Health feature

With top programs, the College paves the way in advancing health and well-being

By Richard Westlund

With top programs, the College paves the way in advancing health and well-being

By Richard Westlund
Varied insights poised to enhance individual and community well-being

Whether peering through a microscope, perusing a database, or making personal connections in the field, College of Arts and Sciences researchers are making significant contributions to individual, family, and community health. “Throughout our college, faculty members are actively engaged in research projects and initiatives that focus on improving health and well-being at every level,” says Dean Leonidas Bachas. “Their insights are making an impact on the complex health challenges facing our world.” Here is a look at some of these ambitious initiatives now under way in the College of Arts and Sciences.

Reducing Global Risk Factors
Racism, unemployment, poor nutrition, and lack of housing are among the stress factors that make individuals and communities more vulnerable to health problems like COVID-19. Louis Herns Marcelin, professor of anthropology and director of Global Health Studies, studies these social determinants of health.

“Mental and physical health are not just a matter of taking the right medicine,” he says. “Good food, care, shelter, and safety are essential for leading healthy lives.”

Marcelin examines interactions among humans and the built and natural environments around the world. “We can continue to build and use up natural resources, but in doing so, we suffer the consequences, such as creating pathways for infection and risks like COVID or the Zika virus,” he says. “We need to look at actions and policies on a global level that could mitigate those risks.”

Marcelin currently co-directs an international study on South-South migration in collaboration with researchers in Haiti, Brazil, China, Ghana, Egypt, Jordan, Ethiopia, South Africa, Nepal, Malaysia, Ivory Coast, Burkina Faso, and the United Kingdom. “How do the movements of populations in the Americas, Africa, and Asia create pathways for pathogens or increase vulnerabilities to health problems?” he says. “We hope the findings will help us to predict health issues and provide effective interventions in migrant populations.”

Another study with colleagues at UM and the Interuniversity Institute for Research and Development (INURED) in Haiti looks at the long-term effect of COVID-19 on marginalized communities throughout the world. “Identifying mental health and secondary medical consequences related to the virus,” Marcelin says, “will help us to better prepare for the next pandemic.”

With INURED’s research team in Haiti, he and his colleague, Toni Cela, are studying the long-term impact of other types of disasters, such as earthquakes, on the lives of vulnerable populations in both urban and rural areas in Haiti.

Decoding a Puzzling Condition
Gastrointestinal (GI) distress is a common, but little understood, a symptom of autism spectrum disorders (ASD).

“Currently there are no curative treatments for GI conditions such as reflux, abdominal pain, and constipation, in ASD,” says Julia Dallman, an associate professor of biology. “We want to better understand the mechanisms behind these problems, which affect the quality of life for children and families.“|

In the past decade, more than 100 genetic variations have been identified in ASD. With a grant from the Simon Foundation, Dallman is studying zebrafish, whose genes are similar to humans, to pinpoint mechanisms that lead to GI problems.

When certain mutations associated with ASD are introduced to Dallman’s zebrafish, the digestive process is interrupted. Because juvenile zebrafish are transparent, researchers can see whether or not the gut undergoes normal peristaltic contractions after feeding, shedding light on how these mutations affect behavior and cause symptoms. Dallman has been studying the development of the nervous system for more than 25 years, and her work is regularly featured in clinical and research conferences. “The genome-sequencing revolution has identified hundreds of genetic mutations associated with neurological disorders that affect human behavior,” she says.

“Our long-term goal is to leverage these models to inform treatment strategies for individuals with inherited disorders of the nervous system. This could open a new field of research for ASD that could suggest treatment strategies.”

Designing Digital Therapeutics
The COVID-19 pandemic turbocharged the adoption of virtual healthcare services ranging from video consultations to at-home diagnostic sensors. Now an array of high-tech tools are paving the way to the next stage in digital therapeutics, according to Yelena Yesha, professor of computer science and the first Knight Chair of the University of Miami Institute for Data Science and Computing.

“Leveraging big data with artificial intelligence, machine learning, and sophisticated analytics supports an interdisciplinary approach to delivering personalized health care,” says Yesha. “In addition, blockchain applications, which record information in a highly secure way, can help protect patient data and provide cybersecurity for providers.”

Yesha is working on healthcare applications to improve diagnosis and therapy for dementia patients, and that utilize machine learning to diagnose COVID-19 from a patient’s lung CT scans and X-rays. In addition, through a collaborative initiative that includes Dean Leonidas Bachas and School of Architecture faculty, she is developing a smart-home health hub that could provide an interactive, mixed-reality experience with real-time connections to a physician.

“We’re looking to integrate state-of-the-art technologies in the home setting for secure acquisition, monitoring, and analysis of patient data that can then be shared with healthcare providers in a seamless way,” Yesha says. “It’s a novel concept with great potential to improve individual and family health.”

Monitoring Pests to Minimize Pestilence
Location, location, location: More than just a real estate meme, it’s an important factor in the health of urban residents. “Geography,” says Imelda K. Moise, associate professor of geography and sustainable development, “is an important consideration that can influence positive or negative disease occurrences, outcomes, and response.”

Moise’s research employs mixed methods such as geospatial analysis to identify ways to reduce the disease load on at-risk families and communities. Current studies include rodent management in cities, ecological dimensions of mosquito-borne diseases, and health effects of natural disasters“One of the side effects of COVID-19 restaurant closures last year was a change in rodent behavior,” Moise notes. “Rats became more aggressive as they sought food in new locations, and most city public health departments lacked rodent programs or protocols to deal with this unexpected rodent outbreak.”      

Supported by a five-year grant from the U.S. Centers for Disease Control and Prevention (CDC), Moise’s collaborative study “A Community-Based Rodent Surveillance Collaborative for Greater Public Health” is gathering data on rat behaviors and developing innovative rodent surveillance-management best practices in collaboration with the cities of New Orleans, Dallas, and Houston.

Among other projects, Moise is also evaluating the pandemic’s impact on the delivery of public services among Florida mosquito control programs and refugee resettlement agencies across the country.

Exploring the Hispanic Paradox

Does ease with expressing emotion translate to better health outcomes? That’s the intriguing premise behind the so-called Hispanic paradox.

Maria Magdalena Llabre, professor of psychology, has collaborated with colleagues on research related to cancer, diabetes, HIV, and cardiovascular disease. While working with Neil Schneiderman, the James L. Knight Professor of Health Psychology, on the multicenter Hispanic Community Health Study/Study of Latinos, Llabre noticed that, despite high rates of obesity and diabetes, Hispanics in the study had lower-than-expected rates for heart disease. 

“Language plays a critical role in emotional expression and processing,” Llabre says. “So one possible contribution to the Hispanic paradox is the Spanish language itself, which has an array of features that facilitate emotional expression.” That, in turn, could protect against stress-related illnesses and improve long-term health and well-being among Spanish speakers.

To test that hypothesis, Llabre launched a pilot study, funded by a Provost Research Award, to see whether writing about a stressful/traumatic event in English versus Spanish made a difference in blood pressure recovery. While the pandemic brought an early end to data collection, Llabre notes that recovery appeared to be somewhat faster among participants whose primary language was Spanish.

“The role of language in health is worth exploring,” says Llabre, who plans further studies to examine it.

Deconstructing Domestic Violence
Along with a wave of deaths and hospitalizations, the COVID-19 pandemic ushered in a nationwide spike in domestic violence. “Since the first quarter of 2020, most large U.S. cities have seen increases in homicides, aggravated assaults, and domestic violence,” says Alex R. Piquero, professor and chair of sociology and criminology and Arts and Sciences Distinguished Scholar.

Piquero led a recent analysis for the National Commission on COVID-19 and Criminal Justice, which confirmed that stay-at-home issued to suppress transmission of the highly contagious virus increased domestic violence incidents by more than 8 percent. “When you have individuals who are not used to being together 24/7, you’re going to have pent-up stress and anxiety,” says Piquero.

For Piquero, health, crime, and racial justice in the U.S. are intimately interwoven on the national, state, and local levels. For instance, residents in distressed neighborhoods in South Florida face a higher risk for medical problems, gun violence, and incarceration than those in affluent areas.

To help address those disparities, Piquero is working with Miami-Dade Mayor Danielle Cava Levine and Miami-Dade State Attorney Katherine F. Rundle, who appointed him to the Executive Committee of the Continuing Justice Reform Commission. “Local leaders are looking at short- and long-term crime prevention policies,” he says. Summer programs for youth, for example, along with skills training and internships, offer an alternative to “hanging out” that can lead to skirmishes with the law.

As another tactic to deter gun violence, Piquero says, “Ex-gang members are going into some communities to talk with young people and defuse violent fights before they happen. It’s a positive approach that could be incorporated into a long-term smart crime policy.”

Improving Health in Prisons and Beyond
Many of the largest single-site outbreaks of COVID-19 have been in U.S. jails and prisons. And when it comes to the public health consequences of mass incarceration, says Kathryn M. Nowotny, associate professor sociology, this calamitous situation is just the tip of the iceberg.

“Incarceration,” Nowotny says, “lowers life expectancies, magnifies the effects of chronic medical conditions, and increases transmission of infectious diseases. The COVID-19 pandemic has highlighted the importance of depopulating our overcrowded prisons.”

Nowotny is a lead investigator on the national COVID Prison Project, which tracks data from 53 state and federal agencies to analyze COVID-19 cases, deaths, testing, and policies and procedures. Funded by the Robert Wood Johnson Foundation and the Langeloth Foundation, the study is gathering and analyzing up-to-date information that may promote healthcare policies such as compassionate medical parole and conversion of solitary cells to quarantine facilities for COVID-positive inmates 

Nowotny is also studying barriers to preventive healthcare faced by individuals who have been in the criminal justice system. Funded by the National Institute on Minority Health and Health Disparities, the project received a grant from the College of Arts and Sciences to conduct a nested COVID-19 study, including surveys of 169 adults under community supervision.

With support from the Office of the Provost, Nowotny is conducting formative research to establish a Miami Transitions Clinic to provide continuity of care to formerly incarcerated individuals. “Inmates have a legal right to healthcare, including medications to manage chronic conditions,” she says. “But once they leave, that right disappears—and, without jobs or insurance, they may not able to access the care and medications they need. 

“There is a clear need for transition support here in South Florida and throughout the country.”