November 16th - Community Based Model for Cancer Prevention Speaker on Campus

Dr. Karen Patricia Williams will visit our campus on Thursday, November 16th to deliver the inaugural presentation for our Cutting Edge research series.  Dr. Williams is the Distinguished Professor of Women's Health, and Director of the Center for Women, Children, and Youth at the College of Nursing, The Ohio State University.  She has developed the  Kin Keeper^SM  Model for cancer prevention, a health advocacy model that involves community, family, and health care providers working together.  Dr. Williams currently serves as a member of the Nursing initial review group (IRG) of the National Institutes of Heath.

DEPUTY DIRECTOR OF PUBLIC HEALTH PROGRAMS

Please see the following announcement for the Deputy Director position at the Cook County Health & Hospitals System.

Lifestyle and Non-Communicable Disease

By Jasmine Swyningan

As humans, we are bombarded with choices on a daily basis.

• Do I go on a diet or maintain my current eating habits? 
• Should I go to work today or play sick and watch movies all day? 
• Should I get the chocolate chip cookie or oatmeal raisin cookie? 
• Should I go for a run or go to a kickboxing class? 
• Should I call my grandmother or aunt? 

You get the idea. 

These choices, when looking beyond this week (or this month, or this year), can have a significant impact on our long-term health. Here’s one way to think about this phenomenon: we are lucky to live in a time where our own lives literally make us sick. We are familiar with the endless amount of diet and fitness fads in the United States (like Beachbody, or Herbalife, or Shakeology, or encouraging a “Gluten Free” or “low carb” or “high fiber” diet), and efforts by political leaders and celebrities to encourage exercise (like Play60, or Worldwide Day of Play, or Let’s Move). Why do so many people obsess over diet and exercise? Because our “Western” lifestyle is, well, in many cases, a synonym for the term “sedentary.” And there has been a significant increase in the prevalence of non-communicable disease–particularly hypertension (high blood pressure) and type II diabetes–over the past 3 decades, not only in the US, but globally. 

Of course, this is a major problem in the US, having lasting impact on people’s quality of life, and also changes the way we need to approach the debate on healthcare. Hypertension and type II diabetes are examples of diseases requiring ongoing care and potentially complex medication regimens. When we think about these issues on a global level, the effect is even more complicated.

The Imperial College London completed and published findings from their 30-year-long project to track diabetes rates globally. What they found was a stark increase in the prevalence of type II diabetes, particularly in countries in sub-Saharan Africa and the Pacific Islands. Especially problematic about the increase in non-communicable diseases in these areas is a clear lack of infrastructure to treat these diseases. Additionally, researchers believe that this issue of non-communicable disease (or NCD) morbidity (having a disease) and mortality (dying from a disease) isn’t going away anytime soon. In fact, NCD rates are expected to surpass those of infectious diseases (like HIV/AIDS, tuberculosis, or malaria) in lower and middle-income countries by the year 2035. 

Why is this happening? Are there more doctors with the ability to diagnose the disease? 

Maybe. 

What research is telling us, however, is lifestyle may be more to blame than we’d like to admit. As countries in Africa continue to globalize and urbanize, their citizens begin to adopt a lifestyle that accommodates accommodations. People are: 

• Walking less and driving more.
• Not traveling as far to access clean water.
• Eating more processed foods.
• Smoking and drinking more often. 

When these changes happen in a short amount of time, say, over the span of one person’s lifetime, their metabolism comes to a screeching halt, and anticipated weight gain due to moving less often and eating more often (and eating lower-quality foods) is exacerbated as a result. Further, myths around health and wealth, unfortunately, encourage this type of lifestyle in lower and middle-income countries. The ability to smoke, drink alcohol, drive, and eat processed food is a sign of wealth; also, weight loss is a symptom of many infectious diseases. Therefore, ailments such as hypertension or type II diabetes are known as the “rich person’s disease.” Infrastructure to manage these types of diseases are scarce, and motivation for patients to make lifestyle changes reminiscent of a time before accommodations were in place (or to take medication that won’t heal, but will only treat their disease) is lacking.

In my own travels, I have witnessed public health efforts to combat obesity and spread awareness about non-communicable disease. Sometimes people don’t believe these diseases exist because they take years to develop. Other times people know about the disease but simply do not care. Most intriguing, though, is working with people who both know about long-term problems associated with eating processed foods and not exercising, but who also respond to calls for lifestyle change with something like, “I don’t live in an area that sells produce.” Or they live in an area where beer is cheaper than water. Or (in the US) where dialysis centers are more plentiful than grocery stores.

The choices we make about our own lifestyle has a domino effect on our health, and research is telling us that such choices are changing the face of disease, both in the US and globally.

Capstone 2017 – Jasmine Swyningan

Presented May 4, 2017, Jasmine Swyningan offered a look into the lifestyle factors that influence hypertension specifically as they are effecting countries in East and West Africa. As noted in Jasmine’s research, along with other non-communicable diseases (NCDs), researchers have documented a significant increase in hypertension and type 2 diabetes over the past 35 years. The lack of research documenting the contributing factors and gaps in treatment and prevention knowledge are limiting elements to the mounting burden of these types of diseases in Sub-Saharan African countries.

Comparing data gathered on non-pregnant women in Kenya and Ghana, Jasmine was able to support some key public health predictions within these areas. Her findings replicated the positive relationship between age/BMI and hypertension. Additionally, as the wealth index increases, so does the prevalence of hypertension. An individual living in an urban environment, having a higher education and being covered by health insurance is more likely to be diagnosed as hypertensive. While all of these factors are a result of movement toward economic development and increased wealth, these are also causing changes in the environment and behaviors that influence the health of the population.

As lifestyle continues to change at varying rates between and even within, countries must look to prepare themselves for the health impact of NCDs. Unfortunately, it may be outside financial reach to install effective prevention efforts that combat the effects of lifestyle changes. However, work could be done to leverage the existing healthcare networks—targeting clinician and patient education—to help curve the long-term effects of NCDs.

Jasmine joined Loyola University’s Master of Health Program with a BS in Economics from Iowa State University and MA in International Relations from the University of Chicago.

Learn more about Jasmine’s capstone experience.

Why did you choose to pursue an MPH? 
My desire to pursue an MPH and specialize in Epidemiology was organic in nature. I was brought to the University of Chicago for a few reasons that have remained unchanged throughout my academic career at Loyola: I am fascinated by economic development, and its intersection with other facets of society (e.g., education, health, gender, culture); I have a passion for enhancing my surroundings in a holistic manner; I love learning and engaging in both sides of an argument. I felt that an MPH at Loyola would allow me to grow in all of these areas.

What led you to your topic? 
Lifestyle and type II diabetes among women in sub-Saharan Africa was the focus of my MA thesis back in 2011, shortly after Imperial College London completed and published findings from their 30-year-long project to track diabetes rates globally. What they found was a stark increase in the prevalence of type II diabetes, particularly in countries in sub-Saharan Africa and the Pacific Islands. Before I even began studying public health, I became obsessed with understanding the social, economic, and cultural forces at play in these low-and-middle-income countries that are influencing the increase in NCD prevalence. After I completed my MA thesis in 2012, I presented my observations at African Studies conferences at Michigan State University Stanford University. At both conferences, people encouraged me to continue pursuing this topic and to look at everything from a public health lens. The transformation of this project has been an interesting challenge that I have come to greatly appreciate.

What personal skills helped you the most in completing your project? 
Time management! I spread out my capstone over two semesters which allowed me to do most of the background during the first semester, and then run the data (and rerun, and rerun, and RERUN the data...) during the second semester. Over the duration of my project, I also worked full-time (sometimes on weekends), completed 2-3 other courses, and started planning my wedding! Time management and an open dialog with my faculty advisers were key to completing this project. I also think that a genuine interest in the topic helped quite a bit.

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Capstone 2017 – Madeline Ruhl

Presented May 4, 2017, Madeline Ruhl explored the realities of individuals entering the U.S. via the U.S.-Mexico border from Mexico and other Latin American countries. Examining migration trends can uncover important insights that can help public health officials and human rights advocates on both sides of the movement. However, while this topic has garnered much political attention over the past 50 years, Madeline’s research focused on a specific reality—the use of smugglers (called coyotajes in Mexican-Spanish)—that is not as well researched.

Coyotajes are routinely recruited or hired by individuals to assist them in traveling from Mexico to the U.S. They are paid a fee for their service. The increased use of coyotajes since the mid-1960s is associated with a complex web of political, economic, and social factors, along with increased surveillance along the U.S.-Mexico border. The number of visas extended by the U.S. has also fluctuated significantly over the 20th century through legislation including the Immigration and Nationality Act, which additionally contributes to the rate of undocumented immigration.

Madeline’s research aimed to uncover whether the fee paid to coyotajes could uncover important patterns in other life effects. Utilizing data obtained from Princeton University’s Mexican Migration Project (MMP), Madeline’s research yielded some interesting results.

• The average fee paid to a coyotaje is as high as $1,929 in some regions. 
• The majority of individuals traveling are male.
• Group sizes tend to be small averaging two individuals.
• Fees paid by women are approximately 18% greater.
• Those in better health paid less.
• Acculturation contributed to lower later self-reported health.

While research in this area may be difficult to gather, Madeline’s project reminds us of its continuing importance. Investigating relationships like those between fluctuating coyotaje fees paid and associated life effects or health outcomes can reveal important information about at-risk populations. This information could then lead to the development of more effective health initiatives, and a better understanding of a path forward for health officials and human rights advocates on both sides of the border.

Learn more about Madeline’s capstone experience.

What led you to your topic?
In 2015, I received an email blast from Loyola’s Public Health department about a volunteer opportunity with an organization called Community for Children, located in the Rio Grande Valley. I applied and attended their January 2016 program. That opportunity not only changed my life, but it fundamentally shaped my career. It sparked my passion for immigration health.

Why was the content or theme important to you?
When I returned from Texas, I dove into studying immigration law, health, and the factors and outcomes associated with the movement of people. I joined organizations like the Migration Policy Institute to help me further my understanding of global immigration legislation. I focused closely on movement into the U.S. from Mexico and the Northern Triangle countries—with a special interest in the movement of unaccompanied children. 

Did you encounter any challenges during your project?
There are always challenges associated with obtaining the data we need as Public Health scientists, and even more so when what those data are extraordinarily sensitive, both ethically and politically.

Where are you headed with your career?
My practicum and capstone projects at Loyola led me to continue my career in immigration health. I currently work as a program evaluator with an organization providing support to unaccompanied migrant children. This summer, I will also be participating in a one-month research project through the American Anthropological Association doing fieldwork in pediatric clinics in Antigua, Guatemala. 

What coursework did you apply to completing your project?
Biostatistics and epidemiology were at the technical core of my project, but I believe that Loyola’s well-rounded curriculum gave me the opportunity to explore the undeniable humanity of my work as well. Fields such as bioethics and research ethics, human behavior and health policies all strongly informed my project. 

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Capstone 2017 – Ashley Hess

Presented May 4, 2017, Ashley Hess took the opportunity to explore the relationship between access to legal services and health outcomes. In her presentation, Ashley reminded us of some of the key social determinants of health. These include, but are not limited to, access to quality housing, education and healthcare as well as employment/income, legal status and even family responsibilities. It should be no surprise that access to legal services is subject to many, if not all, the same limitations as good health.

Ashley’s project centered around examining how medical legal partnerships (MLP)—collaborations among medical and legal services with the aim of addressing legal, social and health related issues for vulnerable patients or those underserved in a clinical setting—have been applied to address the social determinants of health. The Erie Family Health Center, a partner of Loyola’s School of Law and the Beazley Institute for Health Law and Policy, regularly refers patients that meet a list of criteria to the Health Justice Project. By probing the open and closed case data—available since the program’s 2010 inception—Ashley was able to extrapolate the data to the city of Chicago as a whole. The case data revealed case outcomes included enrollment in Medicaid, receipt of SNAP benefits, abatement of substandard housing conditions and eviction defenses provided. Cases were often closed due to immigration status, employment or other family law issues.

Overall, the MLP examined is making a positive impact in this community, however, there is much work to be done to further its effectiveness. Besides increasing staffing, Ashley’s research suggests that MLPs could benefit by expanding their education and legal education offerings, developing a more open communication process between participating entities as well as establishing a more holistic approach to addressing social justice.

Learn more about Ashley’s capstone experience.

Why did you choose to pursue an MPH?
I participated in two public health trips to Honduras through Global Brigades during my undergraduate career. While there, our group was responsible for building a latrine, stove, water storage unit and shower as well as installed concrete floors in the homes of the families we worked with. We were also responsible for preparing an educational program about proper hygiene and hypertension for children at the local school. After having this experience and working with community members, I knew I wanted to do more with public health and empower those around me to better their circumstances. 

What led you to your topic?
I worked with the Health Justice Project during my practicum in the fall of 2016. During this time, I helped research health outcomes related to lead and arsenic exposure through contaminated dust and soil. Through our work, we were able to change HUD’s requirements for blood lead levels to warrant intervention. The legal side of health was something I did not know much about at the time, but as I immersed myself more into the work, I wanted to make sure I incorporated it into my capstone.

Why was the content or theme important to you?
Legal services are not a right for individuals pursuing civil cases but are a right for those involved in criminal ones. When first researching my topic, I was very surprised to see what a difference legal aid has on health outcomes. By simply addressing legal needs in a medical setting, vulnerable populations can gain imperative services such as Medicaid, Social Security, WIC, and receive assistance for paying utility bills.

Where are you headed with your career?
I am currently looking for a job that utilizes my degree and incorporates the legal aspects of policy development. 

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

The Affordable Care Act: A Brief Review

A great new article from LUC MPH professor, Dr. Talar Markossian.

SPENT – Making Sense of Poverty

With an office in Durham, North Carolina, the prestigious McKinney advertising agency developed and launched an interactive game called SPENT for its pro bono client Urban Ministries of Durham. 

Inspired by such games as SimCity and FarmVille, SPENT combines a familiar virtual environment with the reality of those living in poverty. The game guides players through real dilemmas individuals and families make throughout the course of a month. Given $1,000 to live on, the goal is to end up with money left over at the end, however, the challenge is to have enough money at all. Players quickly learn how even minor changes in employment, transportation or health can have disastrous consequences.

Learn more through McKinney’s video about the development of SPENT.

After playing SPENT, Perpetue Bariyanga shared:

As professionals, we tend to want to judge people that we meet. However, we never know what another person is going through.

SPENT highlighted that some people may be doing their best and that might not be enough to help them live comfortably or at the same level that we might expect. No parent wants to see their kids go hungry because they may be bullied or laughed at due to getting free lunch meals. Every parent wants to do what is best for their children, but sometimes budget constraints limit activities—such as fieldtrips or birthday parties—that might not be a necessity at that moment.

For many, every day is a struggle. SPENT helped me better understand what some people might be going through. It reinforced my belief that being compassionate and understanding towards others can go a long way.

Rachel White shared:

On SPENT, I tried to make it through the entire month. However, on day 29, my bank account balance was $3 and the bank charged me $5 for letting my balance go below $50. Throughout the whole game, I tried to use as little money as possible unless it seemed absolutely necessary. I felt bad that I wasn’t paying my bills and loans, but I just didn’t have enough money to pay everything.

The experience was a rather eye-opening activity. I did not expect it to be as difficult as it was.

Poverty is a reality for millions, but unless you’ve experienced it firsthand, it can be difficult to understand. Simulations like SPENT help to bridge the gap in our understanding.

Can you make it through the month? PlaySPENT.org

The Year of Climate Change and Health

The American Public Health Association (APHA) has declared 2017 to be the Year of Climate Change and Health.

What is climate change?

Climate is the usual temperature, precipitation and other conditions that have prevailed in an area over a long period of time. While changes to the weather can occur in a matter of hours, climate changes take hundreds or even millions of years. However, even small changes can have big effects.

According to the United States Environmental Protection Agency (EPA), while fluctuations prior to the Industrial Revolution in the 1700s can be explained by natural events, recent changes cannot. It is extremely likely that human activities, such as burning coal, oil and gas, are the dominant forces behind recent global warming and subsequent climate change. Learn more...

Why is climate change important to public health professionals?

Climate change has the potential to:

• Threaten human safety by increasing the frequency and intensity of extreme weather.
• Disrupt food supply due to droughts, floods and increased plant disease vulnerability.
• Increase risk of illness and death associated with more frequent, hotter days.
• Lead to respiratory and cardiovascular issues due to poor air quality.
• Cause outbreaks of vectorborne diseases in geographic areas, not previously hospitable.

While every American is vulnerable to the impact climate change can have on their health, those that have a chronic disease, are elderly or poor are disproportionately at greater risk of injury or death related to climate change. The effects of climate change are obviously borderless and threaten the global population. Learn more... 

Is there a global plan to reduce climate change?

On November 4, 2016, the Paris Agreement—the world’s first comprehensive climate agreement proposed within the United Nations Framework Convention on Climate Change—was entered into force. Participating countries set nationally determined contributions of reduced emissions to that pooled together should slow rising temperatures. The effects on climate change of this agreement have yet to be realized. Learn more...

Climate change is an APHA priority topic & issue.

APHA recognizes that there is still much work to be done to convince the public and elected officials that climate change effects health and that strong climate change strategies and interventions are just as important to protecting the health and safety of all people.

“Climate change is the greatest public health challenge we face today. We must ensure the best science and policies to reduce our risks.” - Georges Benjamin, MD, APHA Executive Director

Through the declaration of 2017 as the Year of Climate Change and Health, APHA is attempting to heighten awareness and garner the support of more public health entities in the fight against this growing threat. APHA encourages public health advocates to follow the conversation using #ClimateChangesHealth and become a partner.

Capstone 2016 – Deborah Manst

Presented December 9, 2016, Deborah Manst’s Capstone project addressed the magnitude, risk factors and impact of food insecurity. Through three pronged idea derived from a pilot study done in Hartford, Connecticut, Deborah’s Freshplace model combines a food pantry with motivational interviewing and increased access to resources to address the issue.

Food insecurity is defined as the inability to obtain enough nutritious food for a healthy and active lifestyle. Affecting 48 million Americans, risk factors include unemployment, poverty and limited access (such as living in a food desert or limited transportation). Food insecurity is linked to many chronic and mental health conditions. Communities all across the country bear the burden of the negative consequences of this issue.

Even though DuPage County is considered the healthiest in Illinois, 8% of the population is food insecure. Deborah’s Freshplace concept would help close the gap and ensure that the disadvantaged population has access to fresh produce, gains confidence with healthy diet information and feels empowered by professionals trained to build self-confidence. Freshplace is a relatively simple program that could have wide-spread benefits to participating individuals and families that extend to the broader community.

In addition to earning her MPH from Loyola University Chicago, Deborah holds a BS in Molecular and Cellular Biology from University of Illinois at Urbana-Champaign, an MA in Medical Sciences from Loyola University Chicago and an MD from Loyola University Chicago Stritch School of Medicine.

Learn more about Deborah’s Capstone experience.  

Why did you choose to pursue an MPH? 

Prior to starting the MPH program, I went to medical school and residency, but for personal reasons took some time away from medicine. In looking for what to do next, I decided that getting an MPH was in line with my nature to help people. I felt that improving community wellness on a broader scale would be a great way to utilize and further my skills. I appreciate Loyola’s humanistic approach to learning. Having completed my previous graduate and medical programs at Loyola, it was a clear choice for me to return to Loyola. Since I thrive on interacting with people and have strong leadership skills, I entered the policy and management track.

What led you to your topic?  

During my internship at the DuPage Federation on Human Services Reform, a public service organization, I became aware of the problem of food insecurity—a significant issue in which impoverished people are unable to obtain enough healthy food. I visited the Northern Illinois Food Bank and the Naperville Loaves & Fishes food pantry to better understand the magnitude of the issue. This inspired me to work on a capstone addressing food insecurity in DuPage County.

What was your biggest accomplishment while in the program?

I was selected for one of four public health graduate study scholarships from the Illinois Public Health Association and traveled to Springfield, IL to accept the award!

Where are you headed with your career? 

At this time, I am seeking employment in Chicagoland with a public health organization focused on community wellness. I plan to continue in a position where I can make a difference in public health, and may possibly re-enter the medical field to directly apply what I have learned in the MPH program to treating patients. 

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Capstone 2016 – Brittany Lee

Presented December 15, 2016, Brittany Lee’s Capstone presented an innovative, women’s-based health initiative called Monique’s Gift. With the aim of decreasing the number of HIV/AIDS infections among women, the mobile concept raises awareness of the disease, provides testing and offers support. By initially operating only in the Edgewater and Uptown neighborhoods of Chicago, the intervention will reach a higher number of the intended target—African American women.

Why focus on African American women? Brittany’s research uncovered some alarming statistics. African American women are disproportionately affected by the HIV/AIDS epidemic. Although African American women equal just 12% of the total U.S. population of women, they account for 62% of all new HIV diagnosis. Among African American women, 10.5% of HIV transmissions were the result of sharing needles for injection drugs. Monique’s Gift would directly address many of the unique socioeconomic and behavior factors the women of this target group face that are not well-addressed by other programs.

Monique’s Gift puts greater emphasis on analyzing the social conditions that effect African American women’s lives. A program like this could prove effective in these Chicago neighborhoods and scale to produce substantial benefits in other at-risk, primarily African American, communities.

Learn more about Brittany’s Capstone experience.  

Why did you choose to pursue an MPH? 

After earning my Bachelor’s Degree in justice studies from Northeastern Illinois University, I continued my education at DePaul University. While pursuing my Juris Doctorate, with a certificate in International Law, I realized that I didn’t want to practice law in the traditional sense and be a courtroom attorney. I took a health law class and the policy aspect of it really interested me. Some additional field work led me to look at MPH programs. I decided to pursue the policy and management track. I look forward to making an impact with my background in law and justice studies in combination with my new public health knowledge.

What led you to your topic?  

I decide to focus on African American women and HIV because I feel these together are not discussed often enough. Public awareness of HIV in America is primarily focused on men who have sex with men. If race is brought into the conversation, the focus is generally about black men who have sex with men. However, African American women are being infected at alarming rates. This fact deserves focus and resources to address why. Bringing the conversation and testing capabilities to at risk communities—rather than waiting for individuals to seek information or testing for some reason—could influence real change in the transmission rate.

Why was the content or theme important to you?

As an African American woman, this topic was important and personal. It was a process of reflection, research and discovery. I wanted to understand why women with the same racial background as me were being infected with HIV at such an alarming and disproportionate rate. What was different between me and them? What about their lives and community could make them more prone to contracting HIV? This project helped me—as I hope it does others—become more aware that access to quality health education and healthcare can have a grave impact on large groups of people, particularly minorities.

Where are you headed with your career?  

I just started working with Presence Health as a Quality Improvement Specialist. I’m really enjoying the position because I feel it is really important that doctors are held to a standard that achieves the best patient care. I love that I get to write policy and be involved in program development for Presence Medical Group. I hope to continue to grow in this job and with the company over time. 

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Diabetes in Mexico & US Seminar - Tuesday, February 7th

The next Department of Public Health Sciences Seminar is "Diabetes in Mexico & US"

Location: Tuesday, February 7th at 11 a.m. in CTRE room #504.

Drs. Cooper and Durazo-Arvizu are developing a project to follow-up on the findings from Mexico, in particular to determine why case fatality rates are so high.  Comparisons with appropriate cohorts of Mexican Americans in the US should help us understand the question of what key ingredients of diabetes management are missing in Mexico.

We are confronted with the question:  Is prevention the only hope, or can we reduce mortality and morbid events with medical therapy?

The associated readings for the discussion can be found below.

Mexican Cohort Study
Diabetes in the US
Diabetes Interventions
VA Trials

Capstone 2016 – Lawrence Benjamin

Presented on December 15, 2016, Lawrence Benjamin’s Capstone project applied the evaluative criteria of social marketing theory to an assessment of the nutrition guidance resources offered by the American Diabetes Association (ADA) for people with diabetes. Specific recommendations were provided to improve the behavior change effectiveness of the ADA program. The step-by-step evaluative approach and recommendations in this study were also intended to serve a model for evaluating and improving the nutrition guidance programs of other organizations.

In addition to his MPH from Loyola University Chicago, Lawrence holds a BA from Brown University and an MBA from Columbia University.

Learn more about Lawrence's Capstone experience. 

What led you to your topic?  

My topic emerged from my MPH Practicum with the ADA. In the course of the Practicum, I had an opportunity to work with the ADA staff involved in developing the nutrition guidance for people with diabetes. The ADA organization was very open to my suggestions for improving the effectiveness of their program.

Why was the content or theme important to you?

I spent much of my professional career working in the food industry. Throughout my career, I have been surprised and disturbed by the lack of progress of both the food industry and the healthcare community in addressing the obesity problem. I was attracted to social marketing theory as a proven framework (which is included in the Healthy People 2020 goals) for driving real behavior change.

What do you hope to accomplish with your MPH knowledge and skills in the future?

I chose to pursue an MPH because of my interest in becoming a better-informed person and more critical thinker about public health issues. I think that MPH program’s focus on analytical rigor and sound research methodology has trained me well for being more discerning as I wade through the clutter of media and “research” about public health and healthcare. This has been and will continue to be very useful in my professional career as well as in my own decision-making as a consumer of healthcare.

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Capstone 2016 – Lauren Stevens

Presented December 15, 2016, Lauren Steven’s Capstone analyzed visit severities of a level-one, urban trauma center. As a large percentage of Americans rely on emergency departments (EDs) for non-emergent or primary care visits, the misuse can lead to longer wait times, physician shortages, patient overcrowding and unnecessary increased costs of care.

With the implementation of the Affordable Care Act (ACA), many—who previously could not afford or were denied coverage—now have access to health insurance. Medicaid expansion also helped bridge some of the affordable access to care gaps.

To shed light on ED utilization situation, Lauren’s project work leveraged a New York University (NYU) Emergency Department Algorithm (EDA) for examining ED case patterns. Additionally, she studied differences in ED use pre- and post-ACA to understand how changes in affordability may have shifted utilization. Lauren observed:

• Increased utilization of healthcare with either insurance or Medicaid coverage.
• High levels of ED utilization for non-emergent care.
• Higher utilization of the ED by low-income and minority populations.
• An increase from 69% non-emergent patient visits pre-ACA to 77% post-ACA.

Lauren’s research suggests that ED misuse is a significant issue. Public health can, however, help if policy and education efforts are focused on promoting utilization of a primary care physician for treatment of non-emergent or chronic illnesses which make up the bulk of cases currently seen in the ED.

Learn more about Lauren's Capstone experience. 

Left to Right: Asra Khalid, Brittany Lee,
Lauren Stevens and Deborah Manst

Why did you choose to pursue an MPH? 

A health science studies major, I have a Bachelor’s in Education from Baylor University in Waco, TX. Wanting to be a better informed medical school applicant, I looked first to Loyola’s MPH program. I chose the epidemiology track because of my interest in human diseases as an undergraduate. I am now in the process of applying to medical schools. 

What led you to your topic?  

As an undergraduate, I scribed in an emergency room. So, when Dr. Markossian and Dr. Probst asked for help from a public health student in analyzing ER data, I knew I’d be a good fit. After the initial presentation of data, we then wanted to add additional findings that would set our project apart. My Capstone was a natural progression using the NYU EDA. Sifting through the data was definitely challenging, but also a rewarding, collaborative effort. 

What was your biggest accomplishment while in the program?

My biggest accomplishment was seeing the research I had been working with throughout the past year come together. I was also able to present a few projects at the national American Public Health Association (APHA) Conference, which was an amazing experience. Seeing so many people so passionate about numerous public health issues was eye opening. 

What did you enjoy about the project? 

I liked uncovering potential areas for public health improvement and how real world issues are addressed by the Capstone. It is not just a project, it has real potential to make contributions to public health.

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

New physical activity research published from the Department of Public Health Sciences.

In spite of many studies showing that for long term weight maintenance, physical activity levels may not be as important as dietary intake. In an effort to provide more evidence for the role of physical activity and weight gain, we followed 1,944 men and women enrolled in the Modeling the Epidemiologic Transition Study for 2 years. METS is a 5-country study (US, Seychelles, Jamaica, South Africa and Ghana) investigating the role of diet and physical activity in weight change.  

We measured their physical activity levels at baseline and then weighed them every year for 2 years. After the 2 years, weight gain tended to be higher in participants who were normal weight (BMI<25 kg/m) at baseline, compared to participants who were classified as obese (BMI >=30 kg/m). We also found that participants in the US and Jamaica experienced the smallest weight gains compared to participants in Ghana and South Africa. Our study confirms that baseline physical activity levels may not be associated with 2 year weight gain in participants spanning the economic transition.

The link to our study can be found here.

In memory of Dana Riggins - from Dr. Stephanie Kliethermes (former LUC Public Health faculty member)

In the two short years that I was lucky enough to have known and worked with Dana, she had a tremendous impact on not only me individually but also the faculty, students and department as a whole.  Dana grew into a professional right before our eyes.  Having been blessed with the opportunity to work with her both in and out of the classroom, Dana's inquisitive nature and drive to truly understand the how's and the why's of what she learned contributed immensely to her success and growth at Loyola.  For her capstone, Dana independently learned how to apply an advanced statistical technique to her data and was most concerned with understanding the merits of the procedure as opposed to simply interpreting the results at face value.  It was during these conversations that I knew Dana was a special student capable of paving a promising career path for herself.  She was so proud and excited when she learned of her acceptance into the CDC program.

But more importantly than any academic and professional success, Dana was a genuinely good and kind person.  She was a teacher to us all. Dana was constantly helping her classmates in our statistics class because she genuinely wanted to see them succeed.  She lived by the philosophy that if you win, we all win.  We need more of that in this world.  Dana always lit up a room with her wit, humor and intelligence.  She had an uncanny ability to add subtle lightness and ease to frustrating situations which reminded all of us to not take life too seriously.  We lost a bright light in this world last week, but we are all forever better for having Dana as a student and most recently, a colleague.  Her impacts on the MPH program at Loyola will have a lasting effect -- she raised the bar for those around her.  For that, and for so much more, I am forever grateful and honored to have been able to work with Dana.  Teachers are often said to inspire students, but Dana truly inspired me.   

Capstone 2016 – Asra Khalid

Presented December 15, 2016, Asra Khalid’s Capstone explored treatment utilization among patients with—the most common form of liver cancer in the U.S.—Hepatocellular Carcinoma (HCC). Over the past few decades, the incidence rate has increased over three-fold. While early detection and treatment remains the key goal in improving outcomes for patients with this form of cancer, significant racial/ethnic and socioeconomic disparities complicate progress.

Asra’s objective was to compare receipt of HCC treatment and overall mortality by race and income characteristics using a large commercial insurance database. Conducting a cross-sectional analysis, the data revealed that even when insured at the same level, significant racial and income disparities exist in treatment utilization among patients with HCC

Significant discoveries include:

• HCC treatment is underutilized even in a large population of insured patients with a treatment rate of only 35.57%. 
• Out of the total population, whites are more likely to receive treatment as compared to other racial groups even after adjusting for comorbidities and other patient factors.
• Patients with high income level (i.e. 400% above the Federal Poverty Level) are 60% more likely to receive treatment than patients with low income level (i.e. at or below Federal Poverty Level)  
• Whites and patients with high income level are more likely to receive curative treatment rather than noncurative treatment. 

While disparities in treatment selection and outcomes may be influenced by biological, health care utilization and insurance status reasons, consideration for racial/ethnic and socioeconomic differences is essential to developing successful prevention, screening and treatment initiatives in the future.

Learn more about Asra's Capstone experience. 

Asra Khalid

What led you to your topic? 

I initially started working with Dr. Steve Scaglione (Hepatologist at Loyola University Medical Center) on hepatology research. He introduced me to Leanne Metcalfe (Senior Director of the HealthCare Services Corporation’s (HCSC) Center for Collaborative Research). I was offered a graduate research fellowship at HCSC. There, I assisted in investigating the epidemiology, risk-factors and healthcare utilization of patients with chronic liver disease. My capstone project—aimed at leveraging the large employer-based, health insurance claims data to evaluate racial and income disparities in treatment utilization among patients with HCC—came almost naturally.

What did you enjoy most about completing your project? 

I enjoyed working closely with the HCSC analytical team on evaluating and reporting claims data based on the study objectives. HCSC’s dedicated analytical team works diligently to deliver valuable insights based on a lot of data. These insights are then translated into practices that improve patient’s health. The fellowship provided me with an opportunity to use my qualitative and quantitative skills for various research projects.

Why did you choose to pursue an MPH? 

I’ve always believed that an individual’s health status should not be a reflection of his or her ethnicity, income status, gender or neighborhood. Everyone, irrespective of their racial or socioeconomic background, should have equal access to adequate health care. I wanted to pursue an MPH as a means of addressing the issue of health disparities on a grand scale. During the program, I worked with various healthcare and non-profit organizations on issues of diversity, inclusion, and cultural competence. I have extensively researched healthcare disparities, focusing on diversity in clinical trials and treatment utilization. 

Where are you headed with your career? 

I accepted an Epidemiologist position with the State of Tennessee’s Health Department. I’ll be responsible for helping in data management and conducting various epidemiological evaluations and studies on population health. I’m confident the knowledge and abilities gained in my MPH program will serve me well as I hope to reduce population disparities in the future.

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Capstone 2016 – Demitra Runjo

Presented December 9, 2016, Demitra Runjo’s Capstone project explored whether an association exists between the duration of breastfeeding and adolescent overweight and obesity. As dietary behavior starts at birth, this important early predictor may be used in the development of health intervention strategies. Although Demitra identified research existed relating the duration of infant feeding patterns to childhood obesity outcomes, she also recognized a knowledge gap as to whether this association extends to adolescents. Demitra’s research concluded that breastfeeding for 6 months or longer may be protective against overweight and obesity.

Learn more about Demitra’s Capstone experience. 

Demtra Runjo (left) with family.

What led you to your topic? 

I was previously working with Dr. Shoham as a Research Assistant (RA) using the ALSPAC dataset. While working with him as a RA our topic was much different, we believed that the association between breastfeeding duration and obesity/overweight outcomes would be interesting to explore using the ALSPAC dataset. Working with Dr. Shoham, as my mentor, was a more engaging experience than any classroom instruction. He took the extra time to work with me until I understood not only what I was doing but also what it meant… no matter how many annoying meetings I needed!

Did you encounter any challenges? 

As the semester began, we started to dive deep into the data. I was surprised just how much time data management and cleanup takes. That was probably my biggest challenge throughout the semester.

What did you enjoy about the project? 

The capstone truly is a culmination of the entire program and I got to use knowledge and skills from almost every class. It was really rewarding to see just how many pieces and skills—from epidemiology, to biostatistics to public policy—go into a project like this.

Where are you headed with your career? 

I received my Bachelor’s in Health Sciences with a concentration in Public Health (with minors in sociology and psychology) from DePaul University. I began my school program by taking an Epidemiology of Infectious Diseases course. Displaying an interest in the subject, my professor, Dr. Layden, helped me explore it further which eventually led to me getting a position at the University of Chicago Medical Center in the Infection Control Department.

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A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Save the Date – Friday, March 24, 2017

For decades, the Ruth K. Palmer Research Symposium has been an important gathering for health care professionals. Sharing the latest research, this event addressing important matters related to nursing research, education, administration, policy and clinical practice.

When:
Friday, March 24, 2017

Where:
Center for Translational Research and Education, Auditorium

Loyola University Chicago Health Sciences Campus

2160 S. First Ave, Maywood, IL 60153

About:

This year, the symposium will be addressing themes related to Mobilizing Innovative Technology to Transform Research and Promote Health. Keynote speaker Ryan J. Shaw, PhD, RN (Assistant Professor at the Duke University School of Nursing in health informatics) will explore how technology is transforming the way research is designed and conducted. His research—funded by the National Institutes of Health—is uncovering how to improve health outcomes and care delivery in patients with chronic illness through the use of mobile health and sensing technologies.

Additional information and final schedule will be shared closer to the event date.

Registration:

Loyola Public Health students are encouraged to plan to attend. Simply visit LUC.edu/palmer to register. Registration for students and faculty is free. Other attendees, the fee is $75 each attendee, but group discounts are available. Registration is open through March 17, 2017.

Participation:

Researchers, educators, practitioners, administrators and students are invited to submit an abstract of completed or in progress research for a poster presentation. Poster presentations will be competitively selected on the basis of scholarship and scientific rigor. Poster topics do not need to be related to the theme of the Palmer Symposium. One person may submit multiple abstracts. Submissions are due February 3, 2017 at 5 p.m. Click for more information.

Additional questions? Email Palmer_Symposium@LUC.edu.