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WORKING TO IMPROVE COMMUNITY HEALTH IN OREGON
Harvest for Health Getting the Message Across Lessons from the History of Medicine A partnership between PSU, Communicating the Delving into the history of local farms, and health care importance of the efforts to treat and prevent providers brings healthy foods Developmental Origins of malnutrition in Uganda. to people with diet-related Health and Disease. illnesses. Research & Strategic Partnerships Quarterly Review, Volume III, Issue 3, Fall 2016
COMMUNITY HEALTH COMMUNITY HEALTH Table of Contents Research & Strategic Partnerships
2 Introduction: Dr. Jill Rissi,Interim Associate Dean for Academic Affairs, OHSU-PSU Kevin Reynolds School of Public Health Interim Vice President, 3 Harvest for Health Research & Strategic Partnerships A partnership between PSU, local farms, and health care providers brings healthy foods to people with diet-related illnesses. Alan Kolibaba Interim Associate Vice President, 7 Q & A with David Bangsberg, dean of the new OHSU-PSU School of Public Research Finance & Administration Health 9 Simulated Patients Shed Light on Disparities in Access to Health Care Erin Flynn In the wake of the Affordable Care Act, a new study asks: has access to primary Associate Vice President, health care changed for people with different racial, ethnic, and gender profiles? Strategic Partnerships 11 Evaluating Oregon’s Health System Transformation A report from PSU highlights $240M in savings resulting from the implementation Jason Podrabsky of the state’s Patient-Centered Primary Care Home program. Associate Vice President, Research 12 Addressing Diabetes in Indigenous Communities Exploring relationships between discrimination and retention in a diabetes prevention program designed to serve indigenous populations. Joe Janda Director, 13 Disentangling Factors that Influence the Pregnancy Outcomes of Latina Innovation & Intellectual Property Women A partnership between PSU and the Multnomah County Health Department examines a unique dataset that could inform the development of Dawn Boatman interventions to improve pregnancy outcomes for Latina women. Director, Sponsored Projects Administration 15 Getting the Message Across Communicating the importance of the Developmental Origins of Health and Disease. Angela Jackson Director, 17 Lessons from the History of Medicine Center for Entrepreneurship, A forthcoming book from a PSU history professor delves into the history of Portland State Business Accelerator efforts to treat and prevent malnutrition in Uganda.
19 Diatomix, Inc. Amy Spring Improving indoor air quality one coat of paint at a time. Director, 21 On-Site Services Promote Health of Vulnerable Residents Research and Community Partnerships 22 Healthy Classrooms Designed at PSU Open at Lincoln High School The is published by 23 Gates Foundation Grand Challenges Explorations Grant Awarded to PSU Quarterly Review the PSU office of Research & Strategic 24 PSU Wins National Award for Community Engagement Partnerships. Opinions expressed do not reflect the official views of the 25 Preparing for the Impacts of Climate Change university. © 2016 Portland State 26 Combining Research and Advocacy to Improve Air Quality in Oregon University.
27 PSU Study Shows Global Methane Emissions from Fossil Fuel Production Guest Editor: Dr. Jill Rissi are Increasing 28 PSU Awarded $1.2M for Native American Teacher Education Writer/Editor/Document Designer: Shaun McGillis 29 Who Votes for Mayor in America’s Largest Cities? Contributing Writers: Chelsea Bailey, 31 A Message from Dr. Karen Marrongelle, dean of PSU’s College of Liberal Arts and Sciences Nancy Eichsteadt, Karen O’Donnell Stein, Laura Gleim, Stephanie Argy, 34 Elevating Timber to New Heights Suzanne Effors, Phil Keisling, and PSU researchers launch a new study to support the construction of wooden Jason Jurjevich skyscrapers. 35 Research Snapshot Copy Editor: Brendan Brown Cover design: Brett Forman Introduction In the pages that follow, readers will learn about
Epigenetics partnerships that provide access to nutritious foods and measure the positive effects of such access on family, DOHaD economic, and social stability. The notion of “moving upstream” is echoed in research that demonstrates the benefits of access to comprehensive, integrated primary Prenatal Communication Disparities Care care—as well as the need to address disparities in Poverty access to care that persist despite increases in insurance Equity coverage.
Opportunity
Social Justice Clear, accessible discussion of the issues surrounding this upstream movement—particularly within the Preventive Food Community Care Security Health context of highly diverse communities—poses a unique challenge for public health researchers in their efforts to sustain community-engaged research and treatment programs. Understanding the subtle factors that promote (or undermine) healthy pregnancies among Latinas in Oregon, participation in diabetes management programs across the country, and global malnutrition requires scholarship that engages—and is engaged with— communities.
Addressing population health involves more than the health system, and more than socially defined communities. The health of individuals, as of populations, ack in September, when work began on this issue is dependent upon complex social and environmental of RSP’s Quarterly Review research news magazine, determinants. This point is highlighted, for example, in no one could have imagined the magnitude of research into the economic and environmental value of Bthe changes that were taking place. Even now, as we cross-laminated timber and sustainability of the built consider what those changes might be and how they environment, research that explores who votes in mayoral might affect our communities and our health system, elections, as well as in research that exposes a shift in the we are constantly reminded of the importance of higher sources of methane that contribute to global warming and education. Now, more than ever, we can appreciate the suggests ways cities might adapt to climate change. value of programs that prepare students to manage change, to provide leadership, and to craft creative and Throughout this issue, readers will note a common theme: collaborative solutions to the challenges we face. all of these advances stem from the work of researchers who are committed to stringent ethical foundations This issue of the Quarterly Review focuses on population and scientific standards of public health research. health and strategies to improve it. Although these These principles, coupled with our commitments to strategies may be revised and added to in the years ahead, “let knowledge serve the city,” and to educate the next the “Triple Aim” of addressing health costs, improving the generation of public health practitioners, makes all the experience of care, and maintaining healthy populations difference at Portland State University and within the will undoubtedly remain unchanged, as will our drive to communities we serve. better understand the role of public health in developing resilient people and communities.
The research highlighted in this issue also bears witness to the importance of community and the ways in which Portland State University and the OHSU-PSU School of Public Health are empowering communities to live longer, healthier lives. The unique partnership between Dr. Jill Rissi OHSU and PSU continues to produce research-based data Interim Associate Dean for Academic Affairs for decision-making and educating a new generation of OHSU-PSU School of Public Health public health workers to tackle the challenges ahead.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 2 3 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Harvest for Health
By Shaun McGillis
ublic health practitioners often note that the push to improve population health should begin “upstream” of where negative outcomes necessitate socially and economically costly interventions Psuch as hospitalization and continuing care. That means addressing the biological and social determinants of health and well-being, particularly in communities where health disparities exist. But the behavioral, environmental, social, and physiological factors that influence health form strong currents that challenge those striving to navigate upstream.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 4 Zenger Farm, Portland, Oregon, image courtesy Jessica Hardwicke
To answer that challenge, many In Portland, a group of community at Richmond Clinic, Village Gardens, communities have formed stakeholders has banded together and Portland State University. partnerships that leverage their to provide healthy, affordable food collective strengths in efforts to build and nutrition education to families Supported by Kaiser Permanente momentum counter to the current. burdened by diet-related illnesses Northwest Community Benefit They work together developing and and lacking access to fruits and and the Knight Cancer Institute implementing innovative approaches vegetables. Their project is called Community Partnership Program, to health care that are preventative Community Supported Agriculture CSA Partnerships for Health by design and focus on issues (CSA) Partnerships for Health. Its provides one hundred families such as poverty, food insecurity, core members include Zenger Farm, coping with diet-related diseases documentation status, education, the Multnomah County Health and limited access to healthy foods and promoting healthy behaviors. Department, OHSU Family Medicine weekly shares of fruits and vegetables
5 • Vol. III, Issue 3, Fall 2016 • Quarterly Review several Multnomah County Health society. So access to healthy food Department health centers. just makes sense as a preventative measure. Just like exercise does. “This partnership serves families When people eat healthy foods, their without a lot of resources,” said overall health improves. And it’s not OHSU-PSU School of Public just that when they eat well they feel Health faculty member Dr. Betty better; a healthy diet has long-term Izumi, a registered dietitian and implications that are passed from inverventionist whose research generation to generation.” explores methods of addressing diet-related chronic diseases. “These With the aid of Dr. Izumi, the CSA are families that might be socially Partnerships for Health project aims isolated, struggling with problems to build a foundation of qualitative associated with poverty, and they’re and quantitative evidence and managing chronic, diet-related community support to advance illnesses. They’re also motivated to the argument that everyone should improve their health, to eat more have access to healthy foods as a fruits and vegetables, and to learn measure to prevent diet-related about nutrition, cooking, and healthy chronic illnesses, reduce morbidity, e at i n g .” and lower the cost of health care. To achieve that aim, the partners hope “Dr. Izumi is taking the lead on an to translate their findings into policy essential part of the partnership’s recommendations that support the work,” said Mike Wenrick, executive goal of improving overall health director of Zenger Farm, “which is by increasing access to fruits and to evaluate the impact of access to vegetables for those with limited healthy foods and food education resources. on our participating families over the course of three growing seasons. “When you compare the cost of She’s collecting and analyzing data providing families nutritious foods that we hope will demonstrate to the costs of treating illnesses improved overall health and like diabetes and heart disease, ultimately drive health care spending promoting and subsidizing healthy on local vegetables and fruits.” eating starts to look like a really good idea,” Dr. Izumi said. “We hope our As Mr. Wenrick noted, the social and work can contribute to that end.” economic impacts of an unhealthy diet and lack of access to nutritious Providing families dealing with foods are immense. The Center diet-related chronic illnesses for Science in the Public Interest access to locally grown healthy estimates diet contributes to nearly foods and nutrition education as 680,000 deaths a year in the US at a CSA Partnerships for Health does from local farms at a subsidized cost of roughly $958 billion. Food is a common sense solution to a rate of five dollars per share. The insecurity, meanwhile, has negative challenge that needs to be met if partnership also offers nutrition impacts on family stability, workforce society is to move upstream of where education and access to cooking reliability, and performance at negative health outcomes adversely workshops. Participants can use school. affect families and raise the cost of benefits from the Supplemental health care. It’s the kind of solution Nutrition Assistance Program “Food insecurity is a huge driver that emerges when community (formerly called food stamps) of medical costs,” said Dr. Brian stakeholders come together and for payment. And harvests are Frank, MD, a physician at OHSU’s leverage their collective strengths made available at local health Richmond Clinic and liaison to to improve public health and act to clinics including OHSU Family the CSA Partnerships for Health promote positive changes that benefit Medicine at Richmond Clinic and project. “And it really costs us as a all of society.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 6 Q & A with Dr. David Bangsberg, Founding Dean of the OHSU-PSU School of Public Health By Stephanie Argy
School and left to attend college, I never imagined leaving forever. I thought I would go to college and maybe graduate school and then come back. But then job opportunities in New York, San Francisco, and eventually in rural Africa kept me away.
I’ve always loved Portland and Oregon. My family is here. The prospect of leading a new school of public health in my hometown was very compelling. There’s a creative spirit and energy that I think is unique to Portland, which will be great to tap into as well.
What do you see as the particular strengths of the Portland region, in terms of the work you’re doing?
Portland and Oregon are very progressive, interested in health and well-being. At the same time, Oregon also has many significant health challenges, including substance abuse, mental health, obesity, cardiovascular disease, and cancer, to name a few. There are challenges related to access, education, and economic opportunity. Portland in particular has struggled with Dr. David Bangsberg, Dean, OHSU-PSU School of Public Health issues of homelessness. All of these are issues important to Portland, n September, 2016, Dr. David an affiliate of Harvard Medical Oregon, and the US at large. Bangsberg, MD, MPH, School, where he was a professor. became the founding dean I’m very excited that Oregon has Iof the new OHSU-PSU School of You could work anywhere in the been a leader in health care reform Public Health, a joint endeavor world, so how did the OHSU-PSU and was out in front in terms of between Portland State University School of Public Health lure you trying to create equitable and and Oregon Health & Science back to Portland? affordable access to health care University. Bangsberg was most with the Oregon health system. So recently Director of Global Health I was raised here in Oregon. When there are fascinating opportunities at Massachusetts General Hospital, I graduated from Lincoln High to explore how policies that
7 • Vol. III, Issue 3, Fall 2016 • Quarterly Review increase access to health care with The second goal is to listen created by the two combined a public health focus will lead to to the stakeholders in Oregon universities, and to make friends improved health outcomes while who represent marginalized and professional relationships and controlling cost. populations, and who represent generate new ideas. health care leadership in the state, Your past work has been global whether it’s state, county, or local In Uganda, you supported efforts in scope. Will the OHSU-PSU government officials, members to address economic insecurities School of Public Health focus of the business community, or and help people generate steady primarily on this region? the people themselves. We want incomes. Are you interested to make sure we understand in continuing those sorts of A school of public health in their needs and apply the talent ventures here, either on a local or Oregon should focus first and of OHSU and PSU to address global level? foremost on health needs and the public health priorities of health disparities of Oregonians. Oregonians. I love being entrepreneurial. I The school is supported by the look at health through a very state, and the residents of Oregon What sorts of students do you broad lens: not only biological should be its first priority. That hope to attract to the School of health, but also mental health, said, in every university across Public Health, in terms of their social health, and economic the country, there is a new academic backgrounds and health. I don’t know what generation of young people who goals? opportunities will reveal grew up in the Internet age who themselves in this new school. are aware of what global health We want to attract bright, That will require me to get to disparities are and who have a motivated, passionate students know and understand the talent real passion to make a difference. who are interested in working in of the faculty and how that With my experience in global public health and that want to matches the needs of Oregon. But health, I can make connections make a difference in the world by we’ll look forward to exploring and create opportunities for the reducing health disparities. solutions that have that same students and the faculty. broad view and that impact How will you combine the physical, mental, social, and What are your early goals as faculties of PSU and OHSU? economic health. dean of the new program? We look forward to creating new First, though, I would like to get My first job with this new school avenues for the faculties of the to know my new faculty—where is to help bring the faculties from two schools to work together to are the talents, and where are the the two universities together. I’d develop research projects that passions? And how do we best like to foster an environment cross the disciplines at each align those talents and passions in which the faculty feels school, and also to develop new with the greatest public health that they can tap colleagues curricula and new educational needs of Oregon? I have a lot of in other disciplines to create opportunities for students. faith and a lot of optimism that innovative approaches to public we’ll come up with really creative health. OHSU has expertise in Bringing a community together solutions, and I look forward to biomedicine, biostatistics, and requires informal opportunities discovering those, in partnership epidemiology; PSU complements for people to spend time together. with not only the faculty, but that with health policy and We’re looking for ways for people with the students, staff, and community and urban health. to get to know the community community as well.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 8 Simulated Patients Shed Light on Disparities in Access to Health Care
In the wake of the Affordable Care Act, a study led by Dr. Rajiv Sharma asks: has access to primary health care changed for people with different racial, ethnic, and gender profiles?
By Shaun McGillis By Shaun McGillis
9 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Disparities in access to health care studies that collect data via surveys ethnic, and gender-based disparities faced by racial and ethnic minorities, and to avoid the problematic data in offers of appointments in relation people living in poverty, and other from Medicaid and Medicare payment to how generously states compensate vulnerable populations in the US are records that may not accurately physicians who take Medicaid. Future well-documented. The Affordable represent subgroups within the publications, Dr. Sharma explained, Care Act (ACA) was meant to change population. will explore whether disparities exist that. Many of the key provisions of for patients who are obese, smokers, or President Obama’s signature health “In a sense, we’ve taken the pulse who live in poverty. care reform law—the Patient’s Bill of of the American healthcare system Rights, federal investment in primary in the run-up to and after the “What we’re starting to see as we care training programs, modernizing implementation of some of the major analyze the data,” Dr. Tinkler said, “is infrastructure, and insuring more provisions of the Affordable Care Act,” that access might be improving overall, people—were designed to increase Dr. Sharma said. “We’re measuring but some groups are being left behind. access to health care for millions of how often our simulated patients are That might indicate that if you want to US citizens. Several years into the offered appointments with a primary see better access for certain subgroups rollout of “Obamacare,” researchers are care physician or an alternative of the population, a more targeted collecting and analyzing data that will provider and that is a key indicator policy than the ACA may be needed.” help determine whether the ACA has of the performance of the system succeeded in narrowing the disparity as a whole. Our analysis of the data “That is how we hope our work can gap. collected by students during thousands inform the conversation around of phone calls can help us answer the reducing disparities in access to Health economist Dr. Rajiv Sharma question: now that we’ve had this primary health care,” Dr. Sharma said. and his colleagues Drs. Arnab Mitra huge overhaul and expansion of health “This research can help policy-makers and Sarah Tinkler of Portland State care, is access improving and, if so, for identify what is working and what is University’s Department of Economics whom and to what degree?” not in the system and direct resources have broadened PSU’s community to address gaps in access.” health research portfolio with their The team’s initial findings, published NIH-funded Longitudinal Access to in the journal Economics Letters Recent estimates suggest twenty Physicians study. Their work addresses demonstrate that in 2013, the year million Americans have obtained whether, and in what ways, access before the expansion of Medicaid, health insurance under the ACA. to primary health care providers has some subgroups of the population Much of the research emerging in changed in the wake of the ACA for experienced far greater difficulties the wake of the rollout of Obamacare people of different races, ethnicities, accessing primary care than others. shows that the likelihood of all racial and genders who are privately insured, A simulated Hispanic woman on and ethnic groups being uninsured covered by Medicare or Medicaid, or Medicaid, for instance, had just a has gone down since 2014. And while uninsured. fourteen percent chance of being those are positive signs for the nation’s offered an appointment during a phone healthcare system, narrowing the The Longitudinal Access to Physicians call placed by a student posing as a gaps in access to care faced by racial study is the first of its kind to consider family member. A white, uninsured and ethnic minorities, people living the roles of race/ethnicity and gender male, on the other hand, had a seventy in poverty, and other vulnerable in relation to insurance coverage percent chance of being offered an populations will likely require further and access to primary care. Its appointment. efforts. Economists like Drs. Tinkler design innovations included creating and Sharma are helping to identify simulated patients with distinct In the months following their initial places where gaps in access continue profiles to audit the system and using publication, the research team has to exist and where policy could be students posing as family members of continued to analyze data. Their directed to remedy them. It will be a the “patients” in phone calls seeking investigations have yielded several long process and there’s still much to information about appointments forthcoming publications and be done, but their work is bringing from health care providers. These presentations, including one paper us closer to a healthcare system that innovations, Dr. Sharma explained, that suggests nurse practitioners ensures, as President Obama recently allowed the researchers to control for might be an untapped resource in the said in a speech, that health care is not the low levels of responsiveness and nation’s primary healthcare system, a privilege for the few but a right for responder bias introduced into similar and another that examines racial, everyone living in America.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 10 Evaluating Oregon’s Health System Transformation A report from PSU highlights $240M in savings and other successes resulting from the implementation of Oregon’s Patient-Centered Primary Care Home program.
By Shaun McGillis
correlation between the changes in primary care clinics and what people are spending on specialty care and trips to the emergency room. That suggests that the transformation of Oregon’s healthcare system really is resulting in improved health outcomes and reduced spending over t i m e .”
“The PCPCH program is working,” said Dr. Gelmon. “It’s moving the A new study from Portland State “patient-centered lens” and shifted state toward achieving the goals University researchers highlights toward population-based strategies set up by the Triple Aim. Clinics $240M in health care savings over the to improve health and health care are embracing the idea of patient- first three years of the state’s Patient- delivery. In addition to the $240M centered, coordinated care and the Centered Primary Care Home saved, the study reports reductions other standards set forth by the state. (PCPCH) program. in total health care expenditures of We’re hearing it from the people roughly $120 per person per year. working at the clinics and we’re The PCPCH program was created The PCPCH program also resulted seeing it in the data we’ve analyzed.” by the Oregon Legislative Assembly in savings in specialty, emergency in 2009 to achieve the “Triple department, and inpatient care. In 2009, the state set out to improve Aim” of advancing public health, the health of all Oregonians and elevating the patient care experience, Working in collaboration with the reduce costs associated with health and reducing health care costs. Oregon Health Authority, OHSU- care by transforming the state’s To complete this task, the Oregon PSU School of Public Health healthcare delivery system. The Health Authority, which oversees professor Dr. Sherril Gelmon and Dr. report from Drs. Gelmon, Wallace, the PCPCH program, developed a Billie Sandberg of PSU’s College of and Sandberg shows how that standards-for-care model. Under the Urban and Public Affairs conducted transformation has succeeded model, community-serving, patient- qualitative evaluations of twenty and highlights the ways Oregon’s centered primary care clinics that “exemplary” PCPCH clinics around commitment to quality patient- provide accessible, comprehensive, the state to better understand and centered, coordinated care at a large and coordinated care are labeled report on the factors that promote scale is producing positive results. Patient-Centered Primary Care successful implementation of the Homes by the state. As of the release program. Using data provided by “Oregon’s health transformation of the report, the state has recognized the state, School of Public Health efforts are making huge strides over 600 PCPCHs in rural and urban professor Dr. Neal Wallace evaluated toward improving the health of communities throughout Oregon. the impact of the program on health Oregonians and controlling health care expenditures and the use of care costs,” said Lynne Saxton, The findings from the PSU report insurance-covered services. Oregon Health Authority director in show that the state’s efforts to a statement released by the agency. achieve the goals of the Triple Aim “PCPCH clinics serve a large portion “[This report] demonstrates that a have produced positive results and of the state’s population, including focus on integrated primary care have significantly transformed the people on Medicare, Medicaid, can significantly save dollars for the healthcare system in Oregon. Clinics and state employees,” Dr. Wallace state and provide the best health care adopting the program assumed a said. “And the evidence shows a possible for all Oregonians.”
11 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Addressing Diabetes By Shaun McGillis in Indigenous Communities
Dr. Kelly Gonzales explores relationships between discrimination and retention in a diabetes prevention program designed to serve American Indian and Alaska Native populations.
The American Diabetes Association originally conducted the study. resulting in improved retention rates. states that American Indians and Dr. Gonzales recently received She plans to test that hypothesis by Alaska Natives (AI/AN) have the funding from the NIH to conduct a reanalyzing the data with a specific highest prevalence of diabetes secondary analysis of that data to see focus on how discrimination among all racial and ethnic groups if she can identify those insights. impacts participation. in the US and are more than twice as likely to have diabetes than are non- “The dataset from the Diabetes According to Dr. Gonzales, her Hispanic whites. Prevention project is the largest of reexamination of the Diabetes its kind, which makes it a great tool Prevention demonstration project To lay the groundwork to reduce to work with,” Dr. Gonzales said. data and other work she’s planning the prevalence of diabetes among “And while the project produced can help us better understand AI/AN communities, a study really positive outcomes in terms the ways negative factors like conducted between 2006 and 2009 of better diabetes management and perceived discrimination and attempted to replicate the success prevention and demonstrated the positive factors like community of a previous clinical lifestyle benefits of creating opportunities for engagement influence retention in intervention outside the walls of the communities to tailor and manage lifestyle interventions that promote clinic in indigenous communities. interventions in ways that reflect and health and well-being within AI/ The resulting Special Diabetes address their cultural needs, I think AN communities. With that Program for Indians Diabetes there is more that we can learn from knowledge, policy-makers and Prevention (DP) demonstration it.” public health programmers working project developed, implemented, in collaboration with communities and evaluated culturally informed Dr. Gonzales’s hypothesis is can develop inclusive, culturally and community engaged lifestyle that perceived discrimination is informed approaches to addressing interventions that included 3,369 associated with lower levels of critical health disparities in participants representing 80 tribes at participant retention and that underserved communities, which is 36 locations across the nation. While certain community-level factors act essential to promoting health equity the study concluded that it was as a buffer to that discrimination, for all. possible to successfully implement such programs at the community level, it also highlighted challenges in retaining participants.
According to Dr. Kelly Gonzales, a professor in the OHSU- PSU School of Public Health, challenges with participant retention notwithstanding, the dataset produced by the study contains important information on participant experiences of psychosocial stress, which includes discrimination, and other factors that could reveal insights into participant retention investigators had not been looking for when they
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 12 Disentangling Factors that Influence the Pregnancy Outcomes of Latina Women
In partnership with the Multnomah County Health Department, Dr. Lynne Messer examines a unique dataset that could inform the development of interventions to improve pregnancy outcomes for Latina women.
By Shaun McGillis
t Portland State University, partnerships are central to how we fulfill our mission to “let knowledge serve the city.” Partnerships enable students and faculty to work within the community Adeveloping collaborative solutions to society’s pressing challenges. Dr. Lynne Messer, a social, environmental, and reproductive epidemiologist and faculty member of the OHSU-PSU School of Public Health conducts research that connects the university’s mission to the needs of the region’s underserved communities.
While the relationship between Portland State University and the Multnomah County Health Department (MCHD) goes back decades, Dr. Messer recently partnered with MCHD on an NIH-funded study that will provide health practitioners and policy-makers critical information on how factors like nativity, documentation status, and residential context influence pregnancy outcomes for the county’s Latina population. This data could shed new light on what’s knows as the “Latina paradox”—a well-documented phenomenon that suggests pregnancy outcomes for Latinas are nearly as good as those of non-Hispanic white women despite low socioeconomic status and other potential disadvantages. By disaggregating where women were born from their documentation
13 • Vol. III, Issue 3, Fall 2016 • Quarterly Review status, from where they live once they arrive in Multnomah County, and from the blanket category “Latina,” the study could identify nuances in the paradox and provide a more granular level of detail to the pregnancy health profile of Latinas. For the MCHD, the study will help community health providers develop interventions that address specific traumas related to country of origin, documentation status, discrimination, and security, and promote the reproductive health of all Multnomah County’s Latina women and the health of their children over the life-course.
To disentangle data related to neighborhood profile and thereby for undocumented pregnant Latinas. nativity and documentation status, get a more distinctive picture of the That’s why we’re working with Dr. Messer is working with state Latina women giving birth in the PSU and Dr. Messer. Partnerships birth certificate data. To incorporate county.” like this help us better serve the the influence of residential context community. They bring the people on pregnancy outcomes, Dr. Messer Available to qualifying pregnant and resources we need to achieve the will also review data from the women statewide through the kind of evidence base required to US Census and the USDA’s Food Oregon Health Authority, the improve public health services and Access Atlas. An analysis of all the CAWEM-Plus benefits package address health disparities faced by data could identify relationships covers all Oregon Health Plan many in the community.” among a woman’s country of origin, benefits including labor and delivery, documentation status, residential though benefits end at delivery. “Data is a tool for action, and we environment, and pregnancy According to Dr. Aileen Duldulao, hope the findings of this study outcomes, including prenatal MCHD’s Maternal and Child Health will shed more light on the health weight gain, pregnancy-induced Epidemiologist, what makes the data disparities we’ve seen in our hypertension/eclampsia, preterm from CAWEM-Plus so valuable is immigrant communities,” said Olivia birth, and term birth weight within that it’s only available to individuals Quiroz, Senior Policy Analyst and the county’s Latina population. ineligible to receive Medicaid, which Community Liaison at MCHD’s means enrollment can be used as a Equity, Planning and Strategy “The CAWEM-Plus data is the proxy for documentation status. Division. real linchpin in this study,” Dr. Messer said. “Oregon is one of “For us at the county health According to Dr. Messer, some the few states in the nation that department, there is an urgent need of the most interesting work that supports a program that provides to get more and better information will emerge from this partnership insurance and access to affordable about undocumented Latinas who will come after the data has been health care to undocumented are pregnant,” Dr. Duldulao said. analyzed and the findings published. community members, those whose “At this moment, that data doesn’t Backed with data that suggests immigration status precludes them exist in the literature. Getting if and how a woman’s country from enrolling in Medicaid, and who down to that level of detail is why of origin, documentation status, are otherwise unable to purchase the partnership with PSU is such and residential context influence private insurance. And because a great opportunity. In the health pregnancy outcomes, MCHD will be Oregon supports this program, we department, and in public health able to develop culturally-informed have an incredible source of data generally, we want to develop interventions that promote prenatal that enables us to link information preventative programs based on health, pregnancy outcomes, and contained in birth records with a evidence. And right now we lack the support a healthy start to life for the mother’s documentation status and evidence we need to create programs newest members of our community.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 14 Epigenetics
Communication Disparities
DOHaD
Prenatal Care
Poverty
Community Health Equity
Opportunity
Preventive Care
Food Security
Social Justice
Getting the Message Across
Communicating the importance of the By Shaun McGillis Developmental Origins of Health and Disease
It’s been three decades since the age two) have a major influence on different way that we might be used Developmental Origins of Health how vulnerable we are to certain to. They shift our understanding and Disease (DOHaD) emerged as diseases as adults. Epigenetics—the of what causes certain diseases. a field of scientific inquiry. Since study of interactions between our They ask us to pay attention to how then, an idea has gained traction environments and our genes that biology impacts health, but also to among many scientists, medical result in changes in how our genes consider social and environmental professionals, and community express—describes processes which factors, not just within our health practitioners: the health give rise to vulnerabilities that lifetimes but also across the span problems we experience as may be passed on from generation of generations. Because DOHaD individuals and communities to generation. This means that requires thinking about the origins actually take root much earlier than the conditions our grandparents of health and disease in a new way, previously thought. experienced could make us more one of the major challenges facing susceptible to diseases such as scientists and community health Much of the research in the field obesity, type 2 diabetes, and practitioners working to translate of DOHaD suggests that social, hypertension. the science into policy and action environmental, and behavioral is how to communicate the results factors from the time before For many, the ideas emerging of studies so as to focus the public’s conception and throughout the first from DOHaD ask us to think attention on how addressing issues thousand days of life (up to about about health and disease in a very including poverty, food security,
15 • Vol. III, Issue 3, Fall 2016 • Quarterly Review educational opportunity, and safe process the idea that our risk for communications tool, it works to and secure housing will improve disease as adults may be affected by help us conceptualize the range of public health for generations to the food systems our grandmothers sources of risk, from the individual come. were exposed to when they were to the societal level. This gives us pregnant with our mothers,” the opportunity to address all the “Because of this work, we have Dr. Winett said. “And without variables that we think are relevant a new understanding of when that framework, it’s difficult to to health before, during, and after chronic disease begins and why communicate the importance of vulnerabilities occur so that we can we’re seeing widespread increases findings from DOHaD.” minimize the likelihood of disease. in disease rates across the US And it highlights that to truly and around the globe,” said Dr. In a recently published paper, eliminate the ‘hits’ experienced Liana Winett. “That is why it’s so “A Framework to Address during development, we will important that we communicate Challenges in Communicating need to improve the social and what we’re finding to the public. the Developmental Origins of environmental contexts in which We need to start a dialogue to help Health and Disease,” Dr. Winett, in communities operate.” people understand the implications collaboration with fellow OHSU- of DOHaD and to engage the PSU School of Public Health According to Dr. Winett, DOHaD public in a partnership to identify professors Drs. Larry Wallack, has changed our understanding of the range of solutions we’ll need to Dawn Richardson, Janne Boone- when health and disease begin and address some of the societal-level Heinonen, and Lynne Messer, drawn attention to how inequity challenges that result in a higher presented a framework that and injustice can actually get under risk of disease.” scientists and community health the skin, predisposing individuals practitioners can use as a starting and communities to higher risks Dr. Winett is an associate point in their efforts to translate for disease. But we can reduce professor in the OHSU-PSU the findings of DOHaD “from those risks. The work scientists School of Public Health. Her the bench to population-level and pubic health practitioners research focuses on framing health promotion and disease are doing in the field can lead to public health issues in media prevention.” societal-level changes if we start and public opinion. According considering the ways social and to Dr. Winett, communicating The communications model environmental factors influence findings from DOHaD has proved proposed by Dr. Winett and health outcomes and act to challenging thus far because, colleagues is based upon the improve well-being and quality of outside of the scientific world, we “Haddon Matrix”: a framework life for everyone. But the data don’t have not yet developed a collective from the field of epidemiology speak for themselves. Real change framework in which to situate that illustrates the relationships will require communicating the our understanding of the broader between factors that influence the findings from DOHaD to the implications of this relatively new risk of vulnerabilities to diseases public, bringing in communities science and what it means for how and supports decision-making and policy-makers at all levels and we organize society. And without in the design of interventions. It assembling the broadest range of that framework, it’s easy to hear also incorporates the “First-hit, voices possible to identify solutions or read words like “pregnancy,” Second-hit Framework” used by to issues facing society. “prenatal,” “programming,” health researchers to explain how “behavior,” “neighborhood” “lifelong health can be adversely “Our message needs to be clear,” “race,” or “ethnicity” and affected by a series of ‘hits,’ or said Dr. Winett. “It will require misattribute responsibility for the insults, experienced at critical broad societal commitment to causes of disease—to mothers, developmental intervals [before address the full range of causes and communities, or subgroups birth] and across the lifespan.” solutions to problems that impact within the population—because health over the lifespan. These of associations our minds “We developed the First-hit, include problems like poverty, automatically make when we Second-hit Planning Matrix to access to healthful food, safety, encounter those words. support communities and society housing, and social opportunity, in looking at the issues that affect which are among the most “We don’t have a widely shared DOHaD in a comprehensive challenging and urgent issues of cognitive model with which to way,” Dr. Winett said. “As a our time.”
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 16 Woman delivering therapeutic formula to malnourished child at Mwanamugimu, c. 1965 lessons from the history of medicine
By Shaun McGillis Dr. Jennifer Tappan’s research delves into the history of efforts to treat and prevent malnutrition in Uganda.
n the years immediately following Kwashiorkor is one type of severe Beginning in the 1930s and through the Second World War, the World acute malnutrition that affects the the 1960s, the efforts of scientists Health Organization and UNICEF health of millions. Associated with a and physicians to identify the causes I(the United Nations Children’s Fund) diet deficient in protein, its symptoms of, treat, and prevent kwashiorkor trained their resources on addressing include the accumulation of fluid produced many programs, some of malnutrition in countries around in tissue that gives malnourished which were great successes while the world. And yet, while efforts children a swollen appearance, a form others turned out to be horrific have continued, international groups of dermatosis in which skin peels failures. Scientists searching for what combating malnutrition still face a away, and the loss of pigmentation in caused symptoms used ethically global burden of poor nutritional hair. Before treatments were developed questionable methods to conduct health associated with the deaths of in the early 1950s, forty to ninety their research. Miracle treatments nearly three million children under percent of afflicted children died from like protein-rich dried milk that the age of five every year. this particular form of malnutrition. restored health when administered in
17 • Vol. III, Issue 3, Fall 2016 • Quarterly Review kwashiorkor and minimize morbidity cultural lives of the community. It is a from conditions associated with remarkable example of a sustainable malnutrition. public health initiative, a program that could be sustained even in the Dr. Tappan is an Africanist historian midst of waning donor interest and whose work focuses on the history investment following decades of of medicine, public health, and political violence and unrest. historical epidemiology in Sub- Saharan Africa. She conducts much “The history of medicine and of her research in Uganda, peering public health is a field of inquiry back into the turbulent decades that helps us chart past efforts to following the Second World War and contend with contemporary disease the end of colonialism where she challenges,” Dr. Tappan said. “When studies the relationships between the you examine historical epidemiology people of Uganda and the scientists, you often find teachable moments, physicians, and aid organizations hints as to how past generations that worked on kwashiorkor. made forward leaps, and you can Mother with her daughter and second Her investigations weave critical observe the actions that led to child after three weeks at the clinic analysis of historical records and unintended consequences. But the existing scholarship with personal history of medicine isn’t necessarily histories recounted by the medical emphasized in public health hospitals resulted in the deaths of professionals and community training. Consequently, many aid untold children after the program members who experienced Uganda’s organizations and public health was taken out of the clinical setting. emergence as an international center practitioners create programs that As a result, public trust in treatment for nutritional science in the three are not able to take into account centers and biomedical science decades following the Second World what’s been done before and how the waned, resulting in even more War. community received those efforts. negative outcomes. But this failure Historians can bridge that knowledge ultimately prompted a different Next summer, the Ohio University gap and help those working in public approach, one that engaged with Press will publish Dr. Tappan’s first health integrate an understanding the community, creating a culturally book: The Riddle of Malnutrition: The of the past into their current efforts. informed intervention focused on Long Arc of Biomedical and Public And that can have a profound impact nutrition education and empowering Health Interventions in Uganda. on global health programming going women in the promotion of Examining over a half-century forward. It can help us save lives.” nutritional health. of efforts to address kwashiorkor, the book focuses on what led to According to Dr. Jennifer Tappan, the development in the 1960s of a a professor of history at Portland community-based intervention that State University, the events of those has succeeded in improving public years left a lingering residue in the health for decades now. The program, memories of the communities who locally known as Mwanamugimu, are to this day on the front lines of is an intervention that enlists the battle against malnutrition. For Ugandan women and emphasizes the international aid organizations the preparation of Ugandan cuisine and global health programs whose made from nutritious foods found mission it is to treat and reduce in local markets and household instances of kwashiorkor, that gardens. According to Dr. Tappan, residue accompanies them into the program empowers women and the cities and villages where they men in the community to manage the work. An understanding of that nutritional health of their families. complex history and its impact For generations now, these women on communities is essential to the and men have passed on what they design of future campaigns if they learned, making the intervention are going to reduce the prevalence of an integral part of the daily and
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 18 Improving Indoor Air Quality Diatomix Inc.
By Shaun McGillis
MovingBy Shauninnovation McGillis beyond the lab
19 • Vol. III, Issue 3, Fall 2016 • Quarterly Review his past February, Portlanders radon, smoke, molds, mildew, “Broadly used” is perhaps an expressed their collective bacteria, and a surprisingly long understatement. Formaldehyde is outrage following revelations list of VOCs [volatile organic found in cigarettes and e-cigarettes, Tof dangerously high concentrations compounds] that aggregate in manufactured wood products, of cadmium and arsenic in the the air we breathe and can lead to furniture, textiles, air fresheners, air around a Southeast Portland negative health outcomes. We want cleaning supplies, perfumes, neighborhood. to remove some of those pollutants toothpastes, and cosmetics. The by incorporating air-purifying Campaign for Safe Cosmetics “What are your younger children technologies into products like even found formaldehyde in baby and other vulnerable people— indoor paint.” shampoos, lotions, wipes, and other people with chronic health products for children. problems, elderly people—what The technologies that Diatomix are they breathing in?” Susan Beal, develops bridge the gap between So, what’s the danger? a mother of two and resident of nature’s designs and materials Southeast Portland, asked reporter engineering. In a lab at PSU, Well, according to the Oregon Chris Holmstrom of KOIN 6 News. Lampert and Li combined the Occupational Safety and Health unique optical resonance properties Administration, short-term Those questions resonate with Lester of a species of diatom—a unicellular exposure to formaldehyde can Lampert, a PhD candidate in the organism that lives life encased result in eye, nose, and throat field of applied physics at PSU. A within a cell wall made of silica— irritation. Long-term exposure scientist and entrepreneur, Lampert with VOC-degrading photocatalytic can cause asthma-like symptoms cofounded Portland-based clean- nanoparticles to create a and dermatitis. A handful of other tech startup Diatomix with Dr. photoreactive material that uses the states classify formaldehyde as an Haiyan Li, a bioengineer, materials energy of visible and UV light to asthmagen, and the EPA categorizes scientist, and former PSU research chemically transform harmful air it as a probable human carcinogen. associate. Diatomix develops pollutants into benign gases. technologies that improve the air we “Indoor air quality is a major health breathe—not the fresh air outdoors, “We see the potential to target a concern,” Lampert said. “And many but the much more polluted air number of VOCs that accumulate people may not be aware of the in our homes, workplaces, and indoors and affect air quality and potential risks they’re exposing classrooms where we spend as much health,” Lampert said. “Right now themselves to when they’re at as ninety percent of our time. we’re working on breaking down home, work, or school. That is why formaldehyde. It’s one of the most we’re developing technologies that “The EPA has data showing that common VOCs you’ll encounter in will continuously improve the air indoor air quality can be two to built environments and it’s broadly you breathe and that are no more five times worse than that of the used in the production of consumer obtrusive than the paint on the outdoors,” Lampert said. “There’s goods.” wall.”
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 20 The full report and executive summary are available on the Institute for Aging research page.
“Housing with Services provides an excellent example of how housing can be a platform for health among older persons and adults with On-Site Services disabilities who live in low-income apartment buildings,” Carder said. Promote Health of “The collaborative effort by over twenty local housing, health, and Vulnerable Residents social service agencies, along with By University Communications two resident groups, resulted in measurable improvements in the lives of vulnerable older adults.”
Starting in September 2014, housing and service providers worked together to help residents enroll in health plans, access social services, connect with primary care providers, acquire medical equipment, and follow up on other support. They also opened a health and wellness center on the ground level of the 1200 Building on Southwest 12th Avenue and Jefferson Street for health screenings, social events, and activities such as Tai Chi.
The partners in the Housing with Services project include Cedar Sinai Park, CareOregon, Home Forward, REACH Community Development, Asian Health and Service Center, new report from Portland An evaluation by PSU professor Jewish Family and Child Services, State University’s Institute on Paula Carder found that residents Sinai In-Home Care, Cascadia Aging suggests that offering who had contact with the Housing Behavioral Health, and LifeWorks Ahealth and social services on-site with Services team were more likely NW. They have formed a limited in low-income housing can help to use preventative health and liability company to continue the residents stay healthier and in their outpatient mental health services, project. homes longer. and that they had a small decline in emergency department use compared Funding came from all the partner The $1.7M Housing with Services to residents with no contacts. In organizations, a State Innovation project provides coordinated services addition, food insecurity among Model grant to the Oregon in eleven buildings that house 1,400 these residents declined during the Department of Human Services and low-income seniors and adults with program period. Oregon Health Authority, Meyer disabilities in Portland. The new Memorial Trust, Family Care, model of community-based care The evaluation showed that the Enterprise Community Partners, brings together several housing, availability of on-site staff, including NeighborWorks and Providence health, and social service agencies health navigators and community Health System, the Harry and with funding from state and other health workers, improved residents’ Jeanette Weinberg Foundation, and sources. access to health and social services. the HEDCO Foundation.
21 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Healthy Classrooms Designed at PSU Open at Lincoln High School By Karen O’Donnell Stein
tudents at Portland’s Lincoln These sustainable and affordable High School,” said Professor Leite. High School had something buildings are constructed with “Especially since Lincoln is less than new to look forward to when nontoxic materials and VOC-free a mile away from Portland State Sthey returned to classes earlier this paints. They feature efficient energy- University, where the idea for SAGE fall. Four healthy educational spaces, recovery ventilators that provide was conceived and where so much of known as SAGE (Smart Academic fresh air, vaulted ceilings, and large the design work took place.” Green Environment) classrooms, windows that allow natural light into opened their doors on the campus, the room. A team of Pacific Northwest providing spaces for academic companies came together to bring classes, club meetings, and lectures by Former Governor Kitzhaber SAGE classrooms to Lincoln High community leaders. declared the project an Oregon School. Contractor Pacific Mobile Solution in 2011. That designation Structures, manufacturer Blazer In 2015, Portland Public Schools led to the formation of a multi- Industries, Mahlum Architects, and (PPS) selected the SAGE classrooms partner team of public agencies and construction firm Ross Builders NW as replacements for fire-damaged commercial entities that supported collaborated with PPS to purchase portable buildings at Lincoln High the development of these remarkable and install the structures. School. Seeking an economical and classrooms. The first SAGE prototype mobile option, district leaders met was introduced in 2012 at the Leite said she expects future with City of Portland officials and National Green Building Conference architecture classes at PSU will visit determined that the sustainable SAGE in San Francisco. The following year the SAGE classrooms to learn more classrooms would best meet the needs the SAGE classroom project received about healthy, environmentally of the school and its students. a SEED award for Social, Economic friendly building methods up close. and Environmental Design. The SAGE classrooms were designed “We are so glad that PPS is moving by Portland State University School A total of fifty-nine SAGE classrooms toward healthier and happier learning of Architecture professors Margarette have been installed at thirty-two environments with the SAGE Leite and Sergio Palleroni and a team schools around the Pacific Northwest. classroom. We are hopeful that we of students as a healthier alternative will be able to collaborate with this to the ubiquitous portable classrooms “We’re so proud that PPS chose amazing team again at other Portland installed at schools across the country. the SAGE classrooms for Lincoln schools,” said Leite.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 22 Grand Challenges Explorations Grant Awarded to PSU
By Chelsea Bailey
ortland State University announced in November that it had won a Grand Challenges PExplorations grant, an initiative funded by the Bill & Melinda Gates Foundation.
With an initial $100,000 grant, PSU biology professor Ken Stedman will pursue an innovative global health and development research project, titled “Point of Collection Silica- Coating and Preservation of Stool,” to adapt the technique he developed for stabilization of vaccines for use in stool samples.
Stedman will apply a silica coating to stabilize stool samples that can then be transported to central locations for analysis for intestinal parasites. As with vaccines, stool stabilization is a considerable challenge for diagnosis, as stool samples break down quickly and parasites develop during transport. The process Stedman’s lab developed for vaccines Dr. Ken Stedman, Professor, Biology could be a promising development for local public health workers To receive funding, Stedman Foundation, his research has been seeking cost effective stabilization and other Grand Challenges supported by the National Institute methods that can lead to a more Explorations winners demonstrated of Allergy and Infectious Diseases, accurate diagnosis and effective in a two-page online application National Science Foundation, NASA, treatment. a bold idea in one of six critical and American Heart Association. global heath and development Grand Challenges Explorations topic areas. The foundation will be Stedman’s current research focuses (GCE) supports innovative thinkers accepting applications for the next on viruses that infect extremophilic worldwide to explore ideas that GCE round in March 2017. microbes, unique emerging virus can break the mold in how we genomes, and applications of his solve persistent global health and Stedman is the founding member research to vaccine stabilization, development challenges. Stedman’s of PSU’s Center for Life in Extreme particularly for the developing project is one of fifty-five Grand Environments. He has authored or world. He founded the Portland- Challenges Explorations (Round co-authored over sixty scientific based biotech company StoneStable 17) grants announced by the Bill & publications. In addition to funding Inc. to commercialize the vaccine Melinda Gates Foundation. from the Bill and Melinda Gates stabilization technology.
23 • Vol. III, Issue 3, Fall 2016 • Quarterly Review PSU Wins National Award for Community Engagement
By University Communications
he Association of Public PSU and the City of Portland’s community-based classes and Land-grant Universities Bureau of Planning and that work on Planning and (APLU) has named Portland Sustainability have gained national Sustainability projects. TState University the winner of the and international recognition for C. Peter Magrath Community their long-term partnership that “Community engagement is at the Engagement Scholarship Award in engages faculty and students in very heart of public universities’ recognition of its twenty-seven-year education, research, and service. missions,” said APLU President partnership with Portland’s Bureau Results of the partnership include: Peter McPherson. “Portland State of Planning and Sustainability. has established itself as a key • Collection of longitudinal driver of progress in the Portland The award, announced on data on garbage and recycling area through its partnership with November 13th at the group’s annual that shape citywide waste the City of Portland. We applaud meeting in Austin, Texas, honors management policy; their exceptional community four-year public universities for engagement efforts, which serve as extraordinary community outreach • Climate change research and a model for institutions across the and comes with a $20,000 prize. education that informs the country.” region’s Climate Action Plan; “Portland State is truly honored Since 2006, APLU and the to be recognized by the APLU for • Planning and development Engagement Scholarship our longstanding commitment activities that promote an Consortium, with support from to sustainability and civic “Age Friendly City” agenda; the WK Kellogg Foundation, have engagement—two vitally important partnered to recognize programs missions of the university,” said PSU • “Smart Cities” research and that demonstrate how colleges President Wim Wiewel. “The many development focused on and universities have redesigned accomplishments made through our transit access and livability their learning, discovery, and partnership with Portland’s Bureau issues; and, engagement missions to become of Planning and Sustainability have even more involved with their enabled our faculty and students • Placement of Portland communities. The national award is to truly fulfill PSU’s motto ‘Let State capstone students and named for C. Peter Magrath, APLU Knowledge Serve the City.’” interns in local programs and president from 1992 to 2005.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 24 Preparing for the Impacts of Climate Change
By Laura Gleim
In late September, bolstered by a hotter summers, and increased The effort builds on other academic- $400,000 grant from the Kresge flooding, all of which pose increased public sector sustainability Foundation, Portland State risks to human health, ecological partnerships PSU has pioneered, University announced a partnership systems, and city infrastructure. like the Institute for Sustainable with the City of Portland and Solution’s Portland Climate Action the Downtown Neighborhood “Portland State has been committed Collaborative and Sustainable Association to increase the area’s to addressing climate change by Neighborhoods Initiative. resilience to the impacts of climate reducing our carbon footprint change in tandem with similar since 2010, but that’s not enough,” “The City of Portland is excited efforts in two other western US said Jenny McNamara, PSU’s to partner with PSU on this cities. sustainability manager. “The new important work,” said Michele Crim, climate resiliency plan will help us sustainability manager at the Bureau The initiative, known as Climate anticipate and better adapt to the of Planning and Sustainability. Resilience in Urban Campuses + climate disruptions that are already “Downscaling preparation efforts Communities (CRUX), is led by happening and will continue to from citywide to a neighborhood national nonprofit Second Nature increase.” scale is a critical next step in and involves six campuses and their building Portland’s resilience to the community partners in Portland, The PSU-city task force will use coming impacts of climate change.” Los Angeles, and Phoenix. data about projected local impacts of climate change outlined in the Organizers hope that lessons learned The multi-city partnership will updated Portland and Multnomah by the six pilot institutions will support campus-community task County Climate Change Preparation inform a strategy for increasing forces to develop pilot plans for Strategy to create a scaled-down plan climate resilience across the nation adapting to the impacts of climate specific to PSU’s campus and the through campus-community change, such as more severe storms, surrounding downtown community. partnerships.
25 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Combining Research and Advocacy to Improve Air Quality in Oregon By Laura Gleim
Portland State University’s Institute impacts, the Meyer Memorial Trust for Sustainable Solutions (ISS) has award funds a series of community partnered with Neighbors for Clean symposiums and a number of Air and Lewis & Clark Law School’s student interns who will work with Northwest Environmental Defense local organizations to provide the Center to improve air quality public information about air quality throughout the state. issues.
Made possible by a $250,000 grant “The path toward cleaner air is from Meyer Memorial Trust, the complex and requires an informed partnership, called BREATHE and involved public,” said Mary Oregon, will provide Oregonians Peveto, co-founder and president of clear scientific data and legal analysis Neighbors for Clean Air. “Through ensuring residents and policy BREATHE Oregon, we’ll work with makers have the information they those communities most affected need to make decisions that improve by air pollution to ensure they have air quality. a seat at the table and access to accurate and relevant information. BREATHE Oregon expands upon We’re excited about collaborating a research partnership launched with our neighbors, our university, last spring between ISS, the City of and our state regulatory offices in an Portland, and Multnomah County effort to improve air quality.” to assess heavy metal pollution in neighborhoods throughout the As directed by Governor Kate Portland metro region. Brown’s Cleaner Air Oregon initiative, the Oregon Department “The BREATHE Oregon partnership of Environmental Quality and helps ensure that meaningful Oregon Health Authority are in the research focused on local air process of overhauling industrial air pollution moves from PSU labs into pollution regulations to bring them the hands of community advocates in line with state efforts to improve and policy-makers,” said ISS director public health. Robert Liberty. “State health experts and regulators Linda George, PSU professor of depend on accurate, scientifically environmental science and ISS sound data and engaged, well- fellow, is leading the research efforts. informed communities to protect “It’s our hope that our research will the health of Oregonians,” said engage local residents and inform Lynne Saxton, director of the future air quality oversight in Oregon Health Authority. “We Oregon,” George said. welcome the partnership of Meyer Memorial Trust, PSU, Lewis & Clark In addition to scientific and legal and Neighbors for Clean Air to analysis of air quality data and achieve cleaner air in our state.” at PSU SUSTAINABILITY
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 26 PSU Study Shows Global Methane Emissions from Fossil Fuel Production are Increasing By Chelsea Bailey
new study from Portland concentrations, however, proved State University shows more difficult. methane emissions from Afossil fuel production have been on “Regulators at agencies like the rise since 1984. the EPA need a comprehensive understanding of what’s driving The study, published in Proceedings the shift in greenhouse gas of the National Academy of Sciences, concentrations if they are going to found evidence that methane regulate their emissions,” said Rice. emissions from gas and oil extraction increased significantly In addition to increases from oil between 1984 and 2009. and gas, the research team identified other anthropogenic sources of The results challenge two previous methane production, all of which studies, including one published in were slightly offset by reductions Science earlier this year, that suggest in emissions from wetland and that methane emissions from fossil wildfires. fuels have declined since the early 1980s. To arrive at their results, the research team analyzed the isotopic “The results surprised us,” said Dr. composition of atmospheric Andrew Rice, an associate professor methane in air samples collected of physics and fellow of the Institute from sites around the world for Sustainable Solutions at PSU. between 1977 and 1998. The results “We anticipated the modeling would of that analysis was combined indicate what other scientists had with contemporary data to model concluded, that methane emissions changes in methane sources between from oil and gas production were 1984 and 2009. Findings indicate trending down globally, but we methane emissions from fossil fuel found the opposite.” sources were level in the 1980s and 1990s, but increased throughout the Studies have identified multiple following decade. sources that contribute to global methane emissions, including The research was funded through farms, wetlands, and wildfire, as support from the US National well as oil and gas production. Science Foundation, the Miller Identifying sources responsible for Foundation, and the MJ Murdock changes in atmospheric methane Charitable Trust.
27 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Portland State Awarded $1.2M for Native American Teacher Education By Nancy Eichsteadt
he US Department of Education’s will help us sustain a lot of the work increase in Native American TOffice of Indian Education has we want to continue with Oregon teachers in Oregon’s workforce, who awarded $1.2M to Portland State tribes—in fact, some of our first currently account for less than one University’s Graduate School of teachers are now ready to accept percent. Education to recruit and prepare student teachers.” Native American students for “This American Indian Teacher teaching licensure and master’s Portland and the surrounding Program award allows us to build degrees over the next four years. metropolitan region has the largest on our proud and long-standing Native American population relationships with Oregon’s tribal This is PSU’s third Office of Indian in Oregon, yet very few Native nations,” said Dr. Micki Caskey, Education professional development Americans are represented among associate dean for Academic grant in six years. The first award, the ranks of Oregon’s 33,000 Affairs in PSU’s Graduate School received in 2010, established teachers. Since 2011, a total of Education. “Our partnerships the American Indian Teacher of seventeen Native American with the Confederated Tribes of the Preparation program. educators from many tribes and Siletz and the Confederated Tribes nations have graduated from PSU’s of Umatilla Indians will continue “I am elated,” said project director program. The number may seem to benefit the tribal and non-Native Maria Tenorio. “I think this grant relatively small, but it is a significant communities alike.”
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 28 Who Votes for Mayor in America’s Largest Cities?
By Phil Keisling and Jason Jurjevich
ew findings from Portland them—including New York City, aren’t participating. In America’s State University’s Center Baltimore, Dallas, and Miami—was thirty largest cities, roughly for Public Service detail less than fifteen percent. In Las forty-seven percent of registered Nthe shocking low voter turnout Vegas, Fort Worth, and Dallas, voter voters over the age of sixty-five that is now typical in elections for turnout was in the single digits. voted in the last mayoral election mayor across the US. For the most as compared to nine percent of recent round of mayoral elections In addition to abysmally low registered voters aged eighteen in America’s thirty largest cities, turnout, the Who Votes for Mayor to thirty-four. The median age of turnout of eligible citizens in ten of project found that younger voters those actually casting ballots—fifty-
29 • Vol. III, Issue 3, Fall 2016 • Quarterly Review How Cities Ranked The study also found that certain choices that have far-reaching neighborhoods have dramatically consequences across cities and Across the country, cities varied higher turnout than others, yielding regions. greatly in how many people turned an uneven distribution of voting out and how representative of “oases” and “deserts” within the In three quarters of the cities the population voters were. For same city. In Dallas, Texas, for studied, mayors and other local a full comparison, visit www. example, nearly one in three officials are chosen in odd-number whovotesformayor.org/compare residents live in voting deserts, year elections (as opposed to which are neighborhoods where presidential elections and midterm Lowest Voter Turnout turnout was half (or less) than the elections), a remnant of decisions citywide average. made over a century ago when 1. Dallas, Texas, 6.1% these off-year elections were set up 2. Fort Worth, Texas, 6.5% “In the vast majority of local to give voters time to focus on local 3. Las Vegas, Nev., 9.4% elections, young people are ceding issues. Turnout is usually much decisions for the future to their higher during presidential election grandparents,” said Phil Keisling, years, and several cities have moved Highest Voter Turnout director of PSU’s Center for Public their local elections into alignment Service. “There are a number of with the presidential contest. 1. Portland, Ore., 59.4% actions we can take to improve 2. Louisville, Ky., 45.4% turnout, such as coupling local “‘One person, one vote’ is a core 3. Seattle, Wash., 44.5% elections with national elections, principle of American democracy increasing voter registration, for a very good reason—when Most Voting Deserts changing where and how voters can turnout is abysmally low, more receive and return their ballots, and attention is paid to the interests 1. Dallas, Texas, 31.9% who live in reeling in the influence of money in of small groups of people instead voting deserts politics.” of community-wide issues of 2. Fort Worth, Texas, 24.8% who equity and good governance,” said live in voting deserts The Who Votes for Mayor project Benjamin de la Peña, Director for 3. Phoenix, Ariz., 19.7% who live breaks important new ground in Community and National Strategy in voting deserts the world of electoral research by at the John S. and James L. Knight combining voting and US Census Foundation. “The danger of such data from eighty-five mayoral low participation in local elections elections in the nation’s thirty is the risk that elected leaders will largest cities, as well as twenty other not address serious and pressing smaller communities across the US. issues that disproportionately Researchers analyzed more than affect historically disadvantaged twenty-three million voting records communities.” and extensive demographic data from more than ten thousand US Who Votes for Mayor is a joint Census tracts. project of Portland State University seven—was nearly a full generation and Knight Foundation. The study’s older than the median age of the Every day, over half a million research team was led by Dr. Jason eligible voting population. In eight local elected officials across the Jurjevich and former Oregon cities, including Houston, Phoenix, country are making important Secretary of State Phil Keisling, and Oklahoma City, San Antonio, and influential decisions about also included Kevin Rancik, Carson and Dallas, the median voter age core services like police and Gorecki, and Stephanie Hawke. was above sixty. The result of low fire, drinking water, economic turnout among younger voters development, roads, and public City-by-city election data from is that older residents have more transportation for the more than the study is freely available for “electoral clout,” as residents sixty- eighty percent of Americans download on the Who Votes five years and older are up to who live in cities. When voter for Mayor website under a fifty-six times more likely to vote turnout in local elections is low, a Creative Commons license. For than residents between the ages of small percentage of residents can more information, visit: www. eighteen and thirty-four. have outsized influence in policy whovotesformayor.org.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 30 Research Highlights College of Liberal Arts and Sciences
Since I began my position as dean of the College of Liberal Arts and Sciences two years ago, the College has accelerated its research momentum: across our twenty-four academic departments and programs, we have increased proposal submissions by thirty percent and welcomed twenty-two new active research faculty.
As we move forward, our College is working together to advance our interdisciplinary collaborations and create a unified vision for our research direction.
This summer, we seized an opportunity to leverage our research strengths. With eight open positions across seven departments in the natural sciences, Karen Marrongelle, PhD communication, and writing, we began to strategize and envision a cluster Dean, College of Liberal Arts and Sciences hire that could bring us to the forefront of a focal research area. Recently, we launched our search for all eight positions around the theme of Environmental Extremes. “Research is our Through the collaborative effort led by faculty to identify that focus area, value proposition. we also uncovered other key research themes that resonate with our current research and scholarship and offer opportunity for continued growth: There are other 1. Pathways toward social justice universities in 2. Community resilience in social-ecological systems Portland, but 3. Building community capacity and peace in an era of local and none that have global polarizations, extremism, and uncertainty the capacity to In the College of Liberal Arts and Sciences, research is our value proposition. There are other universities in Portland, but none that has the capacity to serve students serve students and engage in world-class research and scholarship like we can, and do! and engage I look forward to sharing more over the coming year about how our faculty and students are realizing a unified and impactful research vision, and how in world-class we can continue to work with our local and national partners on ways to strengthen our work in a way that serves our communities and improves our research and world.
scholarship like Sincerely, we can, and do!”
Karen Marrongelle, PhD Dean, College of Liberal Arts and Sciences
31 • Vol. III, Issue 3, Fall 2016 • Quarterly Review CLAS ResearchCLAS Research Highlights Highlights
Artifact rescue at the Walakpa archaeological site in Barrow, Alaska
Dating to at least 1200 years ago, the Walakpa site in Alaska encompasses a major cultural transition in the western North American Arctic: the migration and evolution of Birnirk and Thule cultures. Now, a team of graduate students led by Shelby Anderson, assistant professor of Anthropology, is working against increased coastal erosion and northern climate change to uncover a record of past Arctic artifacts dating back to potentially 4000 years ago.
PhD student named Oregon Sea Grant Natural Resources Policy Fellow
Cat Dayger, a PhD student in Biology, was recently selected to serve under Oregon Governor Kate Brown as an Oregon Sea Grant Natural Resources Policy Fellow for 2016–2017. In her position, Dayger will travel up and down the Oregon Coast talking to communities and helping assess how changes in the built and natural environment, sea and land, might impact the environment, their communities, and their livelihoods.
Extreme Antarctica ice melt provides glimpse of ecosystem response to global climate change
Stationed in East Antarctica’s McMurdo Dry Valleys—a polar desert that’s among the driest places on Earth—Andrew Fountain, a glacier scientist and professor of Geology, along with his research team, studied the effects of massive flooding caused by glaciers that melted during a sudden warming event in the Antarctic summer of 2001–2002. The warming event had lasting effects on the ecosystem across the continent, which could provide clues to how Antarctica might change as these extreme events occur more frequently.
Preventing campus sexual assault
Sexual assault is a critical issue at universities across the country, and Keith Kaufman, associate professor of Psychology, is leading a national effort to address and prevent it. Boosted by a $750,000 award from the US Department of Justice, Kaufman, who has been studying sexual assault and violence for more than thirty years, is assessing student safety risks and developing a prevention manual that can be used by any university.
Examining the transgender experience across the US
Utilizing interviews with sixty-six transgender men across the country, Miriam Abelson, assistant professor of Women, Gender, and Sexuality Studies, examined how masculinities and social interaction are shaped by region, urban or rural locations, and specific places, such as public bathrooms and health facilities.
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 32 being produced right here in Oregon. Elevating Timber to New Heights Cross-laminated timber, or CLT, is PSU researchers launch a new study to support an engineered wood product that has the construction of wooden skyscrapers. gained popularity among architects and engineers as a building material. By Shaun McGillis It’s made of layers of wood that have been glued together and pressed. Its strength, durability, and versatility are comparable to steel-reinforced concrete. CLT is sustainably manufactured, and unlike steel and concrete it sequesters carbon.
In Portland, several architecture and engineering firms are already designing and building with CLT, the most notable of which is Lever Architecture, the firm behind the twelve-story Framework building (pictured left), which will be the country’s first wooden skyscraper when completed in 2017.
“CLT has elevated structural timber to new heights,” said School of Architecture professor Corey Griffin. “With CLT we have a plainer, two- dimensional product that is as strong as concrete, fire-resistant, and can be used in floor diaphragms and lateral load-bearing walls like those in the center of high-rise buildings. CLT can open the door to taller, mixed- use wooden buildings that weren’t possible before.”
Griffin’s research focuses on structural systems and green buildings. His colleague, Civil and Environmental Engineering professor Dr. Peter Dusicka, is an earthquake engineer whose research focuses on developing and testing components Framework Building, image courtesy Lever Architecture and materials that improve building stability and promote return to occupancy during and after seismic uildings, and many of the of annual anthropogenic global events. Working together, Dusicka methods of their construction, greenhouse gas emissions and are and Griffin are positioning PSU as a are the single greatest collective the first and second largest sources major partner in Oregon’s expanding Bsource of CO emissions in the US. of industrial carbon emissions in the CLT ecosystem. 2 The steel and concrete we use to country. make the mixed-use, high-density Griffin has previously studied buildings we see all around us But as it turns out, a green alternative barriers to the adoption of CLT as account for about eight percent to building with steel and concrete is a building material and mentored
33 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Testing CLT components in the iSTAR lab, image courtesy Tyler Williams graduate students whose research material; and creating educational For cities trying, like Portland, to focused on building with engineered materials to disseminate the results of meet the housing needs of a growing wood products. Dusicka, who their work to industry professionals population while reducing their directs PSU’s Infrastructure Testing and students, and to promote carbon footprint, CLT is a promising and Applied Research (iSTAR) lab, building with wood. According to Dr. building material, but there are works with consultants designing Dusicka the project includes students questions that need to be answered wood components for use in the from the Green Building Scholars before cities begin approving plans Framework building, validating program, an NSF-funded scholarship for high-rise wooden buildings. Chief the “earthquake-readiness” of their program at PSU that connects among those questions in regions designs. The two recently received engineering and architecture students like the Pacific Northwest are: can a a $400,000 NSF grant to address with interdisciplinary educational building made with CLT withstand critical system-level technical and opportunities focused on reducing seismic forces during an earthquake, non-technical barriers to designing the environmental impact of and will that building be safe to and erecting seismically resilient buildings. reoccupy when the shaking stops? high-rise buildings with CLT panel structural cores. “The project is representative of PSU’s “There are currently limits on how position as a regional leader for green tall you can build structures made The project’s three major components building research and education,” of wood because there are a number include developing, modeling, and Dr. Dusicka said. “I think Oregon— of questions that have yet to be testing system-level designs and and Portland, in particular—is answered,” Griffin said. “We want to components for seismically resilient set to become a leader in green answer those questions and provide buildings with CLT structural building design, construction, and evidence showing you can safely cores; assessing the current state of the manufacturing of sustainable build seismically resilient wooden nontechnical barriers to widespread building materials, and PSU has a skyscrapers in places like the Pacific adoption of CLT as a building central role to play in that.” Northwest.”
Quarterly Review • Vol. III, Issue 3, Fall 2016 • 34 Research Snapshot First Quarter, Fiscal Year 2017
Awards by Quarter Awards Received
SS C S . . 72.3M S
6 .1M 6 .7M 9.3M RS / / 6 .5M ther 1 .1M Q4 15. M
9.5M C CS 26.3M C 1 .2M . 7.3M CU 1 . M Q2 . $20.3M S 7.7M . Proposals Submitted
29M 26.7M SS SB 23.2M C S S RS / / R Proposals by Quarter
66 6 6
592 C CS 191 C 179 CU S 1 5 151 Expenditures 169
1 9 16 C S 159 139 . SS 13 . 167 159 C 120 SB C S . Complete lists of awards, proposals, publications, and doctoral degrees conferred can be viewed at RS / / S ther . www.pdx.edu/research/research-snapshot C CS . . 35 • Vol. III, Issue 3, Fall 2016 • Quarterly Review Research & Strategic Partnerships Quarterly Review, Volume III, Issue 3, Fall 2016 Portland State University Research & Strategic Partnerships (RSP) PO Box 751 Portland, OR 97207 www.pdx.edu/research