic in Jacksonville, Florida, most students enter the MHA program intending to work in health care administration. There is an increasing array of career paths for MHAs, however, and one of the strengths of Iowa’s alumni network is its breadth in numerous sectors. One example is Emma Ravenscroft (16MHA), who embraced data analytics well before it was expected knowledge for MHAs. She combined her degree with an MBA and followed her dream of working in consulting. Now a senior manager at Deloitte Consulting in the area of health analytics, Ravenscroft maintains communication with many of her former UI advisors, including faculty member Dan Shane, who created the MHA’s data analytics class. “Emma has become a conduit for us and reaches out to share opportunities for our students at Deloitte," Shane says. He adds that “while consulting firms used to look for MBAs, they are now much more open to MHAs.”
16 FALL 2023 INSIGHT
PROFESSIONALISM AS A CORE SKILL
Of the MHA program’s core competencies, professionalism—skills such as confidence in public speaking, ease in meeting new people, and strong written communication—is taught as a key part of leadership. Alumni are invaluable in providing opportunities for students to practice and improve these skills. They lead an annual seminar on effective networking that includes a speed networking activity. They give special talks, review resumes, conduct mock job interviews, and host field trips to health care centers across the Midwest. “From the day students arrive, there is a consistent conversation about what it means to be a professional in the health care world,” says Shane, who believes it is the hallmark of the Iowa program. “A big part of this is our alumni modeling those expectations and norms.” Some of the skills covered might seem less obvious—like dining etiquette for a professional meal. Eric Ramos (23MHA) says the annual etiquette lunch and executive presence seminar made a big impact: “We learned things like how to signal when we were done with a meal and what to do if we spilled coffee.” COMBINING LEADERSHIP WITH HEALTH CARE
Ramos, who grew up in Storm Lake, Iowa, was attracted to the MHA program out of a desire to use his organizational and management skills in support
of public health. He helped to take care Cedar Rapids and a legal intern for of his grandfather throughout the older the Iowa Hospital Association in man’s later years. “In Mexican culture, Des Moines. A Miami native, she you’re really involved in your elders’ also interned in her hometown as health care,” he says of his family’s a judicial intern for a U.S. federal experience. “I was very impacted by district court judge as well as seeing health care happening in the a law clerk in the Civil Division four walls of my home.” of the U.S. Attorney’s Office. He considered going to medical Upon completion of the JD/ school, but after getting involved MHA program, Skeete Burgess in student leadership roles as an was a Health Policy Leadership undergraduate, Ramos became curious Fellow for Dr. David Satcher, The future of the Iowa about ways to apply those skills to 16th U.S. Surgeon General, in MHA program is bright, health care. When he learned about the Satcher Health Leadership with dedicated faculty the MHA program, it was a natural fit. Institute at Morehouse School of and staff and a devoted While he is still early in his Medicine. This fellowship program alumni network helping fellowship at Northwestern Medicine, focused on the promotion and to prepare and develop Ramos is excited to be working on a implementation of policies and future health care leaders project-based fellowship (graduates practices to reduce and ultimately for the challenges ahead. have the option of applying to a eliminate disparities in health. rotational or a project-based model). As an alum, Skeete Burgess One of his projects is focused on has sought to strengthen and advance the MHA increasing access across the health care program’s commitment to diversity. She advocated system and improving the patient experience. for the MHA program to join the National This attention to fit between graduates and their Association of Health Services Executives (NAHSE), fellowships is reflected in Iowa’s outstanding job a non-profit association of Black health care placement rate. Not only do nearly all MHA graduates executives. NAHSE promotes the advancement have jobs in their field within three months of and development of Black health care leaders graduation—the class of 2022 had 100% success— and elevates the quality of health care services but they often remain in the place where they are rendered to minority and underserved communities. first hired. In the past five years, Iowa MHA students have “Our students seem to like their jobs and have attended NAHSE conferences and competed in long tenures, which is a good sign,” says Corbeil. the organization’s student case competitions. Another indication of the program’s success is the Currently, Skeete Burgess is the interim chief alumni who volunteer to help out almost immediately compliance officer and interim chief privacy officer after landing in the job market. for Emory Healthcare in Atlanta, Georgia. She is president-elect of Iowa’s Health Management ALUMNI GIVING BACK and Policy (HMP) Alumni Board and assists with There is a participatory quality to the program as one the recruitment and mentoring of minority MHA moves from prospect to student to graduate to active students. She continues to advocate that the Iowa alum. Darcelle Skeete Burgess (13JD, 14MHA) is an MHA program prepare students for an increasingly excellent example of an alum who has gone through diverse world. this cycle. She arrived in Iowa in 2010 to pursue a “Health equity should be of importance to health law degree with the intention of applying it to health care leaders since the patient populations we serve care. Gail Agrawal, dean emerita of the College of continue to become more diverse,” she says. Law, encouraged her to also pursue an MHA degree. The future of the Iowa MHA program is bright, While at Iowa, Skeete Burgess interned with the with dedicated faculty and staff and a devoted chief compliance officer at UIHC; she also was a alumni network helping to prepare and develop compliance intern at Mercy Medical Center in future health care leaders for the challenges ahead. INSIGHT FALL 2023 17
Together Hawkeyes, the largest fundraising and alumni engagement effort in the history of the state of Iowa, aims to generate critically needed support for students, faculty, staff, research, and innovative programs while improving facilities and bolstering service to Iowans. The College of Public Health’s fundraising priorities for the campaign focus on securing gifts to support student success and experiential learning, enhance research excellence and discovery, and bolster diversity in all its forms. The campaign also includes goals around engagement, making Iowa one of the first in the Big Ten to publicly announce and track engagement goals as part of a comprehensive campaign. Learn more at foriowa.org/together.
“Philanthropic support is critical to our success as we work to prepare future generations of public health leaders and advance the science and practice of public health. All gifts, no matter the amount, are deeply appreciated and will make a tremendous difference in this campaign.” — Edith Parker, College of Public Health Dean
18 FALL 2023 INSIGHT
Together Hawkeyes – College of Public Health Campaign Priorities Student Success and Experiential Learning: Private gifts support scholarships and provide invaluable experiential learning opportunities for public health students. Through experiences such as research projects, internships, case competitions, national conferences, and study abroad programs, students gain real-world knowledge and practical skills they’ll need as future public health leaders. Research Excellence and Discovery: The College of Public Health’s highly productive researchers are at the forefront of efforts to protect against new and emerging infectious diseases, promote the efficient delivery of health services, support health behaviors, and prevent injury and illness from occupational and environmental hazards. Support for faculty ensures Iowa can recruit and retain the visionary leaders who are creating new knowledge and leading breakthroughs to improve human health. Diversifying Our Community: Recognizing, valuing, and supporting all types of diversity are key components of the College of Public Health’s mission to prepare students to be effective health professionals. Attracting and supporting students and faculty from diverse backgrounds and experiences, expanding enrichment opportunities, and strengthening scholarship programs are part of our commitment to ensuring everyone at Iowa has the opportunity to contribute and reach their full potential.
To make a gift, please visit https://www.foriowa.org/together/ or scan the QR code. To learn more about the Together Hawkeyes campaign and giving opportunities, please contact Madeline Kerr, Director of Development – UI College of Public Health, at Madeline.Kerr@foriowa.org or 319-467-3530.
INSIGHT FALL 2023 19
Nathan Fethke Named Head of the Department of Occupational and Environmental Health Nathan Fethke was
named head of the University of Iowa Department of Occupational and Environmental Health, effective Oct. 1, 2023. He is a professor of occupational and environmental health in the UI College of Public Health. He holds a secondary appointment in the Department of Industrial and Systems Engineering at the University of Iowa. He directs the Ergonomics Training Program within the NIOSH-funded Heartland Center for Occupational Health and Safety and serves as deputy director of the NIOSH-funded Great Plains Center for Agricultural Health. Fethke is a Certified Professional Ergonomist. His research interests focus on developing and improving methods to quantify the physical demands of work as well as the epidemiology of musculoskeletal injuries among working people, including those in the construction industry and agricultural sector. His work includes evolving and evaluating interventions to advance workplace ergonomics and formalizing new methods and strategies for estimating exposure to physical risk factors. Fethke teaches occupational ergonomics and research methods courses. He has successfully
20 FALL 2023 INSIGHT
advised and mentored students into careers in academia, manufacturing, corporate research, and public health leadership. He was awarded the College of Public Health Faculty Teaching Award in 2018 and received a University of Iowa Inventor Award in 2019. “Dr. Fethke’s strong portfolio of extramural research together with outstanding teaching and mentoring skills provide an excellent foundation for his leadership of this distinguished department,” says Edith Parker, College of Public Health dean. “Nate’s interdisciplinary expertise, spanning engineering and public health, and his focus on practical, real-world solutions reflects one of the great strengths of the department, and these same qualities will help guide the continued success of its faculty, students, and staff.” Fethke earned a bachelor’s degree and a master’s degree in biomedical engineering from the University of Iowa, followed by a PhD in occupational and
environmental health from the University of Iowa in 2006. “I am truly honored to serve as OEH department head,” says Fethke. “The department is home to incredibly talented people committed to preventing illness and injury resulting from innumerable, and evolving, environmental and workplace hazards. The department has a collaborative spirit and a distinguished history of national and international leadership. I’m excited for the opportunity to work with colleagues, students, and alumni to continue and grow our outstanding programs.” Fethke will succeed Tom Peters, professor of occupational and environmental health, who served as interim department head since 2022. Peters will remain on faculty in the college. “I want to express my deep appreciation and gratitude to Dr. Peters for his outstanding leadership as an interim department head for the past few years, and I thank him again for his service,” says Parker. 20
Announcing the Institute for Public Health Practice, Research and Policy
HAPPENINGS
As part of a reorganization within the College of Public Health, the Iowa Institute of Public Health Research and Policy will be renamed and combined with the Institute for Public Health Practice and the Center for Public Health Statistics. The new organizational structure encompassing these units will be named the Institute for Public Health Practice, Research and Policy (IPHPRP). The IPHPRP will include the following units: Public Health Practice and Workforce Development Core (incorporating the Institute for Public Health Practice and the Midwestern Public Health Training Center) Statistics/Analytics Core (incorporating the Center for Public Health Statistics) Research and Evaluation Core (incorporating the Health Policy Research Program previously at the UI Public Policy Center) Edith Parker, dean of the College of Public Health, will serve as the leader of the IPHPRP. Other leadership roles within the institute include Vickie Miene, Executive Director; Laurie Walkner, Director of Public Health Practice and Workforce Development Core; Jacob Oleson, Director of Statistics/ Analytics Core; and Natoshia Askelson, Director of Research and Evaluation Core.
Medicaid Expansion Has Dramatic Impact in Redlined Communities A study published in the October 2023 edition of Health Affairs shows that Medicaid expansion has the greatest impact on lowering uninsurance rates among nonelderly adults in metropolitan communities with the highest levels of historical residential redlining. The study was led by Jason Semprini, postdoctoral scholar in the College of Public Health. The researchers found that states that expanded Medicaid in accordance with the Affordable Care Act (ACA) saw an average decrease of 6.2 percentage points in the number of people who were uninsured in the most heavily redlined census tracts. “These findings add to the evidence that structural racism, not race, is the cause of racial and ethnic health insurance disparities,” says Semprini. “To truly advance health equity, policymakers must address the dire effects of structural racism on health by prioritizing and incentivizing financial, educational, and health sector investments in these historically redlined communities.” The publication was co-authored by Abdinasir K. Ali from the University of Iowa and Gabriel A. Benavidez from the University of South Carolina. INSIGHT FALL 2023 21
Young Workers Face High Levels of Workplace Violence Young workers in the United States face a significant risk of workplace violence, especially in the retail and service industries where they are frequently employed, according to recent University of Iowa research. The study, the first national estimate of workplace violence against young people in the United States, involved 1,031 workers aged 14 to 24. Overall, 60 percent of participants reported experiencing some form of workplace violence during their employment. Verbal abuse that made victims feel scared and unsafe was the most prevalent form of violence reported, affecting 53 percent of the respondents. Additionally, 24 percent reported incidents of sexual harassment. Other key findings of the study include: Females were more likely than males to experience workplace violence overall and
sexual harassment in particular, while males were more likely to experience verbal abuse. Workplace violence was most prevalent among workers in health care settings and eating and drinking places. Youth employed in customer service roles reported the highest prevalence of workplace violence. UI researchers Carri Casteel and Jonathan Davis joined with investigators from Boise State University and the University of California San Diego to conduct the study, which was published in the American Journal of Industrial Medicine.
Iowa Researchers Receive $2.7 Million to Study Osteoarthritis University of Iowa researchers have received a $2.7 million funding renewal from the National Institutes of Health (NIH) to continue a multi-year study of the risk factors for knee osteoarthritis (OA) and factors related to progression. The Multicenter Osteoarthritis (MOST) Study began in 2002 and is headed by James Torner, professor of epidemiology. The new round of funding will support a study of impairments in response to exercise in knee OA and its risk factors and consequences with the goal of determining what modifiable factors may play a role in outcomes of pain, structural deterioration, and function loss in knee OA. The University of Iowa will be one of two clinical sites and will include investigators from the Departments of Epidemiology, Physical Therapy and Rehabilitation Science, Orthopedics and Rehabilitation, and Internal Medicine. Researchers from Boston University, the University of California San Francisco, the University of Alabama Birmingham, and the University of Iowa will be designing and conducting the study.
22 FALL 2023 INSIGHT
HAPPENINGS New research center to focus on climate resilience efforts in the Central Midwest
TELEHEALTH SERVICES FILL HEALTH CARE GAPS FOR RURAL SCHOOLS A study published online in Telemedicine and e-Health shows rural telehealth services provide valuable support to rural schools and students. The researchers, led by Marcia Ward, Distinguished Research Professor in the Department of Health Management and Policy, conducted a study over four semesters to examine outcomes for students receiving primary and urgent care through telehealth in 40 schools across the U.S. Over the course of the study, 2,769 students received primary care via telehealth, and 2,238 received urgent care telehealth. Primary care services were provided by a primary care provider, often with a registered nurse involved, while urgent care services were mainly delivered by a registered nurse. Primary care telehealth offered various services, including medication management, counseling, sports physicals, assessments, and evaluations. Urgent care telehealth primarily involved assessments. The researchers found that both services successfully returned most students to the classroom without further follow-up, reducing the need to seek health care outside of school. Additionally, nearly 68% of students using primary care telehealth did not have a primary care provider outside of school, suggesting that telehealth can fill a gap in service in many rural areas.
Researchers at the University of Iowa have received a $6 million grant for a five-year project focused on collaborative research and community engagement in climate adaptation planning. The project will establish a 13th regional team within the National Oceanic and Atmospheric Administration’s Climate Adaptation Partnerships/Regional Integrated Sciences and Assessments network. The center is led by Brandi Janssen, CPH clinical associate professor of occupational and environmental health. The initiative aims to enhance climate resilience efforts in the Central Midwest region (Iowa, Missouri, Kansas, and Nebraska) and will focus on collaborations with two underrepresented groups in the region: tribal nations and women who own farmland.
INSIGHT FALL 2023 23
CLASS NOTES Anne Abbott (23PhD) is an assistant professor, prevention and intervention programming, at Boise State University in Boise, Idaho.
Tasneem Ali (22BA) is a health equity program coordinator at the University of Iowa College of Public Health, Institute of Public Health Practice, in Iowa City, Iowa. Graham Ausdal (23MPH, 23CER) is a PET production technician at PharmaLogic Holdings Corporation in Davenport, Iowa. Lauren Barlow (23MS, 21BS) is an industrial hygienist at Tesla in Fremont, California. Emma Bernick (23BA) is an injury and violence prevention planner at El Paso County Public Health in Colorado Springs, Colorado. Hailey Boudreau (20MPH) is the screening and management section supervisor for the Bureau of Chronic, Congenital and Inherited Conditions with the Iowa Department of Health and Human Services in Des Moines, Iowa. Kristopher Curtis (20MPH) is a public health and safety coordinator at AnokaRamsey Community College in Coon Rapids, Minnesota. Eliza Daly (20MPH) is a public health infrastructure grant program coordinator at the Iowa Department of Health and Human Services in Des Moines, Iowa. Kaitlin Emrich (09MPH) was named public health director at Black Hawk County Public Health in Waterloo, Iowa.
Ben Grauer (23MHA) is a program coordinator at University of Iowa Hospitals and Clinics, Center for Disabilities and Development, in Iowa City, Iowa. Hana Hinkle (09MPH) was recognized by the de Beaumont Foundation as a 40 under 40 Public Health honoree for 2023. Hinkle is currently assistant dean of rural health professions and director of the National Center for Rural Health Professions at University of Illinois College of Medicine at Rockford in Rockford, Illinois. Maddie Huinker (23MHA) is an administrative fellow at Mayo Clinic Florida in Jacksonville, Florida. Trey McCoy (23MHA) is a health care consultant at Deloitte in Nashville, Tennessee. Cory Mead (13MHA) is chief executive officer at HCA Florida Woodmont Hospital in Tamarac, Florida. Michelle Niermann (94MA) is chief operating officer, East Division for UnityPoint Health, and provides leadership to UnityPoint Health hospitals in Cedar Rapids, Waterloo, and Dubuque, Iowa, the Quad Cities, and Madison, Wisconsin. Rebecca Nyangufi (21BA) is a maternal health grant program coordinator at Primary Health Care, Inc. in Des Moines, Iowa. Félix Pabón-Rodríguez (23PhD) is an assistant professor of biostatistics and health data science at Indiana University School of Medicine in Indianapolis, Indiana.
Natalie Peters (23MPH, 22BA) is a community health educator at Dallas County Health Department in Adel, Iowa. Meghan Razimoff (21MPH, 20BA) is a substance use navigation program specialist at Denver Department of Public Health and Environment in Denver, Colorado. Bailey Rickels (21MPH) is the adult injury prevention coordinator for the level 1 trauma program at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Logan Schmidt (23MHA) is an administrative fellow at HealthPartners in New Richmond, Wisconsin. Kenni Sterns (19MPH) is director of nursing at the Paul Rein Detention Facility with Wellpath in Broward County, Florida. Olivia Teach (20BA) is a disaster program specialist at American Red Cross in Chicago, Illinois. Kaley Wilkinson (05MHA) is vice president of enterprise strategy, marketing, and corporate development at WPS Health Solutions in Madison, Wisconsin. Mitchell Wisniewski (23MS, 23CER, 21BS) is a research health science specialist at Veterans Health Administration in Ann Arbor, Michigan. Xing Xin (15PhD) is a senior toxicologist, global product safety, at ColgatePalmolive in New York City, New York.
IN MEMORY Scott Anderson (64MA) of Scottsdale, Arizona, on April 10, 2023. Debra Cumro (97MS) of Summerfield, Kansas, on April 10, 2023. Robert Neppl (81MA) of Iowa City, Iowa, on July 23, 2023. Bradley Randles (09MPH) of Martinez, California, on April 15, 2023. Donald Rodawig (52MA) of Spirit Lake, Iowa, on July 5, 2023. Raymond Rodgers (62MA) of Broken Arrow, Oklahoma, on May 12, 2023.
24 FALL 24 2023 FALL 2023 INSIGHT INSIGHT
GALLERY Making Information Accessible BY SOPHIA MEADOR
Ragan Martin is a fourth-year
undergraduate public health major with a minor in microbiology. As an Undergrad to Grad student, she’s also a first-year MPH student in epidemiology. She completed an internship project with Johnson County Public Health that resulted in a helpful infectious disease resource guide for local childcare centers.
Can you describe the Childcare Facility Infection Prevention Guidance document you completed during your internship? This document serves as a resource for childcare centers that are responding to an infectious disease. There’s a lot of information about what childcare centers need to do if there’s an infectious disease present in their facility. Childcare workers were overwhelmed with having so much information and not understanding all of it. I gathered that information and condensed it down into a readable and accessible document. I’ve also been told by parents that it’s extremely useful for deciding whether to send their child to school or daycare.
Did you encounter any challenges? It was definitely a larger project than I expected. The document required hours of research into different diseases and childcare center requirements. I didn’t have any experience regarding childcare, so I had to learn. The information I collected and kept track of was overwhelming. I understand why childcare workers also struggle with that abundance of information.
PHOTO BY JOEY LOBODA
How did your public health education prepare you for this project? I think it prepared me a lot for the little tasks. I created a survey and sent it out to childcare centers across the county. I went into that knowing how I should design the survey because of a course that I took. I knew from different classes how to analyze that data and organize it. I also had to do some research on my own, looking at common childhood illnesses, figuring out how childcare centers currently address infectious diseases, and understanding the legal and licensing requirements for centers. I took that information and worked with my supervisor, a disease prevention specialist, to edit and finalize the document. So it was a lot of back and forth and communication.
How has this opportunity influenced your career outlook? This opened my mind to childcare and the specific rules and regulations they have to go through when an infection occurs. Now I understand how disease can affect other spaces like nursing homes and prisons. I also didn’t know what a disease prevention specialist was. That seems like a pretty cool position now that I’ve seen what they do. I previously was focused on a lot of big picture stuff, like state public health departments or the CDC. But working at the county level was really interesting. I’m definitely more open to smaller scale public health projects like that.
INSIGHT FALL 2023 25
145 N. Riverside Dr. 100 College of Public Health Bldg., Room S257 Iowa City, Iowa 52242-2007
SPARK Our Graduate Student Ambassadors
strive to inspire, connect with, and represent past, present, and future College of Public Health graduate students. They communicate and connect with prospective and admitted students and alumni through social media, podcasts, and participating in events.
26 FALL 2023 INSIGHT
