Summer 2007 - Protecting People, Protecting the Planet - Public Health by UC Berkeley School of Public Health

University of California, Berkeley School of Public Health

SUMMER 2007

Public Health The Magazine for Alumni and Friends

Protecting People, Protecting the Planet

WHATâ&#x20AC;&#x2122;S INSIDE Pg. 4

Hazards in the Environment

Pg. 7

Mapping for Health

Pg. 10 Evidence inside Our Bodies Pg. 15 Chemistry Goes Green in California

“Establishing a charitable gift annuity at the School of Public Health allows me to support work I believe in while providing income to loved ones.”

Beulah Taravainen is a retired public health nurse, counselor, and educator who remains a staunch supporter of her alma mater, Berkeley’s School of Public Health. “Obesity is one of the things the School is working on,” she says. “This complex problem is an example of the need to translate research into ways to help people.” Further, she notes, “the School’s emphasis on health promotion and disease prevention serves to enhance the quality of life for individuals and families as well as to cut down on the escalating cost of health care.” Beulah’s charitable gift annuity at the School of Public Health allows her to support crucial teaching and research while providing income directly to loved ones who were named as annuity recipients. “It’s a wonderful way to give an inheritance early,” she says. 3

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Support the School of Public Health If you are interested in making a gift of real estate or any other asset to support students, teaching, or research in the School of Public Health, call Pat Hosel, Assistant Dean, External Relations and Development, at (510) 642-9654, or e-mail phosel@berkeley.edu.

SUMMER 2007

University of California, Berkeley School of Public Health

Public Health The Magazine for Alumni and Friends FEATURES

Hazards in the Environment

Disease-causing agents are all around us—in water and air, in our homes and workplaces, in the United States and abroad.

Mapping for Health: New Approaches to Old Challenges

Advanced mapping technology provides a tool for researchers investigating a wide range of environmental health issues, including obesity, asthma, and exposure to emissions.

Evidence inside Our Bodies

Exposure to toxicants leaves traces in our bodies. Researchers are using this information in new ways—to understand how these exposures affect our health, and to effect change at the policy level.

Slums and Sprawl: Perspectives on the Built Environment 7

In developing countries, contaminated water and unsafe play areas endanger the health of the urban poor, while in the United States, overdependence on cars discourages physical activity and contributes to increased rates of obesity.

Chemistry Goes Green in California

A Berkeley public health alumnus and researcher is leading the charge to implement a safer and more environmentally sustainable chemicals policy in California.

In Rural Ecuador, Undergraduates Make a Difference

Student Spotlight: Water Expert Broadens Her Knowledge

Alumnus Spotlight: A Champion for Workers’ Health

DEPARTMENTS Dean Stephen M. Shortell, Ph.D., M.P.H. Assistant Dean, External Relations and Development Patricia W. Hosel, M.P.A. Editor Michael S. Broder Associate Editor Kelly Mills Design Archer Design, Inc.

Past, Present, Future Partners in Public Health Faculty News Alumni News In Memoriam

Contributors Michael S. Broder, Elena Conis, Monica Hazlewood, Johanna Van Hise Heart, Melanie Keilholtz, Lia Marshall, Kelly Mills, Sarah Yang Photography Peg Skorpinski, inside front cover, pp. 2, 10–11, 12, 13, 16, 21–22, 24–25, 29–30, 32–36, 38, 40–41, 46, 53, & back cover; istockphoto, pp. 2–3, 42, & 44; shutterstock, pp. 3, 6, 7, 9, 13, 15, 42, 43, & 45; Elizabeth Carlton, p. 5; corbis p.6; getty p. 7; Lee Riley, p. 12; Nigel Bruce, p. 17; courtesy of Lia Marshall, p. 18; William T. Larkins,

22 29 38 46 51

p. 23; courtesy of Saxon Donnelly/UC Berkeley, p. 28; Ellen Davidson, p. 44; John Minkler, p. 52. Communications Advisory Board Michael S. Broder, Patricia A. Buffler, William Dow, Eva Harris, Patricia W. Hosel, Joan Lam, Kelly Mills, Meredith Minkler, Linda Neuhauser, Steve Selvin, Stephen M. Shortell, Robert C. Spear, John Swartzberg.

UC Berkeley Public Health is published semiannually by the University of California, Berkeley, School of Public Health, for alumni and friends of the School.

UC Berkeley School of Public Health Office of External Relations and Development 417 University Hall #7360 Berkeley, CA 94720-7360 (510) 643-2556 © 2007, Regents of the University of California. Reproduction in whole or part requires written permission.

Public Health

From the Dean

It’s Time to Act

Dean Stephen M. Shortell

“Global Warming Leads To 150,000 Deaths Every Year” “Scholars Predict 50 Million Environmental Refugees By 2010” “More Than Half of U.S. Population Lives In Counties With Unsafe Air”

These headlines are bringing the health effects of continued environmental degradation to our doorstep. They are no longer abstract events that might occur far into the future. In addition to the 150,000 annual deaths, global warming causes 5 million illnesses annually, and these numbers are projected to double by 2030. Because global warming accelerates the spread of infectious diseases such as malaria and dengue fever, it will hit poor countries the hardest with associated increases in malnutrition and diarrhea. Ironically, it is the poor who are least responsible for the production of greenhouses gases that cause global warming. The gains being made by the Global Fund, by the Millennium Development Project, by the World Health Organization, and related efforts to eliminate poverty and improve health around the globe will be seriously mitigated by global warming. One result will be a marked increase in the number of environmental “refugees”—people displaced from their homes because of rising sea levels, desertification, dried up acquifers, weather-induced flooding, and related climate changes. Imagine Katrina on a global scale. Red Cross data indicate that more people are now displaced by environmental disasters than by war. Global warming will also greatly effect the air that we breathe. Smog-related deaths by climate change are projected to increase by about 4.5 percent from the 1990s to 2050. “Health-alert” days among cities in the eastern United States are likely to increase by 68 percent over the coming decades. Smog is directly associated with an increase in a number of respiratory illnesses. Particle pollution is associated with increases in heart attacks, strokes, and emergency room visits for asthma and cardiovascular disease, with children and the elderly particularly at risk. The effects of poverty and racial segregation and discrimination are also a factor, as black Americans are 79 percent more likely than white Americans to breathe unhealthy air because they live in neighborhoods where air pollution is highest.

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A multifaceted approach is needed to address these serious threats to our health. Such an approach will require bold research to develop more carbon-neutral energy sources that will eliminate or greatly reduce greenhouse gases; informed regulatory policies that balance competing economic and political interests in order to promote the public interest; a sensitivity to the ethical issues that underlie the inherent existing disparities in health and access to resources among different populations; and enlightened diplomacy to persuade all nations—developed and developing—of our shared obligation to care for the planet. In this issue of the magazine you will read about what our School is doing to address these and related environmental challenges, using both new and traditional approaches. This includes innovative research using biomarkers for assessing exposure risk; developing new surveillance methods; assessing the impact of the built environment on health; and a number of international initiatives. The School is also participating in campuswide initiatives to develop alternative clean energy sources through the recently announced Energy Biosciences Institute—Berkeley’s new $500 million partnership with the Lawrence Berkeley National Laboratory and the University of Illinois. Faculty are also involved with the Berkeley Institute of the Environment, which was recently established to foster collaboration across disciplines that address environmental problems and to train a new generation of environmental researchers, professionals, and citizens in protecting and nurturing our environment. We understand the imperative for all of us to act now. We hope you draw inspiration and ideas for your actions from the pages that follow.

Stephen M. Shortell, Ph.D., M.P.H. Dean, School of Public Health Blue Cross of California Distinguished Professor of Health Policy & Management Professor of Organization Behavior

Public Health

HAZARDS

in the Environment

By Kelly Mills

Traditionally, the field of environmental health sciences has focused on the harmful diseasecausing agents that are all around us, including biological, chemical, and physical environmental hazards. At the School, environmental health researchers engage in a number of activities within this approach, examining how our surroundingsâ&#x20AC;&#x201D;from our contact with water-borne parasites, to exposures to passive smoke, to occupational contact with infectious diseasesâ&#x20AC;&#x201D;can make us sick, and how we can protect ourselves, whether we live in industrialized urban centers or remote rural villages.

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DANGER IN THE WATER Robert Spear first became interested in the parasitic disease schistosomiasis in 1992. Schistosomiasis is caused by a water-borne parasite, schisto cercaria, which is transmitted by aquatic or amphibious snails and causes cumulative damage to blood vessels surrounding the intestines or bladder. It is prevalent in many parts of the world, including China, the country where Spear, a professor of environmental health sciences, first learned about the disease and subsequently focused his research. Because the disease is generally not fatal unless untreated for years and affects poor people in the developing world, it receives little attention. Most previous national efforts aimed towards dealing with it have involved drug treatment—which is only a partial solution because after receiving treatment, people resume activities involving water contact and become reinfected. An engineer by training, Spear, along with his students and Chinese colleagues, has focused on the environmental determinants of disease transmission and the associated environmental interventions for preventing the disease in rural villages. One of the areas Spear has researched is the appearance of the disease in geographic “patches.” For example, in one village, 65 to 70 percent of the people might have the disease, while only 8 percent are infected in a village just two kilometers away. It has become clear that the reasons for these local differences in disease prevalence relate to agricultural factors like fertilization use, crop type, and the nature

and operation of the irrigation system, as well as environmental temperature and rainfall patterns. These factors are summarized in an index the researchers call “internal potential” that is a property of an individual village. Researchers also discovered that “connectivity” is responsible for some of the variability. The irrigation system often connects villages, enabling the downstream transport of both the parasite and snail larvae. Also, some villages have a high degree of contact with each other through trade or familial ties, so that a village can be infected simply by the introduction of one water buffalo that carries the disease from another village. “You can eradicate the disease in one village,” says Spear, “but if the neighboring village has a high infection rate, the clean village stands a good chance of reinfection.” Both the local nature of internal potential and connectivity make it difficult to develop a broadly effective intervention strategy. Connected villages are sometimes in different counties and therefore fall under different jurisdictions. Often the locally effective intervention involves disparate government agencies, creating difficulties in cooperation and funding. For example, dirt irrigation ditches are a primary habitat for the snails, and pouring concrete irrigation ditches is one method of eradicating them. However, irrigation comes under the purview of government agencies responsible for agriculture, not public health, so they do not allocate funding for disease control.

The work of Spear and his colleagues has shown that in the mountainous areas of western China, successful interventions must be tailored to local conditions and often involve multiple strategies. This implies that public health workers need to be retrained to identify the local determinants of transmission, and government agencies have to cooperate and unify efforts. One intervention that has been well-received is the introduction of biogas digesters in some farmhouses. Traditionally, families in the villages disposed of human waste and pig waste in a large pit, and then use the waste as fertilizer for agriculture, often spreading parasites. However, if a home has a biogas digester, the family can dispose of waste in the digester, and the decomposition of the waste in an anaerobic environment produces methane gas, which can be used as an energy source. The parasite is destroyed in the process, so the waste can be used safely as fertilizer. Spear is continuing to work on schistosomiasis, with the objective of understanding the reemergence of the disease in a number of counties in Sichuan where it had formerly been suppressed to below detectable levels. A second new project utilizes genetic markers in the snail and the parasite to understand issues of connectivity at geographical scales greater than that of a village and its neighbors. continued on page 6 1 Undergraduate student Waiwai Hung collects a water sample from an irrigation ditch in rural Sichuan as part of a project to develop an improved method to detect schisto cercaria in water. 2 Three research teams were deployed to conduct surveys in 53 villages in an area where schistosomiasis was previously controlled and has recently reemerged. The team pictured includes Sichuan CDC staff, Jingyang County schistosomiasis control station staff, and three Berkeley students (Elizabeth Carlton, top left corner; Sacha Ferguson, lower left corner; and Waiwai Hung, lower right corner). 3 A woman spreads night soil (a mixture of human and pig waste) to fertilize her corn in a village in Sichuan. Because schistosome eggs are excreted in stool, night soil use can spread the parasite.

Public Health

Hazards, continued

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HARMFUL SECONDHAND SMOKE Public health has made many advances in the area of smoking, particularly in raising public awareness about the dangers of passive smoke. Historically, passive smoke studies focused on people living in a home with a smoker, but in the last 10 years, research has demonstrated that the workplace can be a primary site of exposure to secondhand smoke, and that there can be overlapping exposures. This has focused attention on the need for a more extensive exposure assessment. For example, one study a few years ago found an association between passive smoking and pre-menopausal breast cancer by separating studies with a comprehensive exposure assessment from those that isolated only home exposure. On the forefront of smoking research and advocacy is professor of environmental health sciences S. Katharine Hammond. Her research, and the work of others in the field, has dramatically increased public awareness of the dangers of secondhand smoke. Ten to fifteen years ago, says Hammond, discussions about smoking centered on issues like adding non-smoking areas to restaurants. Last year, when Hammond worked with the World Health Organization and talked with health officials about ways to prevent exposures to passive smoke,

“they didn’t even try to debate it,” she says. “The tobacco companies keep bringing up the debate, but most of the health organizations are clear we need to move to a smoke-free environment.” Now she believes the discussions will need to shift to protecting children exposed in the home.

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PROTECTING HEALTH CARE WORKERS Hospital workers are on the front lines as far as disease exposure, and they also have the potential to spread disease from one patient to another. Mark Nicas, an associate adjunct professor of environmental health sciences, has been investigating how effectively workers are protected from contracting respiratory diseases, and what strategies we need to employ in order to contain disease. For one study, he assessed how diligently three local hospitals followed protocols for isolating patients with tuberculosis. The protocols include admitting patients with TB or suspected of TB to a negative pressure room in order to minimize the spread of the bacilli through the air; having all health workers wear respirators when they enter the room with the TB patient; and requiring an annual TB skin test for hospital workers. In another study, Nicas worked with a textile chemist, Gang Sun, who developed an anti-microbial finish for fabrics. The finish can be applied to hospital gowns and bed linens in order to reduce the transmission of disease from hand-to-mouth contact—when the disease is spread through particles on surfaces such as gowns. Nicas developed a conceptual model of how a health care worker

might be infected, in order to determine what percentage of disease might be spread from surface particles, as opposed to airborne pathogens and droplet spray, or particles generally coughed onto another person. This information was then used to help determine whether the anti-microbial finish would be effective in minimizing the spread of disease. He found that surface contact could account for up to 50 percent of transmission. Recently Nicas applied this model to seasonal influenza A, in order to determine whether flu prevention strategies recommended by health agencies—maintaining social distance and regular hand washing—would be sufficient for curbing the spread of the disease. “The assumption has been that hand contact and droplet spray are the routes of transmission, and that inhalation is not an issue,” says Nicas. The results of his calculations indicated that inhalation of airborne agents actually could account for a significant portion of disease spread, raising questions about the need for further preventative measures in stemming influenza infection.

Mapping for Health By Kelly Mills

With the advent of Google satellite maps and global positioning devices for cars, people can now use technology to view a street online or get directions while drivingâ&#x20AC;&#x201D;but that is not all spatial mapping can do. Researchers in public health have been using technology such as Geographic Information Systems (GIS) for some time to better understand environmental factors influencing health. Faculty at the School are creating new ways of combining geography and health data, and as improvements in

technology make information more available and more relevant to understanding disease, we will likely see more breakthroughs in the ways geographic information is combined with other data to analyze and prevent risks to health.

New Approaches to Old Challenges

GEOGRAPHIC TECHNIQUES SHED LIGHT ON OBESITY Associate professor Michael Jerrett, considered one of the leaders in geography and epidemiology, is collaborating with other researchers to examine some of the most pressing health problems of our time. For one study, he and colleagues are examining the relationship between obesity and the built environment using geographical data. Intervening during childhood is critical, says Jerrett, because obesity is rising rapidly around the globe, and 80 to 85 percent of those who are obese at age 18 remain obese for their lifetime. He is looking at access to parks and other space for physical activity continued on page 8

Public Health

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Mapping for Health, continued and proximity to healthy food options to see if there are links between these geographic factors and the development of childhood obesity. Using a sample of 11,500 children, his team has been able to map the home address of each child and examine whether the neighborhood offers activity and healthy food access. Jerrett is also examining other factors, such as air pollution, to see if these have a significant impact on obesity as well. ZEROING IN ON AIR POLLUTION, ASTHMA Another study that uses geographic data is the Fresno Asthmatic Children’s Environment Study (FACES), which aims to determine the effects of pollution on children with asthma. Originally funded by the California Air Resources Board as part of its effort to study vulnerable populations, the study is led by School of Public Health professors Ira Tager, S. Katharine Hammond, John Balmes, Kathleen Mortimer, and Mark van der Laan, along with Helene Margolis of the EPA and Fred Lurmann of Sonoma Technologies.

Because Fresno is an EPA Supersite, detailed information is available on chemical monitoring of the environment. Researchers selected a sample of children ages 6 to 11 living within a 20-kilometer radius of the Supersite. They added the EPA information to extensive monitoring of indoor and outdoor areas of 87 of the children’s homes and to detailed monitoring of some of the schools using mobile trailers. “The goal,” says Tager, “is to characterize the spatial distribution of air pollution in that community, so that through modeling we can assign air pollution exposures to each child for every day of the five years we are following the child.” Children in the study also wear GPS devices for a two-week period, so that they can be tracked to help refine the models. The children are studied in all seasons of the year, the air pollution distribution is characterized, and from all the data collected personal exposures and responses to daily changes in air pollution can be assessed. “That information will

help us understand what the relationship is between how they responded to daily changes in air pollution and the growth of their lungs, and the severity or lack thereof of their asthma over the period of time we are following them,” explains Tager. In another asthma study, Oakland Kicks Asthma, Tager works with graduate student Sheryl Magzamen and professors Balmes and Jerrett as part of the CDC’s Controlling Asthma in American Cities Project. The study has added a very extensive asthma surveillance system in schools. Magzamen is using the home address data from the study and looking at the geographical distribution of asthma in relation to a number of social and environmental characteristics. Currently she is examining proximity to freeways, but she plans to add other demographic information, such as indices of poverty and housing. Using sophisticated mapping and statistical analysis, the team hopes to determine which populationlevel factors are influencing asthma severity and occurrence.

Ensuring the Safety of Biofuels With the rush by scientists, venture capitalists, policy

“One of the reasons we want to develop biofuels is

be grown using pesticides that would adversely impact

makers, and engineers to develop biodiesel and other

they can be carbon neutral: You burn them and then

neighboring communities. And the processes of remov-

alternative fuels, most public discussion of the subject

the plants grow back. But you want to make sure

ing the fuel from the source and transporting it to

centers on the methods and feasibility of producing a

that biofuels really are carbon-neutral, because some

various regions both have potentially harmful impacts.

given fuel and the issues related to switching to differ-

agricultural processes deplete carbon out of the soil,”

Fuel storage is another major problem: For example,

ent sources of energy. However, any breakthrough in

says McKone.

MTBE was found to disperse more easily than other gas additives, and leaking has seriously contaminated

biofuels could have unintended consequences—for the health of the population and for the environment.

Another concern is that while biofuels may be helpful

ground water.

in dealing with global warming, there is the possibility Tom McKone, adjunct professor of environmental

they could create a public health dilemma. Methynol,

“People are bothered by what they see as our negativ-

health sciences, currently conducts research for the

for example, is more efficient to make, but it has a

ity,” McKone laughs. “But history is full of examples—

California Environmental Protection Agency on the

higher toxicity than gasoline, and causes blindness at

from nuclear power to DDT—of unintended impacts of

impacts of alternate fuels. He is also working with other

low doses.

new discoveries.”

Biosciences Institute (EBI) to ensure that the alternative

McKone and researchers from the campus’s Depart-

McKone and others in the group hope to serve as

fuels it develops constitute an improvement, not a haz-

ment of Civil and Environmental Engineering, the

sentinels in the process, to guide the new technologies

ard. McKone and colleagues are building a framework

Energy and Resources Group, and Lawrence Berkeley

and ensure advances in alternative energy don’t create

to look at the whole cycle of biofuels—from production

Laboratories are developing a framework to mea-

a new set of hazards.

to storage to transport to use—to assess the potential

sure the impact of new fuels in other areas as well.

impacts on things like communities and biodiversity.

Switchgrass, one possible source for biodiesel, might

UC researchers to establish a component of the Energy

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ized. Using the school-based survey approach, we can pick up asthma that doesn’t lead to hospitalizations—which is the bulk of asthma.”

NEW WAYS OF TRACKING DISEASE The methods developed in Oakland Kicks Asthma can be used by researchers in other regions of the country. The CDC is currently providing funding to many researchers to contribute to environmental public health tracking. In response to congressional concerns, the CDC has taken steps to develop better public health surveillance for a range of diseases, and environmental diseases are crucial to this effort. One part of the surveillance effort is to create a state-based network to link the environmental data about air pollution to health outcomes on an ongoing basis. Whereas most studies are developed for a finite period, this infrastructure would follow and monitor climate change, water quality, and season-related issues such as high temperatures with health. Balmes and others are working on methods for this tracking. For example, Balmes is collaborating with Tager on linking the survey data from Oakland Kicks Asthma with environmental exposure information such as traffic data. Balmes is also replicating the surveillance system of Oakland Kicks Asthma in Fresno and other areas, which will make it possible to study the impact on asthma of other environmental factors more specific to that region—pesticide exposures, for example. This can be done using Geographic Information Systems (GIS) techniques: Addresses can be geocoded and then assigned exposures using software based on distance from fields. Since pesticide use is tracked, this information can be linked to outcomes. “The national system tracks asthma by following hospitalizations,” says Balmes. “That is only tip of the iceberg. Most kids with asthma aren’t hospital-

If these methods are successful, it will mean new ways of tracking asthma and of examining the possible links between pesticide exposures and asthma. Fresno also provides an interesting area of study, because, as Hammond points out, “It is a kind of mini-lab for global warming: It is drier, hotter, and more polluted than other areas.” Understanding asthma in Fresno may yield clues to future health problems presented by climate change from global warming. SPATIAL ANALYSIS GIVES INSIGHT INTO EFFECTS OF GAS EXPOSURE Adjunct professor of epidemiology Michael Bates is combining survey data with spatial analysis to study the health effects of hydrogen sulfide gas. Populations exposed to the gas often raise concerns about possible health effects, particularly because of the gas’s strong “rotten eggs” odor. “Worry about a bad smell in itself can generate symptoms,” says

1990s Bates carried out preliminary studies of the Rotorua population using data from the New Zealand national health care system. These studies suggested that exposure to the gas may have some effects. Now Bates and colleagues are beginning work under a grant from the National Institute of Environmental Health Sciences (NIEHS) to conduct a five-year study of Rotorua residents. The study is a collaboration among researchers from a number of schools, including Balmes from UC Berkeley and several investigators from UC Davis, Stanford University, and the Wellington School of Medicine in New Zealand. They plan to study the impact of hydrogen sulfide on the nervous system, the respiratory system, and the eyes, using a battery of medical tests. The researchers are currently developing detailed study protocols, and will recruit 1,800 people for the project. They will also survey participants about residential and employment histories. These data will be linked to results of detailed modeling of the distribution of hydrogen sulfide concentrations across the city to determine levels of exposure for participants.

If these methods are successful, it will mean new ways of tracking asthma and of examining the possible links between pesticide exposures and asthma. Bates, noting that this makes it harder to understand the health risks of exposures. While the gas is highly acutely toxic, most people receive only sporadic, relatively low-level exposures, through proximity to places like sewage treatment plants, oil refineries, and large-scale animal feeding operations. However, the New Zealand city of Rotorua has a steady exposure to hydrogen sulfide gas. The town was built on a geothermal field, complete with geysers and boiling mud pools. One of the main geothermal emissions in the city is hydrogen sulfide. Since Rotorua has the largest population in the world with relatively high exposure to hydrogen sulfide, it is an ideal site for studying possible health effects of long-term exposure to the gas. In the

“The idea is to be able to create a longitudinal exposure profile for each one of the participants,” says Bates. Since there are many communities in the United States and elsewhere exposed to hydrogen sulfide, it is important to understand whether there are any health effects. There has even been speculation that global warming and climate change might result in greater levels of the gas in our environment, so knowing whether or not the gas is harmful over time may become increasingly important.

Public Health

Evidence Inside Our Bodies By Kelly Mills & Michael S. Broder

What do our bodies reveal about the toxicants to which we have been exposed? The chemicals that surround us can leave traces in our bodies and even alter our cells. Researchers at the School are using this information as a tool to identify which environmental exposures are affecting us, and to understand how they will influence our health throughout our lifetimes. BIOMARKERS REVEAL EARLY-LIFE VULNERABILITY Biomarkers are measurable changes in an organism at the cellular or molecular level. One of the primary advantages offered by biomarker research is that by looking at cellular changes, risks can be identified without having to wait for a population to develop a disease. Biomarkers also allow scientists to mea-

sure exactly how certain exposures are metabolized in the body, and at what doses. They help uncover important evidence that some segments of the population may metabolize toxicants differently than others, and that it may depend on the exposure levels. Associate adjunct professor Nina Holland, a director of the Children’s Environmental Health Laboratory and the School of Public Health Biorepository, uses biomarkers in her research on children. Exposures can have a greater impact on children because they are still developing, both physiologically and cognitively, and their smaller size also makes them more vulnerable.

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“Many things that can happen that affect the health for the rest of children’s lives occur early, maybe even before the child is born,” says Holland. In collaboration with other researchers at the School, including the Center for Health Analysis of Mothers and Children of Salinas (CHAMACOS), Holland has examined the impact of a number of exposures on the short and long-term health of children. CHAMACOS, directed by professor of epidemiology Brenda Eskenazi, continues to develop findings from a longitudinal study of the impact of pesticides and other toxins on Latino children and mothers in the agricultural area. Holland and other CHAMACOS researchers look at biomarkers linked with pesticide exposure to determine the impact on growth, neurodevelopment, and respiratory health. Two studies published last year found that some newborns may be 26 to 1 50 times more susceptible to exposure to certain organophosphate pesticides than other newborns, and 65 to 130 times more sensitive than some adults. OZONE EXPOSURE LEAVES SIGNS OF DAMAGE Global warming and the consequent increase in ozone in the atmosphere have led Holland, with Ira Tager, professor of epidemiology, and John Balmes, professor of environmental health sciences, to examine the effects of chronic exposure to ozone on respiratory health, particularly as an antecedent to chronic lung disease. Balmes had previously conducted studies on the acute effects of

ozone in his lab at UCSF using controlled exposures. The researchers examined UC Berkeley students from Southern California and from the Bay Area to look at genetic markers of susceptibility to ozone, and they also took blood samples to examine markers of oxidative stress. “We found some interesting differences in the kids who grew up in Los Angeles. versus the kids who grew up here in the Bay Area,” says Balmes. “The students who grew up in L.A. had higher levels of oxidative stress, even though they were currently all here.” In a controlled experiment, they then took a subgroup of the students and exposed them to ozone comparable to red-day levels using the EPA’s air quality index. The researchers found injury to chromosomes, as well as evidence of oxidative stress with the same biomarker used for the larger group. This validated the use of the biomarker for the population study. The researchers hope to collaborate in future projects to explore this issue further. Tager and Balmes will both present findings at an upcoming National Academy of Sciences review panel on ozone and mortality. In collaboration with the Holland lab, they are also adding the samples to the biorepository, so that they will be available for continued research. METABOLISM MATTERS Many chemicals that we think of as toxic aren’t intrinsically so, but once they are metabolized, they can produce a host of very toxic byproducts. Adjunct professor Stephen Rappaport has examined biomarkers of exposure, or levels of chemicals or chemical products in the blood and urine of workers. After documenting exposures, his lab develops specific analytic tests for parent chemicals or metabolites in order to better understand the metabolism of the chemicals. Rappaport has looked at a variety of polycyclic aromatic hydrocarbons from asphalt work, jet fuel, and diesel exhaust. He has also worked extensively with professor of toxicology Martyn Smith in evaluating occupational exposures to benzene. They recently found

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non-government sectors.

that benzene is metabolized much more efficiently at lower exposure levels, to which most of us are routinely exposed from car exhaust and passive cigarette smoke. Since EPA’s standards for benzene are based on risk estimates drawn from very highly exposed workers, this finding has important implications.

a research scientist and lecturer at the School, has been working with Smith and the UC Berkeley Superfund Center to develop methods for translating biomonitoring research findings for policy and stakeholder audiences. While biomonitoring itself is not new, its use as a method in public health surveillance and policy is new, says Kyle.

“Since in the case of benzene, the risk is related to metabolism, EPA’s risk assessment assumes the rate of metabolism is the same at high and low exposure levels,” says Rappaport. “In our studies, we found that people exposed to low levels of benzene produced about ten times more metabolites per unit of exposure than people who were exposed at high levels. So in fact the risk of leukemia from benzene exposure may be about ten times higher than the current EPA estimates based on the extrapolations.” Significantly, the findings from the benzene study led the EPA to reduce the allowable levels of benzene in gasoline in 2006.

“What we’ve done in the research translation program at Berkeley, which I think is novel, is to start with the questions that people in our audiences want answered, rather than starting solely from whatever research results we’re reporting,” says Kyle. “We’re trying to bring the intellectual and scientific knowledge that we have in the university setting into the grounds where people are actually working on public policy questions, and not necessarily limit it to our last published paper.”

BIOMONITORING IN POLICY DIALOGUES In recent decades, scientists have used biomonitoring —a technique that looks at evidence of exposures in our bodies—to identify broad environmental health challenges in the population. Amy Kyle,

On September 29, 2006, Governor Arnold Schwarzenegger signed SB 1379 into law, establishing the California Environmental Contaminant Biomonitoring Program and making California the first state to enact such a program. Kyle and colleagues organized and led a series of workshops to help those involved in developing and implementing the legislation, which provided an opportunity for discussion among academic, government, and

Some of the discussion at the workshops touched on the importance of understanding the average experience of the population versus the importance of looking at people who are most affected—a classic public health question, says Kyle. Another important issue that came up concerned people’s right to their own information. “This has been a big question in the national debate over biomonitoring,” she says, “because the tradition of the medical community, and to a great degree the research community, is not to give people their information unless it has a very specific clinical interpretation. The environmental protection world, however, is more in the ‘right-to-know’ tradition.” Ultimately, the decision for the legislation was that people have a right to know what chemicals are in their bodies. Kyle believes this will have repercussions over time for research. “It’s more likely that research results will be provided to people who want to know.” Kyle notes the knowledge resources of the University, which were key to the bill’s development, will continue to be important now that the bill has passed. For example, four of the nine members of the panel that will provide the scientific guidance for the bill’s implementation come from the School of Public Health.

“What these discussions have done is make more of the parties who are going to be implementing the bill aware of the way that different people see it, and create more alignment in thinking and a deeper understanding of the issues,” says Kyle. “For policy makers, having an opportunity to explore, engage, ask questions, think, and talk in an environment that’s not political is invaluable.” 1 Professor Nina Holland discusses the latest results from an experiment with her postdoctoral researcher, Connie Chen, Ph.D. ’07, M.P.H. ’03. 2 Doctoral student Karen Huen, M.P.H. ’05 (left), and undergraduate Seung Pak retrieve biological specimens from the liquid nitrogen tank.

Public Health

Slums & Sprawl

Perspectives on the Built Environment

The built environment—created by people rather than nature — has a profound impact on the health of those who live, work, and play therein. UC Berkeley Public Health asked two experts from the School’s faculty to discuss the health issues of two different built environments: slums and sprawl. Lee Riley has conducted extensive research on health among the urban poor in slums of Brazil, India, and other countries. Richard Jackson has published widely on the health effects of sprawl in the United States and is coauthor of the book, Urban Sprawl and Public Health.

Slums: Contaminated Water and Unsafe Play Areas Cause Disease Lee W. Riley Professor of Epidemiology and Infectious Diseases What do you believe are the primary problems affecting health in urban slums in developing countries? Health in urban slums is affected by multiple factors. Of course, the root cause is socioeconomic. However, there are many environmental structural factors unique to each slum that engender very specific types of health problems. Slum houses built on hills—common in Brazilian cities—have limited access to piped water, since pumps are needed to deliver water to higher grounds. Limited access to clean, potable water is associated with a variety of infectious disease problems, especially diarrhea in children. Houses built along open sewage runoffs, riverbeds, and estuaries (spaces not likely to be taken over by developers) undergo flooding during rainy seasons. Flood water gets contaminated with rat urine, which is associated with epidemics of an often fatal, kidney-damaging disease called leptospirosis. This happens seasonally in Brazil, India, and China. Vertical, multi-story brick or cinderblock houses built due to lack of open recreational spaces are associ-

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ated with falling injuries. Roofs of these buildings are used by children to play (flying kites, etc.), and by adults who get drunk. Slums built next to city dumps upon which the slum residents depend financially (recycling) create conditions that favor occurrence of severe acute and chronic respiratory diseases, diarrhea, and even congenital defects, such as hydrocephalus. Slums are often built adjacent to factories that spew out toxic chemicals and wastes, which are associated with a variety of illnesses as well as death. For example, the 1984 Bhopal pesticide disaster that killed more than 20,000 slum dwellers.

What steps should we take to mitigate the poor health effects? The long-term solution, of course, is poverty alleviation and reducing socioeconomic disparity. This is not likely to happen in our lifetime, despite many well-meaning interventions. But the structural problems—open sewers, lack of barriers on roofs, lack of open recreational spaces, preventing toxic chemical and waste spillage, and preventing exposure to particulate matter released from city dumps—are all amenable to simple structural corrections.

What strategies can we use (policy, interventions, etc.) to prevent these

kinds of poor outcomes in future communities? The most important policy-based intervention is to reduce wealth (and greed): wealth of developers, politicians, investors associated with multinationals, and even urban planners. Then, study and identify the immediately correctable defects in the built environment that directly or indirectly contribute to the health problems of slum residents. Identify groups, organizations, and individuals who can correct these defects, and correct them. This will not solve all the health problems, but it will help to prevent many.

Are there any additional issues public health leaders and policy makers should consider with regards to the built environment? Probably the most important consideration is the recognition by the public health leaders and policy makers that the formal health sector is already expending a large proportion of its resources in taking care of the severe complications of the easily preventable health problems the slum dwellers encounter. These leaders and policy makers need to recognize the existence of this often neglected or invisible population and institute direct interventions in their communities that will prevent the severe complications of preventable health problems.

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Sprawl: Inactivity Leads to Obesity and Related Illnesses Richard J. Jackson Adjunct Professor, Environmental Health Sciences and Health Policy and Management What do you believe are the primary problems affecting health in U.S. cities and suburbs? Today, California, the United States, and the rest of the world confront epidemics of chronic disease: long-lasting difficult diseases like diabetes, obesity, depression, osteoporosis, and cancer. They are costly. “Years of Life Lost” due to obesity is now predicted to cause as much as a 22 percent reduction in life expectancy. The direct cost of obesity and physical inactivity has been estimated at 9.4 percent of U.S. health care expenditures. Obesity increases the risk of becoming diabetic in adulthood nearly 40 times, and today’s children may be the first generation in American history to live less long than their parents. We and our children increasingly cannot walk to where we need to do our life work: schools, sports fields, friends’ homes, libraries, shops or churches. The difference between highly walkable and

non-walkable communities is an average of about seven pounds of body weight. We have “designed” a lot of incidental exercise, such as walking, out of our lives. In 1969, 48 percent of American students (90 percent of those who lived within a mile) walked or bicycled to school. In 1999, only 19 percent of children walked to or from school and 6 percent rode bicycles to school. Overall, Americans walk or bike a trivial amount—only about 6 percent of our trips—as compared to close to 50 percent for the people of Scandinavia. Yet the best way to banish depression and reduce obesity and diabetes is to walk. For persons with diabetes, walking for exercise just two hours per week reduced their death rate by nearly 40 percent. If you ask people why they don’t walk or bike, you get answers like: “There are no sidewalks or bike routes or nearby destinations or transit stops.” Or “I don’t feel safe. We don’t have people watching out for each other the way we did when I was young.”

What steps should we take to mitigate the poor health effects? The built environment must be designed to support people making healthier choices. A doctor telling a patient to exercise is useless if there is nowhere to

walk or run. A neighborhood’s design dictates how people get around, for example walking or bicycling versus automobile use. Transit-oriented neighborhoods generate 120 percent more pedestrian and bicycle trips than those that are car-oriented. We need to create cities and towns that meet the planet’s demands and our pocketbook needs for efficiency; places that allow a child or someone elderly, disabled or poor to meet their life needs for safety, autonomy, transport, access to healthy food and medical care, and to culture and community. We must stop pretending that if we build endless tract houses on fine agricultural land that these human benefits will magically spring up. Better habitation helped beat infectious diseases; it can help to beat the chronic disease epidemic as well.

What strategies can we use (policy, interventions, etc.) to prevent these kinds of poor outcomes in future communities? We need to preserve green space around our cities for “urban edge agriculture”—it brings meaningful work, fresh and local food, air and temperature benefits, and aesthetics. This won’t happen under continued on page 14

Public Health

Genomics Technology Opens Doors to New Possibilities The completion of the Human Genome Project in 2003 has made incredible new technologies available to environmental health scientists. Professor of toxicology Martyn Smith, research toxicologist Christine Skibola, and associate adjunct professor Luoping Zhang are applying these technologies at the Molecular Epidemiology and Toxicology Laboratory, where Smith is director and Skibola and Zhang are associate directors. Working with colleagues in the School and across campus, they are employing new methods that open up possibilities for a new era of scientific discovery. For example, the Genome Project has made it possible to scan the whole DNA sequence for variations that confer susceptibility to environmental diseases and chemical toxicity. The National Cancer Institute recently granted funding to Skibola to scan the human genome for genetic traits that confer susceptibility to lymphoma, a cancer whose incidence has risen dramatically in recent years. Assistant professor of epidemiology Lisa Barcellos is performing a similar scan on multiple sclerosis patients. This research, called “whole genome association” studies, will provide new clues to the adverse gene-environment interactions that cause chronic diseases. Zhang is looking for susceptibility genes using another new technology called RNA interference (RNAi). With Christopher Vulpe of the College of Natural Resources, she uses whole genome analysis initially to look for candidate genes that confer sensitivity to toxic chemicals in yeast. RNAi is used to confirm these candidates in human cells and variation in confirmed genes is examined in human populations exposed to these chemicals. Vulpe and Zhang, with epidemiology professor Allan Smith, are looking for genes that confer susceptibility to arsenic toxicity, while Zhang and Martyn Smith are studying susceptibility to other important environmental pollutants such as benzene, trichloroethylene and formaldehyde. Their work should explain why some people are sensitive to the toxic effects of chemicals and others are not. This will improve risk assessments for these chemicals and help identify and protect susceptible members of the population. Zhang and Martyn Smith are also using these new technologies to better understand the causes of childhood leukemia, working with Patricia Buffler, who holds the Kenneth Howard Kaiser & Marjorie Witherspoon Kaiser Chair in Cancer Epidemiology. As part of the Superfund Basic Research Program, they are using new “omics” methods that detect the expression of genes and proteins to better separate out different forms of leukemia. The project will determine whether these different forms, or “subtypes,” of leukemia have different causes. If different forms have different causes, applying “omics” methods may make it easier to see associations between exposure and effects because these can be assessed separately. With Richard Mathies’s group in the Chemistry Department, Martyn Smith and Zhang are working to develop new high throughput methods for the detection of cancer-related mutations in humans. Such methods could help better predict who will get cancer and detect it early enough for treatment. This research aims to rapidly sequence the DNA of single cells. It forms part of a new Center in Exposure Biology, led by adjunct professor Stephen Rappaport, which has been funded at $1 million per year by the National Institute of Environmental Health Sciences. The center’s main goal will be to apply new technologies, including genomics, lab-on-a-chip, and biosensing, for use in epidemiology studies of blood cancers. “In all my years of research,” says Martyn Smith, “this is the most exciting time, with major breakthroughs possible in the coming year or two as the new center’s collaborative work kicks into high gear.” 14

University of California, Berkeley

Slums & Sprawl,

continued

current tax policies, which make big box stores and auto malls (which generate large sales tax revenue) the desired new developments. Some will say this is expensive, but I think there is a need to compare continued sprawl with the costs of continued bad health and sprawl-requiring car use.

Are there any additional issues public health leaders and policy makers should consider with regards to the built environment? We must rebuild our existing cities; it is absurd to have our downtowns devitalized by acres of baking asphalt. This can be done. Twenty-five years ago when I lived in Berkeley I did not enjoy my many visits to Sacramento. The capital city had no rail service and the city seemed a sea of parking spaces. The downtown (except for the immediate Capitol Park area) was tumbledown and culturally moribund. In 2004 when I returned from CDC in Atlanta to be the California state public health officer, I was pleased with how Sacramento had improved; it has made great strides in reclaiming its downtown, its parks and community. It is now a lively, diverse place filled with lots of young people, good restaurants, and a resurgent cultural life. Capital Area Development efforts have been a major contributor to the change, as have city leaders pushing for vacant and underutilized land to be redeveloped, not just for high rises, but for quality live-work-play multi-story developments with first floor retail, second floor commercial, and third floor and up residential units. This habitation style, so successful in U.S. and European cities, creates an energy- and land-efficient habitation that supports a 24-hour lifestyle with restaurants, transit, culture, and sport. With adequate density and tax base, public safety, sanitation, and other services improve as well.

Chemistry Goes Green in California By Kelly Mills

Most of us feel secure in the belief that chemicals used in consumer products and industrial processes are safe; surely they must be highly regulated to ensure they pose little or no risk to people or the environment. Surprisingly, this is far from true. The U.S. Toxic Substances Control Act of 1979, which was intended to regulate chemicals both before and after they enter commerce, does not require chemical manufacturers to disclose information on the toxicity of the substances they introduce into the market. It also greatly constrains the EPA’s capacity to control the sale of chemicals that are known to be hazardous. “We have built a chemical industry that markets its products—42 billion pounds each day—on the basis of their function, price, and performance,” says Michael P. Wilson, research scientist at the Center for Occupational and Environmental Health (COEH). “The hazard piece, how these substances affect human health and ecosystems, is largely missing as a consideration in the market.” This explains, says Wilson, why “one can earn a Ph.D. in chemistry at universities across the United States without demonstrating even a rudimentary understanding of toxicology or ecotoxicology. These

topics are not part of the curriculum of chemistry students today simply because they are not all that valued in the chemicals industry.” As a consequence, hazardous chemicals have remained competitive in the market, and the public is exposed to them every day in the workplace, in consumer products, and in air, water, food, and waste streams. Scientific evidence showing that chemical exposures can cause chronic diseases, particularly when they occur early in life, continues to accumulate. Professor of epidemiology and maternal and child health Brenda Eskenazi participated in the findings of this past May’s “International Conference on Fetal Programming and Developmental Toxicity,” which concluded that “toxic exposures to chemical pollutants during these windows of increased susceptibility can cause disease and disability in childhood and across the entire span of human life,” and that “these adverse effects have been linked to chemical pollutants at realistic human exposure levels similar to those occurring from environmental sources.”

Potentially hazardous chemicals run the gamut, from those used in the manufacture of goods to consumer products sold at local hardware stores. In California, an estimated 23,000 workers each year are diagnosed with a deadly chronic disease attributable to chemical exposures in the workplace. Enter “green chemistry.” This phrase has become part of the lexicon in California and Washington, D.C., as policy makers have conducted hearings and sponsored legislation and policies that would motivate the production of chemicals that are more environmentally sustainable and safer for the public. The attention is due, in large measure, to a UC Berkeley report, Green Chemistry in California: A Framework for Leadership in Chemicals Policy and Innovation, authored by Wilson and colleagues and published in March of 2006 by the California Policy Research Center, under the aegis of the UC Office of the President. The report, commissioned by the California Senate Environmental Quality Committee and the Assembly Committee on Environmental Safety and Toxic Materials, calls for California to implement a modern chemicals policy or pay the price in environmental and health damage and lost opportunity for new investment in cleaner chemical technologies. It points out that much of the industrial world, particularly the European Union, has already implemented continued on page 16 Public Health

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Chemistry Goes Green, continued such policies, and that by neglecting to follow suit, the United States runs the risk of losing markets and becoming a “dumping ground” for substances prohibited for sale in other parts of the world. When it was released, Wilson’s report produced a firestorm of interest among policy makers and

In August 2006, Wilson was asked to testify before the U.S. Senate Environment and Public Works Committee at the first hearing on the U.S. chemical management system and the Toxic Substances Control Act in 10 years. In May this year, California’s EPA launched the ambitious Green Chemistry Initiative, prompted and enabled by the report. Califor-

The United States runs the risk of losing markets and becoming a “dumping ground” for substances prohibited for sale in other parts of the world. advocates, as well as stiff resistance from the national chemical lobby, the American Chemistry Council, which scrambled to refute it. Other industry leaders, however, confided to Wilson that the analysis was correct, and many softened their position, with some even calling for internal reform and continued leadership by UC Berkeley.

nia State Senator Joe Simitian (D-Palo Alto) and Assemblyman Mike Feuer (D-Los Angeles) have each proposed far-reaching legislation that would help pave the way for California to become a national leader in green chemistry and chemicals policy. Some California industries that are major purchasers of chemicals—such as the electronics and health care industries—are beginning to examine

Michael Wilson and colleagues authored an influential report calling for California to become a global leader in green chemistry innovation.

hazardous chemicals in their supply chains, and they are developing new standards that must be met by chemicals suppliers. Observers attribute the success of the report to a number of factors. Rather than focus on banning or regulating one or two toxic substances, for example,

What Makes an Intervention Sustainable? Catherine Koshland has looked at multiple aspects of combustion, fuels, and emissions, and while her lab employs the latest technologies and has developed new technologies for diagnostics, Koshland believes it doesn’t end there. To develop successful, sustainable interventions to improve health and the environment, she says, it is necessary for researchers to move away from simply creating technological advances, to examine through fieldwork whether the latest alternative energy source is actually workable for the people it is designed to aid. Many interventions have failed because engineers, researchers, and officials neglected to find out if the new technology would actually prove helpful or be maintained in the long term, says Koshland, who is a professor of environmental health sciences, the Wood-Calvert Professor in Engineering, and UC Berkeley’s vice provost for academic planning and facilities. For this reason, Koshland, along with her former student Susan Fischer and anthropologist John Young from Oregon State University, conducted an ethnographic study on the implementation of an alternative bioenergy system in northeast China. The project they examined was an attempt to replace the use of coal or wood for household cooking with a biogas derived from corn stalks. To assess the environmental health impact, they made a series of measurements

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of indoor air quality as well as villagers’ exposures to carbon monoxide. They also conducted interviews and made observations of villagers, the development team implementing the project, and officials in the village and elsewhere to assess the social and economic impact. “Our goal was to try to understand the factors that contribute to a successful project,” says Koshland. They found some serious flaws in the intervention: Although the project was portrayed as a success by the development team, there were problems with its implementation, operations, and contracts, which led to spotty availability of the fuel and poor financial performance. Villagers were very unhappy with the project as a result as their real needs, and concerns were not considered in the project design or in its implementation. Koshland holds that more studies like this are needed when interventions are designed and implemented. “We can’t just work in isolation, she says. “One of the things that characterizes the Berkeley environmental health sciences group is that while we all may be doing fundamental work in the lab…that work is all embedded in a larger context of understanding the landscape around you.”

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Wilson and his colleagues examined the structural problems in the chemicals market and the chemical regulatory system, and they integrated public health concerns with those of economic competitiveness and industrial innovation. Wilson assembled researchers from a wide range of disciplines to guide the report, such that the final document is a multidimensional, solution-oriented analysis of the role of industrial chemicals and their role in society, now and in the future. As a result, the report speaks to a wide range of concerns, from California’s competitiveness in the global economy, to the growing impacts of the state’s expanding population, to the ethical dimensions of allowing children and workers to be exposed to known toxic substances. The report has become a model of effective interdisciplinary work at the intersection of science and policy. Wilson’s interest in chemical safety, particularly among workers, was sparked by his years of work as a firefighter and a paramedic with the Salinas Fire Department, south of San Jose. Not only were he and his coworkers exposed to myriad occupational hazards, they were often called to the scene of workers injured in the Salinas agricultural industry. Most of these calls were for traumatic injuries; some involved chemical exposures. At 36, he came to the UC Berkeley School of Public Health for the express purpose of finding solutions to occupational diseases and injuries. He earned a master’s degree in public health in 1998 and a doctorate in 2003. In his dissertation, he conducted an exposure analysis among auto mechanics in the Bay Area who had developed a neurological disease that caused them to lose function in their limbs. With COEH physician Robert Harrison at UCSF, Wilson traced the origins of the disease back to the mechanics’ use of cleaning solvents that contained hexane, a known neurotoxic solvent. “Here we are in this modern industrial economy with workers using a well-known neurotoxic chemical under totally uncontrolled conditions, inhaling the vapors, and becoming disabled,” says Wilson. “The more I looked at this issue, the more it became obvious that this was not an isolated event but was a lens into an enormous set of problems with the way we design, use, and regulate industrial chemicals.”

Four years later, California is now poised to become the national leader in green chemistry innovation. Stay tuned. To access the reports noted in this article: The Green Chemistry Report: coeh.berkeley.edu/ news/06_wilson_policy.htm

International Conference on Fetal Programming and Development Toxicity statement: www.pptox.dk/ The California EPA Green Chemistry Initiative: www. dtsc.ca.gov/PollutionPrevention/GreenChemistryInitiative/index.cfm

Air Pollution: It’s Not Just Outside “Most people, when they think of air pollution, think about outdoor air pollution—smog in the cities,” says Kirk Smith, who holds the Brian and Jennifer Maxwell Endowed Chair in Maternal and Child Health. “But poor people in rural areas of the world are using poor-quality fuel, which produces a rather large amount of pollution. If they have a stove without a chimney, particulate matter is released right where people are every day. It is among the most important causes of ill health for approximately 40 percent of the world’s population.” Smith has spent more than two decades working to establish the relationship between the use of biomass fuel—wood, crop residue, and dung—and ill health, especially among women and children who spend most of their days within the confines of poorly ventilated houses. Although not widely recognized, the problem is extensive: The World Health Organization estimates that two-thirds of the developing world rely upon these biomass fuels. In homes without ventilation, exposures to particulate matter, along with carbon monoxide, formaldehyde, benzene, nitrogen dioxide, and other gases, can reach 1000 µg/m3 over a 24-hour period—more than 20 times higher than the standards set by the U.S. Environmental Protection Agency. The consequences of burning biomass fuel are especially tragic for children. Consistent exposure to airborne particulates increases the incidence of acute lower respiratory infections (ALRI), such as pneumonia and bronchitis, in children under five years of age. In less-developed countries, where access to medical attention is limited, ALRI is the primary cause of death among children. Although Smith and others sounded the alarm about indoor air pollution in 1984, it took until 2001 to convince funding agencies to support the first randomized control trial. The recently concluded study, conducted in Guatemala, has found a roughly 40 percent reduction in serious childhood pneumonia in households with improved chimney stoves compared to those using open woodfires for cooking. While the statistics for indoor air pollution are staggering in the amount of mortality and morbidity they describe, Smith holds out hope that his careful gathering and interpretation of data will offer a clearer picture of worldwide public health risks and prompt interventions that save lives.

Public Health

In Rural Ecuador, Undergraduates Make a Difference By Elena Conis What do you do with students with big ideas? You give them money. And that’s exactly what the Center for Occupational and Environmental Health (COEH) did to help a group of Berkeley undergraduates realize their dream to make a difference in the lives of Shuar indigenous villagers in Ecuador. The dream was born when Lia Marshall, now a senior majoring in public health, volunteered in the province of Pastaza and was asked by the local people to continue collaborating with them on development projects.

assess current water usage and sanitation practices. On the way they slogged through knee deep mud, spent a day lost in the jungle, played and danced with the children, revised their methodology to overcome the initial distrust of the villagers, and

of their project—to adapt, test, and implement appropriate technologies to reduce widespread water-related illnesses among the 1,000 villagers in the Shuar communities. Their receipt of another $5,000 award, as one of the first 25 winners of a new initiative by UC Berkeley aimed at helping students with “Big Ideas,” has enabled them to make a second trip to extend their previous work. In this follow-up project, the

Undaunted by the enormity of the request, she mobilized a multidisciplinary team through the Cal Undergraduate Public Health Coalition in fall 2005. They designed a proposal for the COEH Student Award program to address malnutrition, safe water, sanitation, and other health needs of the Shuar community. COEH faculty reviewing their project were enthusiastic, but let the students know that they were trying to accomplish too much in their summer field work. Three months later, after successfully shepherding a scaled-back project focused on water and sanitation through the rigorous human subjects protocol process, five students (Marshall, Karis Miyake, Timothy Morrison, David Reynoso and Celeste Wong) set off for Amazonian Ecuador. Buoyed with excitement and their $5,000 award to pay for travel and project expenses, they set off not knowing they were in for a physical, mental, and emotional marathon. Working with local health officials, they hiked from village to village (10 in all), conducting surveys to

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Lia Marshall (second from right) and colleagues hike through the jungle to reach villages where they conduct surveys as part of their project to bring safe water to Shuar villagers in the Pastaza province of Ecuador.

learned that providing clean water would both meet an expressed need of the villagers and have the most impact on community health. The students promised to come back with practical interventions for improving their water. Since their return to Berkeley, the students have been analyzing their data, making multimedia presentations, and seeking more funding for the next phase

students will first communicate to the communities the results of last summer’s needs assessment and environmental health survey. They will then work with community members to conduct pilot studies to assess the feasibility of six different methods for decontaminating water. Finally, they will evaluate the efficacy of these methods by measuring levels of E. coli bacteria as an indicator of the quality of the primary water source in each community.

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The campus put up $100,000 in seed money for the Big Ideas initiative and posted the winning projects on its new web site, Big Ideas@Berkeley Marketplace, where alumni, friends, foundations, and corporations interested in the ideas can donate to the projects. The aim is to mobilize additional financial and in-kind resources to support student ideas. The COEH-funded Ecuador project has not only attracted more funding, but also more students, now working on two projects. One will continue their focus on safe water for the Shuar communities, and the other will tackle the nutritional issues they originally proposed, but had to postpone. They hope to raise $20,000 and attract donations of frequent flyer miles so that as many of the students as possible can travel to Ecuador to contribute to their goal of empowering the Shuar people with the skills and knowledge needed to achieve and sustain a reduction in morbidity and mortality from waterborne diseases. More information on the projects can be found at the Big Ideas web site: bigideas.berkeley.edu. This article originally appeared as “What Do You With Students With Big Ideas?” in the January/February 2007 issue of Bridges, published by the University of California Center for Occupational and Environmental Health. It is reprinted with permission.

If you would like to support projects such as these, please make your check payable to the “School of Public Health Fund” and indicate “student-initiated field projects” in the memo line. Send it to External Relations and Development, School of Public Health, UC Berkeley, 417 University Hall #7360, Berkeley, CA 94720-7360. Contributions can also be made at egiving.berkeley.edu/urelgift/public_health.html. (Indicate the fund name in the “Specific instructions for this gift” box.)

Letter from the Field Children with swollen bellies and skin rashes from parasites bathe in the Amazon ian river. Their mother stands next to them washing the family’s clothes while the two youngest kids of 11 fill their poma (plastic bottle) with water for drinking and cooking. Twenty meters upstream sits the community’s one letrina (outhouse), which consists of a hole through which feces and urine flow directly into the river. Witnessi ng scenes such as these the prior summer first inspired our Cal Undergraduate Public Health Coalition to further investigate the water usage and sanitation practices of these Shuar communities and to conduct a needs assessment to determine the communities’ other environmental health concerns. After an eight hour trip from Quito, our technical assistant tells us to get off the bus. There are no signs—just a small path that leads up to a house in the jungle where his mother and 10 siblings live. This will be our home for the next seven weeks. In the first 10 days, we conduct pilot studies with the nearby community of San Ramon. Making many five-hour roundtrips to the nearest city, Puyo, we revise our surveys and prepare for an intense five weeks of research. Working with the director of health for the District of FENASH, we plan our route to 10 Shuar commun ities within the district. The mud sucks our black rubber boots as we make our first trip into the interior. Five hours later while entering Shakap, we see this community’s primary “water source.” A trickle leads into a large puddle, which is surrounded by rocks with detergent marks and a wooden board for bathing. This site foreshadows what we will later find in other communities—most people use one water source for everythin g— drinking, cooking, bathing, and washing. Our time in the communities had been packed with challenges and obstacles to overcome, which ranged from dealing with community politics, working in extreme environmental conditions, to adapting to a new culture. However, from these experiences we also learned an incredible amount, including how to design, revise, and conduct culturally appropriate surveys and research. We gained practical experien ce in earning the confidence of communities, respecting cultural practices without compromising research methods/results, and working around local conflicts . We also enjoyed an amazing cultural exchange. From attending graduations, baptisms, and clausuras (end of school year ceremonies) to drinking chicha (fermented yucca) and eating mainly yucca, platanos and papa china (starchy “vegetables”), we were fully immersed in the culture. Playing soccer with each community and dancing with the Shuar in their many community celebrati ons brought us even closer to the people. —Lia Marshall

Public Health

Student Spotlight

Charlotte Smith: Water Expert Broadens Her Knowledge By Johanna Van Hise Heart Charlotte Smith, M.A., has risen quickly to the top of her field: She was director of water quality for a corporation that managed 35 drinking water utilities in 15 states; she has published extensively in peer-reviewed journals; she has traveled internationally to offer her expertise in distribution system water quality and regulatory compliance planning; she presents often at professional conferences; she has served the American Water Works Association in several leadership capacities; and she has served on a committee of the National Academy of Sciences. Yet she feels she can do more. To that end, Smith, a first-year doctoral student in environmental health sciences, is back in school after 20 years of professional work at New York City’s Department of Environmental Protection, the General Water Works Corporation, and as an independent consultant. Even if she didn’t have a master’s degree in community health, Smith would be considered a public health professional by virtue of her dedication to providing clean drinking water. “Water quality is public health. If you work to make the water clean, you are looking after public health,” she says. But, so far, she has worked primarily on the operations side of the business—assessing the quality of water after it has been treated, solving the mystery of how quality degrades as it moves through pipes and storage facilities, and identifying ways to fix or counteract problems.

studies is the use of chloramines. Chloramine (compounds of chlorine bound with nitrogen) enables disinfection to occur without the production of harmful chlorinated byproducts. Smith is an expert in employing a “booster chloramine” approach, which enables disinfection to occur without the presence of excess free chlorine and the potential generation of harmful byproducts. This balance between adequate disinfection and overuse of harmful chemicals is one that the water industry has struggled with for more than 30 years. Who can recommend a best practice that balances costs, feasibility, and potential impacts on health? And who is positioned to revise regulations as research reveals more information about water treatment methods and the health risks they pose? Smith hopes her graduate work in public health will enhance her ability to offer assistance. “My interest in degradation of water quality has always been more about the impact on health than the chemistry,” she says. “The public health degree will give me a broader sense of issues from the public health perspective.”

nical work group that will evaluate data and advise negotiators who are revising the “Total Coliform Rule,” one of many gauges of water quality. The rule requires that utilities monitor for coliform bacteria, a family of bacteria that live in the lower intestines of mammals. The presence of coliforms in water indicates contamination and the possible presence of dangerous pathogens, some of which are methodologically difficult to detect. While many strains of coliform are harmless to humans, some, including E. coli, cause problems such as acute gastrointestinal illness. The “Total Coliform Rule” revisers will need to consider what coliform levels should be deemed acceptable and even whether measuring for coliform bacteria is the most effective means of determining health risks. “It is one thing to understand that coliform levels are high and that pathogens may be present,” says Smith of what she will contribute, “and another to understand the risk of disease that the numbers represent.” Smith hopes she will be able to do more good as the complete package. “I often say I have depth but not width. The doctorate will provide me breadth.”

Smith is an authority on assessing and managing drinking water contamination that occurs in distribution systems after the water has been treated. Many water treatment facilities use chlorine as a disinfectant to kill disease-causing organisms. Water engineers know water is disinfected when they can measurably detect excess chlorine. However, any chlorine that does not chemically act to kill organisms can oxidize other organic matter to form potentially carcinogenic chlorinated byproducts.

Already Smith has new opportunities to apply conSo, while as a water quality expert she may already nections between water quality and public health. have arrived, there is a world of difference yet to Recently, she attended a Committee of State and make. “This is what I am all about. This is what I Territorial Epidemiologists conference sponsored by do,” she jokes. “My epitaph will be: ‘She tried to the Centers for Disease Control and U.S. EPA concerning water-borne disease outbreak. “Water utility make the water safe.’” staff and epidemiologists attended the conference,” reports Smith, “but there were very few people who understood both perspecSmith (front left) served on a committee of the National Academy of Sciences that published the tives. It was very exciting book, Drinking Water Distribution Systems: Assessing and Reducing Risks. that I could understand the issues from both perspectives.” The two disciplines have their own languages and methods, and coursework in biostatistics and infectious disease is providing her the tools to appreciate the interrelated work of many disciplines.

What can be done to mitigate carcinogen production in our drinking water? One method Smith

Smith has also been invited to sit on the tech-

University of California, Berkeley

Alumnus Spotlight

Garrett Brown: A Champion for Workers’ Health By Kelly Mills Garrett Brown, M.P.H. ’91, has devoted his professional life and volunteer time to protecting the health of workers, both locally and around the globe. Brown is a compliance officer in the Oakland District Office of the California Division of Occupational Safety and Health (Cal/OSHA). In his 14 years with Cal/OSHA, Brown has conducted more than 500 inspections in Alameda County and as part of statewide teams inspecting California’s Central Valley agricultural fields and garment sweatshops in Los Angeles and Orange County. Brown responds to worker complaints about unsafe conditions in their workplaces, investigates accidents (including worker fatalities), and conducts programmed inspections of high hazard industries, such as agriculture in the Central Valley and garment sweatshops in Los Angeles and Orange counties. Since 1993, Brown has also served on volunteer basis as coordinator of the Maquiladora Health and Safety Support Network (MHSSN), which includes more than 400 occupational health and safety professionals in Canada, Mexico, and the United States. The network provides information, technical assistance, and Spanish-language trainings, all pro bono, to Mexican workers in maquiladoras (factories) on the U.S. border, and conducts ongoing projects in Central America and Asia. The network has organized many trainings in factories that produce goods for major brands. In Indonesia, two trainings were conducted in 2000 and 2002 with a dozen labor, women’s, human rights and communitybased non-governmental organizations and six trade unions. One training included a full day site visit to a 8,000-worker Korean contractor plant producing for Nike. In China, the 2001 project involved a rare partnership between international brands (Adidas, Nike, and Reebok), their Taiwanese contract manufacturers, migrant workers from western China, and four Hong Kong-based labor rights NGOs. The training took place inside a 30,000-worker Taiwanese operated factory making goods for Adidas. In Central America, two trainings with independent monitoring groups, trade unions, women’s and human rights organizations have been conducted in Guatemala in 2003 and 2004. As part of the trainings, day-long field exercises were conducted in two Korean operated garment plants producing for Gap Inc. and other U.S. retailers.

WE’RE IN THE

TOP THREE The Epidemiology Monitor recently compared magazines of all the accredited schools of public health in the United States. UC Berkeley Public Health was ranked in the top three, along with magazines from the Johns Hopkins Bloomberg School of Public Health

As Brown says, “Economic globalization means that environmental and occupational health are more important that ever before. Workplace hazards are now truly spread throughout every country in the world—‘developed’ and ‘developing’ alike—and the impact of industrial production now reaches into virtually every village and every ecosystem around the globe. Public health training and a genuine public health approach to growing workplace, community, and environmental health problems is essential for our collective survival on the planet.”

and the University of Michigan

In October 2003, Brown was a guest co-editor of a special issue of the International Journal of Occupational and Environmental Health (IJOEH) on the vital issue of occupational safety and health in China. He also authored an article on the impact of “lean manufacturing” production techniques on workplace safety in China, which will be published in the IJOEH in late 2007.

The committee called our

In December 2004, Brown authored two major reports issued by the MHSSN on ways the NAFTA trade agreement has failed to protect Mexican workers’ health, and what measures are needed in international trade and investment treaties to effectively protect workplace safety and health in the global economy. Brown has published articles on global occupational health and safety issues in the a number of publications, including IJOEH, New Solutions, Multinational Monitor, Occupational Hazards, Social Justice, The Synergist, and Industrial Safety and Hygiene News.

School of Public Health.

publication “outstanding” and commented that “the

color and photographs in this magazine are among the clearest and most striking of all the magazines.”

Public Health

Past, Present, Future

Farewell, Warren Hall In 1955, construction was completed on Warren Hall, which became home to the School of Public Health. It was named in honor of the chief justice of the United States and former governor of California, Earl Warren, whose commitment to social justice and the public good are hallmarks of the School’s ongoing work. Now, 54 years later, the seismically unsafe building is being vacated in preparation for demolition in early 2008. The campus has received donor support to build the Li Ka Shing Center for Biomedical and Health Sciences on the Warren Hall site. This new facility will house teaching and research focused on the fundamental molecular mechanisms underlying human health and disease. It will include programs in cancer biology, infectious disease, neuroscience, and stem cell research, among others—but it will not serve as a replacement home for the school. Plans are under way to establish a new home for the School of Public Health nearby. The University has acquired the property bordered by Oxford Street, Hearst Street, Shattuck Street, and Berkeley Way, where the former Department of Health Services

building—also seismically unsafe—still stands. The Chancellor has expressed his support for a new building for the School of Public Health to be erected on that site, serving as an anchor for a new Community Health Campus, which may also include the School of Optometry, the clinical portion of the Psychology Department, and part of the Helen Wills Neuroscience Institute. The School will soon be embarking on a major capital campaign to secure the necessary funds for the new building. In the meantime, University Hall (across the street from the current Warren Hall) will serve as the School’s interim home, housing the library, administrative and student services, and most of the School’s non-wet-lab faculty. Wet-lab faculty will be located in Barker, Hildebrand, and Koshland Halls. Watch for updates on the status of the School’s plans for the new building in future issues of UC Berkeley Public Health. THE SCHOOL HONORS ITS PAST On May 4, 2007, many of the School’s students, alumni, staff, and current and former faculty came together to pay tribute to the School and share

3 4

reminiscences at an event titled “Honoring Our Past, Creating Our Future: A Celebration of the School of Public Health and Its History in Warren Hall.” The program included presentations by Chancellor Robert Birgeneau, who addressed the campus’s commitment to securing a new home for the School; Dean Stephen Shortell; former deans Warren Winkelstein and Patricia Buffler; and four of the School’s distinguished alumni: Alameda County Health Department director Tony Iton, M.D., J.D., M.P.H. ‘97, California Dept. of Health Services director Sandra Shewry, M.S.W., M.P.H. ’81, UCSF professor Nancy Padian, Ph.D. ’87, M.P.H. ’83, and CDC director Julie Gerberding, M.D., M.P.H. ’90 (who delivered her greeting by video). Longtime staff member Abbie Smith and student representative Alberto Ortega also shared their thoughts on the occasion. Photos and a webcast of this historic event can be viewed at sph.berkeley.edu/gallery/06-07/ honoring.html.

1 The soon-to-be-demolished Warren Hall was home to the School of Public Health from 1955 to 2007. 2 At a special event to commemorate the School’s history in Warren Hall, former dean Joyce Lashof (left) and Lucy Johns, M.P.H. ’67, talk with Anthony Iton, M.D., J.D., M.P.H. ’97. 3 Dean Stephen Shortell and former dean Joyce Lashof were two of four deans present for the occasion. 4 Former dean Warren Winkelstein (left) and Chancellor Robert Birgeneau listen to opening remarks by Dean Shortell. 22

University of California, Berkeley

Past, Present, Future

5 5 UC Berkeley Chancellor (later UC president) Clark Kerr presided over the dedication of Earl Warren Hall on September 17, 1955. 6 The Public Health Library was located on the ground floor of Warren Hall. 7 Public health students spent many hours in the Anita Baldwin Auditorium. 8 Before the construction of Warren Hall, laboratory courses were held in the Life Sciences Building.

7 8

Public Health

Past, Present, Future

Commencement 2007: Graduates Join a Global Movement As a medical officer with the World Health Organization in the 1970s, this year’s commencement speaker, Larry Brilliant, M.D., M.P.H., managed the smallpox program in India, leading a team of more than 100,000 workers, who in two years successfully searched out the last cases of variola major, essentially eradicating the disease in the subcontinent. Brilliant founded the Seva Foundation and, in 2006, became the first executive director of Google.org, the philanthropic arm of the renowned search engine company.

Excerpts from Commencement Address by Larry Brilliant May 12, 2007 - Zellerbach Hall I had a very typical life for someone from the ‘60s. Four decades ago, I went to medical school. I spent my freshman year marching for civil rights, my sophomore year at teach-ins against the war in Vietnam, my junior year building free clinics, and my senior year driving around the Soviet Union studying international health systems. Then I came to San Francisco for my internship, became a hippie doctor, joined a commune, got on a bus from San Francisco to the East, changed buses in London, spent a couple years on the road to Kathmandu, lived in a monastery for two years, and then exchanged my ashram robes for a three-piece suit and became a WHO medical officer. Typical story for my generation. ...

I have probably seen over 5,000 cases of smallpox. Some of these children died in my arms or were already dead when their mothers handed them to me in a desperate hope that a UN doctor could cure them. Once, in the city of Tatanagar, India, I was in charge of an epidemic of smallpox so severe that thousands died in the streets or the railway station from the disease and the river stopped running, blocked by dead bodies from this terrible scourge. But we did finally eradicate smallpox, a disease that killed over 500 million people in the last century, more than all the wars combined. ...

inspired, so excited that we spread out and spread the virus of optimism to dozens of other institutions and programs: to CDC, NIH, other UN agencies, many large foundations, and many schools of public health; some of our veterans went on to lead programs to combat HIV/AIDS, malaria, and polio to name a few. ... Here is the good news for you, Class of 2007. The largest movement for good in human history is taking place today and you are an important part of it. Your timing is perfect.

And after we had eradicated smallpox, the alumni, the smallpox warriors as we were called, were so

You are part of a global conspiracy of the good. You will save the earth from global warming. You will bring people of all colors, all races, all nations, and all religions back together. You will find ways to lessen the economic divide that separates the rich from the poor and of course, most of all, you will find ways to lift the burden of suffering from the sick—to chart new pathways to a healthier America and a healthier world. You will find innovative ways to finance health care. You will use the Internet and new communication technologies to revolutionize health education and communication. 2 1 Commencement speaker Larry Brilliant 2 Bachelors of arts in public health (left to right) Melissa Amacher, Brittany Barto, Sachini Bandara, Alisa Arce, Janet Ajao, Sarah AdlerMcDonald, and Kathleen Abanilla 3 Sarah Ismail, bachelor of arts in public health 4 Epidemiology doctoral graduates (left to right) Sheryl Magzamen, Melinda Aldrich, Purnima Madhivanan, and Samuel Malamba

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University of California, Berkeley

Past, Present, Future

2007 Awards Alumna of the Year Susan Desmond-Hellmann, M.D., M.P.H. ’88, President, product development, Genentech, Inc. 5

“The largest movement for good in human history is taking place today and you are an important part of it.“ And you will find ways to conquer diseases that fall disproportionately on the poor—polio, malaria, HIV AIDS, TB. You are part of an immense global movement, and you inherit a magnificent tradition. You step into the shoes of those who conquered hookworm and smallpox, who will conquer polio and guinea worm, who have contributed to a doubling of life expectancy in many countries in less than a century and who will extend that blessing to the rest of the world.

The full text of Larry Brilliant’s commencement speech is available at sph.berkeley.edu/gallery/ 06-07/07_commence_speech.html.

Henrik L. Blum Award for Distinguished Social Action Carina Vance, M.P.H. ’07 Distinguished Teaching and Mentorship Award Richard Jackson, M.D., M.P.H. ’79 Zak Sabry Mentorship Award Stephen Shortell, Ph.D., M.P.H.

6 Public Health Alumni Association president Leslie Louie presents the Alumna of the Year Award, which this year went to Genentech president of product development Susan DesmondHellmann.

Outstanding Graduate Student Instructor Awards Manish A. Desai, Ph.D. ’07 Rachael M. Jones, M.P.H. ’03 Sepideh Modrek Michelle C. Odden, M.S. ’06 Alicia L. Salvatore, M.P.H. Katherine B. Saxton, M.P.H. ’06 Vincent M. Yau

7 Masters of public health in epidemiology (left to right) Rajesh Sathy, Alexandre Kunomboa, Tan Ngoc Truang, Tenesayi Kufa, and Sumathi Krishnan

Margaret Beattie Award Karen Clyde, Ph.D. ’07

8 Rene Gonzalez, bachelor of arts in public health

Warren Winkelstein Award James Scott, Ph.D. ’07

5 2007 Class Gift Committee cochairs Yasmeen Drummond (left), a graduating public health major, and Rohini Dhand (right), an M.P.H. graduate, present a check to Dean Stephen Shortell.

Gary Stewart Memorial Award Olivia Lustro, B.A. ’07 Rachel Sax 7

Public Health

Past, Present, Future

Lindheim Award Winner Bridges Health and City Planning COMBATING CHRONIC DISEASE Theoretically, policies and regulations governing such things as zoning, water quality, and roadways are meant to safeguard public health and welfare under the assumption that compliance will ensure a healthy living environment. Kuiper, however, cites a growing body of evidence to the contrary: “Many chronic disease conditions influenced by the built environment have reached epidemic proportions, including obesity, heart disease, diabetes, asthma, depression, and stress.”

Heather Kuiper, recipient of the Lindheim Award

If walking and biking improve health, why aren’t there more safe sidewalks and bike lanes? If limiting our use of cars reduces air pollution and asthma, why are our schools on the outskirts of town and grocery stores outside of our neighborhoods? Why don’t more transit lines link our homes and work? How do we convince decision makers to create built environments that better support health? Dr.P.H. candidate Heather Kuiper has won the Roselyn Lindheim Award in Environmental Design and Public Health for a research project that seeks to understand the role of local health departments in both posing such questions and finding answers. The award, honoring late UC Berkeley architecture professor Roselyn Lindheim, supports graduate students whose work reflects and furthers Lindheim’s innovative, interdisciplinary approach to creating healthier and more humane environments. Kuiper, a 20-year veteran of national and international public health, also strives to bridge disciplines. She is working to infuse health considerations into city and regional planning. 26

University of California, Berkeley

Inasmuch as the built environment—the environment where people live, work, learn, and play—can better support people’s health, Kuiper believes shifting approaches are needed to address the upswing of chronic disease. Additionally, she notes that merely realigning public health and city planning (which historically worked in greater concert) is not enough: “Some strategies intended to resolve earlier health challenges may actually underlie problems now. For example, single-use zoning, decentralized urban form, and discharge-based sanitation systems designed to reduce disease also contribute to climate change, water and air contamination, eutrophication, car dependency, attenuated social networks, nature deficits, and endocrine disruption.” Instead, she intends that this study develop recommendations for a “wiser reunion,” one informed by ecological sustainability and regeneration, to offer long-term health promotion. “We don’t want the solutions of today to be the problems of tomorrow,” cautions Kuiper. “This time around we need to do better. Solutions should address what happens if we multiply times 100 thousand neighborhoods, what happens if we multiply by 100 years.” Her current work suggests that engaging health departments in shaping the built environment can be an effective strategy for improving the public’s health. “Local health departments are well-situated to shape the built environment,” she asserts. “Their regulatory charge, their functions in epidemiology, policy, service, and community outreach, and their proximity to the local level can be assets in this process.”

Dan Lindheim, son of the late professor and a member of the award selection committee, says, “Kuiper is trying to see how people with health expertise in government can have more impact. She is trying to link health, physical plant, land use, and environment—all subjects close to my mother’s vision.” In doing this, Kuiper is bringing together people from different backgrounds and giving voice to those who have not traditionally had a seat at the development table. Dan Lindheim appreciates that she is working in the field with real people: “My mother believed in solving real problems in the real world.” OVERCOMING BARRIERS So what is preventing local public health departments from addressing the built environment? Kuiper’s study has already established that 92 percent of California’s health departments are aware of evidence that the built environment affects health, yet only 42 percent reported actually working in some capacity in the area of land use and transportation. “You ask someone if they value clean air and clean water, if they value their health, and they almost always say yes,” says Kuiper. “This research should help health and planning overcome myriad barriers to better align practice with societal values.” In later phases of the study, Kuiper will assess how the state’s health departments are participating in built environment planning and develop case studies of what has worked and what hasn’t. In keeping with Lindheim’s commitment to conducting accessible research, Kuiper will share her findings with health departments, solicit their input, and make her research available in forms useful to those in practice and policy. Kuiper remains optimistic and connected to the idea that her work will help health departments even beyond California. “California is one of the largest economies in the world. What happens here affects the country and the world,” says Kuiper of what her research can mean globally. “My hope is that there are many story lines here in California that others will be able to draw from.”

—Johanna Van Hise Heart

Past, Present, Future

Roselyn Lindheim, Architect of Healthy Environments S. Leonard Syme, emeritus professor of epidemiology at the School of Public Health, has characterized the late Roselyn Lindheim, a professor at UC Berkeley’s School of Architecture, as one of the most profound thinkers of our time. “There is no question in my mind,” he says of her innovative approach to health care facility design, “that the true dimensions of her contribution will be seen for many decades to come.” In her day, Lindheim challenged a world considered beyond architecture’s ken: health care, or more specifically, conventional hospital environments, which she felt deprived patients of control and autonomy. Lindheim went on to pioneer movements advocating for alternative birthing centers, low-income housing, adult day care, and end-of-life hospice care. Lindheim’s revolutionary ideas emanated from a deeply held conviction that living environments should reflect a respect for human beings and enhance their quality of life. She infused hospital design with homelike, familiar, domestic elements that restored humanity to the natural processes of birth, illness, recovery, and death. She valued all perspectives. In designing a children’s hospital, she interviewed not just medical staff, but also parents and children in order to achieve the right balance

of functionality, safety, and levity. Working with the patient advocacy group Planetree, she created a hospital model that fostered emotional aspects of the patients’ healing environment—social connection, participation, control, and sense of value. It is fitting testimony to her barrier-breaking philosophies that she was the first architect to be elected to the National Academy of Science’s Institute of Medicine. For more than a decade, Lindheim co-taught the very popular interdisciplinary course “Environmental Design, Stress, and Disease” with Syme. The pairing of their interests—hers, in the way living environments influence our lives; his, in ways in which behaviors influence health and disease—resulted in a seminal article, central to syllabi in schools of public health, architecture, and city planning across the globe.

Roselyn Lindheim

The piece, “Environments, People and Health” (Annual Review of Public Health, 1983), outlined their belief in the importance to health of being connected to other people and one’s biological and cultural heritage. Breaking ties between people compromises health, they showed. Lower social status and limited participation in decision-making directly correspond to higher disease rates, they said. And finally, artificial environments designed to enhance comfort, often cause collateral damage to our health in that they deny or render abnormal such rhythmical and natural things as birth and death, seasons, sunlight and darkness, and elements of nature. “No matter how elegantly wrought a physical solution, no matter how efficiently designed a factory, no matter how safe and sanitary a building,” says Syme, “unless people can, in some way, create, manage, change, or participate in activities that affect their lives, dissatisfaction, alienation, and even illness are likely outcomes.”

—Johanna Van Hise Heart

Public Health

Past, Present, Future

William Oswald: A Man Ahead of His Time William J. Oswald, Ph.D. ’57, professor emeritus of civil and environmental engineering and of public health, was among the first engineers to study the symbiotic interactions between algae and bacteria in wastewater treatment ponds. It was in the 1950s that Oswald began his research leading to designs of natural treatment systems powered primarily by solar energy, making wastewater treatment more affordable and sustainable. “William Oswald was a man ahead of his time. He developed and demonstrated sustainable technology decades before sustainability became a popular goal,” said Bailey Green, research scientist at Lawrence Berkeley National Laboratory (LBNL), where Oswald was also a researcher. Green was a former Ph.D. student of Oswald’s in the Energy and Resources Group at UC Berkeley, and a close colleague of his for the past two decades. Oswald is credited with developing the Advanced Integrated Wastewater Pond Systems (AIWPS) technology in which wastewater passes through a series of ponds to be treated. The process involves the use of algae photosynthesis in “high rate ponds” rather than the electro-mechanical aeration devices used in more expensive, conventional wastewater treatment systems. The algae produce oxygen that allows aerobic bacteria to break down remaining contaminants in the water. The water is then reclaimed through a series of tertiary processes for reuse and recycling in such applications as agricultural irrigation. The study of such natural systems has developed in recent decades into the field of ecological engineering. Thousands of communities throughout the United States have adopted successful natural wastewater treatment systems, although large urban areas that do not have enough land required for ponds or wetlands still use mechanical systems. Colleagues of Oswald’s remember his humanitarianism, noting that the needs of the developing world—where many people bathe in and collect 28

University of California, Berkeley

drinking water from rivers polluted with raw sewage—motivated Oswald’s research and the development of simple, affordable, and more sustainable wastewater treatment technology that produces renewable energy through methane fermentation and biogas recovery.

witnessed the choking death of a schoolmate from a roundworm infection caused by poor sanitation. While serving in the U.S. Army as a hospital administrator in Europe after World War II, he coordinated the care of patients suffering from the effects of unsanitary conditions, including contaminated water.

In one of his more recent international collaborations, Oswald worked with Green and Veer Bhadra Mishra, an engineer and Hindu priest from Varanasi, India, to study the use of AIWPS technology to treat the sewage from the city and in the Ganges River. Considered the “Mother of India,” the Ganges River is used by devout Hindus for daily religious bathing and drinking, despite the fact that it is contaminated by human and industrial wastewater and the remains of cremated bodies. The proposal they developed has been supported by city officials in Varanasi, and is currently under consideration by federal and state authorities in India.

Oswald was a prolific writer, authoring more than 400 works published in academic journals, conference proceedings, and books. He won several medals and prizes for his research from the national Water Environment Federation and the American Society for Civil Engineers, and was a fellow in the American Academy for the Advancement of Science and a diplomate in the American Academy of Environmental Engineering. In 2005, the International Society for Applied Phycology presented him with a lifetime achievement award.

There have been other applications for Oswald’s inventions besides wastewater treatment. High rate ponds are used to produce microscopic algae for the health food industry. Oswald also demonstrated a life support system for the U.S. Air Force space program that used algae to treat astronaut waste while producing distilled water and oxygen. The system, however, has never been used outside the laboratory. Oswald’s passion for working on affordable sanitation stemmed from several dramatic experiences in his life. As a child in rural central California, he

In 2005, Oswald and Green were issued two patents—one for a method to establish and optimize methane fermentation in primary wastewater ponds, and the other for an apparatus to recover biogas from methane fermentation. Oswald was also president and founding partner of Oswald Green, LLC, an environmental technology company, and of Oswald Engineering Associates, Inc., an engineering services company. Although Oswald retired from teaching at UC Berkeley in 1990, he continued his research and engineering practice as a scientist at LBNL until his death in 2005.

—Sarah Yang

Partners in Public Health

Honor Roll The School of Public Health gratefully acknowledges the following individuals for their generous contributions from July 1, 2005 to June 30, 2006. $100,000 and Above Dudley Aldous Roni Leitner Karl Peace

$10,000 to $99,999 Betty Austin Seiko Baba Brodbeck Trust Patricia & Richard Buffler Terri & John Carlson Peter Carpenter & Jane Shaw L. Martin & Joyce Griffin Robert Hosang & Joyce Yap Kenneth & Marjorie Kaiser Kathy Kwan & Robert Eustace Cathy & Roderic Park

Kirk Smith & Joan Diamond L. James Strand

$1,000 to $4,999 Marcelle Abell-Rosen & Andrew Rosen Anne Bakar & Joseph Zadik John Balmes & Sherry Katz Raymond Baxter & Aida Alvarez Estate of Marian & Henrik Blum Margaret Cary George & Eleanor Cernada Farah Champsi Pansy Chan Alice Chetkovich Nilda Chong Linda & James Clever Peggy Cory

Associate dean Jeffrey Oxendine, M.P.H. â&#x20AC;&#x2122;80, M.B.A., with his daughter Elizabeth (left), Laura Oropeza, and Michael E. Bird, M.S.W., M.P.H. â&#x20AC;&#x2122;83 attended the Spring Alumni Brunch and Silent Auction, where Bird was the guest speaker.

Lisa & John Pritzker Lola Reshetko Estate Rosalind Singer Allan & Meera Smith Beulah Teravainen

$5,000 to $9,999 Alfred & Eunice Childs Nancy & Sidney Ganis Sylvie Griffiths Michael Hannigan Nancy Lusk & Michael Smith J. Michael Mahoney Stephen & Susan Shortell

Abla & Frank Creasey, Jr. Margaret Deane Jerry & Lorraine Factor Lia Fernald & Guy Haskin Susan & James Foerster Wallace Gee Orville & Ellina Golub Helen Halpin & Scott Gehlke Frances Hamblin David & Katharine Hopkins Kip & Jay Hudson Jeffrey Kang & Brenda Lee-Kang Julia Klees Catherine & James Koshland Joan Lam

Virginia & Franklin Lew Judy Li Arnold Milstein & Nancy Adler Jeffrey Newman Edward & Camille Penhoet Janet Perlman & Carl Blumstein Robert & Mary Porter Donna & Darwin Poulos Sarah & Steven Presser Esther Quirolgico Shirley Roach Robert Scott Paul & Andrea Swenson Irving & Irma Tabershaw Patricia & Kenneth Taylor Kenneth Taymor & Elizabeth Parker Eric Vittinghoff Alejandro & Lida Zaffaroni

$500 to $999 Perry & Colleen Behrens Cedric Brown Elizabeth Calfee Po-Shen Chang & Julie Craig-Chang Connie Chen Carol & Ron Clazie Bernard Cordes Robert Derzon Ursula & Jeffrey Edman Michael & Sandra Fischman Douglas & Arlene Fowler Michael Gallivan Barbara Hansen Dana Hansen David Harrington & Denise Abrams James & Patricia Harrison Barbara Hong Roland Hong Jeffrey Hunter Lynne Johnson Eleanor Langpaap Leslie Louie & David Bowen Gadi Maier Arthur McIntyre, Jr. Anjali Morris Walter & Lela Morris Mary & Raymond Murakami Mary & Craig Noke Lisa & Roger Ota Muriel & Martin Paley Artist Parker Carol Patterson Mary Pittman-Lindeman & David Lindeman Carleton & Maureen Rider Donna Seid Nancy & Robert Shurtleff

Shoshanna Sofaer & Lawrence Bergner Richard Stephens & Sherrill Cook Lorraine Woo Matthew Zack, Jr.

$250 to $499 Ramona Anderson Richard Bailey Ernest Bates Lesley Bennett Michelle Berlin & Robert Lowe Joan & Howard Bloom Karen Boezi Warren Browner Peggy Chan & Frederick Gladstone Pearl Chen Chin Long & Fu Chen Chiang Jonathan Cohn Carol Copeland Douglas & Jacqueline Corley Martin & Diane Covitz Sarah Cox Patricia & Roger Crawford Michael & Nan Criqui Edwin & Naomi Curtis Julian & Dorothy Davis Brandon & Shirley DeFrancisci Kathryn De Riemer James & Dorothy Devitt John & Marlene Eastman Susan Eckhardt Leland Ehling & Marta Ehling Robert Gerdsen & Patricia Gerdsen Carol Giblin Cindy Gok & Brian Wong Mary Grah Frederick Grose Karen & Richard Gunderson Victoria & Nelden Hagbom Cornelius Hopper Jerry & Darlene Jones Arlene Kasa Laurence Kolonel Joyce & Richard Lashof Kate Lorig Donald & Elaine Ludwig James and Sally MacLaren John & Susan Mamer Carol Marquez Elizabeth Martini Mara McGrath & George Pugh George & Joanne McKray Anne & Richard Melbye Juliet Melzer Telford Moore Linda Neuhauser & Craig Buxton Public Health

Partners in Public Health

Honor Roll, continued Evelyn Nodal Jeffrey & Lydia Oxendine Carol Parlette Kathryn Paul Marie & Roy Pearce Laura Peck & Alan Stein Arnold & Karen Perkins Diana Petitti Nicholas & Patricia Petrakis Frederick Pintz & Helen Fragua William Plautz & Kathleen Welsh Malcolm Potts & Martha Campbell

$100 to $249 George & Susan Abbott Barbara Abrams & Gary Root Gwendolyn Adams-Kyles T. Elaine Adamson & Edward Gould Nancy Altemus Adele Amodeo John & Eleanor Anderson Richard & Carlene Anderson Bradley & Elizabeth Appelbaum Michael & Bonnie Applebaum

The annual School of Public Health Appreciation Dinner gathers together many of the Schoolâ&#x20AC;&#x2122;s supporters, such as Frank and Virginia Lew (right), pictured with assistant dean Pat Hosel.

Michael & Denise Prince Jeanne Raisler Kathleen Regilio Arthur Reingold & Gail Bolan Joseph & Nancy Restuccia Edward Reyes Theodore & Gayle Saenger Sidney & Sally Saltzstein Alan & Gail Searcy Rosemary & Gordon Seck Anita Seigel William Sharon Robert & Patricia Spear Harrison Spencer Laura & Donald Stemmle Richard Sun John & Gail Swartzberg S. Leonard Syme Eric Tao Josephine Tao JoAnn Ten Brinke John Troidl Robert & Allene Tumetly Resa & Matthew Warner Michael Weiss Katherine & Robert Westpheling Donna & Philip Wright

University of California, Berkeley

Kristin Arrandale Ann-Marie Askew Margaret & Donald Aumann Howard Backer Cheryl & Marc Bader Dean Baker Joshua Bamberger Marilyn Barkin Marina Baroff Amy Bassell-Crowe & Jeffrey Crowe Gail Bateson & David Rempel Suzanne Battaglia Heidi Bauer Lucinda & Ronald Bazile Melody Bazyar John Beare P. Robert Beatty Robert & Meg Beck James & Lisa Behrmann Stephanie Bender-Kitz & Kevin Kitz Chhaganbhai & Sarojben Bhakta Harvey & Bonnie Bichkoff Michelle Bieber Mark Blumenthal Jeffrey Braff Russell Braun Joseph Brazie Claire & Ralph Brindis

Claude Brown, M.D. Emil Brown, III & Mary Oâ&#x20AC;&#x2122;Connor Jeffrey & Cathleen Brown Julie Brown Laura Brown & Mark Hanson Robert Brown, Jr. & Susan Wilson-Brown Marcia Brown-Machen Nora Brusuelas Katherine Bryon Shirley Burton Michael Butler Myfanwy Callahan Gretchen & Charles Carlson Mark Carlson Catherine Caserza Raymond & Grace Chan Uma Chandran & Shekhar Venkataraman Daisy Chang Helen Chase Donna Chen Jenny Chen David & Stacie Cherner Victoria Chiu Winnie Chu Michael & Jan Clar Florence & William Clark Dolores & Samuel Clement Pamela Cocks Janet Coffman Simon & Janet Cohn Nancy Collins & Francesco Adinolfi William & Joan Colvin Shannon Constant Charles Crane & Wendy Breuer Francine Crockett Audrey Cross & Steve Gambino Helena & James Daly Dale Danley Jeanne Darricades & Michael Gibson David Dassey Gary & Martha Davidson Harry & Laurie Davis Stephen Davis Robert Day Louise Detwiler Hellan & Bradley Dowden Sandra & Jerry Dratler Kathryn Duke & Niels Kjellund Jacob Eapen & Shirley Jacob Kathleen Earnhart Elizabeth Edwards Esther Eicher Joseph Engelman Frederick & Jean Erdtman Denise Evans

Arthur & Florence Feinfield Christopher Fink Kari Fisher Brendan & Luciana Flannery Myleine Flojo Carol & James Floyd Neil Flynn Janet Fogel & Robert Schlegel Mary Foran Michael & Karen Ford Karen Franchino & Reed Foster Robert Frangenberg & Ingrid Lamivault Sara Frank Benjamin & Marianne Fraticelli Robin & Peter Frazier Dava & Donald Freed Katharine & Daniel Frohardt-Lane Ernest & Martha Fujimoto Daniel Funderburk Guangcheng Gao Connie Gee Nicole & H. J. Geiger Marcia Gerin Virginia Gladney Ronald Glass & Merle Lustig Katharine Go Ang & David Ang Martha Goetsch & Linda Besant Amy Goldberg-Day & Mark Day Geraldine Goree Laurel & Michael Gothelf Jill & Larry Granger Michael & Kazue Granich Marian & Roger Gray Susan & Lowell Greathouse Linda Greenberg & Hiroshi Motomura Sadja Greenwood & Alan Margolis Cordelia Grimm & Darren McGregor William & Lynda Gross Valerie Gruber Sylvia & Simon Guendelman Jack Guralnik & Stacey FitzSimmons Richard Gustilo Bernadett & Anacleto Gutierrez Hanns Haesslein John & Patricia Haines Jean Hankin Howard Hansell Norman Haraguchi Lisa Harnack M. Antoinette Harris Dian Harrison Dior Hartford Thomas Hazlet Alvia & Yvonne Hearne Phyllis Hecker Mary Henderson

Partners in Public Health

Alfred & Stella Hexter June & Robert Hiatt Judith & Michael Hibbard Glenn & Jan Hildebrand Barbara Hill & Timothy Livermore Warren & Miriam Hill Christine Ho Carolyn Hoke-Van Orden & Frank Van Orden Karen Holbrook Elizabeth Holly Patricia & Harry Hosel David Hoskinson John Hough Sally Howlett Mark & Estie Hudes Marjorie Hughes Gail Husson & Susan Chen Devra Hutchinson Deborah & Martin Inouye Ellen & Donald Irie Robert & Beverly Isman Betty Izumi & Geoffrey Koch Olive & D. Michael Jack James Jackson Nancy & Kurt Jackson Richard Jackson & Joan Guilford Nicole & J. Thomas Jakaby Lucy Johns Jon Johnsen Warren & Barbara Johnson Laurie Jurs Alma & Ian Kagimoto Irene Kan Leanne & Richard Kaslow John & Kim Kaso Gail Katagiri Kiyoshi & Irene Katsumoto Mildred Kaufman Susan & Harvey Kayman Janice Kim Young Shin Kim James & Sarah Kimmey Arlene & David Klonoff Karl & Sarah Klontz Laura & Arthur Kodama Masako Koga & Richard Murakami Denise Koo Olayinka Koso-Thomas Thomas Ksiazek Ruby Kuritsubo Darwin & Merrily Labarthe Andrew Lan Rebecca Landau Sandra Lane Geoffrey Lang Carol Langhauser

Suzanne Larson & Jeffrey Bartfeld Abiose Lasaki Che Keung Lau & Chi Sim Lau Frances & Ronald Ledford Ai-Chu Wu Lee Kelvin & Brenda Lee Karen Leesman & Robert Cullen Lynn Levin & Stanley Oshinsky Virginia Lew James Lewis & Dale Roche Rui Li William Light & Robin Vernay-Light Michael Lin Zihua Lin & Shengping Yang Lois Lindberg Fenyong Liu & Sangwei Lu Suzanne Llewellyn Cheryl Loehr Geoffrey Lomax Anson Lowe & Sophia Chang Ying Lu & Weizhao Zhou Robert & Sharlene Lund Claudia & Robert Lutz Clare Mahan Mark Mammarella Harry & Claire Manji David Mark Grayson & Sally Marshall Michael & Jeanee Martin Karen Martz David Matherly Ben & Misato Mathews Michael McElroy Alan & Margaret McKay Lou McLaren & Randall Gates Sara McMenamin & Joel Kosakoff Bessanderson McNeil Rosa Medina Vincent Meehan Robert Meenan Mark Mendell Ruth & Harry Metzger Kate & James Meyers Joan Milburn Robert Miller & Paula Shadle Shannon Mitchell & John Siegfried Beth Mitchner & Doug Wertheimer Janet Mohle-Boetani & Mark Monasse Kevin Monroe Rachel Morello-Frosch & David Eifler, Jr. Marian Mulkey & John Powers Catherine Murphy Frank Mycroft & Sue Tsang Ralph & Jane Myhre Suzanne Horsley Nash & Christopher Horsley

Carolyn & John Nelson Marion Nestle Beata & Harlen Ng Stephanie Nishio Elizabeth & Robert Nobmann Barbara Norrish Ann Nutt Roberta O’Grady Cynthia & Brian O’Malley David & Mary O’Neill Karen Oppenheimer Dean Ornish Emily Ozer Edward Panacek Valentine Paredes Ram Parvataneni & Debika Bhattacharya Marie & Ronald Pasquinelli Richard& Martha Pastcan Mildred Patterson Eileen & Mark Pearl Michelle Pearl Eileen Peck Karen Peifer Myrto & Andrew Petreas Thomas & Anna Philipps Charlotte Phillips Mary Philp Therese Pipe Matthew & Jennifer Plunkett Catherine Prato Philip Prendergast Susan Quinn Valerie Randolph & Donald Fenbert Daniel & Elizabeth Rathbun Reimert & Betty Ravenholt David Reese & Ellen Peach Joan Reller Kenneth Renwick, Jr. & Trish Rowe Miriam Rhew Deborah Ridley & Richard Nenoff Lois Rifkin Gordon & Whit Robbins Beth Roemer Anthony & Barbara Rooklin Nancy & Jason Rosenthal Rachel Royce & Matthew Farrelly Linda Rudolph & James Bellows Elva Rust Glen & Corinne Ryland Lisa Sadleir-Hart & Thomas Hart Jose Salazar Michael Samuel & Jane Martin Camille Samuels Sarah Samuels & Joel Simon Andrea & Gopal Sankaran Frances Saunders

Andrea Saveri & Robert Gunier Richard Scheffler Janet Schilling Bruce Schmidt David & Lorraine Schnurr Steven Schwartzberg Betty Seabolt Faith Seal William Seavey Duane & Arnita Sewell Nan & Gary Shaw Donna Shelley Tina Sherwin Sandra Shewry Yoshimi & Grace Shibata Zeheria Shifa Takeo & Maye Shirasawa Karen Shore Betty Shurtleff Jessica Siegel John Sieverding & Elizabeth Tapen-Sieverding Anna Lisa & Victor Silvestre Barton & Kathy Simmons Robert Simon Sally Slavinski Esmond Smith Lorraine Smookler Kristie Snider Krikor & Caline Soghikian Jeanette Spangle & Alan Walfield Robert Sparks Usha & Bharat Srinivasan Susan Standfast & Theodore Wright, Jr. Christopher & Ashley Stephens Judith Stewart Sheila Stewart & Charles Wilson Howard & Virginia Stiver Susan Stokes & William Stokes Sarah & Benjamin Stone-Francisco Joseph Stretch Laurence & Ann Sykes Erin Szeto William & Carolyn Talley Coralyn & Peter Taylor David Taylor Timothy Taylor William & Judith Taylor William & Virginia Taylor Irene & Marsh Tekawa Constantine & Nancy Tempelis Ronald Thiele Geoffrey Thompson Richard & Mary Thompson Todd Thorsen Shirley & Richard Timm Diane Tokugawa & Art Gould Public Health

Partners in Public Health

Honor Roll, continued Kenneth & Winsom Tong Claudine Torfs Robert Traxler Feng Tsai David Tuller Michael & Barbara Turell Sandra Tye Judith & Clarence Ueda Jack Vermillion Frances Veverka Barry & Susan Wainscott Donald Waite Julia Walsh & Stephen Dell William Warner Jessica Watson-Lim & Michael Lim Harvey & Rhona Weinstein Audree & Morris Weiss Peggy Wellman & Loren Dacanay Ardyce Wells Kathryn & David Werdegar Kathleen Wesner & Daniel Sullivan Patricia & Phillip West Eddie & Lynn Whitehead John Williams Michael Williams Julie Williamson Charles Wilson Michael Wilson & Maria Kersey Marilyn Winkleby & Michael Fischetti Sandra Witt Ellen Wolfe Teresa & Otis Wong Emily Woo Annie Worth Linda Young Ann Zukoski

$1 to $99 Effiem Abbah Amanda Ackerman Jerome & Lacey Adams Anita Addison Mary Ader Dorothy Aeschliman Benjamin & Dativa Agustin M. Bridget Ahrens Jerianne Alberti Gian Allen-Piccolo Pamela & Rodrick Alston Virginia Anderson Calvin & Laura Anderson Madel Angeles Balan & Gurdeep Arakoni Tania & James Araujo Betty Arezone

University of California, Berkeley

Jennifer Armstrong-Wells & Jason Wells Marvin & Patty Ashford Carl Atkinson Ahsia Badi Anna Bagniewska Jennifer Balogh Martha Baptie Cecilia Barbosa Lisa & Michael Barcellos John Barker & Fan Cheng Deborah Barnes Philippa Barron & Jeffrey Pilsuk Elaine Base Herbert Bauer Eliane Bautista Kevin & Lori Beagan Henry Behrens Dorothy & Vernon Bengal Lester & Evelyn Bennett Gail Berry Aman Bhandari Tamara Bhandari Dennis Black Kirsten Black Carolyn Blackwood Babette & Sydney Bloch Heather Blume Lauren Blumenfeld Kristin Bodiford Nora & John Boothby Lavern Jane Borg Patricia & Marcus Boyd Lynda Bradford Joan Bradus & Dale Friedman Judith Bramson Ellen & Nelson Branco Robert & Barbara Brandt Rebecca Braun David Breland Deborrah Bremond Letitia Brewster & David Walton Rachel Broadwin Maurice Brookhart Janet Brown Gertrude & William Buehring Alexandre Bureau Evelyn Caceres-Chu & Albert Chu Allyn & Mark Callahan Barbara Campbell Edith Canfield Jeremy Cantor Matthew Carlson Charisse Carolino Catherine Carpenter James Carpenter Ralph & Betty Carpenter

William Carreker, Jr. Arthur Castillo Peter Castro Edward & Joann Cavenaugh Sonia Ceja Jo Chan Keh-Minn Chang Jeffrey Chang Patricia & Scott Charles Harriet Charney & Larry Sirott Arnold Chavez Geeta Chawla Brian Chen Eric Chen Wensi & Lijan Chien Erica Choi Lisa Chu Louis & Margaret Coccodrilli Seymour Cohen Kimberly Coleman-Phox Kitty Corbett & Craig Janes Mario & Margot Corona Cindy Cosenzo Laura Cotter Lawrence & Constance Cowper Marguerite Cowtun & Henry Terrell Alia Creasey James & Evelyn Crouch Carrie Cunningham Emer Cunningham Elizabeth Dadigian Peter & Gwen Dailey Loring & Ann Dales James Dandridge Rupali Das-Melnyk & Ostap Melnyk Rena David & Walter Meyers Sylvia De Trinidad Robin Dean Sigrid Deeds Marlene Dehn Alma DeLeon Rajan & Rhea Dev Alice Diefenbach Robert Diefenbach Lisa Diemoz Peter Dimitrov Rachel Dizon Tri Do Judith Dobbins Neal Dockal & Judy Cook David & Reade Dornan Roberta Doutlick-Peck & Richard Peck Eric Dowdy Harriet & Albert Draper Joan & William Drum, Jr. Erin Dugan & Brian Purcell Gordon Dugan

Guests examine items available for bid at the Spring Alumni Brunch and Silent Auction.

Camelia Dumitrescu Kent & Irene Dunlap Jennifer Eames Molly & Kevin Efrusy Jose Eguia Kathleen & Gerald Eisman Robert Emrey Kathryn Eng David English Shannon & Andrew Erstad Yvonne Esler Nanette Favre Bernard Feldman Sue Felt James & Bette Felton Mark & Robin Fine Gerald & Linda Finer Julie Fishman Leslie FitzCallaghan Robin Flagg Nancy Fleischer Elizabeth Flick Becca Flitter Eduard Flores Patricia Fobair Nohl Fouroohi E. Lynn Fraley & Kenneth Lindahl, Jr. Ellen Frank Constance Fraser Thelma Fraziear Charles & Marilyn Froom Elena Fuentes-Afflick Vicki Fung Deborah & Thomas Gallagher

Partners in Public Health

Sandra Galvez Celeste Garamendi Robert Gaskie Joan Gates Liliane Geisseler & Svein Rasmussen Jack & Karen Geissert Betty & G. Gendler James Gentry, Jr. Neil Gesundheit & Eleanor Levin Houston Gilbert Philip Gillette Jessica Gillota Renee Gindi Alan & Sharonn Gittelsohn Betty & Larry Goldblatt Esteban Gonzalez Burchard Shelley Gordon George & Amy Gorman Deanne & Sidney Gottfried Gloria & Alfonso Grace, Jr. Alisha Graves Howard Graves & Julie Baller Sharon Gray Brent Green Nina & Richard Green Jenalynn & William Greer Barbara Griffiths & Michael Allison Nina Grove & Kenneth Johnson Richard Grundy Erica & Casey Gunderson Victoria Ha Jill Hacker-Chavez & Raymond Chavez Corazon Halasan Thomas & Denise Hales Mary & Paul Hamer Margaret Handley & Leif Hass Jovine Hankins Frances Hanson Rober & Martha Harrell Joan Harris Odette Harris Susan & Stephen Haskelll Tyrone Hayes & Katherine Kim Stephen Hecker & Lucia Lopez-Hecker Susan Helmrich & Richard Levine Melvin & Carol Henry Nancy Heriza Lisa Hernandez Jack Herndon & Nina Herndon Pflumm Elizabeth & David Hibbard Elaine & Joseph Hiel George & Doris Highland Marisa Hildebrand Beverly & Hugh Hilleary Richard Hirsh Rosemary Hoban Donald & Marie Hochstrasser

Frances Hoffman Guenter & Karen Hofstadler Arthur Hollister Ralph Hornberger Eva Hornsby Rita Flick Hose Teh-Wei & Tien-Hwa Hu Daniel Huang Colin & Jacquelyn Hubbard William Huen Jonathan & G. Frances Huenemann Phillip & Marcella Hurley Mark Ibele & Robin Dewey Robina Ingram-Rich & Timothy Rich H. Reece & Margaret Ivey Ritsuko & Yoshio Iwasa Barbara Jackson Nidhi Jain Roland & Reona James Marion Jarrett Joyce Javier Melissa Jennings Petra Jerman Violet & Hong Jew Steven Joffe Kathryn Johnson & John Culver Andrea Jones Christopher Jones Terry Kaiura Ruchi Kapoor Maya Katz Betty Kaufman John Kaufmann William Keene Daniel & Susan Keller Jo-Anne & Juan Kelly Olivia & Richard Kendrick William & Nancy Kennedy Jane Kenyon Margo Kerrigan Kathreen Khavari John Kim Ruth Kiskaddon & John Wright Maria Kivel Freyja Knapp & Laurent Morton Samara Knight Jill Korte Kathryn Kotula Gloria Krahn Nathan Kramer Peter Krewet Dorthy Kuhn Elaine Kurtovich Mark Kutnink Bruce & Phyllis Lane Elizabeth Laposata Diane Lattanzio

Audrey Lawrence William Lawrence Janet Leader Jennifer Lee Roberta Lee Richard & Lois Lehman Mary Leon Carl Lester Yin Yan Leung & Peter Itokazu Sylvia Levinson Arline Lewis Donald Lewis Kenneth Lewis Ruthie Hutson Lewis Wendy Leyden Liana Lianov Adrienne & Van Horn Lieu Jennifer Lin Samuel Lind Robert & Jean Lindblom Rae Lindsay Sibylle Lob & Robert Badal Lisa Loeb Shanon Loftus Donald & Lois Lollich

Margaret & Joseph Masters Nancy Masters & Paul Cohen John Mateczun & Elizabeth Holmes Margaret McChesney Janet McDonald Kathryn McGonigle & David Rawlings Carmel McKay Marta McKenzie & Lawrence Chapter Thomas McMahon & Kathy Ahoy Michael McShane & Peggy Loper Laura Meehan Raymond Meister & Mary Miller Daniel Merians Deane Merrill, Jr. & Anna Morben Jane Merschen Andrew Miller Meredith Minkler & Jerry Peters Luis Mireles Raakhi Mohan Tina Morgan Pat & Ray Morris Arnab Mukherjea Courtney Mulhern-Pearson Mark Munekata Larry & Rita Murillo

Evelyn Nodal, M.P.H. ‘87 (left), Julie Brown, M.P.H. ‘85, M.B.A., and Jim Devitt, M.P.H. ‘78, join others at the Clark Kerr Campus for the Spring Alumni Brunch and Silent Auction.

Cheryl & Clyde Lovelady, III Betty Lucas & Gordon Jackins Roger Luckmann & Erica Foldy Charles & Anne Ludvik Andrea Lum Michael Lyon & Nancy Oliva Thomas Maack Charles & Elissa Maas Lincoln & Flora Maclise Elizabeth Maker David & Anne Manchester Rani Marx & James Kahn

Gita Murthy Michael Musante Maria Nakae Katherine Nammacher Sona Narula Richard Neumaier Keith Ng Vivienne Ng Karen Nikolai Joel & Phyllis Nitzkin Janiece & Robert Nolan Nora Norback Public Health

Partners in Public Health

Honor Roll, continued Jean Norris & Bluford Hestir Helen Nunberg Somao Ochi Michelle Odden Marcellina Ogbu Afolabi & Mojirola Oguntoyinbo Christina O’Halloran Ruby & Donald Okazaki Mary & Arthur Perkins Shawn O’Leary & Patricia Ramsay Katy Olmos Kent Olson Douglas Oman Keith Onodera Alan Oppenheim & Alice Salvatore Laurie & David Ordin Charles & Barbara Osicka Lars & Sally Osterberg June Ostrander Ruth Osuch Michael O’Sullivan & Edna White-O’Sullivan Nitika Pai Sujal Parikh Melissa Parker Tanya Perez Alissa Perrucci Sarah & Zeno Pfau Sharon Pipkin Adam Polis Katherine Pollard Ann & Donald Porcella James & Linda Porter Martha & Cas Pouderoyen Susan & Tomi Poutanen Savitri Purshottam Nancy Puttkammer Theresa Ramirez Nenita Ramos Tricia Ramos John & Judith Ratcliffe Barbara Razey-Simmons & Charles Simmons Kenneth & Ethel Read Irene Reed Danielle Rees Lester Reichek Pamela & Larry Reitman Dorothy Rice Rene Ricks Jean & Francis Riley Thomas Rivard Marc & Karen Rivo Annette & Wilfrid Roberge, Jr. Scott Robinson & Deborah Dobin Judith & Paul Rogers James Rogge Ruth & Guido Rosati 34

University of California, Berkeley

Nicholas Ross Lindsey Olson Roth Elizabeth Rottger Alice Royal John Rubin & Jane Perkins Thomas Rundall & Jane Tiemann George & Mary Rutherford Jeffrey Sacks & Sue Binder Charlene Sacramento Shobha Sadasivaiah

Priya Smith Susan & David Snyder Karen Sokal-Gutierrez Lucia Somberg Lucia & Peter Sommers Linda & Rod Kodman Nannette Stamm Rivka Greenberg James Stark Jacklyn Stein

Bill Ryan, B.S. ’58 (center) joins father and son James Jackson, M.D., M.P.H. ’80 (left) and James E.T. Jackson, M.P.H. ’88, at the Spring Alumni Brunch and Silent Auction.

Lisa & Ali Safaeinili M. Deborah Salach Victoria Sanchez & Chuck Holton Martha Sandy Rhonda Sarnoff Clea Sarnquist William & Enid Satariano Leigh Sawyer & Gerald Quinnan, Jr. Susan Scheer Linda & Harry Schermer Stephen Schultz & Mary Pacey Shirley Schwalm Lois Schwarze William & Valerie Schwimmer Katherine Scott Lynn Scuri & John Glaser Iris Shannon James & Jo Shoemake Jennifer & Joel Silberman Susan & Thomas Silver Ellamae Simmons Ilene & Keith Solomon Gary & Joanne Sims Lillian Sinayuk Mitchell & Bonita Singal Janey Skinner Rachel & Arthur Smith Lance Smith & Constance Huye Margot Smith

Martin & Jane Stein Alan Steinbach Bruce Steir & Yen Aeschliman Edith & Guy Sternberg Ann Stevens & Richard Glaser Wayne Steward Marilyn & William Stocker Elizabeth Stone Katie Stone & Vincent Horpel Corwin & Adrian Strong Martin & Sharon Strosberg Antoinette Stroup Frances & Mark Sturgess Carol Suguitan Ann & Ted Suyeyasu Christine Swanson Tricia Swartling & Chris Williams Louise Swig Ira & Jilda Tager William & Judith Tanner Barbara Tansky Maxine Tatmon-Gilkerson & David Gilkerson Morgan Taylor & Keith Harrington Esther Teo Marilyn Teplow Patricia Terry & Douglas Olson David Theis & Sarah Royce Gregory & Bonita Thomas

Jill Thomas Joyce Thomas Pamela Thompson Nancy Thomson Sheryl Thorburn Terry Tobin April Tong Frank Trafton & Beth Zaentz-Trafton David Tran Hoa Tran Elizabeth Triche Laura Trupin Patricia & Scott Tschirgi Winnie Tse Janis & Daniel Tuerk Robert & Joan Twiss Naomi Ufberg Verna Unger Lori Uyeno Michele & Robert van Eyken Ludenia & Steven Varga Kathleen Vork Katie Vu-Ng Timothy Wade Kay Wallis Jenny Wang Tzuan-Ta Wang Martha Waters R. Berna Watson Patricia Weber Amy Weitz Gordon Werner Sanford & Carolyn Werner William & Maureen Wilbur Constance Williams Diane Williams Trevor Williams Jacquelyn Williams-Uqbolue Gayle Windham Liana Winett Terry Winter Barbara Wismer Sharon Witemeyer Daniel Wohlfeiler Vincent & Brenda Wong Channing Wong Elisa Wong Evaon Wong-Kim & Jean Kim Ron Wood Andrew Woodruff Kara Wright & T. James Lawrence Henry & Mary Yamada Robert Yarwood Joyce Ycasas Mary & Melvyn Yokan Lee & Alan Youkeles Dianne Young Suzanne & John Young

Partners in Public Health

Stella Yu & Hingloi Hung David & Janice Zalk Mary Zernicke & Peter Honigsberg Hanjing Zhuo Evelyn & Robert Zlomke Richard & Debbie Zurow

ORGANIZATIONAL DONORS Alloy Ventures Alta Bates Summit Medical Center American Legacy Foundation Applera Corporation Bank of America Foundation BASF Corporation Baxter International Foundation Bay Area Consortium For Quality Health Care Blue Cross of California Blue Shield of California California Dental Association The California Endowment California Healthcare Foundation California Medical Association Foundation The California Wellness Foundation Catholic Healthcare West ChevronTexaco Chevron Oronite Company Children with Leukaemia Cigna Foundation Colorado State University Council for Education & Research on Toxics Electric Power Research Institute Esperanto/177 Chrystie Inc/ FMC Foundation Freed & Associates Bill & Melinda Gates Foundation General Motors Corporation Foundation Give Something Back Glaxo-Wellcome, Inc. Greenwall Foundation Heinz Family Foundation International Epidemiological Association J. R. Jones Healthcare Management Jewish Community Endowment Fund Robert Wood Johnson Foundation Kaiser Foundation Health Plan, Inc. Kaiser Trust Kennecott Energy & Coal Company Thomas J. Long Foundation Josiah Macy Jr. Foundation Marisla Foundation Dextra Baldwin McGonagle Foundation

Lucinda Bazile, M.P.H. ’94, and associate dean Denise Herd catch up at the Spring Alumni Brunch and Silent Auction.

Merck Company Foundation Microsoft Corporation Gordon & Betty Moore Foundation Nepheli Foundation The New York Times Company Foundation, Inc. Nova Fisheries, Inc. The Oregon Community Foundation OSIsoft Pacific Institute for Women’s Health PCBC The Premier Building Show Pfizer Foundation Philanthropic Ventures Foundation II Public Health Foundation of Alameda Co., Inc. Retirement Research Foundation The San Francisco Foundation Shaklee Corporation Sinkler Miller Medical Association Tsubaki Dance Club The United Way of the Bay Area University of Notre Dame Unocal Foundation Venture Strategies for Health & Development Versant Ventures, LLC Wellpoint Foundation Wells Fargo Foundation Women In Touch Wyeth

CLASS CAMPAIGN 2006 Effiem Abbah Amanda Ackerman Gian Allen-Piccolo Tamara Bhandari Heather Blume Rebecca Braun Jeremy Cantor

Matthew Carlson Jo Chan Jeffrey Chang Brian Chen Lisa Chu Kimberly Coleman-Phox Laura Cotter Carrie Cunningham Robin Dean Lisa Diemoz Camelia Dumitrescu Leslie FitzCallaghan Nancy Fleischer Becca Flitter Robert Gaskie Esteban Gonzalez Burchard Shelley Gordon Alisha Graves Lisa Hernandez Joyce Javier Melissa Jennings Petra Jerman Jennifer Lee Cheryl Loehr Raakhi Mohan Courtney Mulhern-Pearson Maria Nakae Michelle Odden Karen Oppenheimer Nitika Pai Tanya Perez Philip Prendergast Lindsey Roth Clea Sarnquist Lucia Somberg David Tuller Naomi Ufberg Lori Uyeno Trevor Williams Elisa Wong Andrew Woodruff

GIFTS IN KIND Acme Bread Company Adagia Restaurant Bancroft Hotel Bette’s Oceanview Diner Patricia & Richard Buffler Chalk Hill Estate City of Oakland Connie’s Cantina Downtown Restaurant John & Marlene Eastman The Exploratorium Korbel Champagne Cellars Hafner Vineyards David Harrington & Denise Abrams

Lalime’s Restaurant Landmark Theatres Lawrence Hall of Science Carl Lester Leslie Louie & David Bowen Evelyn Nodal PlumpJack Wines Poulet Restaurant Beth Roemer See’s Candies Stephen & Susan Shortell Silverado Vineyards L. James Strand Wine Institute Yali’s Cafe

IN MEMORY OF Lillian Aldous by Dudley Aldous Lyle Anderson by Ramona Anderson Mark Basilin by Donna Basilin Seiko Brodbeck by Stacey Baba & James Vokac James & Marsha Dandridge Michael & Karen Ford Shigeo, Norman, Leonard, John & Ronald Haraguchi Ritsuko & Yoshio Iwasa Virginia Lew Andrea Lum Iris Shannon Grace & Yoshimi Shibata Tsubaki Dance Club Joan & Robert Twiss Frances Veverka Sally Bellows by Sara McMenamin & Joel Kosakoff Mark Berke by Phyllis Hecker Henrik Blum by Anita Addison Patricia & Richard Buffler Shannon Constant Bernard Cordes Peggy Cory & Lynda Brothers Sylvia deTrinidad Brent Green Robert & Martha Harrell Barbara Jackson Merle Lustig Ben & Misato Matthews Daniel & Elizabeth Rathbun William Bruvold by John Hough David & Yoshi Carpenter by Jim Carpenter Maggie & William Carreker by William Carreker, Jr.

Public Health

Partners in Public Health

Honor Roll, continued Lloyd Churgin by Shoshanna Sofaer & Lawrence Bergner Susan DeYoung by Margaret Aumann Robert Dyar by Arthur Hollister Eric Fowler by Douglas Fowler Karen Grant by Judith & Richard Dobbins Reed Grier by Kathryn Duke & Niels Kjellund Mary Pittman-Lindeman & David Lindeman David Taylor William Griffiths by George & Eleanor Cernada Martin & Diane Covitz Charles & Marilyn Froom Sidney & Sally Saltzstein Roderick Hamblin by Frances Hamblin James Hardy by Michael & Barbara Turell Marie Hatherell by Alice Ring Mary Herrerias by Shirley Schwalm Ruth Huenemann by William & Joan Colvin Esther Eicher Jean Hankin Frances Hoffman G. Frances Huenemann A. Arlene Kasa Mildred Kaufman Elizabeth Nobmann Eileen Peck Anne Suguitan Ardyce Wells Robert & Kathering Westpheling Catherine Kennedy by Nancy & William Kennedy Helen Kirsh by David & Janice Zalk Doreen Kotula by Kathryn Kotula The Langpaap Family by Eleanor Langpaap Sum Leung by Yin Yan Leung Priscilla Lind by Samuel Lind Edith Lindsay by Barbara & D.J. Hansen Connie Long by Shirley Roach John Troidl Vern Lyons by Neal Dockal & Judy Cook 36

University of California, Berkeley

Stewart Madin by Abla & Clay Creasey Walter Mangold by Lawrence Cowper Jonathan Mannby by Sadja Greenwood & Alan Margolis Sheldon Margen by Linda Neuhauser Sarah Samuels & Joel Simon Mary Ann McKale by Jerianne Alberti Dorothy Nyswander by Charles & Marilyn Froom Richard & Mary Thompson Mohan Pant by Nitika Pai Parents of Chhaganbhai & Sarojben Bhakta by Chhaganbhai & Sarojben Bhakta Ambrosio & Esperanza Quirolgico by Esther Quirolgico William Reeves by Robert & June Hiatt Thomas & Shirley Ksiazek Steven & Sarah Presser Sally Slavinski & Ralph Russo Constantine & Nancy Tempelis Michael & Barbara Turell Octavio Romano by John Hough Joseph & Esther Sholeye by Abiose Lasaki Charles Smith by Henry Anderson Lavern & Jane Borg Robert & Martha Harrell Sandra Starr by Dorothy & Vernon Bengal Malka Stern by Mark & Esther Hudes Clara Terry by Patricia Terry Samira Theodossey by Abla & Clay Creasey Elaine Walbroek by Ron Wood Veva Winkelstein by Rachel Royce

IN HONOR OF Henry Behrens by Colleen & Perry Behrens Harry Bliss by Howard Stiver Patricia Buffler by Shirley Roach Cheena by John Kaufmann

Chin Long Chiang by Margaret Deane Clare Mahan Leonard Duhl by John Hough Brenda Eskenazi by Berna Atik Watson Anne Good by Howard Graves & Julie Baller Patricia Hosel by Carol Patterson Susan Ivey by H. Reece & Margaret Ivey Richard Jackson by Teresa Heinz

Ruth Stimson by Bob Montgomery David & Mary O’Neill Leonard Syme by Samuel Lind Krisztina Szabo by Mary Leon Mr. & Mrs. Morris Tansky by Barbara Tansky Helen Wallace by Claude Brown Bradley & Elizabeth Appelbaum Alfredo & Roberta Ycasas by Joyce Ycasas

Washington Burns, M.D., B.S. ’52, and his wife, Paula, share a bench with Mark Twain at the School of Public Health Appreciation Dinner at the Doe Library.

Joyce Lashof by Shirley Roach Nancy Lusk & Michael Smith by Linda & James Clever Christine MacKenzie by M. Antoinette Harris Meredith Minkler by Rosalind Singer Carrie Peng by Gordon Gao Public Health Heroes by Linda & James Clever Public Health Nutrition by Susan Foerster V. Ramakrishna by Mildred Patterson Tom Rundall by Daniel Gentry Robert Scott by Merle Lustig Versant Ventures Steve Selvin by Howard Graves & Julie Baller Robert Spear by Arlene Klonoff

DECADE CLUB

Recognizing alumni and other individuals who have given for the past 10 years consecutively. Nancy Altemus Adele Amodeo Ramona Anderson Richard Bailey Marina Baroff James & Lisa Behrmann Joan & Howard Bloom Judith Bramson Claude Brown Jeffrey & Cathleen Brown Patricia & Richard Buffler Ralph & Betty Carpenter Alice Chetkovich Alfred & Eunice Childs Carol & Ron Clazie Linda & James Clever Margaret Deane John & Marlene Eastman Susan Eckhardt Jerry & Lorraine Factor

Partners in Public Health

Michael & Sandra Fischman FMC Corporation Katharine & Daniel Frohardt-Lane Charles & Marilyn Froom Wallace Gee Carol Giblin Virginia Gladney Mildred Goodman Marian & Roger Gray Linda Greenberg & Hiroshi Motomura Sylvie Griffiths Joseph Guydish Frances Hamblin Jean Hankin Thomas Hazlet Dorothy Hertz Glenn & Jan Hildebrand Donald & Marie Hochstrasser David & Katharine Hopkins Patricia & Harry Hosel David Hoskinson Mark & Estie Hudes Robert & Beverly Isman Olive & D. M. Jack A. Arlene Kasa Jane Kenyon James & Sarah Kimmey Julia Klees Clement & Donna Kwong Kelvin & Brenda Lee Lynn Levin & Stanley Oshinsky William Light & Robin Vernay-Light Nancy Lusk & Michael Smith Mark Mendell Joan Milburn Donald & Elizabeth Minkler Meredith Minkler & Jerry Peters Hiroshi Motomura & Linda Greenberg Jeffrey Newman Beata & Harlen Ng Joel & Phyllis Nitzkin Mary & Craig Noke Mildred Patterson Darwin & Donna Poulos Arthur Reingold & Gail Bolan Lois Rifkin Shirley Roach Thomas Rundall & Jane Tiemann Leigh Sawyer & Gerald Quinnan Sidney & Sally Saltzstein Janet Schilling Betty Seabolt Donna Shelley Nancy & Robert Shurtleff

Mitchell & Bonita Singal Rosalind Singer Esmond Smith Kirk Smith & Joan Diamond Robert & Patricia Spear Susan Standfast & Theodore Wright, Jr. Bruce Steir & Yen Aeschliman Howard & Virginia Stiver Laurence & Ann Sykes Marilyn Teplow John Troidl Katherine & Robert Westpheling Michael Williams Channing Wong

BENJAMIN IDE WHEELER SOCIETY

Recognizing donors who have expressed their intention to include the School of Public Health in their estate plans Dudley Aldous Balan Arakoni Stacey Baba & James Vokac Grace Bardine Paul Boumbulian Doris Brusasco Patricia & Richard Buffler Paul & Susan Conforti Colleen Denny-Garamendi John & Marlene Eastman Viola Egli Garold Faber Robert Frangenberg & Ingrid Lamivault Marcia Gerin Joseph Homler Marjorie Hunt Kenneth & Marjorie Kaiser A. Arlene Kasa Jogi & Tejbir Khanna Joan Lam Carol Langhauser Eleanor Langpaap Wallace Lowe Therese Pipe Harper Puziss Ronald & Genevieve Roberto Rosalind Singer Beulah Teravainen Helen Thorall Paola Timiras Barbara & John Whelan Warren Winkelstein

Every effort has been made to provide a complete and accurate listing of individual donors and their gifts to the School of Public Health from July 1, 2005, to June 30, 2006. Should you discover a mistake or omission, please accept our apologies and contact us at (510) 642-2299 or trini@berkeley.edu so that we can correct our records.

School of Public Health Policy Advisory Council 2007–2008 Kenneth S. Taymor, Esq. (Chair) Attorney-at-Law MBV Law LLP

Richard M. Levy, Ph.D. Chairman of the Board Varian Medical Systems, Inc.

Raymond J. Baxter, Ph.D. National Senior Vice President, Community Benefit Kaiser Foundation Health Plan and Hospitals

Leslie Louie, Ph.D. ’90, M.P.H. ’85 President Public Health Alumni Association

Teresa S. Carlson, M.P.H. ’84 Retired Health Care Management Consultant Peter F. Carpenter, M.B.A. Founder Mission and Values Institute Margaret Cary, M.D., M.B.A., M.P.H. Special Adviser, Medical-Surgical Services Veterans Health Administration

Dean Ornish, M.D. Founder and President Preventive Medicine Institute Martin Paley, M.P.H. ’58 Management Consultant Arnold X. C. Perkins Former Director Alameda County Public Health Department Lisa Stone Pritzker Advocate and Activist for Child, Adolescent, and Women’s Health

Linda Hawes Clever, M.D., M.A.C.P. Chief, Occupational Health California Pacific Medical Center

J. Leighton Read, M.D. General Partner Alloy Ventures

Founder, RENEW

Theodore J. Saenger Chairman Sutter Health Care

Abla A. Creasey, Ph.D. ’78 Director, Research & Development Center for Biomaterials & Advanced Technologies Medical Devices Group Johnson & Johnson Lauren LeRoy, Ph.D. President and CEO Grantmakers in Health

Steven A. Schroeder, M.D. Distinguished Professor of Health and Health Care UCSF Department of Medicine L. James Strand, M.D., M.B.A. General Partner Institutional Venture Partners Barbara S. Terrazas, M.P.H. ‘76 Director, Planning, Development, and Policy Tiburcio Vasquez Health Center, Inc.

Public Health

Faculty News

Faculty News and Notes Smoking increases risk of TB infection, finds new study

Bloom Receives PsychoOncology Award

People who smoke have a greater risk of becoming infected with tuberculosis (TB) and of having that infection turn into active TB disease, according to an analysis led by Michael Bates, Ph.D. ’91, M.P.H. ’89, adjunct professor of epidemiology. The authors of the study, published in the February 26, 2007, issue of the journal Archives of Internal Medicine, analyzed 24 studies that included details about smoking and TB outcomes. They found that smokers have a 73 percent greater chance of becoming infected than do nonsmokers. For those who are infected, the chances of developing active TB disease are about 50 percent greater in smokers compared with nonsmokers. Overall, a smoker has about a 2.5 times greater risk of contracting active TB than does a nonsmoker in the same population. This study was supported by the Fogarty International Center Global Tobacco Control Research and Training Program and the UC Center for Occupational and Environmental Health.

Professor of health policy and management Joan Bloom, Ph.D., has been honored with the Bernard Fox Memorial Award by the International PsychoOncology Society (IPOS). Bloom was selected in recognition of her contributions to the field of psycho-oncology research. Her most recent contributions have been in the field of survivorship research, where her work has focused on survivors of Hodgkin’s disease and on younger women with breast cancer. She will receive the award at the IPOS 9th World Congress of PsychoOncology in London on September 18, 2007. A paper based on her presentation at the award plenary will be published in the journal Pscyho-Oncology.

Most California parents support HPV vaccination for daughters, finds study California parents voiced strong support for vaccinating their daughters with the new human papillomavirus vaccine, according to an article published in the February, 2007 issue of the Journal of Adolescent Health. The study, by Norman Constantine, Ph.D., clinical professor of community health and human development, and Petra Jerman, Ph.D., M.P.H ’06, questioned 512 randomly selected parents statewide. The researchers found that three-quarters of parents support HPV vaccination by the recommended age of 13, and 82 percent support vaccination by the age of 16. The majority of parents from all racial-ethnic groups, both genders, all income and educational levels, and all religious denominations, including Evangelical Christians, supported vaccination. The study unveiled several specific concerns of the 18 percent of parents who were unsupportive. Pragmatic concerns about effects on sexual behavior, vaccine safety concerns, moral concerns about sexual behavior, and denial of need were all mentioned by non-supportive parents.

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Dietary patterns of adolescent girls are examined in several studies Adjunct professor Patricia Crawford, Dr.P.H. ’94, R.D., codirector of the Dr. Robert C. and Veronica Atkins Center for Weight and Health (CWH), is an author of several recent studies looking at certain dietary habits in adolescent girls. One study, published June 12, 2007, in an advance online issue of the International Journal of Obesity, looked at the relationship between meal frequency and body mass index (BMI) in black and white adolescent girls, finding that girls who ate three or more meals on more days had lower BMI. Another study, published in the February 2006 issue of Journal of Pediatrics, looked at beverage intake in adolescent girls. This study found that milk consumption decreased and soda intake increased between childhood and adolescence; also that increased soda consumption predicted greater body mass index and lower calcium intake in adolescent girls. A study published in the February 2007 Journal of Nutrition, looked at adolescent dietary patterns and adiposity in young black women and young white women. CWH’s Lorrene Ritchie, Ph.D., is first author of the study; other authors include CWH codirector May Wang, Dr.P.H. ’93, R.D.

The authors found that a cumulative pattern of food intake consistent with recommendations for general health (high intake of fruit, vegetables, dairy, grains without added fats, and a low intake of sweetened drinks, fried foods, burgers, and pizza) was related to lower adiposity, but this pattern was followed by only a minority of adolescent girls.

Bioethicist offers steps to help doctors move past anger with patients Doctors are human, and are thus susceptible to the same feelings of anger and frustration that plague all of us from time to time. But what happens when those emotions are directed at patients under their care? Associate professor of bioethics Jodi Halpern, M.D., Ph.D., addresses this dilemma in an article, “Empathy and Patient-Physician Conflicts,” appearing in the May 2007 issue of the Journal of General Internal Medicine. She noted that doctors may experience a range of negative emotions when confronted with patients who, for instance, refuse necessary treatment or are angry. Physicians also frequently feel overworked, said Halpern, and they may blame a patient for contributing to their workload.

Studies look at association of obesity and socioeconomic status in Mexico In the United States, higher socioeconomic status is associated with decreased prevalence of obesity. But in a recent study by Lia Fernald, Ph.D., assistant professor of public health nutrition, reported in Social Science and Medicine, the reverse association was evident in low-income Mexican adults living on less than $2 per day. In both men and women, body mass index (BMI) was positively associated with education, occupation, quality of housing conditions, household assets, and subjective social status. The combined prevalence of overweight and obesity was over 70 percent in women greater than 35 years old with some educational attainment, compared with a prevalence of 45 percent in younger women with no educa-

Faculty News

tion. The analyses suggest that the consumption of alcoholic and carbonated sugar beverages may partially explain the positive association between socioeconomic status and BMI. The prevalence of obesity is also high in low-income pre-school-aged children and exists concurrently with malnutrition. In the May issue of the European Journal of Clinical Nutrition, another paper by Fernald reported that the prevalence of concurrent overweight or obesity and stunting (malnutrition) was approximately 5 percent in non-indigenous children, and over 10 percent in indigenous children 24-60 months. The factors associated with coexisting stunting and overweight or obesity were lower socioeconomic status, lower maternal age, education, intelligence (vocabulary), and perceived social status, shorter maternal height, and larger household size.

Halpin tapped for presidential candidate’s health care committee Professor of health policy Helen Halpin, Ph.D., M.S.P.H., has been invited to join the Health Care Policy Committee for Democratic presidential candidate Barack Obama’s campaign. The committee will prepare briefing papers and draft policy proposals for the senator. Halpin is providing expertise on prevention and public health, eligibility and benefits for the public plan, and the impact of the reform on those who have adequate coverage, those who are underinsured, and those who are uninsured.

AIDS book challenges UNAIDS reporting Clinical professor James Chin, M.D., M.P.H. ’61, former chief of the Surveillance, Forecasting, and Impact Assessment unit of the Global Programme on AIDS of the World Health Organization, has written a book titled The AIDS Pandemic: the collision of epidemiology with political correctness (Radcliffe-Oxford, 2007). The book asserts that the AIDS pandemic has been distorted by UNAIDS and most AIDS activists in order to support a myth of

high potential risk of HIV epidemics spreading into the general population. Chin says that AIDS has a different pattern in different countries based on behaviors, and for some countries it is better to target high-risk groups than dilute resources in interventions aimed at the general population. He also says that rates of disease projected by public health agencies are often higher than the epidemiology would support; and that social determinants, while playing an important role in all health outcomes, are less relevant for AIDS transmission than patterns of sexual behavior and opportunities for parenteral exposure.

Feachem knighted for his leadership of the Global Fund Richard Feachem, C.B.E., B.Sc., Ph.D., D.Sc. (Med), FREng, FICE, FIWEM, HonFFPHM, professor of international health, was named Knight Commander of the Order of the British Empire by Her Majesty Queen Elizabeth II. This honor recognizes his role in leading the Global Fund to Fight AIDS, Tuberculosis and Malaria from its inception. Feachem has worked in international health and development for more than 30 years and has published extensively on public health and health policy. He took up his position as the first executive director of the Global Fund in July 2002, having served as the founding director of the Institute for Global Health at UCSF and UC Berkeley.

Study looks at characteristics of neighborhoods and obesity risk Assistant adjunct professor May Wang, Dr.P.H. ’93, R.D., codirector of the Dr. Robert C. and Veronica Atkins Center for Weight and Health, is first author of a study that looks at whether socioeconomic and food-related physical characteristics of the neighborhood were associated with body mass index (BMI) independently of individual-level s ociodemographic and behavioral characteristics. The study, published in the June 2007 issue of the Journal of Epidemiology and Community Health, found that living in low socioeconomic neighborhoods, where there is a high density of small grocery and convenience stores and healthy food is not readily available, is associated with increased obesity risk.

However, living close to supermarkets, which typically carry fresh produce and healthy foods, is not associated with a lower risk of obesity. The findings also suggest that women may be more sensitive to the effects of the neighborhood environment.

Harris Named to NIH Study Section Associate professor Eva Harris, Ph.D., has been appointed to the International and Cooperative Projects-1 Study Section, Center for Scientific Review, at the National Institutes of Health. Study sections review grant applications submitted to the NIH, make recommendations on these applications to the appropriate NIH national advisory council or board (in this case the Fogarty International Center), and survey the status of research in their fields of science. Members are selected on the basis of their demonstrated competence and achievement in their scientific disciplines.

Jackson urges transformation of American communities Richard Jackson, M.D., M.P.H. ’79, adjunct professor of environmental health sciences and health policy and management, has been spreading the message about the need for California and American communities to become more health friendly in every sense: sustainable, walkable, and health supportive. Jackson published an editorial in the March 9, 2007 issue of Science and spoke at venues throughout the country, including medical schools at Yale and Stanford, and health departments in Los Angeles, San Joaquin, Napa, and Yolo counties. Jackson, a pediatrician, is on the board of directors of the American Institute of Architects (AIA) and has given talks at AIA meetings in several states. He also recently became the academic lead for the School of Public Health’s Dr.P.H. Program.

Mack travels to Japan to discuss design of innovative curriculum Kevin Mack, M.D., director of the Office of Educational Technology in the UC Berkeley-UCSF Joint Medical Program (JMP) and former director of curriculum, was instrumental in designing the continued on page 40 Public Health

Faculty News

Faculty News and Notes, continued contextually integrated case-based curriculum for pre-clinical medical schools on behalf of the JMP. He was asked by the Kyoto University Consortium to present the theoretical underpinnings of inquirydriven learning and to describe the evolution of a curriculum from the small-group didactic environment to an entirely case-based, problem-based curriculum. The consortium also asked Mack to discuss the use of technology in monitoring student progress, core content acquisition, and faculty development issues that arise from this type of curricular innovation.

Kaskutas honored for contributions to addiction medicine At the 38th Annual Medical-Scientific conference of the American Society of Addiction Medicine, adjunct professor Lee Ann Kasutas, Dr.P.H. ’92, delivered the keynote plenary address and received the 2007 Brinkley Smithers Distinguished Scientist Award for contributions to the field of addiction medicine. The annual award recognizes an individual who has made highly meritorious contributions in advancing the scientific understanding of alcoholism, its prevention and treatment. Kaskutas is director of training at the Alcohol Resource Group in Berkeley and is principal investigator of the NIAAA training grant, “Graduate Research Training on Alcohol Problems,” at UC Berkeley.

Medical education program brings care to urban underserved In Fall 2006, the UC Berkeley-UCSF Joint Medical Program (JMP) and UCSF School of Medicine launched the Program in Medical Education for the Urban Underserved (PRIME-US). The pilot program is part of a statewide initiative of the UC Office of the President to expand all UC medical school classes by approximately 10 percent to help meet the health care needs of California’s growing population and increase California’s pool of physicians committed to caring for the underserved. Associate clinical professor Karen Sokal-Gutierrez, M.D., M.P.H., is the campus site director for the program. PRIME-US is a special track for four students in the JMP and six at UCSF each year. The PRIME-US curriculum includes biweekly seminars and community-based activities that explore the health and health care of 40

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urban underserved populations; a longitudinal clinical experience based at a site focused on providing care for underserved populations; master’s research thesis work related to health care issues for the urban underserved; clinical clerkships in underserved community hospitals and clinics; and strong academic and social support. The pilot class of PRIME-US has completed its first year of the program, and the first official class has just entered.

Health Research for Action center receives multiple recognitions Health Research for Action, a center headed by Linda Neuhauser, Dr.P.H. ’88, and S. Leonard Syme, Ph.D., was awarded four prestigious 2007 Hermes Creative Awards by the Association of Marketing and Communication Professionals. These international awards recognize outstanding achievement in the concept, writing, and design of traditional media and emerging technologies. The center received two Hermes Creative Platinum Awards—the competition’s highest honor—for an issue of its newsletter, Perspectives, that focused on environmental health tracking, and for its consumer health guide, Parents Guide, produced for California’s First 5. The other two awards were for California’s HMO Guide for Seniors and another issue of Perspectives, this one focusing on seniors and the hospital-to-home experience.

Robinson named editor-in-chief of leading health policy journal James C. Robinson, Ph.D., M.P.H. ’81, the Kaiser Permanente Distinguished Professor of Health Economics, has been named editor-inchief of Health Affairs. The peer-reviewed journal, for which Robinson has been a contributing editor, explores health policy issues of current concern in both domestic and international spheres and appears bimonthly in print and on the Web. Since its first issue in Winter 1981, Health Affairs has grown into the nation’s leading journal of health policy, with more than 16 million online

page views per year. It is published by Project HOPE, an international health education and humanitarian assistance organization.

Dr. P.H. Program recognizes outstanding faculty and community members On June 8, 2007, the School’s Dr.P.H. Program held its first annual awards dinner to recognize faculty and community members selected by the students for their contributions to the program. Professor Meredith Minkler, Dr.P.H. ’75, was awarded a Golden Apple for her numerous contributions to the program. Under her leadership, the program saw increases in funding, student diversity, and community involvement, as well as an expanded curriculum. Thanks to her mentorship, Dr.P.H. students have worked with health departments from several cities and counties to work on pressing public health issues through the Dr.P.H. in Action program. Associate dean Denise Herd, Ph.D., received the Distinguished School of Public Health Faculty Award for her excellence in mentorship and contribution to Dr.P.H. education and for being a constant source of academic support, an advocate for increased diversity within the program, and a great mentor to Dr.P.H. students in communitybased practice and translational research. Norm Constantine, Ph.D., clinical professor at the School, and Kurt Organista, Ph.D., associate professor in the School of Social Welfare, received the Distinguished Academic Partner Award for their excellence in translational and transdisciplinary research and action with the Dr.P.H. Program. Cheri Pies, Dr.P.H. ’93, was awarded special recognition by the class that entered the Dr.P.H. Program in 2005. They cited her extraordinary mentorship; her commitment to enabling them to fulfill their academic and personal goals, as a group and as individuals; and the example of public health leadership she sets, both inside and outside the classroom. Sarah Samuels, Dr.P.H. ’82, of Samuels and Associates, and Fr. Rigoberto Caloca-Rivas, Ph.D., of the nonprofit Multicultural Institute, received the Distinguished Community Member Excellence Award for their partnership with the program to solve public health problems.

Faculty News

Implementation of electronic medical records systems discussed in new book

Cancer death rates remain high decades after exposure to arsenic, new study finds

Thomas Rundall, Ph.D., Henry J. Kaiser Professor of Organized Health Systems, has coauthored Implementing an Electronic Medical Record System: Successes, Failures, Lessons (Radcliffe-Oxford, 2007), the only detailed account of the actual implementation of an electronic medical records system in a large health organization. Focusing on the importance of organizational culture and leadership, the authors use qualitative methods to report the experiences of clinicians, managers, and implementation team members. Coauthors are Tim Scott Ph.D., Thomas M. Vogt, M.D., Ph.D., and John Hsu, M.D., M.B.A., M.S.C.E.

Death rates from lung and bladder cancer remained high decades after residents in northern Chile were exposed to high levels of arsenic in their drinking water, according to a new study by researchers from the UC Berkeley School of Public Health and the Pontificia Universidad Católica de Chile in Santiago. That the mortality risks remained elevated long after exposure to high levels of arsenic ended indicates a clear pattern of latency in health effects that had not been known before, said the authors of the study, which appeared in the June 12, 2007, issue of the Journal of the National Cancer Institute. Allan Smith, M.D., Ph.D., professor of epidemiology and head of UC Berkeley’s Arsenic Health Effects Research Program, is the study’s principal investigator and an author of the paper. Guillermo Marshall, Ph.D., professor and dean of the Faculty of Mathematics at Chile’s Pontificia Universidad Católica, is lead author. Coauthors are Catterina Ferreccio, M.D., M.P.H., of the Pontificia Universidad Católica de Chile; and Yan Yuan, M.P.H. ’01, Michael Bates, Ph.D. ’91, M.P.H. ’89, Craig Steinmaus, M.D., M.P.H. ’97, Steve Selvin, Ph.D. ’70, and Jane Liaw, M.P.H. ’00, from UC Berkeley’s School of Public Health. The work was supported by the National Institute of Environmental Health Sciences and the UC Center for Occupational and Environmental Health.

New book examines role of private voluntary health insurance Richard M. Scheffler, Ph.D., Distinguished Professor of Health Economics & Public Policy, has edited the book, Private Voluntary Health Insurance in Development: Friend or Foe?, with Alexander S. Preker, M.D., Ph.D., of the World Bank, and Mark C. Bassett, M.A., FRSA, of the British United Provident Association. Private voluntary health insurance already plays an important role in the health sector of many low and middle income countries. The book reviews the context under which private insurance could contribute to an improvement in the financial sustainability of the health sector, financial protection against the costs of illness, household income smoothing, access to care, and market productivity. This volume, published by the World Bank, is the third in a series of in-depth reviews of the role of health care financing in providing access for low-income populations to needed healthcare, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Vignettes recall history of epidemiology Since September 2006, professor emeritus and former dean Warren Winkelstein, M.D., M.P.H., has been writing a new feature, “Vignette,” in the journal Epidemiology. The vignettes are brief illustrated notes about important historical figures or events relevant to the field of epidemiology. Published vignettes have included “Alice Hamilton: Pioneer Occupational Epidemiologist,” “Janet Elizabeth Lane-Claypon: A Forgotten Epidemiologic

Pioneer,” “Joseph James Kinyoun: First Director of the National Institutes of Health,” “The Halifax Explosion,” and “Austin Flint: Clinician Turned Epidemiologist.”

Dean’s Office News On July 1, 2007, two faculty members began serving in the Dean’s Office in new roles: Thomas Rundall, Ph.D., Henry J. Kaiser Professor of Organized Health Systems, has been appointed the School of Public Health’s first executive associate dean. In this capacity, he will work with Dean Stephen Shortell, Ph.D., M.P.H., to oversee all aspects of faculty review, promotion, and recruitment; academic planning; and policies and practices. Rundall has served the School and the Berkeley campus for more than 20 years, including several stints as chair of the School’s Division of Health Policy and Management and directing the UC Berkeley Center for Health Research. Associate professor Eva Harris, Ph.D., will serve as associate dean for research. In this capacity, she will help facilitate the work of the various research centers within the School; develop effective mechanisms for communicating research opportunities as well as the results of the School’s research; and work with other members of the Dean’s Office in supporting the research enterprise of the School. Harris, the recipient of numerous awards for her research on dengue fever, including a MacArthur Foundation “genius” award, has been at the School for nine years and is chair of the School’s newly created Center for Global Public Health.

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Faculty News

Recent Grants and Contracts

The following grants and contracts support faculty research at the School of Public Health: California Public Health Laboratory Director Training Program

Team Nutrition: Local Wellness Demonstration Project Evaluation

$4,600,000 (over five years) from the California Department of Health Services

$168,632 from the U.S. Department of Agriculture and California Department of Education

PI: Gertrude Buehring, Ph.D. The major components of this program include support for doctoral students (Dr. P.H. and Ph.D.), support for postdoctoral positions, assistance to state and county public health labs and to employ the graduates in paid positions. Other aspects include strengthening of the undergraduate and graduate infectious diseases laboratory courses and outreach at all levels to get people into the pipeline to a career as a public health laboratory director.

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PI: Patricia Crawford, Dr.P.H. â&#x20AC;&#x2122;74, R.D.; Project manager: Gail Woodward-Lopez, M.P.H. â&#x20AC;&#x2122;88, R.D. The Child Nutrition and WIC Reauthorization Act of 2004 required that each local education agency participating in the National School Lunch establish a school wellness policy by 2006. In order to better understand the extent and processes by which school districts develop and implement these policies as well as to assess

the short term outcomes of the wellness policies, the USDA awarded grants to California, Iowa, and Pennsylvania to evaluate the demonstration project.

Arsenic and Child Respiratory Health in Bangladesh $2,297,877 from the NIH National, Heart, Lung, and Blood Institute PI: Allan H. Smith, M.D., Ph.D. The impact of arsenic ingestion on lung function and respiratory health has so far not been studied in children. Smith and his team plan to study 300 children, aged 6 to 16 years, from Bangladeshi families in which at least one member of the family has developed arsenic-related skin lesions.

Faculty News

Most of these families use tubewell water with arsenic concentrations of over 300 ug/L. An unexposed comparison group of 300 children will be selected from Bangladeshi families with no skin lesions, who use tubewell water containing arsenic concentrations of less than 50 ug/L. Lung function and respiratory symptoms, including chronic cough and shortness of breath, will be assessed in relation to current and past arsenic concentrations in all sources of drinking water throughout childhood, including in utero exposure.

Determinants of Schistosomiasis Reemergence $2,295,199 from the NIH/National Institute of Allergy & Infectious Diseases PI: Robert C. Spear, Ph.D. Spear and his team’s long-term objectives for this project are to develop methods for the design of site-specific control programs to achieve the sustainable cessation of transmission and control of Schistosoma japonicum infections in China. The recent reemergence of transmission in formerly controlled Chinese counties has prompted

several hypotheses and utilize a stochastic model of reemergent transmission to explore the effect of chance events on the design of an effective surveillance system.

Fresh Start Evaluation $261,209 from California Department of Education Subcontract PI: Patricia Crawford, Dr.P.H. ’74, R.D.; Project manager: Gail Woodward-Lopez, M.P.H. ’88, R.D. California Fresh Start is a pilot program established by Senate Bill 281 that provides a 10-cent per meal reimbursement to school districts to promote and serve an additional serving of fruits or vegetables in the school breakfast program. The study will evaluate how well the program is working and will identify successful implementation strategies and improvements or additional support that may be necessary to ensure successful implementation.

Research and Training in Environmental and Occupational Health, India $722,500 from the NIH Fogarty International Center PI: Allan H. Smith, M.D., Ph.D.

Spear to study the determinants of this reemergence to inform the design of surveillance programs for the early detection and minimization of the scale and impact of reemergence. The research team will test

The Fogarty Training Program in India, under the direction of Allan Smith and Kirk Smith, has focused on the development of skills and capacity-building for research and interventions concerning the environmental health consequences resulting from widespread arsenic contamination of drinking water (especially in West Bengal), and indoor air pollution from the use of traditional fuels in rural households throughout the country. To address the problem of arsenic-contaminated water, Allan Smith and the research team plan to continue administering their training program with

traditional and molecular epidemiology research studies, including investigations to assess the health impact of early life exposure to arsenic. The team will continue to work with trainees in improving the design of shallow dugwells as a rapidlyimplementable mitigation method to reduce exposure. To address indoor air pollution, Kirk Smith and his collaborators plan to conduct training in both traditional and modern methods of exposure and outcome assessment, as well as further explore the efficacy of such interventions as stoves with highly improved combustion of biomass that will generate less pollution.

Statistical Methods to Study the Epidemiology of HIV and Other Diseases $1,271,337 from the NIH/National Institute of Allergy & Infectious Diseases PI: Nicholas P. Jewell, Ph.D. This project will develop statistical techniques for data on HIV and sexually transmitted infections. A significant challenge is application of causal inference methods to randomized trials for HIV prevention in Africa. Assessment of new interventions— such as microbicides and the diaphragm— are complicated both by concurrent use of traditional prevention methods (e.g. condoms) in both arms of the trial, and by noncompliance with both the primary intervention and other methods. A project theme is the modeling of effects of explanatory factors on time-to-event outcomes with incomplete information and data that is sometimes observational in nature and often high-dimensional. continued on page 44

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Faculty News

Recent Grants and Contracts, continued Using Biomonitoring In Environmental Public Health $15,000 from the San Francisco Foundation PI: Amy D. Kyle, Ph.D. ’96, M.P.H. ’92 Kyle and her team are working on a framework and case studies to examine how questions relevant to policy decisions can be answered through biomonitoring. Questions of policy interest include: What chemicals are found in the human body? Do we know their sources? Do they occur at critical stages of development? Do we see differences over time? Do we see differences by region? Can we identify highly impacted populations? The grant from the San Francisco Foundation will allow the group to work with community-based organizations to examine how their experiences can be integrated into a state biomonitoring program. This work is funded through the Superfund Basic Research Program and the Center for Environmental Public Health Tracking.

benzene on DNA and chromosomal damage in human sperm and will determine the association between chromosomal damage in sperm and blood cells within the same individuals. The study will use samples collected from 34 benzene-exposed male factory workers and 44 controls in Tianjin, China.

contribute to balancing work and family by empowering mothers to succeed at breastfeeding, increasing duration of lactation, and helping infants get a healthy start in life. It will also identify those vulnerable groups more likely to benefit from existing leave policies available in California.

Balancing Work and Family: The Relationship Between Pre and Postpartum Maternity Leave Arrangements and Breastfeeding

Targeted Empirical Super Learning in HIV Research

$30,000 from the UC Labor and Employment Research Fund PI: Sylvia Guendelman, Ph.D., LCSW This study seeks to examine the relationship between maternity leave arrangements, workplace characteristics, and breastfeed-

$2,302,698 from the NIH/National Institute of Allergy & Infectious Diseases PI: Mark van der Laan, Ph.D. Van der Laan plans to study and extend a general statistical methodology called “targeted empirical learning,” which includes a recently developed “targeted maximum likelihood” methodology. He

Genetic Damage in the Sperm and Blood of Workers Exposed to Benzene $119,966 from the NIH/National Institute of Environmental Health Sciences PI: Brenda Eskenazi, Ph.D. This project is one of the first to investigate the relative sensitivities of sperm and blood cells to chromosomal defects induced by benzene. In collaboration with colleagues from the School of Public Health, Lawrence Berkeley National Laboratories, and the Chinese Center for Disease Control, the researchers will examine the effects of

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ing initiation and duration among working women in Southern California. Data will be obtained from “Juggling Life and Work During Pregnancy,” a case-control study conducted in Orange, Imperial, and San Diego counties between 2002 and 2003, and weighted to account for study design. This project will enhance understanding of how maternity leave arrangements may

plans to expand targeted empirical learning into a practical product that be applied to pressing scientific questions. Building on long-standing collaborations with leading scientists in areas of clinical AIDS research, van der Laan and his team will use this novel methodology to address research questions concerning HIV.

How do you... • • • •

Cure the diseases that plague the world? Reform the health care system in the United States? Reduce exposures to toxins in the environment? Ensure that all people have access to clean water and healthy foods?

THERE IS A SIMPLE STEP YOU CAN TAKE TO HELP MEET THE GREATEST CHALLENGES FACING OUR COMMUNITIES. Give to the School of Public Health Annual Fund and support the brightest students and faculty, whose work will bring us closer to solutions that benefit us all. Give online at sph.berkeley.edu/giving/how.htm or mail your gift (payable to the “School of Public Health Fund”) to:

University of California, Berkeley School of Public Health External Relations & Development 417 University Hall #7360 Berkeley, CA 94720-7360 For additional information about making a gift to the School, call Pat Hosel, Assistant Dean, External Relations and Development, at (510) 642-9654 or e-mail phosel@berkeley.edu.

Your Contribution Makes Possible: • Scholarships and fellowships for students who could not otherwise afford to attend UC Berkeley • The best possible field placements for our students, so they can gain the hands-on experience that will serve them in their careers • Technology in the form of updated computers and lab equipment, so that we can use the public health tools of the twenty-first century • Travel for students who have been invited to present papers at professional meetings and conferences • Summer research support, as an incentive for recruiting new faculty Public Health

Alumni News

President’s Message Greetings fellow alumni, We’ve had a productive year thanks to an energetic board of directors. I’d like to especially thank three of our outgoing board members. Jim Devitt, M.P.H. ’78 (Health Administration and Planning), has served on the board for four years, as secretary-treasurer for three years. Jim also chaired the MultiCultural and Diversity Concerns Committee and the Scholarship Committee during his tenure. Sarah Stone-Francisco, M.P.H. ’03 (Epidemiology & Biostatistics), has served on the board for three years, performing the duties of vice president and chairing the Membership and Outreach Committee. Philippa Barron, M.B.A, M.P.H. ’94 (Health Services Management), has served on the board for three years and chaired the Nominations Committee. All three will be missed and we wish them the best.

Public Health Alumni Association Board of Directors 2007–2008 Leslie Louie, Ph.D ’90, M.P.H. ’85 (President) Mindi Lassman, M.A., M.S. ’77 (Vice President) Lucinda Bazile, M.P.H. ’94 (Secretary-Treasurer) Beth Roemer, M.P.H. ’76 (Secretary-Treasurer) John Troidl, Ph.D. ’01, M.B.A. (President-elect) P. Robert Beatty, Ph.D. ’94 Harvey Bichkoff, M.P.H. ’85 Julie M. Brown, M.B.A, M.P.H. ’85 Laurel Davis, M.P.H. ’94, C.I.H. David Harrington, M.P.H. ’88 Joan Lam, B.S. ’62 Sally Lawrence, M.P.H. ’06 Kelvin Quan, J.D., M.P.H. ’81

At the same time we are pleased to welcome our three new directors: Sally Lawrence, M.P.H. ’06 (Public Health Nutrition), Kelvin Quan, J.D., M.P.H. ’81 (Corporate Healthcare Management), and Karen Shore, Ph.D. ’98 (Health Services and Policy Analysis). Our new vice president is Mindi Lassman, M.S. ’77 (Genetic Counseling), and our new co-secretary-treasurers are Lucinda Bazille, M.P.H. ’94 (Health Policy and Administration) and Beth Roemer, M.P.H. ’76 (Healthcare Administration). Our first-ever president-elect is John Troidl, Ph.D. ’01 (Health Services and Policy Administration), M.B.A. On April 15, we held another successful Spring Brunch and Silent Auction, cochaired by Sarah Stone-Francisco and Julie Brown, M.B.A, M.P.H. ‘85 (Health Services Management). It was a gorgeous day and we had a nice turnout of faculty, alumni, and friends who enjoyed friendly competitive bidding on a number of items while sipping mimosas and socializing. (See photos, pp. 29, 32–35.) During the general meeting we amended our purpose: “To build and strengthen personal and professional relationships among public health alumni and students of the University of California, Berkeley.” We heard an inspiring presentation by Michael Bird, M.S.W., M.P.H. ‘83, the first Native American president of the American Public Health Association (APHA), titled “Opening Doors and Opening Your Heart: Diversity and Inclusivity in Public Health.” His remarks helped remind us that we can all do something to support students and junior colleagues to make changes in the future of public health. The PHAA board surveyed the membership and designated the proceeds from the Silent Auction for student scholarships to increase diversity in our profession. We will be awarding a $5,000 scholarship next year for this purpose. With more success in future Silent Auctions, we hope to fund multiple and larger scholarships to support diversity. This year we focused on increasing alumni engagement in SPH activities and PHAA-sponsored events. We had two regional events in the spring where alumni were invited to network, socialize, and get updates on School of Public Health news. Joan Lam, B.S.’62 (Public Health), hosted a luncheon at the National Steinbeck Center in the Monterey area. Mindi Lassman hosted an afternoon tea in San Diego. We consider these events the beginning of our outreach efforts, so keep your eyes open for announcements of future events or contact us to host one for your own area. Last fall at the APHA meeting in Boston, we invited local alumni to attend the SPH mixer even if they weren’t attending the meeting. We had a good turnout to fill out the room. Next year’s APHA meeting will be in Washington, D.C., and the open invitation still stands. It’s a great way to reconnect with former colleagues as well as to meet new ones and to stay connected with the School. So mark your calendars for November 5 and we hope to see you there! Sincerely,

Jan Schilling, M.P.H. ’91 Karen Shore, Ph.D. ’98 Alan R. Stein, M.P.H. ’78, M.S., MFT

University of California, Berkeley

Leslie Louie, Ph.D. ‘90, M.P.H. ‘85 President, Public Health Alumni Association

Alumni News

Alumni Notes 1940s

1960s

Lois (Schulman) Rifkin, B.S. ’48 “Enjoying retirement, volunteering at local multimedia art gallery, visiting children and grandchildren, keeping fit at local gym, and flying at local airport (weather in Northwest permitting).”

Wilbur Hoff, Dr.P.H. ’63, M.P.H. ’54 “I continue to assist the SEVA Foundation to train community health workers to prevent blindness in India, Nepal, and Tibet.”

1950s Donald J. Ludwig, M.P.H. ’54 “In the 1970s I started the first public hospital HMO. I had a plan to allow persons in the county (Contra Costa) to join, full or part pay. The State Dept. of Health liked the idea and together we wrote up the plan and submitted it to the Feds who never bothered to reply! Never got any recognition for my advanced proposal!” Edmund J. Pezalla, M.D., M.P.H. ’55, vice president and medical director for Prescription Solutions, a pharmacy benefit management company, was named to the board of trustees of the Pharmacy & Therapeutics Society, a nonprofit association dedicated to serving professionals concerned with the delivery of high-quality outcomes-oriented pharmaceutical care in all health care environments. Henry P. Anderson, M.P.H. ’56 “Still following up study of bracero ‘guest worker’ program conducted at UC SPH under NIH grant, 1956–1959.” Chhaganbhai B. Bhakta, B.S. ’58 “Last year traveled to China with 65 seniors and enjoyed. My wife Sarojben and I are enjoying three granddaughters: Kushmita, 8 years, Sajni, 5 years, and Preesh, 7 months. In summer traveled to Houston and area around; have remained active with community. I retired on November 6, 1995.”

Mildred F. Patterson, M.P.H. ’65 “I enjoy quiltmaking—have two small quilts at Duke University Eye Center in the Touchable Art Center and a second, different wall-hanging for the October-toDecember show 2006. I enjoy exercise classes six days a week, walking, and reading, in addition to quilting.” Jean H. Hankin, Ph.D. ’66, M.P.H. ’63, received the 2006 Edna and Robert Langholz International Nutrition Award from the American Dietetic Association Foundation at its 2006 Food & Nutrition Conference & Expo. She is professor and researcher emeritus in the Epidemiology Program at the Cancer Research Center of Hawaii and a retired professor of public health from the University of Hawaii, as well as an internationally recognized authority in quantifying the role of diet in chronic disease. She helped create and pioneer the use of dietary assessment methods for discovering differences among populations, such as identifying effects on the “Westernization” of Asian diets on the increased risk for heart disease, cancer, osterporosis, and stroke.

1970s Steven Schwartzberg, M.P.H. ’71 “Retired from Alameda County after 33 years. Last position, director, Alameda County Lead Poisoning Prevention Program.” Allan Rosenberg, M.D., M.P.H. ’72, is a professor of pediatric GI and nutrition at the Louisiana State University Health Sciences Center. He welcomes calls or visits to New Orleans from fellow alumni.

George Cernada, Dr.P.H. ’75 “Met with J.F. “Jeff” Tsai, M.P.H. ’63 (Health Education), in Taiwan in November 2006. A couple of years ago, Jeff retired from Taiwan National Health Ministry (MOH), where he was director, International Office. He continues to consult on international training for MOH, visiting Taiwan and Vietnam on overseas training contract negotiations. Both coauthoring article on Taiwan’s fertility decline for World Bank publication (2007).” Sir Michael Marmot, Ph.D. ’75, M.P.H. ’72, FRCP, FFPHM, FMedSci, was the keynote speaker at the Charles C. Shepard Science Award Ceremony, held June 14, 2007, at the CDC’s Tom Harkin Global Communications Center. His address was titled “Health in an Unequal World.” Marmot directs the International Institute for Society and Health and is research professor of epidemiology and public health, University College-London. He has been at the forefront of research in health inequalities for the past 30 years and in 2000 was knighted by Her Majesty Queen Elizabeth II for services to epidemiology and understanding health inequalities. Arnold Milstein, M.D., M.P.H. ’75, was appointed to the Medicare Payment Advisory Commission (MedPAC), the independent federal body that advises the U.S. Congress on issues affecting the Medicare program. He was also recently elected to the Institute of Medicine. Pamela Peeke, M.D., M.P.H. ’76, spoke about mind and body health in a lecture, “Seven Secrets of Staying Alert and Vertical for a Lifetime,” delivered for the University of Maryland, Baltimore’s Bicentennial Speaker Series. A Pew Foundation scholar in nutrition and metabolism, she holds the position of assistant clinical professor of medicine at the University of Maryland School of Medicine. She also owns her own media company, serving as The Discovery Channel’s chief medical correspondent on nutrition and fitness. continued on page 48

Public Health

Alumni News

Alumni Notes, continued Jim Giuffré, M.P.H. ’77, was named president and chief operating officer of Healthwise, a nonprofit organization that has been providing consumer health information to help people make better health decisions since 1975. Most recently, he was Healthwise senior vice president for new products and custom solutions. Before that, he was vice president for health plan sales with Well Med (and later with WebMD).

James Allen Crouch, M.P.H. ’81 “As of January 5, 2007, I have been honored to serve as executive director of the California Rural Indian Health Board for 20 years.”

Linda Smith Schermer, M.P.H. ’77 “Retired. Living and hiking in Sedona, Ariz. Just planted an orchard.”

Jean Marion Naples, M.P.H. ’81 “I have recovered from significant injuries from an auto accident. I am now back at Johns Hopkins but am on disability and not working. I was wearing my seatbelt.”

Mario Gutierrez, M.P.H. ’78, director of rural and agricultural worker health programs at The California Endowment, received the 2007 Terrance Keenan Leadership Award in Health Philanthropy from Grantmakers in Health at its annual meeting in Feburary 2007. Established in 1993 in honor of Terrance Keenan, the award is intended to inspire others in the field to strive toward a standard of excellence exemplified by Keenan throughout his 40-plus years as a grantmaker. Gutierrez was recognized for his innovative approach to grantmaking—using the power of philanthropy as a force for supporting healthy conditions in the fields, communities, health care institutions, media, and civic life. Gutierrez was one of the visionaries behind the California-Mexico Health Initiative, a binational health program in partnership with the University of California Office of the President and the Ministry of Health of Mexico.

1980s Howard Pollick, B.D.S., M.P.H. ’80, is chair of the Oral Health Section of the American Public Health Association for 2007 and 2008 and is an American Dental Association expert spokesperson on fluoridation. He is also a full-time clinical professor in the Department of Preventive and Restorative Dental Services at the UCSF School of Dentistry.

University of California, Berkeley

Merle Lustig, M.P.H. ’81 “Living in Santa Cruz with husband Ron Glass and son Ben LustigGlass. Evaluator at Educational Partnership Center at UCSC.”

Mary Rodrick, Ph.D. ’82, B.S. ’59 “Retired after 23 years at Harvard Medical School doing research on regulation of immune response following thermal injury.” Jacob Eapen, M.D., M.P.H. ‘84, received the Ellis Island Medal of Honor from the National Ethnic Coalition of Organizations at a ceremony on May 12, 2007, followed by a gala dinner at the Great Hall on New York’s Ellis Island. Eapen has devoted his medical expertise to the health problems of undernourished children in developing countries and to poor and disturbed juveniles in the United States. The Ellis Island Medal of Honor celebrates the immigrant experience and seeks to honor Americans from a wide variety of backgrounds for their positive and lasting imprint on our society. Past recipients of the medal include, Rosa Parks, Elie Wiesel, Muhammad Ali, Arthur Ashe, and six past U.S. presidents. Robina Elaine Ingram-Rich, M.P.H. ’86, M.S. ’85, is a founding member and secretary of the board of directors of the American Thrombosis and Hemostasis Network, and a member and secretary of the board of directors of the Ecumenical Ministries of Oregon.

Anjali Morris, M.D., M.P.H. ’86 “Helping to remodel Child Development Center in Pune, India. Have set up a learning disability center in India. Set up outreach program in schools for learning disabled children. Helping Manavya organization for 52 HIV-positive children (residential).” Lindene E. Patton, J.D., M.P.H. ’86, CIH, senior vice president and counsel in Zurich North America Commercial’s environmental group, has been selected to serve as a member of the U.S. EPA Environmental Financial Advisory Board. She will provide advice and recommendations from a financial services industry perspective for EPA environmental financing programs and remediation projects. Charles A. DiSogra, Dr.P.H. ’87, M.P.H. ’75, has joined Knowledge Networks as vice president, chief statistician. In this position, he leads the scientific elements of the company’s KnowledgePanelSM and its substantial research-on-research efforts. He will also apply his statistical experience directly to client consultations and projects. Previously he was responsible for California’s publicly funded tobacco-related disease research grant program, overseeing a portfolio of approximately 250 active grants through the University of California Office of the President. Earlier, he was the founding director and senior research scientist for the California Health Interview Survey at UCLA’s Center for Health Policy Research. Jenny O’Dea, M.P.H. ’88, is associate professor in health education and nutrition education at the University of Sydney, Australia, and the author of Everybody’s Different: A positive approach to teaching about health, puberty, body image, nutrition, self-esteem and obesity prevention, a new book that draws on her 17 years of research. In it she sets out school-based obesity prevention programs that, she says, “are certain to benefit and do no harm to otherwise weight-sensitive young people.”

Alumni News

Gail Woodward-Lopez, M.P.H. ’88, R.D., and George R. Flores, M.D., M.P.H., have authored Obesity in Latino Communities. The monograph, published by the Latino Coalition for a Healthy California, presents a set of principles and action steps for preventing obesity and overweight among California’s 11 million Latinos. Obesity in Latino Communities

Prevention, Principles, and Action

Irva A. Hertz-Picciotto, Ph.D. ’89, M.P.H. ’84 “Currently deputy director, Center for Children’s Environmental Health, UC Davis, where I am leading the largest, most comprehensive case control study of autism yet. This project, known as the CHARGE (Childhood Autism Risks from Genetics and Environment) study, addresses underlying causes, triggers, and mechanisms for neuropathology leading to autism.”

1990s Lisa Tremont Ota, R.D., M.P.H. ‘90, has launched SacredBite (www.sacredbite.com), an innovative nutrition education web site. “SacredBite inspires us to nourish our relationship with food for the benefit of our individual, communal, and environmental well-being,” she says. “It helps us begin to recover the body-centered spirituality necessary to restore our natural relationship with the environment, and to bring about eco-justice.” Ota has a master’s degree in culture and creation spirituality from Holy Names College and drew upon this background to create SacredBite. “I hope my fellow SPH alumni will join me at the table where together we can raise consciousness around what and how we eat,” she says, noting that membership is “free, fun, and good for you.” Jennifer June (Balogh), M.P.H. ’91, recently published her first book, Cowboy Boots: the Art & Sole (Rizzoli/Universe, 2007). “It’s an opinionated and adventurous book that explains, through photographs and words, why people love

cowboy boots and why boots have remained such a longstanding icon of American fashion,” she writes. Josh Bamberger, M.D., M.P.H. ’97, has worked for the San Francisco Health Department (SFDPH) since 1998. Currently he is medical director of housing and urban health. “Housing and Urban Health is the section of the SFDPH that provides the funding and oversight for programs, as well as medical care, to most of the formerly-homeless people living in supportive housing in San Francisco,” he writes. “We opened our first DPH-run supportive housing site in 1999 and now have 13 buildings housing 1,000 people. In addition, my staff covers 26 buildings funded by the city’s Human Services Agency. Overall, since we began in 1999, we have housed over 3,000 formerly-homeless people in supportive housing. My role is to coordinate all the medical and psychiatric care for these residents, as well as policy and planning to deliver case management services and continue to expand supportive housing.” He is married to Debbie Josephs, a clinician with Planned Parenthood in Richmond, Calif. and the couple lives in North Berkeley with their sons, Noah and Eli. Elizabeth “Betsy” Stone, Dr.P.H. ’98, has been named director of quality management/risk management/quality improvement for Sutter Santa Cruz, a nonprofit that comprises San Cruz Medical Foundation, Sutter Maternity & Surgery Center, and the Visiting Nurse Association of Santa Cruz County. She will oversee patient safety and regulatory compliance. Previously she was at UCSF Medical Center, where she was director of the quality improvement department. Christina Clarke, Ph.D. ’99, is associate director of the Surveillance Research Division of the Greater Bay Area Cancer Registry, where she monitors changes in cancer incidence and survival patterns among various population subgroups. She is also involved with key research projects on breast cancer involving the investigation of geographic and temporal variations of breast cancer incidence in the Bay Area and scientific efforts to uncover immunological causes. Currently she is conducting two population-based control studies to explore

environmental factors associated with immune system development and its link to the evolution of breast cancer.

2000s David Yee, M.D., M.P.H. ’01, a traveling resident scholar with the International Volunteers in Urology (IVU), recently went with an IVU team to Vietnam. He writes, “During my trip to Vietnam, I gained a deeper appreciation of the difficulty of practicing urology in a developing country. Not only did I see varied urologic disease sometimes presenting at much later stages, but I also learned how those diseases were managed given the limited resources. Operating at Binh Dan Hospital has raised my awareness of this country’s urologic disease pattern, particularly kidney stones and their public health impact.” Sarah Altman, M.D., M.P.H. ’02 “After graduating from UCSF in 2003, I headed to the East Coast, leaving the Bay Area for the first time in my life to become a part of the Cambridge Hospital Residency Program. ... This summer I return home to the Bay Area to start my career as a community psychiatrist. I will be working at San Francisco General Hospital as an inpatient psychiatrist on the HIV/GLBT unit, teaching first-year residents and medical students. I am excited about working again at a mission-driven, community-oriented, academic hospital. And I am looking forward to continuing my work on stigma and helping people with mental illness recover.” Dana Gerstein, M.P.H. ’02, R.D., received the 2007 American Dietetic Association Recognized Young Dietitian of the Year Award at the California Dietetic Association Annual Meeting held in Oakland, Calif., this past April. Recipients of the award are recognized by the national organization for having demonstrated leadership and concern for the promotion of optimal health and nutritional status of the population. Anne Gasasira, M.D., M.P.H. ’03, has conducted a study at Makerere University in Uganda showing that taking one inexpensive antibiotic continued on page 50

Public Health

Alumni News

Alumni Notes, continued pill per day (cotrimoxazole) and sleeping under an insecticide-treated mosquito net reduced the incidence of malaria in children by 97 percent. This work was featured in a recent article in the New York Times. She will be returning to Berkeley this fall to begin the Ph.D. program in epidemiology. Michael P. Wilson, Ph.D. ’03, M.P.H. ’98 “Testified in August 2006 before the U.S. Committee on Environment and Public Works (former chair: Inhofe; current chair: Boxer) on weaknesses in the Federal Toxic Substances Control Act that have allowed toxic chemicals to stay on the market and have impeded green chemistry innovation.” LaVera Crawley, M.D., M.P.H. ’04, is an assistant professor (research) at the Stanford Center for Biomedical Ethics. When not working, she and her husband, Alec, enjoy spending their spare time remodeling their bungalow in the Rockridge neighborhood of Oakland.

Marilyn Kwan, Ph.D. ’04 “I currently work for a breast cancer survivorship study being conducted among the Kaiser Permanente Northern California patient population.” Adam Levine, M.D., M.P.H. ’04 “After finishing up my M.P.H. at Cal and my M.D. at UCSF, I spent about six months abroad, completing an internship at the World Health Organization in Geneva and traveling in South America. Afterwards, I bought my first warm coat and moved with my partner Janson to Boston, where I am currently completing my residency training in emergency medicine at Massachusetts General Hospital. When I’m not sewing up lacerations or caring for critically ill patients in the emergency department, I squeeze in time to work on research projects with various faculty members at the MGH Center for Global Health and the universitywide Harvard Humanitarian Initiative (HHI). About six months ago, I was appointed codirector of monitoring and evaluation for a collaborative

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initiative between HHI and the government of Zambia to improve maternal and infant health throughout the country. ... I just returned from a one-month stint in Zambia, helping coordinate a baseline assessment of rural health centers in the Central Province.” Rajnish Joshi, M.P.H. ’06, was admitted to the Ph.D. program in epidemiology last fall and has spent his first year working at home in India. He will return to Berkeley for the Fall 2007 semester. Nitika Pai, Ph.D. ’06, M.P.H. ’03 “Chimes of Campanile calm the mind; Discussions in class enliven our learning experience; Unlocking the free radical Bohemian Berkeleyan in you. Go Cal!” Renée Asteria Penaloza, M.P.H. ’06, describes herself as a “singer, songstress, guitarist, and activist who fuses social work with art.” Her field work as research assistant in Caracas, Venezuela, and Buenos Aires, Argentina, provided inspiration for a new full-length album, Caras de Agente Doble E (Faces of Agent Double E), which includes songs in English and Spanish with creative melodies and song themes, including public health issues (“El Mosquito,” about dengue, and “La Vinchuca,” about Chagas disease). The album was presented live in Buenos Aires, Argentina and aired live on Rock&Pop FM and Open Air Radio (Argentina). It was released in New York City on June 9, 2007. She is scheduled to play at La Pena in Berkeley on September 30, 2007. To download or listen to her songs, visit virb.com/agentdoublee (English) or virb.com/agentedoblee (Spanish).

In Memoriam

In Memoriam Ralph S. Paffenbarger Jr., M.D., Dr.P.H., Sc.D., died July 9, 2007, at his home in Santa Fe, N.M., at age 84. Paffenbarger, who was on the School of Public Health’s faculty from 1968 to 1981, spent several decades studying the exercise levels, illnesses, and deaths of more than 50,000 people who had graduated from either Harvard University or the University of Pennsylvania between 1916 and 1950. In 1986 he published an influential study based on the data he gathered from the alumni. His work showed that men who burned at least 2,000 calories a week had death rates one-quarter to one-third lower than those who did not exercise regularly. His study also showed that the amount of additional life for people who got adequate exercise, compared with those who were sedentary, was one to two years. Paffenbarger took his findings to heart and began competitive running at age 45, ultimately competing in more than 150 marathon events. In 1996, Paffenbarger was a co-recipient of the first Olympic Prize for Sports Sciences for his work showing the link between physical activity and lowered risk of heart disease. A native of Columbus, Ohio, Paffenbarger served in World War II before receiving his M.D. from Northwestern University Medical School and his master’s and doctorate in public health from the School of Hygiene and Public Health at Johns Hopkins University. He is survived by his wife, JoAnn Schroeder, four children, and four grandchildren.

Nancy Hart Markgraf, M.P.H. ’77, died August 26, 2006, at North Adams Regional Hospital in North Adams, Mass., at age 72. Born in West Cornwall, Conn., she received an R.N. degree from Columbia University School of Nursing, a bachelor’s degree from State University of New York at Albany, and a master’s degree in public health from UC Berkeley. She was assistant director of the Visiting Nurse Association of the Berkshires, from which she retired in 1997. Prior to that, she served as director of the Williamstown Visiting Nurse Association and as an administrator for Medical Personnel Pool in Raleigh, N.C. In her earlier years, she was employed as a staff nurse at Columbia-Presbyterian Hospital in New York City, Children’s Hospital in Cincinnati, and Alta Bates Medical Center in Berkeley. Her husband, J. Hodge Markgraf, survived her by four months and died on January 11, 2007. She is survived by two daughters, a sister, five brothers, and one grandson. Jeanne Raisler, C.N.M., Dr.P.H., M.P.H. ’84, died May 19, 2006, at age 59. Born in New York City, she received her M.S.N. in midwifery from Columbia University, her master’s in public health from UC Berkeley, and a Dr.P.H. in maternal and child health from Johns Hopkins University. For the past 10 years she worked in the School of Nursing at the University of Michigan, receiving her promotion to clinical associate professor in her final days. During her 30 years as a nurse-midwife she served as an educator, mentor, caregiver, writer, and editor. An accomplished breastfeeding researcher and advocate, she received the Regional Award for Excellence from and was inducted as a fellow by the American College of Nurse-Midwives. In recent years she devoted herself to promoting the role of nurses in HIV/AIDS care in Africa. She is survived by her husband, Jonathan Cohn, and two children.

Sherry Reinhardt, R.N., M.O.M., M.P.H. ’71, died June 28, 2007, at her home in Berkeley at age 62. An expert on parenting issues, she was often cited by local and national media, and over the years, more than 6,000 women participated in her support groups for new mothers. Born in Hollis Queens, N.Y., and later raised in Garden City, N.Y., she earned her nursing degree from the University of Connecticut. After earning her master’s degree in public health from UC Berkeley, she went on to teach community organizing, group and health team dynamics, and women’s health and mental health care. Following the birth of her first child, she was amazed at the intensity and isolation of the postpartum experience. When she was unable to find a mothers’ group, she organized one herself, which led her to spend the next 30 years organizing first-time mothers into community-based groups. The demand for her support groups grew so large that she enlisted other people to help facilitate them. The groups recently expanded into San Francisco and will be continued by her colleagues. She is survived by her husband, Marvin Brookner, two daughters, her mother, three sisters, and two brothers.

Public Health

In Memoriam

Family Planning Expert Championed Women’s Reproductive Health Donald H. Minkler, M.D., M.P.H. ’68, professor emeritus of maternal and child health at the University of California, Berkeley, died of Alzheimer’s disease at Salem Lutheran Home in Oakland, Calif., on May 4, 2007. He was 85. Known as a champion of women’s reproductive health, Minkler was actively involved in promoting and implementing family planning services, first as a private physician, and then later as a public health researcher and educator. “His death is a great loss,” said Philip Lee, former chancellor and professor emeritus of UC San Francisco (UCSF), and former assistant secretary for health and scientific affairs at the U.S. Department of Health, Education and Welfare. “He was an absolutely wonderful human being who was highly respected by his colleagues.” Lee had recruited Minkler to establish the Center for Reproductive Health Research and Policy at UCSF in 1983. Minkler cofounded and codirected the center, along with Claire Brindis, until his retirement in 1989. Minkler fervently believed that providing all women, particularly those who are low-income and have limited resources, with access to high-quality, culturally appropriate reproductive services was akin to a basic human right, his friends and colleagues said. In the 1980s, Minkler literally became the face of family planning when his image was used in fullpage ads by the Planned Parenthood Federation of America, where he was on the board of directors. The ads were created in response to attempts under the Reagan administration to limit access by teenagers to family planning services, and they appeared in national magazines, including Time. “With the access to birth control pills, the concern over population explosion, and changes in sexual behavior that began in the 1960s, doctors became less paternalistic,” said Malcolm Potts, UC Berkeley professor of maternal and child health and a former colleague of Minkler’s in the field of international family planning. “Minkler appreciated the importance of this respect for women’s reproductive autonomy, and he trained a whole 52

University of California, Berkeley

cohort of students so they understood how this impacts the health not only of women, but also of their children.”

dedication to international women’s health issues eventually led to his work as a consultant in 26 countries.

Born Feb. 19, 1922, in San Francisco, Minkler grew up in the Bay Area. In 1943, he headed off to Harvard Medical School for his medical degree, even though he was just a few credits shy of the requirements needed for a bachelor’s degree at UC Berkeley. That technicality did nothing to deter his ability to earn an M.D. at Harvard in 1947.

“When he shifted from being a private doctor to his public health role, he helped shape a movement that went far beyond the patients he had in his practice,” said Brindis. He returned to the University of California to teach, holding joint appointments at UC Berkeley and UCSF. From 1973 to 1981, he was an associate

“He was an absolutely wonderful human being who was highly respected by his colleagues.” During Minkler’s studies at Harvard, which were funded by the G.I. Bill of Rights, he participated in the U.S. Army Specialized Training Program. After he completed an internship and residency at San Francisco’s Franklin Hospital and the University of California Hospitals, respectively, he was stationed at a U.S. Air Force Base in Wichita, Kan., from 1951 to 1953.

professor in residence of obstetrics and gynecology at UCSF, and then he was promoted to full professor in residence in 1981. At UC Berkeley, he started off as a lecturer at the School of Public Health in 1975. In 1982, he was appointed professor in residence of social and administrative health sciences at UC Berkeley. He retired from the University of California and became a professor emeritus in 1989.

After Minkler’s honorable discharge from the military in 1953, he set up a successful private obstetrics/gynecology practice with Carl Goetsch in Berkeley. In 1968, Minkler decided to leave his private practice of 15 years to broaden his impact on women’s health promotion. He returned to UC Berkeley on a fellowship and earned his master’s degree in maternal and child health from the School of Public Health in 1968.

In 2001, Minkler was named Alumnus of the Year by the UC Berkeley School of Public Health. That same year, he was honored at a day-long symposium and celebration of his wide-ranging achievements that was co-hosted by UCSF’s Center for Reproductive Health Research and Policy, Institute for Health Policy Studies and Department of Obstetrics and Gynecology, and by the UC Berkeley School of Public Health. He also received honorary professorships in obstetrics and gynecology at Xian University and Norman Bethune Medical University, both in China.

At UC Berkeley, Minkler developed a special interest in international women’s health. After earning his master’s degree, he spent a year in Uganda as a visiting professor at Makerere University. From 1971 to 1973, he served as a medical advisor to the USAID Office of Population in New Delhi, India. His

Minkler held numerous appointments throughout his career, including maternal and child health consultant to the World Health Organization’s Southeast Asia Regional Office in 1973, member

In Memoriam

Publisher’s Vision Informed Millions About Wellness New York publisher Rodney Friedman—who conceived of the idea of the UC Berkeley Wellness Letter and partnered with the School of Public Health for 25 years to produce it—died on New Year’s Day, 2007, at his home in Redding, Conn. He was 59. Since its first issue appeared in 1984, the Wellness Letter has grown to be one of the most successful and well-respected publications of its kind, with approximately 300,000 subscribers and one of the highest renewal rates in the industry. The actual monthly readership is estimated to be in the millions. Friedman’s vision was to publish a university-based newsletter on health promotion and disease prevention, which he saw as the future direction of health care. He also promoted the term “wellness,” which was not widely known at that time. He took his idea to Berkeley’s School of Public Health in 1982. To implement his idea, Friedman bankrolled the venture and entered into what were then groundbreaking contract negotiations with the UC Regents over the right to use the university’s name on a commercial

publication. He gave the university full editorial control, and he assumed all financial responsibilities. In return, he agreed to pay royalties to the School of Public Health on the gross receipts of all materials published. Over the last 22 years those royalties have totaled more than $11 million, nearly all of which has been earmarked for graduatestudent support. Friedman is survived by Charlotte Milholland; his three children, Alessandra, Jennesa, and Rafer; his mother, Doris; and a brother, Kenneth.

The Rodney M. Friedman Memorial Scholarship Fund has been established to support students at the School of Public Health, especially those specializing in health communications, health media, or wellness. Memorial gifts should be made payable to the UC Berkeley Foundation (note the fund name on the check) and sent to External Relations and Development, School of Public Health, UC Berkeley, 417 University Hall #7360, Berkeley, CA 947207360. Contributions can also be made at egiving.berkeley.edu/urelgift/public_health.html. (Indicate the fund name in the “Specific instructions for this gift” box.)

Family Planning Expert, continued of the editorial board of the International Journal of Gynecology and Obstetrics from 1978 to 1986, president of the San Francisco Gynecological Society from 1980 to 1981, and chair of the Population and Family Planning Section of the American Public Health Association in 1987. Minkler is survived by his wife of 61 years, Betsy; a son, John; three daughters, Bonnie, Katie, and Jenny; five grandchildren; four great-grandchildren; and a brother, Jason.

If you wish to make a tax-deductible gift in his memory, please make your check payable to the “UC Regents” and note that your gift should be directed to the “Don Minkler Graduate Student Support Fund,” which was established by Nap Hosang and faculty friends of Don Minkler. Checks should be sent to the attention of Patricia W. Hosel, External Relations and Development, School of Public Health, UC Berkeley, 417 University Hall #7360, Berkeley, CA 94720-7360. Alternately, you may make a secure credit card gift on-line via https://egiving.berkeley.edu/urelgift/

public_health.html and note in the “Special Instructions for this gift” box: “For the Donald Minkler Graduate Student Support Fund.” Gifts from UC Berkeley faculty, emeriti faculty, current students, and staff will be matched up to $250,000 by the Chancellor’s matching gift program: Our Promise. Their Future. Chancellor’s Challenge for Student Support.

—Sarah Yang

Public Health

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University of California, Berkeley School of Public Health 50 University Hall #7360 Berkeley, CA 94720-7360

Congratulations, Heroes! At the 11th annual Public Health Heroes Awards Ceremony, the School of Public Health honored a person who helped wipe out smallpox; a diet educator; a health care administrator; and a hospital serving the Chinese community The awards, which recognize pioneers working toward improved health, were presented March 23, 2007, at the Yerba Buena Center for the Arts in San Francisco. 1 National Hero Dean Ornish (center), renowned diet and lifestyle educator, with his wife Anne and son Lucas 2 International Hero D.A. Henderson (right), honored for his leadership in eradicating smallpox, with award presenter Larry Brilliant, executive director, Google.org 3 Brenda Yee and Joe Chan (right), representing Organizational Hero Chinese Hospital, with award presenter Rolland Lowe, past president of the California Medical Association 4 Regional Hero David Kears (left), director, Alameda County Health Care Services Agency, with award presenter Anne Bakar, president and CEO, Telecare Corporation

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