School of Public Health

Why you should vote

By now we are all intimately familiar with the horrific events that have occurred in 2020. It has been a year full of multifaceted injustices ranging from the outrageously high COVID-19 death toll that has disproportionately affected communities of color, to the violence and deaths that have resulted from police brutality. There have been substantial attacks on the rights of the LGBTQ+ community as well as substantial attacks on the democracy of the United States itself. Given the human lives and the human rights that are at stake in this upcoming election, it is arguably more important now than ever before that we exercise our right to vote.

Vote As citizens of the United States, it is our job to be active participants in the democratic process through casting our ballots in elections. As such, it is absolutely vital to the health and to the wellbeing of our country that we all vote this fall, regardless of our excitement or lack thereof for a particular presidential candidate. Additionally, it is of the utmost importance that we make an informed decision when choosing candidates listed on our ballots. This means that we must all educate ourselves on both the political records and the platforms of each candidate on the ballot, regardless of the office they are running for. Although change can happen at a federal level, change often begins with officials elected for local offices, so make sure you are choosing candidates that stand for what you believe in.

In a time where there is much turmoil and unrest present in our country, it is imperative that we all remember change begins with us and with our votes. If you or somebody you love has been negatively affected by the COVID-19 pandemic, educate yourself on how candidates plan on handling the pandemic and choose the people you feel will make a difference in your community. If you have been devastated by the blatant acts of racism that are still plaguing us in 2020, it is your job to learn about the records and the platforms of each candidate so that you know who truly stands for justice and who does not. If you care deeply about any other issues that are influenced by policy makers, it is your responsibility to look up both the records and the platforms of each candidate to make sure that you are making an informed decision when you cast your ballot this fall. If there is not a candidate that you are excited to vote for, it is your job to educate yourself so that you can choose the candidates that will benefit the most vulnerable members of your community. If you are an undecided voter, factcheck your candidates through non-partisan resources to ensure you are making an informed decision.

In closing, if you are looking for justice, vote. If you are looking for a way out of this pandemic, vote. If you are looking for economic relief, vote. Urge your family and friends to vote. Find ways to become politically active in your community to help ensure your voice and the voices around you are heard. Use your voice to fight for justice for the most marginalized members of your community. And above all else, remember that change starts with you and with your vote, so please make a plan and make sure your voice gets heard.

Early voting in Texas lasts through October 30th and election day is November 3rd.


Kayla Tate, School of Public Health PhD student

Julian Rangel, MPH, School of Public Health Alumni

School of Public Health

HSC Regents Professor Dr. Scott Walters and colleagues share progress addressing nation’s opioid crisis in new scientific publication

By Sally Crocker

Scott WaltersA special issue of the peer-reviewed scientific journal Drug and Alcohol Dependence has been released, profiling the efforts of a National Institutes of Health (NIH) study to address the nation’s opioid crisis.

$350 million in funding has been committed to this program between 2019-2022 in what is notably the largest implementation science study ever conducted in the field of addiction.

Scott Walters, PhD, Regents Professor at the University of North Texas Health Science Center at Fort Worth (HSC), is Steering Committee Chair of this program – the HEALing Communities Study (Helping to End Addiction Long-term) – developed through a partnership of the National Institute on Drug Abuse (NIDA) and SAMHSA, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration.

The study will create a national model to address the opioid crisis by speeding solutions and reducing opioid deaths in 67 highly impacted communities across four states – Ohio, Kentucky, Massachusetts and New York – representing more than 10 million people.

Over the last year, research sites at the University of Kentucky, Boston Medical Center, Columbia University and Ohio State University have been testing the implementation of a set of evidence-based strategies, with Dr. Walters managing the project from a national perspective.

The just-published, special edition of Drug and Alcohol Dependence contains 10 research papers on the HEALing Communities’ work over the last year, including the NIH vision and study protocol, implementation methods and measurement. Dr. Walters is one of three guest editors for the issue, along with NIDA and SAMHSA scientific directors. The entire edition is provided as open access, subscription-free, to the public.

“This special issue is important scientifically because of the scope of the problem and breadth of the study,” Dr. Walters said. “In 2017, almost 48,000 Americans died from an opioid overdose. More people died from opioid overdose than from car accidents. The irony is that all of this is preventable. There are proven strategies to reduce opioid use disorder and overdose.”

“As staggering as these numbers are, they are likely underestimates,” Dr. Walters said. “The U.S. has more than 2 million people with an opioid use disorder. It’s hard to imagine the damage that does to families and communities.”

Small gains in reducing those numbers that were achieved prior to 2020 were washed away this year as the nation struggled with anxiety, stress and negative mental health consequences of the COVID-19 pandemic.

“The sharp increases in overdose in the last six months have greatly affected the course of the HEALing Communities study,” Dr. Walters noted. “As we work to solve one crisis in the middle of a second crisis, we are creating a model for future ‘twindemics’ in the new world that exists right now.”

“We already know what works to reduce overdose and opioid use disorder – notably medication to help with recovery, and naloxone to reverse overdoses and safer prescribing practices. This study tests the implementation of those evidence-based practices, and ways to help a community actually put them into practice,” he added.

Healing Comms Bus Ad
Transit ads are a part of HEALing Communities public service campaigns in some communities

Dr. Walters likens these efforts to a “one, two, three punch,” with community engagement, a menu of evidence-based practices and communications campaigns to reduce the stigma around seeking help and increase demand for services.

“We’ve been able to capitalize on some aspects of the pandemic, for instance building attendance at community coalition meetings by taking them online, and ‘fast tracking’ distribution of naloxone to people released early from jail,” Dr. Walters noted. “We accelerated certain efforts, along with our accompanying media campaigns, to respond to the challenges of the pandemic.”

The new Drug and Alcohol Dependence issue detailing the HEALing Communities’ work is consistent with the study’s goal to share information with other researchers.

“We want to conduct this project in a glass house, sharing methods as we are able, describing how communities are engaging, how our media campaigns drive demand, and showing better ways to measure outcomes,” Dr. Walters said.

“No state has been immune to the effects of the opioid epidemic. We all benefit from the work being done to offer new hope for individuals, families and communities impacted by this devastating public health crisis.”

Read more here about the HEALing Communities study in this special issue of Drug and Alcohol Dependence.


Examples of HEALing Communities public service campaigns across different states:

Healing Comms Sample Campaign Ny Healing Comms Sample Naloxone Campaign


Scott Walters
School of Public Health

Exploring the Journey for Homeless Mothers

Dr. Erika Thompson, SPH Assistant Professor and MPH Maternal and Child Health Program Director, will be the featured speaker at an October 20 online event – “Exploring the Journey for Homeless Mothers” – through the Center for Transforming Lives Lecture Series. This event is free and open to the public as part of the agency’s quarterly conversations with North Texas community leaders, researchers and advocates.

For more information and to register, please click anywhere in the image above.
School of Public Health

MHA Program Director Dr. Stephan Davis contributes to national diversity, equity and inclusion report

By Sally Crocker

Dr. Stephan DavisThe Josiah Macy Jr. Foundation, with contributions from the HSC School of Public Health, has released a set of recommendations for building a culture of fairness, respect and inclusion in health professions learning environments.

SPH Assistant Professor and MHA Program Director Stephan Davis, DNP, MHSA, FACHE, contributed to the Foundation’s report and development of four broad recommendations and specific action steps for addressing forms of harmful bias and eliminating discrimination, to make diversity, equity and inclusion top priorities in learning environments and in practice.

Dr. Davis is a recognized nursing leader, healthcare executive and educator who is active in a number of national organizations, including serving as Chair for the American College of Healthcare Executives (ACHE) LGBTQ Forum. He also serves as Co-Chair of the Equity, Diversity and Inclusion (EDI) Committee for the School of Public Health.

The Macy Foundation is dedicated solely to improving health professions education, based on the principle that these fields have at their core a strong social mission to serve the public’s needs and improve health.

“HSC is committed to promoting an understanding of diversity, equity and inclusion,” Dr. Davis said. “We are working together across campus and in partnership with other organizations to equip the public health and health professionals of tomorrow as they prepare to meet the needs of a dynamic global society.”

The Macy Foundation report and recommendations were initiated at the organization’s 2020 conference earlier this year, with input from more than 40 faculty, student and leadership representatives of medical and nursing schools and universities like HSC. Dr. Davis represented the HSC School of Public Health and MHA program. The report was revised and refined in recent months and formally released in September.

“Preparing future health and public health professionals for their important roles in society involves both curriculum and crucial conversations focusing on the ways that racism and other forms of bias can harm people’s health, influence decisions that perpetuate inequities and threaten lives,” Dr. Davis said.

“We have seen the devastating impacts of health inequity and social injustice unfold in tragic, unimaginable ways this year within Black communities, bringing national focus to the need for solutions. It’s time.”

Seeking to eliminate harmful bias and discrimination in the classroom and addressing ways that these issues manifest in professional and clinical environments, contributors to the Macy Foundation report developed four recommendations for the nation’s medical, nursing and health professions schools:

  • Build an institutional culture of fairness, respect and anti-racism by making diversity, equity and inclusion top priorities.
  • Develop, assess and improve systems to mitigate harmful biases and eliminate racism and all other forms of discrimination.
  • Integrate equity into health professions curricula, explicitly aiming to mitigate the harmful effects of bias, exclusion, discrimination, racism and all other forms of oppression.
  • Increase the numbers of health professions students, trainees, faculty and institutional administrators and leaders from historically marginalized and excluded populations.

Aligned with HSC’s campus-wide commitment to Diversity, Equity and Inclusion, the School of Public Health’s EDI committee is already working on initiatives corresponding to the Macy Foundation recommendations and action steps.

Read more about the Macy Foundation report here.

Dr. Stephan Davis
School of Public Health

Planning holiday get togethers during COVID-19

By Sally Crocker

Covid Holiday

Fall and winter holidays have a different feel during COVID-19 as families consider the safest ways to celebrate their usual traditions with friends, neighbors and loved ones.

It’s still possible to enjoy the season during the pandemic, says HSC’s Dr. Diana Cervantes, by approaching your plans and festivities in creative, new ways.

“Even though our world is different right now, people still want to maintain their traditions with those who are closest to them,” she said. “By practicing safe COVID guidelines and rethinking the possibilities, there’s no reason to have to miss the big events you enjoy celebrating each year.”

An Assistant Professor and Director of the HSC School of Public Health MPH Epidemiology Program, Dr. Cervantes is considered one of Tarrant County’s trusted experts on COVID-19 safety, offering the community a steady stream of information and advice these last several months based on public health guidance and science.

FallcovidHalloween is all about masks anyway, so why not create your own this year,” she suggests.

“Kids can have fun designing cloth or surgical masks in clever ways. It only requires a few craft supplies you can order online.”

Going big with your decorations both inside and out is also a good way to get in the “spirit,” she said, and the more elaborate your lights, sounds, effects and front-yard scenes, the better.

Socially distanced costume parades on bicycles can be a great way to shift the focus away from group gatherings on neighbors’ doorsteps. Individual, small bags or cups of candy set outside on a festive table, or in strategic places around the front lawn, are good ways of distributing treats during the pandemic.

“It’s just not the time for all those little hands to reach into the same candy bowl,” Dr. Cervantes said.

Zoom costume parties and virtual pumpkin-carving contests are other ideas she suggests this year.

Thanksgiving is another big holiday just around the corner, and many families are approaching this one in unique ways as well.

“The safest way to get together in person is outside, in small groups of no more than 10,” Dr. Cervantes said. “Even with the Zoom exhaustion many people seem to be feeling right now, virtual events are also good choices.”

Cervantes Diana
Dr. Diana Cervantes

“Maintaining holiday traditions as safely as possible has a positive impact on mental health and can provide some much-needed relief to the pandemic isolation of the last several months.”

Bringing everyone into the planning makes it more of a “together” event. Dr. Cervantes recommends having honest conversations about your personal comfort levels and “non-negotiables.”

“If something doesn’t feel safe to you, don’t be afraid to voice your concerns,” she said. “We all want to be sensitive to the health of others, especially older adults, those with underlying health conditions and people at higher risk. It’s always your choice to skip an event, or to set the guidelines if you’re the host.”

Outdoor parties should have backup weather plans in place, including alternate rain dates and ways to keep warm if temperatures get chilly.

Social distancing, with tables set six feet apart for guests from different households, is still the recommendation, and masks should be available and easily accessible if someone has to go inside or be within close distance of other guests, especially those at high risk like the elderly.

“I like to provide ‘pandemic preparedness party packs’ for each table, with hand sanitizers, disposable napkins, masks in case they forget theirs and other items they might need,” Dr. Cervantes suggests.

Plans can include disposable plates and cutlery, with plenty of outdoor trashcans in strategic places. To further minimize risk, guests should avoid sharing drinks and food. Brainstorm ways to keep smaller kids occupied and in their own space.

“Kids like to hug, and especially if they haven’t seen grandparents or other relatives in a while, it can be a challenge,” Dr. Cervantes said. “Consider table games, puzzles, crafts, contests, bingo, an outdoor movie or other interesting options.”

Bathrooms pose a lot of questions during COVID. The best way to set yours up, Dr. Cervantes recommends, is with paper towels and liquid soap. Remove cloth towels and place an extra trashcan outside the door, so guests can avoid touching doorknobs and handles by grabbing a spare paper towel on the way out. Designate only one bathroom for guests, and limit access to the rest of the house.

“You’ll want to clean all high-touch surfaces after the party, and smaller kids will likely need extra handwashing reminders as they come and go,” she said.

If your party absolutely must move indoors, be sure guests stay socially distanced and wear masks except when eating or drinking, and do all you can to increase ventilation, including opening windows.

“Limit exposure by limiting your time together,” Dr. Cervantes recommends. “It’s helpful to designate one person to be the ‘bad guy’ focused on the time and the rules. People lose their inhibitions the longer parties go, especially if drinking is involved. Someone to end the party in a gracious way, or even to remind people to spread out or wash their hands, really helps.”

Many families and friends have joined in small “social bubbles” this year, so they can feel safer getting together with others who are social distancing in the same ways they are.

“For holiday events, that might mean that everyone quarantines 14 days prior, only going out for quick essential errands, and that they are not running a temperature, haven’t recently traveled or been in large crowds, and are symptom free,” Dr. Cervantes said.

December holidays should follow these same recommendations. Virtual cookie baking nights and tree-trimming from different households, holiday trivia games via Zoom or charades online are all great for including friends and family both nearby and miles apart. Even this year’s New Year’s Eve countdown from Times Square, a longtime New York tradition watched by millions around the world, has gone virtual.

“The goal is for no one to get sick. On average, the spread of COVID is more than one-to-one; a single person can infect 2-3 others,” Dr. Cervantes said. “You don’t have to feel sick to expose someone.”

“This isn’t a forever thing, it’s our way of keeping our friends and loved ones especially safe right now. It’s about all of us working together and doing our best for the health of everyone.”

Covid Holiday
School of Public Health

HSC and National Association for Healthcare Quality partner to prepare MHA graduates to improve quality outcomes

Nahq HqMaster of Health Administration students will prepare to achieve Certified Professional in Healthcare Quality® certification during capstone course.

The HSC School of Public Health has collaborated with the National Association for Healthcare Quality (NAHQ) to provide its Master of Health Administration (MHA) students with the opportunity to pursue the only accredited certification in healthcare quality, the Certified Professional in Healthcare Quality® (CPHQ). Students will be provided with test preparation content and tools during the program capstone course, beginning in the Spring 2021 semester. Through this agreement, HSC has become the first MHA program in the nation to hardwire NAHQ’s content into its curriculum.

“Given our MHA program mission to produce graduates who will influence change and improve quality outcomes across the care continuum, HSC is thrilled to collaborate with NAHQ to now offer content rooted in a twice-validated, industry-standard Healthcare Quality Competency Framework,” said Dr. Stephan Davis, Assistant Professor and Director of the MHA program. “As the only Commission on the Accreditation of Healthcare Management Education (CAHME) program exclusively based in North Texas, we utilize a competency-based approach to educating our students and the NAHQ framework supports our model.”

Added Dr. Arthur Mora, SPH Associate Professor and Chair, Department of Health Behavior and Health Systems, “With a reputation for pushing the boundaries of discovery and innovation, HSC takes pride in becoming the first MHA program to align with the gold standard credential in healthcare quality, NAHQ’s CPHQ certification.”

As holders of the CPHQ credential themselves, Drs. Mora and Davis are among the more than 12,000 healthcare and quality professionals who have achieved the designation. They were both instrumental in facilitating this new partnership, according to Stephanie Mercado, CAE CPHQ, NAHQ’s CEO and Executive Director.

“I wholeheartedly commend Drs. Mora and Davis for creating a pathway for their students to graduate with not only a premier, CAHME-accredited graduate degree but with an industry-recognized credential,” Mercado said. “We see a growing imperative to focus on workforce readiness to delivery on quality, safety and value. NAHQ applauds HSC’s leadership and encourages other health administration academic programs to consider this alignment so we can continue the journey toward consistency in this critical area of healthcare management.”

Dr. Anthony Stanowski, president and CEO of CAHME, added, “HSC’s design of its curriculum provides high value to students who seek to make a difference in healthcare. By linking NAHQ’s certification credential to successful graduates of the CAHME-accredited HSC MHA program, students can present to potential employers that they graduated from an accredited program with the skills and CPHQ credential to improve healthcare quality and safety.”

“I’m excited for HSC’s current and future MHA students,” said Dr. Dan Gentry, president and CEO of the Association of University Programs in Health Administration (AUPHA). “When AUPHA advocated for, and CAHME acted on, moving from curriculum content areas to competencies at the turn of the century, these kinds of opportunities were exactly what we had in mind. Personally, I’ve always advised my own graduate students that getting specialized training, in areas such as quality improvement and Lean Six Sigma, project management and financial management, will set them apart and serve them and their future employers well.”


NAHQ is the leader in healthcare quality workforce competencies and creator of the twice-validated, industry-standard Healthcare Quality Competency Framework. NAHQ provides a strategic advantage to healthcare professionals and the organizations they serve by developing and evolving workforce competencies in healthcare quality that result in better patient and financial outcomes to support the goals of healthcare value.

Nahq Hq
School of Public Health

Each patient’s story illuminates Tarrant County COVID data, strengthens contact tracing

By Sally Crocker

Julia AikenHSC 2020 graduate Julia Aiken was finishing the last semester of her MPH in Public Health Practice when COVID-19 hit this spring. By May, she had wrapped up her degree and was helping out with Tarrant County Public Health’s (TCPH) contact tracing efforts, to track and help stop community spread of the virus.

Aiken volunteered extra hours above her temporary work schedule, eventually joining TCPH full time this summer as an Epidemiology Specialist managing a data intake team.

Every aspect of Aiken’s work begins with people.

When a person tests positive for COVID-19, the public health department is notified. Intake teams like Aiken’s receive case reports for database entry, beginning a process where even the smallest details of a patient’s history are studied for important clues.

As with any virus or infectious disease, it’s a lot like solving a puzzle, looking for pieces of information that fit together, to uncover a trail or series of circumstances leading from person to person.

“Sometimes the data we receive is basic – name, age, contact information, lab results – but with expanded records, we get a better glimpse of a patient’s history, where the person has been, how the virus may have been contracted, and others who could have been infected as well,” Aiken said.

“If the patient resides in a nursing home or other close-contact community setting, if someone else in the family has recently been ill, if the person has traveled, all those things give us more detail and show where we need to follow up to help keep others safe.”

Aiken and her team are focused on the people behind the numbers of COVID cases.

While data does represent numbers, facts, figures and correlations, on a deeper level, it also tells stories. Data provides important insight leading to discoveries and ways of solving problems. It has the potential to save lives.

“How we manage the database really matters, as our work begins a process that other case teams will move forward through the public health department,” she said. “Taking the time to read each case carefully, looking for even the smallest details that might be important, gives the follow-up teams a better perspective on where to go next.”

The work that begins with Aiken’s team leads to other investigators and contact tracing efforts, where TCPH workers call patients; reach out to other, potentially impacted individuals and groups; monitor, report and resolve each case. With the dramatic 2020 numbers of positive COVID cases and deaths, that has resulted in a tremendous effort for Tarrant County and other communities around the U.S.

“It has been an all-hands-on-deck response for TCPH and other public health departments,” Aiken said.

Cooperation among health departments has been important, especially in tracking cases to their appropriate home counties.

“In large, metropolitan areas like Dallas/Fort Worth, a person may reside in one city but get tested in another. The data teams work closely with other public health departments, as well as local clinics, hospitals and testing facilities, to route the patient records appropriately,” she said.

TCPH training reminds COVID worker teams to connect with patients first as people. The job, Aiken said, is one that’s approached with investigative curiosity, care and respect.

“Spending time with the records gives you a real feel for what patients are going through. You learn about their families, their likes and dislikes, their personal situations, who they really are.”

“Public health prevention has to have a foundation of good data, and good data comes from seeing people behind the numbers,” she said. “We do it because we care about the public, and we take the extra time to evaluate all the details that may be helpful to a case and the larger efforts.”

“I feel like that’s my duty right now.”

Julia Aiken
School of Public Health

Dr. Erica Spears named one of 15 national scholars to new, integrative well-being and inequality research training program

By Sally Crocker

Miwi Scholars And Directors


Health inequality and systemic racism have long threatened the lives of African Americans. The COVID-19 pandemic and increased awareness of police violence in 2020 have intensified nationwide action toward solutions and change for traditionally underserved populations.

For health disparities researchers like HSC Assistant Professor Erica Spears, PhD, who has dedicated her career to working on critical public health concerns facing African American communities, there is immeasurable value in collaborating with others, especially across professional disciplines related to social determinants of health.

This year, Dr. Spears was one of 15 scholars chosen for the highly competitive, inaugural cohort of the Michigan Integrative Well-Being and Inequality (MIWI) Training Program, hosted by the University of Michigan Center for Social Epidemiology and Population Health. The program is funded by the National Institutes of Health (NIH), Office of Behavioral and Social Science Research, and the National Center for Complementary and Integrative Health.

The program provides early-career scientists with an opportunity to expand their research skills and extend their network of mentors and collaborators. Cohort members also receive support and assistance with research projects focused on the relationship between mental and physical health.

The cohort recently opened with an intensive, online summer institute and will continue in a structured format through next spring. An important goal of the program is for participants to develop professional partnerships that continue after the first year, as they move on to lend their own expertise to the next, incoming group of promising researchers.

“To connect with other health disparities investigators right now, at such a crucial time – as existing systems continue to threaten the holistic health of African American communities and other historically marginalized groups – is an incredible opportunity,” Dr. Spears said. “It’s a challenging time to work in public health, but I’ve never felt that my work was more necessary than it is right now.”

Dr. Spears focuses on the complex relationship between race-based stressors, holistic health and health behaviors.

“Scholars often find themselves working in isolation,” she said. “As an African American woman who identifies with and belongs to many of the communities I study, this opportunity to collaborate with other health disparities researchers is important to me. It represents an opportunity to extend the reach of my voice and expertise to a larger academic landscape and extend my efforts to improve health outcomes for racial minorities.”

COVID-19 has been more deadly for people of color, revealing stark racial disparities across the U.S. and adding increased burden to communities already long overstressed before the pandemic. African Americans are nearly twice as likely to die from COVID-19 compared to others in the U.S. population. Increasing racial tensions of the last several months and growing reports of African American deaths from police violence across the country have pushed rates of depression and anxiety to unprecedented levels within Black communities.

“It’s a tremendously stressful time. There is a lot of pain, fear, disappointment and other raw emotion right now. It’s very difficult for me too,” Dr. Spears said. “For African Americans, it’s like we are going through two pandemics at once.”

The impact of a person’s mental health on their physical health shouldn’t be underestimated, she said, and the longer-term effects of what people are living through currently will be important down the road as well.

“The complexities contributing to some of the poor health outcomes observed in African American communities are getting more complicated every day,” Dr. Spears said. “How does witnessing a murder on social media or in the news, or experiencing other acts of violence against people you identify with, affect you in the long term?”

“These things are impacting health right now, even if we aren’t sure how. While the pathways may vary, we’ll never truly resolve health disparities without addressing the systemic issues tied to race and racism in this country.”

Health disparities research emerged about 40 years ago, yet African American and certain other marginalized populations have seen little change in health outcomes or quality of life.

“What’s not working? If we are doing things the right way, we should see improvement. But disparities have widened, conditions have worsened,” Dr. Spears said. “The solutions aren’t simple.”

“Health and societal inequalities, and the crisis intersection of COVID-19 and systemic racism, require work at every level of society and across disciplines, which connects to the premise of the MIWI program – health doesn’t happen in a vacuum.”

MIWI cohort participants come from diverse backgrounds and experiences, including researchers studying marginalized populations; physicians, nurses, pharmacists, dentists and allied health professionals; anthropologists, sociologists, social workers, psychologists, economists; and others who address the mental and physical impacts of health disparities.

“The work we do now to ensure that the needs of our most vulnerable communities are met will say a lot about the kind of country we want to be,” Dr. Spears said. “The relevance and consequences of this work take on a deeper meaning when it feels like the whole country is on fire and people are reaching out for healing and solutions.”

The MIWI cohort program and similar efforts around the country bring hope for improved health and societal outcomes among marginalized populations that most need attention, even more so now during the unprecedented challenges of current times.

Miwi Scholars And Directors
School of Public Health

HSC researcher explains why vapers may be at higher risk for COVID-19

By Sally Crocker


Vapers beware, as if the health threats of COVID-19 aren’t enough, there is new evidence linking vaping to a higher risk of getting coronavirus.

The risk has been shown to be 5-7 times higher, according to new scientific research, prompting lawmakers around the country to urge the FDA to temporarily clear the market of all e-cigarettes during the COVID pandemic.

This increased health threat is especially troubling for teens and young adults, considering that the CDC reports nearly one-third of all American high school students used e-cigarettes in 2019.

Why is COVID more dangerous for those who vape?

“There are a number of reasons why vaping leaves users more susceptible,” said HSC faculty researcher Dr. Tracey Barnett, Associate Dean for Academic Affairs at the HSC School of Public Health. Dr. Barnett focuses her work and community outreach on this important public health concern.

“Vaping has been shown to irritate the lungs, leaving users more vulnerable to illness, including flu, asthma and pneumonia. Inhaling e-cigarette products also requires deeper breathing and taking in more air,” Dr. Barnett said. “This is not the scenario you want during the COVID pandemic.”

“Young people are more apt to share e-cigarettes in close social settings, while hanging out, which doesn’t lend itself well to social distancing. Vaping also involves a lot of touching to the face and mouth, which could increase the possibility for infection. Overall, it’s a dangerous situation for spread of the virus.”

Vaping has been associated with lung inflammation, as has COVID-19. Both lead to irritation of the lungs’ protective lining.

“Both of those conditions together do a real number on the lungs, producing a double whammy effect,” Dr. Barnett said.

A recently published study in the Journal of Adolescent Health looked at more than 4,300 survey participants of ages 13-24 from all 50 states, who either had or had not used e-cigarettes in the previous month. The study took into account respondents’ self-reported compliance with shelter-in-place orders and the rates of COVID-19 in their states, as well as age, sex, race/ethnicity, body mass index and socioeconomic status. The researchers noted that sheltering in place may mean different things to different people, and that young adults responding to the survey may have considered sharing a smoke with friends in the backyard to be safe.

Overall, the research found that e-cigarette users were almost 5 times more likely to have had COVID-19 symptoms, testing and a positive diagnosis.

Dual users of both traditional and e-cigarettes were 6.8 times more likely to be diagnosed with COVID. Both smoking and vaping are known to damage the lungs and impact the immune system.

“This is a significant finding, in that adolescents and young adults are more apt to be dual users of both types of cigarettes,” Dr. Barnett said, “putting them at an even higher risk for COVID-19. It’s not a small risk, it’s an important one.”

“Young people who see vaping as the cool thing to do may not fully comprehend the health risks,” Dr. Barnett said. “They also might feel invincible because of their age, or ignore the public health warnings about COVID. Put these two factors together, and the combination presents a real recipe for concern.”

According to the Partnership to End Addiction, teens and young adults say they vape for a variety of reasons, including curiosity, peer pressure, appealing flavors and because they have seen others do it. Some also say they do it because they feel it is less harmful than other tobacco products and it’s also discreet.

It is now widely recognized that vaping is unhealthy and dangerous, with adverse health effects including coughing, wheezing, inflammation and potential severe lung injury. The lungs have to work harder, placing more stress on the body’s other organs.

Nearly all vapes contain nicotine, one of the most addictive substances, and in many cases as much as or more than in traditional cigarettes. Nicotine negatively impacts the cardiovascular system and respiratory/lung functioning.

Vape flavoring ingredients can also be harmful – many have been determined to contain cancer-causing and other toxic chemicals, heavy metals and tiny particles that go deep into the lungs, damaging lungs and cells and reducing the ability to fight off infections.

“A weakened immune system or damage to the lungs from vaping could produce a more serious case of COVID-19, with the body unable to keep up,” Dr. Barnett said.

This new research presents a wakeup call and a warning to young people, Dr. Barnett said, as well as parents and health providers, who can be instrumental in talking to kids about their health, especially during the pandemic.

“Far too many young people have suffered the effects of vaping, and now with the added threat of COVID-19 in communities across the country, it’s important to protect ourselves and stay as healthy as we can,” she said. “I hope this message resonates with young people and their families.”