Fellow and Alumni Accomplishments

Analytics and Modeling Track Class of 2021

Research: Dr. Jennifer Mendoza-Alonzo was awarded a Special Act/Service Award from CDC’s Division of Global Health Protection (DGHP). This award recognized her novel research to model country preparedness using the World Health Organization’s Joint External Evaluation (JEE) indicators and RAND Vulnerability Index and her efforts to disseminate the research findings. In her research, she analyzed 19 JEE technical areas, 40+ indicators, and the interactions between them.

Public Health Impact: Dr. Mendoza-Alonzo’s analysis increases both global and public health knowledge and awareness about the regional risks associated with public health threats in West Africa. Her research findings can help strengthen countries’ programmatic and scientific planning, monitoring and evaluation activities, resulting in better overall preparedness for potential health threats. Since March, 2022, her research findings have aided programmatic planning and decision-making, led to the improvement of country work plans and national action plans, and assisted CDC experts with global health security measures.

Analytics and Modeling Track Class of 2021

Research: Dr. Hasan Symum co-authored VitalSigns article, “Hepatitis C Treatment Among Insured Adults — United States, 2019–2020” published in MMWR in August 2022.  Dr. Symum and co-authors conducted a retrospective cohort study to assess the association between initiation of direct-acting antiviral (DAA) treatment and sex, age, race, payor, and Medicaid restriction status. Over 2 million adults in the United States have hepatitis C virus (HCV) infection, and it contributes to approximately 14,000 deaths a year. Direct-acting antiviral (DAA) treatment is recommended for nearly all persons with hepatitis C and cures ≥95% of cases. Treatment saves lives, prevents transmission, and is cost saving.

Public Health Impact: This analysis found that timely initiation of DAA treatment, regardless of insurance type, is critical to reducing viral hepatitis–related mortality, disparities, and transmission. Treatment rates were low overall and varied by age and insurance payor. DAA treatment was lowest among young adults aged 18–29 years and Medicaid recipients, and within Medicaid, among persons reporting Black or other race and persons in states with treatment restrictions.

CNN published the following article on this study Less than a third of insured hepatitis C patients get timely treatment, study shows – CNN

Analytics and Modeling Track Class of 2021

Research: Dr. Casey Zipfel co-authored the article, “Climate change increases cross-species viral transmission risk,” published in Nature in April 2022. Dr. Zipfel and her co-authors used modeling to determine if and how climate change impacts viral transmissions between species. The study exposes the high number of cross-species transmission events occurring now, and how many more can happen as environments continue to change.

Public Health Impact: Dr. Zipfel’s findings show that new connections between animals can increase the risk of a pandemic in humans, as many diseases start with infections from animals before spreading to a human community. Climate change and land use shifts will push infected animals to new places where they will mingle with other species for the first time. This will extend the reach of viruses to new places, threatening endangered species and increasing the chances of these viruses to infect humans.

Analytics and Modeling Track Class of 2021

Research: Dr. Charniga worked with the city of Huntsville, Texas, when officials found nearly one million Mexican free-tailed bats living in a former cotton warehouse set to be demolished. The city needed help to determine what impacts the demolition may have—on the bats and the local residents. As the bats are protected by state laws, unique solutions needed to be developed. Dr. Charniga created a complicated risk model to provide solutions in the event of the worst-case scenario, if the bats did not relocate to the bat houses constructed across the street. Dr. Charniga’s model found that within a 60-kilometer area, there could be a two-fold increase in contact between people and bats for a year. And without a concentrated effort to raise public awareness about the risks of contact with bats, there could be a severe and significant increase in the risk of contracting rabies.

Public Health Impact: Dr. Charniga’s model found that within a 60-kilometer area, there could be a two-fold increase in contact between people and bats for a year. And without a concentrated effort to raise public awareness about the risks of contact with bats, there could be a severe and significant increase in risk of contracting rabies. Using her model, Dr. Charniga was able to make high-level suggestions for solving potential problems in the future, including tracking the bats using a seroprevalence study and deploying a web-based app to record bat sightings.

Analytics and Modeling Track Class of 2021

Research: Dr. Castonguay, along with a design team of two others, created CDC’s first COVID-19 Quarantine and Isolation Calculator, an interactive digital tool designed to help users determine how long one needs to isolate, quarantine, and/or take steps to prevent the spread of COVID-19. Dr. Castonguay complied with a specific set of design criteria, intended to make the tool as user-friendly as possible. Along with the team, Dr. Castonguay ensured that the tool returned answers to users within 60 seconds and with only 3-4 clicks for maximum efficiency.

Public Health Impact: Dr. Castonguay designed the calculator to counter the confusing “overflow” of information and text on COVID-19 guidelines, which can discourage members of the public from identifying the information that may help them. The calculator represents a potential way of providing a quick-and-easy means of conveying to segments of the population specific public health information that is directly relevant to them. Dr. Castonguay’s calculator was featured on Good Morning America (1:04 mark) in March 2022, resulting in over 750,000 unique users.

Analytics and Modeling Track Class of 2021

To help prevent the spread of COVID-19 and help our country cope during the pandemic, CDC has occasionally issued legally binding orders and regulations. These orders issued by the Division of Global Migration and Quarantine (DGMQ) and the COVID-19 Global Migration Task Force (GMTF) are supported by science and models to support decision-making. Dr. Paige Miller, a Class of 2021 Public Health Analytics and Modeling Fellow, represented GMTF on the Epidemiology Task Force’s Modeling Team and during her time created several models to inform US Government and Canadian government activities. Dr. Miller’s main accomplishments while supporting modeling team included:

• Estimating the risk of transmission on buses using a statistical model
• Modeling outbreaks on cruise ships given varying transmission rates, non-pharmaceutical interventions, and policies regarding testing, quarantine, and vaccination of passengers and crew
• Assessing the risk of infected travelers crossing US land borders given policy changes and “return to normal” land border crossings, building on estimates of infected travelers to determine the probability of outbreaks linked to infected travelers

Dr. Miller’s work was presented to DGMQ leadership throughout the response, among interagency colleagues, with the White House, and even with Public Health Agency of Canada. Her modeling has shown the high risk for COVID-19 outbreaks in various mobile setting such as buses and cruise ships and it has substantiated the continued need for regulation of this space to protect travelers and mobile populations. As such, her efforts were a highly significant contribution to the work of DGMQ and GMTF with effects on the entire population of the nation and beyond.

Dr. Miller earned her PhD in Disease Ecology from the University of Georgia. Her dissertation was titled “Social Structure, Contact Networks, and Spread of Respiratory Diseases”, where she used network modeling to understand how the organization of human mixing patterns affects the spread of respiratory transmitted infections. She also studied how network structure affects spread of COVID in closed settings and found evidence that interventions significantly mitigated spread in vulnerable populations. Dr. Miller is assigned to the National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine under the supervision of Dr. Ardath Grills. There she models traveler mobility using SafeGraph data (with DGMQ group) and analysis of test timing and logistics for US-Mexico travelers (with the Emergency Operations Center modeling group). In addition, she contributes to reading and summarizing recent modeling publications whose summaries are distributed to modelers across the agency. Dr. Miller’s long-term goal is to work in public health, using mathematical modeling, data science, and statistics to study infectious diseases and intervention measures.

PE Fellowship Class of 2020

Research: Dr. Biplap Datta, 2020 graduate of the PE fellowship and current Assistant Professor with the Institute of Public and Preventive Health (IPPH) at Augusta University authored and led a new report: Healthy Georgia – Our State of Public Health.

Public Health Impact: As the inaugural version of the report, Dr. Datta’s work has significant public health impact. The report illustrates how Georgia is doing compared to rest of the US and Southeast region, particularly focusing on the gender, racial/ethnic, and income disparities. In the future, this annual report will serve as a flagship publication of IPPH.

PE Fellowship Classes of 2017, 1996, & 2005

Research: Dr. Xu Ji led the analysis as part of her PE fellowship within the Division of Reproductive Health. Dr. Ji and her team—PE fellows Dr. Scott Grosse and Dr. Rui Li—used their expertise in health economics to apply quantitative methods to assess the value and impact of policies and interventions using data from the 2002-2013 Healthcare Cost and Utilization Project State Inpatient Databases. The objective of their study was to assess the association between the change in statewide smoke-free laws and the rate of preterm or low birth weight delivery hospitalizations.

Public Health Impact: Drs. Ji (lead author), Grosse, and Li received the first ever Shepard Award for Health Equity Science. Their study, “Association of Smoke-free Laws with Preterm or Low Birth Weight Deliveries—A Multistate Analysis” examined how smoke-free policies may improve birth outcomes and reduce long-standing disparities. The study concluded that the change in state smoke-free laws was associated with a reduction in racial/ethnic disparities in preterm or low birth weight delivery hospitalizations in selected US states.

PE Fellowship Class of 2021

Research: Dr. Alberto has published an ASPE Issue Brief titled “Health Insurance Coverage and Access to Care Among Latinos: Recent Trends and Key Challenges.” Dr. Alberto also prepared the overview document in Spanish to accompany the Issue Brief.

Public Health Impact: Dr. Alberto’s work has had significant impact on the diversity, equity, and inclusion initiative, in part due to her translation of public health materials into Spanish. HHS Secretary Becerra has been interviewed about the Issue Brief on Telemundo and Univision, thus further promoting the information among Spanish speaking individuals. Dr. Alberto was instrumental in the updated HealthBuild app, which now includes a Spanish interface.

PE Fellowship Class of 2000

Research: Dr. Roy serves as a lead subject matter expert in economics and provides scientific leadership and guidance to support programmatic efforts and inform strategic science and policy priorities. Most of Dr. Roy’s work and research focuses on strengthening evidence on effectiveness and economic impact of public health programs and policies to guide agency decision making, recommendations, and investments, including work with partners.

Public Health Impact: Dr. Roy’s research has substantially contributed to advancing economic research at CDC, both in terms of specific research projects and journal supplements. Her work has demonstrated the impact of chronic disease prevention programs in reducing the prevalence and costs of preventable conditions, with particular emphasis on addressing health disparities and social determinants of health.

PE Fellowship Class of 2017

Research: Dr. Seonghye Jeon, of CDC’s Division of Preparedness and Emerging Infections Health Economics and Modeling Unit, won the 2022 Kaffee Billah Award, which recognizes an outstanding health economics study published in 2021. The award is administered by the Health Economics Research Group. Dr. Seonghye’s co-authored article titled “The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis,” used a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti. Dr. Seonghye’s team found that human rabies epidemics may occur if rabies vaccinations in dogs remain inconsistent.

Public Health Impact: As a result of this study, CDC released the first-ever Level 2 travel health alert for rabies in 2021. Over 150,000 travel health notices were delivered to people entering and leaving Haiti, warning them about the current rabies risks and what actions to take if they are exposed. The Pan American Health Organization delivered over 4,500 human rabies vaccine doses to Haiti by September 2021, and by December 2021, the Ministry of Agriculture in Haiti resumed the dog vaccination program, vaccinating over 550,000 dogs.

PE Alumni, Class of 2016

Research: Dr. Keith Branham co-authored a January 2017 policy brief entitled, Medicaid Expansion Impacts on Insurance Coverage and Access to Care while assigned to the Department of Health and Human Services, Assistant Secretary for Planning and Evaluation. This brief examined the availability and affordability of plans available through Marketplace for the 2017 Open Enrollment period. He also co-authored an October 2018 landscape brief titled 2019 Health Plan Choice and Premiums in Healthcare.Gov States [PDF – 44 pages]. This brief found increased numbers of insurers operating in healthcare.gov states and documented substantial increases in premiums in those states.

Dr. Branham completed an analysis of various repeal and replace models by applying the RAND COMPARE model to identify research questions and using the tool to support a predictive analyses of options. He currently works for the Data and Systems Group, Division of Business and Data Analysis, at the Centers for Medicare and Medicaid Services.

Public Health Impact: Medicaid Expansion Impacts on Insurance Coverage and Access to Care has been highly influential within policy circles at HHS as ASPE’s role includes ascertaining the economic impacts of Medicaid expansion including the impact on the cost of uncompensated care.

PE Fellowship Class of 2014

Research: In The Lancet article “Preventive malaria treatment for contacts of patients with Ebola virus disease in the context of the west Africa 2014–15 Ebola virus disease response: an economic analysis,” Dr. Bradford Greening and Dr. Caresse Campbell shared study findings centered around administering malaria treatment to contacts of Ebola patients.

Public Health Impact: Their study found that administration of malaria treatment to contacts of patients with Ebola virus disease was cost saving for contacts of all ages in Liberia, Sierra Leone, and Guinea, in both seasons, from a health-care provider perspective and should be considered by public health officials when addressing Ebola virus disease outbreaks in countries and seasons where malaria reaches high levels of transmission.

PE Fellowship Class of 2014

Research: In an October 2016 article titled “Cost and Prevalence of Five Chronic Conditions in School Children” in the Journal of School Nursing, Dr. Gabi Miller used 2005-2012 Medical Expenditure Panel Survey data to calculate the prevalence of asthma, epilepsy, hypertension, food allergies, and diabetes in children aged 0-18 years. Prevalence rates varied by race and ethnicity across conditions. Females had higher prevalence of all chronic conditions except epilepsy. An additional $1,378–$9,059 were spent annually per child with these conditions.

Public Health Impact: This is the first study to examine the costs and prevalence of chronic health conditions in children and adolescents using a single data set.

PE Fellowship Class of 2013

Research:  Dr. Yao-Hsuan Chen, an Operations Research Analyst in CDC’s Division of HIV/AIDS Prevention, has collaborated with experts in the Division and in the Georgia Tech School of Industrial & Systems Engineering to create an HIV network model tool. This tool, based on local epidemiologic data, helps estimate the hidden HIV transmission network among persons who inject drugs, predict the speed and scope of HIV spread, and quantify the impact of HIV interventions. Dr. Chen has also developed an HIV agent-based model that uses HIV molecular surveillance data to target HIV interventions in an outbreak response.

Public Health Impact: Once completed, the user-friendly interface included in the HIV network model tool can enable decision makers or stakeholders at CDC and in state health departments to test various interventions in the HIV transmission model and compare the cost-effectiveness of these interventions. Insights obtained from integrating molecular surveillance data into an HIV agent-based model can help guide HIV outbreak responses in the future.

PE Fellowship Class of 2013

Research: Dr. Kun Zhang used IMS Health’s National Prescription Audit and government mortality data to examine death rates from opioid prescribing and prescription opioid and heroin overdose in the United States during 2006-2013. In his research, Dr. Zhang examined the combined implementation of mandatory provider review of state-run prescription drug monitoring and pain clinic laws.

Public Health Impact: The analysis, published in an October 2016 Health Affairs article titled “Mandatory Provider Review and Pain Clinic Laws Reduce the Amounts of Opioids Prescribed and Overdose Death Rates”, revealed that the policies reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent.

PE Fellowship Class of 2013 (Husain) and Class of 2010 (Kostova)

Research: Noncommunicable diseases (NCDs) are often associated with aging, but in low-and middle-income countries, people are suffering and dying early from NCDs. Dr. Husain and Dr. Kostova are both members of the International NCD Economics Research Network, a coalition  that aims to address this issue from an economic perspective. Dr. Husain and Dr. Kostova are contributors to a December 2017 supplement in the journal Preventive Medicine titled “Economic perspectives of noncommunicable disease risk factors in developing countries.” The supplement highlighted economic research on policies that influence NCD risk factors.

Public Health Impact: “The first supplement from network researchers was a success in connecting modelers, end-users, and policy-makers, and driving conversation around translating evidence into impact,” explains Muhammad Jami Husain, PhD, an economist with the Center for Global Health (CGH) at CDC. “The need for a second supplement for continued evidence generation was deemed critically important.”

“The continued engagement of economic experts is key for finding optimal solutions to the rising burden of NCDs globally,” states Deliana Kostova, PhD, a lead economist also with CGH/CDC. “The International NCD Economics Research Network solidifies and expands CDC’s contribution by advancing the international evidence for NCD prevention and control.”

PE Fellowship Class of 2011

Research:  As an economist with CDC’s National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Dr. Cora Peterson authored a study titled, “Lifetime Economic Burden of Rape Among U.S. Adults” published in the June 2017 issue of the American Journal of Preventive Medicine. She found that the estimated lifetime cost of rape was $122,461 per victim, or a population economic burden of nearly $3.1 trillion (2014 U.S. dollars) over victims’ lifetimes, based on data indicating >25 million U.S. adults have been raped.

Public Health Impact: Preventing sexual violence could avoid substantial costs for victims, perpetrators, healthcare payers, employers, and government payers.

PE Fellowship Class of 2009

Research: Now a lead economist at the Los Angeles County Health Department, Dr. Ricardo Basurto-Davila co-authored a book published in April 2016 by the National Academies of Sciences, Engineering, and Medicine titled, “Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families.” The report highlights the potential for economic evidence to inform investment decisions for interventions that support the overall health and well-being of children, youth, and families. It describes challenges to the optimal use of economic evidence and offers recommendations to stakeholders to promote a lasting improvement in its quality, utility, and use.

PE Fellowship Class of 2009

Research: While working as an economist in CDC’s Office on Smoking and Health, Dr. Xin Xu performed research that describes the success of the Tips from Former Smokers (Tips) media campaign. As a result of the first 12 weeks of the campaign in 2012, “1.6 million smokers tried to quit and more than 100,000 were likely quit smoking permanently.”

Public Health Impact: Results of the analysis showed that the Tips campaign cost only $393 for every life saved – a highly cost effective intervention. This study shows that investing in prevention can reduce disease and save lives and reduce health costs for families and businesses alike. This research was published in an article titled, “Evaluation of the National Tips From Former Smokers Campaign: the 2014 Longitudinal Cohort” that appeared in the March 2016 issue of Preventing Chronic Disease.

PE Fellowship Class of 2001

Research: Dr. Florence Tangka served as editor and significant contributor (along with CDC colleagues) to a special issue in an upcoming December 2017 issue of Cancer Epidemiology, “Cost of Cancer Registration.” The issue highlighted the need for cancer registration in the resource-constrained setting and provides evidence on the overall affordability of operating cancer registries. The special issue reviews the costs of registries in Kenya, Uganda, Colombia, India (Mumbai), and Barbados, and estimates the cost of cancer registration.

Public Health Impact and Key Findings:

• Host institution resources are crucial for registry operations and sustainability.
• Cancer registration involves substantial fixed costs and labor.
• The cost of cancer registration spread over the population covered by each registry was low (less than $0.01 to $0.22).
• The cost per cancer case registered varied across registries ($3.77 to $113.39), and was smaller among registries in low-income and lower-middle income countries ($3.77 to $15.62).
• Approaches to increase efficiency, such as data collection procedures and organization/funding structure, could serve to reduce registry costs.

Dr. Tangka also co-edited a June 2017 special issue of Evaluation and Program Planning titled “Importance of Implementation Economics for Program Planning-Evaluation of CDC’s Colorectal Cancer Control Program.” This issue essentially highlights the need to understand the costs of initiating and operationalizing colorectal cancer (CRC) control programs for planning successful implementation of evidence-based recommendations to reduce disparities and increase CRC cancer screening uptake. It emphasizes the need to increase the number of ‘implementation economics’ studies to develop the evidence-base to guide funding decision making, design cost-effective programs and ensure optimal use of limited resources.

PE Fellowship Class of 1996 (Grosse) and 2005 (Li)

Research: Dr. Scott Grosse and Dr. Rui Li modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. This study, titled “Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016,”was published in the January 2017 issue of Emerging Infectious Diseases.

Public Health Impact: It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention.

PE Fellowship Class of 1996

Research: Dr. Scott Grosse and colleagues conducted a re-assessment of the net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S., which was implemented during 1997–1998. The study found that the fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767.

Public Health Impact: Their study, “Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.”, published in the May 2016 issue of the American Journal of Preventive Medicine, found that folic acid fortification is estimated to reduce the present value of total direct costs for each year’s birth cohort by $603 million more than the cost of fortification. A conservative estimate of cost savings due to folic acid fortification is $299 million per year.