Advances - Fall 2008

2007-2008 Annual Report • Insert

advances Fall

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from the University of Minnesota School of Public Health

CANCER

SPH Researchers Work to Advance Prevention and Policy

TEAM D CRACKS SALMONELLA CASE GOOD FAT VERSUS BAD IN INFANTS ALUMNI LAUNCH BOOK CLUB LOOK TO THE FUTURE: PUBLIC HEALTH 2050

FROM THE DEAN Photo: Richard Anderson

Dear Friends, I don’t know about you, but I still catch myself smiling and shaking my head in amazement at the historic nature of our recent presidential election. The fact that the civil rights movement was followed by the election of our first African-American president in a span of a few decades is nothing short of remarkable. This is why America remains the land of such great promise.

In examining Barack Obama’s health policy proposals, it is clear he has a solid grasp of the important role public health can play in the health of our nation’s citizens, and in the health of our economy. He is committed to lowering health care costs in an effort to insure more Americans. And he has made increased investment in prevention and public health, a core tenet of his health policy proposal. In his plan, presidentelect Obama makes specific mention of addressing health disparities, childhood obesity, and the health workforce shortage.

His ability to achieve these and the long list of other goals remains tied to our collective ability to emerge from the economic quagmire we currently find ourselves in.

The fall issue of Advances is when we present our annual report. We continue to show marked growth in our three mission areas of research, education, and outreach. All indications point to us breaking the $100 million barrier in terms of research funding in the coming year. There is positive momentum on all fronts, leading me to conclude that public health remains a hot field, and the University of Minnesota a destination for students and top-tier faculty.

I will spend a good portion of the month of November in India, advancing our existing partnerships with St. John’s National Academy of Health Sciences in Bangalore and exploring new ones in Coimbatore and Mumbai. Our global relationships continue to take on greater importance, with the need to build the global public health workforce, export our knowledge in health promotion, and work with colleagues around the world to fight infectious disease.

Yours in health,

John Finnegan Assistant Vice President for Public Health Dean and Professor

SCHOOL OF PUBLIC HEALTH LEADERSHIP

advances

John R. Finnegan Jr. Dean

John Connett Head, Division of Biostatistics

Editor Diana Harvey

Judith Garrard Senior Associate Dean for Research and Academic Affairs

Bernard Harlow Head, Division of Epidemiology and Community Health

Managing Editor Kristin Stouffer

Debra Olson Associate Dean for Public Health Practice Education

Ira Moscovice Head, Division of Health Policy and Management

William Riley Associate Dean for Student Affairs

William Toscano Head, Division of Environmental Health Sciences

Diana Harvey Assistant Dean for External Affairs

Joe Weisenburger Chief Administrative Officer/ Chief Financial Officer

Contributing Writers Dixie Berg Adam Buhr Toya Stewart Art Direction Todd Spichke Riverbrand Design

Table of

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FALL 2008

Feature: Cancer

While more common cancers are declining, less common ones are on the rise. SPH researchers discuss how their work has contributed to cutting cancer rates and what’s needed to ramp up future prevention efforts.

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Research News

Health care access affects voter behavior; gay communities become less visible; global HIV trial set to launch; and more.

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School News

SPH experts help create Disease Detectives; school awarded $8.2 million for preparedness education initiatives; faculty join U delegation to Africa; and more.

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Student News

SPH students earn prestigious honors and help solve national salmonella outbreak.

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Philanthropy

U alumnus Lester Breslow returns to campus to accept award and meet with Breslow scholars; SPH donor base

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hits all-time high.

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Alumni News

Learn how to join the SPH alumni book club and submit names for the U’s top alumni award; highlights from recent alumni events; and more.

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CANCER SPH RESEARCHERS WORK TO ADVANCE PREVENTION AND POLICY When it comes to beating cancer, trends are both positive and puzzling.

On the positive side, U.S. death rates continue to decline for all cancers combined and for the four most common cancers, including prostate, breast, lung, and colorectal. The rate of new cancer cases also continues to decrease, a trend begun in the early 1990s.

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But while more common cancers are declining, less common ones are increasing. Through 2005, the National Cancer Institute (NCI) reports an increase in new cases of cancer of the thyroid, kidney, and liver, as well as melanoma of the skin, in both men and women. It also reports more testicular cancer in men and more childhood cancers. Cancer-related health disparities continue, with African-Americans and low-income people experiencing the highest rates of new cancers and cancer deaths, according to the NCI.

F E AT U R E S T O R Y With cancer claiming more than 550,000 American lives (9,000 from Minnesota) each year, there remains much to learn. Public health research, already a major contributor to the understanding of cancer, has a vital role to play in reducing cancer’s toll.

Members of the SPH faculty are among those leading the quest for answers about cancer. Their studies are yielding evidence critical to two key cancer-control strategies: effective prevention and sound policy-making. Find out more in the overview of their work that follows.

Is screening effective in reducing cancer mortality rates?

Screening is widely encouraged as a way to catch cancer early when it is more effectively treated. But is screening effective in reducing cancer death rates? Turns out, no one knows for sure. Studies of the size and duration needed to determine screening’s impact on cancer mortality have never been done. Until now.

For the past 15 years, the nationwide Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening trial has tracked 155,000 U.S. adults, collecting data on their medical and family histories and lifestyle habits and asking half of them to undergo six annual screenings. Among the participants are 29,000 Minnesotans who have been followed by a team led by SPH professor Timothy Church. Answers to the central question—whether screenings for prostate, lung, colorectal, and ovarian cancer reduce mortality—will begin to be released in 2011.

Church’s screening studies, which have collected extensive data and biological samples from participants, are also facilitating other SPH cancer-related research. SPH faculty members have been able to use the data and samples to explore questions as diverse as how cells repair themselves after they are damaged by carcinogens to the effect of cancer treatments on quality of life.

What really works to reduce cancer deaths?

Death rates from colorectal cancer have declined steadily over the years. But why? Is it screenings, lifestyle changes, or chemotherapy treatments that have made the most difference?

SPH professor Karen Kuntz uses mathematical modeling to arrive at answers to such questions. Her study of factors behind the improvement in colorectal cancer death rates found that screening was by far the most important, contributing 80 percent of the improvement from 1978 to 2000. Eight percent of the decline in the death rate was attributed to improvements in risk factors related to lifestyle and 17 percent to advancements in, and increased use of, chemotherapy for cancer patients.

Church and his colleagues are also regional leaders in the eight-year National Lung Screening Trial. Enrolling 50,000 heavy smokers nationwide (6,000 of whom live in Minnesota and Wisconsin) the study aims to determine which of two screening tests—spiral CT (computed tomography, which shows a three-dimensional image of the lungs) or standard chest X-rays (which provide a twodimensional view with lower resolution)—leads to fewer lung cancer deaths through early detection.

“We have to do these large trials to get the answers to these questions,” says Church. “It’s the only way to look at all the consequences.” One key question, Church explains, is whether the harm (increased worry, costs and pain, lost days of work, or mortality) resulting from certain screening methods exceeds the benefit.

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F E AT U R E S T O R Y “Our results suggest that cancer control policies should focus on increasing screening rates, which remain low in the United States,” says Kuntz.

Can consuming certain foods prevent cancer?

Years of animal studies and human observational data suggest that consuming watercress and cruciferous vegetables can reduce the risk of lung cancer. Scientists have even identified the chemical PEITC (2-phenethyl isothiocyanate), found in abundance in watercress, to be the potent force that detoxifies NNK, a carcinogen in tobacco smoke linked to cancer in humans. Studies suggest, though, that PEITC appears to protect only smokers with a particular genetic make-up.

SPH associate professor Jian-Min Yuan is leading the first randomized clinical trial to study whether dietary supplements loaded with PEITC help prevent lung cancer in humans.

During the year-long study, Yuan aims to determine the mechanisms by which PEITC works—and to examine the effects of PEITC supplementation on the metabolism of NNK in smokers who have different genotypes. Yuan hopes to extend his study to other foods and other types of cancer. “Most cancer epidemiologists focus on the cause of the disease,” he says. “I want to learn if there is any way to reduce the risk.”

What evidence links certain carcinogens with human cancer?

SPH associate professor Kristin Anderson and her University of Minnesota Masonic Cancer Center colleagues are building a reputation for finding evidence of several carcinogens’ link to cancer. Their work is providing valuable knowledge for informing health policies and influencing healthy behaviors.

Anderson and her colleagues were the first to detect the carcinogen NNK, found only in tobacco smoke, in the bodies of non-smokers exposed to tobacco smoke in a public venue.

The study measured NNK in urine samples taken from nonsmokers before and after a four-hour visit to a casino where smoking was allowed. The results showed that on average the exposure resulted in a two-fold increase in the carcinogen level and provided biological evidence for second-hand smoke as a cancer risk factor for people who do not smoke.

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University of Minnesota School of Public Health

In another project, Anderson broke new ground by showing that eating large amounts of red meat that has been grilled or fried at high temperatures and cooked to well-done may increase the risk of pancreatic cancer. The fact that cancercausing compounds form on the surface of meat during grilling and frying had been previously established. But Anderson found that the levels of these carcinogens, which depend on cooking temperature and degree of doneness, were related in a dose-dependent manner to risk of pancreatic cancer.

Can a coordinated effort help reduce the cancer burden?

The battle against cancer has long been fought on many fronts by many different organizations, from state and local health departments to universities, private industry, and nonprofit groups. Historically, though, there’s been little coordination among them, a factor believed to hinder efforts to reduce cancer.

That’s changed in recent years in Minnesota, thanks to the development of a comprehensive cancer control plan.

Developed under the leadership of the Minnesota Department of Health and the Midwest Division of the American Cancer Society and with funding from the CDC, Cancer Plan Minnesota laid the groundwork for bringing together some 90 organizations in a Minnesota Cancer

Alliance. Through the alliance, participating organizations have begun to work in concert to reduce cancer incidence and mortality in the state.

What’s working and what isn’t in cancer care?

Among the plan’s architects are SPH associate professor DeAnn Lazovich, a co-leader of the Prevention and Etiology program of the Masonic Cancer Center, and five other SPH faculty members, who are also cancer center members.

Lazovich currently chairs the alliance’s steering committee.

The mountains of cancer patient data collected by large health care organizations—from Medicare and the National Cancer Institute to state health departments—are of little value if not analyzed and interpreted. But in the hands of SPH associate professor Beth Virnig, large health data sets are yielding important new understanding, especially about health care utilization, her area of specialization.

The top priorities spelled out in the plan and addressed by the alliance include expanding the tobacco excise tax and clean indoor air policies, reducing disparities in cancer screening and treatment, improving access to information about services for cancer patients and their families, and increasing colorectal screening rates. A current focus, according to Lazovich, is to drive up colorectal screening rates from 62 percent to 74 percent. That goal, she says, will be achieved by improving access to screening and increasing delivery and demand. “We’re trying to get all the wheels moving,” says Lazovich. “Through the alliance, chances are good the wheels will move together.”

Using the large data sets, Virnig is able to test hypotheses and uncover insights far more quickly and inexpensively than would be possible through primary data collection and analysis.

Her research, which always begins with a hypothesis, has yielded knowledge useful to policymakers, providers, and patients on a variety of trends. She has found, for example, that African-Americans are less likely to receive hospice care, despite comparable health-care plans, than other ethnic and minority groups; that more women with cancer in one breast are choosing to undergo a double mastectomy, even though the annual risk of developing cancer in the second breast is less than one percent; and that men whose prostate cancer is treated with radiation therapy have nearly double the risk of developing rectal cancer, compared with those treated with surgery.

Understanding Cell Dynamics in Cancer Growth and Prevention Why is it that only some smokers— about 20 percent—develop lung cancer? What happens at the cellular level that determines whether or not cancer occurs?

In researching cancer prevention, SPH faculty members Lisa Peterson and Betsy Wattenberg are independently zeroing in on the body’s cells. They’re studying how cancer might be prevented or stopped in its earliest stages through strategies to safeguard cell integrity.

Peterson’s research has focused on the mechanisms by which DNA, when exposed to various carcinogens, is damaged

and repaired. DNA that is not repaired can undergo gene mutation, which in turn can lead to cancer. In one project, she focused on defining the pathways by which DNA, damaged by exposure to tobacco carcinogens NNK and NNN, is repaired. She also examined how the variation in human genetic make-up seems to make a difference in how the body repairs—or doesn’t repair—DNA damage.

In her lab, Wattenberg is exploring how damage to the “switches” that keep normal cells in constant communication with each other may cause cancer. In studying a switch called Ras, which is defective in 30 percent of human cancers, Wattenberg found that Ras-damaged cells don’t always lead to cancer, but they are vulnerable.

“Prevention strategies might focus on how to help those vulnerable cells,” she says.

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F E AT U R E S T O R Y

In addition, Virnig is tapping the data to learn more about the ongoing health status of cancer survivors (a growing cohort as cancer deaths decline) and the lifestyle issues they face. As a co-leader of the Masonic Cancer Center’s Cancer Outcomes and Survivorship Program and as a member of the national Adolescent and Young Adult Oncology Progress Review Group, she is helping develop recommendations for improving treatment, survival outcomes, and quality of life for people who have had cancer.

Do alternatives to smoking reduce the risk of lung cancer?

When cigarette smokers decide to try to lower their cancer risk, they may chew snuff or other smokeless tobacco, switch to “light” or “ultra-light” cigarettes, or smoke fewer cigarettes. But do these alternatives help reduce their exposure to tobacco’s cancer-causing substances?

Masons’ Gift of $65 Million Will Fund Cancer Research at U Cancer research at the University of Minnesota received a $65 million boost earlier this year with a gift from Minnesota Masonic Charities, the largest private donation to the University in history. The gift continues the Masons’ 53-year tradition of support for cancer research at the University, the level of which now exceeds $100 million. The gift will support research at the University’s Masonic Cancer Center, where about one-third of the researchers are members of the SPH faculty.

The gift, to be given over 15 years, comes as federal cancer research funding is declining. It will allow the Masonic Cancer Center to expand its work to improve cancer prevention, diagnosis, and treatment, and better address issues for people living with cancer.

“This generous gift brings with it so many benefits,” says SPH dean John Finnegan. “It will prove invaluable in recruiting and retaining leading faculty, supporting research for novel approaches to cancer control, and supplementing projects that may not receive full federal funding.”

SPH professor Chap Le and assistant professor Xianghua Luo have served as the data analysis team on a number of studies designed to find out if anything other than quitting lowers smokers’ exposure to tobacco’s cancer-causing chemicals.

The studies were conducted by the University’s Transdisciplinary Tobacco Use Research Center. In a study that compared smokeless tobacco users with cigarette smokers, investigators found no protective effect from smokeless tobacco. In fact, snuff users were exposed to higher levels of the carcinogen NNK than cigarette smokers, suggesting that chewing tobacco delivers certain carcinogens to the body even more efficiently than smoking.

Another study found that “light” and “ultra-light” cigarettes deliver similar amounts of nicotine and carcinogens as regular cigarettes. The findings challenged the practice of labeling cigarettes “light” and “ultra-light”—and the government’s method of classifying cigarettes—because doing so suggests that light cigarettes are less harmful.

Does smoking fewer cigarettes help? In a study designed to answer this question, Le, Luo, and colleagues found that while cutting back reduced exposure to carcinogen metabolites, the reduction was only about half of the reduction in cigarettes smoked per day. According to Le, this could reflect “smoking compensation,” in which smokers inhale longer and deeper to compensate for cutting back. Moderate smokers who don’t feel a strong need to compensate may thus benefit more from cutting back than heavier smokers, who feel the strongest need to smoke, but have the greatest need to reduce their intake.

Concludes Luo, “The only safe alternative to smoking is to quit.”

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University of Minnesota School of Public Health

RESEARCH NEWS

MDH and SPH Partner on Public Health Quality Improvement The SPH will partner with the Minnesota Department of Health (MDH) on a first-of-its-kind initiative to improve the quality of public health and prepare for national public health accreditation. MDH has received a $450,000 grant from the Robert Wood Johnson Foundation (RWJF) to support the work.

Minnesota is one of 16 states chosen to participate in the program. The grant will support projects that address specific health issues such as obesity, chronic disease, and tobacco use. The state will also use the funding to improve how public health services are delivered. This includes improving community health planning efforts, collecting and analyzing health data, and providing professional development opportunities to the public health workforce.

The project will play a critical role in helping the public health community prepare for national accreditation in 2011, and it will help local and state health departments ensure they are providing quality public health services and programs.

“Minnesota is a leader in developing innovative approaches such as quality improvement to improve the health of communities,” says William Riley, SPH associate dean and member of the board of directors of the Public Health Accreditation Board. “This is an important step toward preparing for voluntary accreditation for state and local public health departments.”

The initiative comes on the heels of quality improvement projects led over the past three years by the SPH and MDH. The eight projects, also funded by the RWJF, encompassed 28 counties throughout the state and marked one of the first times a school of public health partnered with a state health department to combine efforts and funds in this area.

Internet, Tolerance Spark Change in Urban Gay Communities The world is seeing a drastic change in gay communities— like clubs, bars, events and neighborhoods—due to a number of factors that include Internet dating and gains made in civil rights, School of Public Health research reveals.

Findings come from a 2007 survey of close to 30 HIV prevention experts, researchers, and gay community leaders from 17 cities spanning 14 different countries. The group also participated in a facilitated dialogue asking if gay communities are changing and, if so, how.

They observed that in all cities, the virtual gay community was larger than the offline physical community. And the majority of cities saw that despite a stable or growing gay population, the physical gay community infrastructure was declining.

“With the exception of London and possibly New York, gay bars and culture are changing. On almost all measures, we’re seeing the same trend: decreasing number of gay bars and clubs, decreased attendance at gay events, less volunteerism in gay or HIV/AIDS organizations, and less gay media, resulting in an overall decline in gay visibility,” says SPH professor Simon Rosser, principal investigator on the study.

“The biggest reason for these changes, we think, is the Internet. Traditional gay communities have become much quieter now that most gay men are online. It’s really a worldwide trend.”

This change is also a challenge for HIV/STD prevention.

As gay bars and media decrease, Rosser says it’s time to re-evaluate how to promote HIV prevention.

To hear a Public Health Moment about this study, WEB EXTRA go to www.sph.umn.edu/moment.

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RESEARCH NEWS

Difficulty Accessing Health Care Found to Shape Voting Behavior A study published by SPH researchers in the Journal of Health Care for the Poor and Underserved provides insight for public health policymakers and candidates for public office.

SPH doctoral student Jeannette Ziegenfuss and SPH faculty members Michael Davern and Lynn Blewett compared voter behavior in the 2000 and 2004 presidential elections to determine if there may be a connection between having had to put off medical and dental care due to a lack of money and decisions about whether to go to the polls and for whom to vote.

Between 2000 and 2004, the proportion of voting-age Americans who reported delaying medical or dental care increased significantly from 27 to 35 percent. And those who faced health access barriers voted in higher numbers in 2004 than 2000 (a 22 percent increase versus a 3 percent increase among those who did not face health barriers.)

Among those who had delayed care, the study found a significant shift in candidate preference in 2004. In 2000, people who reported health access problems and voted were no more likely to vote for the Republican than for the Democratic presidential candidate. In 2004, however, 65 percent of those who reported barriers and voted preferred the Democratic presidential candidate.

“The number of working-aged adults who experience difficulties accessing health care is growing,” says Ziegenfuss.

“We found this group is voting in large numbers and they tend to vote in the same direction, making them a potential swing vote. Candidates in future elections will need to address health care access in order to win the votes of this growing population.”

For the study, the researchers examined data from the 2000 and 2004 American National Election Study (NES), conducted by the Survey Research Center of the University of Michigan’s Institute for Social Research.

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University of Minnesota School of Public Health

Global HIV Trial Set to Launch An eagerly anticipated global clinical trial on the benefits of early treatment for HIV is set to launch. Known as the Strategic Timing of AntiRetroviral Treatment (START), the trial has been characterized as the most important clinical trial in the 10 years since highly potent anti-retroviral drugs became available for HIV/AIDS treatment. It will enroll 4,000 randomly selected HIV patients from 30 countries.

START is the latest trial conducted by INSIGHT, a network that includes HIV/AIDS researchers from around the world.

SPH professor James Neaton heads the network, and the SPH Coordinating Centers for Biometric Research serves as INSIGHT’s statistical and data management center and operations core.

START builds on the findings from the earlier Strategies for Management of Anti-Retroviral Therapy (SMART) trial, also conducted by INSIGHT and published in the December 2006 New England Journal of Medicine.

The findings from SMART indicated that uncontrolled viral replication and lower CD4+ cell count increase the risk of a number of diseases, such as cardiovascular, renal, and liver disease and many cancers. START will evaluate the effectiveness of early treatment protocols to prevent AIDS and serious non-AIDS diseases in people with HIV. The trial also represents what many view as the future model of global HIV research. Several governments are sponsoring the work through the National Institutes of Health in the United States and similar agencies in Germany and France. Five pharmaceutical companies will provide drugs.

For Neaton, international collaboration is critical to bringing improved treatment to patients worldwide, and it promises improvements in the way research is conducted. “We are doing these trials more efficiently than ever,” he says. “That means we’re able to conduct more trials to provide a stronger evidence base for clinicians taking care of people with HIV.”

RESEARCH NEWS

A technician, mother, and baby demonstrate the Pea Pod to a group of researchers.

Photos: Tim Rummelhoff

Study Aims to Identify Predictors of Rapid Infant Body Fat Gains SPH researchers are using the latest technology to examine a critical period for obesity risk that has been sparsely studied until recently: the first four months of life.

The Minnesota Infant Nutrition and Neurodevelopment Obesity Study, or MINNOwS, will track fat and lean tissue changes in 150 infants from birth to four months of age to identify factors leading to rapid gains in body fat. The goal is to identify “protective” factors that ensure proper cognitive and physical development, while avoiding later obesity.

Babies who gain weight rapidly—moving up 25 percent or more in weight-for-age percentile rankings in the first months—have twice the risk of obesity compared to babies with more gradual weight gain. However, little is known

Study Seeks Link Between Disease And Different Chemical Exposures When researchers set out to determine the cause of a workplace health concern, they typically focus on one occupational exposure that has been consistently present over a sustained period.

In a new study, SPH environmental health researchers face an unusual challenge: determining the link between exposures to many different chemicals, each over different lengths of time, and the increased risk of worker illness.

Led by SPH occupational epidemiologist Bruce Alexander and occupational physician and epidemiologist Jeffrey Mandel, the study will focus on whether workers at a chemical research and development facility have a greater risk of death because of exposures to different chemicals over varying lengths of time. Alexander and Mandel will be joined by SPH faculty members Timothy Church, Gurumurthy Ramachandran and Susan Gerberich and doctoral student Girard Griggs.

about the proportion of weight gained that is fat versus lean tissue.

To measure body composition in infants—a very tricky task—the researchers will use a state-of-the-art device known as the Pea Pod. Using air displacement technology, the Pea Pod measures a baby’s body fat percentage and fatfree mass. The study’s Pea Pod is the only one in Minnesota and one of just a dozen or so in the country.

MINNOwS will look at premature infants, because rapid weight gain after birth is important, as well as large term babies, whose weight percentiles tend to decline after birth.

The study will also analyze how genetic and prenatal hormonal factors, maternal obesity, and infant feeding patterns affect a child’s fat accrual.

“This work address the early origins of obesity as well as its transgenerational influences,” says study lead and SPH associate professor Ellen Demerath, “It’s a rather unique approach—few U.S. studies are looking at this.”

The facility is operated by chemical manufacturer Rohm and Haas and is located in Spring House, Penn. Concern was initially sparked by the possibility of an elevated incidence of brain cancer among employees. An internal study found no significant elevations for any cause of death. A review by the National Institute of Occupational Health and Safety prompted the company to turn the study over to an independent organization. The SPH team was chosen.

“Our plan is to initially evaluate causes of death in the population of people who worked in the facility,” says Alexander. A major part of this is to understand how to characterize multiple exposures over relevant time periods, based on employee job histories and information about the facility and the products being developed. “Studies like this are very complex,” Alexander says. This one, he adds, will take a couple of years.

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SCHOOL NEWS Moscovice Named Head of Division of Health Policy and Management Ira Moscovice, director of the SPH’s Rural Health Research Center and a noted expert on rural health policy, has been named head of the SPH Ira Moscovice Division of Health Policy and Management. Moscovice was also named a Mayo Professor of Public Health, the school’s highest faculty honor.

A University faculty member since 1981, his research interests include assessment of quality of care provided by rural health professionals, analysis of technology diffusion in rural areas, and evaluation of the implementation and impact of rural health networks and managed care.

“I am confident in Ira’s commitment to shaping the future of the division and the school, and I am deeply grateful for his willingness to provide leadership in this new role,” says SPH dean John Finnegan.

Photo: Matthew Beier

Michael Osterholm and Frank Cerra, senior vice president for health sciences

Osterholm Named to AHC Academy SPH professor Michael Osterholm has been named to the University of Minnesota Academic Health Center’s (AHC) Academy for Excellence in Health Research. Membership in the academy is intended to serve as the highest recognition of excellence in AHC faculty research. Osterholm, an internationally known expert in the field of infectious disease, directs the Center for Infectious Disease Research and Policy (CIDRAP). He is the fifth SPH faculty member to be named to the academy.

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University of Minnesota School of Public Health

SPH Awarded $8.2 Million CDC Grant for Education Research Debra Olson, executive director of the SPH Centers for Public Health Education and Outreach (CPHEO), has been awarded an $8.2 million grant from the Centers for Disease Control and Prevention (CDC). The grant will support interdisciplinary research to develop education models that build the capacity of the public health system for responding to public health threats and emergencies.

The research, to be administered under the auspices of a new CPHEO center, University of Minnesota: Simulations and Exercises for Educational Effectiveness (U-SEEE), will focus on simulation and role-playing education models and effectiveness metrics.

“We’re honored to be among just seven institutions to receive an award to enhance the usefulness of education and training from the CDC-funded Preparedness and Emergency Response Research Centers,” says Olson, who is also associate dean for public health practice education and the study’s principal investigator. “The grant will enable us to build on the school’s growing expertise in innovative course design and delivery for public health workers.”

To gain deeper insight into various training approaches, researchers from the SPH and other parts of the University’s Academic Health Center, the Minnesota Department of Health, and the University of Illinois at Chicago will lead four interdependent initiatives, including: • A retrospective study that will analyze connections between training history and performance in an actual event to identify links between training modalities and development of functional competence.

• A study to evaluate the effectiveness of “live” public health preparedness and response simulations in improving disaster response.

• An analysis to determine factors contributing to the development of high-reliability emergency preparedness teams.

• An assessment of how a computer-generated virtual environment (in this case, Second Life) might support collaborative disaster response planning.

In addition, the grant will provide funds for pilot studies and a fellowship program.

SCHOOL NEWS One-Health is Focus as Health, Environmental Factors Converge

SPH professor William Toscano and others from the University of Minnesota delegation tour the grounds of Peace House, a secondary school for AIDS orphans in Tanzania. The school was started

by Minnesota medical device executive Scott Augustine.

Photo: Chris Polydoroff

SPH Joins University-led Trip to Explore New Ties in Africa Following the University’s strategic re-positioning process several years ago, University leadership decided to deepen international ties at an institutional level. At the time, President Robert Bruininks indicated that sub-Saharan Africa would be among the priority regions where stronger relationships should be explored.

In August, Robert Jones, senior vice president for system academic administration, and Meredith McQuaid, associate vice president and dean of the Office of International Programs, led a fact-finding delegation of University faculty and administrators to South Africa, Tanzania, and Uganda.

SPH professor William Toscano represented the school as a member of the delegation.

“Clearly the future of Africa depends on the health of its citizens,” says Toscano. “The health needs of people in the areas we visited were broad and urgent. I believe that by collaborating with those interested in public health in Africa, we can help make a positive impact.”

Among the organizations with the greatest potential for collaboration with the SPH are the University of Capetown, which sends students to a nearby black township to conduct after-school education programs with schoolchildren and young adults; the South African National Defense Force, with whom the SPH has participated in a longstanding HIV/AIDS clinical trials program; and Uganda’s Makerere University, which has a school of public health similar to the SPH.

In a world in which environmental and societal changes are converging to pose potentially more—and more widespread— threats to health, leaders from all disciplines and sectors need to adopt a broader, more inclusive mindset: a “one-world, one-health” mindset.

That was a central message of a May Global “One-Health” Leadership Workshop, sponsored by the Kellogg Foundation and the University’s Center for Animal Health and Food Safety. Speakers included experts from the Centers for Disease Control and Prevention (CDC) and faculty from the SPH and colleges of veterinary medicine and biological sciences.

The nearly 50 participants represented private industry, commodity groups, nonprofit organizations, and academia.

A “one-world, one-health” mindset embraces the interdependence of ecosystem, animal, and human health. It promotes interdisciplinary collaboration across geographies, institutions, and cultures in order to better understand risks, allocate resources to the most serious potential threats, and act quickly and effectively to prevent the spread of epidemic or chronic disease.

“Animal and human health are a continuum of causality and events and need to be viewed as a continuum and integration of strategies,” said Lonnie King, director of zoonotic, vector-borne, and enteric diseases at the CDC, in opening remarks. Workshop speakers focused on aspects of the “continuum of causality,” including food-borne illness associated with ecological influences, parasitic illnesses, and food industry challenges.

SPH professor Craig Hedberg emphasized the importance of collaboration across industry, government, and academia to assemble the expertise needed for “just-in-time research” when a new disease emerges. “It’s the expertise, not the source of expertise that is key,” he said.

To view presentations from the workshop, visit WEB EXTRA www.sph.umn.edu/onehealth.

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SCHOOL NEWS SPH Welcomes New Faculty Weihong Tang, assistant professor, epidemiology and community health, has research interests in the genetic risk factors that contribute to cardiovascular disease, metabolic syndrome, diabetes, and obesity. She earned a Ph.D. in epidemiology from the University of Minnesota and an M.D. in preventive medicine from West China University of Medical Sciences.

Richard MacLehose, assistant professor in epidemiology and community health and in biostatistics, has research interests in Bayesian statistics, epidemiologic methods, applied biostatistics, and reproductive and environmental epidemiology. He earned a Ph.D. in epidemiology from the University of North Carolina.

Kyle Rudser, assistant professor in biostatistics and in clinical research with the Biostatistics Design and Analysis Center, has research interests in the design and monitoring of clinical trials, survival analysis, longitudinal analysis, and nonparametric approaches.

He earned a Ph.D. in biostatistics from the University of Washington.

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University of Minnesota School of Public Health

‘Public Health 2050’ Roundtable Series to Focus on the Future “The Changing Face of Minnesota Communities Now–2050: How Will Public Health Respond?” is the topic of the first session of the 2008-2009 School of Public Health Roundtable Series, the theme of which will be “Public Health 2050.”

The session will be held from 8:30 a.m. to noon, Thursday, Dec. 4, at the Coffman Theater on the University’s East Bank, Minneapolis campus.

Public health professionals, students, and members of the public are invited. The roundtable is free, but advance registration is requested. To register, visit http:cpheo.sph.umn.edu. A video of the event will be posted at the same Web site soon after the session.

Minnesota state demographer Tom Gillaspy will provide the keynote presentation. In response, a panel representing community organizations, public health agencies, and academic research will offer further insights into the changes ahead. The panel will be moderated by Edward Ehlinger, director and chief health officer of the University’s Boynton Health Service.

“We are very excited to offer this opportunity to discuss changes, challenges, and opportunities ahead—and to analyze them from a broad range of perspectives,” says Debra Olson, SPH associate dean for public health practice education.

“We face a future that promises to test public health professionals in entirely new ways. We need to look ahead and prepare.”

Roundtable sponsors include the SPH Centers for Public Health Education and Outreach, the Minnesota Public Health Association, and the Minnesota Department of Health’s Office of Minority and Multicultural Health.

Topics and dates for future SPH roundtable series sessions will be announced later.

SCHOOL NEWS

The University of Minnesota-Rochester was formally established in December 2006.

SPH Experts Help Create Disease Detectives

School Launches Biostats Program at Rochester Campus

If you want to battle bacteria, meet microbes, and investigate infectious agents, then head down to the Science Museum of Minnesota. It’s the site of Disease Detectives, a hands-on exhibit that explores the world of infectious diseases.

Years in the making, Disease Detectives draws on the expertise of health professionals, including three SPH members. Jill DeBoer and Michael Osterholm, of the Center for Infectious Disease Research and Policy, and Will Hueston, an SPH and veterinary medicine faculty member, served as project advisors.

Museum visitors are invited to solve infectious disease mysteries by role-playing various public health and medical professionals. Participants meet interactive patients, analyze lab tests, and visit the source of each outbreak. In tracking down E. coli, malaria, and influenza, participants learn about how infectious diseases are transmitted and prevented.

They also learn about the wide variety of health careers— information that could help draw new generations to the field of public health. “I like that the exhibit reaches such a young and diverse audience,” says DeBoer.

Visitors are introduced to the work of 11 actual disease detectives, profiling those who specialize in food safety, homeland security, and hospital cleanliness. One of those detectives is SPH alumna Melissa Kemperman (M.P.H. ’07), an epidemiologist specializing in vector-borne diseases.

For Laurie Fink, the museum’s program director for human biology, the exhibit is a way to get serious information out to the public in a fun and entertaining way. “It’s great to have a resource like the University of Minnesota because there are so many experts there who are willing to help us,” she says.

For more on Disease Detectives, go to www.diseasedetectives.org. This project is made possible by funding from the National Institutes of Health.

SPH leaders have partnered with the University of Minnesota-Rochester and Mayo Clinic to extend the SPH master’s degree in biostatistics program. Designed for working professionals, students can now earn an M.S. without having to attend classes on the University of Minnesota’s Twin Cities campus.

Offered through the University of Minnesota-Rochester, the M.S. program is built on the success of interactive television (ITV) courses that the SPH has been offering at the Rochester campus for the past two years. The ITV technology lets students there tune into live broadcasts of SPH courses and interact with professors and students in the Twin Cities.

The program is targeted primarily to employees at the Mayo Clinic’s division of biostatistics who have bachelor’slevel degrees. By accessing the ITV courses, Web-based technology, and Mayo-based adjunct faculty, those employees can earn an M.S. while continuing to work.

The offering is part of a larger collaboration between the SPH and Mayo Clinic. Currently three SPH adjunct faculty members are on staff at Mayo’s division of biostatistics, with additional adjunct faculty to be added. That connection, along with the M.S. curriculum, will allow for more research collaborations and greater learning opportunities for students and faculty.

“This partnership brings together two very strong divisions of biostatistics,” says John Connett, SPH biostatistics division head and professor. “The Mayo Clinic has a distinguished history of statistical innovation and involvement in clinical research. The two groups will complement each other.”

SPH adjunct professor Karla Ballman, who heads Mayo’s division of biostatistics, agrees. “The interactions between the two faculties are particularly appealing because the SPH faculty bring the academic interests, while the faculty at Mayo have a more applied emphasis,” she says.

“Exposure to each other will make both groups stronger.”

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Photo: Patrick O’Leary

Photo: Science Museum of Minnesota

Young visitors at the Disease Detectives exhibit.

STUDENT NEWS Eggebrecht Receives Student Achievement Award Matt Eggebrecht, a second year student in the master in healthcare administration program, has been presented the 2008 Master’s of Public Health Administration Student Achievement Award. The award recognizes his leadership skills and efforts to promote the health of individuals, families, and the community.

During his first year as an M.H.A. student, Eggebrecht served as an executive member of the Center for Health Interprofessional Programs (CHIP), an organization providing students in the health professions opportunities to connect, collaborate, network, and develop. For two years, he has volunteered with the Phillips Neighborhood Clinic, which serves low-income and homeless people in Minneapolis. His peers at the clinic elected him clinic co-chair.

Eggebrecht has served on the Minnesota Department of Health’s pandemic influenza resource allocation panel and as a representative to the graduate and professional student assembly.

Learn more about a day in Eggebrecht’s life at WEB EXTRA www.sph.umn.edu/sphere/matt.

Mullen Named 2008 Juran Fellow Deborah Mullen, a Ph.D. student in the school’s health services research and policy administration program, has been named a 2008 Juran Fellow. She is one of three fellows chosen by the Joseph M. Juran Center for Leadership in Quality at the University of Minnesota’s Carlson School of Management.

Each year, the Juran Center honors doctoral candidates whose work shows exciting promise in broadening thinking and inspiring new practices in quality-related research in their fields. Mullen was recognized for her work, “Moral Exemplars, Outpatient Medical Clinic Climate, Temporal Affect, and Patient Care Errors.” As a Juran Fellow, she will receive an award of $5,000 at graduation to expand upon and apply her research.

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University of Minnesota School of Public Health

Team D (from left): Carrie Klumb, Ryan Gierke, Joshua Rounds, Jena Trask, and Ruthie Luna. Not pictured: Allie Harford, Julie Hoffer, Mac Farnham, and Colin Schwensohn.

SPH Students on Team Diarrhea Help Solve Big Salmonella Case For almost two months earlier this year, federal health officials were stymied in their hunt for the source of a salmonella outbreak responsible for making more than 1,200 people sick.

But then Team Diarrhea—a Minnesota Department of Health team of disease detectives composed largely of SPH students—joined the search. And in just two weeks, the mystery was solved. “Team D” identified jalapeño peppers as the culprit, and in so doing helped close the book on a high-profile and costly food-borne disease outbreak.

Team D joined the hunt after more than 25 people who ate at the same Twin Cities restaurant became ill. The cause: the same salmonella strain (called salmonellastpaul) that had plagued people in other states.

To crack the case, the team extensively interviewed people who had reported their illnesses to the MDH. When two of the victims said they had eaten at the same restaurant, the students gained an important clue. An interview with the restaurant owner found he had stopped serving suspected tomatoes weeks earlier.

The team then interviewed both sick and healthy restaurant customers to learn what both had eaten. This process helped to pinpoint a jalapeño garnish as the culprit. The Minnesota Department of Agriculture then used invoices to trace peppers used in the garnish back to their source— farms in Mexico and a warehouse in Texas.

Joshua Rounds, second-year epidemiology student and a member of Team D for about 18 months, says, “We’ve worked on about 10 salmonella and norovirus outbreaks since I’ve been here, but nothing of this magnitude. It felt really exciting to make an impact.”

PHILANTHROPY

Record Number of Donors Support the School of Public Health

Photo: Tim Rummelhoff

Lester Breslow speaks during the 2008 Medical Alumni Society celebration banquet. Breslow was granted the Harold S. Diehl Award, a lifetime achievement award for individuals who have made outstanding contributions to the Medical School, the University, and the community. The award is named in honor of the Medical School’s fifth dean, Harold Sheely Diehl.

Lester Breslow Meets with Breslow Scholars, Receives Top Medical Alumni Award Students, alumni, and faculty jumped at the chance to visit with public health pioneers and philanthropists Dr. Lester and Devra Breslow during their recent visit to the University of Minnesota. Dr. Breslow made the trip from Los Angeles to receive the Harold S. Diehl Award, a lifetime achievement award granted by the University of Minnesota Medical Alumni Society. He earned five degrees from the University and served as a prominent member of the faculty of the UCLA School of Public Health, holding the position of dean for eight years.

In addition to a dinner celebration attended by medical and public health alumni and faculty, Breslow Scholars visited with the Breslows during a lunch celebration in their honor.

Lester and Devra are generous donors to the School of Public Health, having established the Lester Breslow Scholarship in 1988. Since that time, 45 Breslow Scholars have been named. During lunch, past recipients of the scholarship gathered to show their appreciation. These recipients demonstrated excellence in health promotion and disease prevention as students and are now serving as leaders of the public health workforce and even as top faculty of the SPH. One such scholar, SPH associate professor Traci Toomey, conducts research on alcohol and tobacco

During the past fiscal year, more donors than ever before made gifts to the School of Public Health. The base of donors grew by more than 20 percent to an all-time high for the school. This growth is in no small part due to the enthusiastic effort by the SPH Alumni Society Board.

Their support of the 2008 Alumni and Friends Scholarship Gala in April added significantly to the SPH Alumni Scholarship Endowment Fund and energized alumni and community partners. As always, SPH donors have been generous in endowing new student scholarships and are responding to the University’s matching programs that double the awards of all new scholarships.

“The remarkable philanthropy shown by our alumni, friends, faculty, and staff is building the next generation of public health leadership,” says SPH dean John Finnegan.

“In this time of tremendous economic uncertainty, this type of support becomes even more critical in helping to build a strong financial foundation for our school.”

policy in the Division of Epidemiology and Community Health. “I am proud to not only be a Lester Breslow Scholar but also to have the opportunity to build on his immense career with my own work to promote health,” she says.

As most in public health are aware, Breslow did pioneering work in chronic disease epidemiology and forged the initial link between health behaviors and quality of life. At age 93, he continues to contribute to the field of public health and is keen to explain his work on health measurement in what he calls the “third era” of public health. During this current era, he says, “health” is shifting to a more holistic definition, which accounts for more than just the absence of communicable and chronic disease. Speaking during the Harold S. Diehl Award ceremony, Breslow urged his partners in medicine to make this shift complete by helping patients to not only fight disease but also preserve and improve their health on a daily basis.

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ALUMNI NEWS Sorensen’s Research Focuses on Interventions in Social Contexts Can the workplace serve as an effective venue for public health interventions designed to change behaviors and reduce the risk of cancer? Can interventions through other social contexts—within neighborhoods, for example—promote behaviors that prevent cancer or lower its risk?

These are among the key questions that Glorian Sorensen, Glorian Sorensen who earned an M.P.H. in 1980 and a Ph.D. in sociology in 1983 at the University, currently explores as professor of society, human development, and health at the Harvard School of Public Health. In her other role as director of the Dana-Farber Cancer Institute’s Center for Community-Based Research, Sorensen leads cancer prevention research efforts at one of the nation’s premier institutes dedicated to cancer research.

She focuses much of her research on understanding and addressing social disparities in cancer risk through communitybased approaches. Sorensen’s research has examined social interventions targeting blue-collar workers, people living in low-income housing, and health-center employees at risk for environmental exposures and risky individual choices, such as smoking or poor diet. “Our results have shown the efficacy across diverse populations of intervening in a social context to promote changes in health behavior,” says Sorensen.

A 2003-2005 Fulbright Award took Sorensen to India, where her research focused on disparities in tobacco use. A new study in India, in which SPH professor Harry Lando is co-investigator, is examining the effectiveness of tobacco control interventions with school teachers, key influencers of students, and of community norms.

Sorensen describes her post-doctoral research at the University of Minnesota, from 1983 to 1986, as formative.

“That was the beginning of community-based approaches to heart health. Minnesota was in the vanguard,” she recalls.

“I still refer to that foundation in what I teach.”

First Alumni Book Club Jan. 17: Come in Person or by Phone Do you miss stimulating discussions about public health dilemmas beyond those you normally encounter? Long for diverse perspectives like those that challenged your thinking in school?

Want to connect with other knowledgeable public health professionals?

If you answered yes to any of the above questions, then mark your calendar for Saturday, Jan. 17, 9 a.m. - 10 a.m.

CST. That’s when the first SPH alumni book club will meet.

The book to be discussed is Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World by Tracy Kidder.

Alumni in the Twin Cities region may attend at a campus location to be announced. Those farther away are encouraged to join the discussion via telephone. Either way, if you plan to participate, please register at www.sph.umn.edu/januarybookclub by Jan. 4.

The idea for the SPH alumni book club came from Deb McKinley (M.P.H. ’00), communications and outreach manager at Stratis Health in Minneapolis. “I wanted an ongoing book club that reads a variety of genres covering a range of public health topics,” says McKinley. “Where could I find a diverse group of intelligent people interested in stimulating discussion on health topics? The School of Public Health, of course.”

McKinley says she hopes the book club will “bring back to alumni the diverse and thought-provoking environment of the University.”

At each meeting, two SPH faculty members from different disciplines will offer their perspectives on the book. The discussion will then break into small groups engaging both those in the room and on the phone.

Looking ahead, McKinley says, “If every book-loving SPH alum shares a favorite or ‘latest best’ public health book, we’ll have a terrific list to choose from. We’ll pick books with an eye to rotating through the diversity of public health topics.”

SPH Book Club Sign-Up and Mail and E-mail Address Update

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SPH Book Club sign-up: www.sph.umn.edu/januarybookclub To receive updates on the book club and other SPH events, keep your e-mail and mail addresses current at www.sph.umn.edu/alumni.

University of Minnesota School of Public Health

ALUMNI NEWS Gretchen Taylor (M.P.H. ’82) and Sherry Fletcher (M.P.H. ’83)

SPH dean John Finnegan, Mary Kay Hunt (M.P.H. ’83), and Darlene Lansing (M.P.H. ’85)

Alumni engagement committee members who helped plan the event: Sandra Giovinazzo-Yates (M.P.H. ’04), Cynthia Kenyon (M.P.H. ’99), Gita Uppal (M.P.H. ’99), and Rosemond Owens (M.P.H. ’06).

Mary Sheehan (M.P.H. ’84) and Marcia Robert (M.P.H. ’72)

Alumni Networking Event Draws Crowd More than 130 people turned out for the SPH alumni networking event held recently at the University’s Weisman Art Museum. Organized by the SPH

Alumni Society Board, the event offered the growing community of public health professionals an opportunity to connect with each other. Participants were also treated to a guided tour of the Weisman by museum staff.

WEB EXTRA

To see slideshows of these events, go to www.sph.umn.edu/oct08events.

SPHers meet at APHA Alumni, students, faculty, and staff came together for the SPH reception held at the American Public Health Association’s annual meeting in San Diego.

Partygoers (from left): Donna Anderson (M.P.H. ’71), Tom Arneson (M.P.H. ’91), Mona Bormet (M.P.H. ’05), SPH associate dean Debra Olson (M.P.H. ’83), Ruth Tripp (M.P.H. ’98), Nancy Blume, and Tricia Todd (M.P.H. ’94)

Alumni: Send Names for U’s Outstanding Achievement Award Each year, the University confers its Outstanding Achievement Award on graduates or former students who have attained unusual distinction in their professions or in public service on a community, state, national, or international level.

This year, the SPH Alumni Society Board actively encourages alumni to forward the names of SPH alumni or former students for consideration for the Outstanding Achievement Award, the University’s highest alumni honor.

“If you’re a former SPH student, please send the names of peers from the school who have made outstanding contributions to their fields,” says board member Amos Deinard (M.P.H. ’85), associate professor at the University’s medical school

and SPH adjunct professor. “If you believe you should be considered for the award, send your own name. Alumni can be of enormous help in identifying individuals who deserve to be nominated.”

Once names are received, the alumni board and dean’s office will review them, determine who will be nominated, and develop and submit the nomination. The goal is to nominate one or more SPH alumni for the prestigious award each year.

To submit a name for consideration for the Outstanding Achievement Award, contact Michelle Lian-Anderson, director of alumni relations and special events, at liana001@umn.edu or 612-626-5536. To learn more about the award, visit http://uawards.umn.edu/Awards/Outstanding_Achievement_ Award.html.

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UPCOMING EVENTS

Next Issue

Community Partnerships for a Healthier Minnesota: 2009

SPH Roundtable: Public Health 2050 Minneapolis—Dec. 4 For more information, see page 12.

SPH Alumni Book Club Minneapolis and via phone—Jan. 17 For more information, see page 16.

Minne-College Naples, Florida—Jan. 24 "Advancing the Health of Future Generations: The National Children's Study," presented by SPH professor Pat McGovern www.alumni.umn.edu/events

Minnesota Legislative Briefing Minneapolis—Jan. 28 www.supporttheU.umn.edu

Support the U Day at the Capitol St. Paul—Feb. 25 www.supporttheU.umn.edu

Join Our Online Community

SPH Alumni and Friends Scholarship Gala

The SPH is broadening its reach through several popular online communities, including Facebook, YouTube, and LinkedIn.

Minneapolis—May 16 Keynote from global explorer and bestselling author Dan Buettner www.sph.umn.edu/gala09

See Next Issue for How to Apply To Be an Alumni Board Member Check the winter issue of Advances for information on how to apply to be a member of the SPH Alumni Society Board.

For more information, visit www.sph.umn.edu/alumni/board.

Become a SPH Facebook fan and network with our other fans, get updates on SPH events, and view photos from SPH events. www.sph.umn.edu/facebook On our YouTube page, you can view profiles of our students, learn more about SPH research, and find out what’s on the minds of passersby at the Minnesota State Fair. www.sph.umn.edu/youtube Join our LinkedIn group and network with SPH alumni. You can even engage in public health discussions. www.sph.umn.edu/linkedin

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