Approaches for Addressing Health Disparities

Using Emerging Air Sensors to Identify Community Air Pollution Exposures Specific to South Philadelphia.

A study led by Sheila Tripathy, PhD, Postdoctoral Fellow in the Department of Environmental and Occupational Health at the Dornsife School of Public Health, is being awarded $30,000 for her project, “Using Emerging Air Sensors to Identify Community Air Pollution Exposures Specific to South Philadelphia.” The cross validation of instrumentation to measure particle- and gas-phase emission in this vulnerable community will make an important contribution to the progression of science in this field.

Approaches for Addressing Health Disparities

The Association of Neighborhood-Level Factors with Chronic Kidney Disease in Philadelphia

Led by Suzanne Boyle MD, MSCE, assistant professor of medicine, and Meera Harhay, MD, MSCE, assistant professor of medicine, Drexel College of Medicine

Chronic kidney disease (CKD) is a major public health problem, affecting more than 15 million adults in the United States. Though CKD is progressive, treatment in the early stages of the disease can prevent or slow down its progression. Unfortunately, many patients do not have adequate pre-dialysis health care in the U.S. Additionally, there are substantial racial and socioeconomic disparities in early CKD diagnosis and outcomes, likely due to many factors including genetic predisposition. Research is needed to better understand factors in disparate risks of end stage renal disease (ESRD) and adverse health outcomes, including food and transportation availability, and home safety on CKD and related outcomes.

Using data from five of Drexel Medicine’s primary care practices, this pilot study will identify risk factors for CKD at the neighborhood level. Specifically, researchers will collect and examine data on economic resources, nutritional and public transportation access, as well as race/ethnicity with CKD prevalence in Philadelphia. Findings from this study will be useful for future community-based studies looking to target interventions on risk factors for CKD.

Heterogeneity and Determinants of Health Disparities by Income in US Cities

Led by Usama Bilal, MD, MPH, PhD, postdoctoral fellow, Drexel Urban Health Collaborative at the Dornsife School of Public Health 

The average life expectancy in the United States has decreased for the second year in a row, while the gap between life expectancy by income is growing across the country. Understanding factors associated with the rise in mortality by income — especially those which can be affected by policy — can help researchers provide evidence for future interventions to promote health and equity in urban areas nationwide.

This study will compare ranges of health disparities by income through the examination of six risk factors: smoking, excessive drinking, sedentary lifestyles, obesity, diabetes and cardiovascular disease. Additionally, the study will explore the connection between and changes within income inequality and life expectancy within a city. The goal is to explore the extent which these associations can be explained by disparities within the above listed risk factors. Though tackling disparities in life expectancy by income is a complex task, requiring interventions outside of public health, understanding the specific disparities in risk factors may create feasible targets for intervention. This project has the potential to inform points for action in decreasing health disparities and improving health in cities within the U.S.

Audience Segmentation Research to Improve the Dissemination of Evidence about Health Disparities to City Policymakers

Led by Jonathan Purtle, DrPH, MSc, assistant professor, Dornsife School of Public Health

Mayors and health commissioners have the potential to reduce health disparities in cities, but little is known about how to most effectively communicate information about disparities to these audiences. This study will examine the effectiveness of communications efforts in driving policymaker awareness of disparities within their cities. Specifically, researchers will assess associations between policymaker opinions on health disparities in their cities and data about the scale of health disparities in the same locale. The study will borrow an analytical approach from the field of advertising: empirical clustering audience segmentation.

Researchers will link policymaker survey data about health disparities in their respective cities to existing county-level measures of life expectancy, available through the Health Inequality Project, a unique dataset that linked Internal Revenue Service tax records (W-2s) and Social Security Administration death records.

Findings from this study will provide a basis for communication strategy design for policymaker audiences, especially those with opinions that counter data about the scale of health disparities within their cities. The goal of this research is to find strategies that will increase the likelihood that policymakers will champion policy initiatives that reduce disparities in their cities.

Leveraging Data to Support Health and Policy Needs

Wearable biosensors to detect respiratory depression associated with heroin and fentanyl use

Led by Alexis Roth PhD, MPH, assistant professor, Dornsife School of Public Health

The opioid epidemic is one of the most severe public health crises facing the United States. In Philadelphia, there were 1,200 fatal overdoses in 2017 — more than any other city in the country — with the leading cause of these deaths being the synthetic opioid fentanyl. While the increasing supply of fentanyl has contributed to the rising number of fatal overdoses, what is unknown is how users are accessing the drug and how they are using it.

More data are needed to characterize drug use patterns and outcomes to better understand the context of overdoses in Philadelphia. One promising tool to better understand and provide this context to researchers is wearable biosensors, such as pulse oximeters and accelerometers. This technology has the potential to provide real-time physiologic data, including polysubstance use, withdrawal, and overdose; however, more data is needed to assess the feasibility and acceptability of this approach. This pilot study will demonstrate and explore the feasibility and acceptability of a wearable biosensor to capture incidence and physiologic response to opioid use and detect overdose events. The research will also assess how affective, cognitive, and environmental factors are temporally related to opioid events. Findings from the research will strengthen understanding of the opioid epidemic through better public health surveillance.

Measuring Implementation of a Certified Peer Support Service for Transition Age Youth with Autism Spectrum Disorder (ASD)

Led by Lindsay Shea, MS, DrPH, director, Policy and Analytics Center, A.J. Drexel Autism Institute

As the growing population of children with autism ages into adolescence and adulthood, service systems across states and cities have struggled to identify service models to meet the populations’ needs. Adolescents with autism aging out of services, or approaching a “service cliff,” experience both declines in needed services and experience poor employment outcomes.

One promising model is currently being adapted and implemented for transitioning youth with autism by Community Behavioral Health (CBH) the Medicaid payer in Philadelphia: certified peer support services. This model has been utilized widely across the U.S. within the systems that provide supports to individuals with mental health disorders. The creation of these peer support services in one of the largest cities in the US presents a unique and timely opportunity to determine how the model will support individuals with autism and provide new employment opportunities for individuals with autism as peers.

The Pennsylvania Office of Mental Health and Substance Abuse Services (OMHSAS) has also been engaged in service launch to ensure Medicaid payment. This additional policy mechanism could allow for rapid dissemination of the model to other areas of Pennsylvania. Data collected in this study can be leveraged to support and inform replication of the model, both across Pennsylvania and in other cities.

Addressing methods for capturing within-city variation

Design and Implementation for Spatially‐Distributed Air Monitoring Campaigns in Philadelphia led by Jane Clougherty, ScD, MSC, Department of Environmental and Occupational Health, Dornsife School of Public Health. The primary goal of this study is to design and validate a template for an air monitoring network in Philadelphia. Currently, there is little available data to estimate spatial variation in air pollution exposures across all Philadelphia neighborhoods, for epidemiological and policy purposes. Dr. Clougherty's project will inventory and map available data on air pollution emissions across the City of Philadelphia, develop site selection and temporal allocation to separate impacts of key pollution sources and implement a pilot NO2 air pollution monitoring campaign.

Development of Bayesian spatiotemporal models for small area estimation with an application to tract-level obesity rates in Philadelphia County led by Harrison Quick, PhD, Department of Epidemiology and Biostatistics, Dornsife School of Public Health. Dr. Quick's pilot study will develop new statistical tools to analyze census tract-level survey data in areas of Philadelphia where available data is insufficient to obtain “reliable” estimates using standard statistical procedures. These methods will be applied to data from the PHMC's Southeastern Pennsylvania Household Health Survey to examine obesity rates for adults and adolescents geographically and by race, over time, and by age and sex. The project aims to develop methods that can be applied to a whole host of health indicators for the Philadelphia area.

Indoor environment in urban settings

Development of a self-assessment tool to assess the work environment and policy at nail salons led by Tran Huynh, PhD, MPH, CIH, Department of Environmental and Occupational Health, Dornsife School of Public Health Dr. Huynh aims to improve conditions for Vietnamese nail salon workers in Philadelphia though the development of an evidence-based intervention. The project will focus on the development of a self-assessment tool and technical assistance for nail salon owners. In addition, the project will develop technical training materials and collaborate with the Philadelphia Department of Public Health (PDPH) to identify staff for implementation, with the goal to initiate a pilot study.

Circadian Lighting for Improved Health and Wellbeing for the Older Adults at Casa Farnese led by PI Donald McEachron, PhD, School of Biomedical Engineering, Science & Health Systems. The pilot research seeks to provide evidence that proper circadian lighting can enhance the lives of older Americans, thus maintaining such individuals' lifestyles and independence for longer periods. Dr. McEachron's circadian lighting study will address the need for daylight-mimicking lighting to improve the health, wellbeing and quality of life for older adults, especially for those residents who live in subsidized affordable housing. The results of this study aim to provide a cost-effective and easily implemented approach for health improvement.

Community resilience

The Creating Resilient and Strong Opinion Leaders (CRiSOL) Program led by Ana Martinez-Donate, PhD, Department of Community Health and Prevention, Dornsife School of Public Health Though community‐academic partnerships between Drexel University, The Philadelphia AIDS Consortium, Women Organized Against Rape (WOAR), and Temple University, the project will develop and pilot test a new approach to promote community resilience among Latino immigrant community in Philadelphia. Led by Dr. Martinez-Donate, the pilot research aims to inform a future research trial of an intervention to address the substance abuse, AIDS/HIC, STDs violence exposure, and mental health syndemic in Latino immigrants in Philadelphia.

The UHC awarded the first round of pilot funding to promote urban health research at Drexel University. The first cohort of pilot-funded projects are:

Reasons for Uninsurance Among ACA Eligible Adults in an Urban Safety Net Setting, led by PI Rachel Peters, MPH, doctoral student, Department of Health Management and Policy, Dornsife School of Public Health.

An Investigation of Associations between Heat and Infant Mortality, and Effect Modification by Greenness and Socioeconomic and Demographic Characteristics in Philadelphia, Pennsylvania, led by PI Leah Hope Schinasi, MPH, PhD, Post-Doctoral Fellow, Department of Environmental and Occupational Health, Dornsife School of Public Health.

Using Data Integration to Create a Profile of Violence Needs and Assets to Inform Solutions in the Latino Community of Eastern North Philadelphia, led by PI Amy Carroll-Scott, PhD, MPH, Assistant Professor, Department of Community Health and Prevention, Dornsife School of Public Health.

Intergenerational Associations between Adult Past Exposure to Adverse Childhood Experiences and Offspring Child Health Outcomes: The Philadelphia Urban ACE Study, led by PI Felice Le-Scherban, PhD, MP, Assistant Professor, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, and PI Lee Pachter, DO, Department of Pediatrics, Drexel University College of Medicine.

The Effects of Housing Discrimination across the Generations: A Proof of Concept, led by PI Mariana Chilton, PhD, MPH, Director of the Center for Hunger-Free Communities, and Department of Health Management and Policy, Dornsife School of Public Health.

Using Electronic Health Records for Population-Level Surveillance of Cardiovascular Risk in Patients with Metabolic Disorder: The Heart of Philadelphia Project, led by PI Longjian Liu, MD, PhD, MSc, Department of Epidemiology, Dornsife School of Public Health.

Addressing Urban Community Violence - UHC Community Violence Working Group

The goal of the Community Violence Working Group (CVWG) is to bring together researchers across the University and other key institutions in Philadelphia to develop new ways of understanding and intervening to decrease community violence in urban neighborhoods. A public health framework which considers the underlying causes and social determinants of health is critical to enacting short-term and longer-term interventions to address community violence.

Throughout the course of the year the workgroup will build upon existing relationships with city agencies, community-based organizations, and service providers who focus on violence prevention/intervention efforts and convene these stakeholders using a Human Centered Design Approach. Through a very intentional and iterative process, attendees will help to develop a proposal for a community led research-based intervention to address community violence. The CVWG will also develop a mini symposium series to bring key academic, government and community leaders together to share best practices and better understand how the range of data elements that are held in different systems can be brought together to produce new insights into community violence. Addressing community violence requires that the voices of community members and community leaders have equal standing with the voices of policymakers, researchers, and practitioners to ensure that approaches to addressing community violence are desirable, feasible and viable, and that they take into consideration a long-term perspective.

Led by John A. Rich, MD, MPH, Professor, Department of Health Management and Policy, Dornsife School of Public Health. Co-Founder of “Healing Hurt People” and Co-Director of the Drexel Center for Nonviolence and Justice; Theodore J. Corbin, MD, MPP, Professor and Vice Chair for Research, Department of Emergency Medicine, Drexel University College of Medicine. Co-Founder and Medical Director, “Healing Hurt People”; Amy Carroll-Scott, PhD, MPH, Associate Professor, Department of Community Health and Prevention, Dornsife School of Public Health.

Maternal and Child Health Research, Training, & Practice Collaborative (MCHC)

The Maternal and Child Health Research, Training, & Practice Collaborative (MCHC) is a collaboration between Drexel (Urban Health Collaborative (UHC), School of Public Health (DSPH), St. Christopher’s Hospital for Children (SCHC)) and the Children’s Hospital of Philadelphia (CHOP) to support a broader agenda of improving Maternal and Child Health (MCH) outcomes in the City of Philadelphia. This working group will build upon existing relationships between Drexel and CHOP, led by UHC and PolicyLab but inclusive of broader colleagues, and serve our mutual goals of reducing health disparities for women and children, developing research to inform policy and action, and partnering with the City of Philadelphia and the Philadelphia Department of Public Health (PDPH) in achieving these goals.

The MCHC will use data-informed and partner informed approaches to: 1. Develop, strengthen, and formalize relationships between Drexel, PolicyLab, and SCHC by identifying complementary skills, resources, and shared goals to inform a sustainable partnership; 2. Create an MCH training infrastructure between Drexel and CHOP that builds on the DSPH MCH Program and its HRSA MCH Catalyst Grant, 3. Create a shared research agenda to support the MCH faculty at all institutions in collaborative research endeavors that support professional development of MCH academicians and advance the science and methods for urban MCH research; and 4. Determine the feasibility, community interest, and role of a larger, more formalized cross-institutional center for advancing MCH research and training and facilitating partnership with MCH organizations in Philadelphia.

Led by Amy Carroll-Scott, PhD, MPH, Associate Professor, Department of Community Health and Prevention, Dornsife School of Public Health, Co-Lead, Policy & Community Engagement Core, Urban Health Collaborative; Jennifer Kolker, MPH, Associate Dean for Public Health Practice, Clinical Professor, Health Management and Policy, Co-Lead, Policy & Community Engagement Core, Urban Health Collaborative, Dornsife School of Public Health; Meredith Matone, DRPH, MHS, Scientific Director, PolicyLab, Children’s Hospital of Philadelphia; David Rubin, MD, MSCE Director, PolicyLab, Director, Population Health Innovation, Children’s Hospital of Philadelphia; Renee Turchi, MD, MPH, Professor, Pediatrics and Department of Community Health and Prevention, Dornsife School of Public Health, Chair of Pediatrics, Drexel University College of Medicine, St. Christopher’s Hospital for Children.

Migration, Ethnicity, Race, and Health Working Group (MERHG)

The Migration, Ethnicity, Race, and Health Working Group (MERHG) is a group of Dornsife School of Public Health (DSPH) researchers and graduate students interested in the role that migration, ethnicity, and race play as determinants of health and in developing and evaluating programs and policies to promote the health of immigrants and ethnic/racial minorities, particularly in urban settings. Representing the four DSPH departments, the group will advance the study of Migration, Ethnicity, Race and Health (MERH) and focus on public health issues affecting immigrant, ethnic, and racial minorities.

The group will collaborate on research projects and publications focused on the health of immigrants and racial/ethnic minorities, mentor junior faculty and graduate students interested in MERH, host monthly colloquia and bring together leading scholars in the area to present, and partner with community organizations who serve immigrant, ethnic, and racial minority communities in Philadelphia, the U.S., and Latin America. Findings from the group’s research will be used to catalyze the formation of a Latino Health Coalition in Philadelphia focused on the health of this growing segment of the city’s population. Long-term, the group hopes to evolve into a Center on Migration, Ethnicity, Race and Health (C-MERH). The working group funding provides momentum for activities, strengthen collaborations, and set a strong foundation for a future C-MERH.

Led by Ana P. Martinez-Donate, PhD, Associate Professor, Department of Community Health and Prevention, Dornsife School of Public Health; Félice Lê-Scherban, PhD, MPH, Assistant Professor, Department of Epidemiology and Biostatistics; Dornsife School of Public Health, Brent Langellier, PhD, MA, Assistant Professor, Department of Health Management and Policy, Dornsife School of Public Health; Jessie Kemmick Pintor, PhD, MPH, Assistant Professor, Department of Health Management and Policy; Tran Huynh, PhD, MPH, CIH, Assistant Professor, Department of Environmental and Occupational Health.

Queer Inclusion, Equality, Health, & Rights Working Group (QuIEHR)

The Queer Inclusion, Equity, Health, & Rights (QuIEHR) working group comprises Drexel community members and community partners engaging in research, education, practice, and advocacy related to public health, human rights, and social inclusion for sexual and gender minority (SGM) populations. This working group will bring faculty and students together to collaborate on shared interests, provide students with research and practice opportunities to promote health equity for SGM in the U.S. and globally, and promote professional development of future generations of researchers to support SGM communities. The three pillars of QuIEHR’s work are (1) Research and Education about SGM Health, (2) Advocacy for SGM Rights, and (3) Application of Public Health in Practice. The group will disseminate scholarly work through written and oral mechanisms, support and champion initiatives that promote SGM equality and well-being and connect students to experiential learning opportunities with QuIEHR-affiliated projects.

Led by Casper Voyles, MPH, PhDc, Community Health and Prevention, Dornsife School of Public Health; Randall Sell, ScD, Professor, Community Health and Prevention, Dornsife School of Public Health; and Ayden Scheim, PhD, Assistant Professor, Epidemiology and Biostatistics, Dornsife School of Public Health.

For more information and to get involved, contact Casper Voyles at chv25@drexel.edu.

Migration, Ethnicity, Racism and Health Working Group (MERHG)

The Migration, Ethnicity, Racism and Health Working Group (MERHG) is a multidisciplinary group of Dornsife School of Public Health (DSPH) faculty, research staff, and graduate students committed to reducing health inequities affecting migrant, ethnic, and racialized minorities (MER) both in the U.S. and in global settings. MERHG members have been engaged in research, mentoring, and advocacy aimed at furthering the understanding of the role of migration, ethnicity, and racism as determinants of health; evaluating the impact of policies and programs on the health of MER communities; and increasing representation of members of MER minorities in public health research and practice-based settings. MERHG members work employs quantitative, qualitative and mixed-methods research; community-engaged research and advocacy; social network analyses; geographic information systems (GIS); systems thinking; and agent-based modeling. The group hosts a series of monthly colloquia with both internal and external speakers; supports scholarly work; collaborates on research grants and papers; leads a community coalition focused on reducing COVID-19 and other health disparities in Latino communities in Philadelphia; and maintains a website to disseminate the group’s work. MERHG seeks to expand its range of activities and impact and is committed to creating an environment that supports intellectual exchange, promotes diversity, inclusion, and collaboration.

Led by Ana P. Martinez-Donate, PhD, Professor, Department of Community Health and Prevention, Dornsife School of Public Health; and Mariana Lazo, MD, PhD, ScM, Associate Research Professor, Department of Community Health and Prevention, Urban Health Collaborative, Dornsife School of Public Health.

For more information or to get involved, visit the MERHG website or contact merhg@drexel.edu.

Climate Change and Health Equity Working Group

The Climate Change and Health Equity Working Group will bring together faculty, staff, and students from across the Urban Health Collaborative (UHC) and Dornsife School of Public Health to discuss climate and health equity research and coordinate engagement activities with local policy actors and community members. The group will also seek collaboration with other climate-focused efforts across Drexel. During its first year, the working group will (1) coordinate a comprehensive assessment of climate and health-related research, data, and faculty and staff within the UHC, (2) conduct a broad assessment of climate and health research and available data at Dornsife and the University at large, and (3) summarize existing climate and health-focused curriculum at Dornsife. Key findings and available resources will be shared as a new web resource and during a webinar open to all members of the Drexel and Philadelphia community. The group seeks to leverage existing UHC connections with local public health officials to advance the relevance and accessibility of existing UHC data resources and expertise, and to drive additional research to inform policies that promote health equity in the context of current and future climate change.

Led by Josiah Kephart, PhD, MPH, Postdoctoral Research Fellow, Urban Health Collaborative, Dornsife School of Public Health and Katy Indvik, MSc, Policy Engagement Specialist, Urban Health Collaborative, Dornsife School of Public Health.

For more information and to get involved, contact jlk465@drexel.edu.