Advances - Summer 2016 by publichealthmn

Advances FROM THE UNIVERSITY OF MINNESOTA SCHOOL OF PUBLIC HEALTH

SUMMER 2016

Living Longer, Living Better What really matters as we age

sph.umn.edu A

School of Public Health Leadership Dear Friends,

Beth Virnig Senior Associate Dean for Academic Affairs & Research Kristin Anderson Associate Dean for Learning Systems & Student Affairs Debra Olson Associate Dean for Global Health Bruce Alexander Head, Division of Environmental Health Sciences Bradley Carlin Head, Division of Biostatistics

Dianne NeumarkSztainer Head, Division of Epidemiology and Community Health Ira Moscovice Head, Division of Health Policy and Management Joe Weisenburger Chief Administrative Officer/Chief Financial Officer Tara Anderson Director, Alumni Relations and Annual Giving Louis Clark Director, Development Martha Coventry Director, Communications

Advances Editor Sarah Howard Contributing Writers Elizabeth Foy Larsen Sarah Howard Charlie Plain Stacy Richardson Art Direction Cate Hubbard Design cat7hubb@gmail.com Advances is published by the University of Minnesota School of Public Health. To submit comments, update your address, or request alternative formats email sphnews@umn.edu. Printed on recycled and recyclable paper made in Minnesota with at least 10 percent postconsumer material.

Due to public health advances in the last century, people across the world are living longer. The average life expectancy for a person born in 2005 is about 78 years compared to just 49 years a century ago, according to the National Center for Health Statistics. Longer FROM THE DEAN life is good, but public health wants to ensure that added years are quality years for the whole population. How to do that is the real question. There is no single answer, but there are many pathways waiting to be explored. The School of Public Health is engaged in developing and evaluating public health approaches for people across the aging spectrum. We have adopted the National Institute on Aging’s view that aging is not a single process, but rather an intricate web of interdependent factors: systems, culture, and social determinants that shape our behavior as well as the physiological processes involved in aging. We work with partners across the University, the country, and the community to address the challenges of aging populations and communities in effective and measurable ways. I’m honored to be chairing a faculty and deans steering committee for the six colleges of the University of Minnesota’s Academic Health Center to frame “aging and health” as a transdisciplinary initiative. What is emerging in our discussions so far is an important aspect of aging: the transition to frailty. When elders cross the threshold into increasing physical and cognitive impairment, health costs rise dramatically while quality of life declines. Can this be prevented or delayed, and what are the effective population, community, and public health approaches? “Living Longer, Living Better,” (page 6) sheds light on what our talented faculty are doing to shape a future where we all are living longer. They are asking questions like: Why do some people stay healthier as they age? What can communities do to be more elder-friendly and supportive, and to support their residents aging in place? What is the role of public policy? How do health systems need to change to support elders’ decisions about their health? I’m immensely proud of the impact of our work and know that SPH researchers — and the students they train — will help us move us forward in this grand challenge. We cannot continue to have an impact on the health of all people without your support. This year, we’re celebrating the highest annual giving in SPH history and can happily report that we’ve raised more than $5.5 million to date. Much of this goes to scholarships for our deserving students. My thanks to those of you who continue to engage with our school. Show your support of SPH by making a contribution online at sph.umn.edu/give. You make a world of difference.

Yours in health,

B University of Minnesota School of Public Health

John R. Finnegan, Jr., PhD Assistant Vice President for Public Health Dean and Professor

PHOTO BY MARK BROWN

John R. Finnegan, Jr. Dean

Contents

Features FEATURES

COVER ILLUSTRATION BY SCOTT BAKAL

6 Living Longer, Living Better

SPH faculty pave the way to answering one of our most pressing questions: As we live longer lives, how can we have our highest quality of life?

SUMMER 2016

DEPARTMENTS 2 Findings New and innovative research from SPH faculty and researchers.

Alumni News

Alumnus donates $100,000

12 Stemming Global Climate Change SPH student Abhirup Datta creates

for scholarships; SPH honors its 2016 Alumni Award recipients; Alumni speak on “Future of Public Health” panel.

a new model to help measure worldwide plant levels.

Class Notes

sph.umn.edu 1

FINDINGS

Minnesota aspirin campaign could prevent heart attack and stroke incidence A study published in the Journal of the American Heart Association found that the U of M Minnesota Heart Health Program’s “Ask About Aspirin” initiative is likely a beneficial and cost effective way to reduce the incidence of a first heart attack or stroke. The statewide campaign encourages men between ages 45-79 and women between 55-79 to ask their doctor if a daily 81 mg aspirin could lower their risk for a cardiovascular event. The interdisciplinary research team evaluating the program was by led by SPH Associate Professor Jean Abraham and Professor Russell Luepker and the Medical School’s Alan Hirsch. “There is no other single cardiovascular medication as effective and inexpensive as aspirin,” says Hirsch. The study estimates that nearly 10,000 fewer heart attacks and at least 1,200 fewer strokes would occur as a result of improving public knowledge of aspirin use. The researchers also found the campaign will lower overall health care costs for both men and women. For the full study, visit: z.umn.edu/askaboutaspirin

As a result of improving public knowledge of aspirin use, there would be at least . . .

1,200

fewer strokes

10,000 fewer heart attacks

Obesity can lead to alteration of specific genes SPH researchers have discovered a set of changes in the DNA of obese people not seen in nonobese people. The changes are the product of a process called methylation and were detected in the blood and fat tissues of such individuals. The study was led by Professor Ellen Demerath and looked at participants in the ongoing Atherosclerosis Risk in Communities (ARIC) study. The goal of the study was to gain understanding of how behavioral factors including obesity, exercise, and cigarette smoking, as well as environmental exposures such as air pollution and dietary factors, can change our DNA over our lifetime, and lead to disease. “The results will hopefully be followed up with longitudinal data to assess whether these DNA methylation changes in obese individuals are permanent, or are changed if they lose weight,” says Demerath. “The work is exciting because it might be possible to design pharmaceutical or dietary or other behavioral interventions that specifically target these epigenetic signatures to avert diabetes and coronary heart disease.” For the full study, visit: z.umn.edu/obesitydnachanges

2 University of Minnesota School of Public Health

The work is exciting because it might be possible to design pharmaceutical or dietary or other behavioral interventions that specifically target these epigenetic signatures to avert diabetes and coronary heart disease.

Body satisfaction among overweight girls associated with less weight gain over time

Study confirms that earlier HIV treatment is effective

A new Project EAT study dispels the notion that low body satisfaction motivates overweight adolescents to improve their weight status. Instead, the study, led by former SPH postdoc Katie Loth, revealed that among overweight adolescents, a high level of body satisfaction was not harmful to health and may be beneficial for girls in terms of long-term weight management. According to the study, overweight girls with the lowest body satisfaction at baseline had a nearly 3-unit greater increase in BMI at follow-up, compared to overweight girls in the high body satisfaction group. “We believe this difference in weight gain over time will have important clinical implications for these women over the course of their lifetime,” says Loth. “In our view, the most important takeaway message from this study is that feeling satisfied with their bodies does not lead to higher BMI among overweight girls; on the contrary, satisfaction predicts less weight gain over time.” For the full study, visit: z.umn.edu/bodysatisfaction

The results from a University of Minnesota s ponsored global HIV trial show that when it comes to beginning drug treatments, the sooner HIV patients start treatment, the better — and the discovery could trigger a dramatic shift in how the disease is treated. The trial, called Strategic Timing of AntiRetroviral Treatment (START), began in 2009 and is led by SPH Professor Jim Neaton. It looked at what would happen if a group of HIV-positive — but otherwise healthy — people were put on antiretroviral drugs when their immune system’s CD4+ “t-cell” count was greater than 500. They were compared to a group who didn’t receive drugs until their t-cell counts dropped to 350. The study involved 4,685 people from a geographically broad 35 countries around the world. The results of the global trial showed that across the board — and in every country — early drug therapy bolstered the health of HIV patients and it reduced their viral load, making them potentially less infectious to others. “When you can do a trial on a global basis that concerns clinical disease and shows, in this case, that early treatment is beneficial, the evidence is more convincing,” says Neaton.

Feeling satisfied with their bodies does not lead to higher BMI among overweight girls; on the contrary, satisfaction predicts less weight gain over time.

Study confirms link between indoor tanning and melanoma and leads to new law A new study from Associate Professor DeAnn Lazovich found that almost all women diagnosed with melanoma under the age of 30 reported the use of tanning beds. The women were also six times more likely to develop the disease than study participants who did not use indoor tanning beds. Indoor tanning was first identified as a carcinogen in 2009 and a 2010 study by Lazovich determined that no amount or type of indoor tanning is safe. Lazovich later shared her findings in testimony before the Minnesota Legislature, which led to a new law restricting indoor tanning to people age 18 and over. Twelve other states have also enacted similar laws and the FDA is now proposing additional tanning rules based in part on Lazovich’s research. For the full study, visit: z.umn.edu/ indoortanningmelanoma

Almost all women diagnosed with melanoma under the age of 30 reported using tanning beds.

sph.umn.edu 3

FINDINGS

Facility differences in nursing homes affect quality of life for Minnesota minorities A study of quality of life (QOL) measures among people living in Minnesota nursing homes reveals minority residents are not fairing as well as whites. SPH Assistant Professor Tetyana Shippee attributed the difference to their lower health status. Nursing homes with a higher proportion minority residents also scored lower on overall QOL scores compared to facilities that were predominantly white. In addition to disparities in scores, minority nursing home residents had different health needs compared to white residents. On average, minorities had higher prevalence of mental illness and were 13 years younger than whites. Payment and staffing emerged as key facility-level predictors of resident QOL as well. Shippee says one reason could be that nursing homes with high proportions of Medicaid-only patients may have fewer resources to provide adequate staffing and care compared to those who rely on Medicare and private pay. Additionally, nursing home facilities serving predominantly non-white residents may lack the capacity to adequately meet minority residents’ non-medical needs. These facilities tended to be located in poorer communities, where minority individuals are more likely to live as well. For the full study, visit: z.umn.edu/ nursinghomeqol

Gays, lesbians, and bisexuals more likely to anticipate future long-term care needs An SPH study found that lesbian, gay, and bisexual (LGB) adults are more likely than their heterosexual counterparts to believe they’ll need longterm care in the future. The study by recent PhD graduate Carrie Henning-Smith follows a January 2015 study in Health Affairs, which found middle-age adult Americans (ages 40-65) underestimate their future health care needs for long-term care services and supports. Henning-Smith also discovered LGB adults have higher rates of disability and are more likely to have a close relative who has needed long-term care. The result is they are more likely to believe they will need care for themselves. LGB adults are also less likely to expect family to provide care for them and more likely to expect to use institutional care, such as a nursing home or assisted living facility. “These study findings could help policymakers better predict who is planning for future health care needs and who isn’t and to target educational campaigns effectively,” says Henning-Smith. “They can also be used to estimate the unique care needs and planning behaviors of LGB adults.” For the full study, visit: z.umn.edu/lgblongtermcare

Social support key factor for improved HIV outcomes in Ethiopia In Ethiopia, only 79 percent of new HIV patients are in medical treatment six months after first being diagnosed, raising the risks of spreading and dying from the infectious disease. To combat this, many point to social support, which is considered critical for HIV patients to improve medication-use adherence and increase mental and physical health. In the first of two studies, Professor Alan Lifson found that many new rural Ethiopian HIV patients experience gaps in perceived social support in one or more areas, which contributes to their tendency to drop out of care. In a second study, Lifson investigated the use of pairing new Ethiopian HIV patients with HIV-positive community health support workers to raise their sense of social support and improve health outcomes. The results show that the program is associated with high rates of treatment retention among new patients attending HIV clinics, as well as improvements in their HIV knowledge, physical and mental quality of life, and perceived social support. The HIV patients also experience reduced feelings of selfstigma. For the full studies, visit: z.umn.edu/ethiopiahivsocialsupport or z.umn.edu/hivcommunitysupport

4 University of Minnesota School of Public Health

Doula support important for Medicaid beneficiaries Associate Professor Katy Kozhimannil finds that when a mother is receiving doula care as part of Medicaid coverage, she has . . .

22% lower odds of a preterm birth

56% lower odds of a cesarean delivery

This would result in . . .

$58.4M

3,288

Savings as a result of using a doula

Number of preterm births eliminated per year

What is a doula? A woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born. Minnesota is a state that requires Medicaid payment for doula services. The legislation was passed based partially on Kozhimannil’s body of doula research. For the full study, visit: z.umn. edu/medicaiddoulacoverage

SPH to serve as national center for Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders program The Robert Wood Johnson Foundation (RWJF) has selected the University of Minnesota School of Public Health, in collaboration with several external partners, to serve as the national center for its new Interdisciplinary Research Leaders (IRL) program. The IRL program will train and support a large national network of three-person teams, including researchers from academic settings, health care and public health settings, and sectors outside of the health system. These interdisciplinary teams will work across the U.S. and follow an IRL-designed curriculum to

be more adept at community-oriented action research and to take leadership roles in building a culture of health. The program is directed by SPH Professor Michael Oakes and Jan Malcolm, vice president of public affairs at Allina Health — a pairing that exemplifies the multi-sector partnership that’s at the core of the program. Several SPH faculty are involved in the program. Associate Professor Sarah Gollust is the associate director of curriculum, Associate Professor Ezra Golberstein is associate director of research, Professor Kathleen Call

is assistant director for community engagement, and Professor Ira Moscovice serves as senior adviser. From the U of M’s Department of Computer Science and Engineering, Distinguished McKnight University Professor Joe Konstan will be associate director for information technology. The U of M will design and run the IRL in collaboration with several community partners, including Allina Health, AcademyHealth, ISAIAH, the Twin Cities’ Local Initiatives Support Corporation, and the Minnesota Department of Health.

sph.umn.edu 5

Living

6 University of Minnesota School of Public Health

Longer, Living Better What really matters as we age By Elizabeth Foy Larsen

ILLUSTRATION BY SCOTT BAKAL

When Tetyana Shippee was starting her doctorate in gerontology at Purdue University, she skipped pub crawls and student housing in favor of senior activities and a one-bedroom apartment in a continuing care community for seniors. While that might sound like an odd living choice for someone in her twenties, the two-year experience revolutionized Shippee’s views about what matters to people as they age. “For the residents, these facilities are their universe,” says Shippee, who is now an assistant professor at the University of Minnesota School of Public Health (SPH). In addition to maintaining an apartment in the long-term care complex, Shippee ate dinner five times a week in the dining room and served on several committees. She listened to stories, looked through photo albums, and made close friends — several of whom later packed their walkers and wheelchairs into a van to travel from Indiana to northern Minnesota where they celebrated Shippee’s marriage to fellow SPH Assistant Professor Nathan Shippee. What Shippee discovered was that in our desire to make sure older Americans stay safe and medically healthy, we’ve overlooked one very common sense fact: when it comes to aging, the sights, smells, tastes, friendships, and routines of daily life are crucial to a person’s happiness. “Quality of life is vital to successful aging,” says Shippee.

“When I had to eat the same casserole week after week and experienced the shock of the staff coming unannounced into my apartment, it gave me an appreciation for how much these things interrupt your life.” NAMING THE ISSUE Shippee came to the School of Public Health in 2010 in part because it has long pioneered research about the quality of life in nursing homes, thanks to decades of work by Robert Kane, an SPH professor and the Minnesota Chair in Long-Term Aging, and his wife Rosalie Kane, who is also a professor in the school. Shippee has strengthened that vital research by looking closely at what truly creates and sustains quality of life (QOL) in nursing homes. Measures of family satisfaction with nursing home care that she developed with the Minnesota Department of

sph.umn.edu 7

Global explorations of healthy aging have Minnesota roots and matching conclusions By Stacy Richardson Why do some people suffer illness and die prematurely, and why do some live far into old age? These questions have absorbed philosophers and scientists since ancient times, and both are looking for the same answer to the eternal question of what makes for a long and healthy life. Two research efforts — both born in Minnesota and conducted nearly 45 years apart — arrived at a similar conclusion: How long and how well we live are significantly related to the foods we eat and the customs of our cultures. First came the Seven Countries Study (SCS), led by School of Public Health Professor Ancel Keys. Launched in 1958, the study documented heartdisease risk-factor levels and eating patterns in 14 contrasting areas of the United States, Italy, Greece, Yugoslavia, the Netherlands, Finland, and Japan. During a period when heart attacks had risen to all-time highs, researchers examined thousands of men in these areas over decades and gathered a massive database of comparisons. Fast forward to 2002 when writer, adventurer, and Twin Cities native Dan Buettner began his search for longevity “hotspots” around the world. With the help of demographers and medical scientists, Buettner identified five “Blue Zones” that were home to unusually high numbers of healthy residents over the age of 100. In Sardinia, Italy; Ikaria, Greece; Okinawa, Japan; Nicoya, Costa Rica; and Loma Linda, California, he interviewed and even lived with these individuals to learn about the surrounding cultures that supported their enduring vitality. The SCS’s principal conclusion, according to Henry Blackburn, School of Public Health professor emeritus and SCS project officer in its first decade,

8 University of Minnesota School of Public Health

was that heart attack rates were related to diet, specifically regarding the types of fat people consumed. The Japanese, Italians, and Greeks, who had the fewest heart attacks and the most men who lived to age 85 or older, ate predominately plant-based diets in which the percentage of saturated fat was low. By contrast, the meat- and dairy-based American and Finnish diets contained two to six times as much saturated fats, Blackburn says, and men in those countries “were having five to ten times more heart attacks.” Buettner certainly hadn’t set out to follow in the Seven Countries footsteps. He knew about Ancel Keys as an important figure associated with the Mediterranean Diet, but the Blue Zones journeys were well under way when Buettner decided to “cold call” Keys to talk with him about the pockets of long-lived people he was identifying in areas that included Mediterranean countries. Keys connected Buettner to Robert Kane, Blackburn, and other SPH faculty who had been leading landmark research in the field. Both Buettner and Blackburn were impressed by the extent to which the results of the studies echoed one another. Another parallel between the studies lies in the community programs that grew out of them. As health researchers and policy makers around the world recognized their own population profiles in the Seven Countries Study, communities with a high risk of heart disease sought to apply the knowledge in broad-scale public health efforts, not just in counseling for individual patients. The National Institutes of Health sponsored several long-term interventions in the 1980s that were aimed at promoting healthy lifestyles

and preventing heart disease in whole communities. Blackburn was the principal investigator of the School of Public Health’s three-city Minnesota Heart Health Program, and noted that all the communities made visible changes with measureable effects thanks to successful programs that, for example, helped smokers quit and instituted healthy makeovers for school lunch programs. Buettner’s Blue Zones Projects in 26 American cities are designed to bring about lasting change. In Albert Lea, Minn.; Fort Worth, Tex.; and Hermosa Beach, Calif., civic leaders have committed to a checklist of changes they’re making in policy and the built environment. Assisted by Blue Zones advisers, the cities are converting streets to make them more pedestrian-friendly and changing food policies “to make junk food more expensive or harder to get,” Buettner says. In one California city, 40 percent of kids — up from “nobody” when the program started five years prior — are walking to school. In addition, childhood obesity dropped from 18 percent to 9 percent. A half century apart, these two efforts contributed key knowledge to what we know today about how to take care of ourselves: control your weight, eat a diet low in saturated fat, and get exercise. On top of that, both researchers stress the importance of what we now call wellness, such as finding purpose in life, relieving stress, and investing time and love in the people around us. “Slowing down and the role of family and community are all under-celebrated components of the recipe for longevity,” Buettner says.

Human Services are used across the state and have been added to the state-wide Nursing Home Report Card. And she broke new ground with a 2015 paper examining racial disparities in nursing home residents’ quality of life. At a time when people across the world are living longer — the average life expectancy for a person born in 2005 has climbed to 78 years, according to the National Center for Health Statistics — ensuring that these added years are happy and healthy is a public health imperative that grows more urgent by the day. In the next 15 years, the percentage of people in developed countries over the age of 60 will increase by 50 percent and that number rises to 100 percent in less developed nations. In Minnesota, we will have more people who are 65 and older than those aged 5 to 18 by 2025. That’s a serious challenge when you consider that approximately 92 percent of older adults have at least one chronic disease and that seniors are also more susceptible to infectious diseases and injuries. SPH is actively devoted to finding real solutions for real people across the aging spectrum. More than 20 percent of SPH faculty members contribute research on what will make life better as we grow older. The challenge for public health professionals, who focus on the health of populations rather than individuals, is to remember that there’s no one-size-fits-all solution to keeping people healthy as they age. MORE THAN A NUMBER While people’s individual differences matter in all aspects of life, they are particularly important when it comes to making medical assumptions as we get older. “We don’t want to turn people into patients who aren’t really patients,” says Beth Virnig, an SPH professor and senior associate dean for academic affairs and research. “We need to start asking more nuanced questions about healthy aging. Why can some people break their hips and recover, yet others never quite make it back? These are new questions we need to ask.” Virnig’s research looks at how people should incorporate age into decisions surrounding medical treatment — for example, do you treat prostate cancer the same way for an 85 year old as you do for a 65 year old? In her work, Virnig has found that a high number of seniors are at an increased risk of being either overtreated or undertreated. When discussing solutions, Virnig stresses that we need to keep in mind that age is a relative concept with many variables. A 77-year-old woman may be capable of flying to Tanzania and camping in the Serengeti. Meanwhile, her best friend back home is learning how to navigate the aisles of a grocery store while using a walker. To tease out the impact of these differences among people

as they age, Virnig points to the work of her colleague Nathan Shippee, who has developed a “cumulative complexity” model that factors in many variables, including social supports, cognitive abilities, and stress levels, to determine a person’s ability to manage his or her health care needs. Health promotion strategies, long a hallmark of public health initiatives, must take age into account. “We need to make sure our public health messages are also focused on the needs of the elderly,” says Virnig, explaining that many seniors in the Twin Cities are probably not going to feel comfortable using the cities’ new bike lanes, which are placed directly next to traffic on busy streets. But they would enjoy walking to church instead of driving or participating in community gardening projects. Encouraging these types of functional fitness activities, Virnig says, is an effective way to promote healthy aging. LIFE AFTER HOME As we age, many of us will need higher levels of care, including assisted living and nursing homes, known in the aging industry as “long-term care.” Perhaps no one in the country knows this territory better than Bob and Rosalie Kane, who, between the two of them, have devoted more than 80 years to the field. “Aging is not a disease,” says Rosalie Kane. “It’s a process that begins at birth and continues until you die.” Sitting in her SPH office, which is decorated with framed covers commemorating her years as the editor-inchief of The Gerontologist, Kane narrates the history of assisted living, from a system dependent on impersonal nursing homes to more recent innovations, such as The Green House Project, a national initiative that emphasizes personal autonomy in intimate home-like environments where every resident has a private bedroom and bathroom. A focus of Kane’s research, The Green House Project has gotten more national attention since the publication of surgeon and public health researcher Atul Gawande’s bestselling book, Being Mortal: Medicine and What Matters in the End. Both Kanes are openly critical of the current long-term care options available to seniors, which they say are the result of a haphazard combination of payment policies, regulations, and a priority for physical safety that has resulted in a living experience that few people would ever willingly choose. “It’s a question of ‘Are you in a place where you truly live or are you in a place where you are just following rules?’” says Rosalie Kane. She’d like to see long-term care become a community where older people can test their wings and see what level of independence they can handle, much like 22 year olds do when they strike out on their own after college. That we don’t view it this way is, the Kanes believe, a byproduct of ageism. “We overprotect old people,” says Robert

sph.umn.edu 9

In our desire to make sure older Americans stay safe and medically healthy, we’ve overlooked one very commonsense fact: when it comes to aging, the sights, smells, tastes, friendships, and routines of daily life are crucial to a person’s happiness. Kane. “If you are 18 years old and want to climb a mountain without a rope, we let you. But we don’t let an 80 year old walk across the room without a safety belt.” The Kanes propose a number of forward-thinking fixes, including requiring a holding period between a hospital stay and long-term care that would allow families to make a decision, aided by trained counselors, while not in the midst of a crisis. They’d like to see more attention paid to quality of life and care delivered in more flexible settings that allow older people to maintain greater control over their lives, including being able to choose both the level of care they want and the assistants who will help them with whatever needs they have. GIVING CARE Those caregivers, of course, aren’t limited to paid assistants but also include spouses, children, and siblings. “Adult children and families have to make very complex decisions about care for the older adults in their family,” says SPH Assistant Professor Benjamin Capistrant. One focus of Capistrant’s research is how caregiving has an impact on spouses. His studies have shown that caregiving 14 hours or more a week is associated with an increased risk of cardiovascular disease and hypertension. Caregiving also puts a spouse at a higher risk of developing depression. Capistrant hopes his research will lead to developing interventions for these conditions that caregivers can incorporate into their daily lives, not just in the United States but also in the developing world. Capistrant has extended his research to India, where he did a pilot study of those who care for older adults. Unlike in the United States, which has a formal care system that includes Medicare, nursing homes, and social policies, in India, the responsibility for care relies almost entirely on the family. “Families may look different in different parts of the world, but when we are sick, they step up and become involved in our care, in one way or another,” he says. “It’s a universal phenomenon.” “As we face this demographic transition, we need to think much more boldly,” says Robert Kane. “We have to recognize that we are going to require even more caregivers and the ratio of older people to the next generation of caregivers, either paid or

10 University of Minnesota School of Public Health

family, is much higher than it has ever been. Those caregivers need to be supported and cherished.” ACCESS TO CARE Even the most enlightened support systems for older people and their caregivers won’t matter if you can’t get access to them — a challenge that is especially acute for people of low income and those who call rural parts of Minnesota and the United States home. “If you live in a remote area, it’s common that you have to leave your community to get the medical care you need,” says Linda Bane Frizzell, an SPH assistant professor and tribal member who researches tribal health and policy, long-term care, health reform, and health policy. Frizzell says it’s common for rural residents, particularly in the American Indian and Alaskan Native communities, to feel a pressure to move into town as they get older. It’s a pattern that concerns Frizzell because, like the nursing homes that prioritize safety over creature comforts, it overlooks the fact that these people have spent rich and happy lives in small towns or reservations. More troubling, people who can’t afford to move often simply go without care. Like the rest of the population, American Indians are living longer. But unlike the general public, a lack of access to health services throughout life means they also suffer from higher rates of diseases such as diabetes. Frizzell wants to change our cultural understanding of aging in the United States, starting when people are in high school, not only to build compassion and knowledge but also to develop critical thinking skills that will help people navigate complex systems such as Medicare as their loved ones age. “I want people to learn to advocate for themselves and others,” she says. “It would be great if people could learn early on how to make smart decisions.” There are no quick fixes to any of the challenges that come with aging, and that drives SPH researchers to develop strategies that will help people over the long run. Plus, each of us has to embrace the fact that with every new day, we are all aging. “The public health message about aging should emphasize moderation in all of our daily decisions,” says Robert Kane. “And that to live better, we need to be physically and socially active.”

Avoiding chronic disease: What you can do Chronic diseases account for most deaths in the United States, and Americans are at a higher risk for these conditions as they age. In 2012, up to 83 percent (depending on age group) of Medicare beneficiaries had multiple chronic conditions, according to the Centers for Disease Control and Prevention. Here’s what SPH is doing to address these challenges. Heart Disease Long-term SPH studies have followed people as they age to identify risk factors and causes of heart disease so that doctors can spot patients who need interventions. SPH is also a partner in Minnesota’s “Ask About Aspirin” initiative, which promotes the use of a daily lowdose aspirin to lower the risk of first heart attacks and strokes. What you can do: In addition to talking with your doctor about taking aspirin, SPH Professor Aaron Folsom says it’s important to follow the common sense advice of doctors and public health experts: “Don’t smoke, don’t gain weight, exercise,” he says. “Eat healthy and get your cholesterol under control. And get medication if you have high blood pressure.”

Diabetes SPH Professor Mark Pereira is researching the role that a more active lifestyle can play in reducing type 2 diabetes. Some people may meet the 30-minute guideline for physical activity, but spend much of the day otherwise sitting or sleeping, he says. His research shows that replacing two hours of sitting with standing or light activity improves blood sugar, blood pressure, and cholesterol levels. What you can do: Follow the dietary guidelines for eating sensibly, and plan some kind of physical activity every day. “Stop and think about how much time you spend sitting,” he says. “And then try and be up and moving around a little bit more.”

Cancer SPH is working to continue the Iowa Women’s Health Study, a cohort of nearly 42,000 women who entered the study in 1986 between the ages of 55 and 69 and were followed for the development of cancer to the present day. SPH Associate Professor DeAnn Lazovich hopes to link the participants’ risk factor information to their Medicare records and to expand the research to include questions about diet and dementia. “With that linkage we would have nearly complete information on most women about their medical care from the time they turned 65 until they died.” What you can do: Again, it’s about common sense — stop smoking, eat a healthy diet, and exercise. Because alcohol has been linked to several types of cancer — including breast, colon, and liver — the American Cancer Society recommends limiting alcohol to two drinks a day for men and one drink a day for women. Also, be sure to know the recommendations for screening tests as some recommendations have changed. Keep up to date with cancer screenings, including pap smears, mammograms, and colonoscopies, if appropriate.

sph.umn.edu 11

Stemming Global Climate Change Abhirup Datta creates new model to help measure worldwide plant levels By Charlie Plain

12 University of Minnesota School of Public Health

which would have an impact on everyone.” The project has already caught the attention of the international climate change community. The U.S. Department of Energy’s Oakridge National Laboratory is funding the project with plans to include the model in the next generation of highly accurate climate change models used by scientists around the world. The current models, developed in the 1980s, make broad predictions for changes in global temperature and sea rise. The problem is that these models don’t factor in how plants shape climate change or how climate change will influence the health of plants. The new biodiversity model that Datta and others are working on makes use of a database of 100,000 plants created in part by researchers at the University. Known as the

Plants absorb around

25 percent of the carbon dioxide in the atmosphere and we’re not certain with the changing climate that they’ll continue to do so in the future, which would have an impact on everyone.

PHOTO BY PAULA KELLER

s researchers and scientists tackle the emerging reality of climate change, a key question is on their minds: Just how much Earth-warming carbon dioxide can shrubs, trees, and other plants continue to process? Carbon dioxide is the main culprit in climate change and plants absorb it, along with water and sunlight, to perform photosynthesis and grow. Historically, there have been more than enough plants to keep the Earth’s free-floating carbon dioxide in check and the climate cooler. But now, the effects of deforestation and extra carbon dioxide from fossil fuel usage are degrading the ability of plants to do their job. A major obstacle in gauging the ongoing capacity of plants to process carbon dioxide is that scientists have no accurate way to estimate the current total coverage of plants across the planet or project what coverage will be like in the future. School of Public Health Biostatistics PhD student Abhirup Datta is helping close this mammoth information gap. Datta is a member of a University of Minnesota team developing a new statistical model designed to use global plant data to accurately estimate the amount of greenery across the Earth and its effects on the environment. The model will be used to produce highly detailed maps projecting various climate change scenarios associated with plant coverage. “This work is directly related to the health of the planet and human health,” says Datta, who specializes in geostatistics, which involves performing scientific statistical work using large data sets from across vast geographic regions. “Plants absorb around 25 percent of the carbon dioxide in the atmosphere and we’re not certain with the changing climate that they’ll continue to do so in the future,

Leaf Nitrogen mass data in [mg/g] CURRENT KNOWN AMOUNTS OFusing PLANT NITROGEN Leaf Nitrogen mass map spatial model 80 80 80

●

● ● ● ●

60 60 60

● ● ● ● ●

●

● ● ● ● ● ● ● ● ● ● ● ● ● ●

●

Latitude Latitude

40 40 40

●

● ● ●

●

● ● ● ●● ● ● ● ●● ● ● ● ● ●

●●

●

● ●● ● ● ● ●

● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

●

● ● ● ●

●● ● ● ● ● ● ● ● ●●● ● ● ● ●● ● ● ● ●● ● ●● ● ●● ●

● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ●

● ● ● ● ● ● ● ●● ● ● ● ● ● ●● ● ●● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ●●● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ●●● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ●● ● ● ●● ● ● ● ● ● ● ● ●● ● ● ● ●●● ● ● ● ● ● ● ●● ● ● ● ●● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ●●

● ● ● ● ●

●

● ●

24 24 ● ● ●

●

● ● ●

●

● ● ● ● ● ● ● ● ●

● ●

● ● ● ● ● ●

●

● ● ● ● ●

● ●

20 20

●●

●

22 22

● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ●

● ● ● ● ●

●

●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

● ● ●● ●

20 20

● ● ● ● ● ● ● ● ● ● ●●

000

● ● ● ● ●

●

● ● ● ● ● ●

●

● ● ● ●

●● ● ●

● ● ● ● ●

●

● ● ●

●

● ●

●●

● ● ●● ● ● ● ● ●

● ●

● ● ● ● ●●

●

● ●

●

● ● ● ●

−20 −20 -20

● ●

●

● ● ● ● ●● ● ● ● ● ● ●● ● ●

● ●

●

● ● ● ● ●● ● ● ●

●

● ● ● ● ●●● ●●

●

● ●

● ● ● ● ● ● ● ● ● ● ● ●●

16 16

●

● ● ● ● ●

● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

● ● ● ●

● ●

● ● ● ● ● ● ● ●● ● ● ●

−40 −40 -40

18 18

●

●● ● ● ●

●

● ● ● ● ● ● ● ● ● ●

14 14 ●

● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

●

−100 −100

-100

0 Longitude

Longitude

100 100

100

Leaf Nitrogen mass spatial model Leaf Nitrogen map using spatial model PROJECTED AMOUNTS OF PLANT NITROGEN USING DATTA’S MODEL 80 80 80

24 24 60 60 60

22 22 40 40 40

Latitude Latitude Latitude

TRY database, it contains 5.6 million records describing various plant characteristics. As large as the database is, many regions in areas like Canada, Russia, and large swaths of Africa have never even been surveyed, creating holes in the data that severely limit the new model’s accuracy. Filling in those holes requires someone with the expertise to cleverly use acquired data from one region and extrapolate it to describe what’s happening in another — someone like Datta. Datta got his chance to work on the project through his adviser, former SPH Professor Sudipto Banerjee, who’s now at UCLA. “Sudipto gave me some papers regarding the project and I got really interested,” says Datta. “He gave me a lot of independence in research, but was always there to guide me in all my projects — including this one. He has been a great mentor for me.” A colleague on the University team, computer science researcher Arindam Banerjee, now oversees Datta’s work on the model and says he is uniquely suited for it. “I’ve been learning about the ecology side of this project for five years and Abhirup picked it up in only a few months,” says Banerjee. “You’ll often find someone who is good at the math part of a project but they can’t understand the complexities of a problem and be able to communicate and work with other scientists. But Abhirup got right down to business working with the other researchers.” Completing the project will take place over the next few years. Datta, who graduated in May 2016 and was supported by a graduate school interdisciplinary scholarship, is joining the faculty of Johns Hopkins University and hopes to continue collaborating with the University of Minnesota on creating the global plant maps to help stem the rising risks of carbon dioxide and climate change.

20 20 20 20 20

18 18

000

16 16

−20 −20 -20

14 14

−40 −40 -40

LONGITUDE −100 −100

-100

0 0

Longitude Longitude

100 100

100

Longitude

Datta’s statistical model uses plant data from sample sites (top) to accurately estimate what’s happening across a much larger area. The data generated by Datta’s model will be used to create maps (bottom) that depict projected amounts of plant nitrogen, an essential component for carbon dioxide-consuming photosynthesis.

sph.umn.edu 13

Carrying on tradition Donation creates new scholarship and mentorship opportunities

I want to help people succeed, that goes beyond money. There is a mentorship factor, too.

By Sarah Howard

aving a seizure is scary. Especially for a 13 year old. That’s what happened to Stephen Filler (MPH/MHA ’99). But out of the bad comes the good, because it was during his week in a hospital outside of Chicago that he discovered his interest in health care. “My hospital experience was underwhelming,” he says. “And even at 13, I figured I could work hospital operations better than they could.” From then on, he focused his studies on the health field and eventually ended up majoring in psychology and economics and minoring in biomedical ethics at Lawrence University in Wisconsin. When researching graduate programs, Filler was interested in health care administration and public health. At Minnesota, he could pursue both. “The program really allowed me to see the best of the two disciplines,” he says. “Minnesota really opened doors for me,” says Filler, who worked as a student and new graduate at Mercy Health System in Janesville, Wisc. with president and CEO Javon Bea (MHA ’78). “Thanks to Minnesota connections, working at Mercy was an amazing point in my career.” Shortly thereafter, he was offered a position as an administrator at UC-San Diego and quickly moved his way up through positions at Open Air MRI, Stanford Hospital and Clinics, JPS Health Network, and Accenture. Still in San Diego, Filler was named a partner at Oliver & Wyman in early 2014 where he consulted on the strategic needs of health organizations and served as an expert in the health system value chain. His client list included Pfizer, Johns Hopkins, West Virginia University, and Yale, among others. In the summer of 2016, Steve took his next career step becoming chief operating officer for Practice Fusion, the largest cloud-based electronic health records company in the United States, based in San Francisco. In 2016, Filler pledged to donate $100,000 to the School of Public Health for scholarships. “I’ve reached personal success largely as a direct reflection of the Minnesota

program. If I can help somebody afford to go to Minnesota and reap the same benefits, then the industry will be in a better place,” says the father of two, whose own father, Ronald, started seven scholarships at the University of Illinois at UrbanaChampaign and has helped more than 50 students go to college. “My father bestowed upon me the idea that there are plenty of people who are less fortunate financially, but more deserving [of an education] in many regards,” he says. “I want to help people succeed, that goes beyond money. There is a mentorship factor, too,” says Filler, who plans to guide scholarship recipients and has mentored new employees in past positions. Filler continues to be an active alumnus, serving on the MHA Alumni Association Board of Directors as chair-elect and working to unite the more than 200 MHA alumni in California. “I want to help people network and foster connections,” he says. For Filler, he’ll forever be connected to the University of Minnesota and the MHA program. “This program set me on the right path and opened doors,” he says. “Others should be afforded that opportunity.” Visit sph.umn.edu/give to learn how you can help SPH students succeed.

CONGRATULATIONS TO OUR 2016 ALUMNI AWARD WINNERS

Brian J. Osberg, MPH ‘86 University Outstanding Achievement Award

Robert W. Blum, MD, PhD ‘78, MPH ‘77 Gaylord Anderson Leadership Award

14 University of Minnesota School of Public Health

Monique E. Muggli, JD, MPH ‘99 Alumni Award of Merit

Erin J. Erickson, MS, MPH ‘10 Alumni Innovator Award

Lauren D. Gilchrist, MPH ‘08 Emerging Leader Award

Brian P. Hobbs, PhD ‘10, MS ‘07 Emerging Leader Award

From left to right, Finnegan, Gilchrist, Shanedling, Barry, Ferris, Scheffel.

Alumni Discuss the Future of Public Health

PHOTO BY ERIN KERR

n February 18, 2016, at the Minnesota Department of Health in St. Paul, Minn., a five-person alumni panel discussed the future of public health in front of a crowd of 80-plus alumni and students. The event is part of a new Alumni Leadership Forum series, which aims to highlight and elevate SPH alumni as leaders in public health. Moderator John Finnegan, dean of the School of Public Health, asked the panel to reflect on the past five years in public health and what we have to pay attention to in the next five years. For Lauren Gilchrist (MPH ’08), from the Office of Governor Mark Dayton, the passage of the Affordable Care Act has had a great impact. “We knew we would make progress in the rates of people being insured, but we did not foresee the complexity and the challenges of implementation,” she says. “Instead of implementing on an IT timeline, we had to implement on a political timeline.” “ACA has forced public health and health care to be partners,” says Melanie Ferris (MPH ’06), of Wilder Research. “It opened up different opportunities now that it’s part of a required process within health care.” Joni Scheffel (MPH ’01), serves as the state’s veterinarian at the Minnesota Department of Health, and spoke about how infectious disease outbreaks “are becoming more complex and require partnership.” She emphasized that different organizations have different stakeholders, which can lead to different points of view on how to take action. “There aren’t simple scientific solutions, the solutions are more social and can be highly charged.” “In public health, we get on certain pendulums,” says Stan Shanedling (MPH ’78), from the Minnesota Department of Health. “The attention has swung from HIV/AIDS to the war on drugs to family violence to obesity, and now the focus is on health equity and healthy aging.” For Shanedling, the field continues to be exciting because we don’t know what’s next. In regards to health equity, Anne Barry, MPH ’86, from the Minnesota Department of Human Services, says “the government isn’t trusted because we haven’t served all of the

In public health, we get on certain pendulums. The attention has swung from HIV/AIDS to the war on drugs to family violence to obesity, and now the focus is on health equity and healthy aging. people. In five years, I hope the people who we serve, and are impacted by our work, have a voice.” To solve major health problems, we need to address disparities. “We can do that by going to where people are,” Shanedling says, adding that this has created new positions like community health workers. “We don’t have the same strategies and solutions for everyone,” says Barry. “We need to have a lens that includes all people in everything we do.” View the panel’s discussion online at sphalumni.umn.edu/forum.

sph.umn.edu 15

CLASS NOTES Amira Adawe, MPH ’15 (public health practice), was among eight citizen advisers appointed by Minnesota Governor Mark Dayton to provide input and recommendations on certain regulatory decisions made by the Minnesota Pollution Control Agency. Adawe is a legislative liaison for the Minnesota Department of Health. Sirry Alang, PhD ’15, MS ’14 (health services policy research and administration), published her dissertation, “Black folks don’t get no severe depression: Meanings and expressions of depression in a predominantly black urban neighborhood in Midwestern United States” in Social Science & Medicine. Jamie Armstrong, MHA ’04, was named Assistant Director, Clinical Management Program in the Office of EVP for Health System Affairs at the University of Texas Southwestern Medical Center. Susan Arnold, PhD ’15 (environmental health), SPH assistant professor, was elected board chair of the American Conference of Industrial Hygienists on January 1, 2016. Arnold will serve as board chair for one year. Sister Mary Madonna Ashton, MHA ’58, was named a 2016 National Women’s History Month Honoree, credited with shaping America’s history and its future through public service and government leadership. Cynthia Bennett, CER ’08, was named the clinical manager at Riverwood Healthcare Center, overseeing Riverwood outpatient services and the Specialty and Atkins clinics.

Claude Betene a Dooko, MPH ’13 (epidemiology), joined the United States Air Force in June 2015 as a public health officer in Florida.

Janelle Gunn, MPH ’03 (public health nutrition), was named policy team lead for the CDC’s Division for Heart Disease & Stroke Prevention.

Natalie Bomstad, MPH ’14 (public health administration), received a Future 15 award from the Green Bay Chamber of Commerce for excelling in her field and influencing the growth, prosperity, and quality of life in Brown County, Wisc. Bomstad is the director of operations at Live54218 in Green Bay, Wisc.

Honorata “Kuki” Hansen, DVM, MPH ’12 (public health practice), was recently selected as one of three veterinarians for the 2015–2016 American Veterinary Medical Association Congressional Fellowship Program.

Janny Brust, MPH ’87 (public health administration), retired from her position as Director of Medical Policy and Community Affairs at the MN Council of Health Plans in January 2016. Deanna Camell, MPH ’14 (community health education), accepted an Epidemiologist II position at the Utah Department of Health in Salt Lake City. Farhiya Farah, MPH ’06 (public health administration), was featured in the Star Tribune for her work on teaching food preparation safety classes to immigrant restaurant owners in Minneapolis. Archie Givens, MHA ’68, served as the Grand Marshal for the University of Minnesota Homecoming Parade on September 25, 2015. Mike Gloor, MHA ’87, of Grand Island, Neb., was presented the Chancellor Robert D. Sparks, M.D., Award in Public Health and Preventive Medicine from the University of Nebraska Medical Center College of Public Health on April 5, 2016.

16 University of Minnesota School of Public Health

Michelle Heavens, MHA ’04, was named the new Ascension Health president and CEO fellow in July 2015. Before joining Ascension Health, Heavens held positions at Cleveland Clinic Health System, Henry Ford Health System, and health facilities in Minnesota.

Andrew McCulloch, MHA ’80, was named as one of the Portland Business Journal’s Top 10 Executives of the Year for 2015. McCulloch has served as president of Kaiser Permanente since 2006 and leads Kaiser Permanente in Oregon and Washington. Andrew McLean, MD, MPH ’11 (public health practice), was named the new chair of the Department of Psychiatry and Behavioral Sciences for the University of North Dakota School of Medicine and Health Sciences in October 2015. McLean continues to serve as Medical Director for the North Dakota Department of Human Services.

Rusty Knight, MHA ’77, received the Excellence in Leadership Award from the Iowa Hospital Association (IHA). Knight serves as president and CEO at Mercy Medical CenterDubuque, and is also a past chair of the IHA Board.

Eric Merchant, MPH ’96 (environmental health), has been hired as administrator of the Disease Control and Prevention Division of Lewis and Clark Public Health. He worked for the past 17 years as an air-quality professional with the Montana Department of Environmental Quality.

Linda Knodel, MHA ’96, received the Gold Medal Award from the American College of Healthcare Executives during the 2016 ACHE Congress in Chicago for her more than 30 years of experience in nursing and health care leadership. Knodel serves as senior vice president and chief nursing officer for Mercy in Chesterfield, Mo.

Jenna Neher, MPH ’04 (community health education), was named president of the National Multiple Sclerosis Society, Mid America Chapter in Kansas City. She was previously the Director of Strategic Projects and Volunteer Engagement at the National Multiple Sclerosis Society, Upper Midwest Chapter, in Minneapolis.

Daniel Louvar, MD, MS ’08 (clinical research), joined Rainy Lake Medical Center in January 2016. Daniel specializes in diagnosing and treating kidney disease, hypertension, and kidney transplants.

Randy Oostra, MHA ’89, was elected to the Board of Trustees for the American Hospital Association beginning January 1, 2016. Oostra currently serves as president & CEO of ProMedica in Toledo, Ohio.

Mike Osterholm, MS ’78, PhD ’80 (environmental health), MPH ’80 (epidemiology), professor in SPH’s Division of Environmental Health Sciences and director of the Center for Infectious Disease Research and Policy, was appointed to the Board of Regents of Luther College in Iowa. He is a 1975 graduate of the college.

Ken Smithmier, MHA ’86, joined Ryan Search & Consulting as senior consultant and will concentrate on leadership talent development. Smithmier most recently served as president and CEO of Illinois Health and Science. Barb Spurrier, MHA ’88, joined Delos as the senior vice president of ventures & chief strategy officer of the Well Living Lab. Previously, she served as administrative director of the Mayo Clinic Center for Innovation.

Alison Page, MS ’96 (nursing), MHA ’96, was featured in the Spring 2016 issue of Minnesota Alumni for her dedication to the University of Minnesota by serving as president of the Alumni George Tysowsky, DDS, Association and teaching and MPH ’85 (dental public health), mentoring students. was promoted to senior vice president of technology and Aaron Patnode, MHA/ professional relations at MBA ’09, was named executive director of the Blue Zones Project Ivoclar Vivadent. in Oregon with Healthways. Barbara Vize, MD, MHA ’13, Patnode is the former executive is now a care provider at the director of the Cover Oregon Spring Valley branch of health insurance exchange. Olmsted Medical Center. Kenneth Paulus, MHA ’83, Annette M. Walker, MHA ’96, was elected to the TeamHealth was named the new leader of Holdings board of directors. St. Joseph Health, a 16-hospital Paulus served as CEO of health system serving three states. Allina Health from 2009 to 2014 and currently serves on Perry Witkin, MHA ’81, was the board of Healthgrades and elected to serve as chairman Congentix Medical. of the board of the American Refugee Committee. Witkin and Eric Phillips, MPH ’91 his wife, Cindy, MPH ’82, are the (environmental health), owners of Stat Technologies in was named vice president of Edina, Minn. regulatory affairs of Medgenics in Pennsylvania. Cheryl Robertson, MPH ’88 (public health nursing), was featured in the Spring 2015 issue of Minnesota Alumni for her work as a public health nurse and faculty member at the University of Minnesota.

HAVE AN UPDATE YOU’D LIKE TO SHARE? Visit sphalumni.umn.edu/ quickupdate to fill us in!

ALUMNI IN MEMORIAM: 2015–16 Ivan Anderson MHA ‘53 Guillermo Betanzos MHA ‘50 Ralph Burkhead MHA ‘65 George H. Creel II MHA ‘80 Charles F. Cummins MHA ‘64 Gretchen S. Dale MPH ‘91 (public health nutrition) Wayne W. Daley MPH ‘67 (environmental health) Sarah Gomez Erlach MPH ‘62 (public health nursing) Thomas J. Flynn, Jr. MPH ‘84 (environmental health) Darrol W. Heggen PhD ‘68 (biometry)

Joseph K. McLaughlin PhD ‘82, MPH ‘79 (epidemiology) MS ‘74 (environmental health) Robert S. Miller MPH ‘53 (environmental health) Claude J. Nelson MPH ‘64 (veterinary public health) Leslie D. Nordgren MPH ‘01 (epidemiology), PhD ‘09 (environmental health) Jean A. O’Leary MS ‘80 (public health nursing) Daniel G. Osborn II MPH ‘94 (public health administration) Gerald P. Pearson MHA ‘78

David H. Hitt MHA ‘52

Jean Porta PhD ‘80, MS ‘68 (biometry and health information systems)

Eugene Horton MPH ‘87 (public health administration)

Mary K. Priddy MPH ‘81 (public health nursing)

Frederic G. Hubbard MHA ’50

Victor N. Raiser MHA ‘65

Douglas E. Jensen MPH ‘06 (public health practice)

Donald L. Reichel MS ‘78 (environmental health)

Patrick N. Kennedy MPH ‘74 (public health)

Robert A. Reid PhD ‘79, MS ‘72 (environmental health)

Theodore H. Kittell MHA ‘63

Julie A. Ross PhD ‘94, MPH ‘91 (epidemiology)

Genell L. Knatterud PhD ‘63 (biometry) Thomas M. LaMotte MHA ‘61 Fred E. Linville MHA ‘67 Arthur A. Maher MHA ‘71 Maurice A. Mahli MHA ‘75 Nancy S. Malcolm MPH ‘69 (public health nursing)

Louise B. Scheibe MPH ‘76 (interdisciplinary studies) Harold C. Seim MPH ‘85 (epidemiology) William A. Smoger MPH ‘92 (public health administration) Duane C. Sommers MPH ‘67 (environmental health) David L. Sorbel MPH ‘86 (health services administration) James C. Ware MHA ‘58 sph.umn.edu 17

Nonprofit U.S. Postage PAID Twin Cities, MN Permit No. 90155

420 Delaware Street SE Minneapolis, MN 55455 www.sph.umn.edu

WHAT DRIVES RUBY NGUYEN TO ERASE CHEMICALS THAT DISRUPT A CHILD’S PATH?

Will her eyes be green? Will his hair be curly? Thousands of biological mechanisms naturally determine a baby’s genetic path in its mother’s womb. Yet today, some chemicals found in common products can disrupt a child’s development. That’s what drives Dr. Ruby Nguyen at the University of Minnesota School of Public Health to identify these chemicals and predict what they’ll do. The ultimate aim is to erase harmful chemicals from our daily lives. That way, all children can follow their own paths. sph.umn.edu sph.umn.edu/protect-babies

Crookston Duluth Morris Rochester Twin Cities