Winter 2007 - Healthy Mothers, Children, Future - Public Health by UC Berkeley School of Public Health

WINTER 2007

University of California, Berkeley School of Public Health

Public Health The Magazine for Alumni and Friends

Healthy

MotherS Children Future p. 11 Making Breastfeeding Safe p. 22 Helen Wallace: Maternal and Child Health Teacher and Mentor

Our Children, Our Future From the Dean

“…Our children are taking constant notice, and they are measuring us not by what we say but by what we do.” — Robert Coles, M.D., child psychiatrist and professor of psychiatry and medical humanities, Harvard University We all remember our childhoods. While there were challenges, disappointments, and sorrows, most of us have happy memories of our childhood years. We enjoyed the protection and nurturing of our families, lived in essentially safe neighborhoods, and benefited from quality educational opportunities. For many of us, childhood was a time to engage our curiosity as we made our trial and error journey into adulthood. Whether we knew it or not, public health was a constant companion on our journey, protecting us from disease and promoting healthy life choices. Consistent with the School’s lifespan approach to public health, this issue of our magazine highlights our contribution to maternal and child health. In the pages that follow, you will learn more about the biological, environmental, and behavioral factors that influence maternal and fetal health and child growth and development. For example, women who are stressed during pregnancy are more likely to give birth to preterm infants. Stressful events such as wars and natural disasters are associated with differences in the ratio of male to female births and associated birth outcomes. A mother’s exposure to environmental pollution is associated with poorer birth outcomes. Further, children who are obese or overweight have a significantly higher risk of developing diabetes and heart disease in adulthood. Domestic and school violence wreaks havoc not only on those directly experiencing the violence but those who are “witnesses” to such acts.

Dean Stephen M. Shortell

On almost all dimensions, the problems of poor maternal and child health are greater for African Americans, Hispanics, those of lower socioeconomic status backgrounds, and those who lack health insurance coverage. Many children in California have lost health insurance coverage. The working poor are most affected by the lack of coverage and show the largest disparities in access and use of health care services. Among the working poor, immigrant children are most likely to be uninsured. Women and children in developing countries present special challenges. Our faculty and students go beyond “honoring the problem” through description and documentation to actively designing policies, practices, and interventions that address the problems. This work is led by our nationally recognized Maternal and Child Health Program, but also involves faculty and students throughout the School. In the process, we are identifying new and challenging issues. For example, imagine that within the next five to ten years you will have a list of three million differences between your child’s genes and the “normal” sequence. Further, no one can tell you what it means. Which of the differences are good, which essentially make no difference, and which may be potentially harmful? Your doctor (or nurse practitioner or health provider) will need help deciphering the information. That help may well come from the School's biostatistics faculty, who are at the forefront of the new field of computational biology, which develops methods to efficiently test for such differences. This is part of the “new public health,” and Berkeley is leading the way. In the end, we are all working to make sure that all children are valued and have the opportunity to achieve their fullest potential. We are grateful for the contributions that you will read about, but we are also challenged by how much more needs to be done. We're being measured by what we do.

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

University of California, Berkeley School of Public Health

Public Health Features Maternal and Child Health Throughout Life

A complex array of factors—including stress, nutrition, and physical environment—influence a child’s health before birth and throughout childhood, adolescence, and adulthood.

Our Children, Our Future: Worldwide

Women and children throughout the world face health threats such as postpartum hemorrhage, contaminated water, and indoor air pollution.

Making Breastfeeding Safe

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Mothers in developing countries can reduce the risk of transmitting HIV to their infants through breast milk by using a simple, low-cost method.

Students Learn to Save Lives

Students in the School’s Maternal and Child Health Program are inspired to seek pragmatic solutions for health problems around the world.

Stressed-out Moms, Stressed-out Kids

Studies show that when mothers are anxious and depressed, their children usually are too.

Regional Discrepancies Found in Treatment for ADHD

Researchers question why the rate of diagnosis and treatment for attention deficit hyperactivity disorder—the most commonly diagnosed behavioral disorder in children—varies widely from one community to another.

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Departments Past, Present, Future

Faculty News

Partners in Public Health

Alumni News In Memoriam

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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.

Contributors Michael S. Broder, Elena Conis, Monica Hazlewood, Melanie Keilholtz, Kathleen Maclay, Kelly Mills, Linda Neuhauser, Rick Zurow Photography Getty Images, cover, pp. 2–4; Peg Skorpinski, inside front cover, pp. 14–15, 23–29, 34–35, 39–41, 43, & 48 (Griffiths); Corbis, p. 3; istockphoto, pp. 4, 19, 30–32, 36, & 47 (condom); World of Stock, p. 6; Dana Charron, p. 8; Maria Paz Carlos/Jon Welch/Kiersten IsraelBallard, pp. 11–13; Jupiter Images, p. 17; Michael S. Broder, p. 45 (Green); G. Paul Bishop, p. 48 (Foster); Julie M. Cook, back cover

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, John Swartzberg.

UC Berkeley School of Public Health Office of External Relations and Development 140 Earl Warren Hall #7360 Berkeley, CA 94720-7360 (510) 642-2299

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

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Maternal &

Child Health

THROUGHOUT LIFE By Kelly Mills

Researchers at the School show how biology, behavior, and environment influence the health of mothers and children across their lifespans.

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PREGNANCY:

The Pressure to Remain at Work California is one of only five states that offer paid pregnancy leave. However, Sylvia Guendelman, professor of community health and human development, found that only one in three women with this benefit actually uses it. Those women who did take a leave from employment listed stress, medical reasons, and physical discomfort as the primary motivators behind utilizing the benefit. She also found some predictors of leave-taking were having young children at home, working the night shift, and having work flexibility.

The study helped demonstrate that women use the leave as a way to cope with overwhelming stress and fatigue, rather than as a way of promoting health. Guendelman also noted that women who had a postgraduate education and felt fulfilled at their jobs were less likely to use the leave benefit. However, women who worked for employers that did not offer leave benefits or health insurance were two times more likely to quit their jobs. This work indicates that women are likely responding to a number of pressures to

remain at their place of employment for the duration of their pregnancy. In fact, only one in four of the women who did use the leave listed the availability of the benefit as the basis for their decision to take the time off. Guendelman plans to follow up this research with an investigation of the impact of leave on maternal and infant birth outcomes: whether pregnancy leave impacts the rate of complications such as Caesarian sections or premature birth, and whether it improves a woman’s ability to breastfeed her children.

Pregnancy birth outcomes

BIRTH OUTCOMES:

The Impact of Stress

Traumatic events cause sudden stress, which can be measured by looking at factors such as blood pressure and hormone release. However, these methods aren’t practical in determining how a large group collectively responds to ambient trauma. Ralph Catalano, professor of public health, has developed a method for studying the impact of stress on a community by examining birth weights and sex-ratios.

the number of premature births rises. This is likely due to the release of corticosteroids in women, which causes an increase in the spontaneous abortions of males and speeds up the gestation process. The result is fewer male children, and more lower birth weight babies. Landmark studies of Swedish and East German birth data revealed and confirmed this pattern.

These findings were borne out in the population in New York following the 9/11 terrorist attacks. More women who were pregnant at the time of the attacks gave birth to premature infants, and they were more likely to spontaneously abort a pregnancy. Catalano states that the birth weights and ratios signal “communal bereavement,” where the impact of a trauma is felt throughout a community.

Catalano looked at birth rates around specific traumatic events and found that in times of stress, the number of boys born drops, and

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Maternal and Child Health... INFANCY:

Preventing Exposure to Toxins Every day, many children are exposed to a variety of toxicants, from ambient tobacco smoke to traffic exhaust. Brenda Eskenazi has spent more than three decades researching the effects of toxicants on reproductive outcomes and child development. As principal investigator and director of the Center for Health Analysis of Mothers and Children of Salinas (CHAMACOS), she and other researchers have examined the impact of pesticides on the neurodevelopment and health of children living in the agricultural

area, and worked to develop interventions to prevent further exposures. Their work with children, many of whom have parents and relatives who are farmworkers, has raised serious concerns about current pesticide standards and the health risks associated with exposures. For one study, investigators with CHAMACOS examined the impact of in utero exposure to DDT. They found associations between exposure to DDT and developmental delays in both mental and physical skills in children. The

mothers in the study most likely came in contact with DDT in Mexico, where organochlorine was used in agriculture until it was banned in 2000. However, children who were breastfed scored higher on developmental tests, despite the fact that DDT can be transmitted through breastmilk, indicating that the benefits of breastfeeding counterbalance the negative effects of the pesticide. These findings are vital at a time when many health authorities are considering increasing the use of DDT to fight malaria.

Infancy Childhood

CHILDHOOD:

School Nutrition Makes a Difference Obesity has become a major threat to the health of children in this country. For this reason, the UC Berkeley Center for Weight and Health has focused many projects on ways to intervene with kids to reduce obesity and promote healthy behaviors and choices. Improving childrenâ&#x20AC;&#x2122;s nutritional decisions will not only combat the current crisis of childhood obesity, but optimally will aid children in leading healthier lives throughout adulthood. The center has turned its focus on schools and nutrition for a number of studies. While parents look to schools to provide a 4

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positive influence on children, they may not realize that, unfortunately, many schools serve lunches high in fat and calories; have soda vending machines every few feet; and offer little in the way of fruits and vegetables. California recently passed legislation to phase out sodas and other high-sugar beverages from school grounds, and the state offers subsidies to schools for serving additional fruits and vegetables at breakfast. The legislature also set standards for foods served and sold

in schools. The Center is evaluating the effectiveness of these measures, as well as other nutritional interventions. The Center also conducts research on nutrition education for communities, and develops and evaluates interventions that target specific racial and ethnic groups. Obesity is on the rise among many immigrant groups, and many ethnic groups are at high risk for diseases related to nutrition, such as Type II diabetes. The center partners with many community organizations to examine the â&#x20AC;&#x153;best practicesâ&#x20AC;? in food and lifestyle education.

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ADOLESCENCE:

involving youth In Their Own Health Promotion For years, adults have tried to intervene to protect the health of teens, but these programs typically haven’t involved meaningful input from the teens themselves. Emily Ozer, assistant professor of community health and human development, recently initiated a five-year research program with teens in San Francisco and Oakland public schools to address two main questions: Does including adolescents as collaborators in school-based prevention programs strengthen the effectiveness of the programs? And what are the effects for students who serve in a collaborative research and leadership role? This research

is currently under way in public high schools in Oakland and San Francisco, and is funded by the William T. Grant Foundation and the Centers for Disease Control. In order to strengthen school-based prevention programs, Ozer and her team gather student and teacher feedback on the programs, then help to develop and evaluate locally-adapted prevention programs that are consistent with the principles of the existing programs. They also examine the benefits of a collaborative research role for teens by engaging students in a participatory research class. The class teaches

students how to identify, research, and intervene in school and community issues that they themselves consider important. The researchers then follow these students over time and compare them to students who participate in a peer mentoring program that does not directly engage them in research to improve their school or community. The goal of the entire research program, Ozer says, is “to use systematic research to assess the benefits of engaging adolescents in a different kind of way than is typical as collaborators rather than as only recipients of health programs.”

Adolescence Throughout Life

THROUGHOUT LIFE:

The Importance of Physical Activity

For most of us, sitting in a car takes up far more of our day than time spent riding bicycles or walking to and from destinations. Richard Jackson, pediatrician and adjunct professor, contends that the design of many of our current neighborhoods and cities has helped engineer the activity out of our lives, and this contributes to a host of chronic diseases related to obesity and a sedentary lifestyle.

activities. In addition, most neighborhoods lack safe paths for pedestrians and cyclists, and concern about cars and crime keeps many people from walking. Many neighborhoods do not have parks or other areas for outdoor play and sports. The consequences of an inactive lifestyle affect both adults and children. Lack of physical activity has contributed directly to a num-

ber of health threats, including heart disease, asthma, diabetes, and depression. As a result of increased obesity in youth, chronic illnesses that were previously seen almost exclusively in adults are now more common among children. Working with city planners, architects, government officials, and community designers, Jackson is raising awareness about the impact of sprawl on health, and developing solutions that will help children and adults lead active lives.

Jackson notes that “sprawl” necessitates the use of cars to get to and from work and school, for errands, and for recreational Public Health

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OUR

Children, Future: Worldwide By Kelly Mills

The survival of human beings as a species depends on oxygen, food, water, and the ability to bear children. What happens when the things we need in order to live turn out to be the very things that can sicken, incapacitate, and even kill us? For much of the world, the fight to survive means depending on contaminated water, breathing toxic air, and facing death in childbirth. Researchers at the School are finding ways to protect mothers and children from these threats to their health.

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Preventing Death in Childbirth “Everyone in these villages has lost someone or knows someone who has lost someone to postpartum hemorrhage,” says Ndola Prata, assistant adjunct professor with the School’s Bixby Program in Population, Family Planning, and Maternal Health. The villages to which Prata refers are in Nigeria, where death during childbirth is tragically common. In fact, worldwide each year more than 500,000 mothers die from postpartum hemorrhage (PPH) and many more are left weakened, vulnerable, and unable to care for their children. About 99 percent of the deaths occur in developing countries. Misoprostol sounds like a miracle drug, and in many ways it is. The drug, which stops postpartum hemorrhage, has few side effects, is stable enough to be stored without refrigeration—an important consideration in regions where refrigerators are scarce—and can be easily administered by birth attendants and midwives. But most importantly, the drug is off-patent, and researchers have developed ways to make it affordable to the world’s poorest women. The Bixby Group (headed by Malcolm Potts, Bixby Professor of Population and Family Planning) and the Center for Entrepreneurship in International Health and Human Development (CEIHD, codirected by Martha Campbell, Nap Hosang, and Dana Charron) have worked hard to negotiate the drug through layers of government bureaucracy and into the towns and villages where it is so desperately needed. They work with manufacturers in China and Egypt to produce the drug at a low cost, and with distributors in Africa to ensure both availability and affordability. They also collaborate with partner organizations to secure government approval of misoprostol, often aiding in local clinical trials and developing training programs for midwives and birth attendants, who will be managing the use of the drug in rural areas.

Misoprostol sounds like a miracle drug, and in many ways, it is. The struggle to deliver misoprostol has faced challenges. The drug had to go through clinical trials in many countries before it could obtain government approval. Some governments have expressed concern that making misoprostol available will increase the number of abortions, since the drug causes powerful uterine contractions and can indeed be used for this purpose. However, as Prata points out, “The benefit of saving mother’s lives far outweighs concerns about the drug.” In countries where misoprostol is available, the number of deaths from abortions—the number-two cause of maternal death in the developing world after PPH—has gone down. In March 2006, many years of work came to fruition. The first shipments of the pills arrived in Nigeria, approved by the government and available for use in hospitals and clinics. Bixby Program researchers anticipate the drug will soon be available in pharmacies and midwives’ kits around the country. Researchers continue to work with governments and agencies in Tanzania, Egypt, Bangladesh, Afghanistan, and Ethiopia to secure approval and distribution of the life-saving medication. If they are successful, women in the developing world will be able to celebrate the birth of a child as most women in industrialized nations do, without the fear and reality of tragic loss.

Identifying Damage Caused by Arsenic-Contaminated Water “Imagine this: it is odorless, colorless, and tasteless. It looks like pure drinking water.” Allan Smith, professor of epidemiology and director of the Arsenic Health Effects Research Program, is describing arseniccontaminated water, which can be found in towns, cities, and villages all over the world. Smith’s team has been conducting research for more than 15 years in countries such as India, Chile, Argentina, and Bangladesh, to

better understand the short- and long-term effects of this invisible carcinogen. Two cities in Region II of Chile tragically provided an important population for study. For 13 years, the residents of Antofagasta and Mejillones used arsenic-contaminated rivers as a source of drinking water. In 1971, an arsenic-removal plant was completed and became operational, and the exposures to the population dramatically decreased. Smith and colleagues studied rates of lung cancer and the respiratory disease bronchiectasis among young adults who were exposed to arsenic in utero and in early childhood, and compared them with rates in the rest of Chile. Smith found a shockingly high rate of mortality: Residents who were exposed as children had a death rate from lung cancer at the relatively young age range of 30 to 49 that was 7 times greater than other Chileans, and the death rate from bronchiectasis was 12 times greater. For those exposed in utero, the death rate from lung cancer was 6 times greater, and the rate from bronchiectasis was a stunning 46 times greater. Only active smokers have a greater relative risk of mortality from lung cancer. The research team is planning further cancer studies in Chile led by the program’s associate director, Craig Steinmaus. The research team also studied pregnancy outcomes and infant mortality in arsenicexposed women in West Bengal, India. The women used water from wells with high arsenic concentrations, which were dug to reduce the risk of gastrointestinal disease from drinking bacterially contaminated surface pond water. They found a sixfold increase in the risk of stillbirth among the exposed women, and women with arsenic-induced skin legions were particularly at risk.

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“When we started this work 25 years ago, we found levels of air pollution inside homes that were much worse than in any city.”

With such clear rates of cancer and other health problems, it might seem a simple prospect to mount interventions and convince people to switch to alternative water sources. However, Smith says, because arsenic cannot be detected by taste or smell, people are often reluctant to give up what appears to be perfectly safe water. In one effort to prevent the spread of disease, Smith works with Project Well, a donor funded program that provides arsenic-free water to the residents of West Bengal. Project Well replaces the contaminated tube wells with shallow dugwells, which are maintained by residents.

Reducing Indoor Air Pollution Air pollution is generally thought of as a problem in the developed world, in urban centers packed with cars and factories. However, the worst air pollution can be found inside homes and huts in Third World countries. “When we started this work 25 years ago, we found levels of air pollution inside homes that were much worse than in any city,” says Kirk Smith, Brian and Jennifer Maxwell Endowed Chair in Maternal and Child Health. The cause of this toxic air is the poor quality cooking fuels many people depend on in India, Latin America, Africa, China, and many other parts of the globe. This kind of indoor air pollution is directly linked to a host of respiratory illnesses, including childhood pneumonia, which is the leading cause of child death in the world. Women and children are most affected by the pollution, since they spend more time in the kitchen and inside the home.

Villagers in Uganda receive cleaner-burning, less-polluting cookstoves.

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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

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chimney stoves compared to those using open woodfires for cooking. They are also conducting studies in India and Nepal examining the relationship between indoor air pollution and tuberculosis. This will hopefully pave the way for more studies in other countries, and create resources for interventions. As health officials from one government told Smith, “We have a budget of fourteen dollars per person to spend on health. If we are going to divert money away from vaccines and antibiotics, we need to have a study here that clearly shows the benefit of feasible interventions.”

Trailblazer:

Smith points out that unlike medicines and vaccines, “environmental interventions tend to have multiple benefits.” The benefits of improved cooking stoves, aside from obvious disease reduction, include reduction in greenhouse gas emissions; increased efficiency in fuel gathering and cooking, which improves quality of life for women and can even free time for girls to attend schools; decreased pressures on forests; and, since better stoves lift cooking off the floor, an improvement in hygiene and food safety, as well as fewer burns in children.

Drawing on her experience as a mother and a public health professional, she founded Mothers’ Living Stories (www.motherslivingstories.org), a small nonprofit project that helps mothers living with cancer record their life stories and legacies for their children. As the project grew, she trained volunteer listeners in providing a meaningful service while exploring their own responses to illness and death.

While continued research will raise awareness about the crisis of indoor pollution and ideally result in government funding for improved stoves, some organizations are addressing the problem now. In addition to its work on misoprostol distribution, CEIHD is working on ways to improve stoves using local resources. “Our goal,” says CEIHD’s Charron, “was to identify entrepreneurs on the ground in areas where indoor air pollution is a problem, and provide various sorts of technical assistance to enable them to successfully sell a product that provides good cooking and heating for the consumer and reduces indoor air pollution.” Because the health problems of indoor pollution stem

Linda Blachman, M.P.H. ’79, M.A. For 20 years, Linda Blachman had been a researcher, writer, and consultant specializing in family health, particularly maternal mental health. Then a debilitating back injury altered her life path. She endured three years of disability, the loss of her job, and uncertain prospects of recovery. She also lost her mother during that time. “My world collapsed along with my spine,” she says. “For consolation and inspiration I turned to the stories of others who had lived through serious illness. I began listening to mothers facing far graver circumstances than mine. Mothers with cancer, I learned, were an invisible and underserved group.”

In 2006, she published a book based on the mothers’ stories. Another Morning: Voices of Truth and Hope from Mothers with Cancer (Seal Press, February 2006) shows how mothers from different walks of life and stages of illness go on living and loving in the face of mortality, and how they do so in a culture that denies illness, death, and the darker side of motherhood. Their stories of mothering with cancer reveal how they found ways to live with courage, dignity, humor, and joy, and taught their children to do the same. The book also explores the healing power of telling and listening to stories, as well as of preparing legacies. “The seventy mothers whose personal histories we recorded are women who have risen to the challenge of extraordinary circumstances by transforming their terrible experiences with cancer into offerings,” says Blachman. “They not only wanted to leave a legacy for their children, but, through this book, also wished to share their hard-won wisdom in order to support other parents facing uncertain and challenging times. I promised the mothers that I would bring their voices and messages to the largest possible audience.” A personal historian, life coach, and consultant in private practice, Blachman was nominated in 2005 for UC Berkeley’s Peter E. Haas Public Service Award.

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Our Children..., continued Trailblazer:

Cheri Pies,Dr.P.H.’93,M.P.H.’85,M.S.W.

Cheri Pies has been a leader in women’s health for nearly 30 years. As director of Family, Maternal, and Child Health Programs for the Contra Costa County Health Services Department, she oversees a broad range of programs designed to improve and promote the health of women, children, adolescents, and families. Under her leadership, the county health department has developed unique ways to reach out to the community. For example, the department hosted a film screening about bullying in schools and the link to community violence. It also presented exhibitions of community participants’ photographs that capture their perceptions of community health. Pies is also actively involved in ensuring the implementation of innovative children’s oral health programs in the county. Currently a lecturer in the School’s Community Health & Human Development Division, Pies has served on the faculty since 1993. Her research interests include reproductive health and ethics, contraceptive technologies, qualitative research methods and participatory action research, lesbian and gay health issues, and HIV/AIDS. Last year, as part of its 30th anniversary celebration, the National Women’s Health Network honored Pies for her women’s health activism. In 2005 she won a Distinguished Teaching Award from the UC Berkeley School of Public Health, and in 1999 she received the Sarah Mazelis Award for Outstanding Work in Health Education from the Public Health Education and Promotion Section of the American Public Health Association. Recently, Pies and colleagues have been working on applying the Life Course Perspective (LCP) to the field of maternal and child health. The LCP looks at an individual’s health over her life as an integrated whole rather than as disconnected stages. It suggests that a complex interplay of biological, behavioral, psychological, and social protective and risk factors contributes to health outcomes—including birth outcomes—across the span of a person’s life. Says Pies, “We must look more broadly, beyond the clinical support available during the nine months of pregnancy, to how we can influence the factors that contribute to one’s cumulative life experience and an individual’s health.” To that end, she and colleagues have formed the Life Course Working Group, which plans to host a national conference within the next year or two to discuss the LCP’s implications for maternal and child health practice, policy, education, training, and research in the United States.

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from a basic life activity, traditional health delivery systems may not be able to address them effectively. Instead, CEIHD helps entrepreneurs create a product people want to buy, and, she adds, “they probably aren’t buying it for the health benefits.” For one project, CEIHD is providing assistance to an entrepreneur in Kampala, Uganda, to build and market stoves that are superior in quality, efficiency, and health effects. However, it was also important to create stoves that are aesthetically pleasing to consumers in Uganda. “The stoves are becoming a status symbol,” states Charron. CEIHD also works to provide indoor air quality measurement instruments and systems, so that local people can determine and demonstrate the threats from pollution. These measurements may help stove greenhouse gas (GHG) reductions become eligible for carbon credits. The credits initially emerged from the regulatory framework of the Kyoto Protocol and allow developed nations to offset a fraction of their GHG emissions by funding sustainable energy development projects overseas. Most GHG reductions from biomass stoves are not currently eligible in the official market for carbon credits, but later inclusion might allow for subsidies towards cleaner-burning stoves. A private market for carbon credits has also emerged in which individuals and businesses can offset emissions voluntarily. For example, in the voluntary market, the air travel emissions from a conference at UC Berkeley can now be offset by purchasing credits from a company that is working towards planting new forests or disseminating high-efficiency cookstoves.

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Making BREASTFEEDING SAFE By Kelly Mills

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Mothers with HIV run the risk of transmitting the virus to their children through breastfeeding. Now researchers at the School have developed a low-tech method for heat-treating breast milk that will minimize the risk of infection and save lives. Mothers in the developing world who are infected with HIV face a terrible dilemma. The virus can be transmitted from mother to infant through breast milk; in fact, about 200,000 to 350,000 infants each year become infected with HIV through breastfeeding alone, and 90 percent of these cases are in sub-Saharan Africa. While HIV-positive mothers in industrialized nations are advised to feed their babies with formula, this is often not a viable option for mothers in the developing world, who may not have regular access to formula or cannot afford it. Even more problematic is the fact that these mothers may not have safe water to mix with the formula. Another consideration is that formula-fed infants are deprived of the natural immunities that breast milk can provide. In fact, infant mortality for non-breastfed babies in Ghana, India, and Peru is ten times that of breastfed infants. This problem caught the attention of Kiersten Israel-Ballard, currently working toward her doctorate in public health, when she was an M.P.H. student in infectious diseases at the School. Israel-Ballard noted that since 12

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1 Breast milk can be heat-treated with only a jar, water, and a charcoal stove. 2 Kiersten Israel-Ballard (right) works with project volunteer Helen Mtubatuba in her home in Zimbabwe. 3 Israel-Ballard collects breast milk from healthy women and "spikes" it with highly infectious concentrations of HIV in the lab to determine whether or not heat treatment will kill the virus.

at least 1998, the World Health Organization (WHO) guidelines recommended that HIV-positive mothers breastfeed exclusively for the first months of an infantâ&#x20AC;&#x2122;s life, then wean the infant and switch to an alternative food source. However, this had tremendous problems in practical application, as mothers often lacked a consistent alternative food supply. Abruptly stopping nursing also causes the virus to accumulate in the breast milk, so if a mother did return to

breastfeeding, even infrequently, the risk of transmission was increased. Infants who were abruptly weaned began to show a high rate of malnutrition and a host of related diseases since they were not getting the immune protection of breast milk. The WHO guidelines also mentioned pasteurization, or heat-treating the milk as a possible method of killing the virus and making the milk safe. However, Israel-Ballard was unable to find significant studies to support this

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While HIV-positive mothers in industrialized nations are advised to feed their babies with formula, this is often not a viable option for mothers in the developing world, who may not have regular access to formula or cannot afford it. recommendation. She also realized that nobody had asked the mothers if they would be willing to use heat treatment of milk. She began to wonder if this recommendation was a viable option for mothers in the developing world. As a student in the School’s Dr.P.H. Program, Israel-Ballard has conducted studies on heat-treating breast milk along with School of Public Health professor Barbara Abrams and pediatrician and principal investigator Caroline Chantry from UC Davis Medical Center. They found that, in fact, the virus can be made inactive through a simple, low-tech method of flash-heating using the most basic of

materials—a tin pan, an empty peanut butter jar, and water—to quickly heat the milk, while allowing it to retain its vital antibodies, proteins, and vitamins. By having mothers hand-express milk, then put it in the jar, place it in a pan of water, and bring it to a boil, the milk is pasteurized and can even be stored without refrigeration for a few hours. But would mothers in the developing world be willing and able to treat their milk? As one of the first steps in the study, Israel-Ballard, Abrams, and Chantry addressed the acceptability of this method. They conducted focus groups with HIV-positive mothers in Zimbabwe, and they were surprised

to learn that mothers would be willing to heat treat milk and were also supportive of the flash-heating method. Now Israel-Ballard, Chantry, and Anna Coutsoudis, a renowned international pediatric HIV researcher at the University of KwaZulu-Natal in Durban, South Africa, are beginning research to determine how much support—such as a weekly visit from a counselor—would enable mothers to consistently practice the heat treatment. The next study is being planned in Tanzania. When Abrams, Chantry, and IsraelBallard presented these results at the International AIDS Conference last summer, it brought a new, sudden attention to the subject. “The WHO is now calling for randomized control trials on heat treatment,” says IsraelBallard. “When we began this work we could barely get funding.”

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Students in the “International Maternal and Child Health” class listen attentively to instructor Suellen Miller.

Maternal and Child Health Program:

Students Learn to Save Lives Have a 15-minute conversation with Nap Hosang, and you’ll immediately understand why he is such a beloved and respected instructor. As he explains the issues surrounding the vaccine for human papillomavirus (HPV), a sexually transmitted disease that can cause cervical cancer, he deftly touches on the ethics of vaccination, health disparities, and the uneasy relationship between public health and the pharmaceutical industry, all without straying too far afield or offering easy answers. He quickly addresses multiple sides of the vaccination question, with the deep knowledge of someone who has practical experience with many of the issues.

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Of course Hosang does have much experience to draw from. In addition to being a lecturer at the School of Public Health and head of the Interdisciplinary M.P.H. Program, he is also an ob/gyn and physician administrator at the Kaiser Permanente Medical Center in Hayward, California, and he holds master’s degrees in both public health and business administration. He has been affiliated with the School’s Maternal and Child Health Program for more than 15 years, and his research focuses on finding entrepreneurial and management solutions to the tragic problem of maternal mortality in the developing world. Toward that end, he and School of Public Health lecturer Martha Campbell founded the Center for Entrepreneurship in International Health and Development (CEIHD) in 2000. (See “Our Children, Our

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Future: Worldwide,” p. 6.) Hosang’s ability to work towards pragmatic solutions for the greatest maternal health problems has inspired many students. One such student is Jessica MarterKenyon, an undergraduate majoring in Development Studies. Looking to fulfill a requirement for her major, in the spring of 2005 she took a course in international health taught by Hosang and other notable faculty members such as Campbell, Malcolm Potts, Julia Walsh, Dominic Montagu, and Ndola Prata. “It was so wonderful to be with such incredible professors who are doing such amazing work,” says Marter-Kenyon. “I’d always been interested in international development, but I just didn't know what niche.” The course made an impact on Marter-Kenyon, and she approached Hosang at the beginning of the summer of 2006 to see if he had suggestions for a summer project. He connected her with CEIHD, and she spent three months working with the center to supply people in Kampala, Uganda, with more efficient cooking stoves in an effort to reduce indoor air pollution. She wrote a grant proposal for the stove efforts and assisted CEIHD with many aspects of the project, such as the development of a

business plan for the local small business artisan who manufactures the stoves. Marter-Kenyon is writing a paper, which she plans to submit for publication, on the impact of local entrepreneurial development in reducing poverty. “The work CEIHD is doing is really practical and on-the-ground, and it has such an enormous impact on so many people.” Marter-Kenyon hopes to pursue a master’s degree in public health at the School after she graduates.

health on a global scale, in cultures with a legacy of oppression, where researchers have often come and gone without effecting much change, and where clinical trials are an almost unfathomable concept. She herself has plenty of firsthand experience with this; in fact, she and her colleagues recently received the Polgar Prize for best article in Medical Anthropology Quarterly for a paper on the cross-cultural issues they faced while conducting clinical trials in Tibet.

Marter-Kenyon also had the chance to take a class led by one of Hosang’s former students. Assistant adjunct professor Suellen Miller took “International Maternal and Child Health”—then taught by Hosang—in 1991, while she was pursuing her doctorate. In 1998 Miller began teaching the course herself. Hosang describes her as “a superstar of the program.”

This kind of pragmatic learning is crucial for Miller. When she was training as a nursemidwife in Tennessee, she and her cohort were required to live with the impoverished community they served. “I was pregnant at the time, and trying to make my meals based on what WIC provided,” she says. “It helped me to really understand the part that community plays in health, and to look at the big population problems.”

Miller brings many elements to the course, combining lectures with guest speakers, many of whom are important figures in the field. She asks students to design a practical public health intervention—an experience that does much to raise awareness about all the complicated issues related to working in public

Miller continues to work in the field around the world. Her research centers on the use of the non-pneumatic anti-shock garment, or NASG. The NASG is a neoprene suit that helps stop maternal hemorrhaging in childbirth. The suit helps prevent blood loss, and the compression keeps the blood supply

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Students learn to save lives..., continued Trailblazer: Barbara Staggers,M.D.,M.P.H.’80,

F.A.A.P.

Drug abuse, violence, unprotected sex: These are some of the most prominent issues facing at-risk youths. Barbara Staggers understands that adolescence is a time when many kids take great risks with their health—risks that can have lifelong consequences. This is why she has devoted much of her career to working with teenagers to reduce the threats to their health, and to empower them with skills that can take them into a promising future. By working with kids who have been ignored or discounted by much of society, she has made a dramatic difference in the lives of a great many teens. Staggers is known for her expertise in the areas of multicultural health and urban and minority youth. As division chief of adolescent medicine at Children’s Hospital and Research Center in Oakland, she created school-based centers on or near Oakland high school campuses. Rather than limit services to check-ups and immediate physical health problems, the centers focus on covering the full range of issues that teens face, from home life, school, and work, to diet, sexual behavior, and mental health. The centers were designed and refined with feedback and input from the teens they serve. Staggers also codirects Faces for the Future, a program designed to recruit underrepresented youth to the health professions. The three-year internship program created partnerships with medical schools, colleges, and universities in order to bring diversity to the field. Faces for the Future introduces high school students to these academic institutions, and gives them the skills necessary to succeed in their health education through mentoring, tutoring, and performance monitoring. The goal is to create a pipeline into the health professions for minority youth. In honor of her innovation in working with minority youth, Staggers received the Peter E. Haas Public Service Award in 2004. She was the School’s 1996 Alumna of the Year and received both a National Child Labor Committee Award and the National Violence Prevention Council Angel of Peace Award. She has served on numerous advisory boards and committees, including the National Committee on Adolescence for the American Academy of Pediatrics.

centered on the brain and other vital organs. The suit is lightweight, reusable, and unlike many medications, can be administered by non-physicians. It is a lowtech solution to the number-one cause of maternal mortality worldwide. Miller is excited by the life-saving potential of the anti-shock garment, and this excitement is contagious. This was particularly true for Adeoti Oshinowo, a student in the one-year M.P.H. program and a thirdyear medical student. Oshinowo, who is both a student and graduate student researcher in the international maternal and child health course, was especially impressed when Mohammed Murad, the director of Emergency Services at El Galaa Teaching Maternity Hospital in Cairo, spoke to the class about the use of the anti-shock garment in Egypt and the significant reduction they were able to make in maternal mortality. “So much of the time we do things to make a small impact, and that is great,” says Oshinowo. “But in five years they made a huge impact. I thought, ‘Wow, you really can make a difference.’” Oshinowo worked over the summer on the use of the anti-shock garment in Nigeria. She has been gathering patient and provider perspectives on the NASG, and she says, “everyone I’ve spoken with knows it saves lives.” Ultimately, she and the other researchers plan to use the responses to better prepare patients, providers, and family members for utilization of the garment, and to raise community awareness so the NASG is accessible to mothers who need it. When she finishes medical school, she plans to complete a residency in obstetrics and gynecology, and to continue work in Nigeria. “My passion lies in Nigeria, because my family is from there,” she says. “Seeing how people are affected by the anti-shock garment, seeing all that it does for people— I feel like this needs to be a part of my life for the rest of my life.”

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Stressed-out moms, Stressed-out kids By Kellly Mills

When it comes to the mental health of children, mothers have historically—and unfairly—shouldered much of the blame. Poor mothering was originally believed to be the cause of everything from autism to schizophrenia. And yet while most people today reject the “blame the mother” theory of mental health, we do know mothers have a profound influence over their children. It is also clear that many mothers are dealing with a host of environmental stressors, including poverty and the fight to survive, and that these conditions impact the whole family. So how do health researchers determine the impact of maternal stress on children, and which interventions are effective? Through a variety of studies, faculty at the School are looking at ways to improve the psychological life of kids. continued on page 18

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Stressed-out..., continued In the debate over the influence of genetics versus environment, rats have much to teach us, according to Darlene Francis, assistant professor of psychology and public health. Francis and her colleagues note that not all mother rats behave the same, that some mother rats practice the soothing behaviors of licking and grooming their pups more often than others. The mothers who lick more frequently are less anxious, more tolerant of novelty, and less prone to stress. Francis assembled two groups of mother rats: one strain that was bred to be anxious, and another that was not. She implanted the embryos of “calm” rats in both calm mothers and anxious mothers. Once the rats were born, she divided them again among calm and anxious mothers, who reared the pups. The results were striking: Rats raised by anxious mothers were far more likely to be fearful and prone to stress, despite their genetic make up. And interestingly, this tendency towards anxiety stayed with the rats in adulthood. In contrast, the rats who were reared by calm mothers were themselves calmer and more inclined to explore new environments. This study demonstrated that while genes are significant, early environment has a profound impact on the expression or non-expression of those genes.

Among poor mothers, over 60 percent had the symptoms of depression. In another experiment, Francis examined the impact of maternal stress on rat development. She found that mother rats who experienced stress in the days after giving birth licked and groomed their offspring less frequently than rats who had not been exposed to stressors. As a result, the children of these stressed mothers were more anxious and nervous. This sensitivity to stress also manifested in the next generation of rats: The grandchildren of the stressed mothers were also anxious and fearful.

through a program called Programa de Educacion, Salud y Alimentacion (PROGRESA). While the goal of PROGRESA is to improve the health of children, the program is unusual in that it offers families unrestricted money and allows the families to determine how it will be spent, rather than offering strict subsidies for medical services. The only condition for receiving the cash transfer is that families must give children micronutrient supplements if needed and commit to four health-clinic visits per year.

For Francis, who worked as a counselor for at-risk youth before finishing her graduate work, these studies highlight how crucial it can be to provide effective interventions early in a child’s life.

For part of the program, Fernald studied the mental health of mothers and how it impacted children. Among poor mothers, over 60 percent had the symptoms of depression. Living in poverty and making difficult financial choices with limited resources took a toll on women, and this was reflected in their children: The children of depressed mothers had altered stress physiology.

But does maternal stress and anxiety have the same impact on human children? Many studies have looked at the impact of early life experience on child development, and found similar results. One such study was conducted by Lia C. Haskin Fernald, assistant professor in the Division of Community Health & Human Development. Fernald works with impoverished families in Mexico

When the families were given the PROGRESA money, children’s health improved on a number of fronts. Children in the intervention group were less likely to be anemic, they had fewer sick days, and they were less likely to be growth-retarded as a result of poor nutrition. Because of the PROGRESA program, parents were able to buy healthier and sufficient food and make physical improvements to homes. Fernald believes interventions such as these demonstrate that improving social and economic conditions for families is an effective vehicle for improving children’s health. “The Mexican model of PROGRESA, which is a conditional cash transfer program, is extremely innovative, and should be a model for countries throughout the world,” she says.

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REGIONAL DISCREPANCIES

Found in Treatment for ADHD By Kellly Mills

The subject of attention deficit hyperactivity disorder (ADHD) raises controversial questions: Are the nationâ&#x20AC;&#x2122;s children overmedicated or undermedicated for the disorder? Which children should be treated? Is ADHD generally underdiagnosed or overdiagnosed? What happens to children with ADHD who go untreated? These issues have been debated for years by researchers and pundits, with no signs of cultural consensus any time soon. In 2003, a team of researchers, led by principal investigators Richard Scheffler, Distinguished Professor of Health Economics & Public Policy and director of the Schoolâ&#x20AC;&#x2122;s Nicholas C. Petris Center on Healthcare Markets & Consumer Welfare, and Stephen Hinshaw, chair of the UC Berkeley Psychology Department, were awarded a grant from the National Institute of Mental Health to look at a number of aspects of the diagnosis and treatment of ADHD.

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Research to Action: Parents Kit Helps 500,000 California Families The School of Public Health has made a major contribution to translate research into a large-scale effort to support new parents and their children. Professor Linda Neuhauser and her team at the School’s Health Research for Action center developed the UC Berkeley Parents Guide, an easy-to-use resource providing evidenced-based advice and community referrals for a healthy pregnancy and caring for babies and children. The Parents Guide is part of the Kit for New Parents (funded by a tax on tobacco) that is distributed free to 500,000 families each year by the state of California’s First 5 Children and Families Commission. The kit contains videos and other materials for parents and is available in English, Spanish, Chinese, Vietnamese, and Korean. Neuhauser’s group has also conducted longitudinal research on the impact of the English and Spanish Kit for New Parents. Results showed that 87 percent of the parents who received a kit used it and highly valued the resource. The study found that parents who used the kit significantly increased their knowledge about how to have a healthy pregnancy and care for their child from birth to age five, compared with parents who did not receive a kit. Likewise, parents who received the kit had better parenting practices related to feeding their infants, making their homes safer for children, reading to their children, and obtaining child health insurance. The Health Research for Action group has helped to adapt and extend this successful kit model to other states. Statewide initiatives using this model, including customized versions of the UC Berkeley Parents Guide, have been developed and implemented in Alabama, Arizona, Kentucky, and Pennsylvania, reaching another one million families. School of Public Health collaborators on the Kit for New Parents project include Shelley Martin, Katherine Simpson, Norman Constantine, S. Leonard Syme, and Karen Sokal-Gutierrez. In California, parents can order a free Kit for New Parents by calling 1-800-KIDS-025 (English), or 1-800-50-NINOS (Spanish).

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ADHD..., continued ADHD is the most commonly diagnosed behavioral disorder in children; in fact, one out of every 12 children is diagnosed with ADHD. However, the rate of diagnosis and treatment with psychostimulant medications such as Ritalin and Adderall varies widely among regions and communities. Scheffler and other researchers at the Petris Center are examining the factors— economic, social, and policy-based— that account for the variation in medication use. Clearly biological differences cannot account for the discrepancies in the diagnosis and treatment of the disorder, and in fact, the researchers have found a number of environmental factors linked with higher use of medications. In a paper released in 2005, they demonstrated that U.S. counties with a higher median income, a greater number of physicians per patient, and a higher student-to-teacher ratio were more likely to have above-median rates of psychostimulant use. These areas also had a higher per capita income, a larger population, and lower unemployment rates. Variations in medication use rates also vary among states. California has a low use rate for psychostimulant treatments, “for many reasons—and they could be good or bad,” says Scheffler. He and his team are examining the reasons behind the state’s low use rate. One possible factor is that some populations may avoid medication treatment more than others. Learning more about how ADHD is diagnosed and treated has many implications for the health of children and of the state, since

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ADHD has been linked to many social problems, such as a higher school dropout rate, and illegal substance abuse. Kaiser Permanente has also been a partner in the research. A team led by researcher G. Thomas Ray found that children in the Kaiser system who had not yet been diagnosed with ADHD had significantly higher medical costs, particularly in the year prior to diagnosis, than children who did not have ADHD. Costs in the two years following diagnosis were also markedly higher. Among children with ADHD, Asian Americans, African Americans and Hispanic Americans had lower yearly costs for ADHD medications compared with white Americans, and Asian Americans had overall lower spending on ADHD services than white Americans. The ethnic differences in medical services utilization may be due in part to differing levels of cultural acceptance regarding the diagnosis and treatment; however, more research is needed in this area. Scheffler is looking at ADHD as a “worldwide phenomenon.” He states that in a few years, ADHD medications will be the number one pharmaceutical treatment for children worldwide. “There is a two- to three-billion-dollar industry for ADHD drugs, and it’s growing” says Scheffler. “Ten years ago, about twentytwo countries had these medications. Now there are 50 countries.” As diagnosis and treatment of the disorder spreads around the globe, researchers at the Petris Center continue to identify the factors that result in medication for some children, and none for others.

According to Hinshaw, the stakes are high, as “ADHD is a real condition, which occurs cross-culturally and with a substantial genetic contribution. But without careful diagnosis and careful monitoring of treatment strategies, some children with ADHD will be

missed and other children with problems that are related to family and school issues will receive unneeded and potentially deleterious pharmacologic treatments.” Future trends in this area are of major conceptual, clinical, and policy-related importance.

ADHD is the most commonly diagnosed behavioral disorder in children; in fact, one out of every 12 children is diagnosed with ADHD. Public Health

Past, Present, Future

Helen Wallace, M.D., M.P.H.: Maternal and Child Health Teacher and Mentor For nearly two decades—stretching from the Kennedy era up until the dawn of the Reagan presidency—the UC Berkeley School of Public Health’s Maternal and Child Health (MCH) Program was led by Helen Wallace, who laid important groundwork and mentored generations of students. She joined the School in 1962 as professor and chair of the MCH Program and remained until 1980, when she moved to San Diego to head the Division of Maternal and Child Health at the Graduate School of Public Health at San Diego State University. She still resides in San Diego today.

One of Wallace’s notable students was Peter van Dyck (see profile, p. 42),

associate administrator for maternal and child health at the Health Resources and Services Adminstration of the U.S. Department of Health and Human Services. He remarks on Wallace’s “years of tireless advocacy for the field, and her tenacity in placing her students in high-level and meaningful leadership positions all over the world.” “She convinced me I could make a difference working in MCH,” he says.

Wallace describes herself as a disciple of renowned child health expert Martha May Elliott. Throughout her career, she has followed Elliot’s advice to “look at what others are doing before you do it yourself.” Wallace learned from other maternal and child health programs around the country, asking them not only what they were doing presently, but what their future plans were. She recalls her time at the School with great fondness, especially the support of former dean Chuck Smith. “He would go around the country, especially to Washington, D.C., to build partnerships with the state and federal government agencies,” she says. It was Smith who recruited Wallace to the School, along with four others: Jacob Yerushalmy (biostatistics), Bill Griffiths (health education), Ruth Huenemann (public health nutrition), and Andie Knutson (behavioral sciences). Among Wallace’s accomplishments during her tenure as chair of the program was securing the School’s first maternal and child health training grant from the federal government, which made Berkeley the third school of public health in the nation to receive such a grant.

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MCH faculty member Nap Hosang notes that Wallace “mentored young people during a critical time for women’s health issues in the United States.” Current MCH chair Sylvia Guendelman says of Wallace, “She helped place the Berkeley MCH Program among the top-ranking programs in the country, and she trained students who are today’s leaders in maternal and child health, both nationally and internationally.”

“She helped me—and others—realize that you could touch individuals in public health practice by implementing policies that touched individual people.” Van Dyck recalls that soon after arriving at Berkeley, Wallace called him into her office and asked him what he wanted to do with his future, urging him to start thinking about it immediately. Van Dyck told Wallace he had been considering working in a city, county, or state MCH office.

Past, Present, Future

“Right then,” he says, “she hopped on the phone and started calling directors in places where she knew there might be openings. The words had just come out of my mouth and she was already calling people.” Van Dyck also remembers that when he began his first state job in Utah—a placement that Wallace helped him secure—she told him to visit three or four places along his way from Berkeley to Utah to meet with other MCH directors and find out how they do things. “And when she told you to do something,” he says, “you did it!”

“She mentored young people during a critical time for women’s health issues in the United States.”

Wallace received her bachelor’s degree from Wellesley College in 1933, her master’s in public health cum laude from the Harvard School of Public Health in 1943, and her medical degree from the Columbia University College of Physicians and Surgeons in 1937. She began her long and distinguished career working in the New York City Health Department as chief of the Maternity and Newborn Division and director of the Bureau for Handicapped Children. After 13 years in this position, she went Helen Wallace (left) talks with Professor Emeritus Chin Long Chiang.

to New York Medical College, where she was professor and head of the department of preventive medicine and public health. Following that, she was professor of maternal and child health at the University of Minnesota School of Public Health for three years before coming to UC Berkeley. She is the author of 336 journal articles and 16 textbooks—most recently, Health and Welfare for Families in the 21st Century, the second edition of which was published in 2003. Besides serving as the national health chair of the National Congress of Parents and Teachers, Wallace was secretary of the

maternal and child health section and a member of the committee on child health of the American Public Health Association. She was, in addition, assistant editor of the Journal of the American Women’s Medical Association, as well as a diplomate of both the American Board of Pediatrics and the American Board of Preventive Medicine. She has consulted with the World Health Organization in many countries including Uganda, the Philippines, India, Turkey, Iran, Thailand, Burma, Sri Lanka, and Nepal, and has trained numerous physicians in Africa and Asia.

Public Health

Past, Present, Future

Day of Service Kicks Off Academic Year 1

Sixty incoming public health graduate students started their experience at UC Berkeley with a day of service as participants in the School of Public Health’s second Volunteer Mobilization Day, held August 25, 2006. The day's events began with a welcome from Berkeley mayor Tom Bates (who co-hosted the event), acting dean Ralph Catalano, and associate dean Denise Herd. Student volunteers were then deployed to sites throughout Berkeley serving youth, the homeless, elders, and others. “By introducing the new public health graduate students to Berkeley immediately upon their arrival, we hope that they will find a wonderful and engaging community that extends beyond the walls of the university,” said Bates. Volunteer sites included Bahia School-Age Program, the North Berkeley Senior Center, People’s Park, Fred Finch Youth Center’s Homeless Youth Collaborative, and school gardens at the Malcolm X School and at Berkeley Youth Alternatives. The first Volunteer Mobilization Day was launched in August 2005 by Dean Stephen Shortell and Mayor Bates. “This is one of the most important Welcome Week events, because it provides an opportunity for our new students to be directly involved in their community,” said Shortell, “and that is a key part of public health.”

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1 Berkeley mayor Tom Bates (left) and School of Public Health acting dean Ray Catalano welcome the student volunteers. 2 After the opening ceremony, volunteers head off to their sites. 3 Berkeley Youth Alternatives (BYA) provides an opportunity for public health students to work alongside youth participants in the BYA community gardens. 4 BYA development and policy director Kevin Williams (left) and his son join the volunteers.

Past, Present, Future

â&#x20AC;&#x153;By introducing the new public health graduate students to Berkeley immediately upon their arrival, we hope that they will find a wonderful and engaging community that extends beyond the walls of the university.â&#x20AC;? continued on page 26 4

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Day of Service Kicks Off Academic Year, continued 1

1 Volunteers work beneath the sunflowers in the Berkeley Youth Alternatives community gardens. 2 A residence for homeless youth operated by the Fred Finch Youth Center Homeless Youth Collaborative gets a fresh coat of paint. 3 Volunteers apply their skills at the North Berkeley Senior Center in the gift shop and 4 in the ceramics studio.

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Past, Present, Future

Dr.P.H. Alumnus Returns to Lead Program Jim Meyers joined the School’s Dr.P.H. Program as director on August 1, 2006. Meyers, who received his Dr.P.H. from the School in 2001, is a former U.S. Air Force colonel and a boardcertified health executive with an extensive background in federal government and international health care leadership and education. His international experience includes national health systems development in the Ukraine and leadership of joint civilian and military humanitarian assistance missions in Central America. His previous academic experience includes faculty appointments with Trinity University and Baylor University, where he was assistant professor and director of population health and health information systems.

“I was very fortunate to graduate from this program and have always enjoyed keeping close ties with my colleagues and friends here. It is a thrill to be back.” Prior to taking this position, Meyers was the founding executive director of the U.S. Air Force’s first regional health services research center. His professional and research interests include health disparities, public health leadership

A strong network needs a strong connection. So whether you are networking for fun or for a job, make sure your info is up-to-date in UC Berkeley School of Public Health’s online alumni community, PublicHealth@cal. As an @cal member, you can also visit the new@cal café and create your blog, connect with friends, and set up groups.

core competencies, and heath systems’ electronic medical record repository research collaborations. As director, Meyers is responsible for the day-to-day operations of the Dr.P.H. Program, including teaching, curriculum development, advising, recruitment, fundraising, alumni and professional relations, and program administration. “I was very fortunate to graduate from this program and have always enjoyed keeping close ties with my colleagues and friends here. It is a thrill to be back,” says Meyers. “I have especially enjoyed seeing an amazing level of growth most recently under the leadership of Meredith Minkler and Cheri Pies. It is clear that I join the program at a point of unique opportunity as the School of Public Health and significant external funding have built a strong foundation for continued growth in this nationally prominent program.” Public Health

Faculty News

Faculty News and Notes Coalition for Clean Air Honors Balmes John Balmes, M.D., director of the Center for Occupational and Environmental Health, and longtime American Lung Association of California volunteer and air quality activist, was honored with the Coalition for Clean Air’s Carl Moyer Award for Scientific and Technical Leadership. Every year, the coalition recognizes individuals or corporations that advance the cause of restoring clean, healthful air to all Californians. Balmes has spent his career conducting important studies on the health effects of air pollution. Over the years he has testified at countless state and national hearings on behalf of the American Lung Association. He regularly shares his expertise as a member of the American Lung Association of California Technical Advisory Group on clean air and serves as a volunteer media spokesperson, helping to raise public awareness of the connection between air pollution and health. Barcellos Awarded Institute of Medicine Anniversary Fellowship Lisa Barcellos, Ph.D., assistant professor of epidemiology, received an Institute of Medicine (IOM) Anniversary Fellowship. The two-year fellowship, created to celebrate the 35th anniversary of the IOM’s establishment, enables talented, early career health science scholars to participate actively in the work of the IOM and to further their careers as future leaders in the field. During this time, fellows continue their work at their main academic posts, while being assigned to a board of the IOM. Additionally, fellows participate actively in the work of an appropriate expert study committee or roundtable, including contributing to its reports or other products. The experience introduces fellows to a variety of experts and perspectives, including legislators, government

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officials, industry leaders, executives of voluntary health organizations, scientists, and other health professionals. For the past 10 years, Barcellos has participated in the design, implementation, and interpretation of human genetic disease studies. She has developed a strong research program funded by the National Institutes of Health that focuses on identifying genetic, social, and environmental risk factors for autoimmune diseases. She is a co-investigator for the International Multiple Sclerosis Genetics Consortium as well as a member of the Kaiser Permanente Autoimmune Disease Research Group and of the National Multiple Sclerosis Society Task Force on Prospective Studies of Risk Factors in Multiple Sclerosis. Study Looks at Cardiovascular Disease Risk for South Asians in California South Asians have higher mortality from coronary heart disease than other ethnic groups, and cardiovascular disease is the primary cause of death among South Asians in the United States. However, most research on heart disease among South Asians has been conducted outside the United States. Susan Ivey, M.D., M.H.S.A., associate adjunct professor, is first author on a study that looks at data from two population-based surveys of South Asians in California to compare risk factors for cardiovascular disease. “Prevalence and correlates of cardiovascular risk factors in South Asians: Population-based data from two California surveys” was published in the Autumn 2006 issue of the journal Ethnicity & Disease. One of the study’s findings was that English-language use was associated with increased cardiovascular disease risk—suggesting that the effect of acculturation merits further research.

Minkler Named Pratt Foundation Fellow Professor of health and social behavior Meredith Minkler, Dr.P.H. ‘75, was chosen as the 2006 International Pratt Foundation Fellow and delivered the keynote address on June 20, 2006, in Victoria at the “Communities in Control” conference—Australia’s largest annual gathering of community sector workers, volunteers, and supporters. The theme of the conference was “Challenging the Power of One.” Previous Pratt Fellows have included Professor Emeritus S. Leonard Syme, Ph.D., alumna and Harvard professor Lisa Berkman, Dr. P.H. ’77, and Shelley Martin, M.P.H., C.H.E.S., executive director of Health Research for Action. Study Links Higher Income with Lower Disability Rates Numerous studies have already established the link between extreme poverty and poor health, but a new study led by professor of health and social behavior Meredith Minkler, Dr.P.H. ‘75, has found that health disparities exist even among those with higher incomes. The study, published in the August 17, 2006, issue of the New England Journal of Medicine, found significant differences in the rates of limitations even among those in the upper income brackets. Among those who were 55–74 years old, even those at 600–699 percent of the poverty line had elevated odds of having a disability compared to those at 700 percent and higher. For example, women aged 55–64 in the 600–699 percent category had 16 percent higher odds of disability than women in the 700 percent bracket, and men aged 65–74 in the 600–699 percent group had 44 percent higher odds than men in the 700 percent group. Co-authors of the study are Esme FullerThomson, Ph.D., M.S.W., associate professor of social work at the University

Faculty News

of Toronto, and Jack Guralnik, M.D., chief of the Laboratory of Epidemiology, Demography and Biometry Section at the National Institute on Aging. The study was funded by a grant from the Retirement Research Foundation with additional support from the National Institute on Aging, part of the National Institutes of Health. Traffic Safety Center Presents Paper on Driver and Pedestrian Behavior David R. Ragland, Ph.D., M.P.H.‘80, director of the UC Berkeley Traffic Safety Center, and Meghan Fehlig Mitman, graduate student researcher, were selected to present a paper titled, “What They Don’t Know Can Kill Them: More Evidence on Why Pedestrian and Driver Knowledge of the Vehicle Code Should Not Be Assumed,” at the 86th Annual Meeting of the Transportation Research Board, held January 2007 in Washington, D.C. The paper summarizes results from surveys and focus groups conducted in the San Francisco Bay Area as a component

of a larger study of driver and pedestrian behavior at crosswalks in California. Results confirm that a substantial level of confusion exists with respect to pedestrian right-of-way laws. This confusion was exacerbated by intersections that had unstriped or unmarked crosswalks. Implications for engineering, education, and enforcement countermeasures in light of these findings are discussed and areas for further research are proposed. The study is funded by the California Department of Transportation. Neuhauser Addresses Surgeon General’s Workshop Linda Neuhauser, Dr.P.H.‘88, co-principal investigator of the School’s Health Research for Action center and a clinical professor at the School, spoke at the Surgeon General’s Workshop on Improving Health Literacy, held Sept. 7, 2006, in Washington, D.C. The meeting examined the evidence about the health and financial impacts of low health literacy and ideas for a national agenda to address the problem. Human Rights Center Releases Report on Katrina-Rebuilding Workforce Adjunct professor Eric Stover, director of the UC Berkeley Human Rights Center, is

one of the authors of a report, Rebuilding After Katrina: A Population-Based Study of Labor and Human Rights in New Orleans, released in June 2006. The comprehensive study of more than 200 workers found that undocumented workers face several vulnerabilities—reduced access to health care, wage discrepancy, and unsafe working conditions—as they provide critical help to rebuild the city of New Orleans after Hurricane Katrina. Almost half of the reconstruction workforce is Latino and 54 percent of that group is undocumented, meaning 25 percent of all workers are undocumented Latinos. The report recommends that workers without documents should be allowed to work legally in disaster zones and should receive the same protections as American workers.

Berkeley Hosts Conference for Fogarty AIDS Program Administrators UC Berkeley hosted the fifth annual Fogarty AIDS International Training and Research Program (AITRP) Administrators Conference in November 2006, attended by more than 50 administrators of AITRPs from around the country. The UC Berkeley and UC San Francisco AITRP, directed by head of epidemiology Arthur Reingold, M.D., provides multidisciplinary research training to physicians, dentists, pharmacists, scientists, and support personnel relevant to epidemiologic and behavioral studies related to AIDS, HIV transmission, and treatment in HIV-infected persons. Focus countries include Brazil, Peru, Thailand, India, Cambodia, Vietnam, Uganda, Zimbabwe, and Ivory Coast.

Public Health

Faculty News

Recent Grants and Contracts Awarded The following grants and contracts support faculty research at the School of Public Health: The California Senior Leaders Program: Expanding Intergenerational and CrossClass Networks for Sustainability $252,500 from The California Wellness Foundation PI: Meredith Minkler, Dr.P.H.‘75

This project builds on a successful model for promoting senior leadership in healthy aging and community building that was developed by the School of Public Health and implemented with funding from The California Wellness Foundation in 2002, and refined and expanded in 2004. The third round of this program aims to increase the pool and the capacities of diverse California senior leaders in healthy aging and community building and to strengthen the intergenerational and networking components of the project in ways that will help sustain achievements beyond the project period. Effectiveness of Selected Nonpharmaceutical Interventions in Reducing Influenza-like Illness $956,698 from the CDC National Center for Infectious Diseases PI: Tomás J. Aragón, M.D., Dr.P.H. ‘00

This study will measure non-pharmaceutical interventions’ effectiveness in preventing influenza-like illness among a select population in the United States. The experience and results from this study will provide new information on how effective these strategies are in preventing influenza-like illness and the feasibility of implementing these interventions during a human influenza pandemic. Effects of Long-Term Low Level Hydrogen Sulfide Exposure $2,394,142 from the NIH National Institute of Environmental Health Sciences PI: Michael N. Bates, Ph.D. ‘91, M.P.H. ‘89

In New Zealand, the city of Rotorua is situated on a geothermal field, and residents are continuously exposed to 30

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relatively high ambient levels of hydrogen sulfide gas. The hydrogen sulfide is a component of the geothermal emissions coming from the ground around the city. It is highly acutely toxic, but it is unknown whether long-term hydrogen sulfide exposure causes health effects. Because no other large, similarly exposed population exists anywhere, Rotorua provides a unique research opportunity. The Etiology of Successful Aging $567,475 from the NIH National Institute on Aging PI: Shiu-Ping Constance Wang, Ph.D.

This mentored research scientist (K01) award provides five years of intensive research, training, and career development support for assistant researcher Constance Wang. Her research focuses on the application and extension of methods for complex data analysis to identify determinants of healthy aging, with a concentration on developing epidemiologic analytic approaches that produce directly translatable results for policymakers and health promotion practitioners.

Finance and Mental Health Services Training in Czech Republic/Central Europe $1,020,066 from the NIH Fogarty International Center PI: Richard M. Scheffler, Ph.D.

The Fogarty International Center has awarded UC Berkeley a five-year renewal of its joint program with Charles University, Prague, to train outstanding postdoctoral economists, public policy experts, sociologists, clinicians, and mental health professionals from Central Europe in the latest research methods regarding the financing and delivery of mental health services. Fresno Asthmatic Children’s Environment Study $3,950,857 from the NIH National Heart, Lung, and Blood Institute PI: Ira B. Tager, M.D., M.P.H.

The study will address an important data gap by continuing a longitudinal cohort study, the Fresno Asthmatic Children’s Environment Study, funded by the California Air Resources Board for the past five years. The overall goal of the study is to determine if children

Faculty News

their review of evidence linking water quality indicators to human health. They will enroll at least 17,600 beach users at one of California’s most contaminated public beaches over three summers. The study will expand water quality indicator testing to include new rapid measuring methods and viral agents from the water samples. Important new statistical methods will also be used to investigate the possibility of important multivariate relationship of these indicators to health. The Influence of Environmental Change on Parasite Diffusion through Human, Invertebrate and Environmental Pathways $1,964,058 from the National Science Foundation PI: Robert C. Spear, Ph.D.

with asthma who have adverse responses to short-term, daily increases in concentrations of ambient air pollutants and bioaerosols are more likely to have increased long-term asthma morbidity and decreased lung function growth. A Genome-Wide Association Study of Non-Hodgkin Lymphoma $2,821,719 from the NIH National Cancer Institute PI: Christine F. Skibola, Ph.D. ‘01

While new therapeutic regimens have begun to delay deaths due to nonHodgkin lymphoma (NHL), causes for the majority of lymphomas remain unknown. In one of the largest casecontrol studies of NHL, Skibola and her team will perform the first genome-wide association study of NHL to identify new disease susceptibility markers. Additionally, they will employ fine-map genotyping to investigate the role of genetic polymorphisms in human leukocyte antigen and other candidate loci in the pathogenesis of NHL.

Graduate Research Training on Alcohol Problems $1,569,465 from the NIH National Institute on Alcohol Abuse & Alcoholism PI: Lee A. Kaskutas, Dr.P.H. ‘92

This award reflects the continuation and evolution of an alcohol training program in operation since 1971, designed to embark trainees on a path of active research in alcohol studies. The essence of the program lies in each trainee’s opportunity to learn from an intensive period of residence and involvement in the research training, research staff, and research activities of Training Program Faculty at the two primary collaborating institutions: the Alcohol Research Group (a National Alcohol Research Center) and the School of Public Health. Indicators of Recreational Water Contamination and Illness $2,138,623 from the NIH/National Institute of Environmental Health Sciences PI: John M. Colford, Jr., M.D., Ph.D. ‘96, M.P.H. ‘92

Colford and his team will use advances in microbiologic techniques and statistical methods to continue

Schistosome parasites diffuse through the environment both within moving hosts and as free-living organisms in waterways. Pathways of parasite diffusion in the environment have gone largely unmeasured, let alone the influence of anthropogenic disturbance on these pathways. This project aims to comprehensively assess the role of diffusion in parasite transmission, with a specific focus on how anthropogenic change can modify diffusion parameters, thereby influencing transmission. Latino Traffic Safety Project $465,000 from the California Office of Traffic Safety PI: David Ragland, Ph.D., M.P.H. ‘80

Traffic injury is a leading cause of death for young Latinos. Over the past three years, the UC Berkeley Traffic Safety Center has conducted the statewide Latino Traffic Safety Project (LTSP) in cooperation with the Tomás Rivera Policy Institute at the University of Southern California. In this third phase of the LTSP, the Traffic Safety Center will work with a local community to implement continued on page 32 Public Health

Faculty News

Recent Grants and Contracts Awarded, continued

recommendations gathered during the first two phases of the project. They will conduct a process and outcome evaluation of this effort.

Scholars in Health Policy Research Program $6,627,486 from the Robert Wood Johnson Foundation PI: John W. Ellwood, Ph.D.

The Right Care at the Right Time: Consumer Communications Project $160,000 from The California HealthCare Foundation PI: Linda Neuhauser, Dr.P.H. ‘88

The School of Public Health training site of the Scholars in Health Policy Research Program has received a fiveyear, $6.6 million award renewal by the Robert Wood Johnson Foundation to continue offering postdoctoral fellowships in the field of health policy research. This funding brings the total amount awarded by the foundation to the School of Public Health to more than $18 million. The Scholars in Health Policy Research Program is a national program with training sites at UC Berkeley/UC San Francisco; the University of Michigan, Ann Arbor; and Harvard University. The program’s goal is to foster a new generation of creative thinkers and researchers whose work will inform future health policy discussions.

The School’s Health Research for Action (HRA) center will develop a Spanish-language HMO consumer web site and consumer health coverage applications in Spanish and Chinese for the California Department of Managed Health Care (DMCH). This builds on HRA’s previous DMHC contract during the past year to conduct studies with HMO consumers about information needs related to their HMOs and to translate those findings into a redesigned statewide DMHC web site in English.

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Toxic Substances in the Environment $15,717,177 from the NIH National Institute of Environmental Health Sciences PI: Martyn T. Smith, Ph.D.

The Superfund Basic Research Program consists of six interrelated basic and applied research projects and five core components that provide key project services, such as research translation and training. The overall theme of the program is the application of functional genomics, proteomics, transcriptomics, and nanotechnology to better detect arsenic, mercury, benzene, polycyclic aromatic hydrocarbons, trichloroethylene and other Superfund priority chemicals in the environment; evaluate their effects on human health, especially the health of susceptible populations such as children; and remediate their presence and reduce their toxicity.

Faculty News

Training in Infectious Diseases and Immunity Research $657,295 from the NIH National Institute of Allergy & Infectious Diseases PI: Richard S. Stephens, Ph.D., M.S.P.H.

This award provides five more years of funding for the predoctoral Ph.D. training program in infectious diseases and immunity research established seven years ago to meet the unique and challenging needs for modern research training of individuals with a focus on infectious disease agents. UC Berkeley Academic Geriatric Resource Center $136,350 from the UCOP Academic Geriatric Resource Program PI: Guy Micco, M.D.

This award provides another year of funding for the UC Berkeley Academic

Geriatric Resource Center (AGRC) that has been serving as the central resource and coordination point in geriatric and gerontology education on the UC Berkeley campus since 1985. The center’s primary objective is to gather and disseminate aging-related information to UC Berkeley health care professional students, faculty, staff, health care professionals, and the general public.

health. Selected lecturers, researchers, and students at ABU’s Departments of Public Health and Obstetrics and Gynaecology will be trained and mentored by UC Berkeley faculty and distinguished professors from northern Nigeria. The long-term objective of this five year effort is to create and maintain the Center for Population and Health Research at ABU.

UC Berkeley Global Research Training in Population and Health in Nigeria $711,935 from the NIH Fogarty International Center PI: Malcolm D. Potts, M.B., B.Chir., Ph.D., F.R.C.O.G.

This Fogarty training award will enhance the capacity of two key departments at Ahmadu Bello University (ABU), Zaria, northern Nigeria, to carry out applied research in population

Health Research for Action Publication Receives APHA Honor The American Public Health Association (APHA) Public Health Education and Health Promotion Section awarded the first-place prize in its materials contest to Pennsylvania’s Healthy Steps for Older Adults: A Guide to Preventing Falls, a publication developed and produced by the School’s Health Research for Action center in collaboration with the Pennsylvania Department of Aging. The 64-page guide is part of a Allison Leppke (center), Emory University, representing the Public Health statewide initiative in Pennsylvania intended to prevent falls among older Education and Health Promotion Section of APHA, presents the first-place prize for health education materials to Ivonne Gutiérrez Bucher (left), chief adults. Topics include measuring a person’s risk of falling, how to prevent of staff, Pennsylvania Dept. of Aging, and Linda Neuhauser, co-principal falls, specific exercises that help seniors reduce their risk of falls, and suginvestigator of Health Research for Action at the UC Berkeley School of gested home modifications. Entries from across the nation were judged Public Health. by a panel of health educators and were evaluated based on the quality of the content, appropriateness for the audience, use of health education theory, overall produce quality, innovation and creativity, and their plan for evaluating the success of the product. Health Research for Action co-principal investigator Linda Neuhauser, Dr.P.H. ’88, accepted the prize at the APHA annual meeting in November 2006. Coauthors from the School are Shelley Martin, M.P.H., C.H.E.S., Katherine Simpson, M.A., Marty Martinson, M.Ed., M.P.H.’05, and Wendy Constantine. Coauthors from the Pennsylvania Department of Aging are Ivonne Guierrez Bucher, R.N., M.B.A., and Susan Getgen, R.N.

Public Health

Faculty News

Meet the New Faculty Alan Hubbard, Ph.D. ’98 Assistant Professor of Biostatistics “New” faculty member Alan Hubbard isn’t exactly unfamiliar with the School. Although he was recently appointed assistant professor of biostatistics, he has been teaching classes here for almost ten years, as an instructor, then as a lecturer, then as adjunct assistant professor of biostatistics. He has also worked on many studies at the School, from examining data on schistosomiasis in China to evaluating information on indoor air pollution in Guatemala. He’s even the third generation in his family to earn a degree at UC Berkeley, and his father has a bachelor’s degree in public health from the School. But while the campus may not be novel for him, Hubbard loves the fact that as a biostatistician at the School, he is constantly working on new projects. “I can be studying exotic diseases in foreign places one day, and doing lab science the next. I get to survey a broad spectrum of science—and that's what I like the most.” Much of Hubbard’s research centers on causal inference, looking at new ways of exploring data and defining questions of interest. This is particularly important in observational epidemiological studies, where there is no control over the distribution of the risk factor of interest in the sample population. Hubbard seeks ways of determining whether or not one risk factor plays a causal role in an outcome. For example, he is working with data from an ongoing study, led by professor of epidemiology Ira Tager and pediatrician Yvonne Cheng, which looks at birth complications and an infant’s atypical birth position: face-down as opposed to face-up. The researchers want to determine if having physicians alter the infant’s position to faceup would reduce or prevent the need for

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Cesarean sections. However, C-sections often have multiple risk factors. Hubbard is working with the data to statistically determine how many C-sections could be prevented by reweighting the distribution of other risk factors in the study population. Hubbard also conducts significant research in computational biology—looking for patterns in data sets where researchers collected thousands of variables on every person. Many of these studies gather data using microarrays, collections of microscopic DNA spots used to examine the expression of thousands of genes at the same time. Rather than aim to prove or disprove a particular hypothesis, researchers sometimes examine this data to see what patterns or differences between groups emerge. This creates a welcome challenge for biostatisticians, who must explore the data aggressively but at the same time adjust for that aggressive exploration. “If you’ve ever stared at a stucco ceiling, you can see pictures if you look long enough,” says Hubbard. “People are great at finding patterns, but we need to determine whether or not those patterns are real.” Hubbard has used these methods of exploring data for a number of studies at the School. He worked with professor of toxicology Martyn Smith to study data on people in China who were exposed to benzene in the workplace. Smith’s group collected extensive genetic data on exposed people and on a control group, and is now examining which genes are differentially expressed. The statistical techniques help sift through data on more than 30,000 genes to determine which are effected by benzene exposure with a high level of accuracy. Understanding gene expression can help demonstrate how benzene causes certain diseases such as cancer, but it also may enable researchers to locate biomarkers, which could help predict risk for disease development. Working on different kinds of data analysis for so many disparate studies is part of what

Hubbard appreciates about UC Berkeley. “This is the most collaborative place I’ve ever been,” he says. This, he adds, may be the product of his role as biostatistician. Hubbard quips, “I’m sort of the academic equivalent of a plumber.” He also has a great appreciation for the biostatistics students here. “Our students tend to be a very interesting lot, and we have many brilliant students here now,” he says. “Most of them have pretty varied backgrounds. That's not true for all schools.”

Education Ph.D. Biostatistics, UC Berkeley, 1998 M.S. Geology/Paleontology, Virginia Polytechnic University, 1990 B.A., Geology, UC Santa Barbara, 1985 Selected Experience Assistant Professor of Biostatistics, School of Public Health, UC Berkeley, 2006–present Adjunct Assistant Professor of Biostatistics, School of Public Health, UC Berkeley, 1998–2006 Research Statistician, Environmental Health Sciences, School of Public Health, UC Berkeley, 1999–present Research Statistician, California State Office of AIDS, 1999–2001 Research Statistician, Reproductive Epidemiological Section, California Health Department, 1994–1999 Selected Publications Van der Laan, M.J. and Hubbard, A.E. (2006.) Quantile-function based null distribution in resampling based multiple testing. Statistical Applications in Genetics and Molecular Biology. 5 (1). Rachowicz, L., Hubbard, A.E., Beissinger, S.R. (2006.) Estimating and comparing offshore distributions of marbled murrelets among different regions. Ecological Modelling. 196: 329-344. Hubbard, A.E., Van der Laan, M.J. (2005.) Population intervention models in causal inference. U.C. Berkeley Division of Biostatistics Working Paper Series. Working Paper 191. Hubbard, A.E., Liang, S., Maszle, D., Qiu, D., Gu, X., Spear, R.C. (2002.) Estimating the distribution of worm burden and egg excretion of Schistosoma japonica by risk group in Sichuan province, China. Parasitology 125: 221-231.

Faculty News

Michael Jerrett, Ph.D. Associate Professor, Environmental Health Sciences Michael Jerrett integrates the fields of geography and public health in his work, bringing together individual characteristics affecting health—lifestyle, occupation or genetics, for example—with geographic data to reveal the spatial aspects of health and disease. Jerrett grew up in Ottawa, Canada, and completed his graduate work at the University of Toronto. He came to the United States in 2003, when the University of Southern California recruited him as an associate professor of preventive medicine. Last year, he was invited to apply for his current position as associate professor of environmental health sciences at the School of Public Health. “I was attracted to Berkeley by the campus’s outstanding reputation,” says Jerrett, “and the chance to be a faculty member at one of the world’s greatest research institutions.” Jerrett continues to collaborate with many of his Canadian and southern California colleagues. In one of several studies he is currently working on, he is examining the relationship between obesity and factors in the built environment—including proximity to grocery stores, fast-food chains or parks— in 11,000 children in 16 communities in southern California. To date, most research on the subject has been cross-sectional in nature, says Jerrett. “Our study adds the question of longitudinal progression toward obesity,” he says. It follows what he calls the children’s “obesogenic trajectory” as they go through adolescence.

He’s also collaborating on a prospective cohort study investigating the association between air pollution and asthma incidence in children—a subject he’s explored with his Canadian colleagues as well—and he’s studying the progression of atherosclerosis in the same cohort of children. In addition, he was a coauthor on the first study to link carotid artery thickness in adults to air pollution, published in Environmental Health Perspectives in 2005. This work links to his other studies showing large effects from air pollution on circulatory mortality.

of Public Health. He also has ambitious plans to establish a GIS Health Exposure Analysis Lab on the Berkeley campus. He hopes the lab will improve research opportunities not just for public health students, but for students across campus. And within years, Jerrett says, he hopes the lab will be the “premier GIS lab in the country, if not the world.”

Education Ph.D., Geography, University of Toronto, 1996

“The longitudinal design of these studies is important to show that exposure may be causally linked to disease,” Jerrett explains.

M.A., Political Science/Environmental Studies, University of Toronto, 1988

Canada’s universal single-payer health care system offers excellent opportunities to assemble large data sets on patient characteristics, and Jerrett’s research continues to take advantage of this. He’s currently examining the effects of air pollution on mortality and the risk of Parkinson’s disease. The manganese in MMT, an anti-knock agent added to gasoline in Canada since the 1970s, produces symptoms similar to those of Parkinson’s disease. “This has implications not just for Canada but for the U.S. and beyond—anywhere MMT is available or could be widely used.”

Selected Experience Associate Professor, Environmental Health Sciences, School of Public Health, UC Berkeley, 2006–present

In a separate study examining the relationship between air pollution exposure and mortality in small geographic areas, Jerrett and colleagues have had striking findings: Data from Ontario and Hamilton showed that living within 50 meters of a major road or 100 meters of a freeway essentially nudges a person’s life expectancy down by two-and-a-half years. “That gives society and policymakers something to ponder about the health effects of traffic,” he says.

Adjunct Associate Professor, Graduate Program in Population Health, Ontario Veterinary College, 2002–present

On top of a busy research schedule, Jerrett plans to lead the environmental health doctoral seminar in the Spring 2007 semester and hopes to offer a Geographic Information Systems (GIS) course at the School

Special Graduate Faculty Member, Department of Population Health, University of Guelph, 2002

B.S., Environmental Science, Trent University, 1986

Associate Professor, University of Southern California, 2003–present Codirector, Exposure Assessment and GIS Facility Core, Southern California Center for Environmental Health Science, 2003–present Adjunct Associate Professor, McMaster University, 2005–present Associate Professor with tenure, McMaster University, 1998–2005

Teaching Postdoctoral Fellow, Tri-Council Eco-Research Environmental Health Program and Department of Geography McMaster University, 1995–1997 Selected Honors Dangermond Endowed Speaker, Environmental Research Systems Institute and University of California, Santa Barbara, 2004

Certificate of Excellence in Undergraduate Teaching, granted by the Undergraduate Student Union of McMaster University, 1997 Public Health

Partners in Public Health

Policy Advisory Council Welcomes Two New Members Two new members have recently joined the School of Public Health Policy Advisory Council. One is an advocate for children’s health with a longtime commitment to community service; the other is a leader in health care and smoking cessation and the former head of a major philanthropy. Lisa Stone Pritzker is an advocate and activist for child, adolescent, and women’s health in San Francisco. Her commitment to community service is longstanding. After receiving her B.A. in dance therapy from the University of Wisconsin, she became an active nonprofit leader in her native Chicago, participating on the Michael Reese Hospital and the Hubbard Street Dance Company boards, as well as supporting the Emergency Fund for Needy People in Chicago. Since then she has also remained dedicated to community work, leading to local and national recognition of her leadership as a Wexner Fellow from 1996 to 1999 and in organizations such as the American Israel Public Affairs Committee, the Jewish Community Federation, Jewish Vocational Service, and Jewish Family and Children’s Services. Her involvement in the community, political, and philanthropic arenas has continued to grow as she lends her support and participation to not only local Bay Area organizations, such as KQED and Tenderloin Neighborhood Development Corporation, but also to organizations international in scope such as Conservation International, the Global Fund for Women, and the International Museum of Women. 36

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Since 2000 she has focused her attention on child, adolescent, and women's health issues. For the past three years she has served as a special assistant volunteer within the UCSF Department of Psychiatry Child and Adolescent Services (CAS) at San Francisco General Hospital. In this role, she has represented CAS to the Adolescent Health Working Group and researched barriers to Victims of Crime funding. Her focus on child, adolescent, and women’s health has extended to affiliated public service committees in San Francisco, such as the Center of Health and Community, Langley Porter Clinic, Huckleberry Youth Programs, EngenderHealth International, NARAL, and Talkline. She has also consistently engaged herself in continuing education in these areas of public health, public policy, and political action, and is the founder of a new child and adolescent center in San Francisco. Pritzker looks forward to her involvement with the School. “The School’s mission of improving human health is one that I consider vitally important,” she says, “so I’m delighted to be involved in this capacity.” Steven A. Schroeder, M.D., is Distinguished Professor of Health and Health Care in the Department of Medicine at the University of California, San Francisco (UCSF), where he also directs the Smoking Cessation Leadership Center. From 1990 to 2002, he was president and CEO of the Robert Wood Johnson Foundation, a national health care philanthropy. Under his leadership, the foundation took a bold step, broadening its grantmaking focus to address a number of influences on health traditionally considered outside medical care. Most notable are the foundation-sponsored policy initiatives and research programs during the 1990s, which vaulted tobacco control onto the national agenda and supported substance abuse prevention and treatment through the Center for Tobacco Free Kids, the SmokeLess

States policy initiative, and the Substance Abuse Policy Research Program. Schroeder graduated from Stanford University and Harvard Medical School, and trained in internal medicine at the Harvard Medical Service of Boston City Hospital and in epidemiology as an Epidemic Intelligence Service officer of the CDC. As founding medical director of university-sponsored HMOs at both George Washington and UCSF, he laid the groundwork for the newly emerging field of population health-oriented general medicine. At UCSF he also established a pioneering general internal medicine division that has become a leader in the area of prevention. He currently serves as chairman of the International Review Committee of the Ben Gurion School of Medicine; is a member of the Harvard Overseers and the editorial board of the New England Journal of Medicine; is a director of the Save Ellis Island Foundation, the James Irvine Foundation, the Charles R. Drew University of Medicine and Science, and the Robina Foundation; and is president of the Harvard Medical Alumni Association. He was formerly chairman of the American Legacy Foundation and a member of the Council of the Institute of Medicine. He has six honorary doctoral degrees and numerous awards, including the UC Berkeley Public Health Hero Award, which he received in 2004. “It is a pleasure to serve on the Policy Advisory Council of the UC Berkeley School of Public Health,” says Schroeder. ”Under the excellent leadership of Dean Shortell, the school is well positioned to make a major difference in the health of the public.”

Partners in Public Health

A New Charitable Giving Alternative: Use Your IRA as Never Before On August 17, 2006, President Bush signed the Pension Protection Act of 2006 into law. The act, which encourages financial support of charitable organizations, provides new tax incentives for charitable gifts from donors who are 701⁄2 or older. If you meet the age criterion, under the new law, you can make a lifetime gift using funds from your individual retirement account (IRA) without undesirable federal income tax effects. Previously, you would have had to report any amount taken from your IRA as taxable income and take a charitable deduction for the gift, but only up to the maximum 50 percent of your adjusted gross income. In some cases, this could have meant paying more in income taxes than if you didn’t give at all. Fortunately, these IRA gifts can now be accomplished simply and with zero federal income tax complications. Any distribution made directly to charities from your IRA will count towards meeting the minimum required distribution for the calendar year. Note that this is a non-taxable event, so no charitable deduction is available. Therefore, you can make the gift now and witness the benefits of your generosity, while you are still living! What are the qualifications to make an IRA Direct Gift to a Charity?

You may contribute funds this way this year if: • You are age 701⁄2 or older. • The gift is $100,000 or less per taxpayer. • You make the gift between now and Dec. 31, 2007. • You transfer funds directly from an IRA or Rollover IRA. • You transfer the gift outright to one or more qualified 501(c)3 public charities, such as the UC Berkeley School of Public Health. (You are not allowed to give directly to supporting organizations or donor-advised funds housed at a community foundation).

How to Make a Gift—It’s Simple

Prior to making a gift, contact the School of Public Health’s External Relations Office at (510) 643-1487 to obtain the Schools’ tax identification number and other additional instructions. Then contact your IRA custodian to obtain the transfer form; you fill in your IRA account number, the School's tax ID number and mailing address, the amount to be gifted, and return the form to your IRA custodian. It is very important to let us know who your IRA custodian is and the exact amount, so that we can provide proper acknowledgement when the donation arrives. For More Information

The School of Public Health urges you to seek the advice of an attorney in developing your giving plan. Our expert staff would be happy to provide you with specific ideas regarding charitable giving as a component of your estate plan. Please feel free to call Rick Zurow, philanthropic adviser/major gift officer, at (510) 643-1487, or by e-mail at rzurow@berkeley.edu.

School of Public Health Policy Advisory Council 2006–2007 Kenneth S. Taymor, Esq., Chair Attorney-at-Law, MBV Law LLP Raymond J. Baxter, Ph.D. National Senior Vice President, Community Benefit, Kaiser Foundation Health Plan and Hospitals Terri Carlson, M.P.H. ’84 UC Berkeley Parents Fund 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 Linda Hawes Clever, M.D., M.A.C.P. Chief, Occupational Health, California Pacific Medical Center Founder, RENEW 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 Leslie Louie, Ph.D. ’90, M.P.H. ’85 President, Public Health Alumni Association Director, School-Based Health Clinics and Practice Administrator, Children’s Hospital and Research Center at Oakland Nancy K. Lusk Chairman of the Board, The Lusk Company Martin Paley, M.P.H. ’58 Management Consultant Arnold X. C. Perkins Director, Alameda County Public Health Department Lisa Stone Pritzker Advocate and activist for child, adolescent, and women’s health J. Leighton Read, M.D. General Partner, Alloy Ventures 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. Director, Planning, Development, and Policy, Tiburcio Vasquez Health Center, Inc.

Public Health

Partners in Public Health

New Initiative Bolsters Student Excellence It is sometimes difficult for UC Berkeley, as a public university, to match the fellowships used by so many other institutions to entice highly qualified graduate students. Fortunately, Berkeley is renowned for its superior faculty, and the opportunity to work with luminaries in the field draws many of the top graduate students to the School. Now many faculty and staff are further contributing to support student excellence through the Named Fund Initiative. The initiative matches the financial contributions

of individuals at the School to create fellowships for graduate students. These fellowships can make the difference for prospective students debating their decision to come to Berkeley. The Named Fund Initiative was created after a 2004 survey demonstrated that when UC Berkeley was able to offer a financial package at least $1,000 more than a competing school, 88 percent of graduate students chose to come to Berkeley. With UC Berkeley graduate fees rising by 84 percent since 2002,

and funding for fellowships dropping, additional funding can be crucial to attracting the brightest minds to the university. The initiative offers a way for faculty and staff in a particular department another way to support students in that area of study. Nine faculty and one staff member at the School have already committed to the program, which matches contributions up to $10,000. The $20,000 is then used to create a fellowship that produces annual student awards in the $1,000 range. Friends of the donor may also contribute to the fund.

Alumna’s Dedication to Health Lives On Throughout her 45 year career in public health nursing, Lillian Aldous M.S., M.P.H. ‘68, remained passionate about the importance of quality education for those who dedicate their lives to caring for others. She herself received her master’s degree in public health from the School, as well as a master’s degree in nursing from UCSF, and pursued a dynamic career which included positions as assistant director for public health nursing for Santa Clara County and director of public health nursing for the city of San Jose. To honor the legacy of his late wife, Dudley Aldous established the Lillian and Dudley Aldous Endowed Chair in Public Health. Lillian and Dudley Aldous

Lillian Aldous began her career as a nursing student in Ontario, Canada. After marrying in 1950, she and her husband settled in San Jose. While Dudley pursued a career in engineering, Lillian earned her master’s degrees and dedicated her considerable energy to public health. In addition to a busy professional life, she also followed her other loves: painting, art appreciation, gardening, and travel.

University of California, Berkeley

The Lillian and Dudley Aldous Endowed Chair is a fitting tribute to a remarkable woman who turned her natural enthusiasm and compassion toward working for the greater good. The Lillian and Dudley Aldous Endowed Chair is a fitting tribute to a remarkable woman who turned her natural enthusiasm and compassion toward working for the greater good. The chair will support the education of future public health

students and provide opportunities for researchers at the School. “We are so grateful for this endowment and proud to carry on the legacy of Lillian Aldous at the School,” said Dean Stephen Shortell.

Partners in Public Health

Scholarships Celebrate Seven Areas of Public Health

Joanne and George McKray join the Reshetko Family Scholars at the annual Scholarship Tea. Left to right: Jennifer Ahern, Hui Tang, Viet Nguyen, Joanne McKray, George McKray, Marian Roan, Ray Minjares, and Rosanna Tran. Not pictured: Colleen Reid.

This year the first-ever recipients of the Reshetko Family Scholarships

were fêted at the School of Public Health’s annual Scholarship Tea. The awardees were selected by a School committee based on excellence in one of seven key areas of public health. George McKray, M.P.H. ’57, former director of the School’s Public Health Alumni Association and the facilitator of the scholarships, spoke of the need for student financial support in today’s academic world. The scholarships were established by Lola E. Reshetko, who bequeathed the

majority of her estate to UC Berkeley in order to create scholarships for students in the School of Public Health and for biological sciences students in the College of Letters & Science. In many ways, the scholarships continue Reshetko’s life work. After receiving her bachelor’s and master’s degrees in bacteriology from UC Berkeley, she completed a teaching certificate and spent most of her career teaching science at Mission High School in San Francisco. She created a program, “Mission Possible,” which

provided students with the opportunity to gain experience in the medical field through work at local hospitals. Each of the scholarships is named in honor of a notable faculty member from UC Berkeley who advanced public health in one of seven areas. Former dean Charles E. Smith is honored for epidemiology, especially for his research on coccidioidomycosis, or Valley Fever. Dorothy Nyswander, whose work led to major changes in school health services, was celebrated for public health education. For public health nutrition, Ruth Huenemann was chosen for her many contributions to improving nutrition and for

establishment of the School’s public health nutrition program. Chin Long Chiang was selected for biostatistics for his many accomplishments in the field. Robert Cooper was named for environmental health sciences, for his work in water quality and health, environmental health microbiology, and water reuse. Sanford Elberg was honored for infectious diseases for his research on diseasecausing microorganisms and airborne agents. Edward Rogers, second dean of the School, who served as George McKray’s mentor when McKray was a student in public health, was celebrated for health and medical sciences.

Joanne McKray (right) talks with Hui Tang (left) and Viet Nguyen.

Public Health

Keep “The Berkeley Difference” Alive and Well

In 1965, when I started at the School of Public Health, historical changes were happening in the nation’s health care system. Strategies for implementing Medicare and Medicaid were being debated and formulated by Congress and the states. The education I received fully equipped me to obtain employment in the policy arena in this challenging environment, and it also gave me a spirit of service. I have maintained my connections with the School since 1965, as a way of returning to the School some of what the School has given me. Now, as in 1965, the School of Public Health is faced with significant educational challenges and limited funding options to meet them. We see that the health care workforce is in a growing crisis because the nation’s population is growing older and becoming more culturally diverse. And African Americans, Latinos, and Southeast Asians are still grossly underrepresented in the health care workforce. The School of Public Health has implemented several programs to recruit and graduate underrepresented minorities. I participate in these efforts by helping to build educational pipelines for underrepresented students. As alumni, we must continue to help the School of Public Health maintain its eminent stature as a public health leader. We can do this through our energy and commitment, and through our donations. We must keep the “The Berkeley Difference” alive and well.

-Carl N. Lester, M.P.H. ’65 40

University of California, Berkeley

Support the Annual Fund Your tax-deductible contribution to the School of Public Health ensures the viability of valuable School of Public Health programs, such as scholarships and recruitment efforts. Support the future of public health. Give online at sph.berkeley.edu/giving/how.html or mail your gift (payable to the “School of Public Health Fund”) to: University of California, Berkeley School of Public Health External Relations & Development 140 Earl Warren 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.

Alumni News

President’s Message Greetings Friends and Alumni, We’re off to another great year with lots of things to plan and to be excited about. This past fall, we had the pleasure of attending the first student-faculty mixer, hosted by the Undergraduate Public Health Coalition. More than 50 students met with 10 faculty and public health community representatives in Senior Hall to network and socialize. This is the same group that publishes the award-winning Public Health Advocate magazine, supported in part by funds from the Public Health Alumni Association (PHAA). We also had another successful Scholarship Tea, where scholarship recipients met with donors to personally thank them for their commitment to supporting students in the School of Public Health and to share with them their vision and goals for the future. We are currently in the process of redesigning the application for scholarships, which award $1,500 to 20 to 40 graduate students in a variety of disciplines. We have been exploring ways to also support our undergraduate students and diversity in the public health profession through scholarships. The Career Café took place February 8, 2007. PHAA and the Center for Public Health Practice co-host this annual event, where we gather with alumni and community partners representing the various disciplines in public health. We have a series of roundtable discussions with students who are interested in asking practical questions of professionals working in the field to find out about job prospects, job requirements, valued experience by employers, and possible internships. In short, the Career Café is a fabulous networking opportunity, not only for the students but for the roundtable hosts as well. This is a place where the perfect future coworker can be found. In the spring, we will again have two amazing events. The first is the Public Health Heroes Awards Ceremony on March 23 to honor our regional, national, international, and organizational heroes who have made significant contributions to the field. The event is truly memorable and serves to remind us all of our profession’s value to humanity. (See p. 44 or go to www.publichealthheroes.org for more information.) On April 15, we will be continuing with our Spring Brunch and Silent Auction, which was revived last year after several years’ hiatus. The Silent Auction raises funds to support student scholarships and other activities as determined by surveying the alumni’s preferences. Last year we exceeded our fundraising goal, so we’ve set the bar a little higher this year. We hope that you can join us again and bring along some of your former classmates to join in the fun! Get your taxes done early—but just in case, we'll have extension forms available for you to file for more time! Keep your eyes open for more information about this event. Finally, I would like to thank all the directors who have served on the board or who will in the future. That could even be you. If you are interested in participating in any of the PHAA activities, you need not be a director to do so. Our membership includes all graduates from the UC Berkeley School of Public Health. If you would like to play a role in establishing and contributing to PHAA goals, objectives, and activities, you can apply to be a director on the PHAA board. We have three to five spots opening up every year, and are always interested in meeting fellow alumni who share our passion for supporting students and alumni, andworking more closely with the dean to help the School. For more information about PHAA, please contact Eileen Pearl (phaa@ berkeley.edu), associate director, external relations. Sincerely,

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

Leslie Louie

Public Health Alumni Association Board of Directors 2006–2007

Leslie Louie, Ph.D ’90, M.P.H. ’85 (President) Sarah Stone-Francisco, M.P.H. ’03 (Vice President) James H. Devitt, M.P.H. ’77 (Secretary-Treasurer) Philippa Barron, M.B.A., M.P.H. ’94 Lucinda Bazile, M.P.H. ’94 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 Melinda “Mindi” Lassman, M.A., M.S. ’77 Beth Roemer, M.P.H. ’76 Jan Schilling, M.P.H. ’91 Alan R. Stein, M.P.H. ’78, M.S., M.F.T. John Troidl, Ph.D. ’01, M.B.A.

Public Health

Alumni News

Alumnus Spotlight: Public Service Has Great Impact Peter van Dyck, M.D., M.P.H. ’73 Peter van Dyck remembers the shared sentiment of his cohort in the School’s M.P.H. maternal and child health program: “We had similar interests, and we all wanted to do something instead of or in addition to private practice that would touch more people’s lives in some significant way.” Van Dyck’s desire to improve the health of the greatest number of people led him from practice as a pediatrician into public service, and he is currently the associate administrator of Maternal and Child Health (MCH) in the U.S. Department of Health and Human Services Health Resources and Services Administration, a position he has held since 1999. Prior to his appointment, he served as acting associate MCH administrator and was the first permanent director of the Maternal and Child Health Bureau’s Office of State and Community Health. As associate administrator, van Dyke has had the opportunity to make significant changes in order to safeguard and promote good health for mothers and children. One major step has been to implement a data collection and performance measurement system that enables the MCH Bureau to better understand how well grantees deliver care. This national reporting system and hotline covers all states and the approximately 1,000 grantees who receive funds from the bureau. “It allows us to manage in a way that is very transparent, and that is good for the public trust,” says van Dyck. “It allows us to tell Congress exactly what we are doing.” Prior to implementation of the online system seven or so years ago, reporting was ad hoc and was not performancebased. “We developed this system in partnership with the grantees: They do good work, and they want to tell about it. It has been a real win-win situation.” Managing this large federal bureau with an $836 million annual budget for 2006 brings many challenges. 42

University of California, Berkeley

One of the biggest problems is understanding what the needs are across the nation, and then assessing which of the many maternal and child health issues take priority. Obesity, infant mortality, perinatal and postpartum depression, prenatal care, workforce training, care for children with special health needs, and newborn screening are just few of the key areas the bureau tries to address. The financial balancing act is not easy, as enough funds must be allocated to a single program or issue have an impact, while so many programs are in urgent need of resources. Van Dyck, who directed the Family Health Services Division of the Utah Department of Health before coming to the federal government, advises current

Maternal and Child Health students to “have a clear purpose, set goals, get good training, and try to decide where exactly you feel you can have the most impact.” His own experience has been diverse, as he served as chief of pediatrics for an army hospital in Germany and as a pediatric consultant for the Red Cross in Jordan before moving into public policy. He was also a professor in the Department of Pediatrics at the University of Utah Medical Center. Whether they hope to work for a nonprofit, city, university, large pediatric practice, or the federal government, he recommends students talk to people in the roles and organizations they want to be in, and to investigate the wide range of options available to them. “There are many opportunities out there,” he says.

Van Dyck advises current Maternal and Child Health students to “have a clear purpose, set goals, get good training, and try to decide where exactly you feel you can have the most impact.”

“My gift of real estate to the School of Public Health provides financial aid for the future leaders of our professions—and gives me income for life!”

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 pwh@berkeley.edu.

Bobbie Singer is a retired public health educator and a lover of New Orleans jazz. She’s also a strong believer in Berkeley’s School of Public Health. “Public health education,” she says, “is a process of empowering people to be involved in their own health and health care.” Bobbie used her second home to create a charitable trust to benefit the School of Public Health. This gives her an income for life plus substanial tax advantages. She explains: “I want to make sure the School continues to offer first-rate training to tomorrow’s public health leaders—to enhance health for all, regardless of social or economic background.”

Public Health

11th Annual

Public Health Heroes Awards Ceremony BUY YOUR SEATS NOW Friday, March 23, 2007 Yerba Buena Center for the Arts, San Francisco www.publichealthheroes.org or (510) 643-6382 The annual tradition of honoring public health heroes was initiated in 1996 by the School of Public Health’s Policy Advisory Council. This honor acknowledges individuals and organizations for their significant contributions and exceptional commitment to promoting and protecting the health of the human population, and through this public recognition, broadens awareness and understanding of the public health field.

2007

International Hero: D.A. Henderson, M.D., M.P.H., distinguished scholar at the Center for Biosecurity of the University of Pittsburgh Medical Center and professor of public health and medicine at the University of Pittsburgh, for his outstanding leadership in directing the World Health Organization’s global smallpox eradication program and his vision in establishing the organization’s global program of immunization.

2007

National Hero: Dean Ornish, M.D., founder, and president, of the nonprofit Preventive Medicine Research Institute and clinical professor of medicine at UCSF, for his work as a researcher, public educator, and change agent regarding the role of diet and lifestyle and its impact on heart disease.

University of California, Berkeley

2007

Regional Hero:

David J. Kears, M.S.W., director of the Alameda County Health Care Services Agency, for his decades of leadership in finding ways to expand access and improve quality for those most in need of mental health, alcohol, drug, public health, environmental health, and medical services.

2007

Organizational Hero: Chinese Hospital, a general acute care community-owned, not-for-profit organization in San Francisco, for providing culturally competent health services to the Chinese American community.

Alumni News

Alumni Notes 1950s Robert Darter, M.D., B.S. ’54, received the first-ever Lifetime Achievement Award from the Chamber of Commerce in St. Helena, California, for “singular, lifelong, and multifaceted achievements” in the community. He has been a member of the St. Helena advisory board for 41 years and has been an adviser with the Boy Scouts of America since 1962. He has been in medical practice in St. Helena since 1961.

1960s Bradley E. Appelbaum, M.D., M.P.H. ’64, and Elizabeth Appelbaum, Ph.D. “Enjoy our retirement but remain involved. I remain a consultant to the Maternal and Child Health Bureau HRSA/HHS.” Robert Gerdsen, M.D., M.P.H. ’66 “Celebrating the 40th anniversary of my M.P.H., I would like to express my appreciation to the faculty for the incredible knowledge and skills I gained at the School, which had a profound effect on my career and what I was able to accomplish. It indeed was quite different from the other medical directors and chairmen of pediatric departments during the 60s, 70s, 80s, and 90s. Best wishes to all.” Robert C. Harrell, M.P.H. ’67, is a resident of O’Connor Woods in Stockton, California. Irene M. Reed, M.P.H. ’67 “After 30+ years with the U.S Dept. of Health and Human Services, I retired in July 2002. After three-and-a-half years caring for my grandson, my daughter graduated magna cum laude from Southwestern Law School and I am fully retired.” Lawrence W. Green, Dr.P.H. ’68, received an honorary doctor of science degree from the University of Waterloo, Canada, at the university’s Fall

2006 convocation. A leading researcher and innovator, Green has advanced the field of health promotion and disease prevention around the world. His most influential book, Health Promotion Planning: An Educational and Environmental Approach, integrates the fields of health education and public policy to enhance planning in major population interventions. He was the first director of the U.S. Office of Disease Prevention and Health Promotion in the Department of Health and Human Services.

executive officer of several California entities, including St. Joseph Hospital of Orange, Pacific Health Resources, California Hospital Medical Center, HealthForward, and others. Since 1999 he has been a senior vice president at Kaiser Permanente, first in the San Diego Region, and since 2003 in the Inland Empire Region.

Robert E. Tumelty, Dr.P.H. ’69, M.P.H. ’52 “Continue to serve on the Advisory Board of the Health Care Administration Program, California State University, Long Beach, and chair the Institutional Review Board of Los Alamitos Medical Center, Los Alamitos, California.”

Lawrence Marum, M.D., M.P.H. ’76, heads the Global AIDS Program in Kenya. Under the direction of the U.S. Global AIDS Coordinator’s Office, the HHS/CDC Global AIDS Program is a partner in the unified U.S. government effort to implement the President's Emergency Plan for AIDS Relief.

John G. Williams, M.P.H. ’69, was named CEO of Barton HealthCare System in South Lake Tahoe, California. He has 30 years’ experience as a chief executive officer, chief operating officer, and in executive-level management positions within the hospital and health-system industry. For the past several years he has held senior-level executive positions with Sutter Health, starting as president and chief executive officer for St. Luke’s Hospital and Health Care Center in San Francisco and most recently serving as Sutter Health regional vice president.

1970s Terry Belmont, M.P.H. ’71, was named chief executive officer of Long Beach Memorial Medical Center and Miller Children’s Hospital—the second largest community hospital campus in the West. The 743-bed facility is a teaching hospital affiliated with several colleges and universities, and one of the few campuses nationally with separate adult and children’s hospitals. Belmont has been president and chief

Bessanderson McNeil, M.P.H. ’71 “Retired from health field three years ago. Have my own business and am loving every minute of it.”

1980s Robert Hiatt, M.D., Ph.D. ’80, M.P.H. ’72, was appointed joint chair of the Department of Epidemiology and Biostatistics at the UCSF School of Medicine. He is also director of population science and deputy director of the UCSF Comprehensive Cancer Center. Hiatt came to UCSF in 2003 after leading the National Cancer Institute’s Division of Cancer Control and Population Sciences as deputy director. Before that, he was director of prevention sciences at the Northern California Cancer Center and assistant director for epidemiology at the Kaiser Permanente/ Northern California Division of Research. He continues at Kaiser Permanente in a senior scientist role. Howard Pollick, M.P.H. ’80, is chair of the American Public Health Association’s Oral Health Section and also chairs the Oral Health Section of the California Public Health Association-North.

Public Health

Alumni News

Milstein Elected to Institute of Medicine

Alumni Notes Kathy Go Ang, M.P.H. ’81 “I’m working as a renal dietitian for Davida Dialysis, Inc. I enjoy the challenge of clinical nutrition. My kids are growing up fast—Brian is 20, a junior at UC Davis, and Christine is 17, a senior in high school. My husband Dave continues with his dental practice here in Yuba City.” Ellen J. Mangione, M.D., M.P.H. ’85, has left the Colorado Department of Health and Environment, where she was deputy chief medical officer and director of the Division of Disease Control and Environmental Epidemiology, to become chief of staff for the VA Eastern Colorado Health Care System.

Arnold Milstein, M.D, M.P.H. ’75, was elected to membership in the Institute of Medicine (IOM) in October 2006. Milstein is medical director for the Pacific Business Group on Health, the largest U.S. employer health care coalition; chief physician and national health care thought leader for Mercer Health & Benefits LLC; and an associate clinical professor at the University of California, San Francisco. Established in 1970 as a unit of the National Academy of Sciences, the IOM is concerned with the protection and advancement of the health professions and sciences, the promotion of research and development pertinent to health, and the improvement of health care. Milstein is the first benefits consultant to be tapped for IOM membership. “Arnie Milstein is one of the country’s foremost thought leaders on how to reform our nation’s health care system,” said Dean Stephen Shortell. “He had a great influence on California’s Pay-for-Performance program and similar initiatives across the country.” In addition to his degree from the School of Public Health, Milstein has a bachelor’s degree in economics from Harvard University and an M.D. from Tufts University.

University of California, Berkeley

Jeffrey Fontaine, M.S., M.P.H. ’87, has been named executive director of the Nevada Association of Counties, moving on from his post as director of the Nevada Department of Transportation (NDOT). He has been with NDOT since 1995, first as deputy director, and since April 2003 as director, overseeing the agency during a huge expansion of major roadway projects in the state. Prior to working at NDOT, he was a public health engineer with the Nevada Health Division, where his work on water-quality issues sparked his interest in county and local government.

and evaluate child health promotion initiatives. She has been a consultant to Nemours for the past four years, managing a grantfunded anti-tobacco project with the pulmonary division of the Alfred I. duPont Hospital for Children. She also has served as a consultant to the Department of Health and Social Services and the Delaware Public Health Association. Katherine Feldman, D.V.M., M.P.H. ’99, received the James H. Steele Veterinary Public Health Award at the 55th Annual Epidemic Intelligence Service (EIS) Conference in Atlanta, Georgia. The award recognizes outstanding contributions of current or recent former EIS Officers in the investigation, control, or prevention of zoonotic diseases or other animal-related human health problems. She was recognized for carrying out numerous epidemiologic investigations, including a landmark epidemiologic study of primary pneumonic tularemia in Martha’s Vineyard, Massachusetts, for which she was principal investigator; investigation of West Nile virus infection in New York City; and investigation of tickborne relapsing fever in Nevada.

2000s 1990s Giorgio Piccagli, Ph.D., M.P.H. ’91, president of the California Public Health Association-North (CPHA-N), was elected to the executive board of the American Public Health Association. He has been active in CPHA-N since the early 1990s, serving on its governing council and holding several positions, including vice president for operations and affiliate representative to the governing council of the American Public Health Association. Judith Feinson, M.C.P., M.P.H. ’94, has joined Nemours Health and Prevention Services, near Newark, Delaware, as a program and policy analyst. She will work to develop, implement,

Michael Musante, M.P.H. ’03 “I work for a biotech company in South San Francisco on a possible immunotherapy for prostate cancer.” Annette Molinaro, Ph.D. ’04, an assistant professor of biostatistics in the Department of Epidemiology and Public Health at Yale, has received a three-year $500,000 grant from the National Cancer Institute to advance the use of statistics for predicting outcomes in cancer patients. The grant will partially fund a project that pairs large disease-related data sets with clinical information to find variables that are significantly linked to disease outcomes.

Alumni News

Berkeley Alumni Receive APHA Honors UC Berkeley School of Public Health alumni were among those receiving awards at the 134th Annual Meeting of the American Public Health Association (APHA), held in Boston November 4–8, 2006.

Mary Sylla, M.P.H. ’04, is policy and advocacy director for the Center for Health Justice, a nonprofit agency that over the past four years has distributed 14,000 condoms in the Los Angeles County Jail. Sylla, known in the L.A. jail as “the condom lady,” worked with Assemblyman Paul Koretz, D-West Hollywood, to draft Assembly Bill 1677, which would have enabled public health agencies to provide condoms to California prison inmates in order to control the spread of HIV/AIDS. The bill, sponsored by the Southern California HIV/AIDS Advocacy Coalition, AIDS Project Los Angeles, and AIDS Healthcare Foundation, was passed by the California Legislature on August 24, but was later vetoed by Governor Arnold Schwarzenegger. Janine Santimauro, M.P.P., M.P.H. ’06, married David James Deming in August. The two met at UC Berkeley while both were working on master’s degrees in public policy. Santimauro is a project specialist in the decision support and quality management unit at Massachusetts General Hospital in Boston.

Adele Amodeo, M.P.H. ’70, received the Committee on Affiliates 2006 Award for Excellence at the November 2006 annual meeting of the American Public Health Association (APHA). The award is presented annually to an APHA state affiliate leader whose contributions to her affiliate are exceptionally meritorious. As executive director of the California Public Health Association-North (CPHA-N), Amodeo has significantly increased CPHA-N’s legislative advocacy capacity through her own actions and through recruitment and retention of savvy public health advocates to work collaboratively with CPHA-N’s governing council. She has had a major impact on California’s state public health legislation throughout the years. This year, in part due to her exceptional work and influence, California established an independent Department of Public Health—an important step in rebuilding the public health infrastructure in California and protecting and improving the health of the public. She has expanded CPHA-N’s educational capacity, solicited the funding to offer this education and training, and positioned CPHA-N as the continuing education provider for health professions whose own boards abandoned that function. Amodeo is senior policy associate with the Public Health Institute, an independent, nonprofit organization. Anthony B. Iton, M.D., J.D., M.P.H. ’97, received APHA’s 2006 Milton and Ruth Roemer Prize for Creative Local Public Health Work in recognition of his exceptional creative and innovative local public health efforts. Iton is a health officer with the Alameda County Public Health Department in Oakland, California. Prior to that post, Iton was director of health and social services for Tony Iton (right) at the APHA award presentation in Boston, with Alameda County the city of Stamford, Connecticut, where, Public Department deputy director Anita through a partnership with the schools and Siegel and former director Arnold Perkins. local hospital, he enabled the health department to design targeted interventions that directly address persistent health disparities in lead poisoning, asthma and obesity prevention. He also initiated Stamford’s Westside Project, an interdisciplinary chronic disease prevention program focused on involving an inner-city community in the city’s redevelopment process with an eye toward increasing citizens’ ease of walking and biking around the city. Iton previously worked as an HIV disability rights attorney at the Berkeley Community Law Center, a health care policy analyst with Consumers Union West Coast Regional Office, and as a physician and advocate for the homeless at the San Francisco Public Health Department. His experience practicing both medicine and law independently has enabled him to blend both disciplines in the day-to-day practice of public health and in responding to recent public health emergencies such as severe acute respiratory syndrome (SARS) and anthrax.

Public Health

In Memoriam

In Memoriam Michael Alcalay, M.D., M.P.H. ’74, died November 18, 2006, at age 65. A pediatrician at Kaiser Permanente Medical Center in Oakland, Alcalay spent much of his career providing health care and advocating for disenfranchised patients. He opened a health clinic for farmworkers in Watsonville, produced a syndicated AIDS radio show, and served as medical director of the Oakland Cannabis Buyers’ Cooperative, among other accomplishments. He grew up in Los Angeles and attended UC Berkeley, and later UCLA medical school, on scholarships. After serving two years as a physician in the Vietnam War, he moved back to the Bay Area, and through his partner, who was Puerto Rican, he became interested in Latino immigrants’ health issues. In 1975, he opened Salud Para la Gente, a free clinic for farmworkers, in Watsonville. The clinic was staffed by Bay Area doctors and nurses who donated their services. In 1980, Alcalay began working abroad, in England, Germany, Kenya, Mexico, and Nicaragua. In Nicaragua, he made his first foray into media, co-producing a 90-minute video documentary about gains in health care under the Sandinistas. After Alcalay was diagnosed with HIV in 1986, he started producing a 15-minute radio show called “AIDS in Focus” through KPFA in Berkeley. In the early 1990s, Alcalay’s attention turned to the medical properties of marijuana. He spent years researching the drug and its effects on various conditions, enrolling more than 1,000 patients through the Oakland Cannabis Buyers’ Cooperative. He was also featured on a PBS documentary called “Waiting to Inhale.” Alcalay is survived by his twin sons, his mother, stepfather, two brothers, and a sister. George McClelland Foster Jr., Ph.D., a professor of anthropology and lecturer in public health at the University of California, Berkeley, died May 18, 2006, at age 92. He was generally known as the founder of medical anthropology and for his pioneering contributions on peasant societies and long-term field 48

University of California, Berkeley

research documenting societal change. Foster, who received his Ph.D. in anthropology from UC Berkeley in 1941, established himself as one of the most distinguished anthropologists of his generation during a career spanning more than six decades. Key areas of his work included historical reconstruction, social roles and structure, material and visual cultures, international public health, ethnography and field methods, and pottery technology. He also earned a reputation as an outstanding scholar for his theories such as the “principle of limited good” in times of scarcity, as well as for his work on medical systems based on the concept of the human body’s need for a temperature balance between hot and cold. Foster authored nearly 300 publications, including more than a dozen books on theory, method and ethnography. Over the years, Foster served as a consultant on international health for numerous agencies such as the World Health Organization, UNICEF and others, and he traveled widely throughout Asia, Africa, and Latin America. He was elected president of the American Anthropological Association in 1970. He was elected to the U.S. National Academy of Sciences and the American Academy of Arts and Sciences. He received the Malinowski Award from the Society for Applied Anthropology, a Guggenheim Fellowship, and a Lifetime Achievement Award from the Society for Medical Anthropology. Foster also received an honorary doctorate from Southern Methodist University. Upon his retirement in 1979, Foster received the Berkeley Citation, the campus’s highest honor. Foster is survived by his son and daughter, five grandchildren, and four great-grandchildren. Sylvie Redmond Griffiths, M.A., died on September 6, 2006, at age 90. Born in New York City, she received her B.A. from Bennington College and her M.A. in psychology from the University of California, Berkeley. She was married to the late William (Bill) Griffiths, professor emeritus at the UC Berkeley School of Public Health, who played

a vital role in building the School’s Health Education Program and was adviser and mentor to generations of international students. The couple often hosted public health students in their home. They traveled extensively to many Third World countries in conjunction with Bill’s work in health education and population planning. After Bill’s death, Sylvie established the William Griffiths Endowed Fund at the UC Berkeley School of Public Health in his memory. She remained an active supporter of the School and regularly attended the annual Scholarship Tea. She took active leadership roles in numerous state and local organizations, including serving terms as president of the Richmond League of Women Voters, the Richmond YWCA, the Bay Area YWCAs and the Faculty Wives’ Section Club at UC Berkeley. She also served as a member of short memoirs that recounted significant incidents in her life, many of which included famous people, including J.D. Rockefeller II, Dorothy Day, B.F. Skinner, and Franklin Delano Roosevelt (her mother’s first cousin). She is survived by four children and nine grandchildren. To make a gift in memory of Sylvie Griffiths, please make your check payable to the “William Griffiths Endowed Fund” and mail it to Pat Hosel, Office of External Relations, UC Berkeley School of Public Health, 140 Warren Hall, Berkeley, CA 94720-7360. James P. MacLaren, M.P.H. ’62, died August 15, 2006, at age 91. He led a life full of adventures in Montana, Minnesota, Korea, Mexico, Peru, and the Panama Canal Zone, and retired in Oakland, California. He is survived by his wife, two daughters, a son, and eight grandchildren. Joyce Ann Vermeersch, Dr.P.H. ’75, M.P.H. ’69, died June 12, 2006, at age 60. Born in Detroit, she received her B.S. cum laude from Western Michigan University in Kalamazoo. After receiving her doctorate in public health, she moved to Davis, California, where she was an assistant professor in the Department of Nutrition until 1979. After a successful career as a health

In Memoriam

Alfred Wheeler Childs, M.D., M.P.H. ‘64 Health on the UC Berkeley Foundation Board of Trustees. In 1993, School of Public Health dean emerita Patricia Buffler established the Alfred W. Childs Distinguished Service Awards to recognize faculty and staff who exemplified Childs’s generosity of spirit and commitment to the school. In 1991 he received the California Alumni Citation and in 1994 the Trustees Citation.

Alfred Wheeler Childs, M.D., M.P.H. ‘64, a former professor at the UC Berkeley School of Public Health and a dedicated and committed alumnus, died on July 5, 2006. He was 84. Childs spent much of his life working towards improved health for all people, as a physician, faculty member, and advocate for advances in health care services. He participated in every aspect of patient care, from treating individuals at home and abroad, to directing an artificial kidney unit, to supporting the next generation of public health leaders through active involvement at the UC Berkeley School of Public Health. Born in 1922 in San Francisco, he received a bachelor’s degree in medical science from UC Berkeley in 1943 and a medical degree from UCSF in 1946. He enlisted in the Army Reserve from 1943 to 1946, served in the Air Force as a medical officer for two years, and in the Air Force Reserve from 1949 to 1964. He was a visiting fellow in medicine at Columbia University, New York City from 1954 to 1956. In 1964 Childs received his master’s degree in public health from UC Berkeley. He served on the faculty for the next 11 years, as well as on the clinical faculties of Stanford Medical School and UCSF. He also worked on the medical staff of Alta Bates Hospital in Berkeley and Presbyterian Hospital in San Francisco. He became director of the artificial kidney unit at Presbyterian, a role that brought media attention from television programs such as “Science In Action.”

program consultant, she entered McGeorge School of Law and received her J.D. with high distinction in 1985. She clerked for U.S. District Judge Edward Garcia and entered private practice. She returned to the U.S. Attorney’s office in Sacramento as an assistant U.S. attorney in the Civil Division for five years.

“Al was a tireless supporter of the School, and we were fortunate to benefit from his leadership and dedication,” said Dean Stephen Shortell of the School of Public Health. “We were all privileged to work with him.” Childs was well known for his commitment to volunteering and working towards creating health care systems that meet the needs of all people. In 1962 he went to Peru with Project HOPE, an organization that seeks to address health problems around the globe, particularly in developing nations. He served on the UC Berkeley School of Public Health’s Policy Advisory Council from its inception.

Childs is survived by his wife Eunice and his loving family. To make a gift in memory of Alfred Childs, please make your check payable to the “Alfred W. Childs Endowed Fund” and mail it to Pat Hosel, Office of External Relations, UC Berkeley School of Public Health, 140 Warren Hall, Berkeley, CA, 94720-7360.

An active alumnus, Childs lent his time and leadership skills to the California Alumni Association, the University Art Museum Council, and the board of directors of the UC Berkeley Public Health Alumni Association. He also represented the School of Public

In state service, she served with the formation of the Department of Managed Health Care, where she supervised 14 attorneys engaged in the regulation of health care service plans. Later, she joined the California Public Employees’ Retirement System (CalPERS), where she served as chief of the Health Program Development Division and was

responsible for negotiating and administering HMO contracts for 1.2 million CalPERS members. She was also an attorney with the CalPERS legal office. She is survived by her husband, Scott Merrill, and two cousins.

Public Health

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T HE N EW C LASS AT A G LANCE

This fall, 204 new graduate students entered the School of Public Health, representing a wide range of backgrounds and academic interests. The new class comprises 138 women and 66 men, ranging in age from 22 to 56 years old. There are 154 students working on M.P.H. degrees (20 of whom are in concurrent or joint degree programs); 8 working towards an M.A. or M.S.; 11 students in the Dr. P.H. Program; and 31 Ph.D. students. The students hail from 17 states (California, Colorado, Connecticut, Illinois, Massachusetts, Maryland, Michigan, Minnesota, North Carolina, Nevada, New York, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, and Washington) plus the District of Columbia, and 14 countries (Brazil, Canada, China, Great Britain, India, Iran, Ivory Coast, Japan, Korea, Mexico, Nepal, Philippines, Taiwan, and Uganda). In addition, the Schoolâ&#x20AC;&#x2122;s undergraduate program, which was reinstated in 2003â&#x20AC;&#x201C;2004 after a break of more than 30 years, continues to grow in popularity: There are currently 202 undergraduate public health majors, with approximately 85 more expected to declare the major in the spring.