InSight Spring 2024

SPRING 2024

PROTECTING YOUNG WORKERS

FROM THE DEAN

For many teens and young adults, summer means taking a break from school, hanging out with friends, and getting a job. Work offers young people numerous benefits, including earning money and learning new skills. Unfortunately, many employers don’t adequately train new employees, which can increase their risk of getting injured on the job.

Diane Rohlman, professor and Endowed Chair of Rural Safety and Health, notes that workers in their teens and 20s are more likely to get hurt than older employees. In her research about the unique occupational safety hazards young workers face, she has found three common causes of this susceptibility to injury: their lack of experience, developing bodies and brains, and reluctance to speak up.

In this issue of InSight, Rohlman explains these factors and discusses how some states, including Iowa, have recently weakened labor laws that affect the type of work teens can do and the number of hours they can work. She also provides steps that employers can take to make work safer for younger employees.

You’ll also find a story introducing the Iowa Cancer Affiliate Network, a collaboration formed to support small hospitals’ ability to provide and expand cancer services and achieve Commission on Cancer Accreditation Standards. Doing so allows rural cancer patients to receive quality care closer to their homes.

Another story focuses on the Iowa Immunization Research Network, a collaboration formed by the University of Iowa and Iowa Immunizes. The network is bringing together a statewide group of researchers, health care professionals, and organizations to increase vaccination uptake and lower vaccine hesitancy in Iowa.

You’ll also read about alumni achievements, recent research endeavors, and student accomplishments. I hope you enjoy catching up with some of the many exciting activities taking place in the college, and I wish you a happy, healthy, and relaxing summer!

Edith Parker

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

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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.

The Iowa Cancer Affiliate Network helps community hospitals provide enhanced levels of cancer care to rural patients.

Workers in their teens and early 20s are more likely to get hurt than older employees. Here’s what employers can do to reduce young workers’ risk of injury.

A new partnership, the Iowa Immunization Research Network, is working to increase vaccination uptake and reduce vaccine hesitancy in Iowa.

In addition to being a public

Natalie Peters (22BA, 23MPH) is improving the health of her community as a health educator.

QUICK TAKES

DID YOU KNOW?

The University of Iowa was the first U.S. public university to admit men and women on an equal basis.

Rima Afifi, professor of community and behavioral health, presented the CPH Distinguished Faculty Lecture, “Narrative Change and Relationship Building: Why Love Matters in Achieving Social Justice,” on April 15.

On March 4, Kelly Garcia, director of the Iowa Department of Health and Human Services, and Robert Kruse, state medical director and director of the Division of Public Health, visited the college for an Executive in Residence presentation. (From left: Robert Kruse, CPH Dean Edith Parker, and Kelly Garcia)

The Iowa Board of Regents has approved the UI’s request to create an online Executive Master of Health Administration program through the College of Public Health. The program will be available in August and taught by primary faculty members in the Department of Health Management and Policy.

In February, Christopher Coffey, director of the Clinical Trials Statistical and Data Management Center and professor of biostatistics in the UI College of Public Health, along with Cristina Tilley, Claire FergusonCarlson Faculty Fellow in Law and professor in the UI College of Law, presented the 41st annual Presidential Lecture titled “Pathways to Discovery: Clinical and Legal Trials, Academic Rigor, and Public Perceptions.”

In March, Leandris Liburd, acting director of the CDC’s Office of Health Equity, delivered a virtual guest lecture to the college titled, “Health Equity Perspectives: Then & Now.”

# 25 Best School/Program of Public Health in the Nation

Additional College of Public Health rankings

14. Health care management*

17. Environmental health sciences

20. Biostatistics

22. Health policy and management

U.S. News & World Report Best Graduate Schools 2024

Rankings with an asterisk (*) were not evaluated this year, but represent the college or program’s most recent ranking.

200 MILES

Keeping Cancer Care Close to Home

The Iowa Cancer Affiliate Network helps community hospitals provide enhanced levels of cancer care to rural patients.

BY JENNIFER NEW

Cancer patients have days when it’s easier to feel nearly “normal,” and others when physical pain and emotional distress are overwhelming. These harder days often coincide with challenging treatments like chemotherapy and radiation. Even seemingly routine oncology appointments can elicit doubt and confusion.

The bottom line is that cancer treatment is rough, riddled with affronts to the body and complex challenges to the psyche. What makes it easier to navigate is being able to sleep in one’s own bed, having loved ones nearby, and receiving advice from trusted and familiar doctors. For too many rural

Iowans, however, cancer treatment means long hours in the car and visits to unfamiliar people and places.

ENHANCING COMMUNITY CANCER CARE

Amy Fernandez, the chief of clinic services at Mahaska Health in Oskaloosa, Iowa, knows how hard this can be on patients. An experience she had as part of a friend’s caretaking team inspires her to work to improve rural cancer care.

“We would drive three hours total to and from [the hospital],” she recalls of their trips to University of Iowa Health Care in Iowa City. “He was so sick on the way home. I’d try to drive as carefully as I could, and sometimes we’d have to pull over. I can’t help but think how much easier it would have been on him to drive 20 minutes to a local hospital.”

This is exactly the intention of the Iowa Cancer Affiliate Network (I-CAN). Established three years ago with funding from the National Cancer Institute, a part of the National Institutes of Health, I-CAN is a conglomerate of hospitals that work together to provide enhanced levels of care to cancer patients. It is coordinated by researchers and staff in the University of Iowa (UI) College of Public Health, the Holden Comprehensive Cancer Center at UI Health Care, and the Carver College of Medicine, under the leadership of Mary Charlton, professor of epidemiology. Charlton stresses that they are building a collaborative approach that focuses on all levels of cancer care, “from dietary needs to access to national trials.”

Charlton and members of the I-CAN team were inspired by a network approach spearheaded at the University of Kentucky. In a state that has a similar rural-to-urban composition, the Markey Cancer Center Affiliate Network program has grown to include 19 community hospitals and medical centers. In 2023, I-CAN members traveled to Kentucky to learn how they established and continue to maintain their network.

Dave Evans, the clinic manager at the Southeast Iowa Regional Medical Center in West Burlington, was part of that trip. “I got to meet people who have similar-sized health systems to us. It was very helpful to see their workflows.”

Evans says that in the past, he and his colleagues worried about competing with other hospitals, especially larger ones. Last year, Southeast Iowa

There are myriad benefits to keeping patients in their home health care facilities. An important one is that it’s easier to involve family and friends in caretaking and appointments.

Regional Medical Center provided chemotherapy to about 800 patients. By comparison, a large hospital might provide chemotherapy to thousands of patients each year. With I-CAN, however, everyone is on the same team. “It’s a true partnership,” says Evans.

REDUCING RURAL CANCER DISPARITIES

Working together to combat Iowa’s dire cancer numbers is at the heart of I-CAN. As Charlton points out, “Iowa has the second highest cancer rate in the country, and we know that rural patients fare less well than their urban counterparts.” By combining the strengths of a research hospital that has access to the latest information, technology, treatment trials, and more, with the strengths of rural hospitals, the hope is to shift the disparity of outcomes.

There are myriad benefits to keeping patients in their home health care facilities. An important one is that it’s easier to involve family and friends in caretaking and appointments. Also, some patients are much more likely to accept treatment advice from trusted, long-term providers.

I-CAN also focuses on benefits that are less visible to patients, such as connecting providers in the network to training and guidance from team members in Iowa City, and via them, to the international oncology community. In addition, I-CAN works in collaboration with the Iowa Cancer Registry, which is directed by Charlton, to help build infrastructure for data collection and monitoring in network hospitals.

“We worked with the UI to do a gap analysis,” says Fernandez, “determining what services we have available and what we’re missing. We decided to get two of our people trained as tumor registrars, and we’re now seeing about a hundred patients a year for tumor analysis.”

She says that this hands-on approach to data collection is helping them to hone their understanding of the local situation: “When we first looked at statistics for Mahaska County, cases were being diagnosed later here than in other parts of the state.”

Mahaska Health is the smallest of the six rural medical centers that are part of I-CAN. Today, Fernandez is excited by the breadth of services and information they can provide. “At a hospital our size,” she says, “we don’t have a geneticist, but now we have access to this—someone who is encouraging testing for the patient and family members. And instead of one oncologist looking for trials and the latest research, we have access to an entire team focused on it.”

LEARNING OPPORTUNITIES

One of the people who visited Mahaska Health at an initial meeting is Madi Wahlen, an MD/PhD candidate in the Medical Scientist Training Program at the UI. She coordinates I-CAN’s research activities and facilitates data collection.

“It’s a very small hospital, but close to 20 people showed up for that first meeting,” Wahlen remembers, adding that although their annual number of cancer patients is relatively small, “their passion for improving the level of care was so impressive.”

As a student, Wahlen has had the unique opportunity to attend the meeting in Kentucky and visit all six of the network hospitals. Learning how hospitals work is not directly taught in medical school. “I’ve really been able to understand the strengths of small hospitals,” says the Minnesota native, “as well as the bandwidth issues they face.”

The project has also afforded firsthand experience in implementation science, which is at the heart of I-CAN. This developing field studies why interventions, such as diet or exercise, are or are not successful. “You can have the best intervention on paper, but if you don’t facilitate it well and people don’t do it, then it doesn’t matter,” Wahlen explains.

SHARING RESOURCES

A key goal of I-CAN is to have all members successfully implement the evidence-based quality practices and protocols set forth by the American College of Surgeons Commission on Cancer (CoC), the standard-setting consortium. “The amount of resources required to meet the CoC standards favor larger hospitals that tend to be located in urban areas. We want to share resources so that smaller hospitals located in rural areas can achieve CoC standards,” says Charlton.

The effect is a win-win. Hospitals like Evans’ in West Burlington now have tumor boards, in which “a team sits down and discusses scans to establish a plan of care before treatment has even begun.”

While at Mahaska Health, patients work with cancer navigators who help meet their psycho-social needs, such as finding quality wigs or a prosthetics provider.

“Cancer has affected us all in one way or another,” says Fernandez. “Through I-CAN, we’re expanding our footprint while keeping care close to home.”

Mary Charlton (left) confers with Madi Wahlen.

Protecting Young Workers

WORKERS IN THEIR TEENS AND EARLY 20s ARE MORE LIKELY TO GET HURT THAN OLDER EMPLOYEES. HERE’S WHAT EMPLOYERS CAN DO TO REDUCE YOUNG WORKERS’ RISK OF INJURY.

BY DIANE ROHLMAN

Think about your first job. Maybe it was delivering pizza, bagging groceries, busing tables, or doing landscaping work. Did you get enough training to avoid potential injuries? Chances are, you didn’t—and your boss or supervisor just told you to get to work. Employing young people helps them in many ways. They can learn a trade, develop job skills, become more responsible, and earn money. But there’s danger, too: Americans between 15 and 24 years old are up to 2.3 times more likely to get injured on the job than workers who are 25 and over. In 2021, 398 workers under 25 died after getting injured on the job.

In my research about the unique occupational safety hazards young workers face, I’ve identified three common causes of this susceptibility to injury : their lack of experience, developing bodies and brains, and reluctance to speak up.

PHYSICAL AND COGNITIVE LIMITATIONS

The 19 million young people employed today make up approximately 13% of the U.S. workforce. Work is more dangerous for young people because they’ve simply had less time to become aware of many common workplace hazards than their older co-workers. And yet this problem isn’t typically addressed during onboarding: Even those who have been trained to do a specific job may not be taught ways to avoid common injuries . These include tendinitis from scooping ice cream for hours on end, burns from operating a deep fryer, lacerations from sharp objects, and slips, trips, and falls.

It’s also important to remember that bodies and brains continue to develop well into adulthood— up to age 25. This can make some tasks riskier

before that point for the 55% of individuals between the ages of 16 and 24 who work.

For example, workers in their teens and early 20s may be smaller and weaker than older workers. Furthermore, some safety equipment, such as gloves and masks, may not properly fit.

In addition to physical changes that occur during adolescence, the brain is also developing and restructuring into early adulthood . The frontal cortex, which is used for decision-making and helps you to think before you act, continues to develop into adulthood and can lead to risky behaviors . Young people are inclined to seek approval and respect, which influences their decision-making. They also engage in risky behaviors both on and off the job that may affect their performance at work. Finally, many young workers are reluctant to speak up if they have concerns, or to ask questions if they don’t know what to do, because they don’t want to lose respect from their boss or supervisor. To avoid appearing unqualified, they may not want to admit that they need help.

WEAKER PROTECTIONS IN SOME STATES

Despite these inherent risks, Arkansas, Iowa, and other states have recently weakened labor laws, loosening restrictions about the kinds of work teens can do and increasing the number of hours they can work. This is happening at a time when the number of child labor violations are rising and more children are dying or getting injured , especially when they do tasks that violate federal labor laws .

Duvan Tomas Perez , for example, died on the job while cleaning machinery in the Mar-Jac Poultry plant in Hattiesburg, Mississippi, in August 2023. Perez was 16. So was Michael Schuls , who died in June 2023 while attempting to unjam a wood-stacking machine at Florence Hardwoods, a Wisconsin lumber company. Will Hampton , another 16-year-old, also died that month in Lee’s Summit, Missouri, while working at a landfill.

Teachers at a Nebraska middle school figured out that students who had trouble staying awake at school were working night shifts at a slaughterhouse, doing dangerous cleaning work that caused chemical burns .

Enacted in 1938, the Fair Labor Standards Act established federal standards to ensure workplace safety for workers under 18 and bars employers from interfering with their educational opportunities. This law sets 14 as a minimum age for formal employment, restricts when and how many hours children may work, and outlines the type of work children may safely perform.

Some of the new state labor laws allow children to work in more dangerous jobs and limit their employers’ liability for injury, illness, or even death on the job. When state labor laws are less restrictive than the federal law, however, the federal standards apply.

The federal government is also ramping up enforcement efforts. The Labor Department found 4,474 children employed in violation of federal child labor laws between Oct. 1, 2022, and July 20, 2023. Employers, including McDonald’s and Sonic fast-food franchisees, owed more than $6.6 million in penalties as a result.

3 STEPS EMPLOYERS CAN TAKE

In addition to following the law, I believe that employers and supervisors need to address the unique risks to young workers by taking these necessary steps: Provide training on how to do tasks safely and supervise young workers until key tasks have been mastered. Training should not only occur right before a new employee gets ready for their first shift, but whenever new tasks are assigned, when there is a new hazard in the workplace, and after an injury or near miss occurs in the workplace.

Model safe behaviors. Remember that young workers often learn by watching their bosses and co-workers, whose actions can reinforce safety expectations and build a culture of safety

Take into account a worker’s abilities when assigning tasks, and check in on them regularly, especially when switching tasks. Ask open-ended questions, such as, “What are the steps you are going to take when you do this task?” as opposed to questions that can be answered with a yes or no, like, “Do you know how to do this task?” Be sure to let workers know how to report concerns and who they can talk to if they have questions about workplace procedures and policies.

These strategies are easy to implement and cost little to follow. And they surely make it safer for workers in their teens and early 20s to gain the valuable work experience they want and need, while helping their employers to maintain safe, productive workplaces that nurture the workers our economy will increasingly depend upon in the years ahead.

Diane

Rohlman, Associate Dean for Research, Professor and Endowed Chair of Rural Safety and Health, University of Iowa College of Public Health

This article was originally published on The Conversation (theconversation.com)

Encouraging Immunization in Iowa

A new partnership, the Iowa Immunization Research Network, is working to increase vaccination uptake and reduce vaccine hesitancy in Iowa.

BY DEBRA VENZKE

Measles has been eliminated in the United States since 2000, but outbreaks of the highly contagious disease continue to occur around the country. As of early May 2024, 131 cases of measles have been reported across 21 U.S. states this year, according to the Centers for Disease Control and Prevention.

Cases are usually tied to international travel, but the disease—which can cause severe health complications—can spread in communities that have pockets of unvaccinated people. While many vaccine-preventable diseases are now rare in the U.S. due to high immunization rates, vaccine hesitancy is increasing, and fewer children and adults are receiving the recommended vaccines, putting them at risk for serious illnesses or even death.

Forming a Research Network

The University of Iowa and Iowa Immunizes, a coalition of individuals and organizations dedicated to improving vaccination rates for all Iowans through education, advocacy, and statewide partnerships, have collaborated to form a new initiative called the Iowa Immunization Research Network (IIRN). The network is working to increase vaccination uptake and lower vaccine hesitancy in Iowa by bringing together a statewide group of researchers, health care professionals, and organizations.

“There’s a lot going on in the immunization field right now,” says Natoshia Askelson, head of the IIRN and associate professor of community and

behavioral health in the UI College of Public Health. “New immunizations are being developed at a record pace. At the same time, and some of it is a result of COVID, we have a lot more vaccine hesitancy in our population than we’ve ever had before.

“It’s this perfect storm where we have a lot of really exciting things happening, but if people aren’t ready to embrace those immunizations, then they’re not going to be useful,” she adds. “This is a critical time where we should bring our resources together to think about how we solve these big challenges.”

The IIRN was established in May 2023 and is funded by the Iowa Institute for Public Health Practice, Research and Policy at the University of Iowa as part of the institute’s collaboratory program. A collaboratory (a combination of the words “collaboration” and “laboratory”) is a creative group process designed to solve complex problems and form new organizational networks.

The University of Iowa has a strong foundation in immunization research, Askelson says.

“Researchers in the Carver College of Medicine have been working on clinical trials around immunizations for a long time. Others are trying to figure out what’s driving vaccine hesitancy,” says Askelson. “And we have folks like me who are really interested in how you actually get shots in arms. How do you change clinic practices so that immunizations are more fully embraced and become the norm? The thought for the collaboratory was, ‘How do we all work together so that we can really address this problem from bench science all the way to the clinic?’”

Two additional aims of the IIRN are to help health care providers, pharmacists, dental professionals, and public health experts find and use effective evidence-based strategies that encourage vaccination, and to conduct and share research and help shape future interventions. The network’s long-term goal is to create a center for immunization research at the University of Iowa.

Key Partnerships

The IIRN includes researchers from the University of Iowa Colleges of Public Health, Pharmacy, Dentistry, Liberal Arts and Sciences, the Carver College of Medicine, and University of Iowa Health Care. Organizations are also part of the network,

including Iowa Immunizes, American Cancer Society, Iowa Cancer Consortium, and Iowa Department of Health and Human Services.

Iowa Immunizes serves as a strong community partner for the IIRN. “They have a really amazing network of immunization providers, immunization advocates, and people who’ve benefited from vaccines,” Askelson says. The piece that was missing from the picture, she notes, was a research arm, a role that the IIRN now fills.

“Iowa Immunizes is extremely proud of the formation of the Iowa Immunization Research Network and was an early champion,” says Elizabeth Faber, director of Iowa Immunizes. “This collaboration is extremely innovative, and not many states are as engaged with the academic institutions and researchers as we are in Iowa.

“It’s important that we approach public health concerns using sound science and promote evidence-based educational programs and policy,” Faber continues. “By partnering with renowned researchers, we are assured to have the latest information backed by science. Having access to those conducting research also benefits us in our efforts to educate the public, health care officials, and decision-makers about the importance, safety, and development of vaccines.”

Concerning Trends

The CDC recommends children be vaccinated against more than a dozen preventable diseases by the age of 6. All 50 states have legislation requiring specified vaccines for students, and most grant religious exemptions (45 states) or philosophical exemptions (15 states), according to the National Conference of State Legislatures.

“One concerning trend in Iowa is in relation to the rise of religious exemptions across the state,” says Faber. “There are immunization requirements for Iowa children to attend licensed childcare and elementary or secondary schools, unless they have a valid medical or religious exemption. Iowa does recognize personal belief, or philosophical

exemptions. Post-COVID, the rise of religious exemptions has risen from 2.6% of students to 3.0% of students. While this may seem like a small amount, many exemptions are in pockets of the state, which can increase the likelihood of a disease outbreak.”

Globally, the public perception of the importance of vaccines for children declined during the COVID-19 pandemic in 52 out of 55 countries studied, according to a 2023 UNICEF report on immunization. The same report warns vaccine hesitancy may be growing due to the confluence of several factors, including uncertainty about the response to the pandemic, growing access to misleading information, declining trust in expertise, and political polarization.

The IIRN is working with its partners to respond to the changing landscape of public perception about vaccines.

“I think there are some strategies that that seem to be really effective across lots of groups, regardless of vaccine, regardless of age, regardless of geography,”

“ There’s a lot of evidence that when your health care provider tells you to do something, you’re just much more likely to do it."

says Askelson. “One of them is a strong provider recommendation. There’s a lot of evidence that when your health care provider tells you to do something, you’re just much more likely to do it.”

“The COVID-19 pandemic did teach us many things in terms of messaging and education about vaccines,” adds Faber. “We learned that now, more than ever, the public wants to hear information from trusted sources, such as their own providers. We have also learned that trying to shame or scare the public is not effective. We focus on how vaccines fit into your overall plan for a healthy, productive, and full life.”

Learn more about the Iowa Immunization Research Network at cph.uiowa.edu/iirn/

MAKING A POSITIVE DIFFERENCE WITH PUBLIC HEALTH

Natalie Peters (22BA, 23MPH) grew up in Bettendorf, Iowa, and is now a community health educator for the Dallas County Health Department in Adel, Iowa. She recently shared some background about her path to public health and career.

PHOTO BY JOEY LOBODA

How did you become interested in public health?

As a freshman at Iowa, I started as an open major because I wasn’t exactly sure what I wanted to study or where I saw myself working at the end of my four years.

Once I took my first introductory public health classes as an undergrad, I knew that’s what I wanted to study. It made so much sense to me to focus on preventing diseases in populations rather than treating individuals after they’ve become sick.

I was an undergraduate public health student when the COVID-19 pandemic hit. During the early stages, I saw inequities be front and center when marginalized and minority populations were contracting and dying from COVID at a much higher rate. I also saw the important role that communities and local public health played in supporting people’s health during that time. That’s when I knew I wanted to pursue an MPH in community and behavioral health as well.

Can you describe your work and the type of projects you work on?

The purpose of my job is to connect with the residents of Dallas County to promote healthy behaviors and share resources that improve their quality of life. One of my main projects is being a nutrition educator for the Pick a Better Snack program. I go into elementary school classrooms to talk to students about a different fruit or vegetable each month. We usually read a book, do a physical activity, and then the kids get to try the fruit or vegetable of the month.

I also do a lot of community outreach for the health department. Usually this means being a vendor at community events in our county. This is a great way to share our resources and health promotion materials with community members, as well as offer some fun, healthy activities for kids.

I try to share health information with our residents in several ways, including writing weekly news articles, routinely being interviewed by a local radio station, and hosting educational events with community partners like our local libraries.

JANUARY

My most impactful experiential learning opportunity was being a graduate research assistant for the Building Health Equity initiative. The program focuses on educating public health department staff on health equity and how to incorporate those principles into their work. Through this experience I saw the unique role that local public health plays in promoting the wellbeing of their communities, and I knew I wanted to pursue a career in a health department after graduation.

I also mentor several high school and college students every semester to introduce them to public health and guide them as they create their own projects.

What public health classes and experiential learning experiences help you most in your day-to-day work?

As a health educator, I’m always thinking about how I frame my messaging and what additional barriers people may be facing that prevent them from making healthy choices. The theories I learned about in the Health Behavior and Health Education course have been very helpful to me for that reason.

I was also able to volunteer with the nonprofit Healthy LifeStars a couple different times throughout college. The experience of teaching elementary students about healthy habits and leading fun physical activities with them was great practice for the job I have now as a nutrition educator.

Did any of your experiential learning experiences help lead you to your current job?

If so, how?

My experience leading nutrition and physical activity lessons as a Healthy LifeStars coach prepared me to do so in my position now because I knew how to communicate with kids about healthy habits. This experience also helped me to understand just how much I enjoy working with kids, so I’m thrilled that I get to do so in my current role.

My graduate research assistantship also deepened my understanding of health equity and how to contextualize that to a local setting, so I felt prepared to take on a role in local public health for that reason as well.

What do you enjoy most about your work?

Teaching my nutrition education lessons is definitely my favorite part of my job. The kids are always so excited to learn about new fruits and vegetables. When I see them being curious or trying a new healthy food that they’ve never had before and liking it, it really makes me feel like I’m making a difference.

Anything

else you’d like to add?

It can be overwhelming to be a part of the field of public health and see all of the issues in the world that threaten people’s health and wellbeing. Working in community health and focusing on a smaller scale has made it feel much more manageable for me. It’s rewarding to connect with my community directly. I know that I’m making a positive difference in the world, even if it’s on a smaller scale.

HONORING THE PAST, IMPACTING THE FUTURE

Scott Davis is not one to forget his roots.

The longtime Florida health care leader earned his master’s degree in the University of Iowa’s Graduate Program in Hospital and Health Administration in 1984, then went on to a successful career in public accounting and consulting before finding his way into health care financing. Over more than two decades with Memorial Healthcare System in South Florida, Davis’ responsibilities in corporate finance steadily expanded: He led management of Memorial’s hospital charges and revenue capture, oversaw the health system’s participation in the U.S. Public Health Services Act’s 340B Drug Pricing program, and led Memorial’s reporting to the federal Centers for Medicare and Medicaid. All were vital components in one of the

largest public health care systems in the nation. Widely recognized as an expert in governmental reimbursement, Davis was named Memorial’s Vice President of Reimbursement and Revenue Integrity in 2022.

Through their generous support of the College of Public Health’s Strategic Leadership Fund, Scott Davis and his wife, Anna, are honoring the Iowa education that helped prepare him for success. They are also impacting the future by ensuring outstanding learning opportunities for the next generation of health workers.

“Practice-based experiences are particularly important,” says Scott. “Being able to use the skills you developed and put them into practice is a high priority. We want to do what we can to make sure future professionals coming into the field are properly prepared to help move the U.S. health system forward.”

To make a gift to the College of Public Health, please visit https://www.foriowa.org/together or scan the QR code.

To learn more about the University of Iowa’s 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.

IN MEMORY: Linda Baker

The College of Public Health was saddened to learn that Linda Baker, a generous University of Iowa alumna (68BA) and philanthropist, died on Dec. 27, 2023, at age 77. Linda Ihrke Baker was born May 9, 1946, and grew up in Chicago. She enrolled at the University of Iowa, where she met her future husband, Dale Baker. The couple graduated from the UI in 1968—Dale with degrees in business administration and accounting, and Linda with a degree in English and a certification in secondary education.

Dale enjoyed a successful career in public accounting at Ernst & Young, where he rose to partner before taking the entrepreneurial plunge. In 1990, he founded Baker Healthcare Consulting, which specialized in Medicare payment strategies. He also consulted with members of Congress on a variety of health care issues and worked as a federal lobbyist.

Linda pursued community and children’s services opportunities, working as a preschool teacher for a United Way agency, as a middle school teacher, and as an investigative reporter for a local consumer magazine. She also spent 19 years working in an elementary school library. Linda served on the UI Alumni Association Board from 2009-2015 and was honored with the 2023 UI International Impact Award. Together, the couple received the UI’s Distinguished Alumni Award in 2016.

The Bakers have been among the most generous donors to the university. That includes support for the Tippie College of Business and the Colleges of Education, Public Health, and Liberal Arts & Sciences, as well as women’s basketball, Hancher, and UI Libraries.

The couple’s generous gifts to the College of Public Health have provided funding for the college’s Global Public Health Program. The gifts have enabled the college to support student and faculty travel expenses as well as programmatic development that allows engagement with global public health issues in the classroom, across campus, and internationally.

Their gifts also have provided supplemental funding to aid graduate and undergraduate student success through scholarships and awards, educational innovation, health sciences research collaboration, entrepreneurship, and community outreach and engagement.

The College of Public Health is deeply grateful to the Bakers for their generosity and support that has made a lasting impact for future generations.

ILLUSTRATION BY NICK BEECHER

HAPPENINGS

2024 OUTSTANDING ALUMNI AWARD RECIPIENTS

The College of Public Health has named Vijay Golla and Daniela Moga the recipients of its 2024 Outstanding Alumni Awards.

Golla received a doctoral degree in occupational and environmental health in 2007 from the University of Iowa College of Public Health, an MPH in 2003 from Western Kentucky University, and a Bachelor of Medicine Bachelor of Surgery in 2001 from Andhra Medical College, N.T.R. University of Health Sciences at King George Hospital in India. He is currently vice provost for research and health sciences and professor of health and behavioral sciences at Texas A&M University-San Antonio. He is also an adjunct professor in environmental and occupational health and primary care and rural medicine at Texas A&M School of Public Health and School of Medicine, respectively.

Moga received a doctoral degree in epidemiology in 2012 from the University of Iowa College of Public Health, and an MD degree in 1997 from Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania. She is currently the Larry H. Spears endowed chair in pharmacogenetics, associate professor of pharmacy practice and science, assistant dean for research, and an affiliated faculty member in the Institute for Pharmaceutical Outcomes and Policy at the University of Kentucky College of Pharmacy. Moga is also jointly appointed as associate professor in the Department of Epidemiology in the University of Kentucky College of Public Health and serves as faculty associate with Sanders-Brown Center on Aging.

The award recognizes College of Public Health alumni who have made distinguished contributions to the field of public health and demonstrated a strong interest and commitment to the mission, vision, and values of the college. The recipients will be honored at an event this fall.

Iowa’s MHA program earns ACHE Higher Education Network Award

The University of Iowa’s Master of Health Administration (MHA) program is the recipient of the 2024 ACHE Higher Education Network Award for graduate programs given by the American College of Healthcare Executives (ACHE). The award recognizes one graduate and one undergraduate program annually that demonstrates the highest level of ACHE engagement.

Vijay Golla

Daniela Moga

4 projects earn prizes for Climate Change and Health Solutions Challenge

Four projects shared $32,500 in prize money at the first Climate Change and Health Solutions Challenge held in February. The challenge, open to University of Iowa students, faculty, and staff, asked teams to develop sustainable innovations that reduce health effects of climate change.

The top three teams received $10,000 each — Project Refill, Earthmind, and Team Bike Commuting. UI Rooftop Solar Panels received $2,500. The teams will now move to the implementation phase of their solution.

Project Refill  is a vending system for dispensing and refilling reuseable containers with consumer products such as shampoo and soap.

Earthmind is a student mental wellness program to relieve stress and climate anxiety using outdoor activities and programming in natural settings.

Team Bike Commuting  is a program to expand safe bicycle commuting to the UI campus.

UI Rooftop Solar Panels encourages the adoption of and education around solar installations on UI residentialstyle buildings such as cultural centers.

The Climate Change and Health Challenge is supported by the Burroughs Wellcome Fund, a generous gift from Don Diebel, MD, PhD, and Cindy Diebel, made through the University of Iowa Center for Advancement, as well as funding from the University of Iowa John Pappajohn Entrepreneurial Center, and the University of Iowa Office of the Vice President for Research.

Peter Thorne, UI Distinguished Chair and professor of occupational and environmental health in the College of Public Health, is the principal investigator of the Climate Change and Human Health seed grant.

HAPPENINGS

Casteel, Kennelty land $17.9M award for hypertension management study

Two University of Iowa researchers have been approved for nearly $18 million to help older adults with multiple chronic medical conditions better manage their hypertension. The award comes from the Patient-Centered Outcomes Research Institute (PCORI).

Carri Casteel, professor in the Department of Occupational and Environmental Health and director of the Injury Prevention Research Center in the College of Public Health, and Korey Kennelty, the Patrick E. Keefe Professor in Pharmacy in the College of Pharmacy and the vice chair for research and implementation science in the Department of Family Medicine, are dual-principal investigators on the award.

They will test two team-based care approaches to manage high blood pressure in older adults, both involving self-measured blood pressure, which involves the patient using a personal blood pressure monitoring device at home, recording their blood pressure at different times during the day, and using this information to work with their health care team on blood pressure management.

In the first approach, the patient will work with a health care team that includes nurses and primary care providers. In the second approach, pharmacists also will be part of the health care team. Patients will be followed for 12 months to examine changes in blood pressure. The research team aims to enroll 930 patients and will partner with more than 60 primary care clinics across the United States.

Mueller honored for outstanding work in rural health care

Keith Mueller, Gerhard Hartman Professor in Health Management and Policy and director of the RUPRI Center for Rural Health Policy Analysis, has been awarded the 2024 Louis Gorin Award for Outstanding Achievement in Rural Health Care by the National Rural Health Association (NRHA).

Throughout his 40-year career, Mueller has advanced rural health through expert nonpartisan policy analysis, national presentations and testimony, and the education of future health care researchers and administrators. He currently serves as Gerhard Hartman Professor in Health Management and Policy in the College of Public Health at the University of Iowa and as director of the RUPRI Center for Rural Health Policy Analysis.

Snetselaar named to National Academies expert committee

Linda Snetselaar, CPH professor of epidemiology and Endowed Chair of Preventive Nutrition Education, was recently named to a National Academies of Sciences, Engineering, and Medicine committee of experts to review, evaluate, and report on the current scientific evidence on the relationship between alcohol consumption and health outcomes. This study will have implications for the next edition of the Dietary Guidelines for Americans.

AFIFI, CHRISCHILLES HONORED FOR FACULTY EXCELLENCE

Rima Afifi, professor of community and behavioral health, and Elizabeth Chrischilles, Marvin A. and Rose Lee Pomerantz Chair in Public Health in the Department of Epidemiology, have been named recipients of the University of Iowa's 2024 Regents Award for Faculty Excellence. The award recognizes their extraordinary contributions and sustained record of excellence in teaching, scholarship, and service.

Examining

stress among women farmers

UI researchers Carly Nichols, assistant professor of geographical and sustainability sciences, and Jonathan Davis, research assistant professor of occupational and environmental health, have created and tested a new tool—the Women Farmer Stress Inventory (WFSI) to better understand the types of stressors women farmers face as well as the conditions and context associated with the greater levels of stress. The study was published in the Journal of Rural Health. The researchers used responses from a random sample of 592 Iowan women farmers who replied to a mailed survey. The results revealed five unique factors that reflected different aspects of women farmer stress: time pressures and workload, environmental concern, external stressors from governments and markets, interpersonal relationships, and rural amenities. Young age, being married, engagement in off-farm work, and smaller farm size were associated with greater levels of stress across most domains. The WFSI is a promising tool for use in future research and community-based interventions for understanding and reducing female farmer stress.

Meet the 2024 Iowa Public Health Heroes

The University of Iowa College of Public Health recently honored three Iowa public health leaders whose work is helping to promote better health, prevent disease, and build stronger communities throughout the state.

The 2024 Iowa Public Health Heroes Awards were presented to: (from left) Katie Owens, senior director of engagement for the Iowa Primary Care Association; Elizabeth Faber, director of Iowa Immunizes; and Lina Tucker Reinders, executive director of the Iowa Public Health Association.

The award recipients were honored in March during a reception and awards ceremony at the Public Health Conference of Iowa in Des Moines. Since 2012, the College of Public Health’s Iowa Public Health Heroes Award program has recognized exceptional efforts by individuals from diverse career paths whose work improves health and wellness throughout Iowa. Award recipients are nominated by their peers in the Iowa public health practice community.

“The health of all Iowans is enhanced through the leadership and service of so many dedicated

professionals working in the public health sector,” says Edith Parker, dean of the College of Public Health. “We are proud to honor these three individuals and to recognize their outstanding work in the communities they serve.”

Hamann honored with Faculty Communicating Ideas Award

Cara Hamann, associate professor of epidemiology, received the 2024 Faculty Communicating Ideas Award from the Office of the Vice President for Research. This award recognizes excellence in communication about research and scholarship in the sciences and humanities and the study of creative, visual, and performing arts to a general audience directly or via print and electronic media.

Hamann has frequently shared her work on transportation issues, including teen driving, bike and scooter safety, and pedestrian safety, through peer-reviewed journals and extensive media outreach.

2024 Cancer in Iowa report focuses on alcohol-related cancers

Iowans’ alcohol consumption—in volume and frequency—is among the highest in the nation, and puts residents at greater risk for cancer, according to the 2024 Cancer in Iowa report issued by the Iowa Cancer Registry.

The annual report, produced by the College of Public Health at the University of Iowa, notes that the state of Iowa has the fourth-highest incidence of alcohol-related cancers in the U.S. and has the highest rate in the Midwest. Only Kentucky, Louisiana, and Mississippi have higher rates of alcohol-related cancers among U.S. states. The full report is available online at shri.public-health.uiowa.edu .

“With this year’s report, we seek to increase awareness that all types of alcoholic beverages increase cancer risk, and reducing the amount we drink will also reduce alcoholrelated cancers,” says Mary Charlton, CPH professor of epidemiology and the report’s co-author. “What’s especially noteworthy is while any alcohol can increase one’s risk of cancer, heavy drinking and binge drinking pose the greatest risk.”

Other findings from the report included:

ƒ An estimated 21,000 cancers will be diagnosed among Iowans this year.

ƒ An estimated 6,100 Iowans will die from cancer.

ƒ The number of cancer survivors is growing, with an estimated 168,610 Iowans who overcame cancer between 1973 and 2019.

STUDY LOOKS AT RESOLVING ALCOHOL USE DISORDER WITHOUT TREATMENT

While highly effective, specialty alcohol treatment may present barriers, such as cost and stigma. A variety of strategies and other factors—often in combination—help people address their problem drinking without the use of specialized alcohol services, according to a study of untreated people in recovery from alcohol use disorder. Social support and changing one’s social and physical environments were the strategies participants most frequently found helpful, and most used a combination of multiple strategies to reduce or quit drinking.

The study, published in Alcohol: Clinical and Experimental Research, suggests that identifying individual motivations for behavior change may help people with alcohol use disorder find a set of recovery strategies and resources most relevant to their values and needs.

The study team included CPH researchers Loulwa Soweid, Paul Gilbert, Gaurab Maharjan, Paul J. Holdefer, and Sydney Evans, and Nina Mulia from the Alcohol Research Group, Public Health Institute.

CLASS NOTES

Tala Al-Rousan (15MPH) has been selected by the Arab American Businesses and Professional Association as one of the 10 most inspiring and influential women in the nation. Al-Rousan is an assistant professor at the Herbert Wertheim School of Public Health at the University of California San Diego.

Sameer Ali (22BS) is a data analyst at the Institute for Health Metrics and Evaluation in Seattle, Washington.

Timothy Chwirka (12MHA) is a health care manager at Huron in Des Moines, Iowa.

Steve Corbeil (84MA) was named CEO of LucidHealth, a national leader in radiology services for 60 hospitals and over 200 care sites across the country.

Anna Correa (22MPH, 21BA) is a project manager of quality networks at the American Academy of Pediatrics in Chicago, Illinois.

Adaeze Enekwechi (07PhD) has been named CEO of Cayaba Care, a maternal care company reaching underserved and high-risk populations, bridging the maternal health equity gap through personalized wraparound services during pregnancy and several months postpartum, in Philadelphia, Pennsylvania.

Joshua Goeller (12MHA) is chief strategy officer at DMC Huron ValleySinai Hospital in Commerce, Michigan.

Brittan Gregoire (22BA) is a maternal and child health and community outreach technician at the Denver Department of Public Health and Environment in Denver, Colorado.

Paige Grissinger (22BA) is a deployment and distribution flight commander at United States Air Force in Boise, Idaho.

Karen Hammar (23MHA) is interim director of clinical services at the Center for Disabilities and Development at University of Iowa Health Care in Iowa City, Iowa.

Lena Hann (08MPH) is an associate professor of public health at Augustana College and affiliated faculty in Scandinavian Studies and Women’s, Gender, and Sexuality Studies. She has been selected as a Fulbright Scholar for the 2024-2025 academic year.

Madeleine Hornick Danner (13MS) is a senior risk control consultant at Travelers in Portland, Oregon.

Nick Howald (15MHA) is CEO of TriStar Southern Hills Medical Center in Nashville, Tennessee, where he oversees operations at the 136-bed hospital and an 11-bed freestanding emergency room.

Maryn (Torner) Kanter (09MPH) is clinical faculty and current 2023-2024 fellow at UCSF Center for Health Equity in Surgery and Anesthesia in San Francisco, California.

Kimberly Kim (11MPH) is a prevention specialist at Bethany for Children and Families in Moline, Illinois.

Mike Lightbody (15MPH) is CEO of Creative Living, a nonprofit organization that provides adapted housing and support services for people with physical disabilities in Columbus, Ohio.

Ellen Maahs (13MPH) is an executive officer 3 at the Iowa Department of Health and Human Services in Des Moines, Iowa.

Abby Maples (09MPH) is a nurse clinician for Iowa River Landing Digestive Health Clinic at University of Iowa Health Care in Iowa City, Iowa.

Stacey Milunsky (08MHA) is a senior strategist at ChristianaCare in Philadelphia, Pennsylvania.

Samantha Reed (10MHA) is the director of business development and ancillary services at Medical Associates Clinic in Dubuque, Iowa.

Breana Rinker (22BS) is a health education coordinator at Wisconsin EMS Association in Milwaukee, Wisconsin.

Rebecca Ritter (15MS) is a senior data manager at University of North Carolina at Chapel Hill Global Women’s Health in Carrboro, North Carolina.

Roz Smith (16MPH, 16CER) is a senior res earch and evaluation specialist at the C o unty of Santa Clara Department of Public Health in San Francisco, California.

Elly Steffen (01MPH, 01MHA) is the executive director of Surgery Center Cedar Rapids in Cedar Rapids, Iowa.

Jenna Takes (15MPH) is the population health program manager at UnityPoint Health in Cedar Rapids, Iowa.

Emily (Houston) Tokheim (21MPH, 20BA) is a behavioral risk factor surveillance system coordinator at Iowa Department of Health and Human Services in Coralville, Iowa.

Emily Westfall (13MS) is the region manager - risk control at Liberty Mutual Insurance in Chicago, Illinois.

Sadie Wilson (21BA) is the drug-free communities coordinator at Focus on Community in Racine, Wisconsin.

IN MEMORY

Kenneth Courey (63MA) of Philadelphia, Pennsylvania, on November 24, 2023. Gerald Dokka (60MA) of Minneapolis, Minnesota, on November 10, 2023. L. Milton Holmgrain (61MA) of Litchfield, Illinois, on September 8, 2023. Richard Konzen (70PhD) of Bryan, Texas, on March 26, 2024. Stephen L. Ummel (65MA) of Savannah, Georgia, on March 22, 2024. James Warren (65MA) of Hayden, Idaho, on November 23, 2023. Hugh Witham (64MA) of Saint Clair Shores, Michigan, on February 25, 2024.

Addressing Period Poverty

Why did you choose to study public health?

I’m fascinated by the hard sciences and mechanisms of life, but I’m also passionate about social justice. Public health addresses the root causes of health inequities, and I get an interdisciplinary breadth of study while intertwining the aspects of life and health I wanted to make a difference in, not only the biological side of medicine, but the humanitarian side, too.

What motivated you to found an organization to help fight period poverty?

I founded Love For Red (www.loveforred.org), a registered 501(c)(3) nonprofit organization that works to fight period poverty in Iowa through service, advocacy, and awareness, in 2020 as a sophomore in high school. Growing up, women in my life recounted stories about their difficult experiences with menstruation from a lack of available period products, and in high school I learned of the struggles women in prisons go through due to not having these products. I found that this issue of inaccessibility was prevalent in the United States and specifically in our communities as well. I realized that there were not many organizations addressing this issue, so I decided to establish my own!

The reality is that the over-stigmatization and under-discussion of menstruation and period poverty is causing people with periods to suffer

Maanya Pandey, a public health undergraduate student from West Des Moines, Iowa, is highly engaged in the community and founded her own nonprofit organization. She recently discussed her interests in public health and women’s health.

in silence due to both monetary and physical inaccessibility of period products.

Love For Red’s work is about more than just access to hygiene products; it’s about dignity, equity, and empowerment. We take a multifaceted approach to address and tackle period poverty in which we donate period products to schools and organizations, advocate for systemic policy change at the state and local level, and bring awareness to period poverty and challenge the stigma.

What other activities are you involved in?

On campus, I direct the Love For Red Iowa City team, conduct research in the Obstetrics and Gynecology Clinical and Research Laboratories, and dance as a part of Iowa Andhi, the university’s South Asian Fusion Dance Team. Outside of campus, I am on the board of directors for the Family Planning Council of Iowa (an organization that works to provide Iowans with quality reproductive health care and family planning services through delegation of federal Title X funds), and I lead Love for Red’s work across Iowa.

What are your plans post-graduation?

My goals are to pursue medical school to contribute to women’s health and better health outcomes for underserved demographics and communities. I also plan to continue expanding Love For Red and integrating this work with my career ambitions.

PHOTO BY JOEY LOBODA

145 N. Riverside Dr.

100 College of Public Health Bldg., Room S257

Iowa City, Iowa 52242-2007

SPARK

This year, 23 new Herky statues have been placed across campus as part of the 2024 rendition of Herky on Parade. The statues, which were unveiled on May 1, include the “Colors of Courage” Herky placed near the College of Public Health Building and sponsored by the Holden Comprehensive Cancer Center. The parade concludes at the end of August.