It is no secret that public health is facing challenges on multiple fronts: from infectious diseases and environmental hazards to inequitable healthcare access, increasing drug prices, and an aging population. And yet, distrust of public health, fueled in part by political polarization and rampant misinformation, has become a major factor in American life. Plus, the changeover in Washington D.C. is impacting research in unprecedented and unpredictable ways.
In a time of growing health challenges, the work of public health professionals has never mattered more. At the School of Public Health (SPH), our researchers push forward—fighting urgent threats with evidence-based solutions, standing up for health equity, and sounding the alarm on emerging risks. Despite the obstacles, SPH faculty persist because good research saves lives.
Irina Stepanov: Fighting the Global Tobacco Threat
Irina Stepanov, Distinguished McKnight University Professor and Mayo Professor in Public Health gets impatient when people say that concern about tobacco is passé.
“They say, ‘we all know it’s harmful. People just choose to smoke. What can we do?’ she says. “Well, no—it’s not a matter of free will, because tobacco is highly addictive. Seventy percent of people who want to quit smoking find they can’t.”
Tobacco is a powerful carcinogen, and that’s why the Institute for Global Cancer Prevention Research (IGCPR), which Stepanov directs, is dedicated to enhancing global research capacity to prevent its deadly effects, with a particular focus on cigarettes and smokeless tobacco.
Stepanov, trained as an analytical biochemist, works with her colleagues to analyze the chemical profiles of tobacco products and their effects on people, and collaborates with behavioral scientists, epidemiologists, and communication and policy experts to understand and minimize exposures to tobacco-related chemicals and the associated cancer risks.
Stepanov brings the knowledge gained from these studies directly to the public via publications, public forums, and a yearly appearance at the Minnesota State Fair. Her work also informs the FDA on how to regulate tobacco products to protect public health.
And then there is the global context to her work: ongoing IGCPR efforts, based in Mumbai, India, are focused on how smokeless tobacco products, which are extremely popular in Southeast Asia, produce oral, head, and neck cancers. “When we have our collaborative studies published, there is extremely wide coverage of findings by the media in India,” Stepanov says. “And that is very important, because India has the highest rate of head and neck cancers due to tobacco use in the world.” In addition, Stepanov notes that conducting research in countries where there are unique carcinogenic exposures and risks, and learning from our global partners, can inform cancer prevention strategies here in our own backyard. “Conducting research across continents and time-zones is not trivial, and the value of such partnerships is difficult to over-estimate.”
Jesse Berman: Defending the Right to Breathe
“My work is to understand how the environment affects human health,” says Jesse Berman, an associate professor at SPH. He is a tireless communicator, urging common sense prevention methods to environmental hazards.
Berman is currently leading an NIH-funded study on the impact of daily air pollution on people with chronic respiratory diseases such as asthma, COPD, and emphysema. “We know that people with these conditions are going to be more vulnerable,” he says, “but how much more vulnerable is still an unanswered question.”
The study is timely, given the increase of air pollution caused by wildfires. “A great deal of my research focuses on extreme weather events,” he says. “We know that things like drought, extreme heat, and wildfires are going to become more frequent, more severe, and longer in duration as our climate changes. So people are going to be exposed to more of these conditions, particularly in areas where they have never experienced them before.”
And all of this is happening, he notes, at a time when “top-tier groups doing climate and health research at agencies like the Centers for Disease Control and Prevention (CDC) have been eliminated. A great deal of data that was formerly collected is no longer available to the public.”
He’s hopeful that, if the public health establishment can do a better job of communicating its value, the widespread distrust in public health will decline. “We have to be better,” he says, “at letting the public know how the work we do benefits everyday people, since they are the ones who will be affected.”
Simon Rosser: Putting Sexual Health on the Front Line
“I consider myself one of the most fortunate people in the world,” says Professor Simon Rosser, “because I research the public health aspects of sex. Sex is incredibly important to a lot of people, and you can do so much good—using simple interventions, reassuring people they’re okay, helping people learn about sexual health, helping parents love their kids if their kids have a sexual issue, helping protect the vulnerable from people who would exploit them.”
Rosser has been on the front lines of sexual health studies since completing the second dissertation in the world on HIV at Australia’s Flinders University. He came to the University of Minnesota in 1990 and spent a couple of decades designing HIV-prevention programs, until HIV became a manageable illness.
Then his husband was diagnosed with prostate cancer.
“I went to the literature,” he says, “and found that there was almost none on prostate cancer in gay men. First of all, I got annoyed; then I got angry; then I decided, well, somebody’s got to develop it.”
From 2014 to 2017, he led the pathbreaking RESTORE study, which, he says, “positioned us as the leading place in the world studying prostate cancer in LGBTQ populations.”
There are important reasons to study phenomena like cancer in diverse populations, Rosser says. “If we only ever studied a disease in one population, we’d never know what’s unique to that population and what’s generalizable to all. And just as significant: minority Americans deserve health.”
“Addressing sexual health is a good thing for all health!”
Simon Rosser
In March of 2025, however, the Trump administration cut NIH funding for a major follow-up effort that Rosser led. It was one of dozens of grant cancellations, many of which focused on the health of minorities, including LGBTQIA+ people.
Undeterred, Rosser forges ahead with other work, including an initiative that trains African medical and nursing students in sexual health and assesses the results. “One of the things we’ve found,” he says, “is that if you provide sexual health education to students they get more comfortable addressing anything with their patients, and you actually improve their clinical skills. They’re also more likely to follow laws that mandate the reporting of sexual abuse.”
Sayeh Nikpay: Finding Where the Funding Gets Stuck
There is a healthcare “safety net” for people who can’t afford care, but its holes are large and numerous. That’s what Associate Professor Sayeh Nikpay studies: the complicated, often ad-hoc, network of federal reimbursement programs (such as Medicare and Medicaid), special pricing plans, and low-cost or no-cost care policy mandates that attempt to secure affordable healthcare for every American.
To be precise, Nikpay pays attention to how money flows in that network, and where it gets stuck and never quite reaches the consumer.
“A lot of the money from the federal and state governments that goes into reinforcing the healthcare safety net goes to the providers,” she says. “They are supposed to use the funds to make care more affordable. But the way some of those programs are structured, money gets stuck in organizations and doesn’t end up actually improving access to care for patients.”
An outstanding example of this blockage, one that Nikpay has studied in depth, is the 340B drug discount program. Named for a section of the Public Health Service Act, 340B requires drug manufacturers to reduce the prices of prescription drugs to qualified healthcare entities that serve low-income patients. The organizations can then pass the discounts to uninsured or underinsured patients, or bill insurers for the cost of the meds, usually at market rates. The point was to allow the organizations to use the savings that resulted to expand care for low-income patients. But the legislation doesn’t require them to do so, and the federal government doesn’t monitor 340B money.
Nikpay’s research has shown that most hospitals that sign on to the 340B program do not meaningfully increase their engagement with the safety net, and the eligibility criteria for the program don’t focus enough on providers who have committed to be part of the safety net. At the same time, the pharmacies that contract with the program are less likely to be located in medically underserved areas, or areas with higher uninsured rates.
She’s been bringing these and related findings to policymakers on both sides of the aisle via testimony and publication. She plans to keep up this advocacy by continuing to talk with policymakers on how healthcare can and should be affordable to those who rely on the safety net—and why it often isn’t.
Joseph Gaugler: Developing Dementia Care that Works
The understanding of Alzheimer’s disease and related dementias (ADRD) has advanced in recent years. But what about dementia care? What interventions work best for patients and their caregivers?
It’s a question that Joseph Gaugler, Distinguished McKnight University Professor and Robert L. Kane Endowed Chair in Long-Term Care and Aging, has been asking for years. Most recently, he’s been named director of the Establishing Mechanisms of Benefit to Reinforce the Alzheimer’s Care Experience (EMBRACE) AD/ADRD Roybal Center, whose goal is to find out why and how dementia care interventions work in the community and to identify their essential elements that seem to be driving the most benefit.
“Community settings vary in resources, population, and professional expertise,” explains Gaugler. “If we know why an intervention works, then when we modify it to fit those contexts, the essential ingredient of the intervention is maintained.”
EMBRACE, a partnership between SPH and three other universities, will supervise six trials of interventions proposed by researchers—one of whom is SPH Assistant Professor Manka Nkimbeng, who will investigate cognitive behavioral support for family dementia caregivers, focusing on the African immigrant community.
Gaugler also directs the State Alzheimer’s Research Support (StARS) Center, which helps state-level entities identify and share data that can help them understand the effectiveness of dementia care services in their states or regions, and the BOLD Public Health Center of Excellence on Dementia Caregiving, which supports public health agencies that want to expand their dementia-care offerings.
With BOLD, Gaugler has been feeling the headwinds blowing from Washington D.C. He was expecting a Notice of Funding Opportunity (NOFO) from the CDC for five more years of financial support for the center, but it hasn’t come. “There were significant reductions in force in the CDC, and the staff of the entire healthy-aging branch is no longer there,” he says.
Political vagaries notwithstanding, Gaugler literally carries the message of ADRD care to where it’s needed. He vowed in 2018 to visit all 87 Minnesota counties with his “roadshow” of informal presentations and conversations about dementia and resources for dealing with it. To date, he’s visited 37. “I’m consistently surprised that a lot of people don’t know what’s available in their own towns to help navigate ADRD, find information, and connect people,” he says. “Addressing that in itself is an important outcome of these county visits.”
Rebecca Wurtz: Getting the Right Data
SPH Professor Rebecca Wurtz began her career as an infectious disease physician. But public health beckoned, and since those days she has dealt with a range of issues from immunization to the role of generative AI in public-health misinformation.
“In recent years,” she says, “I’ve focused on what might be called data modernization. Getting our hands on the data we need to make informed decisions in public health.”
She leads an initiative focused on educating students in public health, nursing, and related fields—particularly from underrepresented groups—about how to collect, analyze, and disseminate data, supported by an $8.2-million-dollar federal grant. The grant was canceled in January, then reinstated by a judge’s temporary restraining order three days later. “So we’re proceeding,” she says.
She’s also been a compelling voice on immunization, giving journalists data-driven perspectives on how and why people should keep up with what she calls the evolving landscape of immunization—from the emergence of new mRNA-based vaccines to the need for boosters against new strains of Covid and flu.
Wurtz has a unique perspective on the future of data modernization: she wants to see the public health field adopt and adapt modern consumer marketing data-gathering processes.
“When we order something from Amazon or do a Google search,” she says, “we give up all sorts of information about our needs and wants. Our phones ping cell towers every few seconds, and our location data is used mostly to sell us products. But all of that information has health implications. My dream is that some of it could be aggregated in ways that tell us about what neighborhoods or jobs are healthy, the connection between diet and cancer over a lifetime, and more—with that data properly de-identified and confidentially stored.”
And she has another take on the current chaos in health politics, one that is decidedly hopeful. “The future is actually bright,” she says, “because we’re going to have to rebuild structures that have been dismantled. A lot of senior people have been laid off or retired early. I think here’s a chance for people like my students to bring their young energy, knowledge, and passion to bear. There’s going to be an incredible need for a new generation of people with a new outlook to rebuild.”
–Editorial note: This information was accurate at the time this article went to press. The situation may have changed as funding decisions continue to be made.
