Advances - Spring 2009

Taking the Lead on H1N1 Response • page 11

Advances SPRING

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from the University of Minnesota School of Public Health

Global Health A New Age in Worldwide Partnerships

Prostate Tests Fail to Save Lives Diabetes and Postpartum Depression Binge Drinking in the Military School Lunches Still Fall Short

FROM THE DEAN

Dear Friends,

Photo: Richard Anderson

The novel H1N1 influenza outbreak certainly reminds us that public health is truly global. What happens in Mexico can impact the health of people living in not only Minnesota but Madrid, Mumbai, and beyond. In this issue of Advances, we cover the global reach of the work done by University of Minnesota School of Public Health faculty, staff, students, and colleagues around the world. It is exciting work that has the potential to impact the health and lives of people in villages, towns, and cities across the globe (see page 2).

The H1N1 influenza outbreak tested the public health response system from the World Health Organization to the University of Minnesota. As the University’s assistant vice president for public health, I got a firsthand look at how our planning over the past four years has paid off. We are now incorporating lessons learned from these events to further improve protection of the University community’s health should a more severe outbreak occur.

Springtime is a busy season for marking milestones and celebrating special events at the SPH. At our commencement ceremony a few weeks ago, we watched with pride as more than 200 students representing 48 countries graduated. Eric Whitaker, noted authority on health disparities and confidant of President Barack Obama, served as our commencement speaker (see page 12). That same weekend we held our second annual Alumni and Friends Scholarship Gala, where explorer and health guru Dan Buettner captivated the audience with a talk about what he calls “Blue Zones,” spots around the globe where people live longer by living better in an interesting list of ways (see pages 10 and 15). All of the proceeds from the event go toward student scholarships.

Yours in health,

John R. Finnegan Jr. 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 Education

Ira Moscovice Head, Division of Health Policy and Management

William Riley Associate Dean for Strategic Partnerships and Relations Mary Story Associate Dean for Student Life and Leadership Diana Harvey Assistant Dean for External Affairs

William Toscano Head, Division of Environmental Health Sciences Joe Weisenburger Chief Administrative Officer/ Chief Financial Officer

Contributing Writers Nicole Endres Lindsey Heffern Toya Stewart Art Direction Todd Spichke Riverbrand Design

Contents Table of

Advances

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Feature: Global Health

Never before has there been such a strong worldwide

SPRING 2009

desire to partner on the health challenges that affect us all. Take a tour of some of the latest SPH work abroad.

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Research News

Information technology is doing little to protect patients;

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deaths in HIV cases linked to blood biomarkers; a push to regulate nanotechnology products; and more.

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School News

New simulation focuses on dirty bombs; national public health leader speaks at commencement; photos from the Alumni and Friends Scholarship Gala; awards roundup; and more.

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Student News

Students take honors at SPH Research Day; and study finds binge drinking a problem in the military.

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Philanthropy

National award named after SPH alumnus; and more.

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Alumni News

SPH alumnus leads University of Minnesota Alumni Association; around the world with SPH alumni; and more.

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University of Minnesota School of Public Health

FEATURE STORY

Global Health A New Age in Worldwide Partnerships

When reports of the H1N1 influenza outbreak started hitting the news earlier this year, much of the discussion centered on how to contain the disease. Some people assumed that limiting travel or closing borders would prevent the spread of this new, potentially deadly, strain of influenza.

But anyone who has worked in public health knew this wasn’t possible. We are living in a world where infectious diseases spread around the world in a matter of hours. Perhaps the biggest lesson of the H1N1 outbreak is that we are truly living in an era of global health. Where we live is becoming less important than how we live. More than infectious agents, chronic conditions such as obesity, cardiovascular disease, and certain types of cancer, once limited to affluent countries, are now circling the globe to developing countries.

The University of Minnesota School of Public Health is built on the tenet that public health is global health. Some of the school’s earliest researchers helped to pioneer this philosophy.

In the early 1960s, the University’s own Ancel Keys traveled to Europe, Africa, and Asia to systematically study the diets and customs of different cultures. SPH professor emeritus Henry Blackburn worked with Keys on the project, known as the Seven Countries Study, one of the first global research initiatives to link lifestyle and diet to health.

Today the work of SPH faculty is conducted on five continents and in more than a hundred countries. While challenges such as HIV prevention, pandemic planning, tobacco control, and food safety are immense, so are the opportunities.

Technological advances have paved the way, but so has a worldwide desire to collaborate on the health issues that affect us all. Never before has the school partnered so extensively with researchers and educators throughout the world.

John Finnegan, Hitakshi Sehgal, and Harry Lando at the 14th World Congress on Tobacco or Health.

Tobacco Control While America has seen progress in cutting smoking rates, tobacco use remains the single largest preventable cause of disease and premature death in the world. The World Health Organization estimates that of the world’s 1.22 billion smokers, 1 billion live in developing or transitional economies. If left unchecked, deaths from tobacco use are expected to double by 2030.

Tobacco control in the developing world was the focus of the 14th World Congress on Tobacco or Health held earlier this year in Mumbai, India. Originally scheduled to be held in Geneva, Switzerland, some involved felt that a conference focusing on smoking in the developing world should be held in the developing world. Leading that charge was SPH Distinguished International Professor Harry Lando, an expert on global approaches to tobacco reduction.

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As vice president of the conference, Lando played a lead role organizing the event and raising financial support.

Sponsors included the Bill and Melinda Gates Foundation, World Heart Foundation, Pfizer, and the SPH. Attendance exceeded expectations with some 2,000 people from more than 130 counties. Speakers included the heath minister of India and the director general of the World Health Organization.

SPH alumna Hitakshi Sehgal (M.P.H. ’08), who lives in India, worked with Lando on conference planning.

“This conference was key in setting a unified and global agenda on tobacco control,” says SPH dean and attendee John Finnegan. “Harry’s leadership was critical in pulling together the network that made this event a success.”

Lando says he is pleased that the World Congress is starting to have an impact on countries with the greatest tobacco burden. He notes that more than 60 percent of the conference delegation represented countries of middle to low incomes.

“This is a first for us,” he says. “But we have so much more to do.”

Lando and colleagues are working to cut the projected death toll from tobacco—estimated to be in the billions—by at least 10 percent. “Imagine the impact, the lives saved,” says Lando. “The goal is, really, to change the world.”

Global Learning The school is globally engaged in the pursuit of educating the next generation of public health leaders. Over the past five years, the SPH has forged partnerships with colleagues in India to help build the country’s nascent public health infrastructure and develop a healthy workforce.

Those partnerships helped pave the way for Global Health India, a collaboration of the SPH, St. John’s Medical College in Bangalore, and several other colleges in India. The fiveday institute, held on St. John’s campus, offered courses examining the impact of globalization and strategies for a healthy workforce. Nearly a dozen University of Minnesota students, mostly from the SPH, attended. They learned alongside some 160 Indian students.

Half a dozen SPH faculty members taught courses, as did instructors from Indian institutions. University of Minnesota faculty members from nursing, dentistry, medicine, and veterinary medicine also taught. Topics included infectious diseases, genomics, climate change, nutrition, children’s health, and health management. Students and instructors discussed strategies for developing international partnerships to create globally minded public health interventions.

“Public health issues transcend national borders,” says SPH professor William Toscano, an institute instructor. “If we are to effectively address these issues, we need to do so from a global perspective.”

Scenes from Global Health India 4

University of Minnesota School of Public Health

of patient education. “We want to make sure the assessment is quickly translated to interventions,” says Lifson. “The goal is to use scientific methods to create the best available care to improve the health of HIV-infected persons.”

Alan Lifson in Africa

HIV Prevention

Environmental Health

For more than 20 years, SPH professor Alan Lifson has traveled throughout the world to improve care for those with HIV. This work has taken him to Asia, Eastern Europe, Latin America, the Caribbean, and Africa. Ethiopia is the sixth African country he has worked with, and it is the site of one of his current projects.

SPH assistant professor Paul Allwood is working with health officials in Jamaica on a range of initiatives aimed at protecting the public from environmental hazards.

Ethiopia, like other African countries, has some of the world’s highest HIV rates and some of the most limited resources to deal with the immense challenge. Treatment of the disease requires lifelong therapy. It can be complicated, costly, and associated with side effects. Many patients stop taking medication or are lost in follow-up.

Lifson’s team is conducting an evaluation to identify the reasons patients are lost in the health system or stop HIV treatment. Once those reasons are identified, the team will create interventions to improve retention. Partnering organizations include the National Alliance for State and Territorial AIDS Directors and the World Health Organization, with support from the Centers for Disease Control and Prevention.

“We’re finding that rural areas face a unique set of barriers,” says Lifson. For instance, those in remote villages may not have access to reliable transportation or a nearby clinic.

This is a case where HIV care must be available at local health clinics, and where community health workers may be called upon to act as a bridge between clinics and the villages where patients live.

The evaluation is comprehensive, taking on a wide scope of potential barriers to treatment, such as availability of family and community support, distance to and accessibility of clinics, social stigma, drug side effects, nutrition, and lack

The Jamaican Ministry of Health enlisted Allwood to research the causes of leptospirosis, a potentially harmful infectious disease that is endemic to tropical climates. In 2005, a leptospirosis outbreak caused hundreds of cases of illness and death among Jamaican adults and children.

While it is known that domestic animals, especially dogs, play a large role in the transmission, there has been little scientific surveillance of the disease in Jamaica.

Allwood is working to change that through a series of field visits, surveys, and geographically referenced data. The information will be used to predict future outbreaks and as a basis for community-based interventions to prevent transmissions. Preliminary data is beginning to come in now, and the team expects to have recommendations within the next six months.

The Ministry of Health in Jamaica, along with the University of the West Indies, is working with Allwood to plan research and interventions aimed at curbing violence among Jamaican youth. The government has identified violence as a priority area in its healthy youth initiative.

Outside of the research arena, Allwood is working to promote partnerships between faculty of the SPH and the University of the West Indies. For several years, he has been involved in planning an annual conference that draws participants from the United States and the Caribbean.

Presenters at the last conference included SPH dean John Finnegan, who discussed the use of scientific evidence in the policymaking process.

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Food safety partners kick off a program in Rome.

MCEIRS members meet with colleagues in India.

Influenza Surveillance The recent H1N1 influenza outbreak confirms the need to ramp up worldwide surveillance so that disease can be limited in its most early stages. This is especially true in developing countries with limited resources and large human and animal populations. A team from the Minnesota Center of Excellence for Influenza Research and Surveillance (MCEIRS) recently met with colleagues in India to enhance regional influenza surveillance.

India is just one country in the global network forged by MCEIRS since it launched two years ago. Funded by the National Institutes of Health, the center’s goal is to enhance understanding of how avian influenza viruses evolve, adapt, and spread. MCEIRS is part of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP).

Discussions with Indian officials were led by SPH professor and MCEIRS director Michael Osterholm. Wildlife refuges were identified as a starting point for surveillance of India’s vast population of wild migratory birds. Surveillance near the flyways will be conducted in backyard farms, live poultry markets, and processing facilities.

Plans include training local workers to collect samples from birds, conduct laboratory diagnostics, and sequence viral genomes. The group proposed U.S. and India academic and professional exchanges to share surveillance techniques.

“One major lesson from the H1N1 outbreak is that we need to make our recommendations for reducing transmission relative to the severity of the disease,” says Osterholm, citing unnecessary school closing as an example. “Ramping up worldwide surveillance is key to improving disease response.”

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University of Minnesota School of Public Health

Food Safety The Centers for Disease Control and Prevention estimates that 75 percent of the food we eat has at least one ingredient grown, processed, packaged, and shipped from another country. As our food supply continues to become more globally sourced, ensuring the safety of what we eat and drink becomes more challenging.

Since launching in 2007, the Global Initiative for Food Systems Leadership (GIFSL) has provided educational opportunities to emerging leaders from 35 countries. GIFSL fosters experiential education through a global network of universities, intergovernmental agencies, and private industry.

Partnering organizations include the World Health Organization, the Food and Agriculture Organization of the United Nations, Cargill, and General Mills. GIFSL executive director Will Hueston, a professor in the SPH and College of Veterinary Medicine, is an internationally known expert on global food systems. SPH professor Craig Hedberg also serves on GIFSL. In the past year, GIFSL has led a “farm-to-table” study tour in the Netherlands, lectures for students at the University of Iceland, and an international working group on leadership involving government, industry, and non-profit organizations.

Under the guidance of GIFSL, 19 senior Chinese officials spent two weeks gathering food safety strategies in Europe and the United States. The tour included stops in Italy, Belgium, the Netherlands, Washington, D.C., and Minnesota.

“The premise was that food safety is a shared responsibility between the public and private sectors, academia, and consumers,” says Hueston, who led the program. “The idea was to introduce some universally accepted international standards for safe food production and trade.”

Next up for GIFSL is a farm-to-table study tour of Uruguay and Argentina. The group plans to visit a dairy processor and beef plant, tour a cattle farm, and meet with faculty and students from the Universidad de la Republica veterinary school in Uruguay.

RESEARCH NEWS

A rendering of the HIV virus in the bloodstream infecting cells

Non-AIDS Deaths in HIV Cases Linked to Inflammation, Coagulation

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A recent study in the journal PLoS Medicine indicates that patients with HIV have elevated levels of biomarkers linked to inflammation and coagulation. These elevations are associated with an increased risk of death. Most of the deaths are not attributable to AIDS. The study was carried out by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), led by SPH professor Jim Neaton. INSIGHT represents the world’s largest collaboration of HIV researchers. The group includes a network of 400 study sites in 37 countries. More than 10,000 patients have been enrolled in clinical trials over the last eight years.

The Strategies for Management of Antiretroviral Therapy trial or SMART was stopped early in 2006 when researchers discovered that patients who received episodic antiretroviral therapy (ART) for HIV were more than twice as likely to develop disease or die compared to those taking continuous ART. But at the time, the reasons behind the deaths were unclear.

Neaton and colleagues looked at 85 of the patients in SMART who died early and compared their blood samples to 170 patients who did not. They found that death was linked to three biomarkers specific to inflammation or coagulation of blood: high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), and D-dimer.

“While the link between these biomarkers and mortality is significant, more research is needed to understand reasons for the elevations and whether treatment to reduce these biomarkers is beneficial,” says Neaton.

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

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Diabetes Doubles Risk of Postpartum Depression Women with diabetes have nearly double the risk of developing depression during pregnancy or in the months after childbirth than non-diabetics, a new study finds.

Researchers at the School of Public Health and Harvard Medical School analyzed health records of more than 11,000 low-income women enrolled in New Jersey’s Medicaid program.

Their study, published in the Journal of the American Medical Association, reports that 15 percent of women with diabetes experienced depression during or after pregnancy, compared with 8 percent of women without diabetes.

“Even diabetics who weren’t depressed during pregnancy had higher odds of becoming depressed within a year of giving birth,” says SPH professor and study co-author Bernard Harlow.

SPH associate professor Mark Pereira is another co-author.

One theory is that diabetes triggers hormonal changes in the body that can lead to depression. “The stress associated with managing a chronic illness and pregnancy at the same time can contribute to depression as well,” says Harlow.

Diabetes and depression have been linked before, but this is the first study to examine diabetes and depression in new mothers.

The researches suggest that women using state Medicaid services may be particularly vulnerable to postpartum depression due to higher rates of known risk factors. Yet, while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.

Says Harlow, “Health care providers should pay particular attention to managing the mental health concerns of women with diabetes during pregnancy and the postpartum period.”

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RESEARCH NEWS Health IT Has Little Effect on Patient Safety University of Minnesota researchers have found that the use of health information technology (IT) has little or no effect on patient safety. But they caution that more research is needed to judge the effectiveness of health IT. SPH assistant professor Jeffrey McCullough and Stephen Parente, associate professor in the Carlson School of Management, write about the study in Health Affairs. They explain that early adopters of health IT were typically large academic medical centers that provide high quality care and likely have better-than-average outcomes.

Consequently, generalizations from early health IT adopters could overstate health IT’s value on a national scale.

McCullough and Parente examined Medicare data on more than 10 million hospital inpatient stays from 1999 to 2002. They looked at the effects of electronic medical records, nurse charts, and automated imaging on three patient safety indicators: infection, post-operative hemorrhage or hematoma, and postoperative pulmonary embolism or deep vein thrombosis.

They found that electronic medical records are the only IT application to have a clear, though marginal, effect on patient safety. Electronic medical records reduced infections, but had no effect on the other two patient safety indicators.

The benefits of electronic medical records did grow with time.

“While these are interesting findings, much more research is needed,” says McCullough. “Our work has helped establish methods that are shedding new light on this issue. We WEB EXTRA WEB EXTRA suggest that planned federal investment in health IT be accompanied by investment in the evidence base needed WEB EXTRA to evaluate its effectiveness.”

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

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SPH Study Finds Prostate Tests Do Not Save Lives

“What this report tells us is that the short-term benefits of prostate cancer screening, using present methods, do not result in the reductions in death that we had hoped,” Annual screenings for prostate cancer led to more diagnoses says SPH professor Timothy Church, study co-author and principal investigator for the University of Minnesota site. of the disease, but not fewer prostate cancer deaths, according The U.S. Preventive Services Task Force, whose recomto a new report from the Prostate, Lung, Colorectal, and mendations are considered the gold standard for clinical Ovarian (PLCO) Cancer Screening Trial. The results preventive services, recently concluded that there is appeared in the New England Journal of Medicine. insufficient evidence to assess the balance of benefits and More than 76,000 men were tracked at 10 national study harms for prostate cancer screening in men younger than sites, including the University of Minnesota. The university age 75 and recommended against prostate cancer screening was the largest of the sites, enrolling nearly a quarter of in men age 75 and older. the participants, who were monitored over a decade.

“It is possible that prostate cancer screening may produce Researchers found that men who had yearly PSA tests—a longer-term benefits,” says Church. “We will continue to blood test that screens for prostate cancer—or digital rectal monitor men in this study with the hope that we eventually exams had essentially the same risk of dying from prostate WEB EXTRAwill see reduced WEB EXTRA death from this disease.” cancer as men who didn’t have the tests. They also found To hear a Public Health Moment on this research, evidence that the screened men were treated unnecessarily.

WEB EXTRA go to www.sph.umn.edu/moment.

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University of Minnesota School of Public Health

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RESEARCH NEWS

New Approach Needed to Govern Nanotechnology Risks

School Food Environments Need Improvement

To assess the potential health risks associated with nanotechnology, the U.S. regulatory system must change, according to new SPH research.

“Nanomaterials are essentially unregulated in the United States, even though they are used in a lot of products,” says SPH professor and study co-author Gurumurthy Ramachandran. “What’s more, the current regulatory system for chemicals is broken. Most chemicals used in consumer goods haven’t been subjected to health and safety risk assessments. We run the risk of repeating this situation for nanomaterials if the same processes are used.”

The current U.S. regulatory system places the burden of risk assessments on federal agencies. However, these agencies do not have the budget to adequately test nanomaterials.

Nor do they have sufficient toxicity or exposure information from nanotechnology firms, since industry is not required to divulge this information.

In order to avoid crippling the burgeoning nanotechnology industry, the researchers support a tiered risk assessment strategy similar to legislation used in the European Union.

“While this approach places the burden on industry, the tiered strategy effectively uses scarce resources,” says Ramachandran.

Ramachandran and colleagues suggest that these testing tiers account for potential human exposures and toxicity of the nanomaterial in question. Prioritizing these risks is timeand cost-effective for industry. It also frees regulatory agencies to monitor industry rather than burdening them with costly risk assessments.

“We’re hopeful that this study can be used as a starting point to discuss U.S. legislation regarding nanotechnology risks,” says Ramachandran.

While the past decade has brought improvements in the nutritional quality of school meals and foods outside of school meal programs, there is still drastic need for improvement. That’s according to the results of a national study reported in the Journal of the American Dietetic Association.

In the journal, findings are presented from the third School Nutrition Dietary Assessment (SNDA-III) study, the most comprehensive assessment of foods available in schools sponsored by the U.S. Department of Agriculture.

The analysis includes the National School Lunch Program, the School Breakfast Program, and other foods and beverages available during the school day.

The SNDA-III study found that while 70 percent of the schools surveyed served meals that met the standards for many nutrients (such as vitamin A, vitamin C, calcium, and iron), just 7 percent of schools met all nutrition standards.

About 42 percent of the schools offered no fresh fruits or vegetables in the lunch program on a daily basis. Foods from vending machines, at school stores, and for fundraisers fared especially poorly in middle and high schools.

“Schools need to do even more to reduce the availability of high-calorie, low-nutrient foods and make school meals more nutritious,” writes SPH professor Mary Story, guest editor of the special journal supplement.

“Many public schools are constrained in providing better meals because of limited funds,” continues Story. “It is time to reexamine the formulas used to set national reimbursement rates with reference to the costs of producing and serving school meals that meet the Dietary Guidelines for Americans.”

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SCHOOL NEWS

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1) Keynote speaker Dan Buettner 2) D irector of Q Health Services Clarence Jones and SPH dean John Finnegan

8 Photos: Leslie Hale

SPH Gala Supports Student Scholarships More than 200 people turned out for the SPH Alumni and Friends Scholarship Gala on May 16. The second annual event raised money to support scholarships for SPH students. Keynote speaker Dan Buettner discussed his bestselling book, The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest. For several years, the well-known explorer has collaborated with SPH faculty.

3) K atie Gruner (M.P.H. ’07), SPH student Renzo Amaya Torres, Samuel Simmons, SPH student Glenise Johnson, and Helen Parsons (M.P.H. ’08)

4) John Prebish and Barbara O’Grady (M.S. ’73) 5) SPH students Emily Matson and Katie Muehe 6) Frank Toomey and SPH associate professor Traci Toomey 7) SPH student Lorna Schmidt and Li Ding (M.S. ’95) 8) C ynthia Kenyon (M.P.H. ’03), Jim Anderson (M.H.A. ’68), and James Wolf (M.H.A. ’68)

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University of Minnesota School of Public Health

SCHOOL NEWS

Reported cases of H1N1 More than 500 Fewer than 500 (as of June 1, 2009)

U of M Takes Lead on H1N1 Response There have been few more dramatic moments in public health than on April 29 when the World Health Organization declared that the H1N1 (swine) flu outbreak had rendered the human race in peril. While a shock to some, it was a moment that the Center for Infectious Disease Research and Policy (CIDRAP) has been preparing for since it opened its doors in 2001.

Throughout the outbreak and in the weeks since, CIDRAP experts have worked tirelessly to advise various groups— from the general public, to multinational corporations, to government officials—on how to respond to the virus. “Our work is what I like to call consequential epidemiology. It has an immediate and real impact,” says CIDRAP director Michael Osterholm.

Sharing his knowledge with the general public through news channels has always been central to Osterholm’s mission as one of the world’s top experts on pandemic planning. In the first weeks of the outbreak, the SPH professor received up to 200 media requests a day. He appeared on all the major television networks and 24-hour news channels, as well as in newspapers around the world.

CIDRAP’s website (www.cidrap.umn.edu) has long been regarded as a source of timely and scientifically sound information concerning infectious diseases. In the second week of the H1N1 outbreak, daily page views exceeded 215,000 by visitors from 37 countries. CIDRAP staff worked around the clock to provide up-to-the-minute analysis as the virus spread.

Visits to CIDRAP Business Source (www.cidrapsource.com) increased by more than 600 percent for the same week, as

companies struggled with issues such as employee protection, border closings, and supply chain continuity. In fewer than 36 hours, CIDRAP Business Source staff members developed a web-based conference with 550 participants from more than 200 organizations. “Webinars are an ideal way to reach out to many people very quickly,” says Business Source director Aaron Desmond. “The response from our participants was overwhelmingly positive.”

Strong ties to private industry helped CIDRAP to monitor coal stockpiles, medical supplies, and other vital goods.

The center also worked through government channels to ensure that critical supplies were not being held up at U.S. borders, amidst misinformation that closing borders could halt the spread of disease.

To help organizations provide accurate information, CIDRAP’s Promising Practices (www.cidrappractices.org) staff compiled pandemic preparedness tools. Resources included fact sheets on hygiene, a family disaster plan, and a psychological first aid kit. The peer-reviewed practices were submitted and developed by health departments nationwide.

While public concern over the H1N1 threat has eased, the virus continues to spread, and the potential for a pandemic still looms. CIDRAP is maintaining its role as advisor on the big decisions that lie ahead: How to proceed with a flu vaccine? How to conduct disease surveillance in developing countries? How to keep critical supplies going in a global supply chain?

“We’ve been given an opportunity to understand what it means to be ready for an influenza pandemic while the H1N1 virus is generally causing mild to moderate disease,” says Osterholm. “We must prepare now because one day we are going to be in it for more than a few weeks. If it’s not this virus, there will be another one.”

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SCHOOL NEWS

A scene from Dirty Bomb! After the Blast

Eric Whitaker Photo: Eric Miller

Eric Whitaker Delivers Commencement Address Nationally noted public health leader Eric Whitaker delivered the commencement address to the 2009 graduates of the University of Minnesota School of Public Health. Whitaker is an expert on minority health issues and, in his own words, “country doc” for some of Chicago’s poorest communities.

As a vice president and dean at the University of Chicago Medical Center, Whitaker is a key player in building community partnerships to address health disparities and improve access to care. Prior to that appointment, he was director of the Illinois Department of Public Health, and before that he was an attending physician at Cook County Hospital. He attended Harvard University with Barack Obama, and the two have remained close friends. Whitaker is an advisor to the president on issues related to health care reform.

Whitaker gained national attention as founder and director of Project Brotherhood: A Black Men’s Clinic. In 1998, he developed a clinical model for African American men that combined health care and disease prevention with vocational and spiritual guidance, all in the setting of a barbershop. The award-winning program improved care for an often underserved population.

“We must speak for those who don’t have a voice in global society,” said Whitaker to the graduates. “This has led me to be involved in research, particularly qualitative research. You can ask open-ended questions without constraining research participants to a certain set of answers. There is always an unexpected answer that we researchers are not smart enough to ask.”

“Graduates, I am confident that you will make your own mark, in large and small ways. . . . We are counting on you. Welcome to the public health family.”

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Dirty Bomb Simulation Provides New Training Opportunity An explosion has just occurred in the middle of Sen. Lund’s political rally. The cause: a dirty bomb. Radiological contaminants have jeopardized the health and safety of the community. What will you do to respond to this public health emergency?

That’s the fictional scenario used in Dirty Bomb! After the Blast, a new online simulation created by the SPH’s Center for Public Health Preparedness (CPHP). The 3D simulation puts learners in the decision-making role to navigate through three missions, working as a public health responder. The interactive training creates a world where learners go through the motions in a real-life setting in order to understand what a successful response looks like.

“Training the public health workforce with a computer simulation is innovative and promotes outside-the-box thinking,” says Debra Olson, SPH associate dean for education and CPHP principal investigator. “It provides a new costeffective way to train public health professionals for large-scale emergencies.”

Dirty Bomb! After the Blast focuses on emergency preparedness concepts like decontamination, mass fatalities, disaster mental health, and personal protective equipment, but it is not just for emergency preparedness responders.

The comprehensive simulation is designed for all types of public health professionals, who may be called to respond during a large-scale disaster.

While providing an opportunity to apply concepts learned in CPHP’s online Public Health Emergency Training (PHET) series, Dirty Bomb! After the Blast introduces public health professionals to a new way to train for their jobs. “Pairing the fundamentals with a new learning environment that is story-based and visually enticing encourages retention of the basic material,” says SPH assistant education coordinator Amy Scheller.

Dirty Bomb! After the Blast is available at no cost WEB EXTRA at http://cpheo.sph.umn.edu/umncphp/phet/.

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University of Minnesota School of Public Health WEB EXTRA

SPH Inducts news members of Delta Omega

SCHOOL NEWS

The SPH recently inducted new members into the Pi Chapter of the Delta Omega Honorary Society for Public Health.

Faculty: Bruce Alexander, Tracy Bergemann, Jennifer

Alumni: Deborah Freeman (M.P.H. ’08), Elizabeth Ralston

Students: Matthew Allerson, Marisa Bargsten, Erica Bohan, Emily Brown, Jason Brown, Majken Hall, Sarah Klawitter, Barbara Knust, Meijuan Li, Annie Mach, Deborah Mullen, Heather Oleson, Ryan Otten, Erin Roche, Jocelyn Walton, Shi-yi Wang, Jason Weaver, Jessica Zeglin

Howe (M.P.H. ’07), Andrea Leinberger-Jabari (M.P.H. ’04), Jessica Buck Nerby (M.P.H. ’03), Dan Sargent (Ph.D. ’96), Avula Sreenath (Ph.D. ’98), Jill Wilson (M.P.H. ’92)

Linde, Karen Kuntz

Honors and Awards Kristin Anderson received the Excellence in Advising Award from the SPH in recognition of extraordinary dedication to student mentoring. Anderson teaches courses on cancer epidemiology.

James Begun received the SPH’s highest teaching honor, the Leonard M. Schuman Award for Excellence in Teaching. Begun teaches courses in health care leadership and management.

Youth Winner Robert Gabbert, Hilliard, Ohio “Distracted Driving”

School Awards Winners in PSA Contest The SPH received 67 entries in the school’s third annual “It’s Global” Public Service Announcement (PSA) contest.

Amateur and professional filmmakers made a 30-second statement on the public health topic of their choice. Top selections were screened at the school’s National Public Health Week Film Festival.

View the winning entries at www.sph.umn.edu/psa.

Kathleen Thiede Call received the University of Minnesota Outstanding Community Service Award. Call was recognized for working with community groups to improve access to health care.

Dianne Neumark-Sztainer received the Distinguished Women Scholars Award in Humanities, Social Sciences, and Arts from the University of Minnesota. She is a nationally noted expert in adolescent health and nutrition.

Susan Gerberich and Debra Olson were named among the 100 Distinguished Nursing Alumni and Centennial Distinguished Faculty Alumni from the University of Minnesota School of Nursing. They were selected for their impact on communities, education, and the nursing profession.

Harry Lando received the John Slade Award from the Society for Research on Nicotine and Tobacco. The award is presented to an individual who has made contributions to public health and tobacco control through science-based policy and advocacy.

Susan Telke received the Charles N. Hewitt Creative Teaching Award from the SPH. She was recognized for her outstanding methods in teaching introductory courses in biostatistics.

Adult Winner Erik Lundin, Chaska, Minn.

“Change a Light Bulb Change the World”

Sharon Vegoe received the Professional and Administrative Excellence Award from the SPH. She was recognized for her work as an education specialist for the Centers for Public Health Education and Outreach.

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STUDENT NEWS

Photo: Paula Keller

Research Day winners and SPH dean John Finnegan

Students Awarded at SPH Research Day Eight blue ribbons were awarded to SPH students at the school’s second annual Research Day. For the event, held in conjunction with National Public Health Week, students created a poster outlining the research project of their choice.

Judges selected awards for posters in three categories. The winners and their poster titles, broken out by their degree program, are:

Student Choice M.P.H. - Kristen Godfrey, Patient Enrollment in Public Health Insurance Programs at the Phillips Neighborhood Clinic: Identifying Barriers and Remedies Ph.D. - John Li, Evaluation of a Statewide Foodborne Illness Compliant System M.S. - Alyssa Olson, Estimating the Beneficial Effects of Recalls for Preventing Foodborne Illness

Faculty and Alumni Choice M.P.H. - Akshay Gupte, Mitika Kanabar, and Emily Wang, Impulsive Behaviors and their Association with Dopamine Agonistic Medication Use in Parkinson’s Disease.

Ph.D. - Jee-Ae Kim, Medicare Expenditure Among Racial/Ethnic Groups for Elderly Medicare Beneficiaries with Diabetes M.S. - Alyssa Olson, Estimating the Beneficial Effects of Recalls for Preventing Foodborne Illness

Delta Omega, Pi Chapter Tran Huynh, Duck Husbandry Practices and Farmer’s Beliefs about Avian Influenza in South Vietnam John Li, Evaluation of a Statewide Foodborne Illness Compliant System The Delta Omega winners received $500 to cover the expense of attending a national scientific meeting of their choice. All other winners received a $50 gift certificate to the University of Minnesota bookstore.

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University of Minnesota School of Public Health

Startling Numbers Surround Binge Drinking in the Military Forty-three percent of active-duty military personnel report binge drinking in the last 30 days, according to a new study from the School of Public Health and Centers for Disease Control and Prevention.

The numbers come from an analysis of 16,037 active-duty military personnel who participated in a 2005 survey conducted by the Department of Defense. This translates to approximately 30 million episodes of binge drinking or roughly 30 episodes per person per year. About two-thirds of the episodes were reported by 17-to-25-year-olds. About 5 million of these episodes were reported by those under 21 years of age.

The study includes other alarming findings: more than 7 percent of binge drinkers reported to work drunk or had consumed alcohol during work hours. Nearly 9 percent had been in physical fights. Over a quarter of binge drinkers reported that they had driven while drunk.

“Our study clearly shows that binge drinking is a significant problem in the military, and that it is dangerous to both the drinkers and to those around them,” says Mandy Stahre, SPH doctoral candidate and first author of the study. “This work underscores the importance of implementing strategies to prevent binge drinking, such as enforcing the minimum legal drinking age and increasing alcohol excise taxes.”

As with all self-reported surveys, binge drinking and WEB EXTRA WEB EXTRA related consequences are generally underreported. Thus, the researchers suggest that binge drinking estimates among WEB EXTRA active-duty military personnel may be conservative.

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

WEB EXTRA

PHILANTHROPY

Premier Renames CLARION Award in Honor of Retiring CEO and SPH Alumnus Richard Norling has spent his career focused on improving the quality, safety, and cost-effectiveness of patient care.

A graduate of the SPH’s Master of Healthcare Administration program, Class of 1975, Norling is retiring after 12 years as president and CEO of the health care alliance Premier, Inc. To honor Richard Norling his contributions to the company and to care improvement, Premier is making a gift to the University in Norling’s honor.

The company’s gift—$15,000 per year for 10 years— goes to the newly renamed Premier Richard Norling Scholarship Fund. Scholarships from this fund will be awarded to students who show their commitment to improving health care by participating in the CLARION National Case Competition.

CLARION—a University of Minnesota organization started

by Master of Healthcare Administration students and housed in the Academic Health Center’s Center for Health Interprofessional Programs—is designed to give health professional students a “360-degree” look at how collaboration across disciplines can help solve problems in the current health care system.

Every year, the group holds a national competition through which four-student teams, which include students from at least two disciplines, are given case studies and are charged with finding the cause of the problem and recommending solutions. Judges evaluate each team’s analysis in the context of “real world” standards of practice.

Students on the first-, second-, and third-place teams receive financial awards through CLARION. “The Premier board of directors is pleased to support CLARION students and to reward their case work in improving the quality and safety of health care,” says chairman Lowell Kruse, who is also president and CEO of Heartland Health and an SPH alumnus (M.H.A. ’67).

“Initiating and sustaining health care improvement through collaboration has been a priority goal of Richard Norling and the members of the Premier alliance, and this scholarship award … creates incentives for a new generation of students to follow this example.”

Frank Cerra, senior vice president for health sciences at the University, says Premier’s gift acknowledges the importance of CLARION and its participants.

“The future of health care resides in the success of programs like CLARION, something recognized by Rick Norling and Premier,” Cerra says.

Norling’s education at the SPH isn’t his only connection to the University: He also served as president and CEO of Fairview Hospital and Healthcare System from 1989 to 1997.

Today Norling says he’s proud to have this CLARION scholarship bear his name.

“The goals of this program are wholly consistent with the values that I have worked to instill within Premier,” he says.

“I look forward to playing a role in rewarding innovative ideas to resolve challenges facing the health-care system— for the benefit of patients nationwide.”

Gala Brings in Funds for SPH Scholarships The School of Public Health and SPH Alumni Society Board would like to thank everyone who supported the Alumni and Friends Scholarship Gala on May 16. Attendance for the second annual event increased sharply over the previous year. Proceeds from the event will add more than $25,000 to the SPH Alumni Scholarship Endowment.

In addition to an exciting keynote address by author and explorer Dan Buettner, Deborah Caselton, a new SPH graduate, spoke about the importance of scholarships for students. Caselton received the Cecilia Goetz Memorial Scholarship for her international field experience in Zambia.

Thank you to the following table sponsors: Donna Anderson (M.P.H. ’71) Judy Beniak (M.P.H. ’81) Cynthia Kenyon (M.P.H. ’03) and Trent Lunder Pat Koppa (M.P.H. ’79) Mayo Clinic Minnesota Medical Foundation Minnesota Public Health Association Q Health Services Brigid Riley (M.P.H. ’98) Mary Sheehan (M.P.H. ’84) and Tim Sheehan State Council on Black Minnesotans Beth Virnig (Ph.D. ’93) and Jonathan Levy For more on the gala, see page 10.

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ALUMNI NEWS SPH Alumni Book Club Sept. 12, 11 a.m. (Central time)

Location: University of Minnesota, A-301 Mayo Memorial Building Book: Three Cups of Tea: One Man’s Mission to Promote Peace . . . One School at a Time To participate in person or by phone, contact Michelle Lian-Anderson at liana001@umn.edu.

SPH Grad Leads University of Minnesota Alumni Association Archie Givens (M.H.A. ’68) has been named president of the National Board of Directors of the University of Minnesota Alumni Association (UMAA).

“As a former Gopher football player and life UMAA member, I am so honored to have this opportunity to be alumni association president at this time,” says Givens.

Givens is president and CEO of the Legacy Archie Givens Management and Development Corporation. The real estate company is a leader in developing affordable housing solutions in Minnesota. He is also president of the Givens Foundation for African American Literature, which directs a variety of programs and outreach efforts.

He is not the only SPH graduate to serve on the UMAA board. Alison Page (M.H.A. ’96, M.S. ’96) is an at-large representative. After seven years, Brian Osberg (M.P.H. ’86) has stepped down as the board’s SPH Alumni Society representative and Judy Beniak (M.P.H. ’81) is now serving in that role.

The alumni association has more than 60,000 members, representing nearly 375,000 living alumni of the Twin Cities campus of the University. The UMAA is both the University’s department of alumni relations and an independent nonprofit association, governed by a volunteer board of directors.

Past presidents of the SPH Alumni Society Board recently met with current board members to discuss strategies for alumni programming.

Back row: Judy Beniak (M.P.H. ’81), Richard Huset (M.P.H. ’82), Val Baertlein (M.P.H. ’81), SPH dean John Finnegan, Tricia Todd (M.P.H. ’94), Jodi Eiesland (M.P.H. ’95), Esther Tatley (M.P.H. ’84).

Front row: Cynthia Kenyon (M.P.H. ’03), Donna Anderson (M.P.H. ’71), Gretchen Musicant (M.P.H. ’86), Janny Brust (M.P.H. ’87).

Tempe, Arizona, was the site of the Health Leadership Academy, a joint effort of the SPH and Arizona State University. The continuing education and networking event drew alumni from the Master of Healthcare Administration program. From left, Timothy Hanson (M.H.A. ’73), Brian Younger (M.H.A. ’77), Sarah Miller (M.H.A. ’92), William Kreykes (M.H.A ’66), SPH associate professor Sandra Potthoff, MHA director of alumni relations Mark Reitan (M.H.A. ’81), and Mike Albertson (M.H.A. ’92).

We want to hear from you!

Submit news, connect with fellow classmates, and learn about alumni events at www.sph.umn.edu/engage.

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University of Minnesota School of Public Health

Around the World with SPH Alumni Anne Bunde-Birouste (M.P.H. ’86) Job title: Senior Lecturer and Convener of Health Promotion Program Employer: School of Public Health and Community Medicine, The University of New South Wales Location: Sydney, Australia, with travel throughout the Asia, the Pacific, and Africa Main focus: Teaching and key researcher for Football United: Social Cohesion through Football, which studies soccer as a vehicle for social inclusion in communities with refugee populations Interesting job facts: It is not uncommon to have more than 20 nationalities in my classes. My research enables me to engage and support refugees from many different countries as they settle in Australia.

Global health philosophy: Good health is a necessary foundation for productive, harmonious, peaceful, and prosperous societies across the globe. It is critical for communities and individuals to exercise their entitlements and rights.

Time spent in global health field: I have worked abroad most of my professional life, starting with the U.S. Peace Corps in Africa. Following graduation from the SPH, I moved to France where I lived until 2002, when I moved to Australia.

My work has involved health promotion in both industrialized and developing countries.

Mansur Ahmed (M.P.H. ’81) Job title: Professor and Head of the Department of Community Medicine and Course Chairman, Noncommunicable Disease Employer: Bangladesh Institute of Health Sciences Location: Dhaka, Bangladesh Main focus: Teaching and research in public health. The Bangladesh Institute of Health Sciences is a collaborative organization of Oslo, Norway, and the University of Dhaka, Bangladesh. I am also a visiting professor in one of the country’s leading private universities, North South University, where I teach epidemiology.

ALUMNI NEWS Interesting job facts: Among the Institute faculty members, 80 percent are female.

Global health philosophy: Health systems of the world are no longer separate entities. World travel and the technology of worldwide communication means that knowledge about a disease—and the disease itself—can be transmitted throughout the globe within a very short time. Bangladesh is geographically far from Mexico, but recently a Bangladesh citizen was killed by the H1N1 virus.

Trisha Wood (M.P.H. ’04) Job title: Associate Program Officer, Integrated Health Solutions Development Employer: Bill and Melinda Gates Foundation Location: Seattle, Wash.

Main focus: I support the director of the Integrated Health Solutions Development (IHSD) division in the Global Health Program. I am a liaison among the different teams within IHSD and the director. I also work on a Mesoamerica health initiative that contributes to malaria and dengue control in the region from Southern Mexico through Panama.

Interesting job facts: I work with Gates fellows like William Foege, former director of the Centers for Disease Control and Prevention and leader in the eradication of smallpox, and Peter Piot, former executive director of UNAIDS: The Joint United Nations Programme on HIV/AIDS and under secretary-general of the United Nations.

Global health philosophy: The goal is to work ourselves out of a job. I truly believe that someday the field of global health development will not exist because all countries will have the capacity and resources to better the health of their own populations.

SPH studies as career prep: My studies at the SPH gave me the foundation I needed to get started on my career in global health. I can’t say it was any particular class or area, because I find more and more that everything overlaps and needs to be integrated fully—research, implementation, evaluation, epidemiology, policy, and advocacy—it is all necessary. For me, the global piece came from several years of field experience in a developing country. I think that is the only way to really understand the issues people face in improving their own health and that of their families.

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Upcoming SPH Reunions

The school will host reunions in conjunction with national public health conferences.

June 25, 7 p.m.

Society for Epidemiologic Research Hyatt Regency Orange County Anaheim, Calif.

June 29, 7:30 p.m.

AcademyHealth’s Annual Research Meeting Mercat a la Planxa restaurant Chicago, Ill. For more information, contact Michelle Lian-Anderson at liana001@umn.edu.

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Notes from the Field

Read SPH student blogs from abroad at www.sph.umn.edu/notes09.