December 7, 2015
Student-led publications are marked with **.
ESE Environmental Sciences and Engineering
HB Health Behavior
HPM Health Policy and Management
MCH Maternal and Child Health
PHLP Public Health Leadership Program
Cancer and cancer-related health disparities
Two recent study reports from Gillings School co-authors shed light on the reasons for some cancer-related health disparities. The first, from co-author Andrew Olshan, PhD, Barbara Sorenson Hulka Distinguished Professor of Cancer Epidemiology and chair of EPI, in the June 17 issue of the Journal of the National Cancer Institute, found that early age of first menstrual cycle (before age 11), could play a role in the disproportionate incidence of estrogen receptor (ER)-negative breast cancers diagnosed and higher breast cancer mortality among African-American women. Age at menarche has declined in recent years, particularly for African-American girls.
**In another study, published July 6 in the Journal of Clinical Oncology, Caitlin Murphy, MPH, predoctoral fellow in EPI, showed that among patients diagnosed with stage III colon cancer, there were significant differences between whites and blacks in whether they chose to have chemotherapy, likely a reflection of ability to pay. Not having treatment may contribute to health disparities and partly explain the higher mortality rate from colon cancer among African- Americans.
Research has shown that physicians tend to under-report patients’ side effects while in cancer clinical trials compared to what patients report. Ethan Basch, MD, associate professor of HPM, and Bryce B. Reeve, PhD, HPM professor, known for their work on patient- reported outcomes, tested the reliability and validity of patients’ self-reporting of side effects, using measures Basch and others previously developed. In a study published Aug. 13 in the Journal of the American Medical Association (JAMA) Oncology, they concluded that the measures permit reliable reporting by patients. This is an important advance. Advocates have noted the discrepancy when patients provide their own responses to questions about side effects, compared to data reported by others.
Diabetes, other chronic diseases
Edwin B. Fisher, PhD, professor of HB and global director of Peers for Progress, has worked with more than 60 collaborating groups on peer-support projects worldwide. On Aug. 24, Annals of Family Medicine published a special supplement on Peers for Progress, featuring 11 articles showing not only effectiveness in varied settings, but also the global feasibility, reach and adoption of peer support for people with diabetes and other health challenges.
Elizabeth Mayer-Davis, PhD, Cary C. Boshamer Distinguished Professor and chair of NUTR, was co-lead author of a key paper documenting the increasing prevalence of both Type 1 and Type 2 diabetes in youth. The work was published May 7 by the Journal of the American Medical Association.
**Daniel Erim, MD, doctoral student, and Stephanie Wheeler, PhD, assistant professor, both in HPM, co-authored a paper published May 18 in the Journal of Crohn’s and Colitis which found the drug vedolizumab could improve quality of life for people with Crohn’s disease, an inflammatory bowel disease.
Karin Yeatts, PhD, research assistant professor of EPI, co- authored a study in the Aug. 18 Journal of Asthma that found a multi-level intervention program for low-income, underserved children with asthma in N.C. resulted in improved lung function and fewer emergency department visits, hospitalizations and school absences.
In a study co-authored by Andrew Nobel, PhD, professor of BIOS, researchers described the Genotype-Tissue Expression (GTEx) project, which reveals precise ways in which genetic variation affects gene expression and disease development. The NIH-funded study was published May 8 in Science. Nobel said the research was analogous to deciphering genetic “recipes.”
Valerie L. Flax, PhD, research assistant professor of NUTR, led a study that highlights the negative impact of antiretroviral therapy (ART) upon HIV-positive breastfeeding women in Malawi. The study, which found that ART diminishes the benefits of iron and folate supplements taken by the mothers, was published July 8 in the Journal of Nutrition.
**Clinicians recommend that high-risk men, especially those who are HIV-positive and who have sex with men, be screened for anal cancer, but those who need it most likely avoid screening because of stigma. A study published June 16 in the Journal of Lower Genital Tract Diseases, led by alumnus Joshua Thompson, MD, MPH, and Noel T. Brewer, PhD, associate professor of HB, found that a majority of at-risk men surveyed said they would conduct a self-collected test at home but would not visit a doctor for screening.
Nutrition, diet and obesity
**NUTR alumnus Christopher Ford, PhD, and colleagues Shu Wen Ng, PhD, research assistant professor, and Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor, both in NUTR, found that financial incentives to avoid sugar-sweetened beverages (soda taxes) may persuade families to purchase fewer high-fat, high-sugar beverages. Their research findings were published online June 10 in the Journal of Nutrition.
Leslie Lytle, PhD, professor of HB and NUTR and chair of HB, and co-authors offered new evidence for interventions that can help people of low socio-economic status provide more healthful food for their families. Published July 27 in the International Journal of Behavioral Nutrition and Physical Activity, the authors found that changing mealtime culture (e.g., turning off the television) and avoiding unhealthful food choices (including restaurant food) can empower families to improve eating habits.
**Oral health services, delivered by primary care clinicians and designed to prevent dental caries in young children, can improve the oral health of kindergartners enrolled in Medicaid, found Ashley Kranz, PhD, 2013 alumna, and Gary Rozier, DDS, research professor of HPM. Their research was published June 29 in Pediatrics.
**A study led by Brystana Kaufman, MSPH, HPM alumna, determined that critical-access rural hospitals in N.C. that closed in 2009 tended to have lower levels of profitability, liquidity, equity, patient volume and staffing at the time of closure. Published July 14 in the Journal of Rural Health, the study was co-authored by George Pink, PhD, Humana Distinguished Professor, and Mark Holmes, PhD, associate professor, both in HPM.
Tobacco and e-cigarettes
**HB alumnus Joseph G.L. Lee, PhD, now assistant professor at East Carolina University, led a team that reviewed published articles associating tobacco marketing with the demographics of given neighborhoods. Lee found excess marketing in neighborhoods with more low-income and more African-American residents. Findings were published July 16 in the American Journal of Public Health.
Jessica K. Pepper, PhD, postdoctoral fellow at UNC’s Lineberger Comprehensive Cancer Center and 2014 HB alumna, and Noel T. Brewer, PhD, associate professor of HB and UNC Lineberger member, co-authored the first national study to examine how pediatricians and other physicians interact with teenage patients regarding e-cigarettes. The study was published Aug. 19 in the Journal of Adolescent Health.
Water and environment
**Julia Marie Naman, MSPH, 2014 ESE alumna, and Jacqueline MacDonald Gibson, PhD, ESE associate professor, examined disparities in access to municipal water and sewer services in N.C. Published Aug. 13 in the American Journal of Public Health, the study found that understanding costs and benefits of water access – and integrating findings into local decision-making – may address disparities and improve service quality.
Women’s and children’s health
A study co-authored by Til Stürmer, MD, PhD, professor of EPI, found that women without psychiatric diagnoses who were treated with serotonin reuptake inhibitors (SSRIs) for menopausal symptoms were at higher risk for bone fractures. The findings, published June 25 in Injury Prevention, have implications for the growing population of women at risk for osteoporosis.
Barbara K. Rimer, DrPH, dean and Alumni Distinguished Professor, is co-editor of the 5th edition of Health Behavior: Theory, Research and Practice (Jossey-Bass). Co-editors are Karen Glanz, PhD, George A. Weiss University Professor of epidemiology and nursing at the University of Pennsylvania, and K. Viswanath, PhD, professor of health communication at Harvard T.H. Chan School of Public Health. Gillings School contributors include Noel Brewer, PhD, associate professor; Edwin Fisher, PhD, professor, and Laura Linnan, ScD, professor, all in HB.
Arnold Kaluzny, PhD, professor emeritus of HPM, is co-author of Managing Disruptive Change in Healthcare: Lessons from a Public-Private Partnership to Advance Cancer Care and Research (Oxford University Press). Donna M. O’Brien, MHA, president of Strategic Visions in Healthcare (N.Y.), is co-author.
Julius Atashili, PhD, 2005 and 2009 EPI alumnus, died Oct. 24, in Cameroon. He was 38.
Amit Bhaskar, first-year student in the Gillings School’s Master of Science in Clinical Research program and fellow in the UNC medical school’s gastroenterology and hepatology program, died Sept. 1. He was 35.
Timothy R.L. Black, MD, MPH, CBE, School alumnus and visionary international advocate for women’s reproductive rights and family planning services, died Dec. 11, 2014, in Sussex, England, at age 77.
Heather Waterman Huneycutt, DVM, recent alumna of NCSU School of Veterinary Medicine and first-year PHLP student, died Aug. 23 from injuries sustained in a motorcycle crash. At 26, she was a prize-winning runner and dedicated captain in the U.S. Army Veterinary Corps.
C. Arden Miller, MD, national leader and expert in child health, died July 26 in Chapel Hill, N.C., at age 90. Miller served as president of the American Public Health Association (1974-1975), vice chancellor of health sciences at UNC-Chapel Hill (1966-1972), and chair (1977-1987) and professor of MCH at the UNC Gillings School.
Michael O’Malley, PhD, associate director of the UNC Lineberger Comprehensive Cancer Center and adjunct associate professor of HPM at the Gillings School, died unexpectedly on June 24 at his home in Chapel Hill. He was 64. A tribute website is at michael.web.unc.edu.
Norman Fred Weatherly, PhD, professor emeritus of parasitology, died July 13 in Durham, N.C. He was 83.
Clare Barrington, PhD, associate professor of HB, was awarded a five-year, $15 million grant as the only U.S. university collaborator on HIV disparities research in Central America. Funded by the CDC and PEPFAR, Barrington will work with the Universidad del Valle de Guatemala to develop and evaluate interventions that protect transgender women and men who have sex with men, two groups in Guatemala most affected by HIV.
Michael R. Kosorok, PhD, W.R. Kenan Jr. Distinguished Professor and chair of BIOS, was awarded a five-year, $10.4 million National Cancer Institute grant to continue finding ways to design more powerful cancer clinical trials, effectively delivering better and more personalized new therapies to cancer patients sooner. The grant originally was funded in 2010. Partners include Duke University and North Carolina State University.
Kosorok also co-directs the Big Data to Knowledge (BD2K) Training Program, which provides integrated training for graduate students in biomedical science, informatics and statistics. The program was made possible by a training grant award from the NIH’s BD2K Initiative.
The SEARCH for Diabetes in Youth project has won $1.9 million in CDC support for another five years’ surveillance of the incidence, prevalence and complications of childhood diabetes in the U.S. Elizabeth Mayer-Davis, PhD, Cary C. Boshamer Distinguished Professor and chair of NUTR, is principal investigator for the UNC site, one of five national SEARCH centers, and national co-chair for the project, which she has helped oversee for the last 15 years.
Vineet Menachery, PhD, postdoctoral fellow in EPI, was selected for a five-year Pathway to Independence Award from the National Institute on Aging. The award provides career transition support and funding for his research project on aging pathogenesis.
Steven Meshnick, MD, PhD, EPI professor, and co-principal investigator Thomas Mather, PhD, of University of Rhode Island at Kingston, were awarded a four-year grant of more than $2 million to study Lyme disease prevention and exposure among outdoor workers in Rhode Island.
Kavita Singh Ongechi, PhD, research assistant professor, and Ilene Speizer, PhD, research professor, both in MCH; Clare Barrington, PhD, associate professor of HB; and Bruce Fried, PhD, associate professor of HPM, will collaborate with others on a $500,000 Gates Foundation grant to evaluate maternal and newborn interventions in Ethiopia.
Bryan Weiner, PhD, HPM professor, is co-investigator for a $15 million Agency for Healthcare Research and Quality grant that will help primary-care practices use the latest scientific evidence to improve the heart health of millions of Americans.
Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit sph.unc.edu/cph.