Honorees announced for 2021 undergraduate research recognition awards

Aayushi Dhebar (Pre-Major), Carbon Dioxide and Temperature Levels of Areas with Varying Tree Density

Population health is defined as what is necessary to bring about “healthy futures for everyone everywhere.” In order to improve the physical and mental health of everyone, it is crucial to consider the very basics of population health, air quality. Air pollution is one of the least recognized but greatest threats to human well-being, even in developed nations. If nations continue to build on the physical and mental well-being of their citizens without considering the surroundings in which they live, their efforts will appear quite meaningless. An ameliorated environment ensures an equally healthy space for people all around the world to thrive in. These efforts will eventually also help to reduce the effects of climate change.

The research submitted to the symposium dives into the effects of varying tree density in an area on its respective carbon dioxide levels. Since carbon dioxide is one of the main contributors to poor air quality, and trees are vessels that directly decrease those levels through dark reactions in photosynthesis, this is a fitting topic to begin on. With research collected twice a day, at daytime and nighttime, it became apparent that in areas with higher tree density, carbon dioxide levels decrease, since more is used up by the tree in photosynthesis. With more businesses moving into urban areas, it is vital to take steps to reduce poor air quality. Planting more trees in an area will improve air quality, and in the long run, provide a healthy space for better population health.

Annette Mercedes (Anthropology, Biology), Dancing Around the Point: Addressing Vaccine Hesitancy amid the COVID-19 Pandemic in the Puget Sound Region

Americans cherish their health autonomy, and efforts by our government to supersede individual health care choices, especially when it comes to vaccinations, tend to be viewed with suspicion (Field, 2008). In addition, the very success of vaccine programs has seemingly fueled increasing vaccine concern as vaccine-preventable diseases are no longer prevalent in the United States. This has led the attention of the public to shift from the necessity of vaccines to the safety of the vaccines themselves. In light of the current pandemic, the first global pandemic seen since 1918, and the heavy economic and public health toll it has taken, it became clear that a vaccine may be the “magic bullet.” In the midst of COVID taking thousands of lives and devastating society, many people will find these uncertainties acceptable. While for others, as with many trade-offs, the benefit may have less emotional resonance than the possibility, no matter how small, of a potential risk.

My research seeks to understand the risk perceptions of vaccination in an adult population in the Puget Sound region of Washington State. The research I have been doing directly aligns with the Population Health Initiative’s goal of improving health outcomes by working to understand what drives vaccine hesitancy in a way that can inform public health. Better informed public health messaging has the potential to increase vaccination rates, which in turn can help reduce disease burden, disease transmission and the need for disease-specific therapeutic intervention within our communities.

Genesia Paolo (Public Health-Global Health), A Literature Review of Mental Health in the Pacific Islander Community

My research aligns with two pillars of population health because it seeks to learn more about the social and economic inequities in the mental health of an underserved population, which has great implications for human health. I am conducting a literature review of research articles concerning risk and protective factors for Pacific Islander mental health to investigate both social and economic risk and factors that promote resilience within young people’s environment. Much of Pacific Islander data is aggregated within the larger racial group of Asians and Pacific Islanders (API), rendering Pacific Islander data invisible.

This project aims to put Pacific Islanders at the forefront so their experiences can be better understood. Disaggregating API data is a matter of equity because it helps determine decisions about allocations of resources, funding, and support that are based on data. Decisions made with data that obscures health impact on Pacific Islanders further harm this marginalized community.

The aim of this review is to both identify gaps and sources for future research, which can lead to alleviating health inequities related to mental health, thus addressing an important aspect of the population health initiative. This, in turn, allows the Pacific Islander population to live their most fulfilling lives.

Irika Sinha (Biology, Biochemistry), Engineered CAR T-Cell Immunotherapy Approach for Epstein-Barr Virus-related Cancers

Epstein-Barr Virus (EBV) is a herpesvirus that infects over 90% of the population. It is implicated in more than 200,000 new cases of cancer each year, along with 140,000 deaths. Following primary infection, the virus persists latently in B-cell lymphocytes for the life of the host. Essentially all malignant cells in EBV-associated cancers are infected, indicating a strong association between the disease and cancer. Furthermore, EBV-related malignancies are demographically biased. Cases occur predominantly in East Asia, where there are fewer resources to combat this type of disease.

When an antigen, or foreign structure to the body, is found, antibodies with high specificity for the antigen are created but cannot contain the infection on their own. Cell-mediated immune mechanisms such as the activation of cytotoxic T-cells are necessary to eliminate virus-infected cells. Activation of cytotoxic T-cells and the subsequent killing of infected cells depends on T-cell receptors (TCRs) recognizing virally-encoded peptide antigens displayed on infected cell surfaces by major histocompatibility complex (MHC) class I molecules. Chimeric antigen receptors (CARS) combine the antigen-specificity of antibodies with the potent cell-killing abilities of cytotoxic T-cells. As such, CAR T-cells are able to independently directly target and destroy cells expressing the desired surface-antigen.

My research plans to create CAR T-cells to treat EBV-associated cancers. A successful method of cancer treatment is important to human health overall. By creating a treatment for EBV, population health overall will increase, leading to economic growth and societal equity which are also enhanced when public health improves.

Katie Simons (Biology), Re-envisioning Healthcare to Meet the Needs of a Historically Marginalized Population: A Health Needs Assessment for Unhoused Men in North Seattle

Seattle is at the center of a growing public health crisis with nearly 12,000 unhoused people in King County as of July 2020. This population is high-risk with unique health needs and barriers to healthcare that requires an interdisciplinary approach to effectively address the complex intersectional factors that influence the health of the unhoused community. Our research identified a significant gap in accessing primary care services, including sexually transmitted infections and substance use treatment. Common barriers to these services included lack of trust in healthcare providers and descriptions of discrimination in prior healthcare experiences.

This study supports ongoing efforts at Aurora Commons to expand of low-barrier primary care services, and the introduction of novel telemedicine approaches for the homeless to address described barriers and improve access to primary care services for this high-risk population. A patient-centered population health approach brings together interdisciplinary services to more effectively address historical barriers to healthcare.

A majority of individuals interviewed repeatedly accessed emergency departments for healthcare rather than primary care services. This is unnecessarily expensive and contributes to the inequities in healthcare access and lack of coordination of care. Understanding barriers to care, treatment gaps and feasibility for novel telemedicine technology may help reimagine our approach to healthcare delivery for the homeless. This is an opportunity to improve the health outcomes of the high-risk homeless population by delivering coordinated care in a culturally competent manner that meets their needs and reduces expensive downstream emergency services.

Kaya Bramble (Industrial Engineering), Ultrafine Particle Inequality by Race, Ethnicity, and Income in Seattle

My study investigates how factors such as income, race, ethnicity, and urban planning influence the levels of air pollution our Seattle community members are exposed to. Previous research has shown that long-term air pollution exposure has detrimental effects on health, specifically respiratory, cardiovascular, and cerebrovascular health, increasing morbidity and mortality risks. My research focuses on ultrafine particles (UFPs), which are nanoscale air pollution particles. Growing evidence suggests that UFPs can deteriorate brain health by crossing the blood-brain barrier that protects the brain from toxins and pathogens. I used linear regression modeling and other statistical methods to estimate the association between race-ethnicity and income with UFP exposure in the greater Seattle area.

People of color and low-income communities have been more likely to be exposed to higher concentrations of air pollution, likely due to factors such as historical discrimination, segregation and urban planning. My preliminary results indicate an increase in UFP exposure for low-income communities and people of color in Seattle, which implicates an inequitable environmental health hazard in our community.

The United States Environmental Protection Agency has air quality standards for other categories of air pollutants, such as PM2.5 and PM10. EPA guidelines for UFP exposure are lacking, and disparities in UFP exposure have not been studied thus far. To fill this lack of existing research, my study can be extrapolated for future study in other locations and can inform public policies that promote healthier and more equitable communities.

Lukas Metzner (Neuroscience), Effects of Inhibition of P2Y12 Receptor during Opiate Withdrawal on Microglia Activation and Behavior

The number of opioid overdose deaths, especially resulting from synthetic opioids such as fentanyl, has notably increased in the US in the last two decades, forming what has come to be known as the Opioid Epidemic. Chronic use of opioids leads to withdrawal, which has physical effects, including hyperalgesia, cramping and diarrhea, and psychological effects such as dysphoria, anxiety and insomnia. The severe effects of withdrawal are a factor precipitating opioid addiction and are a major obstacle to cessation for ongoing users. Recent research has found that microglia, immune cells of the central nervous systems, modulate the effects of substance abuse.

The Neumaier lab studies the cellular and molecular mechanisms of stress and addiction, and is currently looking into the role of microglia in opioid withdrawal. This study will investigate P2Y12, a purinergic G-coupled protein receptor able to activate microglia, as a possible target for treating opioid withdrawal. In the central nervous system, P2Y12 is primarily expressed by microglia, and it is a novel target for addressing physiological withdrawal symptoms. We will administer Clopidogrel, a widely-available antiplatelet drug and selective antagonist of P2Y12 receptors, during withdrawal and examine its effects on hyperalgesia. We will also use immunohistochemistry and microscopy to study the morphological effects of withdrawal on microglia to study the role of P2Y12 in this process.

Maryan Y. Abdi (Public Health-Global Health), Barriers to Wearing the Hijab as a Healthcare Worker in a Healthcare Setting

My study explores barriers to wearing the hijab, specifically, dress code policies or other workplace issues that would contribute to denying Muslim women the right to wear the hijab. The goal of this project is to understand whether there is: 1) consistent interpretation of dress code policies within the healthcare setting, 2) whether dress code policies need to be revised to be more inclusive and 3) whether there are additional barriers to wearing the hijab. The hoped-for outcome is to create more inclusive spaces for current and future Muslim healthcare workers.

This study aligns with the theme of population health because an inclusive and hijab-friendly healthcare workplace is critical to ensuring diversity, equity and inclusion in the workforce. It is well established that a diverse workforce is associated with better patient care. Therefore, a diverse workplace improves the health outcome of the population that is served. Muslim women, who already face a triple penalty (woman, a person of color and Muslim), would feel comfortable visiting a healthcare setting that has staff that looks like them. They would feel welcomed as who they are when the healthcare establishment is making an effort to be inclusive of them and, in turn, gaining the trust of the community. My study will be able to inform what needs to be changed to create a workplace that is desirable for Muslim women, helping with recruiting and retaining a diverse workforce to improve the health of the population.

Pavithra Prabhu (Microbiology), Firearm Injury and Violence Research Articles in Health Sciences by Funding Status and Type: A Scoping Review

This research project benefits the broader field of population health by describing the impact of federal policies on funded and published ‘firearm injury and violence’ (FIV) scholarship. Despite being one of the leading causes of death in the United States, FIV research receives significantly less funding and publishes fewer articles compared to other leading causes. The Dickey Amendment passed in the 1997 federal budget had a profound impact on the FIV field when it reallocated its funding to studying brain injuries. Without governmental financial support, researchers have either left the field or sought alternative financial means to study FIV in the US. A lack of research means less information about the ripple effect of easily accessible firearms on local crime, suicide, accidental deaths, mass shootings and their consequences on mental health, security of communities and identity of a nation.

This research project fits into two of the Population Health Initiative’s focus areas: ‘Spurring interdisciplinary collaboration’ and ‘Advancing violence and injury prevention.’ This project is guided by the expertise of researchers specialized in epidemiology, health policy, law, and medicine from various academic institutions. Furthermore, this study is the first, to our knowledge, to characterize published scholarship for FIV in health sciences by funding status and type through a scoping review. The results of this study show promise for the future of FIV research funding and demonstrate the limited financial resources available to researchers. Without proper funding, our ability to implement effective, data-driven preventive measures to save lives is hindered.

Samantha Garcia Perez (Public Health-Global Health), Understanding the Parenting Strength, Stress and Law Needs of Latinx Families

Our project narrows in on the 4.5 million Latinx children in mixed status families in the US. Vulnerable immigration status is a risk factor for poor mental health, child developmental delay, housing instability and limited access to social services. This risk can be mitigated with responsive parenting that plays an important role to promoting childhood resilience.

Our investigation aligns thoroughly with population health as prior to delivering a Social, Emotional and Academic Competence for Children and Parents (SEACAP) program, we will adapt the program based on the determinants of stress and legal needs Latinx parents express. The foundation of this intervention builds off of the population health notion that health is not only determined by the absence of disease, but one’s social and physical environment. This intersectionality of factors requires a holistic approach from various entities to promoting social and health equity.

As a result, our work is realized through a new collaboration among faculty members from Pediatrics, Psychology, Social Work, the Center for Health Equity, Diversity and Inclusion, members of the medical-legal partnership with advising from UW School of Lawand community partner organizations. Supporting Latinx parents of young children with tools for parenting, stress-management and legal education investigation is currently funded by a grant from the UW Population Initiative.

Shirley Qian (Public Health-Global Health, Biology) and Andrea Scallon (International Studies), Opt4Studies: Barriers and Facilitators to Achieving Viral Suppression in Children and Pregnant/Postpartum Women Living with HIV in Western Kenya

In Kenya, only 68% of the estimated 1.5 million adults and children living with HIV have suppressed viral loads in 2019. Given this, the primary goal of our study is to optimize viral suppression among pregnant/postpartum women and children living with HIV in western Kenya. Currently, the laboratory-based viral load (VL) testing and drug resistance mutation (DRM) testing recommended by the Kenyan Ministry of Health have various issues, including long turnaround times and high costs of transportation and labor at numerous steps of the process.

We are exploring the potential of point-of-care (POC) VL and targeted DRM testing to improve viral suppression rates. Our research study, Opt4Mamas and Opt4Kids, aligns with two pillars of population health: human health and social and economic equity. The POC VL and targeted DRM tests are more cost-effective and have quicker turnaround times than current national testing standards. This can improve community health outcomes by allowing providers to make more rapid decisions and incorporate patients into the treatment cascade earlier compared to current testing protocols.

In addition, we are using the socioecological model to examine the individual, interpersonal, organizational, societal/cultural and structural/policy factors that influence viral suppression in children and pregnant/postpartum women. By examining the relationship between the social determinants of health and viral suppression, we are addressing the social and economic inequities that prevent patients from achieving viral suppression. Ultimately, our research will inform future policy development efforts surrounding HIV and will be used to critically evaluate current healthcare systems.