In 2016, Drexel's Urban Health Collaborative began awarding pilot funding to promote urban health research at Drexel University. The UHC encourages interdisciplinary project teams, including partnerships from across Drexel and involving external partners, and promoted a range of methodologies and approaches, all with the aim of understanding and improving health in cities.
We’re excited to announce the awarding of funding across five proposals for research projects impacting urban health. The funding will enable researchers to understand issues that impact health in cities, as well as promote action and policy changes.
Approaches for Addressing Health Disparities
The Association of Neighborhood-Level Factors with Chronic Kidney Disease in
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.
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.
How to apply
Topics addressed should be clearly related to the mission of UHC with a focus on understanding and improving health in cities and a range of approaches are of interest. Investigators are encouraged to consult with UHC Research and Data core staff to explore the possibility of utilizing data on the Philadelphia area compiled by the UHC if appropriate for the research question.
Drexel University faculty members, postdoctoral fellows, or doctoral students are eligible to submit a proposal. We anticipate our next cycle of accepting proposals will be in early 2018. Join our mailing list to stay in touch with Drexel's Urban Health Collaborative and learn when the UHC requests proposals.
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