The Centers for Disease Control’s Advisory Committee on Immunization Practices recommended new treatment practices Wednesday for shingles based on a vaccine initially developed at the University of Colorado Health Sciences Center, now the University of Colorado Anschutz Medical Campus.
Paul Tabor, Associate Director of CU Innovations at the University of Colorado Anschutz, said, “The Shingrix vaccine is an important advance in the prevention of a very painful disease that affects millions of people each year and disproportionally impacts patients over 50 years old.”
Shingrix received approval by The Food and Drug Administration last week and is the second vaccine approved to prevent Shingles. The existing drug treatment, Zostavax, also was developed at the University of Colorado and has been prescribed in the US since 2006.
According to the CDC, one in three people in the US will contract shingles during their lifetime. Shingles is caused by the Varicella Zoster virus, which also causes chicken pox. It presents as a painful, itchy rash that is particularly debilitating for the elderly and people with weak immune systems. It causes blisters that last for several weeks and cause shooting, burning pain.
The virus remains latent in the body, even if contracted as chicken pox in youth, to present as shingles later in life.
“We are proud that this breakthrough was initially discovered and developed at the University of Colorado,” said Kimberly Muller, Managing Director of CU Innovations. “It is a powerful example of how CU, CU Innovations and its partners translate cutting-edge research into products that significantly improve lives.”
Shingrix is a recombinant plasmid vaccine based upon a truncated Varicella-Zoster virus glycoprotein which is effective at immunizing humans against shingles. It stimulates an immune response that can be more powerful and longer lasting than current therapies. The technology was developed by former CU professor of neurology and microbiology Abbas Vafai in the 1980s.
“It was a long road to get here, but the obstacle was because it is a unique vaccine,” Vafai said. “The vaccine involves single-gene genetic engineering. The vaccine contains a single viral protein purified in the lab – not the whole virus.”
The CU Board of Regents was granted two patents related to Shingrix, both now assigned to a commercial partner.
Don Elliman, Chancellor of the University of Colorado Anschutz Medical Campus, said, “The CU Anschutz Medical Campus has a history of rigorous research and innovation, as the development of these vaccines illustrates. The pace of these innovations is only quickening. Last year alone, more than 20 patents were granted, six more start-up companies were formed and invention disclosures increased by 125%. We’re continuing the CU Anschutz tradition of translating research into practice, leading to important discoveries that improve lives.”
On October 19, Chancellor Don Elliman welcomed more than 75 guests to the first annual Endowed Chair Celebration at the Parkside Mansion in Denver to celebrate the power of philanthropy. Both benefactors and chair holders were in attendance to meet and talk about the incredible work fueled by philanthropic support.
Guest speakers included Slater Family Endowed Chair Malik Kahook and benefactor Craig Slater. This endowed chair has given Dr. Kahook the valuable gift of time to develop groundbreaking technologies and therapies. “Holding an endowed chair is one of the biggest honors for a professor at a university,” said Dr. Kahook. “And this one is special because of the personal relationship I’ve developed with Craig.”
Inspired to Give
Slater and his wife, Colleen, have wrestled with which organizations to support throughout their careers. Slater said, “Philanthropy is hard. It sounds easy at first, but we have found that it’s more difficult than we thought.” Finding an organization whose mission aligns, has sound financial practices and the dedicated professionals to follow through can be daunting. But that’s just what they found at the CU Anschutz Medical Campus. “This is one of the gifts we feel the best about and know that we are making a difference,” said Craig.
Dr. Naresh Mandava, Sue Anschutz-Rodgers Chair in Retinal Diseases and director of the UCHealth Eye Center, introduced Dr. Kahook and the Slaters after learning of Craig’s interest in fueling scientific discovery. After a two-hour dinner with Dr. Kahook, Craig knew this was the place to invest. In 2013, he and Colleen created the Slater Family Endowed Chair to give Dr. Kahook the funding to pursue innovative research and get new therapies and technologies to patients quicker than ever before. Dr. Kahook said, “What excited me is that just in the last 11 years since I came to CU, we’ve spun out eight different companies and filed over 100 patents. Right now, the number one growing glaucoma surgical device is the dual blade that we developed right here.” The Kahook Dual Blade is being used in eye centers around the country and is projected to bring upwards of $1 million to the university in royalties next year.
The Gift of Site
When internationally recognized painter Philip Tarlow learned he had a cataract and glaucoma in his right eye and would need surgery, he panicked. “My eyes are my life and the prospect of eye surgery was terrifying.” He chose UCHealth Eye Center because of its outstanding reputation. “From the moment I met Dr. Leonard Seibold, I relaxed and knew I was in the presence of a truly great surgeon.” He evaluated Tarlow’s condition and performed a combination glaucoma-cataract surgery using the Kahook Dual Blade, both pioneered at Rocky Mountain Lions Eye Institute.
The very next day after surgery, Tarlow was back in his studio painting. “Although I knew it would take time for my eye to fully heal, even at that early stage, my vision was good enough for me to paint. My gratitude for the center and Dr. Seibold’s mastery and superb communication style with patients, is profound. I also work with kids and have touched the lives of thousands, with plans to touch thousands more. For all those who support the work of the UCHealth Eye Center, know that you are not only touching the life of one patient; often that person’s work in the world goes on to touch many more. The impact of your giving is far more than you can imagine!”
Philanthropy Full Circle
This is philanthropy at its best – where generosity was transformed into life-altering technology. The Kahook Dual Blade is just one example of the innovative work happening at CU Anschutz. There are currently 94 fully-funded endowed chairs on campus, and each one is producing tangible benefits for the field of health care and helping propel CU Anschutz to new heights. “Not a day goes by that we aren’t trying to recruit someone or keep someone on campus, and endowed chairs are powerful tools to keep the very best talent in Colorado,” said Chancellor Elliman.
Researchers with the Rocky Mountain Prevention Research Center were recently awarded two grants from The Colorado Health Foundation (TCHF) to continue their work in southeastern Colorado and San Luis Valley schools. The money allows for a significant expansion of the center’s strategic planning process, Assess, Identify, Make it Happen (AIM XL), through which district-level comprehensive health and wellness plans can be developed.
“What is most exciting to me is that this grant gives us a chance to continue our longstanding partnerships with these rural school districts and to expand our work to now support children’s emotional health in addition to physical activity and healthy eating,” said Elaine Belansky, PhD, RMPRC director and co-principal investigator of the Working to Improve School Health and the Healthy Eaters, Lifelong Movers (HELM) projects. “We’ve been focused on the obesity-prevention side of things, which is really important and a significant issue in rural Colorado, but so is emotional well-being.”
Longer reach, broader focus
In HELM’s first three years alone, moderate to vigorous activity levels in elementary school PE classes increased by 66 percent, and nearly 100 evidence-based environment and policy changes to combat childhood obesity were implemented in the southern Colorado study area. The current project, which encompasses 27 school districts, now will align with the Whole School, Whole Community, Whole Child (WSCC) model.
WSCC’s holistic focus with attention to 10 components, ranging from physical education and physical activity to counseling and social services, could have a dramatic effect in the region, Belansky said.
“We’ve heard from so many principals and superintendents that their No. 1 concern about students is their mental health,” said Belansky, adding that the region’s high poverty levels bring stressors that can sabotage children’s learning. In the largely agricultural San Luis Valley, an area the size of New Jersey with a population so sparse it could not fill Mile High Stadium, health-care resources are also stretched thin.
“There is a lot of need there,” said Benjamin Ingman, PhD, principal investigator of AIM-XL. “Being able to bring this focus to the kids’ well-being is really important. Kids need to feel safe and be well-fed before they can start thinking about being successful and happy in school. I hope that this program will help these schools focus on some of these baseline concerns.”
Happy kids, better learners
During her years focused on southern Colorado’s rural areas, Belansky has heard many heart-wrenching stories related to hunger, parents in prison, family addictions and poor living conditions, all matters that make focusing on school difficult for students and place huge burdens on teachers and administrators.
The RMPRC, with the help of project manager Shannon Allen, PhD, and others, aims to ease those burdens by helping school districts bring all players ̶ including community agencies, staff,
teachers, parents, administrators and students ̶ to the table to build programs and partnerships that support students’ overall well-being. Ingman, who wrote the recent grant proposal, said he hopes lessons learned from the team’s work eventually will reach beyond rural boundaries and influence other schools to broaden their educational aims.
None of the work would be possible without Ingman’s dedication, TCHF’s funding, and the support of school districts in the San Luis Valley and southeastern Colorado, Belansky said. “I’m so proud that we have somebody who understands schools and how important it is to focus on the health and happiness of the child, not just academic achievement,” she said of Ingman. “And I’m really proud that all of these districts in rural Colorado value working on the WSCC model to make a child’s educational experience a richer one.”
On October 17, over 70 benefactors gathered to celebrate the official unveiling of the recognition walls in the Research I North and Education II South buildings. “These walls are a fitting, and permanent, recognition of your generosity. It’s an honor to be here tonight to personally thank you,” said Chancellor Don Elliman.
This event was an opportunity for benefactors to see their plaques in person and to join together to celebrate CU’s philanthropic community. Collectively, the individuals, families and organizations highlighted on these walls have given to programs in every school and college on campus, provided seed grants for research initiatives and named scholarship funds. This group of dedicated supporters has helped propel the CU Anschutz Medical Campus to new heights and realize a 40-year vision in just over a decade.
A new study using data collected in a national sports injury surveillance system by researchers at the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus has found that state-level TBI laws are, in fact, beneficial in reducing the rates of new and recurrent concussions among U.S. high school athletes. Between 2009 and 2014, all 50 states and the District of Columbia enacted one or more traumatic brain injury (TBI) laws, more commonly known as concussion laws. These laws often include mandates to remove athletes from play following an actual or suspected concussion, a medical clearance before they can return to play, and annual education of coaches, parents, and athletes regarding concussion signs or symptoms.
The study, led by Dr. Ginger Yang at the Center for Injury Research and Policy at Nationwide Children’s Hospital with researchers from the Colorado School of Public Health and Temple University, is published in the November 2017 edition of the American Journal of Public Health. The study found that rates of new and recurrent concussions initially increase after a law goes into effect due to mandated reporting, but this is also likely due to greater awareness of the signs and symptoms of concussion itself. The authors also indicated that approximately 2 ½ years after a TBI law is in place, the data indicated that rates of recurrent concussions resulted in a significant decline.
“These concussion laws follow in a long-line of successful legislation efforts in public health injury prevention,” said Dawn Comstock, PhD, principal investigator of High School RIOTM (Reporting Information Online), the national surveillance database that tracks high school sport injuries at the Colorado School of Public Health. “These laws in particular were passed quickly and are truly effective as found in the data and this study. What is even more interesting is even though there isn’t an enforcement of these laws—people wouldn’t be ticketed like they might be with speeding or not using their seatbelt, these laws did make a difference. It is a great example of how legislative efforts can actually drive public health and injury prevention.”
This study looked at TBIs in high school athletes who competed in at least one of nine sports between 2005 and 2016. The high school sports included boys football, boys wrestling, girls volleyball, boys and girls soccer, boys and girls basketball, boys baseball, and girls softball. Over 11 years, there were an estimated 2.7 million reported concussions in high school athletes engaged in these sports, which translates to an average of 671 concussions per day, or about one concussion in a high school athlete every two minutes. Of the reported concussions, approximately 89 percent were new while 11 percent were recurrent (a repeat concussion in an athlete that has already had at least one other concussion).
The data also showed that concussions were more frequent among male athletes, particularly in football, and during competitions. Football had the highest average annual concussion rate, followed by girls’ soccer and boys’ wrestling. Overall, males have a higher average annual concussion rate than females, but when comparing the rates in gender comparable/available sports (basketball, soccer, baseball/softball), females had almost double the annual rate of concussions as males.
This study was funded by a grant from the Robert Wood Johnson Foundation’s Public Health Law Research program. State-level concussion law data was obtained from LawAtlas. Concussion data was collected from High School RIOTM (Reporting Information Online), a prospective, longitudinal internet-based surveillance system housed in the Program for Injury Prevention, Education and Research at the Colorado School of Public Health that collects sport-related injuries and exposures among athletes from athletic trainers at a nationally representative sample of U.S. high schools.
Researchers from the University of Colorado Anschutz Medical Campus and the University College London have developed a new theory of molecular evolution, offering insights into how genes function, how the rates of evolutionary divergence can be predicted, and how harmful mutations arise at a basic level.
“Molecules are the basis of all life and we wanted to find out why molecules evolve the way they do,” said study co-author David Pollock, PhD, professor of biochemistry and molecular genetics at the CU School of Medicine.
Pollock and fellow author Richard Goldstein, Ph.D., professor of infection and immunity at University College London, published the study October 23, 2017 in the journal Nature Ecology and Evolution.
Their theory of evolutionary mechanics transforms evolving molecular systems into a framework where the tools of statistical mechanics can be applied, opening a novel window into how protein evolution works.
“The approach rests on understanding proteins as integrated systems,” said Goldstein. “Too often we ignore interactions between different parts of a protein, but we know that changes in one part of the protein affect subsequent changes in other parts. It turns out this is really important for understanding why these molecules evolve the way they do.”
Proteins constantly change as mutations become fixed or eliminated depending on the protein structure, function and stability. This depends on amino acid interactions throughout the protein that cause evolution at one site to alter the chance of evolution at other sites.
The scientists discovered that they could predict rates of protein evolution based on their biochemical properties.
“This was a real surprise,” Pollock said. “Our theory accounts for well-known population genetics effects such as strength of selection and effective population size, but they drop out of the final equations that predict the rate of molecular evolution.”
For years, researchers have run up against problems with standard models of molecular evolution used in studying the evolutionary relationships among species. This led to difficulties in reconstructing important evolutionary events in ancestral organisms.
These patterns of molecular convergence were found to change regularly over evolutionary time in ways that indicated continually fluctuating constraints in different parts of proteins.
“This flips around the usual idea that the amino acids will adjust to the requirements of the rest of the protein,” Goldstein said. “But we couldn’t explain exactly why this happened, or whether there was any regularity to the process.”
But once the system was placed into a statistical mechanics framework, the magnitude of amino acid entrenchment was seen as central to understanding rates of evolutionary divergence.
The researchers said that the strength of selection in protein evolution is balanced by the sequence entropy of folding, the number of sequences that provide a protein with a given degree of stability.
“We like to think of the other amino acids as a bunch of kids jumping down on a memory foam mattress while you try to walk on it,” Pollock said. “Most of the time your feet are sunk into the mattress and you can’t step forward, but every so often the kids will create a dent in the mattress that allows you to step ahead.”
The title of the paper is “Sequence entropy of folding and the absolute rate of amino acid substitutions.”
Getting enough vitamin D during infancy and childhood is associated with a reduced risk of islet autoimmunity among children at increased genetic risk for type 1 diabetes, according to a study published this week in the journal Diabetes.
The study’s lead author, Jill Norris, MPH, PhD, of the Colorado School of Public Health, and her co-authors examined the association between vitamin D levels in the blood and islet autoimmunity. Islet autoimmunity, detected by antibodies that appear when the immune system attacks the islet cells in the pancreas that produce insulin, is a precursor to type 1 diabetes.
“For several years there has been controversy among scientists about whether vitamin D lowers the risk of developing of islet autoimmunity and type 1 diabetes,” said Dr. Norris.
Type 1 diabetes is a chronic autoimmune disease that is increasing by 3-5 percent annually worldwide. The disease is now the most common metabolic disorder in children under age 10. In younger children, the number of new cases is particularly high. And the risks seem to be greater at higher latitudes, further north from the equator.
Vitamin D represents a candidate protective factor for type 1 diabetes as it regulates the immune system and autoimmunity. Moreover, vitamin D status varies by latitude. But associations between vitamin D levels and islet autoimmunity have been inconsistent. This may be due to different study designs, population variation in vitamin D levels, or a failure to account for the combined effect of exposure and underlying genetic variation in the vitamin D pathway.
The findings are part of The Environmental Determinants of Diabetes in the Young (TEDDY) study, a large, multi-national study funded by the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases.
TEDDY’s effort began in 2004 with children from six clinical centers: three in the U.S. (Barbara Davis Center for Childhood Diabetes at CU Anschutz, the Pacific Northwest Research Institute in Seattle, and Augusta University in Georgia) and three in Europe (Universities of Turku, Oulu, and Tampere in Finland, Helmholtz Zentrum München in Germany, and Lund University in Sweden). The aim of the study is to search for triggers and protective factors for type 1 diabetes in 8,676 children with elevated type 1 diabetes risk.
The TEDDY children were followed with blood samples drawn every three to six months from infancy, to determine the presence of islet autoimmunity, as well as levels of vitamin D.
The authors compared 376 children who developed islet autoimmunity with 1,041 children who did not. The authors found that in children with a genetic variant in the vitamin D receptor gene, vitamin D levels in infancy and childhood were lower in those that went on to develop islet autoimmunity compared with those that did not develop autoimmunity.
This study is the first to show that higher childhood vitamin D levels are significantly associated with a decreased risk of IA.
“Since this association does not prove cause-and-effect, we look to future prospective studies to confirm whether a vitamin D intervention can help prevent type 1 diabetes,” Dr. Norris said.
“Incredible work is happening right here, right now. And we are all a part of it.”
Kim Christiansen, 9News co-anchor
On October 12, over 150 supporters attended Libations for Life, an annual event sponsored by the CU Cancer Center to benefit women’s cancer research. This event brings together women and men from around the Denver metro area for an evening of signature cocktails, a silent auction and paddle raising. Bartenders and mixologists from El Jefe, Beast and Bottle, Bar Helix, Breakthru Beverage and Bar Fausto created signature cocktails specifically for the event. This year, the CU Cancer Center’s community of supporters gave over $60,000.
Director of the Young Women’s Breast Cancer Translational Program Virginia Borges, MD, spoke about the importance of private support for research. “Every dollar raised this evening stays in our community, but also has an impact on the global fight against cancer,” said Dr. Borges. For the past seven years, this event has raised money for some of the best and brightest minds at the CU Cancer Center. Much of the funding from this event fuels the work of junior faculty, working to further research endeavors in their early careers.
Sarah Chase-McRorie, the evening’s key note speaker, talked about her diagnosis with cancer at age 34. “I had just finished breast feeding my daughter, Sloan, she was nearly a year old at the time. Shortly after, I noticed a lump in my armpit at work.” After consulting her doctor, Sarah was diagnosed with Stage III breast cancer. Sarah said, “It turned my world upside down, and now I’m committed to making sure my daughter doesn’t have to worry about young women’s breast cancer.” Today, Sarah is cancer free and was able to have a second child.
This year’s funding will support Kian Behbakht, MD, Elizabeth Wellberg, PhD, and Carol Sartorius, PhD. Dr. Behbakht focuses on identifying new therapeutic targets for ovarian cancer. Drs. Wellberg and Sartorius are targeting obesity in women’s cancer with a focus on the links between obesity and breast cancer.
Speaking to a very full house at this year’s State of the Campus address, CU Anschutz Chancellor Don Elliman shared his unwavering vision for the university: “to be the place where anyone who needs it can find the finest medical care in the world; where the science of that care is being pushed to new horizons and where the health care workforce of our future is being trained.”
About 250 faculty, staff and students came to the Hensel Phelps West Auditorium in the Research 1 North Building Wednesday afternoon to hear Elliman discuss university progress, strategies and goals. He began his speech with a memory of the 2016 CU Anschutz State of the Campus address, which took place one week before the U.S. presidential election.
“I think it’s fair to say that the last nine months have brought the potential for some very challenging changes in health research and health care,” he said. “With national uncertainty as a caveat though, the headline on the state of our campus and our institutions is that we are in good shape and growing stronger all the time.”
As a testament to the university’s ever-expanding and improving clinical care offerings, Elliman cited several U.S. News & World Report rankings, including University of Colorado Hospital rising five spots to No. 15 and the CU School of Medicine Department of Pediatrics achieving top 10 standing in five specialties.
“As we strive to be the best, these rankings need to continue to rise. What makes it happen is very simple: the recruitment and retention of great faculty. That is you.”
2. Boost NIH funding
Total research sponsorship funding at CU Anschutz increased by 8 percent last year to just over $490 million. About 42 percent of that total – 4 percent more than last year – came from the National Institutes of Health (NIH).
“I believe our focus needs to be on increasing that stream. Most pundits opine that the number of serious players among academic medical centers in research is bound to decline. We have to be one of the winners.”
3. Diversify the university research portfolio
He was there:
“I’m pleased to hear that the campus is making an economic impact. It’s also good to see that
some grass roots initiatives now seem to be coming from the top down.”
Ryan Holland, Director of PreAward and Contracting Services
More than 200 companies from around the world have applied to come to this campus and engage in university partnerships that lead to diverse research and innovation projects. Elliman praised the recently established CU Innovations team for helping make this possible. To accommodate this increase in research enterprise initiatives, the Fitzsimons Redevelopment Authority Board approved the plan and design of a 120,000-square-foot Bioscience 3 Building – construction should begin in spring 2018.
“We are seeing success in research diversity with growing industry funding and clinical trial revenues. Invention disclosures and patent applications are both growing … We’ve become a test bed for commercial innovations.”
The university has commissioned a study to catalogue its activity in the area of mental and behavioral health to help connect clinicians and researchers in the field.
“I believe we have an obligation, because of our mission, to up our game in the area of mental health. We have done just that.”
5. Expand health care workforce training
The College of Nursing has expanded its psychiatric nursing education program. Project ECHO received a new $3 million grant to continue its specialty education for physicians, nurses and other providers. And the university has, for the first time, convened a team to explore more possibilities for digital education.
“We have an obligation, I believe, to try to enhance our capacity to educate the health care work force at all levels.”
6. Enhance marketing efforts
Elliman celebrated the press coverage generated within schools and colleges and the work of the Office of Advancement to inform donors of faculty accomplishments. He gave a promise to do more work to tell the university’s story to the world.
“Although much work has been done on developing an overarching message, we have not yet been able to bring that to fruition, and as such, we remain one of the better kept secrets in the region.”
7. Leverage co-location of schools and colleges with hospitals
She was there:
“Mr. Elliman brought good energy to the address. I like the message of trying to bridge the silos, and I think it’s exciting to hear the news of CU Anschutz building our own identity.”
Natalie Buys, Grants and Contracts Manager, Department of Family Medicine
While acknowledging efforts in this area, Elliman said we could take better advantage of the co-location of six schools and two hospital systems on one campus. The common success of CU Anschutz, UCHealth and Children’s Hospital Colorado depends on breaking down silos, building bridges, sharing information and nurturing the cross-pollination of ideas, he said.
“I would assess that, in spite of occasional and sometimes strong differences of opinion, those relationships are now either as good as or better than they have been in a long time, perhaps ever … [but] I can’t tell you how many times I hear the expression from faculty that goes something like, ‘I had no idea we were doing that.’”
8. Become more risk-tolerant
Elliman noted that he has signed more indemnification waivers in the last 12 months than he believes the university has ever granted before – and got a hearty laugh from the audience.
“The projects were all judged to be worth it on the risk/benefit ratio, and I am glad the regents delegated the authority to us.”
“I think it is clear that each school and college is establishing and pursuing its own priorities.”
The driving forces behind this strategic work, Elliman said, include clinical revenue, partnerships, innovation, philanthropy and technology.
“Our foot needs to stay on the accelerator,” he said.
From the details of the nine strategies, he moved on to updates on campus infrastructure and space, which include:
Aimco’s plans for a new hotel and food market near Fitzsimons Apartment Homes;
Approval for the university to plan the new $240 million home of the Colorado Center for Personalized Medicine just west of the Research 2 Building;
300 new parking permits issued in the past year; and
University plans for a new parking garage north of the Research 2 Building.
In light of the need for more space on campus, Elliman displayed a photograph of a construction crane and called it the “campus mascot.” Audience members laughed out loud.
Then, he addressed the matter of the university identity and announced plans for CU Anschutz to establish its own website URL, independent of CU Denver.
“I think identity is important, and we need our own: CU Anschutz,” he said. “We do not have a plan today that will get us there, but we will make one.”
Elliman concluded the address with praise and gratitude for the people at CU Anschutz.
“We are built on one simple ingredient: talent,” he said. “The quality of the faculty and staff are both the key to our success and the key to our future. You got us to where we are today. I hope you are as excited as I am, even given the challenges, of where we can be tomorrow.”
“Both campuses have important missions, but those missions are very different, and so is each campus’s business infrastructure,” he said. “At CU Anschutz, we need our own identity, and I promise that will happen.”
Another attendee raised a question about the growing need for vivarium space on campus. Elliman said a portion of the basement in the new building to be built next year has been earmarked for this purpose.
Continuing on the topic of campus space, the final questioner asked about plans for maintaining historic Building 500. The university has spent $8 million in the last two years on Building 500 renovations and has committed to renovating additional floors, as well, Elliman replied.
“It’s cheaper to build new than to renovate,” he said. “We know the need for more space exists, and we want to try to make better use of the space we have.”
In under an hour, Margaret, 57, a grandmother who suffered a stroke and is partially paralyzed, lost her foods stamps, faced eviction from her home and was robbed of her jewelry and valuables. These events left her and her son, Miles, 36, his wife, Melinda, 36, and their daughter, Mandy, 15, confused, frustrated and worried.
This was no ordinary family. First-year CU School of Dental Medicine students took on these roles during the first-ever Poverty Simulation, a three-hour session in which they experienced the same struggles as real low-income families. Having the time and money for dental and health care was often last on the list as these families worked to pay rent, buy food and take care of their children.
“My family is out working or looking for work and it’s kind of frustrating because I’m paralyzed and I have to stay here and can’t help more,” says dental student Rebecca Ryan, 24, who played Margaret, the family matriarch. “But that’s the reality of life – it can change in a second and that’s what happened to Margaret.”
The Poverty Simulation is part of Community Engagement I, a fall class that introduced 81 first-year dental students to public dental health, says William D. Bailey, DDS, MPH, CU School of Dental Medicine Chair, Department of Community Dentistry and Population Health.
“We want our students to be aware of the barriers and inequities in accessing dental and health care,” says Bailey, adding that the hands-on Poverty Simulation experience is more powerful than any lecture.
The goals of the simulation were to raise students’ awareness of the realities of poverty, while helping them understand stereotypes and misconceptions about low-income families, says Deidre Callanan, RDH, DC, MPH, a CU School of Dental Medicine Clinical Instructor, Community Engagement.
“The hope is that students now understand some of the barriers and frustrations to accessing services, including health and dental care for those with limited resources,” Callanan says. “We want our students to graduate with a deeper understanding, respect and compassion for their patients while they are out in the community, in the school clinics and when they become practicing dentists.”
How the simulation works
At the start of the Poverty Simulation, students received packets and worked in groups as makeshift families. The packets provided them descriptions of family members, their ages, employment situation, health status, income and monthly bills. Some families owned vehicles; others could only use bus passes to get where they needed to go.
Their tasks? They had to provide food, shelter and basic necessities for a month. They also received information on resources that would help them survive. About 20 community volunteers represented various agencies that could provide services for these families – from food and rent assistance to childcare. Each 15 minutes of the simulation represented a week in their lives.
There also was a bank, an employer, a juvenile detention center, utility and mortgage companies, a pawnshop, and a health care clinic, among other businesses and agencies.
The students represented four different types of families during the simulation. They included a family of four or five; some had two parents and others were single parents with children. Some students posed as elderly single people with health issues and little family support.
Dental student Ryan Koster, 22, was surprised to find out he was a pregnant 16-year-old girl.
“I’m due in two months, we just got evicted and I’m not doing too hot,” says Koster, adding that he’s had no access to health care. “It’s crazy, it’s eye-opening. It’s a lot more interactive than I thought. This experience has helped me understand different people and situations. This will make me a better dentist.”
A family in crisis
For the family of Margaret, Miles, Melinda and Mandy, the struggles resonated with the dental students who played their parts.
“It definitely gives you a different perspective of how people live,” says Hassanain Zaheer, 23, who was15-year-old Mandy. “This simulation helps us understand the hoops people have to go through. This is the first time I’ve done anything like this – it’s a unique experience.”
Stanford Smith, 29, who represented Miles, the father, said he gained new insight as the only wage earner in a large family.
“I didn’t know what we were going to do – it was hard to get things done and you had to learn to work the system,” he says. “It was so frustrating because you’re trying to do everything, but the lines were long and you couldn’t get stuff done.”
He says the experience helped him understand the complexities low-income families face every day.
“This is a great program – it really made me see what it’s like to live on minimum wage,” he says. “It makes me want to do more and help the people I see as patients.”
While her “family” faced challenging life situations and tough decisions, Messay Ibrahim, 25, said she didn’t realize life could be so difficult.
“As Melinda, I’m unemployed and I tried to get a job, but I couldn’t,” she said. “It was just so hard trying to pay our bills and we still got evicted. We just had so many things thrown at us.”
She says the experience will make her a better dentist.
“It helps us to know where our patients are coming from and all the emotions and stress that comes with living in poverty,” she says. “The one thing I did like was that our family did try to work together to overcome all our challenges – and I’m thankful for that.”