The alliance, known as CARE, is a joint partnership between the School of Public Health and Southern Connecticut State University that uses community-engaged research to help improve the health of low-income and marginalized communities. This is the second consecutive five-year grant from the CDC’s Racial and Ethnic Approaches to Community Health program, which funds various initiatives that target health disparities across different racial groups. 

According to Alycia Santilli, the director of CARE at SCSU, the alliance hopes to use this new funding to expand access to healthier foods, support breast-feeding accommodations and strengthen transportation infrastructure.  

“In New Haven’s low-income neighborhoods — predominantly communities of color — we see wealth disparities that are staggering; 34 percent of residents live below the federal poverty threshold, compared to 26 percent across New Haven and 10 percent in [Connecticut],” Santilli wrote in an email to the News. “More than 30 percent of [households] in these neighborhoods experience food insecurity. Wealth disparities drive health disparities.” 

CARE directs multiple initiatives that address different health issues, including vaccine outreach, chronic disease prevention and health education in New Haven Public Schools. In 2019, CARE founded Supporting Wellness at Pantries, or SWAP, a health advocacy program that seeks to improve the community’s overall nutrition by increasing the selection of healthier food options at New Haven food pantries.  

Sofia Morales, a program manager of research and evaluation at CARE, said the program hopes to expand to 12 additional food pantries across the city.  

“If we really want to increase the access to healthy foods at food pantries, we need to change the system,” Morales said. “We need to work with the regional food bank and others at the policy level to make healthy food accessible so pantries can procure more nutritious options for community members.” 

The new grant will also allow CARE to form a working group to help identify and implement policy changes in the food access system. Morales said members of the working group will include food pantry workers, leaders from community-based organizations, representatives from regional food banks and those with lived expertise of food insecurity.  

Along with SWAP, CARE hopes to expand two other initiatives. The first is the ​“Support Breastfeeding Anytime, Anyplace” campaign, which seeks to provide more breastfeeding accommodations in community spaces. The second is the “Roots of Racial Inequities in Breastfeeding” program, which offers healthcare providers cultural competence training to target breastfeeding disparities among Black and Brown patients.  

Further, CARE hopes to reinforce its “Safe Routes For All” active transit plan, which, in collaboration with the New Haven government, seeks to expand the city’s walking, biking and transit infrastructure. The plan also is looking to promote road safety measures to make New Haven safer for walkers and bicyclists.  

Jackson Higginbottom, a program administrator for health and vaccine communications at CARE, pointed to how CARE listens to community members who have advocated for greater support for maternal care and road safety. 

“I really hope that as long as we are continuing to support and listen to our community, and our priorities are in alignment with theirs, we will have the impact that we are hoping for,” Higginbottom said. 

Morales emphasized that CARE prioritizes input from community members who have endured socioeconomic inequities to inform their approaches to current health disparities in New Haven.  

To expand its outreach and impact, CARE relies on the partnerships it has formed across different cities to help provide input on pertinent local issues, Santilli said.  

“This work should not ever be done in a vacuum,  but in close collaboration with folks on the ground who are deeply tied to — and experiencing — health inequities every day,” Santilli wrote to the News. 

CARE was founded in 2007 at the School of Public Health. 

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Led by Santiago Clocchiatii-Tuozzo, a postdoctoral researcher in the Department of Neurology at the School of Medicine, the researchers gathered self-reported sleep data from the past nine years and neuroimaging scans from almost 40,000 middle-aged adults. Defining suboptimal sleep durations as less than seven hours and more than nine hours per night, the researchers found a link between those with poor sleep durations and neuroimaging profiles often associated with worsened brain health that precedes issues such as strokes and dementia. 

“We found a significant correlation between suboptimal sleep durations and poor brain health, even after accounting for variables such as nicotine and diabetes,” Clocchiatii-Tuozzo told the News. 

The researchers analyzed the presence and volume of white matter hyperintensities — subcortical brain lesions that often reveal themselves on MRI scans and are strong indicators of brain aging and reduced blood flow. They also found the average of 48 white matter tracts to create a fractional anisotropy, a statistic that indicates the brain’s overall connectivity and white matter integrity.  

“We focused our attention on these neuroimaging metrics [because they] are known to precede stroke and dementia,” Clocchiatii-Tuozzo said. 

According to Clocchiatii-Tuozzo, middle age is a crucial time to improve sleep duration.  

He likened sleep to cardiovascular health in how it can affect one’s health in a slow-onset manner. For him, poor cardiovascular health during one’s middle ages can slowly impact different parts of their physiology. 

“Likewise, suboptimal sleep during the middle ages of life could potentially affect some aspects of our physiology that lead to poor health outcomes later in life,” Clocchiatii-Tuozzo said.

Christine Won, the medical director of the Yale Center of Sleep Medicine, specializes in disordered breathing and sleep impairments in women. In an interview with the News, Won noted that sleep disorders, especially sleep apnea, become more common for women as they age because “there are so many hormonal changes that occur throughout a woman’s life span.” 

More broadly, Won said that the study highlights the importance of sufficient sleep to increase healthy longevity.

“I think a lot of times people want to give up sleep for work, school, and social commitments, for example,” Won said. “This study emphasizes that we have to prioritize sleep. It’s just as important as a proper diet and exercise for longevity health.”  

Andrey Zinchuk, a physician specializing in sleep medicine and critical care medicine, pointed to how other chronic health conditions can impact the quality of sleep and how sleep can shape the effect of these diseases. He emphasized that disturbed sleep and sleep apnea are associated with risks of future stroke, heart failure, and dementia. 

Zinchuk said that local and state-level policy changes could help people get more sleep. 

“We need to devote more attention to modifiable factors that affect sleep, and work that into primary care clinics and the way we write laws and run our workplaces,” Zinchuk said. “For example, laws that address early start times in high school can be effective methods for young adolescents to obtain enough sleep each night.” 

According to the CDC, 34.6 percent of adults in Connecticut reported shorter sleep durations in 2020. 

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Led by Pratap Vydyam, a postdoctoral associate who studies infection biology, and Choukri Ben Mamoun, a professor at the School of Medicine and an infectious disease specialist, used a technique called combination therapy to merge the antimalarial drug tafenoquine with the antifungal drug atovaquone. After re-exposing the parasite to immunocompromised mice, the researchers found that mice treated with both drugs were cured of infection and exhibited high antibodies in their blood against Babesia parasites.

“This specific combination has the advantage of what’s referred to in drug discovery as repurposing,” Vydyam said. “Both drugs in this combination are already approved for treatment of various diseases.” 

Babesiosis is a rare, though sometimes severe, disease that develops when microscopic parasites from a tick bite infect human blood cells. Most prevalent in New England and the northern Midwest, it is often treated with antimalarial and antiparasitic drugs. 

However, new Babesia parasite strains have recently emerged and proved resistant to existing treatments, inspiring Vydyam and Mamoun to research new drug combinations.

“The currently approved treatments, clindamycin and quinine for severe disease and atovaquone and azithromycin for mild disease, do not perform very well,” Vydyam said. “Some patients fail therapy and the rate of relapse can be very high in some cases.”

Vydyam and Mamoun then conducted experiments on mice, hoping to use them as a model for how the parasite impacts humans. 

According to Mamoun, the drug combination therapy in their study not only killed the parasites but also induced immunoprotection, meaning that the mice gained protection from future infections. 

“If patients are treated with this combination therapy, you might have cleared the infection and also mounted immunity to subsequent infections,” Mamoun said.

Vydyam noted that their findings are particularly significant because they tested the drug combination in vitro, meaning outside living organisms, and in vivo, or in living organisms. Unlike malaria parasites, which don’t currently have mouse models to test drug efficacy, babesiosis parasites were able to be cultured in vivo in immunocompromised and immunocompetent mice.  

“Babesia duncani is the only parasite that can culture in vitro continuously in red blood cells,” Vydyam said. “Once we determined their effectiveness, we tested them in animal models to test their efficacy.” 

Peter J. Krause, a senior research scientist in epidemiology, previously collaborated with Mamoun on analyzing babesiosis’ genetic mechanisms. For Krause, Vydyam and Mamoun’s findings are critical because babesiosis can be transmitted via blood transfusions. He hopes that new combination therapy can reduce infection rates in vulnerable patient populations.

“Most people do well with current accommodations,” Krause said. “But people who are immunocompromised, which includes people with HIV and cancer, usually have a more severe acute illness, and many can go up to months or even years of therapy, and there is still a 20 percent mortality rate in the group.”

To ensure their drug combination can combat new babesiosis strains, Vydyam and Mamoun plan to conduct additional clinical trials to examine the efficacy of the combination therapy in human subjects. Vydyam said they hope to study whether the combination therapy provides protection for more strains beyond Babesiosis duncani. 

Babesiosis is the second most commonly reported tick-borne disease in Connecticut.

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