From natural disasters to drug addiction to rising energy demands, these are challenging times. But ask any USC researcher and they’ll tell you: Symptoms spark solutions.
After burn
Wildfires take a major toll on life and property
Five years ago, a news story about a fire in California sparked a change in Mohammed Baalousha’s research that could help mitigate the fallout.
A professor of environmental health sciences in the University of South Carolina’s Arnold School of Public Health, Mohammed Baalousha studies the safety of engineered nanomaterials — ultra-tiny particles designed to do everything from delivering drugs into human cells to improving electrical conductivity in computer chips. He was particularly interested in understanding how such particles seep into water and soil and how they might impact environmental and human health.
Then one evening, while he was explaining his research to his 8-year-old daughter, a news story about California wildfires grabbed his attention. That was in 2020, long before the most recent wildfires in and around Los Angeles overtook headlines and captured our attention, but the problem was already a serious one.
“My daughter was talking about nanomaterials, I was seeing fires, and I realized I wanted to link them together,” Baalousha says. “I wanted to look at how fires impact the formation of nanomaterials, what kind of nanomaterials are generated during fires and how they get released into the environment.”
The devastation on TV was occurring in the western United States, but Baalousha knew that his research would be relevant nationwide, including in the Southeast.
The western United States may be ground zero for wildfires in the U.S., with hundreds of thousands of acres burned each year due to the dry climate, but wildfires are not uncommon in South Carolina. In a typical year, according to the South Carolina Emergency Management Division, firefighters respond to more than 5,000 wildfires across the Palmetto State. While the fires tend to burn much smaller areas compared to those in the western U.S., climate change could lead to larger burn areas in South Carolina.
And even when they don’t happen in the state, fires elsewhere can still impact air quality. The 2023 Canadian wildfires led to air quality alerts statewide.
Since shifting gears, Baalousha has learned a lot about what happens to nanomaterials and metals when they burn. He and his colleagues have been studying soil, ash and water samples from major California disasters, including the 2020 LNU Lightning Complex and North Complex fires, research that is supported by a National Science Foundation grant. Then, after a devastating wildfire tore through Maui in August 2023, Baalousha received another National Science Foundation grant to study samples from there, too.
“Because it’s right at the coast, there were a lot of concerns about these materials flushing into the ocean, impacting coral reefs and so on,” he says.
The list of related research projects has continued to grow. Recently, he and other scientists from the California State University, Chico and the University of California, Davis, received funding from the National Science Foundation to collect and archive ash, soil and water samples from the Park Fire, which consumed 429,000 acres of wildland in northern California.
In collaboration with colleagues at the Université Laval in Quebec, Baalousha also investigated the release and dispersion of nanoplastics and metallic nanomaterials from open-air waste combustion, a common waste management approach, in Canadian Indigenous Arctic communities.
Closer to home, he and a multidisciplinary team of USC researchers have also partnered with researchers at Clemson to gather data from two burn sites in South Carolina. That project, he hopes, will shed light on how contaminants from lower-intensity prescribed burns differ from those produced by wildfires. Additionally, he is leading another NSF project, in collaboration with Susan Richardson in USC's chemistry and biochemistry department, to investigate how wildfire intensity impacts metal transformations and mobilizations along with the formation of byproducts.
Some data from these projects has been published in journals including Environmental Science and Technology and Journal of Hazardous Materials. Other analyses are ongoing, but his team has already made surprising discoveries into how wildfires impact the surrounding environment.
“The biggest thing we started learning, and it scares me sometimes, is when you burn materials, they completely change,” he says. “Materials in the structures or in the trees that are naturally benign — metals like chromium or arsenic, for example — can be present in one form before the fire, but the fire transforms them into potentially more mobile and more toxic forms.”
Arsenic, which most often occurs as arsenic(V) in the environment, is a prime example. Baalousha’s team has found that wildfires convert some of the arsenic(V) into arsenic(III), a form that is more mobile and more bioavailable. When colleagues at the Environmental Protection Agency recently reported seeing higher arsenic concentrations in aquifers near burn areas, he wasn’t surprised.
“That could explain why this is happening,” he says. “Because if the arsenic goes from arsenic(V) to arsenic(III), it becomes more mobile, and when it rains, it gets flushed into the groundwater.”
Not all fires are equal when it comes to environmental contaminants. Vegetation fires result in less metal mobilization because trees absorb metals from the soil in low concentrations. Structure fires, on the other hand, are a mixed bag of materials with elevated metal concentrations — electronics, copper pipes and treated wood, to name a few. That’s a concern in places like Maui, where more than 2,200 structures were destroyed, according to the U.S. Fire Administration.
What does this mean for our health? Research has shown a link between fire exposure and dementia as well as increases in hospitalizations, cardiovascular disease and respiratory disease. Baalousha believes some health issues could be related to metal transformations during fires. For example, his team has found that wildfires can transform iron into magnetite, a particle that has been linked to Alzheimer’s disease. And fellow Arnold School researcher Sean Norman found that metals in wildfire ash can alter bacterial growth and gene expression, potentially increasing antibiotic resistance.
Baalousha is also collaborating with colleagues at the Arnold School and with Mohamad Azhar at USC’s School of Medicine Columbia to further understand the impact of metal transformations in wildfire on metal uptake in aquatic organisms and cardiovascular disease.
Understanding these potential dangers is necessary as wildfires worsen. Since the mid-1980s, the total area burned by U.S. wildfires has steadily increased, and today fire season peaks a full month earlier than it did 40 years ago, according to the EPA. Case in point: This year’s devastating Southern California fires were unusual for January.
“Now the fire season is becoming longer and longer,” Baalousha says. “I was at a conference recently, and they were saying that we’re moving from a fire season to a fire year. There could be consistent exposure for a longer duration, and the longer you expose people, the more they’re breathing in.”
Beyond the diagnosis
Xueying Yang tracks HIV care from youth to adulthood
In the epidemic’s early years, HIV and AIDS were death sentences. Most who tested positive were dead within 1-2 years of AIDS diagnosis.
Today, thanks to advances in antiretroviral therapy, people with HIV can expect to live nearly as long as those in the general population.
While longer lifespans are a victory in the fight to end the HIV epidemic, they present new public health challenges. For researcher Xueying Yang, an assistant professor of health promotion, education and behavior in USC’s Arnold School of Public Health, one of those challenges is ensuring that young people with HIV successfully transition to adult-oriented health care.
“The pediatric-to-adult HIV care transition, or HCT, is often viewed as a high-risk time for care disengagement, where youth must navigate forming new relationships with providers and taking on greater independence in their care,” Yang says. “Therefore, HCT is a pressing public health issue with implications for ongoing national efforts to end the HIV epidemic in the U.S.”
Yang has been awarded a $400,000 grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to study these transitions. Her team will use data available through USC’s Big Data Health Science Center to better understand the factors that help or hinder the shift to adult HIV care.
Their findings matter in South Carolina, which has the nation’s ninth highest HIV case rate. Approximately 20,000 state residents have an HIV or AIDS diagnosis. The Palmetto State sees about 1,500 new HIV diagnoses each year, a quarter of which are in people age 24 or younger. Poverty is a driving factor behind those figures and can exacerbate a young patient’s odds of disengaging with health care providers.
“Youth living in economically disadvantaged areas, such as South Carolina, are less likely to make appointments and demonstrate consistent adherence to antiretroviral therapy,” Yang says. “Poverty can impact prioritizing competing needs such as food and housing over adherence to care and may also affect logistical needs in the health care transition process, including insurance and transportation to the clinic.”
Then there are the other challenges that come with an HIV diagnosis. Mental health issues, for example, are already common during adolescence, and they can be even worse for young people grappling with an HIV diagnosis. That’s before adding in the stigma and discrimination often experienced by the sexual, gender, racial and ethnic minorities who are disproportionately affected by HIV/AIDS. And in South Carolina, there is always the potential complication of health care access for those living in the state’s rural areas.
These factors and others likely influence the pediatric-to-adult care transition. But to get the full picture, Yang’s team will analyze 15 years of statewide HIV cohort data from the South Carolina Department of Public Health. Since HIV reporting is mandatory, these electronic health records offer the researchers a comprehensive look at South Carolina’s HIV landscape.
The dataset captures data over a period of time, allowing the team to assess whether transitions were successful, delayed or failed. They will also be able to study how patients fared post-transition and whether factors like substance use or socioeconomic status correlate with specific outcomes.
Young people who fall through the cracks not only risk their own health but put the community at risk, too.
“To fully realize the public health benefits of treatment innovations,” Yang says, “this population must remain engaged in care after their transition to the adult oriented care so that they will remain healthy, maintain the undetectable viral load and reduce the secondary transmission.”
The study’s insights may help state health departments develop more targeted intervention strategies and allocate resources in the communities where they’re needed most. They may also provide evidence to support new strategies, such as expanding access to pediatric HIV services or integrating HIV care with mental health services.
And Yang is hopeful that the findings will guide policymakers as they improve the systems and services that young people living with HIV depend on.
“I know that’s a challenge,” she says. “Policy change is not one step forward. It’s really a lot of changes, but I hope that it will tell them, ‘This is the current situation. These are the areas that need to improve.’”
Treatment access
Christina Andrews explores link between health care access and outcomes for people with substance abuse disorders
Substance use disorder has become one of the greatest public health challenges nationwide, and the problem is particularly pronounced in South Carolina.
Some hard facts: According to the Substance Abuse and Mental Health Services Administration, one in 10 Americans ages 12 and older has dealt with an alcohol use disorder in the past year. Similarly, one in 10 has struggled with a drug use disorder.
Meanwhile, in South Carolina, drug overdose deaths have doubled in the past five years. An estimated 450,000 people currently suffer from substance-related problems.
The numbers paint a stark picture. But to fully understand the issue, researchers also need data on whether people receive treatment. Getting that data isn’t easy.
“Right now, we do not have that information,” says Christina Andrews, an associate professor of health service policy and management in the Arnold School of Public Health. “It sounds so simple, right? But we don’t have it. And very few states actually do because it involves a lot of hard work to access the data and build relationships with partners in state government.”
Andrews is working to change that through two grants, totaling $5 million, from the National Institutes of Health. The studies will look specifically at Medicaid enrollees and assess the effects of the generosity of coverage for substance use disorder treatment on treatment access.
Why Medicaid? Forty percent of people with a substance use disorder are covered by the health insurance program. And even though Medicaid is partially funded by the federal government, it is managed at the state level and often outsourced to managed care organizations, meaning benefits aren’t consistent across the board.
“We understand that Medicaid managed care plans are making different choices about what to cover and how to restrict access to those benefits,” Andrews says. “But what does that actually mean for access to treatment? How does the generosity of coverage influence whether people get access to care, how long they remain in care? Also very importantly, how likely they are to have a drug-related overdose or even death? What we’re trying to do through these studies is tell that whole story.”
Her team has found that where a person lives and which managed care plan they use affect treatment access. Case in point: Some plans require prior authorization for buprenorphine, a prescription drug that cuts overdose risk up to 50 percent. Only a quarter of Americans who need buprenorphine end up receiving it.
“You could have great access to care with all of the key services and medications covered and freely available, where someone in another plan may have heavy restrictions on access and face a lot of hurdles to accessing care,” she says. “Things like prior authorizations, quantity limits and fail-first policies can make it difficult to get that treatment even when they have coverage.”
Addressing addiction
The University of South Carolina is committed to improving access to evidence-based addiction services and programs in the Palmetto State. That’s why, in 2022, USC partnered with other universities and state agencies to form the Center of Excellence in Addiction. USC leads the center’s Data Analytics Core, which is collaborating with the Big Data Health Sciences Center to build an interactive web-based dashboard of opioid-related data at county and regional levels.
“As we fortify that collaboration and coordination and communication, we’re able to do so much more than when we were operating alone,” says Sara Goldsby, director of the South Carolina Department of Alcohol and Other Drug Abuse Services, one of the center’s five partner organizations. DAODAS oversees the state’s response to the opioid crisis.
Goldsby, a 2015 graduate of USC’s joint public health/social work master’s program, says the center is tackling the state’s addiction crisis by analyzing data on the state’s treatment systems, providing evidence-based guidance for clinicians, assisting community leaders with abatement strategies and offering tele-mentoring to community leaders and stakeholders.
“The universities have so much brainpower and expertise that state governments really are not tapped into,” Goldsby says. “To be able to leverage that, to apply that knowledge and that expertise and the work that we’re doing in real time is incredible.”
Kinship care
KinCarolina studies outcomes in kinship placements throughout South Carolina
A stable home environment can give children the emotional, educational and financial support they need to become successful adults. And when parents are unable to provide that, close family and friends often step up to help.
According to recent KIDS COUNT data, about 6 percent of children in South Carolina reside with a relative with no parent present. These arrangements, known as kinship care, are sometimes made through the child welfare system, but most are informal.
Kinship caregivers are often — but not always — biological family who step in to help in the wake of child abuse, neglect, parental incarceration and other unhealthy situations.
“They could be grandparents, aunts, uncles, siblings, any relatives,” says Yanfeng Xu, an assistant professor in the University of South Carolina’s College of Social Work. “They also could be a family’s close friend, a neighbor, even the kid’s teacher.”
Research has demonstrated that kinship care is better for children, which is why the child welfare system prioritizes kinship placements. But when placements occur outside of the child welfare system, caregivers take on the extra responsibilities of raising children without the financial assistance and government services that foster parents receive.
“They are way underserved in the community,” Xu says. “There are scant resources or services for them. It’s like they are invisible in this society. But their needs are very high. That’s a mismatch.”
Xu focuses on improving the well-being of children in foster and kinship care. Her newest project, KinCarolina, studies how extra support can make a difference for families who have taken on kinship care responsibilities.
Funded by the Duke Endowment, KinCarolina studies whether a six-month intervention program — with peer-to-peer supports, peer support groups, educational trainings, and financial assistance — can improve outcomes of kinship caregivers and children in kinship placements.
The study focuses specifically on families raising children with disabilities or special health care needs, including ADHD and mental health issues.
“Based on the literature and our prior pilot study, we know this group of children is particularly underserved among all children involved in the child welfare system and in kinship care,” Xu says. “And often because of prior traumatic experiences, they have a high level of special health needs.”
At the conclusion of the study, well-being assessments for the intervention group participants will be compared to control group data to ascertain how increased support improves outcomes of kinship caregivers and their children. Xu and her team have also formed an advisory board to improve how South Carolina’s kinship caregivers navigate the available systems and resources at the system level.
Her research was partly inspired by her own experiences growing up in China, where child care truly does take a village. “My grandparents played an important role in my life,” she says. “It’s a very common practice in current Chinese society. Grandparents step in and help their kids raise their grandchildren together.”
She now hopes that her research might open the door for systemic policy changes in South Carolina and other states in the United States.
“It leads to less trauma for the kids, fewer behavioral and mental health issues, better academic outcomes, and it’s a more stable home for them,” Xu says. “They are able to stay in one place longer, and they can keep their cultural connections.”
A better battery
William Mustain leads charge for battery innovation in the Palmetto State
Today he’s an engineering professor and the director of the Carolina Institute for Battery Innovation in the Molinaroli College of Engineering and Computing, but William Mustain’s roots are working-class.
Mustain’s father worked on a manufacturing line his entire career. But he worked side-by-side with engineers and introduced his son to the profession at an early age — even making sure his son met several engineers as he started to find his college and career path. Seeing the types of problems they worked on and the impact their work had on people’s lives inspired the younger Mustain to become an engineer himself — and eventually a leading authority in the world of batteries and battery technology.
“I’m a first-generation college graduate,” Mustain says. “Getting my chemical engineering degree lifted my entire family tree out of poverty. The university can do that for people across the state. And I’m going to use our battery work to help.”
It’s already happening. In 2024, USC received $10.2 million from the U.S. Economic Development Administration to build out the Carolina Institute for Battery Innovation’s pilot-scale manufacturing and testing facilities on campus, building on USC’s four decades of experience in battery science and engineering. Mustain is the first director of CIBI and has a strong vision for where it will go.
CIBI is a key project of the SC Nexus for Advanced Resilient Energy, a statewide consortium federally designated as a Regional Technology and Innovation Hub. CIBI brings together nearly 100 battery researchers across disciplines to solidify the university’s reputation as a national leader in battery research, education and manufacturing.
Why now? South Carolina’s advanced manufacturing sector is growing by leaps and bounds. Meanwhile, the shift toward renewable energy and the need to increase grid resiliency have increased battery demand worldwide.
“Batteries are one of the key things that will enable grid resiliency — not just in South Carolina or the Southeast, but in California, Texas, Michigan and other states,” he says.
The institute is already attracting manufacturers to the Palmetto State. In 2023, Pomega Energy Storage Technologies broke ground on a $3,000,000 lithium-ion battery manufacturing plant in Colleton County. The facility will create nearly 600 jobs. Pomega has also co-sponsored a USC project with Mustain, four graduate students, and professors Golareh Jalilvand and Ralph White to develop digital twins — virtual models of large-scale energy storage batteries that can be used to test potential approaches to cut costs and enhance performance. In February 2025, Phenogy announced that their headquarters will move to Columbia, and they will collaborate with USC and CIBI in research, development and battery demonstration projects.
To bridge research and commercial manufacturing, CIBI’s pilot manufacturing lines will open the door to partnerships with manufacturers of all sizes seeking to test or validate products on a smaller scale before committing to full-scale production. “A pilot manufacturing line might cost $20 million to build,” Mustain says. “Not every small business or startup has the capability to build one. And not every large company wants to do pilot manufacturing in-house on every single idea that they have.”
These industry partnerships, as well as the influx of manufacturers, will mean big things for the state’s economy and job opportunities for USC engineering graduates. Already, Mustain fields calls from companies looking to create an employment pipeline with the college.
While the surge in battery research might come as a surprise to some, USC has long been ahead of the curve.
“The last five years have seen unprecedented investment,” he says. “That has led a lot of people to then try to become the experts. USC hired the first battery person in the 1980s. Batteries have been a core part of what we’ve been doing as a university for 35 years.”
