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Since its establishment five years ago, East Tennessee State University’s Center for Applied Research and Evaluation (CARE) in Women’s Health has continued to make an outsized impact on child and maternal health in Appalachia and the Southeast, securing more than $18.6 million in external grant funding.

The goal is to advance health programs and policies and improve access to health care. It’s one of the many reasons why ETSU is the flagship institution of Appalachia.

“This past year was particularly impactful,” said Dr. Amal Khoury, director of CARE Women’s Health and chair of the Department of Health Services Management and Policy. “CARE faculty have secured new grants while completing significant projects aimed at advancing women’s health in our Appalachian region and across our home state.”

In 2024, Drs. Nathan Hale and Wondi Manalew received a grant from the Health Resources and Services Administration’s Maternal and Child Health Bureau to examine postpartum screening for diabetes and primary care transitions among mothers experiencing gestational diabetes during pregnancy.

Hale is the ETSU College of Public Health’s associate dean for research and CARE Women’s Health’s research director. Manalew is a research assistant professor with the college. They are working with researchers from the University of Alabama at Birmingham to examine differences among rural and urban mothers.

“We know that about half of mothers experiencing gestational diabetes during pregnancy go on to develop Type 2 diabetes. Screening for diabetes postpartum and transitioning to primary care are very important for optimizing the health of women long term,” said Hale. “Unfortunately, many mothers do not make the transition. We know very little about how this might be different in rural communities that have historically experienced gaps in primary care.”

Last year also marked the completion of the center’s work with the Tennessee Department of Health to lead a statewide assessment and develop a strategic plan for improving maternal health in Tennessee. Dr. Mike Smith, CARE Women’s Health’s director of policy and programs, led the work.

“We will combine the things we learn from Tennesseans across the state with population-based data to inform the efforts that TDH will fund for the coming years to improve maternal health,” said Smith. “This will include identifying barriers to healthy living that we can work to overcome and things that promote good health that we can continue to invest in.”

This past year, CARE Women’s Health also expanded its collaboration with the ETSU Center for Rural Health and Research.

“Working together, we can maximize our impact and make a real difference for advancing health care access and outcomes for the people of Appalachia,” noted Khoury.

One of those collaborative projects culminated in the creation of the North Carolina Maternal and Child Health Dashboard that highlights health outcomes and social determinants of health across North Carolina, with an emphasis on western North Carolina.

The interactive dashboard was created as part of a project led by Dr. Kate Beatty and Dr. Qian Huang, with funding from the Dogwood Health Trust. The work earned the Association of American Geographers Health and Medical Geography Specialty Group Health Data Visualization Award.

“I’m honored to receive the award for our North Carolina Maternal and Child Health Dashboard,” said Huang. “This recognition highlights the importance of making data accessible and actionable for public health. I’m excited to see our work making an impact.”

It’s one of the many ways CARE Women’s Health has made an impact in Appalachia and beyond.

By offering user-friendly tools like the dashboard, and other resources like issue and policy briefs, infographics, and journal articles, CARE Women’s Health supports policymakers, health care providers and community organizations in making data-driven decisions to improve health outcomes.