March 24, 2017
Four UNC Gillings School of Global Public Health students have won The UNC Graduate School’s Impact and Horizon awards for outstanding research that benefits the people of North Carolina and beyond.
They are Katy Brown, doctoral student in environmental sciences and engineering (ESE); Maggie Reinsvold, Public Health Leadership Program (PHLP); Dalia Stern, PhD, 2015 alumna in nutrition (NUTR); and Frank Stillo III, doctoral student in ESE.
For many years, The Graduate School has honored UNC graduate students with the Graduate Education Advancement Board (GEAB) Impact Award for research discoveries that contribute to better futures for people in North Carolina. New this year is the Horizon Award, which also recognizes discoveries with potential to benefit North Carolinians and communities everywhere.
The Horizon and GEAB Impact Award recipients will be honored at the 19th annual Graduate Student Recognition Celebration, held on April 20 at the George Watts Hill Alumni Center’s Carolina Club. Awardees will be recognized from 4 to 4:30 p.m., followed by research poster presentations and a reception.
Katy Brown (ESE)
Brown, whose project, “Testing for Antibiotic-Resistant Bacteria in Environmental Waters,” won a Horizon Award, worked with Mark Sobsey, PhD, Kenan Distinguished Professor of ESE, to evaluate a method for detecting antibiotic-resistant bacteria in treated sewage and surface water.
Brown collected environmental water samples in Chapel Hill from raw domestic and hospital sewage, treated sewage effluent and surface water from a stream in which the effluent is released. In collaboration with UNC Hospitals, the Orange Water and Sewer Authority, N.C. State University College of Veterinary Medicine and the National Autonomous University of Nicaragua at León, she found that 44 percent of microbes in hospital sewage and 12 percent in raw sewage were antibiotic-resistant.
An increase in antimicrobial resistance, resulting from human, agricultural, medical and industrial waste, threatens the prevention and treatment of infectious diseases worldwide. Brown’s study of the direct, one-step, culture-based testing method proposed by the World Health Organization provides a model for effective and low-cost monitoring of water in other geographic regions in the U.S. and abroad.
“Katy has contributed new insights into the presence of highly antimicrobial resistant enteric bacteria in a representative urban community and the extent to which these bacteria enter the aquatic environment and potentially impact downstream uses of this water,” Sobsey said. “Her evaluation methods are simple yet powerful enough to gain wide use, both locally and globally.”
Maggie Reinsvold (PHLP)
Reinsvold, who recently earned her master’s degree at the Gillings School, won an Impact Award for her project, “Detecting Heart Risk Factors for Farmworkers.”
More than 86,000 migrant and seasonal farmworkers find work in North Carolina, and when their dependents are included, that number swells to more than 155,000. Even though research about this population has centered on occupational and environmental health issues, Reinsvold focused upon the group’s cardiovascular risk factors, examining the records of North Carolina farmworkers served by the N.C. Farmworker Health Program in 2012 and 2015.
Reinsvold conducted her research with advice and support from Anthony Viera, MD, MPH, director of PHLP’s health care and prevention Doctor of Medicine – Master of Public Health (MD-MPH) program and professor of family medicine at the UNC School of Medicine, and Gayle Thomas, MD, assistant professor of family medicine and medical director for for the North Carolina Farmworker Health Program (NCFHP).
She found that 23 percent of farmworkers served by the NCFHP and included in the study in 2012 were hypertensive (i.e., their blood pressure measured at or above 140/90); in 2015, 25.6 percent of the population were hypertensive. Almost 79 percent of all participating farmworkers whose body mass index (BMI) data were available were overweight or obese in 2015. Compared to seasonal farmworkers, migrant farmworkers were more likely to experience hypertension (1.5 times the odds in 2015; nearly double the odds in 2012).
The N.C. Farmworker Health Program is using Reinsvold’s research to improve blood pressure screening and cardiovascular health of farmworkers. Her research provides greater understanding of broader health challenges facing this underserved population in North Carolina.
“Maggie carefully considered in advance how her analysis could be used to increase awareness of issues in farmworker health and how the information could be shared,” Viera said.
Dalia Stern, PhD (NUTR)
Stern’s research project was titled “Do More Food Shopping Options Lead to Healthier Decisions?”.
About 30 percent of adults in North Carolina – and 37 percent of adults in the United States – are obese, according to the U.S. Centers for Disease Control and Prevention.. Some research suggests that less access to grocery stores and higher access to smaller convenience stores contribute to the national obesity epidemic. Stern wanted to discover whether shopping at grocery stores led to healthier food purchases, compared to other types of stores.
Using information collected from a large, nationally representative sample of households between 2000 and 2012, she examined where people shopped for food, which foods they purchased and the nutrient profile of their purchases. Her analysis suggests that while grocery stores account for the majority of U.S. household food purchases, a growing volume of packaged food is purchased through mass merchandisers. Racial minority households are more likely to shop at a combination of large and small stores, compared to non-Hispanic white households.
Her findings showed no nutritionally meaningful differences in the energy, sugar, saturated fat and sodium content of total packaged food and beverages purchased at grocery stores, mass merchandisers, warehouse clubs and convenience stores. She also found that salty snacks, grain-based-desserts, breads and tortillas, candy and sweet snacks, sugar-sweetened beverages and fruit juices were among the main foods and beverages purchased in all types of stores. Stern’s research suggests that future food policies focused on improving eating habits should go beyond healthy food access to incorporate consumers’ complex shopping behavior—and their ease in locating less nutritious food and beverages in all stores.
“Dr. Stern’s research was particularly innovative and impactful,” said her adviser, Barry Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of nutrition. “Hers was the first nationally representative set of studies showing that low-income and minority shoppers did not only shop at local small bodegas (or similar small stores that had no produce or healthy food), but rather shopped at a mixture of stores—from supermarkets to large club stores to small local stores.”
Frank Stillo III (ESE)
Stillo, awarded for his project, “Water Quality, Health Disparities in Wake County (N.C.),” earned an Impact Award for work he conducted under the direction of Jacqueline MacDonald Gibson, PhD, associate professor of environmental sciences and engineering.
North Carolina households without access to municipal water service typically rely on private wells for their drinking water. These households are solely responsible for ensuring the quality of their water. Several studies have identified African-American communities that are completely encircled by municipal borders yet do not have access to municipal water services.
MacDonald Gibson had conducted research within communities meeting these geographic criteria in Wake County, finding that the likelihood of exclusion from that county’s municipal water service increased with the proportion of African-Americans in the population. Her research identified 1,010 households with approximately 3,800 residents adjacent to municipal borders that lack connections to nearby municipal water infrastructure.
Although previous studies have documented disparities in access to municipal water service, little is known about health risks of exclusion from municipal water service. Stillo followed up with residents in Gibson’s study, testing private well water samples for 57 households. He recruited and trained volunteers from a UNC-Chapel Hill student organization to collect the samples and perform microbial testing.
Overall, 65 percent of homes and 47 percent of samples tested positive for microbial contamination. Stillo used these findings in estimating the number of emergency department visits for acute gastrointestinal illness within the neighborhoods studied. He found that about 22 percent of 114 annual emergency room visits may be attributable to private well water contamination. Stillo’s study findings have informed N.C. Division of Public Health outreach initiatives to affected Wake County residents and policy discussions about addressing drinking water disparities in North Carolina.
“Frank’s research not only has had an impact upon programs within the North Carolina Division of Public Health but also has directly benefited individual North Carolina households struggling to ensure the safety of their drinking water,” MacDonald Gibson said.
“Whether it is discovering new information about N.C. water or about how people shop for food today, our students’ research is contributing to a healthier state,” said Barbara K. Rimer, DrPH, dean and Alumni Distinguished Professor at the Gillings School. “Their research takes them out of our classrooms and across North Carolina to gain new insights into risk factors for disease and how to protect and promote the health of North Carolinians. I am so proud that, even while in school, our students are having a positive impact on the health of people in our state. That makes our School and their education an even better value for the investment made in us by the people of North Carolina.”
For information on all 19 winners, visit The Graduate School’s website.