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MAGAZINE OF THE COLUMBIA UNIVERSITY MAILMAN SCHOOL OF PUBLIC HEALTH
2020–2021
Columbia
WE ARE WHAT WE EAT
Food & Health
AN ESSENTIAL SKILL
Public Health
Data Science
TAKE CHARGE
Lessons in
Leadership
Pandemi c PREPARING • RESPONDING • MOVING FORWARD
2020–2021
Corporate
Partnerships at
View the digital version at
publichealth.columbia.edu/
CPHmagazine
Columbia DE AN
Linda P. Fried, MD, MPH
Mailman School
C H IE F COMMU NIC ATI O N S O FFI C E R
Vanita Gowda, MPA
The premiere academic partner providing the private E DITOR IN C H IE F
sector with comprehensive solutions to COVID-19 Dana Points
return-to-work planning and worksite strategies
ART DIRE C TOR
Diana Gazzia
E DITORIAL DIRE C TO R
Experts from Columbia Mailman Tim Paul
School work with companies to COPY E DITOR
design and implement practices that Emmalee C. Torisk
protect your workforce, operations,
and customers. We provide:
As part of our commitment to
• Protocols for testing and handling environmental stewardship, this
of infections in the workplace, issue is printed by The Standard
Group on Rolland Enviro™ 100%
including contact tracing
recycled paper.
• Forecasting tools and customized
dashboards to help businesses identify
and manage infection hotspots
• Planning for phased business © 2020 Columbia University
reopening
• Design and communication of CONNE C T WIT H U S
workplace safety policies Alumni: msphalum@columbia.edu
publichealth.columbia.edu/alumni
• Training programs for managers
S U P P ORT U S
• Help for employees coping
Development:
with increased stress and mental
msphgive@columbia.edu
health challenges publichealth.columbia.edu/give
WORK WIT H U S
Career Services:
Learn more about partnering with us: msphocs@cumc.columbia.edu
publichealth.columbia.edu/careers
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L E ARN WIT H U S
Admissions: ph-admit@columbia.edu
publichealth.columbia.edu/apply
In This Issue
24
34
12
20 30 38
COLUMNS FEATURES
2
3
Letter From the Dean
Momentum
12 Prepared for a Pandemic
Decades of focus on
infectious diseases from every corner
30 The Cannabis Comeback
Use of the substance is on
the rise and the School’s experts are
Learning during the pandemic •
of the campus meant Columbia exploring what this means for public
Students publish op-eds • The
Mailman School was poised to take health. BY ALLA KATSNELSON
School commits to antiracism •
a leadership role in the fight against
34
Reproductive health at the
COVID-19. BY JIM MORRISON Public Health In Prison
fore • Honors, awards, and more
The pandemic has brought
7 Impact
A time for syndemics • Studying
schizophrenia’s origins • COVID-19
20 Frontiers in Food
The School’s food curriculum
is plentiful and varied, and comes at
the importance of caring for people
in the carceral system and the larger
carceral community into the spotlight.
and obesity • New bullying insights • the topic from every angle. Students BY ALEXANDER GELFAND
Opioid overdose solution • Folate are eating it up. BY SHARON TREGASKIS
missing in Mexico, and more
42 Graduates
24 Learning to Lead
Seven alumni share the lessons
38 Let the Data Do the
Talking
Three faculty members working at the
46 Scholars they learned that ensured they were intersection of public health and big
48 Alumni on the Front Lines of the ready to take on a trailblazing role in data talk about statistics and science.
COVID-19 Fight public health. BY NANCY AVERETT INTERVIEW BY TIM PAUL
publichealth.columbia.edu 1
Letter From the Dean
Coming C
OVID-19 has done its best to pull us apart, disrupting nearly every
aspect of how we live, learn, and work. Since the first reports of
the new coronavirus, I have watched with gratitude as our commu-
Together nity—students, faculty, staff, alumni, and friends—joined together to face
unprecedented challenges with grace, compassion, and resilience. I would
in a like to express my sincere condolences to those of you who have lost loved
ones during the course of this pandemic. Our thoughts are with you.
Early on, our faculty partnered across disciplines and sectors to answer
Pandemic vital questions about the virus and its spread, advise policymakers and the
scientific community, guide Columbia’s university-wide response, support
clinical care response, and inform the public through media and other out-
reach. In many cases the foundation for their work was developed years ago
in anticipation of this moment. Our students responded to the pandemic
in myriad ways, including volunteering with the CUIMC Student Service
Corps, working as contract tracers, developing healthcare service-learning
projects, serving as campus safety ‘ambassadors’, and raising awareness of
critical health issues at the community level. Around the world, our alumni
are working in hospitals, national health ministries, local health departments,
scientific research organizations, and elsewhere to contain the virus.
The pandemic has awakened the world to the paramount importance
of public health, which has seen declining investment in recent years.
The disparate and devastating toll of COVID-19 on marginalized groups,
including Black and Latinx communities in the U.S., and vulnerable and
displaced populations around the world, has laid bare vast health disparities
and inequities. The tragic violence in the U.S. against Black and Transgender
communities, particularly Transgendered people of color, which is just the
latest in a long line of violence, shows how much we need to do, individu-
ally and collectively, to create an antiracist and inclusive society. As ever, it
is our mission as public health professionals to ensure every person’s right
to health, dignity, safety, and wellbeing. We must act with renewed urgency.
As the pandemic evolves and we establish a “new normal” I am confident
that as a community we will continue to be there for each other and for the
public whose health we work to protect.
Wishing you good health,
Dean Linda P. Fried, MD, MPH
2 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITION
MOMENTUM
MOVI N G FO RWA RD AT CO LUMB I A MA I LMA N SC HO O L O F P UBLIC HEALTH
Students attend virtual orientation on Zoom.
Logged in and Learning HONORS
STUDENTS SCATTERED TO THE WINDS AS THE COVID-19 PANDEMIC DESCENDED , Salim and Quarraisha Abdool Karim
but classes continued online, essentially uninterrupted. “Even in the middle recognized for HIV breakthrough
of a pandemic—especially in the middle of a pandemic—the value of a pub-
lic health education has never been more evident,” says Dean Linda P. Fried,
MD, MPH. “I’m proud of everyone who made this transition happen. It is
inspiring to see us adapt as a community in the face of this emergency.”
As New York’s tally of COVID-19 faculty were already familiar with
cases climbed, the rapid move to distance learning through the
virtual classrooms took a massive, Department of Epidemiology’s
coordinated effort. The School’s Episummer@Columbia program.
Board of Advisors and other donors Those new to it rapidly became
provided funding to help students adept, teaching and making them-
quickly move off campus. Teaching selves available through virtual
assistants mastered using Zoom. office hours. The Department of Epidemiology professors Salim Abdool
Office of Education staff created an Biostatistics hosted weekly “T-time” Karim, PhD, DSc, and Quarraisha Abdool
online repository of best practices. sessions, fostering a sense of com- Karim, PhD, were named the 2020 John
The HR and IT teams provided munity with virtual trivia games. Dirks Canada Gairdner Global Health
crucial support. Wellness, career Sharon Schwartz, PhD, professor Award laureates for their outstanding
services, and academic support of Epidemiology, invited students achievements in global health research.
all continued from a distance. The to contact her if they needed help The Abdool Karims, who are married, re-
Office of Diversity, Culture, and getting groceries. “Social distancing ceived the award for their discovery that
Inclusion hosted a virtual town hall. doesn’t mean we have to lose our antiretrovirals prevent sexual transmis-
Student groups met on Zoom. sense of community,” says Alexis sion of HIV, which laid the foundation for
Even before the pandemic, the Smith ’20, who TA’d a class from preexposure prophylaxis (PrEP), the HIV
School was on a digital learning path, her childhood bedroom in southeast preventive now used around the world.
developing well-designed programs Alabama. “It felt good to check in Both of the Abdool Karims hold appoint-
intended for the long term. Some and see everyone, even at a distance.” ments at the University of KwaZulu-Natal,
Photographs, from left: Eileen Barroso; Diana Gazzia; courtesy of CAPRISA. publichealth.columbia.edu 3
South Africa; Salim Abdool Karim is also
chair of the UNAIDS Scientific Expert Students Take a Stand
Panel and WHO’s Strategic and Techni- ADVOCATING EFFECTIVELY FOR PUBLIC
cal Advisory Group on HIV and Hepatitis. HEALTH MEASURES IS A CRITICAL SKILL for
He is also director of CAPRISA and Quar- Columbia Mailman School graduates,
raisha is its associate scientific director. and first-year students practice speak-
ing up by writing op-eds. Written with
Two faculty members elected to passion and persuasion, the articles
National Academy of Medicine promote policies to improve health and
Election to the National Academy of Medi- social justice for marginalized groups.
cine is one of medicine’s highest honors. From left: Austin, Greenberg, Karp. In a historical look at the systematic
Charles Branas, PhD, Gelman Endowed marginalization of midwives, Kennedy Austin (’21) argued that the profession
Professor of Epidemiology, and chair of the has the potential to redress both shortages and racial disparities in maternal
Department of Epidemiology, and Andrea healthcare. Meanwhile, Mara Greenberg (’21) examined the role highways
Baccarelli, MD, PhD, Leon Hess Professor have played in segregating urban populations and how infrastructure projects
and Chair of the Department of Environ- could heal these wounds. Other students took on discrimination against Indig-
mental Health Sciences, have both been enous people’s health practices and the debate over requiring bike helmets for
named members. Branas is known for his bike-sharing programs. After the pandemic began, still others covered topics
scientific leadership on gun violence pre- related to COVID-19. At Columbia Mailman School, “we’ve been exposed
vention and his work on access to medical to issues impacting myriad marginalized communities, including LGBTQ+
care. Baccarelli was recognized for being individuals, ethnic and racial minorities, immigrants, and refugees. I really
among the first to show that environmental appreciate that I’ve been able to discuss these issues openly in a safe space
chemicals and lifestyle risk factors ad- with my peers,” says Veronica Karp (’21) who wrote about doctors’ stigmati-
versely affect the human epigenome. zation of mental illness. “I think that my ability to hear different perspectives
has made me a more competent public health professional.”
Lesley A. Sharp named a
Guggenheim Fellow
Lesley A. Sharp, PhD, a senior research A Deeper Focus on Climate
and Health
scientist in Sociomedical Sciences at Co-
lumbia Mailman School of Public Health
and a member of the faculty of Barnard
Environmental Health Sciences has gained new faculty members
College, has been named a Fellow of the
as the School expands its Climate and Health Program.
John Simon Guggenheim Memorial Foun-
dation. One of 175 honorees selected from LEWIS ZISKA, PhD, one of the world’s and spatial statistics to study the
nearly 3,000 applicants, she was recog- leading experts on the effects of relationship between emerging
nized for research that addresses inmate- climate change on plants and agricul- environmental exposures and health.
run, prison-based hospice programs. As a ture, joined the School as associate She investigates exposures that occur
medical anthropologist, she has focused professor of Environmental Health from natural gas and oil development,
on the ethical and moral considerations in Sciences after nearly 25 years at the noise pollution, and concentrated
human-animal encounters in lab research, United States Department of Agri- animal feeding operations. Her work
organ donation and transplantation, and culture. “I’m excited to continue my considers vulnerable populations and
experimental biotechnology. research in an environment where health disparities.
climate change is about science, not
W. Ian Lipkin honored by the politics,” he says. At the Interna- MAYA DEYSSENROTH, DrPH ’14, another
government of China tional Rice Research Institute in the new assistant professor, is a mo-
The government of China honored W. Ian Philippines, Ziska did some of the lecular epidemiologist. She studies
Lipkin, MD, with a medal recognizing his first research into how rising CO2 pathways through which the placenta
profound impact on the country. For near- corresponded with a reduction in rice conveys intrauterine exposures and
ly 20 years, Lipkin, the John Snow Profes- protein. He has contributed to several their effect on postnatal health. She
sor of Epidemiology and director of the United Nations Intergovernmental incorporates biostatistical and bioin-
Center for Infection and Immunity at Co- Panel on Climate Change reports. formatic tools to evaluate multi-pol-
lumbia Mailman School of Public Health, lutant exposures. She is both an alumni
has worked closely with scientists and JOAN CASEY, PhD, a new assistant pro- of Columbia Mailman School and a
officials in China to strengthen its public fessor, uses electronic health records former EHS research associate.
4 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITION
MOMENTUM
health system and protect its people from
infectious disease outbreaks. Read more
about his work on page 12.
Diana Hernández recognized by New
York League of Puerto Rican Women
Diana Hernández, PhD, assistant professor
of Sociomedical Sciences, was awarded
the Public Health Service Award from the
New York League of Puerto Rican Women.
Hernández studies the impacts of policy
on the health and socioeconomic well-
being of vulnerable populations. Her com-
munity-oriented research examines the
intersections between housing and neigh-
borhoods, poverty, equity, and health, with
a particular emphasis on energy insecurity.
Columbia Mailman School Much of her research is conducted in her
native South Bronx neighborhood.
Commits to Becoming Terry McGovern named to Council on
an Antiracist Institution Foreign Relations
Terry McGovern, JD, professor and chair
AS MASS MOBILIZATIONS AGAINST THE KILLINGS OF BLACK AND TRANSGENDER of the Heilbrunn Department of Popula-
P E OP LE F IL LE D STR EETS, DeanLinda P. Fried, MD, MPH, announced a tion and Family Health, was invited to join
schoolwide initiative called FORWARD (Fighting Oppression, Racism, the Council on Foreign Relations, the U.S.
and White supremacy through Action, Research, and Discourse) to accelerate membership organization and think tank
the School’s efforts to transform into an antiracist, multicultural, and fully specializing in foreign policy and inter-
inclusive institution. FORWARD aims to expand the pipeline of Black, national affairs. The Council is a resource
Indigenous, Latinx, Asian, and Middle Eastern and North African students on foreign policy choices for government
into Columbia Mailman School and from here into the field of public health. officials, business executives, journalists,
The program will also focus on recruiting faculty and staff from these groups; educators, and civic leaders. McGovern is
deepening ties with local, marginalized communities; and creating a more founder and director of the School’s Pro-
robust, school-wide research effort into health inequities and racism. gram on Global Health Justice and Gov-
FORWARD is comprised of the mentoring program for students of ernance. Her research focuses on health
Action Corps, groups that currently color and first-generation graduate and human rights, sexual and reproductive
total more than 100 student, faculty students. FORWARD’s work has rights and health, gender justice, and envi-
and staff volunteers. The FORWARD been advanced by a set of early com- ronmental justice.
Accountability Cabinet, a permanent mitments made by Dean Fried in
multi-stakeholder advisory body to the June 2020, which include mandatory Crain’s New York Business honors
Dean, will develop measures of suc- racial awareness, anti-bias and inclu- School faculty and alumni
cess and continually assess progress sion training for all students, faculty The publication’s 2020 Notable in Health
towards goals, and provide oversight and staff; additional funding for Care list applauded Dean Linda P. Fried,
of the Action Corps. The Cabinet is student mentoring and scholarships; MD, MPH, who “engineered a strong re-
co-chaired by Charles Branas, PhD, and support to help recruit and nur- sponse to COVID-19 on multiple fronts.”
chair of the Department of Epidemi- ture promising faculty. “Racism is Craig Spencer, MD, MPH ’13, assistant pro-
ology, and Raygine DiAquoi, EdD, a social determinant of health; thus, fessor of Emergency Medicine and Popu-
assistant dean, Office of Diversity, public health is inherently an anti- lation and Family Health, was recognized
Culture, and Inclusion. racist endeavor. Our field has com- as a “trusted source of information and
FORWARD builds on the mitted to addressing how structural insights” during the pandemic. Alumni
School’s longstanding focus on racial racism engenders and perpetuates James Gasperino, MPH ’11, and Anthony
justice and equity. In 2016, it created health inequities and FORWARD Shih, MPH ’01, were also honored.
the Office of Diversity, Culture, and helps us fulfill this promise,” says
Inclusion, which launched the RISE DiAquoi.
Photographs, from left: Courtesy of subject (3); Leslye Smith publichealth.columbia.edu 5
MOMENTUM
PopFam Speaks Out on
SUPPORTING OUR WORK
Huo Scholars Program continues
Columbia Mailman School alumnus and
Board of Advisors member Xue Fang,
Reproductive Health
DURING AN ERA OF INCREASING RESTRICTIONS ON ACCESS TO REPRODUCTIVE
PhD, MS ’98 has pledged renewed sup-
HEALTH SERVICES IN THE UNITED STATES , the Heilbrunn Department of Popu-
port from the Huo Family Foundation
with a commitment of $2.5 million over
lation and Family Health has launched an online forum focused on repro-
five years. Each of the five annual Huo
ductive health justice, #SpeakEvidencetoPower. “It is critical that evidence,
Scholars receives a two-year scholarship
not ideological zeal, is the driving force for policy,” says chair Terry McGovern,
along with a practicum stipend valued at
JD. “The sexual and reproductive health of millions of people in this country
$40,000 per year. In addition, the Foun-
and globally is at stake.”
dation will support 20 summer practica in
The platform provides scientific evidence supporting access to a range
public service each year for the next five
of reproductive health services and serves as a resource to researchers,
years. The goal is to enable scholars to fo-
advocates, and the media. Leading thinkers in the field, including Phumzile
cus on public service practica, which are
Mlambo-Ngcuka, executive director of UN Women, and Winnie Byanyima,
usually unpaid.
executive director of UNAIDS, have shared their expertise on current issues
and news. “Information is power,” says McGovern. “It will lead to informed
Bristol Myers Squibb Foundation action and promote justice for reproductive health.”
helps ICAP train health workers
A gift of $100,000 from the Bristol Myers
Squibb Foundation is supporting ICAP’s
training of frontline health workers to miti-
gate COVID-19 in Eswatini, Ethiopia, and
Tanzania. Leveraging ICAP’s strong part-
nerships and vast network of community
health workers, the gift funded the rapid
design and implementation of training
that prioritizes essential, functional com-
petencies required to effectively respond
to the pandemic.
The Anahata Foundation makes a
critical climate gift
The Anahata Foundation has stepped up
Serra Sippel (left), president of the Center for Health and Gender Equity, and PopFam
its support for the Global Consortium on
chair Terry McGovern attend the rally for reproductive justice on March 4, 2020.
Climate and Health Education (GCCHE),
pledging to fund the recruiting and sal-
ary of a director for the Consortium over
two years. The Foundation has consistently
supported the GCCHE, and this gift helps
ensure strong and continuing leadership
during a critical time for climate science.
Jack Rudin Family Foundation
supports CII
The Jack Rudin Family Foundation made
a gift of $1.5 million to the Center for
Infection and Immunity to fund COVID-19
clinical trials. The contribution provided aid
for an assessment of hydroxychloroquine
and a multistage project to identify
FDA-approved drugs to treat or prevent
COVID-19. Students and other members of the School’s community join in a “Speak Out for
Reproductive Health and Justice” event on campus after the 2019 election.
6 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITION
IMPACT
DI SCOVERI ES THAT A RE MA K I N G A DIFFER ENCE
What Comes After a
Pandemic? Syndemics
T
he global pandemic is in the spotlight, but experts much worse.” Fixing syndemic problems requires a multifocal
at the School are already raising concerns about approach. Branas points to a program called Operation Peace-
its downstream effect on other public health crises. maker Fellowship in Richmond, California, as an example. Young
The economic downturn and high unemploy- people who have been involved in gun violence are given sti-
ment are driving concerning trends in suicide pends, mentorship, job training, and other benefits. This has been
and an increase in opioid-related fatalities. Symptoms of anxiety shown to significantly reduce the likelihood of future gun crimes.
disorder and depressive disorder increased considerably in the Faculty Kara Rudolph, MPH, PhD, and Katherine M. Keyes,
United States between April and June of this year, according to MPH, PhD, did research that supports this and similar violence
Morbidity and Mortality Weekly Report. And spikes in gun pur- interruption programs.
chases beginning in March were followed by significant increases Branas hopes that future solutions to gun violence will arise
in firearm fatalities in April and May when compared to the same out of the SURGE program (Scientific Union for the Reduction
months in 2019. of Gun Violence), which he and others launched in February
Charles Branas, PhD, Gelman Professor of Epidemiology and with a consortium from across Columbia University to make
chair, Department of Epidemiology, believes these trends are best gun violence a top focus for Columbia and promote scientifically
examined through a syndemic lens. His focus is on gun violence. supported solutions. The group has already logged one success:
“Equity and social justice issues are longstanding and an epidemic Earlier this year, SURGE led universities to petition legislators to
unto themselves, and when you mix them with COVID-19 you get provide CDC and NIH grants for gun violence research, the first
a syndemic. The two feed on each other and make the outcome such grants from these agencies in decades.
Photographs, left: Margaret Kramer (2) publichealth.columbia.edu 7
Seeking the Your Sofa
Origin of Could
Schizophrenia Make Your
in Africa Cat Sick
Sounding a
An international group of scientists, includ- Cats exposed to flame retar-
ing investigators from Columbia Mailman
School and the New York State Psychi-
Warning on dants found in sofas may be
at greater risk for feline hyper-
atric Institute, as well as the University of
Cape Town and the University of Wash-
COVID-19 thyroidism according to a study
by researchers at Columbia
ington, has conducted the first genetic
analysis of schizophrenia in an ancestral
and Obesity Mailman School and Oregon
State University.
African population, the South African Early on in the pandemic, For the study, 78 cats wore
Xhosa. Africa is the birthplace of all hu- Andrew Rundle, DrPH, as- silicone collar tags that picked
mans, and almost 99 percent of human evo- sociate professor of Epidemiol- up contaminants in the air; their
lution took place in Africa before humans ogy, drew national attention by owners filled out a question-
migrated from Africa to Europe and Asia predicting that school closures naire. When the researchers ana-
50,000 to 100,000 years ago. Yet ancestral would exacerbate the epidemic lyzed the tags, they found higher
African populations have rarely been the of childhood obesity in the levels of TRIS, a common flame
focus of genetics research. United States. Writing in the retardant in stuffed furniture,
journal Obesity, he noted that air fresheners, and plastics—on
the data show that children the tags of hyperthyroid cats, in
99% experience unhealthy weight
gain primarily during the
summer months when they are
comparison to those worn by
non-hyperthyroid animals. The
amount of TRIS in use in the
The researchers analyzed blood samples out of school. This is particu- U.S. has risen more than 50-fold
collected from 909 individuals diagnosed larly true for Black and Latinx over the past 20 years; cases
with schizophrenia and 917 controls living youth, as well as children who of feline hyperthyroidism have
in South Africa. Their study, published in are already overweight, and also climbed precipitously dur-
Science, revealed that people with schizo- weight gained is typically main- ing this period.
phrenia are significantly more likely than tained during the school year. “We want a healthy home
others to carry rare, damaging genetic During the pandemic, for our animals and ourselves,”
mutations. (There is no evidence that the households stocked up on ul- says Julie Herbstman, PhD, a
Xhosa have an unusually high risk of tra-processed shelf-stable foods study co-author and director of
schizophrenia.) and calorie-dense comfort the Columbia Center for Chil-
The genes and pathways identified by foods. Social distancing and dren’s Environmental Health.
this research inform the understanding stay-at-home orders reduced “What we’re seeing in cats is a
of schizophrenia for all humans, the re- opportunities for exercise, warning sign that exposure to
searchers say. Further studies in African particularly in urban areas. these chemicals may disrupt the
populations might also suggest potential And video game usage soared. human thyroid system as well.”
mechanisms for the design of more effec- Rundle presented several inter-
tive treatments. “The presence of only a ventions, including providing
few DNA variations damaging to synap- grab-and-go meals at schools
tic function could have an outsized effect to reduce food insecurity, which
on schizophrenia,” says co-author Ezra is linked to unhealthy weight
Susser, MD, DrPH, professor of Epide- among children. He also recom-
miology and Psychiatry at the Columbia mended making physical activ-
Mailman School, Columbia University ity an aspect of online school-
Irving Medical Center, and New York State ing, which will continue to be
Psychiatric Institute. critical in the winter.
8 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITIONIMPACT
Insurance and
Pregnancy:
A Dangerous Gap
Black, Hispanic, and Indigenous women are more
likely to lack insurance for some period around the
time of pregnancy than white women, a new study
by researchers at Columbia Mailman School and the
University of Michigan suggests. Nearly half of all
Black, Hispanic, and Indigenous women had no cov-
erage at some point between preconception and after
delivery compared to about a fourth of white women,
according to the research published in Obstetrics and
Gynecology. Spanish-speaking Hispanic women had
the lowest rates of steady insurance.
A New Perspective The study comes as Black and Indigenous women
are two to four times more likely to die from pregnan-
on Bullying cy-related causes compared with white peers. “Racial
and ethnic disparities in maternal and child health
Youths who report that they have been outcomes are a national public health crisis,” says senior
author Lindsay Admon, MD, an obstetrician-gynecol-
the perpetrators of bullying are more ogist at Michigan Medicine’s Von Voigtlander Women’s
likely to develop mental health prob- Hospital. The researchers analyzed data from 107,921
lems compared to those who say they women in 40 states between 2015 to 2017 for the study.
Income gaps between white and Black populations
don’t bully others, new research shows. play a big role in insurance disparities. But among the
biggest factors for disrupted care is Medicaid discon-
Previous studies have focused 5 percent reporting having bul-
tinuity. Pregnancy-related Medicaid coverage is only
on the causes and consequenc- lied others in the past month.
offered for up to 60 days after a baby’s birth, but there
es of bullying victimization, The results are published on-
are bipartisan federal and state efforts to extend the
but this research breaks new line in the Journal of Adolescent
coverage to a year. “Medicaid stability before and after
ground. “While it is well docu- Health. Among the findings:
pregnancy is critical for ensuring continuity of cover-
mented that being a victim Bullying perpetration increased
age and access to care for women of color,” says lead
of bullying is associated with the risk of developing inter-
author Jamie Daw, PhD, assistant professor of Health
immediate and lifelong mental nalizing problems—such as
Policy and Management at Columbia Mailman School.
health problems, this is the depression, withdrawal, anxiety,
Improving coverage before conception is also critical
first to comprehensively ex- and loneliness—and having
in identifying underlying health issues that may nega-
amine the hypothesis that the internalizing problems also
tively affect a mother’s or baby’s health.
relationship between bullying increased the probability of bul-
perpetration and mental health lying others.
problems may be bidirec- “Our findings indicate
tional,” says Marine Azevedo that bullying prevention and
Da Silva, PhD, a postdoctoral intervention strategies among
researcher at the Columbia youth should consider how to
Mailman School. take into account and handle
The researchers analyzed negative feelings and mental
data from 13,200 youths aged health problems” in a healthy
12 to 17 years. Among them, way, notes Silvia Martins, MD,
21 percent reported ever hav- PhD, director of the Substance
ing bullied others, with 16 per- Abuse Epidemiology Unit of
cent reporting having bullied the Department of Epidemiol-
others over a month ago and ogy and senior author.
Photographs: iStock 9Reaching Teens
with HIV in Africa
Adolescence is a time of emotional turmoil and for
young people living with HIV in Africa, stigma, lone-
liness, and poverty can increase the burden. ICAP is
piloting innovative projects designed to reach adoles-
cents with HIV care, treatment, and prevention, as well
as psychosocial support. Reaching young people is
key to eventually controlling the epidemic worldwide.
In Kenya, with the support of a philanthropic gift
Sonalee Rau, MPH ’20, helped revive a man in East Harlem using naloxone. from Alan and Jane Batkin, ICAP is expanding its
successful photography workshops and entrepre-
A Hands-On Solution for neurial leadership training program, opening new
avenues for young people with HIV to express them-
Opioid Overdose selves creatively through photography while also
earning income to help them live independently.
Since mid-2019, Columbia University’s naloxone training
program, a partnership among Columbia Mailman School, In Tanzania and nine other sub-Saharan African
Columbia Health, and the Columbia School of General Studies, countries, the DREAMS program is helping girls and
has trained 1,342 students, faculty, and staff to recognize signs young women living with HIV develop into Deter-
of opioid overdose and administer potentially lifesaving nalox- mined, Resilient, Empowered, AIDS-Free, Mentored,
one. After completing an hourlong training, trainees receive a and Safe women. With funding from the U.S. Presi-
free naloxone kit provided by New York City’s Opioid Overdose dent’s Emergency Plan for AIDS Relief (PEPFAR),
Prevention Program. ICAP provides reproductive health and education
The training initiative, launched in response to the rising services, HIV testing, peer support, and economic em-
concern around opioid usage and potential for overdose on college powerment training for young women aged 15 to 24 years.
campuses, has generated strong interest. In a roundtable hosted
by the Office of National Drug Control Policy last fall, Rachel In Mozambique, adolescents with HIV struggle
Shelton, ScD, MPH, assistant professor of Sociomedical Sciences, with stigma and often shy away from health facilities.
was among the Columbia representatives who shared insights and ICAP is creating adolescent- and child-friendly areas
presented recommendations for facilitating engagement in training at three of the largest health facilities in Nampula
among special populations including athletes, resident advisors, province, transforming “empty” wait time into an
fraternity and sorority members, veterans, and students in recov- opportunity to provide adolescents with support from
ery. The audience of government representatives and attendees peers who are also living with HIV. Says Mirriah Vitale,
from other academic institutions took away actionable advice on MPH, ICAP country director in Mozambique, “these
how to bring naloxone to more campuses. groups have struggled to gain the benefits of HIV care
The initiative, funded by two grants from Columbia’s Irving and treatment and now we look forward to seeing the
Institute CTSA Collaborative and Multidisciplinary Pilot positive impacts.”
Research Awards, has provided an opportunity to address the
dearth of research on naloxone training and use of the therapy
in university settings and contributed crucial learnings to the
field of college health. Data collected will help investigators assess
participant interest, motivation, and attitude. The team seeks to
understand the level of concern around administering naloxone,
including potential punitive or legal implications; assess the
confidence and willingness created in participants to carry and
administer naloxone; and consider opportunities and barriers to
expand the program to other college campuses nationally.
Trainings have continued during the pandemic, with attendees
at 35 virtual trainings receiving naloxone kits by mail. The best news
of all? Thus far, graduates from the program have saved six lives.
10 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITIONIMPACT
An Unexpected The
Gender PayGap Weight/
Before the COVID-19 pandemic, the
United States had seen a dramatic rise in Prostate
Cancer
nontraditional “gig economy” jobs where
workers are hired for single projects, often
on a short-term basis. Researchers at
Mexico: Columbia Mailman School and Cloud-
Research.com identified a gender pay gap
Connection
Focusing on among gig workers, determining that, on
average, women’s hourly earnings were
Being overweight in middle
age is linked to many health
Folate 10.5 percent lower than men’s.
The researchers examined the work of
problems, and we can add
a greater risk of advanced
Up to 32 percent of Mexican girls over 20,000 men and women who complet- prostate cancer to the list,
aged 14-18 years and between 9 ed more than 5 million tasks online in Am- shows research led by Jeanine
and 28 percent of the country’s azon’s Mechanical Turk (MTurk) platform, Genkinger, PhD, associate
women aged 19-39 years continue which connects employers (“requesters”) professor of Epidemiology at
to have folic acid (FA) intake levels to employees (“workers”). “Due to the Columbia Mailman School.
below the World Health Orga- platform’s anonymity, workers’ self-selec- Prostate cancer is the sec-
nization (WHO) recommended tion into tasks, the relative homogeneity of ond most common cause of
amount, potentially raising the risk the tasks performed, and the flexible work cancer in U.S. men and fewer
for neural tube defects in their off- scheduling, we did not expect earnings than one in three men with
spring. Fortification of wheat and to differ by gender on this platform,” said advanced prostate cancer live
corn flour with FA was mandated Zohn Rosen, PhD, lecturer in the Depart- five years beyond diagnosis.
in 2008 but without enforcement. ment of Health Policy and Management.
Manuela Orjuela-Grimm, MD, “However, contrary to our expectations, a GREATEST RISK
AGE: 50–64
assistant professor of Epidemiology robust and persistent gender pay gap was
and Pediatrics, and other research- observed.” Adds Lisa Bates, ScD, assistant
ers collaborated with the National professor of Epidemiology, “Our results
Institute of Public Health, Mexico,
to measure the nutrient’s content in
showed evidence of a gender wage gap not BMI: >25 kg
m 2
fully accounted for by such factors as task
bakery bread and tortillas collected heterogeneity, experience, and task comple- Using data from 15 large
from geographically diverse areas. tion speed.” A significant portion of the studies combined, Genkinger
They then extrapolated these data gap seems to result from women selecting determined that a body mass
to the larger population, using tasks that have a lower advertised hourly index over 25 kg/m2 during
intake tables from a 2012 national pay. Writing in the journal PLOS ONE, the middle to late adulthood (me-
health and nutrition survey. They authors hypothesize, “Women may select dian age of 50 to 64 years) was
found that overall folate intake im- lower-paying tasks because cumulative ex- linked to the greatest risk for
proved, but is still below the WHO periences of pervasive discrimination lead developing advanced prostate
goal. Corn tortillas from rural women to undervalue their labor.” cancer. They also found that
areas were especially likely to lack greater waist circumference
the nutrient. The researchers also was linked with increased risk
determined that up to 1.9 million of advanced prostate cancer
young children are at risk of ingest- and death. Published in the
ing FA at levels above the tolerable Annals of Oncology, this is the
upper limit, a potential cancer risk. first study to connect waist
“More oversight of fortification circumference with elevated
may avoid health risks from overex- risk. “Adopting and maintain-
posure, as well as insufficient intake ing healthy weight in middle to
in the population initially targeted late adulthood can especially
by the fortification program,” says reduce risk of advanced pros-
Orjuela-Grimm. tate cancer,” says Genkinger.
Photographs, from left: Courtesy of subject; Courtesy of ICAP; iStock. publichealth.columbia.edu 11Prepared for a Pandemic Experts from every corner of the Columbia Mailman School campus mobilized quickly when a devastating pneumonia-like illness surfaced and quickly swept around the globe. After all, they had been warning that this moment was coming for years. By Jim Morrison 12 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITION
Photograph: iStock/Marco Piunti publichealth.columbia.edu 13
“I hate to say it, but this is the worst respiratory viral pathogen
we’ve faced since 1918.”
W
hen the first news of what “you always wonder if you’re really going to He and his team have discovered more than
would become a global pan- see something like this,” says Jeffrey Sha- 1,800 infectious agents. In recent years,
demic emerged from China, man, PhD, the director of the Climate and they worked on outbreaks of West Nile vi-
the world’s leaders immediately turned Health Program and an expert on disease rus, SARS, MERS, and others. (In the 2011
to researchers at the Columbia Mailman transmission. “I hate to say it, but this is the movie Contagion, for which Lipkin served as
School, who moved with lightning speed to worst respiratory viral pathogen we’ve faced scientific consultant, Elliott Gould’s charac-
begin unraveling the mysteries of the novel since 1918.” ter, a scientist named Dr. Ian Sussman, was
coronavirus. The scientists were tapping a based on Lipkin.)
deep well of innovative research and policy Until October of last year, CII was
expertise going back decades. From discern- Virus Hunter vs. Virus deeply engaged in PREDICT, the United
ing who is particularly vulnerable to the virus States Agency for International Develop-
and why, to determining how an infection
spreads, to developing diagnostic methods
and treatments, Columbia Mailman School
I t was only natural that W. Ian Lipkin,
MD, the John Snow professor and direc-
tor of the Center for Infection and Immu-
ment-funded decadelong program to detect
viruses with pandemic potential in animal
hosts and to examine how they make the
experts supplied critical data and advice to nity (CII), heard about the novel virus from leap into humans. CII researchers were
governments, nonprofit organizations, and a colleague in Guangzhou a month before among the first to show that bats were an
private sector entities. Even as the campus the rest of the world became aware of it. animal reservoir for coronaviruses such as
and the city closed down, the School’s re- One of the foremost authorities on infec- SARS-CoV-1, MERS CoV, and SARS-
searchers, staff, and students worked into tious agents, Lipkin has hopscotched the CoV-2. A significant source of support for
the night building vital knowledge that deci- globe helping tamp down outbreaks over their work with bats, the PREDICT study
sion-makers would use to determine how to three decades. In late January, he spent a was abruptly shuttered, its funding pulled
address the rapidly evolving crisis. week in China advising the Chinese govern- only weeks before the first cases of the novel
For many of those at Columbia Mail- ment and top scientists about its response coronavirus were reported in China. This
man School, the battle against COVID-19 to the mysterious illness. He and his team would prove to be just one example of how
was only the latest in a decadeslong fight to at CII collaborated with Chinese scientists poorly prepared the United States was to
prevent and combat deadly outbreaks. But to identify and control the SARS coronavi- face new viral threats.
this one was unlike any others. For decades, rus outbreak there in 2003. “Methods that When Lipkin began his work, it took
Earth has been primed for a pandemic: we’ve piloted over the past 15 years enabled years to identify a virus. Now, it takes hours.
Airplanes speed pathogens across borders; the discovery of this new coronavirus,” he He rose to prominence by using molecular
humans encroach on animal habitats (CO- says. “These techniques allow researchers methods to identify viruses, infecting rats
VID-19 likely started with an animal infec- to take samples from individuals who had an with a disease and then subtracting the
tion); and climate change expands the range unknown disease and to identify the caus- rats’ DNA, leaving the virus. He developed
of disease-carrying insects. Meanwhile, ative agent very quickly.” MassTagPCR (polymerase chain reaction),
countries, including the United States, Lipkin has earned the title of “virus which detects multiple viruses at once,
have disinvested in public health systems hunter” for revolutionary research that has and GreeneChip, a glass slide containing
that prevent disease in recent decades. De- transformed the speed at which health au- 500,000 genes that tests for known patho-
spite all the ingredients for a perfect storm, thorities respond to emerging infections. gens. He then pioneered the use of high
Columbia Mailman School faculty are answering critical questions about COVID-19. A sample of their work:
14 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITIONLipkin (right) visited in China with Zhong Nanshan, MD, Andrew Rundle, MPH, DrPH, associate professor of Epidemiology, harnessed data
an epidemiologist and pulmonologist, who discovered the from the U.S. Census Bureau, Medicare, and Medicaid, among other sources, to create
SARS coronavirus in 2003. Photograph: Cheng Guo interactive maps showing covid vulnerabilities at a county level.
throughput sequencing for pathogen sur- Later in the spring, Lipkin and Mishra more than a dozen countries, is designed
veillance and discovery. The tests, fast and examined the therapeutic effects of conva- to equip scientists with biomolecular tools
cheap, are needed when pathogens travel lescent plasma for COVID-19 in a study to quickly identify novel pathogens and to
thousands of miles in mere hours. funded by a $2.5 million award from Ama- raise early alarms. “We’re not done,” says
Earlier this year, after returning from zon. The U.S. Food and Drug Adminis- Lipkin. “This is not the last threat. It may
China, Lipkin made television appearances, tration later authorized emergency use of not even be the worst.”
promoting isolation of patients, testing, and plasma. The CII team is also studying the
contact tracing, among other critical con- repurposing of previously approved drugs
tainment measures he had seen in China. for COVID-19 treatment, investigating the Predictions from the Past
Meanwhile, working in CII’s high-security, appearance of multisystem inflammatory
pressurized Biosafety Level 3 laboratory,
he and the CII team, including Nischay
Mishra, PhD, an assistant professor in Epi-
syndrome in children after COVID-19 in-
fection, and examining the effect of ultra-
violet light and other disinfectants.
W hile Lipkin and his team broke new
ground in the lab, Jeffrey Shaman
looked back, turning for insight to a ground-
demiology, developed an antibody test for While helping to stop one pandemic, breaking study he had conducted before the
SARS-CoV-2 as well as a PCR assay that CII is preparing for the next ones, plan- crisis with the aim of advancing understand-
can simultaneously detect influenza A, in- ning a surveillance system, the Global ing of how disease is transmitted, even by
fluenza B, and SARS-CoV-2 viruses. Gen- Infectious Diseases and Epidemiology seemingly healthy people, and improving ex-
erous donors stepped up to fund this work; Network (GIDEON). With initial sup- perts’ ability to forecast spread. From 2016
at press time the School had raised $10 mil- port from the Skoll Foundation, the net- through 2018, during his Virome of Manhat-
lion for COVID-19-related science. work, which involves epidemiologists in tan project, Shaman and his team tracked
Salim Abdool Karim, DSc, PhD, was appointed to the Lancet COVID-19 Commission Sara Abiola, PhD, JD, is leading research exploring expanded access to
to help speed up global solutions to the disease. Supplemental Nutrition Assistance Program benefits during the pandemic.
publichealth.columbia.edu 15Shaman and his team, including Sen hundreds of thousands of Americans, Sha-
Pei, PhD, associate research scientist in man examined the possible intersection be-
Environmental Health Sciences, then built tween the pandemic and climate change. An
models projecting the disease’s spread in expert in climate and disease, Shaman pub-
the United States using data provided by lished projections on the potential spread of
The New York Times. Their calculations laid the novel coronavirus following an evacua-
bare the destructive potential of the virus, tion from a hurricane, which also has impli-
and exposed the fact that had mitigation cations for evacuations from wildfires.
measures been used just one week earlier,
36,000 lives could have been saved. “We’re
looking at something that’s catastrophic,” Helping Africa Face the Fight
Shaman told the Times. They weren’t done,
A CII team trains to use the new, more efficient
though.With support from the Morris-Sing-
er Foundation, they accurately predicted a
large resurgence of cases and deaths start-
C olumbia Mailman School’s long his-
tory of fighting infectious diseases ex-
tends into the field worldwide. As news
Triplex SARS-CoV-2 rRT PCR assay developed
by Nischay Mishra, PhD, assistant professor of ing in June. Shaman advised policymakers of the virus broke, Wafaa El-Sadr, MD,
Epidemiology. Photograph: Eileen Barroso across the U.S. and his models served as a MPH ’91, MPA, the Dr. Mathilde Krim-
respiratory viruses throughout the borough foundation for data visualizations of critical amfAR Chair of Global Health, a profes-
by following 214 people. “Until the Virome care capacity developed by Charles Branas, sor of Epidemiology and Medicine, and
project, we didn’t realize to what extent PhD, chair of the Department of Epidemi- the founder and director of ICAP, a global
the rapid movement of a virus is fueled by ology, and Andrew Rundle, MPH, DrPH, research and capacity-building center at
undocumented infections. That project in- associate professor of Epidemiology. Columbia Mailman School, was already
formed the way we thought about this coro- Shaman continued to mine his earlier focused on the world’s most under-re-
navirus,” says Shaman. work for insight into reinfection, another sourced countries in Africa, Asia, and the
Shaman and his team concluded by pressing concern. His Virome project had Americas. ICAP quickly moved to assist
late February that “stealth transmission” by found that 12 of 137 people who were in- national ministries of health in developing
asymptomatic yet unidentified carriers was fected with a coronavirus that causes the and implementing a response plan, while
driving the spread of SARS-CoV-2, a head- common cold were reinfected. That, Sha- at the same time working on the ground
line-making turning point in understanding man says, was a signal to policymakers and to help health workers and health facilities
the virus. They determined that in China, others to proceed cautiously when consid- prepare to address COVID-19.
a stunning 86 percent of early infections ering whether those infected had immunity El-Sadr brought decades of experience
were not documented. “That’s what led from SARS-CoV-2 and for how long. “It translating scientific best practices into re-
to its rapid spread,” he says. “People who, opens lots of questions,” he says, “for exam- ality in resource-limited environments. She
because their symptoms are mild or nonex- ple, are repeat infections going to be milder, led the Division of Infectious Diseases at
istent, are out and about, going shopping, about the same, or worse?” Harlem Hospital Center in the early years
going to work or to school, and bringing the Later in the summer, as wildfires raged of the AIDS epidemic, when support for
virus to new populations.” across California and hurricanes displaced patients with another mysterious disease
Wendy Chavkin, MPH ’81, co-authored a report on global policies to address an Merlin Chowkwanyun, MPH, PhD, co-authored a New England Journal of Medicine
expected second wave of COVID-19. article about racial disparities and COVID-19.
16 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITIONwas hampered by limited resources, stigma, her team initiated in sub-Saharan Africa. In management, and pursued participation in
systemic discrimination, and community 2003, El-Sadr founded ICAP, which now vaccine development. Closer to home, El-
distrust of the medical establishment. In works in more than 30 countries. Its vision Sadr also chaired the public health response
response, she launched community- and is centered on the following principles: true group guiding Columbia University’s CO-
family-centered models for HIV and tuber- partnership with in-country leadership, as VID-19 Task Force. More recently, ICAP
culosis (TB) management. She remembers well as a focus on strengthening health sys- launched a major study to understand the
caring for a woman with HIV in Harlem tems and on building indigenous capacity. impact of COVID-19 on hard hit commu-
who was reluctant to accept treatment and “We provide the technical assistance and nities in New York City and on older adults
was deteriorating rapidly. Ironically, the pa- support,” she says. “We’re not there to do in particular. El-Sadr worries that even
tient was vigilant about taking care of her the work for the people on the ground. The though the infection may have lagged in
young child with HIV. “It made me realize people we work with bring great ideas. They reaching some countries, it is raging in oth-
that we needed a family-focused model of just need the support to do what they know ers. “Global partnership and commitment
care. We started a clinic where she’d be seen needs to be done. We offer training and re- are critical, combined with rapid action on
at the same time as her child.” sources to enable them to move forward.” the ground,” she says. “So much is at stake,
El-Sadr was among the first to integrate That work earned El-Sadr a MacArthur which compels us to act now.”
research and care, in response to feedback “genius” grant, and it positioned ICAP to
from the community. That model became be ready to assist countries in responding to
the precursor to groundbreaking interven- COVID-19. “When HIV spread like wild- How to “Think” Like a Pathogen
tions for HIV, and later TB and malaria and fire across the African continent, it took de-
other public health priorities, that she and cades for the global community to mobilize
a response,” says El-Sadr. “We certainly did
not want such a delay in response to this
B arun Mathema, MPH, PhD ’11, as-
sistant professor of Epidemiology,
views risk through the eyes of the pathogen
new pandemic.” In a passionate New Eng- adapting to find a host, and explores how
land Journal of Medicine Perspective article housing, and the design of a city and its
about COVID-19, she wrote, “Epidemics transportation systems, can have an out-
know no borders, and success in control- sized effect on transmission. He quickly
ling the epidemic in any one country will joined a study earlier this year to explore
be limited if epidemics continue to rage evolution and transmission of SARS-CoV-2
elsewhere.” Throughout the spring, El-Sadr using data from a New Jersey hospital
and ICAP mobilized, supplying some form system. That work follows a path Mathe-
of COVID-19 support in 23 countries rang- ma has blazed toward understanding the
ing from Angola to Zambia. ICAP helped transmission of TB.
to set up laboratories and isolation units, Since getting his PhD at Columbia Mail-
conducted surveys to assess the infection’s man School, Mathema has spent almost a
spread, procured personal protective equip- decade researching the multiple dimensions
ICAP helped construct handwashing stations
ment, trained frontline workers on infection of how TB transmission is influenced by
in Kisumu, Kenya. Photograph: Joash Asiko prevention and COVID-19 diagnosis and culture, geography, and economics. His re-
Dean Linda P. Fried, MD, MPH, and others are undertaking a global survey on how Diana Hernández, PhD, and Markus Hilpert, PhD, testified to the New York City
people are coping, and the pandemic’s effect on loneliness. Council on COVID-19 in communities of color.
publichealth.columbia.edu 17Predicting the Ebb and Flow of the Virus
F or Micaela Martinez, PhD, an assistant
professor in Environmental Health Sci-
ences, the new coronavirus offered an op-
portunity to explore questions that she has
delved into for several years, using cutting-
edge statistical inference techniques and
mathematical models. Martinez won a Na-
tional Institutes of Health Director’s Early
Independence Award to explore fluctua-
tions in the body’s biological rhythms over
the course of the seasons. In 2018, she pub-
El-Sadr on a field visit to Mazowe, Zimbabwe in November, 2015. Photograph: ICAP
lished a calendar showing the seasonality of
69 infectious diseases. She also found that
geography mattered. Syphilis thrived during
search involves populations in New York and had begun more than a decade before the winter in China, while gonorrhea peaks in
China, as well as in South Africa. “Trans- outbreak surfaced. His work on TB informs summer and autumn in the United States.
mission is really the interface between how his thinking on how COVID-19 spreads. “I wasn’t expecting seasonality in things like
people behave and how a bug can adapt in His long-term COVID-19 study is track- herpesviruses, tuberculosis, HIV,” she says.
that environment, and I’ve always been in- ing the evolution of the virus and how that “I was very struck by this.”
terested in both aspects,” Mathema says. affects patient outcomes as vaccines and That led to her ongoing research proj-
“How do infectious diseases originate and new drug therapies become available. As the ect evaluating how immune systems change
propagate? What drives epidemics? Who are virus encounters those barriers, it likely will over a day as well as over a year. Each season,
the people who are really infecting people?” evolve, he says. New techniques like high volunteers spend 24 hours at the University
Pathogens like TB and COVID-19 are in- throughput sequencing and global sharing of Surrey, United Kingdom having their
terwoven into society. Looking at their of data, things not readily available even as noses swabbed and blood sampled to check
transmission raises major questions. “How recently as the H1N1 pandemic in 2009, for 16 respiratory viruses. The pandemic
do we design our cities to reduce transmis- make his work possible. interrupted the analysis of samples, but
sion? Housing has a measurable impact on The idea is to pick up a dangerous strain of she reports that there are indications that
diseases, for example,” he says. Last year, the virus before it spreads and give public health the immune reactions of the body change
Mathema published a study in Proceedings of leaders information so they can act. “One of our with the seasons and even within a 24-hour
the National Academy of Sciences of the United hard lessons with drug-resistant TB has been cycle. The applications of this knowledge
States of America that traced an outbreak of that we find out when the cat’s out of the bag,” could include administering vaccines dur-
drug-resistant TB in a South African prov- he says. “That’s really difficult. The basic idea is ing a particular season and time of day to
ince, finding that the origins of the outbreak to know earlier so we can prepare.” get the best protection possible.
Neetu John, PhD, co-authored an analysis suggesting that gender-based Peter Muennig, MD, MPH ’98, developed a cost-effectiveness model to assess
violence would increase during the COVID-19 pandemic. the value of infection control measures at a school or business.
18 COLUM B I A P U BLI C H E A LT H 2020–2021 EDITIONYou can also read
