School of Public Health

Overcoming Pandemic Fatigue to Promote Health Equity

As the holidays fast approach and 2020 continues to give us a run for our money, many people are feeling the effects of pandemic fatigue. Pandemic fatigue occurs when people grow tired of practicing measures meant to slow the spread of COVID-19, such as social distancing, wearing a mask, staying away from large gatherings, etc. The feelings of social isolation, frustration, lack of motivation, resignation, and general irritability are all signs that you may be experiencing pandemic fatigue.

Health Equity 1COVID-19 cases in the United States continue to surge as we seem to be at the beginning of a second wave, although it may seem that we never truly defeated the first wave. With the holiday spirit slowly creeping into our everyday conversations and thoughts, it’s important to consider the potential effects and develop strategies to remain safe and combat pandemic fatigue.

While Thanksgiving, Hanukkah, Kwanza and Christmas are typically holidays where families and friends gather to eat and fellowship with one another, the CDC recommends limiting your interactions and travel during this time.

Strategies to enjoy the holidays and fight pandemic fatigue, while also doing your part to slow the spread of COVID-19 include:

  1. Limit your gatherings with people outside of your household. Gatherings of 10 or fewer people are associated with a lower risk of transmission.
  2. Self-care. The holidays are times when we forget about taking care of ourselves, because we are focused on being a part of the holiday spirit. Make sure to stay up-to-date with all medications and doctor’s appointments, exercise regularly, don’t overeat, and make sure to get enough sleep.
  3. Be selective. When choosing to gather in groups, make wearing a mask mandatory for everyone, frequently disinfect commonly touched surfaces, advise those that don’t feel well to stay home, choose activities or locations that will make it easier to maintain social distancing precautions, and make sure everyone is regularly washing their hands. Gather outdoors and in shorter durations whenever possible.
  4. Be gracious. This year has been hard for a lot of people. It is ok not to be ok right now. Setting realistic expectations of yourself and others can help to combat the feelings of being overwhelmed. Take a moment to yourself, try deep breathing exercises, and don’t forget that your mental health plays a part in your physical health.
  5. Connect virtually. Stay in touch with friends and family virtually. Video conferencing platforms, such as Skype, FaceTime, and Zoom allow for people to stay connected from all over the world. In fact, Zoom is lifting the 45 minute limit on free Zoom calls on Thanksgiving.  Try creating a schedule to remain consistently in touch with those closest to you.

COVID-19 and Racial and Ethnic Minorities1

Throughout the pandemic, trends in COVID-19 infection, hospitalization, and death rates have shown disproportionate effects on racial and ethnic minority populations.

Health Equity 2Racial and ethnic minorities are at an increased risk of becoming ill and dying from the virus due to several social-ecological factors: healthcare access and utilization, occupation, housing, and educational, income, and wealth gaps.

  • Decreased healthcare access and utilization result from factors including lack of transportation, inability to take time off work or obtain childcare, communication and language barriers, distrust in the healthcare system, and cultural differences between patients and providers.
  • The essential workforce, consisting of healthcare workers, farming, grocery stores, and public transportation have a large proportion of minority workers. These essential positions place the workers at increased risk of contracting COVID-19 due to the public nature of the jobs; as well as the inability to take paid sick days, properly social distance, and work from home.
  • Households with a greater number of co-habitants or families that live in crowded dwellings increase the risk of COVID-19 transmission. In addition, the financial strain caused by COVID-19 has resulted in the loss of employment, which contributes to unstable housing and the increase of household size due to the sharing of housing and resources.
  • Lack of access to high-quality education creates a domino effect in terms of income and wealth gaps. Without access to adequate and complete education, it becomes challenging to obtain and maintain gainful employment. Job availability to those that fall in this category are typically in industries with increased risk of exposure to COVID-19 and does not allow for the time or monetary flexibility that would be needed if the employee does fall ill.

With increased demand being placed on essential workers as the holidays approach, particularly those in service industries, it is important to remain mindful of public health recommendations amidst the continuing pandemic. The ultimate goal is to keep everyone as safe as possible. It is on all of us to do our parts to help those that are at a disproportionate risk of COVID-19.

Stay motivated. Stay safe. Happy Holidays.

Author:
Ashley Lamar, MPH, CPH: Ms. Lamar is an HSC alumnus and received her MPH degree from the School of Public Health. She is a member of the SPH Equity, Diversity, and Inclusion committee and is employed by the JPS division of Injury and Violence Prevention.

Editor:
Emily Spence, PhD, Associate Dean for Community Engagement and Health Equity

Citation:

  1. Centers for Disease Control and Prevention (CDC). (July 24). Health Equity Considerations and Racial and Ethnic Minority Groups. Retrieved November 16, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

Image Credits:

Photo: Photo credit: Drazen Zigic, creator. Retrieved from www.hopkindsmedicine.org

Graph: Figure 1 image credit: KFF (2020) Racial disparities in COVID-19: Key findings from available data and analysis. Retrieved from https://www.kff.org/report-section/racial-disparities-in-covid-19-key-findings-from-available-data-and-analysis-issue-brief/ 

Click through image: Getty images

Georgie Institute of Technology, COVID-19 Risk Assessment Planning Tool

Health Equity
School of Public Health

MHA program earns seven-year CAHME re-accreditation

By Sally Crocker

PrintThe Master of Health Administration (MHA) program at the University of North Texas Health Science Center at Fort Worth (HSC) has achieved the highest, seven-year re-accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME).

The HSC School of Public Health has been recognized as providing the first and only CAHME-accredited MHA program based in North Texas since 2013, giving students a career advantage and assuring that the program has met rigorous review for quality standards that only certain schools achieve. CAHME has been recognized as the standard of excellence and the benchmark in healthcare management education for more than 50 years.

Arora
Dr. Arthur Mora

CAHME is a premier, global professional accrediting board that reviews programs educating healthcare administrators. CAHME is fully recognized by the Council on Higher Education Accrediting (CHEA). The CAHME review process is voluntary – universities that go the extra step to achieve accreditation are rigorously monitored for excellence and continuous quality improvement.

“Employers look for assurance that graduates’ learning and experience have prepared them well for the wide variety of management responsibilities they will encounter in their career,” said MHA Program Director Stephan Davis, DNP, MHSA, FACHE. “This designation distinguishes our program and aligns with our vision to be the trusted leader in providing healthcare management talent to North Texas and beyond that helps advance the health of communities.”

“We are very proud of our program, faculty and partners who are committed to providing a valuable learning experience at HSC, as we applaud the outstanding efforts of our students and alumni who are accomplishing great things in their careers,” he said.

Dr. Davis joined HSC as MHA Program Director in May 2020.

Dr. Stephan Davis
Dr. Stephan Davis

“So much of the credit for this CAHME accomplishment goes to the guidance of Arthur Mora, PhD, Chair of Health Behavior and Health Systems, for his work over the last year with the re-accreditation teams, SPH leadership, faculty and others who helped support the process,” Dr. Davis said. “Preparing for a rigorous review like this involves considerable time and effort.”

This year, the MHA program made strides in other important areas as well, formalizing a partnership with the National Association for Healthcare Quality (NAHQ) to become the first MHA program in the nation to fully integrate a curriculum pathway toward the Certified Professional in Healthcare Quality (CPHQ) credential.

A new Executives in Residence program is also being introduced, to connect students with high-profile, healthcare leadership authors, speakers, thought leaders and executives, to open up new perspectives and further enhance their learning experience.

The program also offers a part-time MHA Online option for working professionals interested in advancing their career options while continuing to work full-time in their field.

Visitus A
School of Public Health

HSC researcher, collaborators help homeless mothers and children find their road back

By Sally Crocker

Erika Thompson
Dr. Erika Thompson

Hundreds of thousands of families across the U.S. struggle with homelessness each year. Living on the streets, in cars, at shelters or temporarily bunking up with others poses many risks and challenges, greatly intensified this year by the COVID-19 pandemic.

Erika Thompson, PhD, Assistant Professor at the HSC School of Public Health and Maternal and Child Health MPH Program Director, is a partner with the Center for Transforming Lives (CTL), a local agency providing homeless services, early childhood development, childcare, economic stability programs and other resources to those in need. CTL has stepped up in 2020 to respond to the added burdens on mothers and children during the pandemic.

Dr. Thompson is an epidemiologist and community-based researcher, focused on finding public health solutions to the challenges faced by women and children. She recently spoke at a CTL Virtual Lecture Series event about her work, community collaborations and how COVID has made many of the challenges even more difficult for these families. Her presentation, on “Exploring the Journey for Homeless Women,” can be found on YouTube.

“COVID has had a profound effect on all the population, in terms of both mental and physical health and well-being,” Dr. Thompson said. “It’s a difficult time for everyone, while for mothers experiencing homelessness, the burdens are greatly intensified.”

“The negative stresses of homelessness impact both body and mind, often with long-lasting health consequences for the mother and child, even as children move into adolescence and adulthood. Some kids are more resilient and able to overcome certain stressors, but for many, the experience can impact mental and physical health throughout their lifetime,” she explained.

Pre-COVID, Dr. Thompson led research teams, funded in part by United Way of Tarrant County, to meet women where they were in their journey, spending time on the streets and in shelters to conduct personal interviews and learn where they needed help in navigating the healthcare system, securing housing and childcare services, connecting with workforce training and employment assistance, and accessing community resources for food, daily living supplies and other support.

“It takes a village to serve this population,” Dr. Thompson said. “The work of so many in the community – agencies, volunteers, donors, local advocacy efforts, the commitment to women’s and children’s health – is needed even more now during COVID-19.”

CTL reports that more than 7,000 children under age 6 will experience homelessness in Tarrant County this year, and national data show that the number homeless mothers in need of assistance has grown considerably during the pandemic. Job losses in a destabilized economy, potential for evictions, family struggles and other factors are severely challenging this already overburdened population.

“2.65 million women have left the U.S. workforce since February, with many facing difficult choices in how to find their way right now. The pressures are enormous,” Dr. Thompson said. “It’s hard to be solely responsible for the care and well-being of your children in an environment of upheaval where you yourself don’t feel safe, certain or secure.”

In many ways, Dr. Thompson said, systems and shelters are more apt to focus on the adult male, typically seen as most representative of the homeless population. Women and children tend to be overlooked in the traditional view of homeless individuals, although research reflects that up to 84% of families experiencing homelessness are those led by the mother.

Safety is a big issue for these women, as is the hardship of what Dr. Thompson calls “public parenting.”

“Some moms are living and parenting in their cars, in crowded motels or temporary-stay hotel rooms, in other people’s homes for a while, or in shelters with many other families,” she said. “Parenting under unstable living circumstances strips away privacy and adds even more pressure to all that the family has been through.”

Many women go through multiple living situations in their journey, sometimes transitioning 4-5 times in a year.

There is also a lot of fear among these moms – fear for safety, of being judged, of their kids being exposed to situations they shouldn’t be, of having their children taken away. For some of these women, the best choice seems to be living in their cars.

The experience is characterized by transitions and instability.

In collaboration with local agencies like CTL and others, researchers like Dr. Thompson work to find solutions for these families, from food, housing, transportation and cash assistance programs to child care services, technology and Wi-Fi connections for school-age children, health provider networks, social and mental health services, vocational programs and more.

“The full spectrum involves recognizing the complete family unit and the complexity of their needs. Many of these families are having to navigate each of these processes separately to just meet the basics of daily living,” Dr. Thompson said. “The more we learn about their journey and where they need the most help, the better we can serve them.”

Partnerships with different support organizations and an opportunity to work directly in the community are most important for a public health researcher helping to drive change, she said.

“There are so many mothers doing the very best they can to succeed in this community, to build lives that are independent, where they can fulfill their dreams,” noted Carol Klocek, CTL Executive Director and CEO.

“We’ve seen some amazing women come through this journey into education programs, living wage jobs, places to raise their families and rebuild their lives,” Klocek said. “Our collaboration with Dr. Thompson, the HSC School of Public Health and other dedicated community partners is truly making a difference for these families.”

Erika Thompson
School of Public Health

APHA 2020 conference news

By Sally Crocker

Apha LogoSPH students, faculty and staff were active in this year’s Annual Meeting and Expo of the American Public Health Association (APHA), with PhD student Anna Galvin (PhD in Public Health Sciences, Health Behavior Research) winning the Public Health Education and Health Promotion student award contest. Galvin was one of 15 students selected nationally for this honor and was invited to provide an oral presentation of her research on “Assessing Cervical Cancer Screening Adherence Using a Multidimensional Health Literacy Framework.”

Epidemiology PhD student Ashvita Garg received the Lyndon Haviland Student Assembly Annual Meeting Scholarship, presenting a poster for her research on “Predictors of Pap-HPV Co-Testing and Pap Testing Among Women in the United States: Results from the National Health Interview Survey.”

PhD candidate Jonathan Moore, Department of Biostatistics and Epidemiology, shared a poster presentation on “Racial Differences in Hepatitis C Virus Infection Among Baby Boomers Using the National Health and Nutrition Examination Survey (NHANES).”

HSC TESSA Program Manager Jessica Grace, LMSW, presented with a panel of Dallas-Fort Worth area speakers on the efforts of healthcare entities in screening for Intimate Partner Violence, in a conference session titled “Is technology the answer? Examining the successes and challenges of tablet based IPV screening in primary care settings.” Grace shared information about TESSA and the program’s screenings in primary care clinics. She was joined by speakers from JPS Health System, Parkland Health & Hospital System, UT Southwestern Medical Center Dallas and Texas Health Resources. TESSA (Technology Enhanced Screening and Supportive Assistance) is a program of the HSC School of Public Health that collaborates with local health providers, community resources, agencies and advocate services to help screen for, identify and address the needs of interpersonal violence victims. TESSA is designed to give a voice to victims of interpersonal violence and help these individuals feel physically and emotionally safe, noticed and listened to.

SPH Assistant Professor Stacey Griner, PhD, MPH, also presented at this year’s conference, sharing her research on self-sampling methods for sexually transmitted screening. Her presentation focused on the use of these innovative methods for women who are survivors of sexual assault.

The SPH’s collaborative efforts with community partners were also highlighted at the conference.

Assistant Professor and MPH Maternal and Child Health Program Director Erika Thompson, PhD, MPH, presented a poster on “Navigating the system for families experiencing homelessness,” as part of a collaborative effort with local partners Carol Klocek and Heather Lowe at the Center for Transforming Lives and HSC colleagues Anna Galvin, Danielle Rohr and Dr. Emily Spence.

Dr. Thompson also presented at a roundtable on “Validation of a child physical and sexual abuse prevention scale for a school-based prevention program,” which was a collaborative effort with partners Katharine Collier-Esser and Deborah Caddy at the Women’s Center of Tarrant County and HSC colleagues Ashvita Garg, alumna Sarah Matthes, Danielle Rohr and Dr. Emily Spence.

Apha Logo
School of Public Health

Dr. Stacey Griner appointed as APHA Section Councilor

By Sally Crocker

Dr Stacey Griner
Dr. Stacey Griner

HSC Assistant Professor Stacey Griner, PhD, MPH, has been appointed to serve a three-year term for the American Public Health Association (APHA) as Section Councilor in the Sexual and Reproductive Health (SRH) Section. Appointments are made through peer elections.

Since 1975, SRH, formerly known as the Population, Reproductive and Sexual Health Section, has worked to improve the health and well-being of women, men and children. The SRH Section strives to build bridges between local and global reproductive health issues, between research and public policy and advocacy, and across academic disciplines and professions. SRH seeks to ensure that sexual and reproductive health remain major domestic and international priorities.

Dr. Griner is involved in a number of North Texas community-based sexual and reproductive health collaborations, including serving as Treasurer for the Tarrant County Infant Health Network.

At HSC, she serves as Director of the MPH Public Health Leadership program and focuses her research and teaching on maternal and child health and human sexuality and reproductive health.

Dr. Griner recently led a School of Public Health team at HSC that received an Innovative Teaching Award from the Association of Teachers of Maternal and Child Health (ATMCH) for development of course materials addressing sexual and gender minority healthcare needs.

APHA Section Councilors make recommendations on the APHA Annual Meeting program, act on Section membership and policies, formulate rules of procedure for the Section, advise on the publication of papers and reports, advise the APHA Executive Board on issues, and assist in preparing annual work plans of the Section.

APHA’s mission is to improve the health of the public and achieve equity in health status, as a champion for the health of all people and all communities.

Dr Stacey Griner