BOONE, N.C. — Sarah Ulrich '24, an alumna of the graduate geography program, is the lead author of a new paper published in the high-impact scientific journal The Lancet Regional Health - Americas. Ulrich's research was advised by Dr. Maggie Sugg, an associate professor in the Department of Geography and Planning at Appalachian State University. The study, titled "Mental Health Disparities among Maternal Populations Following Heatwave Exposure in North Carolina (2011–2019): A Matched Analysis," analyzes the effects of extreme heat on maternal mental health, particularly among vulnerable subpopulations.
Supported by funding from the National Science Foundation and the National Institute of Environmental Health Sciences, Ulrich and her co-authors incorporated a matched analysis design using statewide hospital discharge data to examine emergency department admissions for psychiatric conditions during the warm season. The researchers examined extreme heatwaves by matching them with unexposed periods and using advanced environmental epidemiological models at the sub-county scale. They also examined the moderation of key variables, such as the rural-urban continuum, physiographic regions, neighborhood racial and economic inequality measurements and individual-level sociodemographic factors.
The findings from the analysis indicated significant increases in maternal mental health burdens following heatwave exposure. Acute heatwave periods were associated with a 13% higher risk of severe mental illness, while prolonged exposure to moderate-intensity heatwaves was associated with 37% higher risk. Individual factors and neighborhood-level characteristics further modified the risk of adverse maternal mental health outcomes.
In addition to contributing to the growing evidence of the impact of extreme heat on maternal mental health, the findings emphasize the influence of socioeconomic and environmental contexts on mental health responses to heatwave exposure.
"As a department, we take great pride in the groundbreaking research conducted by our faculty and graduate students," wrote Dr. Saskia van de Gevel, chair of the Department of Geography and Planning. "The Lancet represents the highest standard in global health scholarship, and we are proud of our students engaging in health geography research of this caliber. Under the mentorship of Dr. Maggie Sugg, Sarah Ulrich's thesis exemplifies the critical contributions our students are making in addressing urgent public health challenges, reinforcing the importance of rigorous, data-driven complex analyses in an era of climate uncertainty. Scientific inquiry and data accessibility are essential for advancing knowledge and driving meaningful change."
Dr. Dennis Guignet, an associate professor in the Department of Economics at Appalachian State, and Dr. Jennifer Runkle, an environmental epidemiologist at the North Carolina Institute for Climate Studies, co-authored the study with Sugg and Ulrich.
Ulrich, originally from Jamestown, earned her bachelor's degree in geography with minors in urban and regional planning and environmental justice from the University of North Carolina at Chapel Hill (UNC-CH). She graduated from App State in 2024 with her master's degree in geography with a concentration in planning. Ulrich is currently pursuing her doctorate in geography at UNC-CH. In the future, she hopes to pursue a career in academic research focused on the intersection of geography and environmental justice.
Related: Geography graduate student Sarah Ulrich awarded NSF GeoHealth award
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About the Department of Geography and Planning
The Department of Geography and Planning promotes the understanding of the spatial dimensions of human behavior within the physical and cultural systems of the earth, and the role of planning in achieving improvement in those systems. The department offers degrees in geography and in community and regional planning. Learn more at geo.appstate.edu.
About the College of Arts and Sciences
The College of Arts and Sciences (CAS) at Appalachian State University is home to 17 academic departments, two centers and one residential college. These units span the humanities and the social, mathematical and natural sciences. CAS aims to develop a distinctive identity built upon our university's strengths, traditions and locations. The college’s values lie not only in service to the university and local community, but through inspiring, training, educating and sustaining the development of its students as global citizens. More than 6,800 student majors are enrolled in the college. As the college is also largely responsible for implementing App State’s general education curriculum, it is heavily involved in the education of all students at the university, including those pursuing majors in other colleges. Learn more at cas.appstate.edu.
About Appalachian State University
As a premier public institution, Appalachian State University prepares students to lead purposeful lives. App State is one of 17 campuses in the University of North Carolina System, with a national reputation for innovative teaching and opening access to a high-quality, affordable education for all. The university enrolls more than 21,000 students, has a low student-to-faculty ratio and offers more than 150 undergraduate and 80 graduate majors at its Boone and Hickory campuses and through App State Online. Learn more at appstate.edu.
By Lauren Gibbs
February 10, 2025
BOONE, N.C.
Sarah Ulrich '24 (left) and Dr. Maggie Sugg (right) are co-authors of a new paper published in the high-impact scientific journal The Lancet Regional Health - Americas.
Sarah Ulrich '24 (left) and Dr. Maggie Sugg (right) are co-authors of a new paper published in the high-impact scientific journal The Lancet Regional Health - Americas.