School Notes: School of Public Health
May/June 2010

Minority high school students consider careers in public health

Just what do public health professionals do? At YSPH’s ninth annual Diversity Day in February, minority high school students from the New Haven area learned that the profession offers an unusually wide variety of opportunity, from testing pharmaceuticals to improving access to clean water to studying why African Americans are more likely to suffer from chronic health conditions.

Nearly 30 students were on hand as Dean Paul D. Cleary, along with faculty, current Yale public health students, and an alumna, talked about their public health careers and how their work has taken them as far as Indonesia and Ethiopia. The researchers also sought to demystify the profession—and college—for the teenagers, explaining terms such as epidemiologist, biostatistics, and dean.

Harmful protein linked to experiences of discrimination

African Americans who report experiences of discrimination have higher levels of a particular protein that is associated with cardiovascular and other health problems, according to a study by YSPH researchers. “While previous research has linked discrimination with poor health outcomes, we know very little about the underlying biological mechanisms. This study sheds some light on one potential pathway,” said assistant professor Tené Lewis, the study’s lead researcher.

The protein marker, C-reactive protein (CRP), is found in the blood, and its levels increase in response to inflammation. In addition to heart problems, its presence has also been linked with several psychosocial processes such as mental stress and depression. The researchers studied 296 older African American adults and assessed their experiences with “everyday” forms of discrimination through a nine-item questionnaire that rated the frequency of various forms of mistreatment (ranging from subtle forms of disrespect to outright insults and harassment). A “significant” correlation was identified between CRP levels in the participants’ blood and degrees of discrimination experienced. The research is published online in the journal Brain, Behavior, and Immunity.

Heart attack care improving with quicker, coordinated responses

Health care professionals using new time-saving strategies to coordinate care for heart attack patients saw dramatic improvement in “door-to-balloon” (D2B) times—the time from when a patient enters the hospital to when blood flow is restored to the heart by opening a blockage with angioplasty. Prompt treatment results in improved chances of survival.

A Yale team surveyed D2B times in 831 hospitals and found marked reductions in unnecessary delays in treatment and widespread adoption of recommended strategies to improve care. The improvement was seen across the nation, not just in select hospitals or states. Some examples of strategies to reduce delays in door-to-balloon times include emergency medicine staff activating the catheterization laboratory with a single call and expecting to have the catheterization team in the laboratory within 20 to 30 minutes of being paged. “This campaign has changed the way heart attack care is delivered—for the benefit of patients,” said Professor Elizabeth H. Bradley, the study’s first author. The results are published in the Journal of the American College of Cardiology.