Hongmei Wang, PhD

Hongmei Wang, PhD

Hongmei Wang, PhD

Faculty Highlight – Dr. Hongmei Wang teaches two courses: Quantitative Methods in Health Services Research, a required course for the PhD students in Health Services Research and Administration, and Health Economics, a concentration course for MPH students in Health Policy. In addition, she directs independent study courses on Economic Evaluation with PhD students from the UNMC College of Nursing and provides guest lectures on Economic Evaluation for other courses at UNMC. She also offers training at state and regional meetings. Dr. Wang serves as both an academic advisor and a capstone committee advisor for MPH students and as a committee member for doctoral students.

Dr. Wang’s research interests focus on socioeconomic determinants of health and economic evaluation of health care programs and medical intervention strategies. She is particularly interested in examining how individual choices, organizational schemes, and sociocultural structures collectively influence population health and health care systems. Dr. Wang has been working on projects exploring the protective effects of social capital on health outcomes and health-related behaviors. Recently, she has been evaluating and examining the effects of community intervention strategies on promoting healthy lifestyle behaviors and reducing obesity. She currently works with colleagues from the UNMC College of Public Health (COPH) Department of Health Promotion, Social and Behavioral Health and the UNMC COPH Department of Epidemiology to evaluate Nebraska Department of health and Human Services Cancer Screening programs, Douglas County community obesity interventions, school-based health centers, and Nebraska Juvenile service delivery projects.

Dr. Wang serves as a member of the Curriculum Committee, Community Engagement Coordinating Council, and Sparks Pre-professional/Undergraduate Student Scholarship in Health Promotion & Disease Prevention Selection Committee.

Hongmei Wang, PhD, is an assistant professor in the UNMC COPH Department of Health Services Research and Administration

Rohan Jadhav

Rohan Jadhav

Rohan Jadhav

Student Highlight – Rohan Jadhav is a PhD student in the Department of Environmental, Agricultural and Occupational Health. He is from Mumbai, India, and has finished the first year of his doctoral program. Rohan earned an undergraduate degree in Ayurvedic Medicine and Surgery from Maharashtra University of Health Sciences, Nashik, India. After finishing his medical training, Rohan worked as a family physician for two years in his hometown, Dombivali, a suburb near Mumbai. While working as a physician, he gradually realized that although one-on-one medical consultation is important, it is not enough to improve the health of a community and that public health research and advocacy was also necessary. With this understanding, Rohan decided to pursue higher education in public health and moved to the United States for training in public health science and research at Missouri State University, where he earned an MPH degree. During an internship at Linn County Public Health, Cedar Rapids, Iowa, Rohan was exposed to a variety of public health disciplines and experienced how these disciplines worked hand in hand. This experience expanded his view of public health practice in the United States.

Rohan’s interest in injury and disease prevention and in teaching healthy behaviors motivated him to pursue doctoral education in Environmental, Health, Occupational Health, and Toxicology at the College of Public Health (COPH) of the University of Nebraska Medical Center. His dissertation is focused on risk factors in agricultural injuries. Agriculture is one of the most dangerous industries in the United States and in many parts of the world. Farmers are exposed to various dangers, including hazardous machinery, large animals, and working on large bins. The complex nature of farming makes it difficult for farmers to avoid these exposures, putting them at risk of fatal and non-fatal injuries. Rohan is working to identify the factors that elevate injury risk so that researchers can target specific populations with appropriate interventions.

Rohan is also interested in risk evaluation of exposures that are generally considered safe. One such exposure is to the smoke created by electrocautery during surgery. Rohan is working to evaluate the risk of pollutants in the surgical smoke. Rohan hopes that in the future, his expertise in environmental and occupational health and medicine will enable him to improve the health outcomes of communities across the United States and in India.

Rohan finds the learning atmosphere at UNMC highly encouraging to students, noting that faculty and staff have been very helpful and attentive. He also observes that the abundant resources for research in public health set the UNMC COPH apart from other institutions

Fernando Wilson, PhD: Research on Public Health Policy and Health Services

  source: teens.drugabuse.gov


source: teens.drugabuse.gov

Spotlight on Research at COPH – Dr. Wilson studies public health issues using econometrics. Econometrics brings together economics, mathematics, and statistics to analyze data. This type of analysis allows researchers to test theories, forecast outcomes, and evaluate policies. Currently, Dr. Wilson is principal investigator for a project examining the effectiveness of state distracted driving policies in decreasing motor vehicle injuries and fatalities. This work is funded by the Robert Wood Johnson Foundation’s Public Health Law Research program. Driving while distracted has become a high profile threat to road safety in recent years with the proliferation of cell phones and other mobile electronic devices, resulting in thousands of fatalities every year. However, designing and enforcing policies to effectively discourage drivers from using electronic devices while driving has been difficult. For example, there is little evidence that bans on texting while driving have been effective in curbing this behavior. Dr. Wilson’s study seeks to analyze which policies work to reduce crashes from distracted driving and, if a policy is not working, to determine how it can be improved.

Econometric techniques may also shed new light on long-standing problems in public health and health services research. For example, policies that restrict access to health care and other services by immigrants have been—and will continue to be—points of contention among state and federal policymakers. The unauthorized immigrant population in particular is notoriously difficult to study, and thus, inferences about their impact on the US health care system are largely speculative. Yet knowledge of this impact is an important but missing component of the policy debate surrounding immigration reform and immigrant access to health insurance exchanges in the Affordable Care Act. By using sophisticated econometric analysis with nationally representative data on immigrants, Drs. Jim Stimpson, Dejun Su and Wilson were able to predict health care utilization and expenditures for the unauthorized immigrant population in the United States, thus providing an important contribution to the policy debate. Results from this study were recently published in Health Affairs.

Dr. Wilson joined UNMC in January 2013. He received a PhD in economics from the University of Chicago and BA in economics from the University of Texas at Austin. He has worked in public health since 2006.

Fernando Wilson, PhD, is an associate professor in the UNMC COPH Department of Health Services Research and Administration. 

Sun: Friend or Foe?

source:apod.nasa.gov

source:apod.nasa.gov

Public Health Community Advisory – Break out the dancing elephants and the 76-trombone marching band:  Summer is finally here! As we welcome back our tank tops, shorts, and sandals from their six-month exile, we mustn’t forget the other bare essentials for a fun day in the sun: plenty of water, a hat, and of course, sunscreen. But is all sunlight dangerous? How essential is sunscreen to protecting ourselves from skin cancer, and does one size–or SPF–fit all? Sunlight, or more specifically ultraviolet radiation (UVR), does contribute positively to human health. Sunlight helps with seasonal mood disorders and helps humans produce compounds that fight infection. Our skin’s exposure to UVR helps our bodies produce the active form of vitamin D. Most Americans fall within the healthy range of circulating vitamin D; however, in some studies, more than 60% of African Americans, 40% of Latinos, and more than 80% of youth of some Midwestern Native American Tribes are severely deficient (less than 20ng/ml in blood serum) (3,8,9,) putting them at increased risk for asthma-related hospitalizations, certain cancers, upper respiratory infections (colds), and hospital-acquired infections and death (2,11,12).  One study reported that 86% of African American children with asthma were severely deficient in vitamin D (9).

How do we find a balance between healthy sun exposure, diet, vitamin D supplementation, and sufficient vitamin D levels? First, know your skin type. The Centers for Disease Control and Prevention references the Fitzpatrick Skin Tone Scale (FSTS), with designated levels of I, II, III, IV, V, VI, when discussing skin cancer prevention (1). The website http://www.skincancer.org/prevention/are-you-at-risk/fitzpatrick-skin-quiz

is a good place to start if you are not sure where your skin tone falls on the FSTS. Skin tone is not determined wholly by race but by the type of melanin found in the skin of every human. Pheomelanin is lighter and predominates the skin of FSTS types I and II. Eumelanin is darker and predominates the skin of FSTS types V and VI. Why is this important? It has been stated that melanin is the most perfect protection against UVR photodamage (of skin). Of the two types of melanin, Eumelanin blocks harmful sunlight (UVR) three to six times more effectively, making FSTS types V and VI 70 times less likely to develop skin cancer than those with lighter skin tones I and II (4).

Because there is no free lunch in biology, walking around with skin naturally infused with the equivalent of SPF 4 (SPF is sun protection factor) comes at a cost. If you are an FSTS type IV, V, or VI in North America, the melanin in your skin blocks about 75% of UVR, and you typically will not be able to produce vitamin D at sufficient levels solely from sun exposure. Second, embrace your skin type. If you are an FSTS type I or II, understand that you should protect your skin from harmful sunlight at all times. Your skin has virtually no innate protection from damaging UVR. SPF 30 or higher should probably be worn when in summer sun for extended periods of time. However, types I and II need very little sun exposure to maintain healthy vitamin D levels. If you are a type V or VI, your risk of skin cancer is extremely low because Eumelanin blocks 83%-93% of UVR (5). However, due to geographic, dietary, and cultural factors, types V and VI in North America are at serious risk of vitamin D deficiency-associated disorders.

As a result, everyone—especially those with skin type IV, V, or VI–should have their vitamin D levels evaluated with their primary care physician. Based on your circulating vitamin D levels, you may need to modify your diet and/or take a vitamin D supplement to get within the healthy vitamin D range (30ng/ml-80ng/ml). Also, the appropriate sunscreen SPF should be used according to your skin type and sun sensitivity. One size does not fit all. And if you choose to get your vitamin D the traditional way (unfiltered sunlight), morning sunlight is least dangerous. Talk with your physician about your personal risk of skin cancer, for no one is immune. Knowledge is empowering! Have a healthy summer.

1) National Institutes of Health, Office of Dietary Supplements (ODS). Retrieved from  http://www.cdc.gov/excite/skincancer/mod08.htm

http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

2) Abbas, S., Nieters, A., Linseisen, J., Slanger, T., Kropp, S., Mutschelknauss, E., . . . Chang-Claude, J. (2008). Vitamin D receptor gene polymorphisms and haplotypes and postmenopausal breast cancer risk. Breast Cancer Research, 10(2), 31.

3) Blaney, G. P., Albert, P. J., & Proal, A. D. (2009). Vitamin D metabolites as clinical markers in autoimmune and chronic disease. Annals of the New York Academy of Sciences, 1173(1), 384-390.

4) Brenner, M., Hearing, V. (2008) The protective role of melanin against UV damage in human skin. Photochem Photobiology 84(3):539-549

5) Gloster, H.M. Jr, Neal, K. (2006) Skin cancer in skin of color. J Am Acad Dermatol ;55:741–760. 761–744. quiz.

6) Halder, R.M., Bang, K.M. (1988) Skin cancer in blacks in the United States. Dermatol Clin. 6:397–405.

7) Institute of Medicine, Food and Nutrition Board. (2010). Dietary reference intakes for calcium and vitamin D. Dietary Reference Intake. Retrieved from http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx

(8) Jacobs ET, Alberts DS, Foote JA, Green SB, Hollis BW, Yu Z, Martínez ME Vitamin D insufficiency in southern Arizona. Am J Clin Nutr. 2008 Mar;87(3):608-13.

(9) Litonjua, A. A., & Weiss, S. T. (2007). Is vitamin D deficiency to blame for the asthma epidemic? Journal of Allergy and Clinical Immunology, 120(5), 1031-1035.

(10) Nsiah-Kumi PA, Erickson JM, Beals JL, Ogle EA, Whiting M, Brushbreaker C, Borgeson CD, Qiu F, Yu F, Larsen JL. Vitamin D insufficiency is associated with diabetes risk in Native American children. Clin Pediatr (Phila). 2012 Feb;51(2):146-53.

(11) Peppone, L. J., Rickles, A. S., Janelsins, M. C., Insalaco, M. R., & Skinner, K. A. (2012). The association between breast cancer prognostic indicators and serum 25-OH vitamin D levels. Annals of Surgical Oncology, 19(8), 2590-2599.

(12) Youssef DA, Ranasinghe T, Grant WB, Peiris AN. Vitamin D’s potential to reduce the risk of hospital-acquired infections. Dermatoendocrinol. 2012 Apr 1;4(2):167-75.

 

This article was written by Michael L. McCaskill, MPH, PhD, assistant professor in the UNMC COPH Department of Environmental, Agricultural, and Occupational Health.

Organ Donation

source:donatelife.net

source: donatelife.net

Public Health in the National News –  The statistics are sobering: 118,288 people are waiting for an organ as of June 10, 2013; 18 people die each day waiting for an organ. The statistics are also hopeful: 1 organ donor can save up to 8 lives; 1 eye and tissue donor can enhance the lives of as many as 50 people. The percentage of transplant recipients who are still living 5 years after transplant ranges from 54.4% for lung transplants to 74.9% for heart transplants.

Anyone, regardless of age or medical history, can sign up to be a donor. Every state provides access to a donor registry where its residents can indicate their donation decisions. When matching donor organs to recipients, the computerized matching system considers issues such as the severity of illness, blood type, time spent waiting, other important medical information, and geographic location.

Behind the facts are the people. One member of the UNMC College of Public Health (COPH) family has firsthand experience with organ donation. Fran Neff’s husband, Leonard, was diagnosed with end stage renal disease while they were dating. Fran is an office associate in the UNMC COPH Office of the Dean. Her husband’s kidney disease-related health issues have been a part of their daily lives. Leonard has had 3 cadaveric kidney transplants since 1989, with the third one in August 2012. Fran says, “It’s humbling to know that with the joy and happiness of each transplant Leonard has received there is sorrow too, a person has died and given the ultimate sacrifice for him—the gift of life.”

Fran points out that a common misunderstanding is thinking organ transplantation is a cure and not just a temporary form of treatment for the disease. All transplant patients take immune suppressant drugs and possibly steroids for the life of the transplanted organ. The drugs can cost from $2,000 to $4,000 a month and carry serious side effects. In addition, the patient undergoes considerable lab work. “You’re never far from that ‘leash’ to the Diagnostic Center and the transplant team,” Fran says.

When asked what one thing is most important for readers of The GroundBreaker to know, Fran says “Awareness! Even with all of the medical miracles we have, people continue to die every day waiting for a transplant. I encourage you to become an organ and tissue donor. Talk with your family and let them know your wishes now so there are no last minute struggles concerning your donation wishes.

References:

US Department of Health and Human Services (June 6, 2013). Retrieved from http://organdonor.gov/index.html