Master 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.

By Sally Crocker

HSC 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.”

By Sally Crocker

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.

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.”

By Sally Crocker

The last two years had brought small but significant victories to the nation’s opioid crisis, with slow, steady declines in opioid use and deaths marking a positive change to this major public health problem.

That was until the COVID-19 pandemic hit, bringing months of an uncertain and unsettling new normal to people around the world.

As the pandemic continues to stretch on with no clear end in sight, the U.S. rates of anxiety, depression and drug use are all on the upswing.

“Tighter drug monitoring, recovery programs and medical treatments were all making a difference,” said HSC Regents Professor Scott Walters, PhD, who serves as Steering Committee Chair for the HEALing Communities Study, an aggressive, National Institutes of Health (NIH) trans-agency effort to speed scientific solutions to the national opioid public health crisis.

Other factors had also been helping.

Many states began to make naloxone, a rapid-acting overdose antidote, accessible to the public through pharmacies or by mail without the need for a prescription. Some states also began distributing this lifesaving medication to people at risk for overdose, such as those being discharged from jail or prison.

“These changes have greatly helped people who are trying to quit, or to stay clean, achieve more successful outcomes,” Dr. Walters said.

But now, there is worry that these gains are being lost due to the anxieties, stresses and negative mental health consequences of COVID-19.

In an August 2020 report, the CDC estimated that as many as 40% of U.S. adults have struggled with mental health or substance use during the pandemic. The study, which looked at a one-week sample period in June, found that 31% of participants had suffered with anxiety and symptoms of depression; 26% had trauma or stress-related symptoms; 11% had seriously considered suicide; and 13% had started or increased substance use.

“The pandemic has really complicated our efforts to address these problems,” Dr. Walters said.

In July, the New York Times reported that drug deaths for 2020 had risen an average of 13% over last year, with warnings that, “If this trend continues for the rest of the year, it will be the sharpest increase in annual drug deaths since 2016, when a class of synthetic opioids known as fentanyls first made significant inroads in the country’s illicit drug supply.”

“Supply and demand in the illicit drug industry was impacted early on by COVID-19,” Dr. Walters said. “Some states initially experienced decreases in drug use because supply chains were pinched – chemicals were harder to get, shipping was slowed, and people couldn’t produce or deliver the product – in this case, illegal drugs.”

“But then it came back with a vengeance. Homegrown, locally-manufactured drug supply took over.”

With drugs like fentanyl, where even the slightest changes in chemical compounds or dosing can mean the difference between intoxication and death, the results can be tragic.

Users who are unable to get illicit drugs because of supply chain slowdown, Dr. Walters noted, will also have lower tolerance when reintroduced to drugs, which could put them at serious risk for overdose, even if they are using their usual amount.

Treatment services and recovery groups have also suffered disruptions during pandemic closings and social distancing, leaving users in a perilous place for support.

“Most of these services are online now,” Dr. Walters said. “It’s more challenging to connect with a provider, especially for treatment programs requiring an initial in-person assessment or follow up, as with methadone programs. Many of the usual safety networks are operating differently now.”

“Other likely contributors to the increase are people having more time on their hands without much to do, social isolation, substances being used to cope with the anxieties of COVID life, employment concerns, loneliness, fear, personal or family issues,” he added.

With Texas overdose rates mirroring other states around the U.S., at about 18% higher for the first six months of 2020 compared to 2019, the big question is, where do we go from here?

“Federal guidance waiving in-person requirements for drug disorder visits will continue to be important, as will the programs that have already started to support at-risk populations,” Dr. Walters said.

“Most people who start using opiates get them from someone’s medicine cabinet, so securing prescription medicines at home, using socially-distanced drop off programs in your community to get rid of old medications, or even flushing medicines on the FDA’s approved list might make the difference in saving a life,” he said.

When community take-back options are not available or impacted by a crisis like COVID-19, the U.S. Food and Drug Administration offers a listing of specific drugs that may be flushed, including fentanyl and oxycodone.

Community programs like HSC’s new partnership with Deterra pouches by Verde are also helping to distribute tools that destroy drugs when warm water is added to bags containing deactivating pods.

“Responding to this public health threat is even more critical right now,” Dr. Walters emphasized, “as communities struggle with the realities of COVID-19’s impact on mental stress and substance use. The actions we take now will affect today’s outlook as well as tomorrow’s.”

Sally Crocker, Communications Manager for the HSC School of Public Health, has been recognized with the Grand Prize: Nonprofit Communications Professional of the Year Award in PR Daily’s 2020 Nonprofit PR Awards, for her work this year during the COVID-19 pandemic.

“Sally Crocker was among the many faculty and staff at the University of North Texas Health Science Center who began working from home on March 13, 2020, as the coronavirus began its devastating path across the U.S.,” Ragan Communications reported. “Sally set out to reinforce key messages (including the fact that science is important).”

To achieve those goals, Ragan said, she researched COVID-related topics and developed a list of articles and website content ideas that could provide helpful information to the public.

“She conducted countless interviews and assembled visuals to accompany articles and help promote them on social channels, resulting in ongoing press pitch opportunities and news coverage for the University,” the judges noted.

Between March 18 and April 24, Crocker produced and published 10 School of Public Health articles on the pandemic, two Dean’s e-newsletters, and shared content with HSC News Team colleagues and community partners for extended communications outreach.

Article topics were intended to help the public understand the pandemic, offer expert advice from faculty researchers on staying safe and emotionally well in a challenging time, reflect on history and science, address important public health concerns and perspectives, separate COVID facts from fiction and share real stories involving HSC’s commitment to the community.

“We congratulate Sally on her remarkable achievements,” wrote Brendan Gannon, Marketing Manager of Awards Programs for Ragan Communications and PR Daily. “Well-deserved recognition!”

By Sally Crocker

Behind the numbers of COVID-19 are real people. Real stories. Real experiences.

In her final term as an HSC School of Public Health student, Sujita Adhikari joined Tarrant County Public Health’s (TCPH) contact tracing team, calling quarantined, COVID-positive patients to track their connections to other community members who may also have been exposed to the virus.

This major community health effort was quickly set up in March as the pandemic spread across U.S. cities and states.

Adhikari was one of the HSC students involved in the COVID response collaboration between the University and the public health department.

“Our HSC students were ready to step up and respond to the call when needed,” said Dr. Dennis Thombs, SPH Dean. “They were able to put their public health training to work in a very real way, serving the community at a time of crisis. For many of these students who joined the effort, the work still continues.”

Adhikari said that even with a full schedule finishing up for graduation – toward her MPH in Maternal and Child Health, leading to a Program Manager position with HSC’s INCEDO office of continuing education – it was “really important to get involved” in the community’s COVID contract tracing efforts.

During April and May, she called approximately 60 COVID-positive patients, both asking and answering questions, listening to their experiences, sometimes working with a translator to gather needed details.

She rejoiced with those who were recovering and feeling very thankful.

She offered support and resources to those who felt concerned and afraid.

And she was there for patients who were lonely, sad, not doing so well – and for those who were missing their families, those who had no families, individuals out of work, and the people who were unsure if they would have a home to go to when they left the hospital.

“Some days were emotionally exhausting,” Adhikari said. “Our supervisors encouraged us to take breaks in between calls to clear our minds and just breathe, maybe go outside for a few minutes to process it all and put our work into perspective.”

“I talked to people who trusted me so much. I couldn’t stop thinking about those conversations at the end of the day.”

Others didn’t want to talk or disclose their personal health information. Some couldn’t recall their experiences, how they might have contracted the virus, or others they may have come in contact with.

“It was very challenging to create a connection within a few short minutes. You have to develop a rapport right away. Some people were open to that, while others were more guarded, or even angry about the overall circumstances of the pandemic,” Adhikari said.

Contact tracers also risked calling people who were resting and didn’t want to be disturbed, or those who were having a really bad day.

Contact tracing isn’t an easy process. It takes time, and investigators like Adhikari are only the first step that leads to other team efforts like reporting and monitoring, infection control and those who follow up with close contacts of infected patients.

Investigators like Adhikari asked questions about where people worked, if they had traveled recently, large gatherings they might have attended, people they may have come in contact with, their signs and symptoms, risk factors and underlying conditions, and if they suspected where they might have been exposed to COVID.

They gave advice on protocols, whether retesting would be required, when quarantine could end and when patients could feel safe being around others. If someone needed a thermometer, it was arranged.

“People had so many questions and weren’t sure where to reach out,” Adhikari said. “We were all learning and navigating the situation as we lived through it.”

Working as a contact tracer has its own personal challenges too. The nature of the job calls for employees to be at the public health department. Social distancing was well enforced, with computers stationed six feet apart and masks required.  Temperatures were taken daily, and student shifts were designed to accommodate classes, job interviews for positions after graduation, and other obligations.

For Adhikari, the opportunity to serve the community at such an important time was “a privilege.”

She moved to the U.S. from Nepal after completing her pharmacy degree and working in the field. She was led to HSC because of her interest in maternal and child health and her desire to work closely with the community and impact public health on a broad scale.

“Being able to help North Texas during the COVID-19 pandemic was an important experience for me. I feel as though I was really able to help others and be a part of finding solutions,” she said.

“It felt really good to feel trusted by so many patients who are relying on us during this very challenging time.”

By Sally Crocker

Dr. Thad Miller

The world’s attention has been laser focused on COVID-19 for months, but the current pandemic isn’t an isolated problem threatening the health of communities, points out one HSC public health researcher.

“Many other infectious diseases, like tuberculosis, share similar characteristics and present dire health risks, require equal consideration of resources and prevention, and may, in fact, offer insight into models for controlling contagion and saving lives from COVID-19,” said Dr. Thaddeus Miller, HSC Associate Professor and co-author of a recent editorial for The Union, a scientific-based lung health organization, prior to publication in the International Journal of Tuberculosis and Lung Disease.

TB has long been a public health focus area for Dr. Miller, who leads one of the CDC’s 10 select U.S. research sites, based at HSC.

“There are epidemiologic overlaps between COVID-19 and TB,” Dr. Miller said. “Both are passed through close contact, both impact the respiratory system, and both diseases are more serious for already at-risk individuals and populations.”

“Anybody’s health is everybody’s health in a pandemic, and to deny that is to risk the health of everyone,” he said.

Immigrant populations, especially from countries at higher risk for TB, have long been a focus in the U.S. for testing, treatment and prevention, and may be more vulnerable to COVID-19 as well.

Language barriers, economic challenges and healthcare access can be contributing factors for risk, as well as fear of seeking resources among undocumented populations, employment or living conditions where close contact is more common and less opportunity to quarantine without serious financial hardship.

“The community spread of COVID-19 into the existing U.S. immigrant population mix of poor healthcare access, higher poverty rates and political disenfranchisement creates a perfect storm,” wrote Dr. Miller and colleagues from Drexel University and the University of Utah, “threatening an epidemiological disaster about which there appears to have been little to no discussion by policymakers.”

In these populations, the demographic risks for COVID-19 run almost in lock step with the risks for TB, Dr. Miller said.

“Ignoring the parallels between these two infectious diseases would be somewhat like a neighbor who sees fire ants next door but doesn’t consider the other family’s problem as his problem too.”

According to Pew Research Center, the United States has more immigrants than any other country in the world, with more than 40 million people living in the U.S. who were born in another country. Pew reports that most immigrants, about 77%, are living in the U.S. legally, with about 23% unauthorized.

“Failing to consider the impact of COVID-19 on those who don’t live here legally can increase the risk for everyone. The goal should be for all those living in the U.S. to be inside our safety net,” Dr. Miller said.

The authors are also concerned that with COVID-19 requiring so many resources, important TB efforts may suffer, as well as other public health needs with far-reaching global impacts.

TB killed 1.5 million people worldwide in 2018 and infected millions more, and even with COVID’s astounding climb, TB is still expected to account for a higher number of deaths globally in the years to come.

“As we continue fighting the flames of COVID-19 ahead of us, it’s important to not turn our backs on the other fires still smoldering behind us,” Dr. Miller said. “They’re not going away, they won’t wait on us to start paying attention again before flaring up.”

World economies also rely in large part on U.S. immigrant populations, who often help support families in other countries.

“The health of U.S. immigrant populations has far-reaching impacts at home and on the global community, both in terms of the resources they need to stay healthy and productive here, and the meaningful ways they contribute funds and goods back to their extended families and economies around the world,” Dr. Miller said.

“The consequences of poor health have a great affect on all of society.”

“Problems like COVID-19, TB and other public health concerns show how much larger the world’s health is than where a person comes from, how much money they make or the resources they have,” he said. “Reducing the risk for one population reduces the risk for all of us.”

By Sally Crocker

Layer upon layer, a music video is developed, as is a heartfelt message of utmost respect and gratitude.

Such was the case when the HSC School of Public Health planned a special tribute to the healthcare industry, recognizing the many challenges that hospitals, providers, staff and support workers have faced over the long months since the COVID-19 pandemic first barreled into states and communities across the U.S.

“Now, with COVID-19 resurging to unprecedented highs over the summer, it is an even more important time to thank the nation’s healthcare leaders and providers who are working in difficult and dangerous situations to fight the pandemic and help stop the spread of this highly infectious disease,” said Dr. Stephan Davis, Director of HSC’s Master of Health Administration program.

Working with staff from the Association of University Programs in Health Administration (AUPHA), Dr. Davis and Dr. Arthur Mora, Chair of the HSC Department of Health Behavior and Health Systems, pulled off a surprise opening to this year’s AUPHA annual conference, which was moved to a virtually-attended and recorded event this year.

The AUPHA network includes colleges, universities, faculty, individuals and organizations dedicated to the improvement of health and healthcare delivery in healthcare management and policy education.

Making a music video isn’t an easy process, or a quick one, but as this year’s AUPHA Conference Tribute Sponsor, HSC wanted to do something very special to show how much healthcare professionals are valued in these challenging times.

“The HSC School of Public Health is lucky to have a very talented musician on our faculty, and Dr. Davis was more than willing to select and arrange a well-known song we could make our own for this event,” Dr. Mora said.

A longtime composer and saxophone performer, Dr. Davis found just the right musical material, creating his own version of “Hero,” originally made famous by Mariah Carey.

After finding a high-quality background track, securing copyright approval and scheduling time at a local recording studio, he consulted with a videographer he had worked with before.

With in-studio social-distancing protocols in place, Dr. Davis played saxophone over the background to create the first musical layer. Additional layers of embellishment were then recorded over the song’s final chorus, to build on the melody and create the sound of multiple saxophones playing together.

The audio file was mixed and emailed to Dr. Davis, allowing him to develop the third layer – the video portion – from his own living room at home.

“Even though we weren’t recording for sound at that point, I upped my speakers and played along with the studio mix so the visuals could be realistically captured, as though actually playing live in that moment,” he said.

This method of visually “playing along” enabled Dr. Davis to shed the neck strap, headphones and microphone typically needed for audio production.

Overall, the video was produced in record time – less than two weeks from top-secret idea to finished product.

“We wanted to create a storyline highlighting the roles and sometimes competing priorities of various frontline healthcare workers, so in the finished video, you see different characters, including a wife, mother and professional as she goes through different aspects of her day, caring for others both on the job and at home,” Dr. Davis said.

The story unfolds through cinematic background footage, with the musician’s face as the only live performer recorded.

Dr. Daniel Gentry, AUPHA President and CEO, said the video both moved the organization’s members and took them by total surprise.

“I can’t think of a better way of opening our virtual meeting than with HSC’s tribute to healthcare heroes everywhere,” he said. “We thank HSC, Dr. Mora and the entire team, and especially Dr. Davis, for this tribute and sponsorship of our Annual Meeting.”

The amount of work that goes into an endeavor like this, Dr. Davis noted, “is far exceeded by the emotions and deep gratitude so many Americans are feeling right now for our nation’s healthcare workers.”

“I haven’t felt this moved and inspired in a very long time,” he said.

View the video: Healthcare Heroes

By Sally Crocker

There’s a lot of drinking going on during COVID-19.

Dr. Dana Litt

Takeout, home deliveries and curbside pickup of beer, wine, liquors and other alcoholic products have increased significantly – from 40-50%, according to different sources – over the months since the U.S. first locked down over coronavirus concerns.

“There is a tremendous amount of psychological stress associated with the pandemic, and a lot of people are really suffering,” said Dr. Dana Litt, a faculty researcher with the HSC School of Public Health who studies drinking patterns and develops alcohol preventions and interventions.

“People are drinking more than normal, and what’s concerning is that we’re not likely to see those numbers go down anytime soon, since COVID-19 will probably be with us for a long while,” she said.

Dr. Litt joined social psychology researcher Dr. Lindsey Rodriguez from the University of South Florida-St. Petersburg and Dr. Sherry Stewart, Canada Research Chair in Addictions and Mental Health at Dalhousie University’s Faculty of Medicine, to examine the ways that COVID-19 psychological stresses are impacting drinking behavior among men and women ages 18 and older.

The results of their study – surveying 754 U.S. adults split equally between males and females, with an average age of 42, who were working either part- or full-time during the April 17-23, 2020, time period when the pandemic and state lockdowns were hitting most Americans hard – will be published this fall in the peer-reviewed journal Addictive Behaviors and is in early, online release now to the scientific community.

Dr. Lindsey Rodriguez

Participants were asked about their alcohol use and their thoughts and feelings on the COVID-19 pandemic.

The research investigated how worried and afraid people were about the virus, how stressed they felt about being around others, and whether the pandemic was impacting their psychological well being and making them feel depressed.

These feelings and reactions were correlated to respondents’ self-reported alcohol use during the month leading up to and including the week of April 17-23, giving the researchers a point-in-time look at peak and typical drinking behaviors and their relations to people’s psychological distress about the pandemic.

Significantly, this time period overlapped with the beginnings of COVID-19 widespread awareness in the U.S. and into the first early weeks of stay-at-home measures, rising virus rates and breaking news coverage that consumed most media reports.

The researchers found that the more stress people felt about COVID-19, the more heavily they were drinking.  This was particularly true for the women surveyed, such that at high levels of COVID-19 psychological distress, their drinking caught up with that of men’s.

“We discovered that women’s heavy drinking was more impacted by psychological distress around the pandemic than was men’s heavy drinking,” Dr. Rodriguez said. “This is very concerning, given that adverse health effects, like liver and heart disease, happen at lower doses of alcohol use for women than men, suggesting that women are catching up with men’s drinking at high levels of distress – this data is of grave concern.”

Dr. Sherry Stewart

Various internal and external pressures are running high during the pandemic.

“The increased stresses that many parents have been feeling while navigating their jobs, facing possible financial and family health concerns, keeping up with the household, trying to homeschool their children and keep them engaged, have all been significant on their psychological overload, demands on their time and conflicting responsibilities, which likely contributes to more frequent and heavier drinking,” Dr. Litt said.

“It’s a very unique time and context for everyone – we’ve never been in this type of situation before – and people have been making tremendous sacrifices at a time when there are so many unknowns.”

“Our findings may have reflected more solitary, coping-related alcohol consumption, not like having dinner and drinks out with friends,” Dr. Stewart said. “Pandemic drinking at home appears to be more about people’s responses to the uncertainty and anxiety many are faced with at this time.”

The researchers emphasize that these findings are worthy of attention, especially with COVID-19 again spiking in many U.S. states.

“The public health impacts are of great concern right now, especially for women,” Dr. Litt said.

“As the pandemic continues to evolve, it’s crucial to include and work on COVID-19  -related stress as a health concern that also requires resources and solutions,” she added. “Habits that are formed right now could have far-reaching consequences for the future.”