OCTOBER 2025

Policy Perspective:

Environmental Exposures & Health

A recent Washington Post investigative article found that the six leading states for corn production — Iowa, Nebraska, Illinois, Minnesota, Indiana and Kansas had a cancer frequency rate 5 percent higher for young adults and 5 percent higher for the overall population than the rest of the country. In a report last year, the University of Iowa’s Environmental Health Sciences Research Center focused on the land itself, casting Iowa as a “hotspot for environmental exposures to cancer-causing agents.”

The assessment noted that the state’s soil harbors some of the nation’s highest natural radon levels, while its groundwater carries the country’s highest average nitrate pollution, largely due to decades of fertilizer use.

Several IHPS faculty study environmental toxins, their effects on health and policy. Tracey Woodruff, PhD, MPH, and colleagues recently released an International Federation of Gynaecology and Obstetrics (FIGO) committee opinion that provides a comprehensive synthesis of the current evidence linking environmental toxicants-including air pollution, endocrine-disrupting chemicals, heavy metals, and climate-related stressors-to common obstetric outcomes such as preterm birth, hypertensive disorders of pregnancy, gestational diabetes, and impaired fetal growth, as well as to early childhood outcomes including neurodevelopmental delay, metabolic disease, and atopic conditions. Lena Winestone, MD, and colleagues looked at the associations between residential pesticide use during key developmental periods and 5-year survival in children treated for acute lymphoblastic leukemia (ALL).

IHPS FACULTY SPOTLIGHT CONVERSATION

Michelle Nakphong, PhD

"In the first half of my career I was working directly with communities, on the non-profit side and in economic development. Much of what I saw impacts health is just the difficulty of meeting your daily needs and not being able to prioritize or take care of your health in the way you actually might want to when you feel financial strain."

Michelle Nakphong, PhD, is a social epidemiologist and her research focuses on how social exclusion and inclusive policies impact the health of marginalized populations. Currently, her work focuses on guaranteed income as an inclusive policy as well as immigrant policies, housing, and sexual and reproductive health care. Building on over 2 decades of community-based policy advocacy work, she strives to amplify voices from low-income and minoritized communities.

Her research addresses the core question: Can fostering social inclusion reduce health inequities? She builds from a social exclusion framework conceived by Naila Kabeer (2000) and takes a structural and policy approach to examining people's lived experiences. She uses quantitative and qualitative methods to illuminate the complex mechanisms that underlie health disparities. Ultimately, Michelle aims to influence inclusive policymaking and programs to promote health equity.

IHPS FOCUS

Naomi Bardach, MD

What are you currently working on?

I am in the start up phase of the Family Input for Quality and Safety (FIQS) Implementation and Dissemination R01. We received funding Sept 1 for this NICHD-funded R01 to study the dissemination and implementation of the FIQS mobile phone tool (text message plus website) to gather patient and family-member observations of safety at the point of care in the inpatient pediatrics setting, and share those observation rapidly to hospital and unit leaders and safety teams to inform safety efforts. This is a fun and meaningful study done in collaboration with family members and family advisory councils. Five other hospitals are participating across multiple states (Washington, Texas, Virginia, and CA). This is a follow-on from an earlier R01 developing and refining the FIQS tool and convening a quality improvement learning collaborative to facilitate shared lessons learned across units across three UCSF hospitals (the two BCH hospitals and ZSFG). Given digital health disparities, we have focused on supporting participation across racial/ethnic groups, and will continue to do so in the next phase of the project.   

I’m also working on a climate resilience study, led by UCSB, focusing on understanding heat measurement and resilience in schools in CA, in areas with higher social risk.

What drew you to work on this?

For FIQS, I was drawn to it based on my experience with children and families in the inpatient setting, as well as my own experience as a family member sitting at the bedside of a sick loved one.

I’m drawn to climate change work based on my commitment to child and family health and health equity. Climate change is the biggest threat to child and family health now and in the future and marginalized communities here and globally are at the highest risk.

What's next?

First, I have to finish writing up the first round of FIQS papers! I submitted a T32 on clinical research informatics to the NIH in September, to be reviewed in early 2026. I’m hoping to do some work in AI in relationship to the FIQS project, and potentially lead some follow-on climate research looking at health outcomes related to the work we are doing in schools, or to lead some interventions to address heat impacts.

Kristin Hoeft, PhD, MPH

What are you currently working on?

I work on a range of dental public health projects. My newest initiative is an Oral Health Workforce Research Center–funded pilot project exploring the role of school nurses in oral health. Building on initial research with California school nurses, I will expand this work nationally to better understand what school nurses know, do, and need to support students’ oral health. I also serve as Co-PI with Beth Mertz on a California-funded pilot evaluating whether a managed care approach in dentistry can increase access to and utilization of dental care. In addition, I conduct tobacco-related research with teens and young adults and direct the California Oral Health Technical Assistance Center, which supports local health jurisdictions in implementing oral health programs.

What drew you to work on this?

When I transitioned from general public health to oral health, I was struck by how underdeveloped oral health infrastructure is compared to other public health areas. Tooth decay remains one of the most prevalent and persistent health disparities among children. These projects leverage established workforce and care models that are widely used elsewhere in public health but remain underutilized in oral health.

What's next?

These pilot projects are still in early stages, so my immediate focus is on implementation. I’m hopeful that our findings will inform future training and policy efforts to strengthen dental public health systems and improve access to care. 

FRONTLINE FINDINGS

MEDIA MENTIONS

Since its founding 50 years ago, IHPS has been dedicated to training the next generation of leaders in interdisciplinary research to solve our most important health policy issues. In celebration of our 50th anniversary and to honor our founders, Phil Lee and Lew Butler, we established an endowment fund for the Philip R. Lee Fellowship. We hope to continue to keep this fund and our fellowship program robust.

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IHPS has recently begun using LinkedIn and Instagram. Please follow us at the link below! We will be sharing valuable updates regarding the work the IHPS community is engaged in, insights on current health policy-related matters, and information regarding IHPS-related events regularly as well as infographics of faculty work