By Sally Crocker

“Wear a mask. Wash your hands. Stay six feet apart from others in public. And stay home if you can.”

The Texas Governor’s Office issued an updated Executive Order on June 26, closing bars and certain other businesses and reducing indoor restaurant capacity to 50% around the state.

In light of these new recommendations for Texas and a growing number of other states seeing dramatic, recent increases in COVID-19 cases, how advisable is it to go through with July 4th cookout plans, gatherings with family members outside your immediate household, and other activities that make summertime so much fun?

Dr. Diana Cervantes

“The top three factors contributing to virus transmission have to do with how many people you are around, how close you are and for how long,” said Dr. Diana Cervantes, HSC Assistant Professor and Director, MPH Epidemiology Program. “Smaller periods of time around small groups of people are less risky.”

If you’re partying outside, with good air circulation, there is less concern, she noted, but the more time you spend around others, especially when alcohol is involved, the more people can lose inhibitions and neglect safe social distancing.

“It’s hard to rate any activity as high, medium or low risk, as it all depends on the situation,” the epidemiologist said.

In general, distancing outdoors in groups of 10 or less is better, and it’s important to not share food, drinks, utensils or cups.

That means no bowl of potato salad with a giant serving spoon; no snack platters of burgers, hot dogs or chips where everyone can dig in; no shared lemonade jugs or iced tea pitchers; or other similar setups.

Paper plates and plastic utensils are a really good option, although Dr. Cervantes said it’s okay to bring out your own too, as long as there’s no sharing and you wash them well afterward.

Disposable party cups are pretty much a staple of outdoor gatherings anyway, and they work well to keep germs from spreading, especially if everyone writes their name on the cup.

Should people bring their own food?

“COVID-19 has not been shown to be a foodborne virus, so that shouldn’t be an issue,” Dr. Cervantes said.

Is it risky for party guests to come inside for the bathroom?

“That shouldn’t be a problem, as long as you’re doing routine cleaning and washing your hands,” Dr. Cervantes said. “There is potential to pick up germs from surfaces, so good handwashing is very important.”

Many people have found that having a small safety network of specific people they come in contact with – others who are not taking unnecessary risks or going many places beyond quick trips to the store for essential items – can relieve stress and loneliness and help them feel more positive right now.

“It’s good for your own mental health to engage safely with the people who are close and important to you,” Dr. Cervantes said. “Just don’t mix groups, and be open in your conversations about others that your networks may be in contact with, including through their jobs, roommates and other conditions.”

“The higher risk is being around people you don’t know, or even large groups of people you do know, for prolonged periods of time.”

Much of the summer guidance for communities remains the same as over the last few months:

· If you must grocery shop in a store, go on a weekday when it’s less likely to be crowded; wear a mask; wash your hands before and after and again when you get home; and don’t linger, as every moment you’re there increases your potential risk.

· Try to not obsess too much – if someone just walks past you without a mask, that’s a very low risk, Dr. Cervantes said.

· Being closer than six feet to someone else in public for 15 minutes or more is high risk. “At a salon and in similar situations, the conditions can stack on top of each other the longer you’re there and the more you engage,” she said. “Evaluate what the business is doing to minimize risk and how transparent their precautions are.”

· How helpful are gloves? “Gloves can give you a false sense of security – they get just as dirty as your hands, and then what do you do with them afterward? They are not impenetrable – germs can still get in through micro tears in the material, so don’t completely rely on them. If you’re washing your hands well, including under the fingernails, they’re not really necessary,” she said.

· How safe are playgrounds, amusement parks and water parks? “Social distancing in these situations is hard, even if facilities are doing their best to reduce the risk, and you have no way of knowing all the people you’ll come in

contact with, or their levels of exposure. I would avoid these types of activities right now,” Dr. Cervantes said.

“We all remain susceptible to COVID-19, and it’s likely to stay with us for a while, even though it seems like a lifetime since it first became a global health crisis,” she said. “We’ve learned a lot but we are still learning, both about the immediate effects and the longer-term impacts the disease can have, including potential chronic health conditions later down the road.”

“For me right now, and for my family, if a situation involves too many people, being too close to each other for too much time, I’m out,” Dr. Cervantes said.

By Sally Crocker 

New HSC faculty member Charlotte Noble, PhD, MPH, and her family moved from Florida to Fort Worth in the early days of the COVID-19 pandemic, when little was yet known about the reach of the virus, its outcomes and how long it would last.

Months later, as states like Texas and others are seeing a serious resurgence of the virus, leading to heightened concerns for the public’s safety, many families and communities struggle with issues impacting health and basic daily living.

Dr. Charlotte Noble

Dr. Noble, an Assistant Professor for the HSC School of Public Health, has spent the last 14 years focusing her teaching, research interests and service on the impact of food insecurity and nutrition on the day-to-day experiences of living with infectious and chronic disease.

When she and her family arrived in Fort Worth in mid-March, they found businesses closing and grocery store shelves mostly bare. Schools like HSC were extending spring break and in discussions to move classes online.

Under normal circumstances, a two-day caravan across several states in three cars, with furniture and moving pods sent ahead, would be pretty stressful, but in the middle of a pandemic, it was quite intensified for the family.

“There was a lot of panic at that time – things were happening fast,” Dr. Noble said. “Gas stations along the way were still open, but there were questions about safe food options, using public restrooms and the possibility that state borders might close.”

When the family arrived, there was no bread or milk to be found, and meat cases were wiped out. Essential canned goods were sparse. People were already starting to avoid others in the grocery aisles, trying not to get too close.

“That first shopping trip was kind of scary, not at all like we had expected for arrival at our new home. Luckily, we were able to find some rice, beans, tortillas and a few other healthy options to get us by for a while,” Dr. Noble said.

Many people found themselves in this unfortunate position in March, scrambling for food and supplies like the Nobles and worried about what would come next.

With the recent summer surges of COVID-19 in a growing number of states, community food banks and other providers are working overtime to keep up with demand. Loss of jobs and the U.S. economic downturn have led many families to seek assistance.

From worker infections at processing plants, through delivery services and all along supply chains, the problems are compounded as many Americans find less food and fewer options while continuing to brace for the unknown duration of the virus.

College and graduate students, too, are among the growing number of people seeking resources, as university food pantries around the country, like HSC’s and so many others, continue collecting and distributing food donations and personal care products at record numbers.

Under the shadow of the pandemic, some of country’s biggest public health problems are revealing weak spots for low-income and marginalized populations that suffer from these types of stresses on an everyday basis. The new COVID-19 reality communities are facing is showing just how vulnerable our world is.

“Hunger and food insecurity have been critical issues for a long time, and they have now become COVID-19 concerns as well,” Dr. Noble said.

Dr. Noble studied anthropology as an undergraduate. During her graduate program, working on a dual MPH-Global Health Concentration and MA in Applied Anthropology, followed by her PhD, she began examining the health of vulnerable populations through a social determinants of health lens.

Her research on the relationship between food and housing security, mental health and HIV in the U.S. and abroad has looked at communities in Florida and taken her to places like Costa Rica, Haiti and the country of Lesotho in Southern Africa.

“Health disparities and social, political and economic circumstances are very much linked to food insecurity,” Dr. Noble said. “Physical, social and economic barriers all have an impact on individual health behaviors and how people are able to live.”

“There is a certain degree of knowledge that most people have, knowing what they need and what they need to do to stay healthy, but they may not always have access to those things because of the surrounding environment and conditions.”

COVID-19 is the perfect example that illustrates this point.

“There are so many issues that people may be going through right now – loss of jobs, risk of eviction, lack of transportation, being able to find healthy food close to where they live, having the personal protective equipment to go out for what they need and having a safe way to get there. For communities already suffering before the pandemic, these problems are intensified,” Dr. Noble said.

“Perhaps now more than ever before, these common threads are bringing people together across communities, as we all try to successfully navigate as best we can and help each other get through.”

“It’s an important time for strategizing on where things go from here, both through the remainder of the pandemic and beyond,” Dr. Noble said, “to focus on the bigger, longer-term issues that need all of our attention.”

By Sally Crocker 

What’s known is that 66% of oropharyngeal cancers are HPV-related. In mid June, the FDA approved the HPV vaccine, Gardasil 9, for the prevention of certain HPV-related head and neck cancers.

What’s still to be explored is why HPV vaccine rates remain low – despite strong public health recommendations in favor of this important protective measure – and how oral health providers can take the lead in encouraging their patients to immunize.

HSC School of Public Health Assistant Professor Stacey Griner, PhD, is seeking solutions to these issues by connecting with other health investigators and scientific mentors through a program of the National Institutes of Health (NIH) Training Institute for Dissemination and Implementation Research in Cancer (TIDIRC), supported by the National Cancer Institute.

She was selected earlier this year for this highly competitive, health investigator-training program and will move on to the next stage of her research when the 2020 TIDIRC session completes in August.

“Dental providers can be instrumental in recommending the HPV vaccine to their patients,” Dr. Griner said.

“Having been there myself earlier in my career, working as a Registered Dental Hygienist for many years, I see ways that dentists and their staff can be a good resource for patients who don’t know about, may have questions or may have hesitations about the HPV vaccine,” she said.

Dr. Griner worked as a Dental Hygienist for 10 years and always had an interest in teaching and doing more related to research and prevention.

At one point along the way, a dentist she worked with suggested that public health might be something she would want to look into.

She decided to pursue a Master of Public Health degree, then her PhD in Public Health, joining the HSC faculty in 2019.

“Dental hygienists focus on prevention, so it was a natural for me to move into public health,” Dr. Griner said. “Since many oral cancers are linked with HPV, it’s a unique opportunity to look at the information oral health providers can share with their patients to prevent these types of cancers, including recommending the HPV vaccine.”

While the American Dental Association, American Academy of Pediatric Dentistry and other related societies have recently released policies in support of the HPV vaccine for oral cancer prevention, questions remain as to how informed oral health providers are on this new guidance and whether they have implemented recommendations with their patients.

There is also work to be done, Dr. Griner said, on ways of best conveying the policies to dentists and dental hygienists.

“Right now, it’s not clear how many oral health providers are aware of the HPV vaccine policies from their professional organizations, or how they learned about them if they are aware,” she said. “This work will explore the ways these providers want to receive the information and how they want it framed, so they can incorporate the recommendations into their daily practice.”

The long-term goal for Dr. Griner, with SPH research colleague Dr. Erika Thompson, will be to assess providers’ current awareness, acceptability, adoption and practices related to HPV policies, to ultimately reduce the rates of HPV-related oral cancers among their patients.

By Sally Crocker 

Dr. Stephan Davis could never have predicted the tumultuous world events that would impact his new leadership role with the American College of Healthcare Executives (ACHE) LGBTQ Forum.

As the HSC Assistant Professor and School of Public Health MHA Program Director prepared for his incoming year in this important, national position, getting ready to serve as Chair from April 2020-March 2021, the world was reeling from the COVID-19 pandemic, special attention was being paid to health inequities dramatically threatening the lives of African Americans and other vulnerable populations, and the call to end racism and cultural divide was moving communities across neighborhoods and continents to take action.

This year’s LGBTQ Pride Month has never had more meaning.

“Pride Month has always been special for me as an adult,” Dr. Davis shared in a recent ACHE blog post. “Having grown up as part of a Midwestern Black family with traditional values, I was raised to believe that being gay was morally wrong, and I was required by my parents to attend conversion therapy in effort to alter my orientation.”

“It was only as an adult that I was able to begin to embrace all of who I am. For me, this is what National Pride Month is all about.”

Pride Month is a way of bringing people together each June to honor the work that has been done over the last several decades, and continues now, to raise awareness, advocate for and protect LGBTQ human rights.

With experience as a nursing leader, healthcare executive and educator, Dr. Davis said he has witnessed “tremendous change” since he began working in hospitals 15 years ago.

“We see organizations today making bold commitments to LGBTQ inclusion, and over the years we have seen increasing numbers of LGBTQ healthcare executives reaching the highest levels of leadership while being ‘out,’ as accrediting bodies and other healthcare organizations have strengthened their inclusion policies and efforts.”

The national Forum that Dr. Davis now leads has been a part of that change, established four years ago by ACHE in its continuing diversity and inclusion endeavors.

“The progress in healthcare that I’ve seen over my own years of experience has been inspiring, but we still have far to go,” Dr. Davis said.

“As a Black gay man, this Pride Month feels a bit different. In this moment, I believe it is clear that no group will advance and realize true equity without the partnership of others.”

Dr. Davis said he hopes that Pride Month 2020 will encourage dialogue focused on how people of all perspectives can be better allies, build broad coalitions and advocate for justice for all communities and individuals.

“For members of all historically marginalized and excluded groups to be safe from victimization, achieve health, realize their full potential and contribute to society, we must be allies with each other and work together to advance equity, inclusion and belonging for all people,” he said. “Our voices collectively can go farther and have more impact when we work together.”

By Sally Crocker

There was a big celebration in Kuwait when new HSC graduate Maurico Ripley’s diploma arrived with the daily mail.

Ripley is a Chief Warrant Officer 3 (CW3) who has been deployed to the Middle East for most of his graduate program, studying with the HSC School of Public Health online – and today, he proudly holds an MPH degree with a Graduate Certificate in Food Security.

He has a big job as Army Reserve Senior Food Safety Officer, managing teams that inspect all food products coming in to base stations from the U.S.

Since the military procures items like fresh milk, poultry, fruits, vegetables and more from local contacts within the Middle East, it is also CW3 Ripley’s job to audit food-manufacturing facilities and ensure that U.S. Forces food rules and regulations are met.

“I basically act as USDA/FDA Inspector in the Middle East,” he said.

At some point further down the road, he hopes this experience will lead him to a similar position at the federal level back home, possibly as a U.S. based FDA Consumer Safety Officer.

When CW3 Ripley is not on deployment status, he serves as a Health Inspector for the San Antonio Metropolitan Health District (SAMHD). He has been with SAMHD since 2007 and with the Army Reserves since 2001.

“So far, I have deployed quite a bit, spending time in Iraq, Kuwait and Afghanistan,” he said, so it was not a surprise to be finishing his last HSC class and preparing for graduation this year while once again serving his country overseas.

Ripley was deployed at about the time that COVID-19 began to spread throughout the world, arriving in Kuwait in mid-March, as military public health leaders were advising on appropriate measures for U.S. troops’ safety during the pandemic. He expects to return home to San Antonio sometime in December.

It was an exciting moment and a real feeling of accomplishment for the officer when his HSC degree arrived.

It was also time for a party, as friends from his unit hosted a cookout and shared their congratulations with a card and cake.

Adding the MPH to his other academic experience – bachelor’s degrees in Geography and Criminal Justice – has expanded his knowledge in public health, Ripley said, providing insight into the ways that public health policy, epidemiology, biostatistics, food safety and public health leadership can all inform his work.

“I had been looking for an affordable online MPH program when I found HSC,” he said. “HSC is recognized as having an excellent program in Texas.”

“Being able to complete this higher level of education has given me greater perspectives, opportunities to do more in my current work and career progression down the road, and has earned recognition from my peers for what the degree means. It’s been a really rewarding experience.”

By Sally Crocker

The world is having some important conversations right now.

The burden of COVID-19, especially on communities of color, has been heavy over the last several months. Health and social inequities, racism and basic human rights have taken center stage as problems that all citizens must address.

In recent weeks, one of the leading voices standing for change has been the American Nurses Association (ANA).

The month of May has typically served as a time to honor the many contributions of these healthcare professionals and to recognize the mother of modern nursing, Florence Nightingale.

Dr. Stephan Davis

200 years from her birth, nurses are today following in her bold and compassionate footsteps to stand united in advocating for a new, healthier, more just and inclusive future for all communities and within the profession.

Nurses from around the U.S. recently joined HSC faculty leaders and ANA President Ernest J. Grant, PhD, RN, FAAN, for a National Nurses Month webinar focused on leading change and advancing health during the current, unprecedented times.

HSC’s MHA Online and MPH Online faculty hosted the virtual educational event, opened by the University’s Vice Provost of Academic Innovation, Jessica Rangel, MSL, BSN.

Special guest Dr. Grant shared important national nursing perspectives and words of support for all the efforts of nurses, in both everyday situations and today’s new normal.

Dr. Kayla Fair

Stephan Davis, DNP, MHSA, FACHE, HSC School of Public Health Assistant Professor and MHA Program Director, who has taught seminars for nurse executives across the country, and Kayla Fair, DrPH, MPH, BSN, RN, HSC Assistant Professor of Public Health Education, served as lead facilitators for the event.

Drs. Davis and Fair addressed the importance of nursing leadership in this pivotal moment, along with the various educational and professional pathways available to help nurses prepare for new challenges.

Discussions focused on essential competencies for nursing leadership and public health; career planning and development; individual talents and strengths; advanced academic degrees; the importance of self-awareness; and developing personal mission, vision and values statements.

“Given the increasing complexity of the healthcare system, nurses are being called to lead, but that responsibility may not always come with the education and training needed to support their work,” Dr. Davis said. “One of the goals of this program was to give nurses information, examples and a view into different educational and professional pathways that can help them prepare.”

Supporting and advocating for enhanced ethnic and gender diversity in the workforce was also an important focus of the webinar.

“At this critical time in our nation, nurses have a responsibility to use our voices to call for change,” Dr. Grant said. “This pivotal moment calls for each of us to ask ourselves which side of history we want to be on and the legacy we will pass on to future generations.”

Being able to provide this online educational experience for nurses, Dr. Davis said, was a great way to connect with the profession, engage in meaningful, national dialogue and offer what is planned to be just the beginning of more HSC-sponsored healthcare leadership workshops.

“At a time when there are so many challenges in healthcare and our world,” Dr. Davis said, “investing in leadership development opportunities for members of the most trusted profession in America is very important to improving the health of the public.”

By Sally Crocker

When Bruce Crow, PsyD, MPH, retired after 30 years of active duty as a U.S. Army Colonel and military psychologist, he was still in the prime of his career and seeking answers to one of the biggest problems plaguing those in the uniformed services today – suicide.

According to the American Psychological Association, approximately 17 U.S. veterans die every day by suicide, and among active-duty troops, suicide rates are on the rise. Over the past decade, these growing numbers have raised public and professional concerns, with suicide now being the second-leading cause of death in the military.

“In many ways, suicide is not well understood,” Dr. Crow said. “As a clinical psychologist, I was trained to focus on the individual, but there is perspective to be gained by studying the problem from a broader, population health approach, especially as relates to clusters, communities and groups, like those developed among a military base, unit or team.”

Being able to complete an MPH degree online through the HSC School of Public Health provided Dr. Crow with the opportunity to study suicide risk factors and prevention through the population health lens.

A number of important factors can be associated with risk, including social or environmental stressors, relationships, workplace issues, injuries and health conditions, sleep disorders, post-traumatic stress disorder, substance use and others.

Dr. Crow enrolled in HSC’s MPH program while stationed in San Antonio, where he had served as Chief of Behavioral Medicine at Brooke Army Medical Center, completing the program in December 2019.

He now applies his public health training in a senior position with the Department of Veterans Affairs Suicide Prevention Program in Washington, D.C., as Associate Director, Program Evaluation.

Dr. Crow is being honored this year with one of the top School of Public Health graduation awards, for exemplary leadership and service to the school and community.

In an interesting twist, he is no relation to the man for whom the annual SPH award is named – Bob J. Crow, former Amon G. Carter Charitable Foundation Executive Director and member of the Steering Committee founding the SPH in Fort Worth more than 20 years ago – but the two do seem to demonstrate the same values and commitment in their work and contributions to community.

As a clinical psychologist, Dr. Crow’s work addressing uniformed services combat stress control, suicide prevention, life threatening behaviors, soldier shootings and post-incident behavioral health response began in the late 1990s.

For eight years, he served as Clinical Psychology Consultant to the U.S. Army Surgeon General in Washington, D.C., and spent four years as Director of the Warrior Resiliency Program for active duty Army personnel at the Fort Sam Houston military base.

Prior to his position with the VA, he served as Senior Fellow for the Military Suicide Research Consortium at the University of Washington in Seattle.

He is the recipient of numerous awards.

“Being able to complete my MPH demystified public health and showed how the broader components of this approach to the problem of suicide can offer insight to complement and expand what might be done for prevention on an individual basis,” Dr. Crow said.

“While there have been conflicting research findings, it does not appear that suicide is directly related to combat or deployment,” he said, “making it all the more crucial to get to the real issues behind the problem.”

As Dr. Crow and colleagues continue their critical work in this area, he said he is glad to have gained formal public health training and a view of population health that adds to his clinical psychology background.

“Being able to apply the public health perspective has confirmed for me that pursuing my MPH was a good decision; it has opened up new ways of tackling solutions,” he said.

By Sally Crocker

When Jialiang Liu was a little girl, she wanted to be just like her dad.

Her father is a pediatrician in China, and both parents have always encouraged their only child to go for her personal best, even if it meant spending years away from home to pursue graduate school in another country.

“I always dreamed of going into medical practice like my dad, but along the way I discovered public health and research science,” said the graduating HSC student who has spent seven years in Fort Worth, working first on an MPH and now the completion of her PhD in Biostatistics through the School of Public Health.

“Now we are both doctors, with the same goal in mind, just in different types of practice,” she said. “The role of a pediatrician and a public health scientist are complementary, in that they both focus on improving health, whether it be the health of individual patients or larger populations and communities.”

Commencement ceremonies are online this year, and while Liu’s parents won’t be traveling to Texas due to COVID-19 travel restrictions, the family will still be celebrating this proud moment – just remotely.

Liu is graduating with high honors as this year’s SPH Dean’s Award winner for scholarly excellence in research.

Among other things, she’s been recognized for her work as a graduate research assistant on a Texas Center for Health Disparities Pilot Project led by SPH Assistant Professor Dr. Menghua Tao, studying minority population nutritional and health status, as well as for her work as a biostatistics consultant for HSC’s Biostatistics and Epidemiology Consulting and Collaboration Services (BECCS).

She has also published two peer-reviewed articles in the scholarly journal Nutrients with Dr. Tao and other colleagues, analyzing essential dietary intake among minority women of childbearing age and magnesium intake among Hispanic adults.

In addition, she’s worked on projects impacting probationers, geriatric patients and vulnerable populations through the Tarrant County Community Supervision and Corrections Department, HSC’s m.chat health coaching technology program and the HSC Center for Geriatrics.

Liu first became interested in public health as an undergraduate in China, where she provided statistical support for epidemiologic research at a public health institute.

She found that she really liked biostatistics, deciding to pursue that field to improve lives through quantitative research.

She wanted to see more of life in other countries as part of her graduate studies, ultimately settling on Texas as an interesting place to be. When she found HSC, the journey began.

Liu hadn’t considered going for a PhD, but the encouragement she received from her SPH faculty advisor, Dr. Sumihiro Suzuki, early in her MPH program inspired her to take her talents one step further in making meaningful contributions to public health research.

“I never thought about one day working toward a PhD – it just wasn’t anything I ever considered,” she said.

She decided to go for it, and now her goal is to become a public health academic expert.

At this point, she is working on publishing her dissertation and presenting one of her dissertation topics at the upcoming Joint Statistical Meetings, one of the largest gatherings of statisticians held in North America.

Interacting online has pretty much become a way of life now for most people during the pandemic, and Liu said she’s ok with that, as long as it helps people stay safe and healthy.

“Family Zoom get-togethers, my dissertation defense, commencement, job interviews and professional activities are all different at this point,” she said.

“When the time is right, I plan to take a little break to just enjoy my personal life a bit, maybe take a trip, see more places and experience more of the world before launching into my next steps.”

By Sally Crocker

School of Public Health honors graduate Julia Aiken is researching a topic that far too few people know about, that the #MeToo movement also has special significance for male victims of sexual violence.

She hopes to get her work published, but for now, there’s more to do in a number of areas, including commencement, moving on with her career after graduation and continuing to assist with Tarrant County Public Health’s COVID-19 contact tracing efforts throughout the summer.

Aiken recently received this year’s Kenneth H. Cooper Award for Outstanding Research, as the graduating public health student best demonstrating excellence and quality in the application of research methods. The award is named for bestselling author and health/wellness guru Dr. Kenneth H. Cooper, founder of the Cooper Aerobics Center in Dallas.

In addition, she has been named to a prestigious group, the Delta Omega national public health honor society.

Aiken graduates this month with an MPH in Public Health Practice.

She has been interested in sexual health research since her undergraduate days at Oklahoma State University, leading her to public health.

“Around 2016, before #MeToo became a widely-publicized movement, I conducted social media research on sexual consent, rape and assault through OSU’s Sexual Health Research Lab, and later went on to become a peer-educator teaching safe sex practices at the University of Central Oklahoma,” Aiken said.

“I would get so mad about the injustices of gendered violence – immersing myself in research gave me a way of channeling those frustrations, to look at the problem from a clinical perspective with solutions to reduce that suffering.”

Aiken pointed out that, while it’s not talked about as much, a staggering number of men – about 1 in 6 – are sexually abused before the age of 18, creating lasting trauma that can impact their future health and the health of others.

“Research to prevent the violence and sexual assault of men is years behind that of women, so there’s some catching up we need to do,” Aiken said. “It wasn’t until actor and former NFL player Terry Crews publicly stepped forward in 2017 that men received a place in the #MeToo movement alongside women.”

With a focus on prevention, Aiken began working with SPH faculty member Dr. Stacey Griner last November, to analyze CDC data on the prevalence of sexual assault among males in the U.S. and the health outcomes associated with this type of violence. The two are now co-authoring a paper on the topic.

“Studies show that violence is a learned behavior, impacted by what individuals believe is normal and acceptable,” Aiken said. “It is a growing, global public health problem – each year, more than one million people lose their lives and many more suffer injuries from violence. It is preventable.”

Aiken’s goal is to use her data collection, coding and analysis to show that there are real people behind the numbers, real lives at stake.

She’s interested in other areas of public health prevention as well, and while celebrating commencement online isn’t how she expected to finish the semester, she sees many opportunities for the field of public health as the result of COVID-19 and other serious problems our world faces.

The ideal next step for Aiken would be a position combining her interests in both data collection/analysis and community service, like some of the projects she’s taken on for the Women’s Center of Tarrant County and, most recently during the pandemic, for Tarrant County Public Health.

“Most people don’t think or hear much about public health until times of crisis, such as with COVID-19, or even more so for preventing sexual violence,” Aiken said. “That’s when the work of our public health system and the many scientists behind the scenes comes to the forefront … that’s why I chose the field and am so excited to launch this next stage of my career.”

By Sally Crocker

Even though states and cities are now reopening, the threat of COVID-19 still looms large for especially vulnerable groups across the U.S. that have been hardest hit during the pandemic.

African Americans represent 13% of the country’s population, according to U.S. Census data, yet these communities account for more than half of all COVID-19 cases and almost 60% of related deaths so far.

Dr. Erica C. Spears

“The pandemic has underscored the dire consequences of the health disparities that persist in African American communities,” said Erica C. Spears, PhD, MA, a health disparities researcher and HSC Assistant Professor of Health Behavior and Health Systems.

“During this crisis, there’s a spotlight on some of the ways structural inequalities negatively impact health. You can’t have a healthy community if part of it is marginalized. It’s a time to consider the bigger picture and recognize that we are all part of the same community.”

There are many factors that impact health, including education; employment; income/financial security; housing, safety and other social and environmental issues; lifestyle behaviors; family genetics; and access to healthcare.

Data shows that as a group, the African American or Black population experiences significant disparities related to chronic conditions, access to care, preventive screenings and mental health.

Dr. Spears grew up in New Orleans, a city that is roughly 60% African American and was at one point considered a COVID-19 hotspot. A number of chronic health conditions plague the city’s residents at disproportionate rates, conditions that are also listed as underlying factors in many of the COVID-19 deaths the city has suffered.

“As with so many communities around the U.S., there are food deserts where people don’t have access to grocery stores, fresh foods or healthy options,” she said. “If you have diabetes, which is very much related to what you eat, but there are limited healthy food options in your area, how can you improve your condition? … When you don’t feel safe walking in your neighborhood, how does that affect how you exercise?”

With COVID-19, sources like the CDC say, disparities like these go a long way in making African Americans more vulnerable to serious health implications, even death.

“It’s not that more African Americans have become infected with the virus, it’s that the underlying health conditions – like diabetes, asthma, hypertension, obesity and others – where the African American community is already disproportionately represented make the consequences of contracting COVID-19 potentially more severe,” Dr. Spears said.

Health disparities, she noted, are complicated and go back through generations of stress, unequal opportunities and options, and other socioeconomic factors that manifest in worsened health outcomes.

“Our immune system is a function of the communities we grew up in and where and how we live now, the environments we are a part of every day. Genetics and our early-life exposures have a profound impact on health, as do the stressors in your life, such as whether you have access to good food, transportation, child care, a safe place to live, financial security, healthcare or even the ability to take time off work when you’re sick,” Dr. Spears said. “It all adds up.”

Most of us in the U.S. have never been through something like COVID-19, so it’s challenging for everyone right now, she said, especially as communities continue testing the waters for a safe return to everyday life.

“For all of us, maybe it will be a time of reflection, to ask ourselves, what parts of public health’s greatest challenges can I do something about,” Dr. Spears said, “to help promote a healthier place in my own community, in the country and in the world.”

“It might be working on research and advocacy, supporting your community in some other way, or perhaps just being a little nicer to the cashier at your local store or the person who delivers your packages. Amid the many crises created by COVID-19, we also have an opportunity to learn and grow as a society … we have a chance to show how we care for each other through our actions, and to hopefully grow stronger as a collective.”