April 18, 2024

The UNC-Chapel Hill Graduate School’s Impact Awards are designed to recognize graduate students in programs across disciplines for their powerful discoveries that contribute to the educational, economic, physical, social or cultural well-being of North Carolina communities and citizens.

This year, seven of the 12 recipients are from the UNC Gillings School of Global Public Health.

The 12 students and recent alumni honored in 2024 are emblematic of graduate students and their dedication to improving the lives of North Carolinians. The Impact Awards are generously supported by The Graduate School’s Graduate Education Advancement Board.

The winners from the Gillings School include:

Eric Brown

Eric Brown

Eric Brown, doctoral candidate in environmental sciences and engineering

Topic: Preterm birth disparities

Identifying placental mechanisms linking environmental chemical mixtures to preterm birth disparities

“Prenatal exposure to various environmental chemicals, including lead in drinking water, is associated with increased risk of preterm birth. With a rapidly changing climate, the toxicity and distribution of environmental chemicals are projected to increase. To make matters more complicated, research is increasingly demonstrating that pregnant women are exposed to multiple chemical and non-chemical stressors, simultaneously.

Using N.C. birth certificates between 2003 and 2015, my research seeks to examine how climate change-related factors (PM2.5, ozone, and extreme heat) will increase the toxicity of lead on preterm birth.

My study showed two major findings: (1) first-trimester exposure to PM2.5 drives the toxicity of the mixture, (2) extreme heat increases the toxicity of environmental chemicals, and (3) neighborhood socioeconomic status (SES) characteristics are associated with exposure to the environmental chemicals. Notably, climate change-related factors and extreme heat above 70°F jointly increase the odds of preterm birth by 577%. Areas with less integration may be more likely to be affected by climate change-related stressors, highlighting the need to identify environmental chemical reduction technologies for disease prevention. These results inform an ongoing biomonitoring campaign with partner physicians at UNC-Chapel Hill to build in chemical testing at routine pregnancy visits.”

Clara Busse

Clara Busse

Clara Busse, doctoral candidate in maternal and child health

Topic: Postpartum acute care

Acute care use in the postpartum period: patterns and maternal perspectives

“In N.C., more than half of pregnancy-related deaths occur after birth, and Black mothers are nearly twice as likely to die from pregnancy-related causes compared to White mothers.

Once they leave the hospital after having their baby, many mothers do not see a health care provider until their postpartum check-up about six weeks later. This system, along with the fact that postpartum health concerns are often urgent, may lead mothers to seek care in an emergency department for their postpartum health concerns. Through my dissertation research, I am seeking to understand how often and for which reasons mothers and other people who give birth in N.C. use emergency healthcare after giving birth.

For this project, I interviewed mothers who used emergency healthcare and analyzed electronic medical records from the University of North Carolina Health System to study postpartum emergency healthcare use. Findings from my dissertation research and related research projects at the University of North Carolina are being used to improve the care that N.C. mothers receive throughout the University of North Carolina Health System, where one in eight births occur in the state of N.C., approximately 17,000 births per year.”

Mekhala Dissanayake

Mekhala Dissanayake

Mekhala Dissanayake, doctoral candidate in epidemiology

Topic: Maternal health inequities and systems

Race and racial composition of county: investigating maternal health inequities and healthcare systems factors in the rural south

“There are stark disparities related to both race and rurality in maternal health outcomes in N.C. Availability of maternal health care is likely a major contributor—from 2014-2019, six hospitals and nine obstetric units closed in rural N.C. Rural N.C. is racially diverse and geographically stratified by race: counties in Appalachia and the Outer Banks are up to 95% white, while counties in Central/Eastern NC have high concentrations of Black, Hispanic, and American Indian populations. It is important to consider the geographic contexts in which rural people live because of the differential availability of maternal health care and subsequent effects on maternal health outcomes.

My dissertation addresses this by contrasting counties within Appalachia/Outer Banks to Central/Eastern N.C. and determining distributions of maternal health care resources (hospitals, obstetric units and maternal health providers) and outcomes at delivery and the postpartum period. My first aim is to investigate changes in maternal outcomes after hospital and obstetric unit closures in these different county contexts. The second aim determines the effect of equalizing distributions of maternal health resources across rural counties on disparities in maternal outcomes.

My work aims to identify the salient healthcare factors that contribute to racial disparities in maternal outcomes among those living in rural N.C. I hope to provide critical public health information on which populations have the highest burdens, where they are concentrated, and potential interventions.”

Clara Eichler

Clara Eichler

Clara Eichler, doctoral candidate in environmental sciences and engineering

Topic: Neutral PFAS in indoor environments

Characterization of the distribution and fate of neutral PFAS in indoor environments including the role of clothing

“N.C. is among the states with the highest population exposure to per- and polyfluoroalkyl substances (PFAS) in the US. The contamination of the Cape Fear watershed with these ‘Forever Chemicals’ has frequently made headlines in recent years. And rightfully so, because the health effects of PFAS include liver disease, neurodevelopmental problems and cancer; although for many PFAS, toxicological data are sparse.

Because PFAS make products stain- and water-repellant, they are used frequently in products like cookware, raingear and upholstery. Therefore, even if all PFAS were successfully removed from water sources, PFAS can linger in homes, where many people spend a lot of time. Unfortunately, we do not know much about the magnitude of indoor exposure to PFAS or about the ability of different indoor reservoirs to accumulate PFAS.

The Indoor PFAS Assessment (IPA) Campaign gave me the opportunity to measure PFAS in indoor air, cloth, dust and other reservoirs in 11 N.C. homes. I found significant amounts of PFAS in all indoor reservoirs in all homes, and my research characterizes how PFAS are distributed indoors. For example, I was able to show that cloth is a major reservoir for PFAS, even if the cloth was initially PFAS-free. My research highlights the importance of addressing all potential pathways of exposure to PFAS, including indoor exposure. Further, this knowledge can help to develop strategies for PFAS exposure mitigation in homes.”

Ximena Perez-Velazco

Ximena Perez-Velazco

Ximena Perez-Velazco, doctoral candidate in nutrition

Topic: Food insecurity among UNC students

Combatting food insecurity among college students at UNC: testing a social marketing intervention to promote SNAP use

“Food insecurity (FI)—defined as a lack of consistent access to enough quality, variety and culturally appropriate foods—is recognized as a major public health crisis in the United States.

Food insecurity affects a wide range of social, socio-economic and age sub-groups; including college students. College students experience food insecurity at a disproportionately higher rate than the general public. This has significant public health implications because this experience gives rise to unique consequences for college students related to poor academic performance and college graduation rates, notable determinants of health.

The Supplemental Nutrition Assistance Program (SNAP) is the largest U.S. federal-level nutrition assistance program that provides food purchasing benefits to eligible low-income individuals and families. It is well understood that SNAP is an effective method to combat food insecurity and improve diet quality. Even though many may be eligible, students enrolled in institutions of higher education rarely apply for or receive SNAP benefits.

The purpose of my study is to inform, develop, and test an intervention designed to address the misunderstandings and lack of awareness surrounding SNAP benefits, to evaluate how to best increase applications to SNAP, and self-efficacy around SNAP, among college students at UNC-CH. If evidence is provided on the effectiveness of the intervention, we will provide recommendations for how it can be disseminated to other institutions of higher learning to address food insecurity on a larger scale.”

Allie Reimold

Allie Reimold

Allie Reimold, doctoral candidate in health behavior

Topic: Dollar stores as food retailers

A mixed methods approach to studying dollar stores as food retailers

“Dollar stores like Dollar General and Dollar Tree are the fastest-growing food retailers in the U.S. This growing retail sector may negatively impact nutrition and associated health outcomes, especially for low-income communities who disproportionately shop at them. As a result, more than 25 U.S. municipalities have passed policies to limit dollar store growth.

New Hanover County, in the Cape Fear Region of N.C., has more dollar stores by land area than any other county in the state. To ensure an equitable food environment, local organizations and policymakers need to better understand this emerging issue. In collaboration with the local non-profit, Feast Down East, my research aims to: 1) understand how and why individuals with low incomes rely on dollar stores for food; and 2) highlight their voices in local discussions about policy and programmatic options.

I found that study participants rely on dollar stores because the affordable prices and convenient locations address their persistent barriers to accessing food at traditional retailers. Though they appreciate dollar stores, participants frequently discussed wanting fresh fruit and vegetable options and higher-quality proteins in the stores. Participants support policies and programs like SNAP dollar-for-dollar matching for fruits and vegetables, increasing the variety of fruits and vegetables available, and promoting healthy options at dollar stores. These findings have informed Feast Down East efforts and were presented during a participatory ‘Data Party’ with the Cape Fear Food Council for collaborative identification of responsive next steps for decisionmakers in the Cape Fear Region.”

Molly Remch

Molly Remch

Molly Remch, doctoral candidate in epidemiology

Topic: Restrictive housing in N.C. prisons

Evaluation of two novel restrictive housing diversion units in N.C. prisons

“Mass incarceration is a clear and pressing public health and health equity issue in N.C., with an incarceration rate that far surpasses that of most democratic countries in the world. Incarceration and restrictive housing (i.e., solitary confinement) are each disproportionately applied to Black North Carolinians and North Carolinians with mental health disorders.

Through ongoing collaborative partnerships with the N.C. Department of Adult Corrections and Division of Public Health, I led evaluations of two novel N.C. prison restrictive housing diversion units, Therapeutic Diversion Units (TDUs) and the Rehabilitative Diversion Unit (RDU).

We found that individuals in TDU had lower rates of inpatient mental health admissions and self-injury than those placed in restrictive housing; these benefits were not sustained when individuals returned to the general prison population. Similar rates of infractions among those in TDU and restrictive housing indicate TDU does not pose a security risk. We concluded that TDU is a viable, health-promoting alternative to restrictive housing, but additional step-down programming and continued access to therapeutic services in the general prison population would be beneficial. In our evaluation of RDU, we found that rates of violent infractions, mental health needs and self-injury were lower in RDU than in restrictive housing. However, violent infractions resumed more quickly post-RDU than post-restrictive housing. We concluded that RDU was an important tool for improving mental and behavioral health, but this population would benefit from sustained step-down programming.”

Learn more about all of the 2024 Impact Awards winners from The Graduate School.

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