Preparing the Front Lines of Public Health • page 15
Advances F A L L 2003
from the University of Minnesota School of Public Health
AROUND THE WORLD In Ten Minutes Global Health's Greatest Challenges
CANCER STUDY HITS MILESTONE
Faculty in the New York Times CDC DIRECTOR SPEAKS AT SPH
Dual Degrees for Hot Careers
FROM THE DEAN: Dear Friends, There was a time not long ago that the term “international health” was used to describe issues related to population planning and infectious disease in developing countries, especially those countries south of the equator. International health was about addressing public health issues in, and isolated to, non-industrialized nations. Today, in the era of economic globalization, we must adopt a larger, more inclusive view—global health, as opposed to international health. Global health is bi-directional, it recognizes the import and export of public health issues the world over. With the advent of modern transportation and global commerce, people and products are transported around the globe on a daily basis. The reality is that we live in a society where environmental toxicants and infectious agents unrestricted by geopolitical boundaries are rapidly spread around the world. Recent examples, such as West Nile virus, SARS, and monkeypox, characterize a situation that CDC Director Julie Gerberding has coined “the new normal.” Infectious diseases, unfortunately, are not the only public health challenges spreading freely around the world. Chronic diseases such as obesity, cardiovascular disease, and diabetes, once considered limited to the affluent Western societies, join HIV/AIDS as rapidly emerging epidemics in such developing countries as India and China. In response, SPH faculty and students are orienting their research and studies toward a global view of public health. I hope you enjoy reading the cover story on page 2 that highlights these activities. With your support and the work being done here, we will make significant contributions to meeting the tremendous public health challenges facing our world. All the best,
SCHOOL OF PUBLIC HEALTH LEADERSHIP Mark P. Becker Dean
John Connett Head, Division of Biostatistics
John Finnegan, Jr. Associate Dean for Research and Academic Affairs
Susan Bartlett Foote Head, Division of Health Services Research and Policy
Debra Olson Associate Dean for Public Health Practice Education
Russell Luepker Head, Division of Epidemiology
Mary Story Associate Dean for Student Affairs
William Toscano Head, Division of Environmental and Occupational Health
Advances Editor Diana Harvey Managing Editor Kristin Stouffer Contributing Writer Dean Neumann Art Direction Todd Spichke Riverbrand Design
Contents Table of
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Advances
Feature: Global Health
Take a round-the-world tour of the School of Public Health's
FALL 2003
vital work on a host of global health issues
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Division News
Retiring professor takes on fiction writing, SPH hosts medical technology leaders, cancer control in Minnesota, and more
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School News
Professor honored for humanitarian work, SPH welcomes new faculty members, and more
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Student News
Students receive top University honors
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Alumni News
Alum serves Native American community, Join the Public Health Mentor Program
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Philanthropy
New scholarships support biostatistics students, SPH hits five-year fundraising campaign goal
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Focus on Centers
Improving quality of life for older Americans is an aim of
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the Center on Aging
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AROUND THE WORLD In Ten Minutes Global Health's Greatest Challenges What does the phrase “global health” mean to you? Does it mean doing HIV/AIDS education in Mysore? Working to improve air quality in Manila? Or marrying eastern and western health practices for the Hmong in Minneapolis? If you answered “all of the above,” you’re right. Global health is all this and more.
2 University of Minnesota School of Public Health
F E AT U R E S TO RY At the University of Minnesota School of Public Health, we ascribe to the philosophy whereby public health challenges are exchanged equally between developed and developing countries, and together we share the responsibility for finding solutions to these challenges. Think about it: SARS (severe acute respiratory syndrome) makes its way from a rustic village in China to cosmopolitan Toronto, closing the city to tourism for weeks. At the same time, U.S.-based corporations are skirting our environmental laws by setting up factories in developing countries, to the detriment of the health of their populations. Monkeypox enters our lexicon by way of The Gambia, West Africa, while young people in India and former Soviet bloc countries are bombarded with advertising by U.S.-based tobacco companies. It is a strange and often vicious circle. Here in Minnesota, Somalis and Latinos have in recent years joined Southeast Asian and Russian immigrants to weave a rich tapestry of cultures. As rich as it is, the public health challenges facing immigrant populations attempting to maintain their cultural integrity while trying to navigate an often rigid and confusing American public health system are not to be dismissed. University of Minnesota School of Public Health faculty members are conducting research on hot global health issues here and abroad. Let’s take a quick round-the-world tour of their important work. Ian Greaves is back from a steamy summer in Manila, where he worked with colleagues at the University of the Philippines to investigate exposures of public utility drivers to vehicle-related air pollution and to set up future research projects on childhood asthma. In collaboration with Jean Forster, Greaves is designing a study to assess the effectiveness of new anti-tobacco legislation in the Philippines. He does this when he’s not in India, working with Minnesota physicians and nurses, Indian health officials, and industry leaders to establish an HIV/AIDS prevention and treatment program for the cities of Bangalore, Mysore, and Mangalore. Greaves is involved with the nascent Center for Global Health at the University of Minnesota, along with colleagues from the SPH, the Medical School, and the School of Nursing.
Harry Lando is involved in a program to incorporate tobacco prevention and cessation content into the medical school curriculum at the University of the Philippines. Lando also is the principal investigator on a project to promote tobacco cessation in India and Indonesia, two countries particularly hard hit by the tobacco epidemic. As president of the Society for Research on Nicotine and Tobacco, he organized a conference on global initiatives in tobacco research—a conference former Surgeon General C. Everett Koop praised as "historic." There was hardly a major newspaper that didn’t carry a quote from Michael Osterholm during the SARS outbreak. Osterholm serves as an advisor to U.S. Secretary of Health and Human Services Tommy Thompson and CDC Director Julie Gerberding and played an integral role in the United States’ response to the outbreak. Near daily dispatches on the Web site for the Center for Infectious Disease Research and Policy (www.cidrap.umn.edu), which Osterholm directs, helped the public health community stay abreast of breaking developments during the SARS outbreak.
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ROUNDTABLE SERIES 00
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Public Health Roundtable Series to Address Global Health Issues Mark your calendar for Friday, November 7, 8:30-10:30 a.m., as the School of Public Health Roundtable Series is launched around the theme Global Health Issues—Minnesota Perspectives. The four-part series features school faculty presenting their research along with key members of the public health community linking the research to practice and policy. November’s installment, “Human Rights, Civil Liberties, and Public Health in the Age of Terrorism,” will feature SPH professor Michael Osterholm. The Roundtable Series is free and open to the public. It will take place at Coffman Memorial Union on the east bank of the University of Minnesota campus. The Roundtable Series will continue with these topics in 2004: February 6—The International AIDS Crisis April 2—A Global Commitment to Nicotine Reduction June 4—Cultural Barriers to Preventive Health Care For more information on the School of Public Health Roundtable Series, visit www.cpheo.umn.edu/roundtable or call 612-626-4515.
Photos: Bill Alkofer
4 University of Minnesota School of Public Health
Feature Story
Noted health economist Roger Feldman is advising the Bahamian government as it considers the introduction of national health insurance. Feldman has assisted the government in several critical issues involved in undertaking reform of this magnitude, among them designing a system of national health spending accounts and identifying the data needed to quantify the sources and uses of health care funds. And finally, back in Minnesota, Blewett and Kathleen Thiede Call have developed unmatched expertise on the state’s immigrant populations and their health needs. They are using their research to address the health disparities faced by these populations.
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Cheryl Perry, director of the School of Public Health’s Center for Youth Health Promotion, is widely recognized for her community- and school-based intervention programs around tobacco and alcohol use. Recently, she took her welltested theories to India, where relentless marketing and wide availability of these products have contributed to an emerging public health crisis. Gurumurthy Ramachandran is collaborating with Robert Town and Bruce Alexander on a study in India on indoor air pollution and its health effects and economic consequences. According to Ramachandran, women and children are most exposed to indoor air pollution from burning fuels such as kerosene or wood in poorly ventilated homes. Jim Neaton is working with investigators in South Africa, from the National Institutes of Health and the U.S. Department of Defense to develop screening and treatment protocols for those afflicted with HIV in South Africa, where infection rates are among the highest in the world. He recently returned from Pretoria, where he helped organize a data management center to coordinate large treatment trials. Alexander, Lando, and Bill Toscano are working with colleagues from the School of Nursing and the National Centers for Disease Control (NCDC) in the Republic of Georgia to train public health practitioners in modern public health surveillance and intervention. They hope to establish a surveillance and informatics system of adolescent health in the Republic of Georgia that will be used to mitigate chronic disease. While the United States and France were engaged in a war of words over the war in Iraq, Moïse Desvarieux and 12 colleagues from the French Institute of Tropical Medicine and Epidemiology at the Université de Paris, the Institut Pasteur, and the Université de Montpellier were engaged in a partnership that brought French faculty to Minnesota to team-teach a course in global infectious disease. Students in the course were eligible to return with the faculty to Paris to conduct research that eventually will take them to field assignments in Africa, India, and the Middle East. This initiative is part of the INTREPIDE program (International Training and Research Program in Infectious Disease Epidemiology) established by Desvarieux and French colleague Jean-Pierre Coulaud. John Kralewski is leading an effort to build a mentoring relationship with the University of Puerto Rico Medical School to assist in health services research to improve clinical practice. This fall, the program's first student entered the SPH’s doctoral program in Health Services Research and Policy. Also in Puerto Rico, faculty researchers Donna McAlpine, Bryan Dowd, Krawlewski, Lynn Blewett and Town are involved in a $1.2 million research project focused on health insurance coverage and health disparities.
THINKING LOCALLY, ACTING GLOBALLY SPH Students Apply Classroom Smarts to International Field Experiences University of Minnesota School of Public Health students realize the importance of understanding public health from a global perspective. Many have taken the opportunity to do international field experiences on the way toward earning their degrees. Lindsay Plaisted Five months in Guatemala Linday Plaisted, a graduate of the maternal and child health program, applied her public health skills in San Lucas Toliman, Guatemala. She worked with Soy La Vida, a nutrition outreach program for severely malnourished Guatemalan friends teach Lindsay mothers and children. Plaisted to weave traditional cloth She also teamed up called a huipel. with local health promoters and a nurse to start a prenatal vitamin distribution program. Plaisted completed her field experience six months ago, but her work continues to improve the lives of Guatemalans: The vitamin distribution program she helped start is expanding to serve additional communities, and will celebrate its one-year anniversary this fall. “Working in Guatemala taught me how to respectfully intervene in a community that I was not initially a part of,” says Plaisted. “The experience really added to my public health education.”
Taimur Malik Two months at the United Nations As a physician in Pakistan, Taimur Malik learned how discrimination against women leads to their poor health. He decided to do something about it. He knew his first step would be enrolling at a top public health school. His second step would be interning at the United Nations, where he could learn about international health policy. Determination, real world experience, and a stellar academic career as a SPH public health administration
student helped Malik to become one of 450 interns—out of 1.5 million annual applicants—to serve at the United Nations Headquarters in New York. Working within the Economic and Social Council (ECOSOC), he prepared analytical summaries of U.N. sessions on behalf of the Division for the Advancement of Women. Malik still revels in how he learned, first-hand, how international policy is implemented throughout the world. “Being a part of the U.N. really was my dream come true,” he says. “The discussions I saw there will improve not only my understanding of public policy but the lives of millions of people. What an amazing opportunity.”
Denise Feda outside one of the hospitals she partnered with in Cameroon.
Denise Feda Three months in Cameroon Environmental and occupational health student Denise Feda became part of a groundbreaking international study on HIV medications when she signed on for her field experience in Douala, Cameroon. The study is the first to analyze use of antiretroviral HIV medications in Cameroon. Feda was charged with the great task of collecting patient data from multiple hospitals, clinics, and physicians. Her efforts paid off: By the end of her field experienced she had created a database of more than 2,500 patient visits. Researchers in France are analyzing the data to inform Cameroonian physicians on how they can improve antiretroviral drug therapies. In Cameroon, Feda says she learned how public health can be both a driving force for enriching the well-being of populations and a rewarding opportunity to explain how this work benefits individuals. “As I was collecting data on all of these patients and looking at their medical files, I was also looking at them,” she explains. “They were part of my study and numbers on my computer, but they were also people I could talk to.”
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Biostatistics
Anne Ipsen Goldman
Photo: Dawn Villella
Biostatistics Chapter Closed, Goldman Embarks on Writing Career Anne Ipsen Goldman admits that she didn’t set out to be a trailblazing woman in a field once dominated by men. Nor did she intend to work on groundbreaking research concerning AIDS, cancer, and marrow transplantation. A second career in fiction writing was not in her plan either. Goldman’s remarkable career can best be explained not by painstaking goal setting but rather by sheer industriousness and curiosity: “If I’m not busy, I’m not happy,” she says, discussing her 33 years as a professor in biostatistics. In 1970, she and her mathematician husband both accepted positions at the University and moved to Minneapolis with their three children. At the time, there were no tenure slots at the School of Public Health and formal professional mentoring by senior faculty was uncommon. When her first division head took sabbatical, he simply divvied up his work for the other professors to continue. Goldman found herself the statistician for a large Veterans Administration study on hypertension. “In retrospect, I should have been daunted,” she says. “But I was so naïve, I didn’t think anything of it.”
6 University of Minnesota School of Public Health
The experience sparked her interest in planning and analyzing large clinical trials. Wanting to understand the questions behind the research lead her to collaborate with the University’s Cancer Center. For roughly 20 years she has served as senior statistician for the University’s Blood and Marrow Transplant (BMT) Program. To date the program has treated more than 3,000 patients, many of them children who suffer from leukemia and genetic disorders. Outside collaboration didn’t deter Goldman from contributing to her own division. “She wasn’t afraid of the ‘dirty jobs,’” says professor Brad Carlin, citing her service as director of graduate studies and participation on several controversial committees. “Anne was never one to shirk such duties merely to remain ‘politically correct’ or ‘above the fray.’ She was a good citizen of our division.” Goldman’s good work also resulted in critical milestones: In 1981 she became the first woman in the Division of Biostatistics to receive tenure and until 1990 was the only female full professor in the School of Public Health. “I feel lucky to have been able to work with Anne,” says Todd Defor, a former student of Goldman’s who is now a senior research fellow with the BMT program. “She had a solid understanding of where our research group should be headed, and she worked hard to put us on that course. She has shared a lot of her knowledge with me.” The desire to share knowledge is what led Goldman to pursue writing. While on sabbatical 15 years ago, she began a memoir of her childhood experiences in Denmark during the Nazi occupation of World War II. She gave chapters as Christmas presents to her family and finished the manuscript during her second sabbatical in 1995. “I wanted to share my story because I thought the time in which I lived would be forgotten,” she says. After A Child’s Tapestry of War was published in 1998, Goldman branched out to historical fiction. She has since completed two novels about a Danish woman in the late 1800s. The story follows the heroine’s experiences on a seafaring island and emigration to a Danish settlement in southwestern Minnesota. Goldman is currently doing research for a novel set in Concord, Mass., during the time of the Salem Witch Trials. Biostatistics and historical fiction may seem worlds apart, but Goldman says the two aren’t really that different. She’s used to the pressure to “publish or perish” and the idea of searching for the right theme or expressive phrase. But essentially she’s still motivated by the idea of communicating with others. “I don’t just write for myself,” she says. “It’s something that I want to share. It’s in me.”
SPH to Take Part in $5 million Lung Health Study
Biostatistics
Biostatistics division head John Connett will lead the data coordination portion of a five-year, $5 million study funded by the federal National Heart, Lung, and Blood Institute. The study will include the work of the Chronic Obstructive Pulmonary Disease (COPD) Clinical Research Network, a cooperative made up of researchers from seven U.S.-based clinical centers. The study will focus on an investigational treatment for COPD. COPD is a term used to describe an airflow obstruction that is associated mainly with emphysema and chronic bronchitis. According to the American Lung Association, more than 16 million Americans have been diagnosed with COPD and it is believed that another 16 million remain undiagnosed. Most often caused by cigarette smoking, COPD is the fourth leading cause of death in the United States.
NCI-Funded Study Focuses on Cancer Control in Minnesota Cancer control is the focus of a $1.4 million study for which Brad Carlin is serving as the principal investigator. He is joined by four other biostatistics colleagues from the SPH (as well as SPH alumnus Sally Bushhouse from the Minnesota Department of Health). Through this National Cancer Institute-funded study, Carlin and colleagues will develop new statistical methods for analyzing data related to cancer control. While a good deal of cancer data are collected by geographic region in Minnesota, they are often difficult to interpret. The goal of the study is to help the Minnesota Cancer Surveillance System (a division of the Minnesota Department of Health) obtain a better picture of the underlying geographic trends in cancer across the state. The findings from this study will help inform other cancerrelated research projects. One example, according to Carlin, is the concern among cancer professionals that breast cancer patients in rural areas of the state opt for mastectomy even when breast-conserving surgery (commonly known as a “lumpectomy�) would be the better option. The reason many rural women opt for mastectomy, Carlin suspects, is the difficulty of weekly drives to the nearest radiation treatment facility. (Radiation therapy is necessary following a lumpectomy, but generally not mastectomy.) This is one of the many projects Carlin hopes to undertake once the relevant data have been matched to their precise geographic coordinates by Bushhouse and her staff. 7
Environmental and Occupational Health
take a 10-day "immersion" tour into the natural resources of a specific geographic region. Swackhamer was an instructor for the area focused on the upper Great Lakes, and spent several days on Isle Royale National Park talking about Great Lakes issues and some of her current research.
Photo: John Finnegan
Minnesota waters are a chief concern for Deborah Swackhamer.
Swackhamer Named to Water Resources Center Post As the summer comes to a close and we reflect on the season’s golden days, there is a good chance that many readers spent time enjoying some of Minnesota’s 10,000 lakes, not to mention its rivers, creeks, streams, and ponds. One School of Public Health faculty member in particular gives more consideration to this region’s waters than most of us. While we’re skipping stones or rigging lures to land a big trout, Environmental and Occupational Health Professor Deborah Swackhamer is looking closely at the water for signs that something is awry. Swackhamer was recently named Co-Director of the University of Minnesota’s Water Resources Center. In that position, she will be responsible for overseeing research and educational activities, including the Minnesota portion of the National Water Research Institute research program of the U.S. Geological Survey. The Water Resources Center is a focal point for a broad range of water-related research and education, including the Water Resources Science graduate program. “I’m thrilled to be able to broaden my research in this new position at the Water Resources Center,” says Swackhamer. “The work I’ll be able to do there will help bring the issue of stewardship of our lakes and rivers to life for students at the School of Public Health.” Never far from the water, Swackhamer recently spent three days as an instructor for the Institute of Journalism and Natural Resources, which provides fellowships to journalists to 8 University of Minnesota School of Public Health
SPH Cancer Study Hits Milestone A School of Public Health research group studying lung cancer has just reached its goal of recruiting 5,000 participants, nearly a year ahead of schedule. “This achievement is a testimony to the generosity of the great people in Minnesota and western Wisconsin,” says Tim Church, associate professor and the study’s principal investigator. Last summer, President George Bush announced the National Lung Screening Trial initiative from the White House Rose Garden. Its purpose is to see whether screening for lung cancer saves lives. Nearly 30 study centers around the country began the mammoth job of recruiting 50,000 participants whom they will follow for eight years. The University’s share of this commitment was to enroll 5,000 participants by the end of June 2004. The goal was reached this month, nearly a year ahead of schedule. The study is comparing spiral CT (Computed Tomography) with standard chest X-rays to learn which test results in fewer lung cancer deaths through early detection. (Spiral CT scans the entire chest and produces a three-dimensional model of the lungs; chest X-ray is a single, two-dimensional view.) “Lung cancer is the biggest cancer killer in the country,” says Church. “In the short run, screening is the best way to reduce the number of people dying from lung cancer. We need a large, randomized study to determine which of two diagnostic tests result in a lower chance of death from lung cancer.”
Photos: Dan Marshall
Health Services Research and Policy
Also participating were leaders of top medical technology firms, including St. Jude Medical, Guidant, Medtronic, Surmodics, and Medical Alley, as well as leading physicians and bioengineers from around the country. MTLF was founded in 1996 to address policy issues facing the medical technology community and general public. For copies of MTLF reports, go to www.mtlf.org.
FDA Commissioner Mark McClellan discusses medical technology at the University of Minnesota.
SPH Hosts Medical Technology Leaders and Top Federal Officials Medical technology innovation is evolving faster than government policies can evaluate its safety, efficacy, and clinical benefit, according to experts who gathered at the University of Minnesota recently for the Medical Technology Leadership Forum (MTLF). During the two-day event, they also discussed what policy reforms might streamline the government’s role so that beneficial technologies can reach patients faster. Participants included FDA Commissioner Mark McClellan, and Sean Tunis, chief medical officer of the Centers for Medicare and Medicaid Services. University of Minnesota participants included Frank Cerra, senior vice president for health sciences, Terry Bock, associate vice president for the Academic Health Center, Maureen Reed, chair of the Board of Regents, SPH Dean Mark Becker, and professor Kenneth Keller, who chairs MTLF’s board. University of Minnesota President Robert Bruininks welcomed the group and encouraged its work. “Innovation in medical technology happens in an iterative, not a linear fashion,” says Susan Bartlett Foote, MTLF board member and division head of Health Services Research and Policy at the School of Public Health. “At this forum, we identified alternatives to existing hurdles so that new technologies can move rapidly from the experimental to the clinical setting.” Participants also discussed how the FDA and Medicare could coordinate review processes so that new products can move to market more efficiently. “If Medicare and the FDA could work in tandem and share information innovations and those who invent and sponsor them could move ahead,” says Foote.
From left, Ken Keller, Maureen Reed, Sean Tunis, Terry Bock, Susan Foote, and Mark Becker
Designing a More Competitive Medicare System Recent discussions about Medicare reform have focused on the hot button issue of prescription drug coverage. But also being considered are the critical fundamentals of Medicare coverage: how much it will cost, who will pay for it, and how it will be organized. Much of this debate centers on the appropriate roles of private health plans and of the government’s plan, “fee-for-service” Medicare. SPH health care economists Roger Feldman and Bryan Dowd recently briefed Centers for Medicare and Medicaid Services Administrator Tom Scully and other CMS staff on how to design a more competitive Medicare system. Feldman and Dowd offered expertise on how consumers choose health care plans and how market structures affect health care competition. CMS is the federal agency that administers the nation’s $375 billion Medicare and Medicaid programs. “There is wide variation in the goals for Medicare reform in Congress,” says Dowd. “CMS has the difficult job of thinking through system design issues without knowing which vision will dominate the final legislation.” The briefing follows Feldman and Dowd's five-year effort with CMS to design a competitive pricing demonstration, an experiment in which the rules of Medicare are changed for a specific geographic market. “Under the current Medicare system, the government determines how much it will pay for health care, regardless of the market conditions,” explains Feldman. “If we allowed private health care plans to bid on how much it costs to provide care, it would make for a more efficient and cost-effective system.”
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Epidemiology
“I’m now 48 years of age and probably entering my last year of life,” he wrote on his Web site in 2001. “There is no sense of regret however, as I’ve had a wonderful life. The principal recollection I have is the legions of nice people I’ve met. This suggests to me that simple friendship is the greatest gift of all.” McGovern is survived by his wife Lourdes, daughters Fiona and Tara, mother Eileen, brother Enda, and sisters Crona and Eilis.
Photo: Richard Marshall.
Paul McGovern and his daughter Tara photographed weeks before his death from ALS.
Used with permission from the St. Paul Pioneer Press
Remembering Paul McGovern
Faculty in the
Paul McGovern’s death in October 2002 was not unexpected. In, fact what surprised McGovern’s family, friends, and colleagues was how long he managed to live with amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease)—five years longer than most people with ALS. Also not a surprise to those around him was McGovern’s commitment to living his life to the fullest and his intense interest in others, even after ALS had rendered him unable to talk or move. McGovern grew up in a small coastal village in County Donnegal, Ireland and left his country to get a PhD at Iowa State. He joined the epidemiology faculty here in 1988, specializing in statistical research about cardiovascular disease and smoking. “Paul was never demeaning of those of us who knew less than he did, and that was the majority,” said Russell Luepker, head of the Division of Epidemiology, in the eulogy he delivered at McGovern’s funeral. “In a field not always known for its clarity or nice people, he was a kind but brilliant statistician who could explain things.” McGovern exemplified these traits in his course on epidemiology, for which he received the 1996 Leonard Schuman Award for Excellence in Teaching. His colleagues in epidemiology also honored him in 1999 with a colloquium on cardiovascular disease research. Researchers came from throughout the world to participate in the event.
Its slogan is “all the news that’s fit to print” and lately the New York Times has seen fit to cover a fair amount of news coming out of the School of Public Health’s Division of Epidemiology. First, a July 22 Science Times cover story titled “The Gorge-Yourself Environment” featured mention of the work Simone French and her colleagues have done in the area of food pricing. In looking at vending machine purchases in schools and workplaces, French found that the price of vending machine snacks affected purchase decisions far more than stickers promoting the low-fat attributes of a particular snack. Then, two weeks later, on August 5, a landmark study led by Moïse Desvarieux was published in the American Heart Association journal Stroke and covered by the Times and dozens of other major media outlets worldwide, including the BBC. The study provided what the Times called “the most solid evidence yet” of the relationship between periodontal disease and the risk for cardiovascular problems. It found that the more teeth older adults had lost due to cavities and periodontal disease, the greater was their risk for suffering a stroke. While the data from study stopped short of proving a cause and effect relationship between periodontal disease and stroke, Desvarieux and his colleagues will follow the study participants to continue to learn more.
10 University of Minnesota School of Public Health
Since September 11, 2001, and the subsequent anthrax attacks, “public health preparedness” has been elevated to priority status at all levels of government. While the threat of bioterrorism clearly justifies public health’s sharper focus on preparedness, the very definition of public health has always encompassed prevention, preparedness, and response. “Public health has always been about protecting the health and welfare of populations,” says Debra Olson, Associate Dean for Public Health Practice Education. “Preparing for and responding to emergencies makes up an important part of what public health agencies and professionals do.” These emergencies encompass everything from weather-related incidents such as hurricanes, to crises such as fires, to worksite injuries and events that necessitate the clean-up of hazardous materials, to bioterrorism. The recent emergence of preparedness as a recognized national priority has meant additional funding for the School of Public Health to meet the educational needs of various groups on the subject of preparedness, response, and recovery. Here are examples of how federal funding is supporting SPH preparedness education activities: The Centers for Disease Control and Prevention fund over 20 academic centers for preparedness nationally, including the University of Minnesota Center for Public Health Preparedness, which is responsible for Minnesota, North Dakota, and Wisconsin. These centers are charged with conducting preparedness education for frontline governmentemployed public health workers at the state, county, and municipal health department levels.
SPH continuing education courses teach workplace safety, among other topics.
The Midwest Center for Occupational Health and Safety, funded in part by a grant from the National Institute for Occupational Safety and Health, is designed to provide courses for health and safety professionals who address work-related injuries and illnesses related to a variety of health threats in the workplace. Course participants have included physicians, nurses, industrial hygienists, policy makers, and injury epidemiologists. For more information on the educational opportunities described here, visit www.cpheo.umn.edu.
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Public Health Education and Outreach
SPH Prepares Public Health Workforce
A HRSA (Health Resources and Services Administration) grant to the Midwest Center for Life-Long-Learning in Public Health provides continuing education funding for the public health workforce in the public, private, and government sectors. Preparedness is one among many areas of coverage for this center. The National Institute for Environmental Health Sciences grant to the Midwest Consortium for Hazardous Waste Worker Training funds preparedness education for hazardous waste workers whose job it is to clean up spills and Superfund sites and for first responders such as police and fire department employees. The School of Public Health is a partner in the Great Lakes OSHA Training Center, which provides support for courses in workplace safety, primarily for those who work in industry. Safety officers in manufacturing companies, as well as front-line workers, attend these courses in areas such as ergonomics and respiratory protection.