Advances - Winter 2010 by publichealthmn

advances Winter 2010

f r o m t h e U n i v e r s i t y o f M i n n e s o ta S c h o o l o f P u b l i c H e a lt h

Beyond “what’s for dinner? ”

Asking bigger questions about food

> Casual Sex: Surprising Findings > Tailgating Leads to Trouble >

Making Over a Minnesota Town

> Cooking up Healthy Lives

from the dean School of Public Health Leadership

Judith Garrard Senior Associate Dean for Research and Academic Affairs Debra Olson Associate Dean for Education 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

John Connett Head, Division of Biostatistics Bernard Harlow Head, Division of Epidemiology and Community Health

Dear Friends, Food has become our favorite four-letter word, as you will come to understand by reading the cover story, which highlights the depth and breadth of our research and expertise on the issue. From farm to fork, our food experts play a role in everything from food safety to obesity prevention.

Ira Moscovice Head, Division of Health Policy and Management William Toscano Head, Division of Environmental Health Sciences Joe Weisenburger Chief Administrative Officer/Chief Financial Officer

advances Editor Diana Harvey Managing Editor Kristin Stouffer Contributing Writers Martha Coventry Nicole Endres Lindsey Heffern Art Direction Cate Hubbard Design cat7hubb@gmail.com Advances is published four times a year by the University of Minnesota School of Public Health. To submit comments, update your address, or request alternative formats email sphnews@umn.edu.

The SPH has been particularly active on the food front during the last several weeks: The U.S. Department of Homeland Security renewed the University of Minnesota’s funding for our National Center for Food Protection and Defense (NCFPD), totaling nearly $20 million over six years. The NCFPD is an international consortium of academic, private, and public-sector partners. On campus, SPH faculty members work with colleagues from the College of Veterinary Medicine and the College of Food, Agriculture, and Natural Resource Sciences on projects associated with the NCFPD. The University hosted a visit by Jacques Diouf, director general of the Food and Agriculture Organization of the United Nations. The U of M is heavily invested in food-related research and advocacy, and we took the opportunity to showcase our work in an effort to partner with the United Nations on global food initiatives. The Robert Wood Johnson Foundation-funded Healthy Eating Research program, led by SPH professor Mary Story, was asked to share findings with White House staff. First Lady Michelle Obama recently launched a childhood obesity prevention program called “Let’s Move,” and President Obama has assembled a taskforce on childhood obesity. We are pleased and proud that our research will be translated for broad consumption (sorry, couldn’t resist). Closer to home, our alumni and students are making meaningful contributions to issues surrounding food. Read their stories on pages 7 and 15. Please make plans to join us at our third annual Alumni and Friends Scholarship Gala the evening of April 1. We are thrilled to welcome internationally renowned inventor Dean Kamen as our keynote speaker. The event is a wonderful opportunity to re-connect with old friends, greet your favorite SPH professors, and support our students, tomorrow’s public health leaders.

Yours in health,

Printed on recycled and recyclable paper made in Minnesota with at least 10 percent postconsumer material.

John R. Finnegan, Jr., PhD Assistant Vice President for Public Health Dean and Professor © Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer.

Photo by richard anderson

John Finnegan Dean

Winter 2010

contents

Features 2 Beyond “What’s for dinner?” Asking bigger questions about food

Eating right has become complicated. Now more than ever, Americans are grappling with the complex issues that surround food. SPH experts weigh in on the political, scientific, societal, and environmental challenges that confront us at the table.

7 Prescription for Change SPH alum Ellie Zuehlke works to bring healthy foods to a network of hospitals and clinics.

Departments 8 Research News

16 Alumni News

More breast cancer patients opting for mastectomies; revealing drinking trends at pro sporting events; car recycling goes nano; and more.

Another SPH alum brings home a Baldrige; class notes; and more.

10 School News Stimulus funds lead to new research lines; renowned inventor headlines scholarship gala; longevity lessons from a Minnesota town; and more.

Special Insert Donor and financial information for the 2008-2009 fiscal year.

14 Student News A chef’s love of cooking fuels her passion for public health; and Crystal Liu studies the intriguing intersection of law and health.

Beyond

“What’s for dinner? ” Asking bigger questions about food SPH experts explore the complicated issues around how to eat better, together, more safely, and as a global community.

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e’ve just emerged from the “food decade.” In the last 10 years, entire food broadcast networks have sprung up, journalist-turned-professor and bestselling author Michael Pollan reached food superstar status, the Farm Bill moved from wonkish obscurity onto the front page, and organics became big business. Americans continued to ask, “What’s for dinner?” but they wanted to know what was in that dinner, how it was grown or raised, how far did it travel, was it safe to eat, and what kind of profits did it generate and for whom. All these things will be just conversation starters for the decade to come as health researchers, scholars, and average citizens look more closely at food, especially in the context of politics, policies, and human rights, issues the School of Public Health has been concerned with for years. The school’s faculty is tackling more nuanced issues as well, like food access and food choice, why family mealtimes matter, how we can enhance the security of food, and whether we can sustainably and wisely manage our global food systems. When it comes to food, SPH faculty quickly move from being academics to becoming advocates. They’re working to assure that everyone has the right to safe and healthy food, and the ability to make choices about what we eat.

Finding oases in food deserts “Public health has always been concerned about prevention and health equity,” says SPH epidemiology professor Mary Story. “But you’re seeing more attention now focused on food access compared to other [equity] areas like health insurance or health coverage.” Story is one of the nation’s top food experts and her research has had a direct influence on national food policies and the entire food research agenda. She served on Institute of Medicine panels on school lunches and marketing food to young people, convenes an annual meeting of top food researchers, and is head of a major Robert Wood Johnson Foundation initiative on healthy eating. Recently, she and colleagues Nicole Larson and Melissa Nelson Laska have been exploring what it means to people’s health to live where immediate access to nutritious food is limited. These areas, known as “food deserts,” are more common than you think in inner cities. Grocery stores have long moved out of these lowor mixed-income neighborhoods because of changing demographics, loss of profitability, and crime. What remains are gas stations, convenience stores, and fastfood outlets, all with a preponderance of high-calorie

processed food and a paucity of fresh produce. Since large supermarkets are many blocks away, a lack of transportation can present a significant barrier to eating a healthful diet. That these neighborhoods have the highest proportion of city residents with food-related illnesses, like high blood pressure, heart disease, and obesity, may correlate with limited access to fruits and vegetables and easy access to fast food outlets or convenience stores. “Inequalities in food access make it more difficult for families to bring home healthful foods and beverages, putting their children at risk for problems like iron deficiency and poor school performance, and for chronic diseases later in life,” says Larson. But this is not a problem without solutions. “The presence of each additional supermarket,” Larson says, ”is related to a 32 percent and 11 percent increase for blacks and whites, respectively, in meeting guidelines for fruit and vegetable intake.” Because of research like this, cities all over the country are recognizing the major impact the food environment can have on health, and they are trying to persuade supermarkets, through tax and zoning incentives, to move into neighborhoods with limited food access. In Minneapolis, the Institute of Agriculture and Trade Policy (IATP) has helped set up mini farmers markets in food vulnerable parts of the city. Statistics gathered in 2006 show that vegetable consumption was up 20 percent among patrons of these markets during the growing season. And last summer, a Minnesota law went into effect requiring the 525 stores statewide, many of them convenience stores, that are approved to accept Women, Infants and Children’s (WIC) food assistance coupons to stock at least five varieties of fresh produce, and seven varieties if they’re in the metro area.

Choosing healthy foods Choosing the right foods is a problem that besets most Americans. Even if we have money, access to good stores, and knowledge about nutrition, we will make our choices based on whims and memory, comfort and taste, and a host of influences we ourselves don’t even recognize. For epidemiology professor Simone French, who has extensively researched how to steer people toward healthier food, why we choose the foods we do remains a mystery. “We don’t know what ultimately drives choice,” she says. “It’s not just education, it’s not just income,

political support behind our work, the research “It turns out will just sit there going nowhere,” says “If you do have political support that a good way to French. the seemingly insurmountable barriers to influence food choice change get solved quickly.” is to offer more healthy Living with risk If we’re going to eat fresh fruits and food choices and vegetables, or any food, we want to know it’s safe. But here’s the rub: according fewer unhealthy tothat food safety expert and SPH faculty member Will Hueston, “safe food” is an oxymoron. ones.” “There is no food that we know of that has zero

it’s not just availability. It’s not just anything.” French examines three things she knows can play a part when we choose certain foods—availability, pricing, and promotion. Much of her research involves young people who need to form good eating habits early to help avoid chronic disease later on. French has been looking at what are called “competitive” or “à la carte” foods in secondary school lunchrooms. These are foods the school sells as additions to the National School Lunch Program, and for many students, these high-caloric, high-fat selections are lunch. French’s research is the first to use these competitive foods as the focus of school-based nutrition interventions. But if healthier options were offered à la carte, would students buy them? To see if price might play a part, French reduced the cost of fresh fruit and baby carrots by 50 percent in two secondary school cafeterias. The result was a fourfold increase in fresh fruit sales and a twofold increase in carrot sales. In a second project, the TACOS (Trying Alternative Cafeteria Options in School) study, she wanted to see if students would make healthier choices if those choices were promoted. “We worked with 20 high schools in Minnesota to see if students would buy healthy foods in the cafeteria if we increased their proportion to other foods,” French says. “Some people [in the schools] said that it would be a waste of money and that we could put out 50 healthy choices and the students would continue to buy only the chocolate chip cookies.” They were wrong. “It turns out that a good way to influence food choice is to offer more healthy food choices and fewer unhealthy ones,” says French. To implement some of the findings about price and options in the real world, with its reluctance to change, may demand political intervention, French says. “We can do all the studies we want, but if there’s not the

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risk,” says Hueston. “What’s required [to lower the threat] is a continuous commitment to safety from the farmer, the food processor, the restaurants, the supermarkets, and the consumer.” The threat of food-borne infections is real. They cause more than 5,000 deaths and 300,000 hospitalizations each year. Minnesota leads the way nationwide in aggressively tracking down food-borne disease patterns through a collaboration among SPH experts and Minnesota’s departments of health and agriculture. Environmental health sciences professor Craig Hedberg specializes in food-borne illness surveillance and works to get other states to replicate this Minnesota model. In the past decade, says Hedberg, vehicles for infection have often been fresh fruits and vegetables—a source of salmonella, e. coli 157, and norovirus—and a place we wouldn’t have thought to look 20 years ago. “We are eating more fresh fruits and vegetables. We haven’t hit our target yet, but we’re doing a better job, so there’s greater demand,” says Hedberg. “We

Web Extra Watch a video on “Team D,” the SPH student supersleuths who help track down food-borne illness outbreaks. www.sph.umn.edu/teamd

Your mother was right There’s no substitute for eating your fruits and vegetables

The unexpected power of the dinner table Family meals = emotionally healthy adolescents “Eating together as a family is the best thing you can do for your children,” says epidemiology professor Dianne Neumark-Sztainer. Her groundbreaking study of adolescents, Project EAT (Eating Among Teens), backs up that assertion. Its findings have been part of more than 200 articles published in major peer-reviewed scientific journals. Here’s what it found: • Frequent family meals protect against low grade-point average, depression, and suicide—particularly among adolescent girls. • F amilies who routinely eat meals together also read together and devote more time to homework. •A s the amount of family meals together goes down, the percentage of students engaging in risky, including sexual, behavior goes up. •O f teens who shared at least 7 meals per week with their families, 17 percent of the girls and 22 percent of the boys smoked. Out of students who did not share any meals per week, 50 percent of the girls and 36 percent of the boys smoked. The results are similar for alcohol and marijuana use. Project EAT > www.sph.umn.edu /eat

Epidemiology professor David Jacobs’ message is clear: when it comes to advising people what to eat, focus on the food, the whole food, and nothing but the food. In his research, Jacobs analyzes the data from three studies, including the landmark Iowa Women’s Health Study, to look at diet and events. If it emerges, for example, that few people who regularly ate broccoli got cancer, he can say (after correcting for variables) that broccoli may have a protective effect against cancer. We can break broccoli down into all its elements but we shouldn’t, according to Jacobs, use those elements to advise people what to eat. “We know broccoli contains isothiocyanate,” he says. “We also know from laboratory studies that this element inhibits cancer cell growth. But we don’t want to tell people to go out and take iosothiocyanate supplements to prevent cancer. We want to tell them to eat broccoli.” It’s important to remember that we don’t know the whole story when it comes to how different elements and chemicals work together in a food, says Jacobs. Maybe isothiocyanate needs to be in concert with other elements in broccoli to do its work. People, he believes, would do a lot better to eat whole foods and get the nutrients from that food as they are naturally occurring and working together.

Collective action for food security Creating an international leadership network To make sure each person on the planet has decent and reliable sources of nutrition, says Will Hueston, we need diverse food systems, robust supply chains, enforceable safety standards, and guaranteed access and affordability. A tall order, especially as the population grows, but Hueston, a veterinarian, food safety expert, and professor in the School of Public, believes a new model of collaboration can make it possible. Hueston directs the Global Initiative for Food Systems Leadership (GIFSL), a first of its kind public-private-academic partnership that helps organizations and individuals— from Chinese officials to small farmers in Ecuador—develop the skills, expertise, and confidence to create safe and sustainable food systems. It also teaches a nontraditional concept of leadership. Leadership, in GIFSL’s work, is not an individual quality, but a collective effort. It entails people working together and using their knowledge and commitment to make change and influence policy. “We need to help people learn to take collective actions in their own countries,” says Hueston. Through the people it works with literally all over the map, GIFSL hopes to develop an international leadership network. Such an alliance could bring to bear its experience and expertise to help ensure what the United Nations, World Health Organization, and other organizations around the world consider a basic human right—the certainty of “an adequate supply of safe, affordable, nutritious food.” GIFSL > www.foodsystemsleadership.org

To make sure each person on the planet has decent and reliable sources of nutrition, we need diverse food systems, robust supply chains, enforceable safety standards, and guaranteed access and affordability.

Food terms to watch (and watch out) for One food item can carry all three labels, but they’re not interchangeable LOCAL—Some people define food as local if it is raised, grown, or made within a 50-mile radius, others use 100 miles or more as a marker. Buying local keeps dollars closer to home. The label also carries the image of sustainable, small enterprises, but big business has caught on to its marketing potential. So keep an eye on who’s using the term. ORGANIC— Your organic food might come from across the St. Croix River or from China, but, for now, you can still be sure that the label means the growers do not use chemical pesticides, herbicides, or fertilizers on their crops and growth hormones or antibiotics with their animals. SUSTAINABLE—It’s as simple as “don’t take out more than you put back in.” Sustainable farming practices minimize damage to the surrounding ecosystem and protect the long-term health of soil, water, forests, and grasslands. Economic sustainability is also gaining ground as a significant marker of a socially responsible farm.

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have larger production farms that can efficiently grow and ship produce around the country. That matters because if a problem occurs, it’s a bigger problem— we’re more liable to see it.” As an example, Hedberg cites the 2006 outbreak of e. coli 157 that was associated with bagged baby spinach. “That was essentially a nationwide outbreak not because of the scale of production, but because we had an efficient system of [nationwide] distribution,” he says. Hedberg is quick to point out that if people switch to local vegetables, rather than those from further afield, to avoid food-borne illness, they will get a false sense of security. “Anytime you’re using fresh produce or you’re raising animals nearby, chances are you can have some contamination,” says Hedberg. “We want to see a robust local produce industry in Minnesota, but it has to be developed with the knowledge that our animal populations present the same hazards as they do in California.” It has been more than 50 years since SPH professor Ancel Keys suggested that a diet rich in plant food and low in saturated fats is protective against disease. His “Mediterranean diet” may still be the ideal prescription for healthy eating, but there are scores of things that keep us from embracing it, like poverty, ignorance, lack of accessibility, and the simple urge to eat what makes us if even for a moment, happy—the high-fat,high-sugar products we crave. When it comes to food, SPH research can help us choose better, stay safe, form good habits in our children, make sure everyone has enough, and most of all, understand the most basic and pleasurable, yet often confoundingly complex, act of eating.

Web Extra Learn about stove-top interventions, the danger of care packages, and other foodrelated insights. www.sph.umn.edu/food

Prescription for change

Photo by Darin Back

SPH alum Ellie Zuehlke leads an effort to bring healthier foods to Allina’s employees and patients. As director of community benefit, Ellie Zuehlke is focused on connecting with the world outside of Allina Hospitals and Clinics. But she was just a few months into her job at the large health system when she noticed something unsettling about the community within Allina. “I was struck by how much food there was at meetings and other work gatherings, and I was surprised by how unhealthy it was,” says the 1999 public health administration grad. Food offered at Allina’s 11 hospitals and 85 clinics wasn’t any better. Cafeterias served sugary drinks with fatty, deep fried meals. And patients entering Abbott Northwestern Hospital were greeted by the Golden Arches of McDonald’s. Added to the irony of being an organization charged with making people healthier was data showing that when compared to other similarly sized businesses, Allina’s 23,000 employees were more likely to be heavier and less likely to meet daily nutrition guidelines. So Zuehlke teamed up with colleagues to create Allina’s healthy food taskforce. After just a couple of years, the group has implemented a series of small changes that have added up to a healthier food environment. Now the fare at meetings includes a healthy choice. Some cafeteria foods and beverages are labeled “Be Fit” based on accompanying nutrition information. And portions have been scaled down. A grant from Blue Cross and Blue Shield of Minnesota will help evaluate the impact of the changes. A big challenge has been accounting for diverse settings with multiple vendors. For instance, what works at a large Minneapolis hospital such as Abbott doesn’t always work for a small hospital in Owatonna, Minn. To help navigate, Zuehlke’s team turned to SPH research on improving food environments. “We realized we have some tremendous resources right in our own backyard,” she says. Even though she didn’t study food policy or nutrition, Zuehlke relied on her public health background to make a case for investing in the taskforce. “A key takeaway from school is that environment really matters. It’s such a fundamental principle of public health,” she says. “That knowledge helped me to show others that this is something we should do.”

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research news

Investigating nano dangers in auto recycling Not long ago, unwanted cars were stripped, crushed, and left to rust at the local junkyard. Now most car parts are recycled, and the business has gone high tech. The shift mirrors the high-tech nature of cars themselves, with more and more parts being manufactured with nanotechnology. Nanocomposites— plastics made with nanomaterials smaller than one-ten-millionth of a meter in one dimension—are used to make fenders, bumpers, and other parts that are extremely strong yet lightweight. But what happens to nanomaterials when parts are shredded for recycling? SPH assistant professor Pete Raynor set out to learn more in a study funded by the U.S. Council for Automotive Research. With growing health concerns over these largely untested materials, U.S. automakers have a stake in ensuring their safety.

“ Now [automakers] have comfort that they aren’t, to the best of their knowledge, going to create problems for workers or the environment.” Raynor’s team worked with engineers at Argonne National Laboratory to simulate the recycling process for a specific nanocomposite used in cars and then measured particle concentrations in the air. The team didn’t find any evidence that the recycling process released airborne nanomaterials. “Actually, the ambient air generally had higher levels of nanoparticles than the air we tested,” says Raynor. Raynor is pleased that the auto industry is supporting this sort of safety research, especially considering that car parts manufactured now won’t likely be recycled for at least another 10 years. “It’s pretty forward thinking,” he says. “Now [automakers] have comfort that they aren’t, to the best of their knowledge, going to create problems for workers or the environment.”

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Mastectomies on the rise for breast cancer patients More and more women with cancer in one breast are choosing to have the healthy breast also surgically removed, find University of Minnesota researchers. The news adds to a growing body of evidence that contralateral prophylactic mastectomy (CPM) is on the rise in the United States. The trend is concerning because CPM does not improve survival from breast cancer, but rather only helps prevent another type of cancer in the other breast. And this strategy can bring complications to patients, especially those who opt for immediate reconstructive surgery to create new breasts. This study—led by U of M cancer surgeon Todd Tuttle and designed by SPH professor Beth Virnig—goes a step further by being the first to analyze the patient and surgeon characteristics associated with CPM. The researchers studied the records of 571 Twin Cities patients who underwent mastectomy for breast cancer in 2006 and 2007. They found that age was a major indicator, with 46 percent of patients under the age of 40 choosing CPM, compared with 13 percent of patients older than 70. Women who opted for the aggressive treatment tended to have larger tumors, a family history of the disease, and a female surgeon. Researchers aren’t sure why, but surgeon gender was one of the strongest predictors of CPM use, with females performing the surgery at double the rate of males. The team stresses that more research is needed to confirm the finding.

Tailgaters most likely to drink above the legal limit In the first study on alcohol consumption at professional football and baseball games, SPH researchers have found that young people and tailgaters are the most likely to have blood alcohol concentrations (BAC) above .08, the legal limit in Minnesota. The researchers collected BAC tests from fans leaving pro football and baseball games. Over the course of 16 different games, 362 BAC tests and surveys were collected. The team found that 40 percent of the participants had a positive BAC reading, and 8 percent were over the legal limit. Age was a major factor, with those 35 or younger being nine times more likely to be legally drunk. Tailgaters were six times more likely to have a positive BAC and 14 times more likely to be above the legal limit. While only 18 percent of the study participants reported that they had been tailgating, half of all BACs above the legal limit were from tailgaters. Whether the study participants drove after the game is unknown, but the sheer numbers indicate that policymakers should consider beefing up law enforcement in the parking lot before the game and on the roads afterwards. “Our findings suggest that about 5,000 people leaving one NFL game would be above the legal BAC limit,” says SPH assistant professor Darin Erickson. “With some 130 million pro sports attendees a year, it’s a major public health issue.”

Casual sex and youth: surprising findings

Did you know? SPH experts partner with U colleagues from virtually all disciplines. For instance, SPH biostatistics faculty members and students are working with brain researchers to develop new methods to screen and monitor treatment for neurodegenerative diseases. The team is studying whether an MRI technique called spectroscopy can detect a specific neurodegenerative disease in its earliest stages. It’s work that may someday be used to fight Parkinson’s disease, dementia, and other progressive disorders. Read more at www.sph. umn.edu/brain.

Casual sex does not cause emotional or psychological distress for young people, finds SPH researchers. The study began with the expectation that casual sex would be associated with higher rates of depression, more suicidal thoughts, and lower self-esteem. But after analyzing the responses of 1,311 young Minnesotans, there was no difference among those who engaged in casual sex and those in committed relationships. “We were so surprised,” says Marla Eisenberg, SPH assistant professor and lead researcher. “The conventional wisdom is that casual sex, ‘friends with benefits,’ and hooking up is harmful. That’s what we’ve been teaching kids for a decade.” But the takeaway message isn’t that casual sex is OK—there are significant physical risks. “When talking about sex with teens, we should focus on the real threats, such as violence, unintended pregnancy, and STDs,” says Eisenberg. The survey-based study is part of Project EAT, an ongoing research project on adolescents and nutrition. Participants were questioned about their sexual behaviors and emotional well-being. All the respondents, aged 18 to 24 years, said they were sexually active. Referring to their most recent sexual encounter, 55 percent said it was with an exclusive partner; for 25 percent it was a spouse, fiancé, or life partner; for 12 percent it was a close but not exclusive partner; and for 8 percent it was a casual acquaintance. 9

school news Join the Public Health Institute May 24-June 11 Registration is open for the 2010 Summer Public Health Institute. The annual three-week offering of courses, field trips, and other educational opportunities draws participants from throughout the world. From public health fundamentals to emerging issues, courses are organized around nine focus areas, shown on the right. The institute will also offer free lectures, open to the public. Topics include connecting leadership development and neuroscience, careers in public health, and using design to influence health.

•A pplied Biostatistics and Research Methods

• Infectious Disease Epidemiology

• Culturally Responsive Public Health Practice

• Public Health Leadership and Management

• Environmental Health Sciences

• Public Health Preparedness, Response, and Recovery

• Food Protection

• Woman and Child Health and Nutrition

• Global Health

Learn more at www.sph.umn.edu/ce/institute.

Scientific discovery will inspire at SPH scholarship gala Innovation and scientific exploration are key components to pushing the threshold of achievement in public health. That notion has fueled Dean Kamen to become one of the country’s top inventors, and it is a message he will bring to his keynote address, “Innovation and Health Care Reform,” at the third annual Alumni and Friends Scholarship Gala on April 1. Kamen, a physicist, holds more than 440 U.S. and foreign patents, many of them for medical devices. Time magazine called his nonpolluting water-purifying system designed for use in the developing world one of the “coolest inventions of 2003.” Other notable devices include a wearable insulin pump for diabetics, a portable dialysis machine, and a self-balancing wheelchair that climbs stairs and navigates curbs—technology similar to what is perhaps Kamen’s most recognized creation, the Segway transporter.

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His latest breakthrough is a robotic prosthetic that virtually reacts to the user’s thoughts. The first two galas raised more than $100,000 for the SPH Alumni Scholarship Endowment. The funds come at a time when state support has never been so precarious. “Now more than ever, alumni and friends of the school will play an instrumental role in providing an affordable, top-notch education for future leaders in public health,” says Brigid Riley, president of the SPH Alumni Society Board. As in years past, all funds raised at the gala will go directly to student scholarships. Tickets are $60 and can be purchased at www.mmf.umn.edu/sph. A $40 ticket can be donated so that SPH students can attend. The gala will begin at 5:30 p.m. near the U’s Minneapolis campus. To learn about how to support SPH scholarships, contact Adam Buhr at a.buhr@mmf.umn.edu or 612-626-2391.

Recognizing stars on the frontlines of public health Amy Brugh is one of many community partners honored by the school.

Community Partner Star awards honor individuals making exemplary contributions to the mission of the SPH. Winners from 2009: Ken Bence (MHA ’92) Terry Bernhardt Jean Bey (MPH ’87) Mark Boye Amy Brugh (MPH ’99) Jim Chase (MHA ’83) Tamara Downs Schwei Kristen Ehresmann (MPH ’90)

Photo by Paula Keller

my Brugh is the kind of alum that every school hopes for—she’s an advocate, a leader, and invested in her alma mater. That’s why the SPH honored her with a Community Partner Star award last year. As public policy director at the Minnesota AIDS Project, Brugh works diligently to prevent HIV infections and improve the lives of people living with HIV/AIDS. She also educates legislators about the issues surrounding the disease, so they can create effective public policy. Brugh relies on the SPH as an important part of her network. “Nonprofits like the Minnesota AIDS Project should partner with the school, so that we can learn from each other, do our work better, and generate improved public health outcomes,”she says. Like many SPH Community Partner Stars, Brugh finds time to keep an active role with the school, working with students in the mentor program and sharing new research findings with colleagues. It’s not just Brugh who values this connection though. For decades, the SPH has been committed to building partnerships with exceptional professionals and celebrating their noteworthy contributions. This is why Debra Olson, SPH associate dean for education, helped to establish the Community Partners award program in 2004. “Our community partners act as an important link between research and practice,” says Olson. “Thanking the leaders who strive to bring new research from the school into the workplace can only strengthen the initiatives of the school and the field of public health.”

Nancy Eitler Joan Griffin Larhae Knatterud Deb McKinley (MPH ’00) Jerry Nye (MHA ’77) Scott Redd Kathleen Schuler (MPH ’83) Emily Wang (MPH ’03) David Zanick (MPH ’74)

Community Partner awards go to outstanding organizations and individuals. Winners from 2005 to 2009: Minnesota Public Health Association, 2005 HealthPartners Research Foundation, 2005 Bell Institute of Health and Nutrition; General Mills, 2006 Allina Community Benefits Committee; Park Nicollet Institute, 2006 Will Hueston, 2006 UnitedHealth Group, 2007

Neighborhood House, 2007 Minnesota Health Commissioner Sanne Magnan, 2008 Cultural Wellness Center, 2008 Minnesota Pollution Control Agency, 2008 Mercy Health System, 2009 Team Diarrhea; Minnesota Department of Health, 2009

Above: Amy Brugh with a Minnesota AIDS Project display showing compelling evidence of the health care needed to treat HIV/AIDS.

school news

SPH experts team up with National Geographic explorer to make over a Minnesota town.

an Buettner has traveled the world on a quest to find what he calls Blue Zones, places where people live long, healthy lives. Over the past decade, the famed explorer found these longevity hotspots scattered around the globe, in Italy, Japan, and Costa Rica, among other places. After writing a bestselling book about his adventures, Buettner decided to help a community closer to home get healthier. He reached out to AARP and the United Health Foundation. Next, he called on the School of Public Health. “It’s clearly one of the top public health schools in America, and it was my first choice when seeking an academic partner,” says Buettner. “When Blue Zones was just an early idea, [SPH] faculty were very generous with their time, helping to evolve the concept.” SPH experts helped Buettner choose Albert Lea for what came to be known as the Vitality Project. The southern Minnesota town is statistically normal in that it hits American averages of health indicators like obesity, cancer, and cardiovascular disease. The project launched last January by inviting Albert Lea’s 18,000 residents to calculate their life span through 36 lifestyle questions. The online tool, known as the Vitality Compass, was designed with the help of SPH professor Robert Kane, an expert in aging. Twenty percent of the townspeople participated in the 10-month project, which called for simple changes to the way

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“ It was amazing. All these changes were coming right from the community in a real, organic way. This project showed me that we [researchers] can be part of change instead of just pointing to the direction of change.” – Leslie Lytle, SPH professor

“It was amazing. All these changes were coming right from the community in a real, organic way,” says Lytle. “This project showed me that we [researchers] can be part of change instead of just pointing to the direction of change.” Now, larger cities want to be a part of that change. Along with his new partner, Healthways, Buettner is taking applications from U.S. towns of more than 100,000 for the next Vitality Project. Again, the focus will be tailoring the concepts to a unique community. “You can’t just hand a city a manual. This work takes a highly trained team,” says Buettner. “It’s a cycle of innovation.” Above: SPH professor Leslie Lytle talks school lunch with kids in Albert Lea, Minn.

Photo by Allen Brisson-Smith

Vitality project adds three years to participants’ lives

the residents eat, work, exercise, and socialize. SPH professor Leslie Lytle worked with schools to encourage more fruits and vegetables, and discourage junk food, especially for fundraisers, incentives, and events. She visited workplaces to advise on making environments healthier. And she brought the concept of “walking school buses” to the project. By the time the work concluded in October, participants had tacked on an average of three years to their life expectancy. Nearly 70 percent of restaurants had added healthy fare to menus. Some 600 residents had joined walking groups, collectively tallying more than 37,500 miles. Participants had cut estimated health care costs by 48 percent. And new community gardens, sidewalks, and bike lanes had been created. Both Lytle and Buettner say working with the community to create long-lasting change is the biggest success of the Vitality Project. For Lytle, that idea rang true at the final town meeting, where the city dedicated a new Vitality Center to the community. On the spot, AARP and the United Health Foundation pledged funds to support it. The next day, a community clinic followed suit.

SPH researchers awarded $12M in stimulus funds School of Public researchers have been awarded $12 million for 21 research projects through funds authorized under the American Recovery and Reinvestment Act. The projects will examine a host of public health issues, from preventing common and rare cancers, to understanding alcohol’s connection to violence, to promoting healthy eating among teens, to managing nuclear power. At $6 million dollars, the largest amount of stimulus funds went to SPH professor Robert Kane to support three years of work at the Minnesota Evidence-based Practice Center, which provides scientific findings to improve the delivery of health care. Another large sum, $1.6 million, went to SPH professor Jim Neaton, who leads an international

network of HIV researchers. Three SPH researchers were awarded “Challenge” and “Grand Opportunities” grants. Both grant programs are new National Institutes of Health (NIH) initiatives aimed at quickly advancing research that would benefit from shortterm funding. The challenge grants were highly competitive; The NIH received more than 20,000 proposals and awarded only 840 grants. Challenge grant recipient Alvaro Alonso will investigate the causes of a heart disease called atrial fibrillation, the most commonly diagnosed heart arrhythmia. Sudipto Banerjee will investigate how climate change affects health risks such as asthma, skin cancer, and food-borne diseases.

Health informatics expert Julie Jacko (also appointed in the School of Nursing) received a Grand Opportunities grant to build an information technology infrastructure that will leverage a network of personal health records for large epidemiological and genetic studies.

Using music to demonstrate the importance of collaborating, improvising, and thinking creatively was the focus of an exercise for the inaugural class of the Executive Master of Healthcare Administration (MHA) program. The new 25-month program brings students to campus for up to eight days each January and four days each August. The remainder of the curriculum is delivered online. One third of the class of 33 are physicians, and one third have post-graduate degrees. The students come from across the United States and Europe.

student news

Where health meets law A joint MPH/JD expands concepts and career opportunities for Crystal Liu.

he intersection of health and law grabbed Crystal Liu’s attention when she was an undergrad at the University of California, Berkeley. After spending a year in Australia studying the regulation of assisted reproductive technologies as a Fulbright Postgraduate Scholar, Liu in 2006 enrolled in the MPH/ JD joint degree program in public health administration and policy and law at the University of Minnesota. She felt that the cross-disciplinary program would be a great way to nurture her interests. The MPH/JD joint degree program, a partnership between the University’s School of Public Health and Law School, trains creative thinkers to bridge the gaps between ever-advancing health science and related laws and policies. Students can complete both degrees in four years—instead of the typical two for an MPH and three for a JD—by taking classes in epidemiology, biostatistics, and constitutional law, as well as health policy, public health law, and health law. As a University student, Liu has been able to take advantage of the many opportunities offered through the program and continues to work on issues that intrigue her. “My education through the joint degree program has taken me on an amazing intellectual journey,” she says. For instance, Liu wrote an article

“ My education through the joint degree program has taken me on an amazing intellectual journey. I am excited about the opportunities that I will be able to pursue in the future, and I feel that my education has prepared me to work in a number of fields.” published by the Minnesota Journal of Law, Science and Technology on whether access to infertility services should be regulated. She studied the health care policies of leading presidential candidates and the implications of new Centers for Medicare and Medicaid Services rules. Liu most recently received an award from the University’s Consortium on Law and Values in Health, Environment, and the Life Sciences. The stipend that came with it enabled her to go back to Australia for four months in 2009 to pursue an independent research project in close collaboration with the Victorian Assisted Reproductive Treatment Authority. The research she conducted there

Scholarship matching programs double impact SPH students continue to benefit from two scholarship matching programs. The President’s Scholarship Match and 21st Century Graduate Fellowship Endowment double the impact of newly endowed scholarships for students completing their PhD, MPH, MS, and MHA degrees. The matching programs have invigorated SPH donors, who have endowed 11 new scholarships during the past year. Through these programs, the income from newly endowed scholarships is matched by funds from the University, doubling the impact of donors’ gifts and the support provided to students. To learn more, call Adam Buhr at 612-626-2391.

14 University of Minnesota School of Public Health

will form the basis of her master’s thesis, which focuses on the rights of donorconceived children and their ability to access identifying information about their donors. Liu also received financial support from the Lee and Donna Stauffer Scholarship. Lee Stauffer served on the SPH faculty for 36 years, 12 of which he spent as dean. Following his retirement in 1991, Lee and his late wife, Donna, both MPH alumni, took their advocacy to the next level by establishing a scholarship fund. The Stauffer scholarship supports students who are pursuing a master’s degree in public health, with preference given to those in the Public Health Administration and Policy program. Liu is finishing her last classes as a visiting law student at Rutgers University and is completing her master’s thesis. She’ll take the Minnesota bar exam in July, and at the end of the year she’s planning to move to Washington, D.C., to start a new job with the law firm Hogan and Hartson LLP, where she’ll be working in the government and regulatory practice group. “I am excited about the opportunities that I will be able to pursue in the future,” Liu says, “and I feel that my education has prepared me to work in a number of fields.”

Food for thought Chef Jenny Breen believes that in America’s fight against obesity, we’ve lost sight of a fundamental strategy—cooking.

Photo by Darin Back

Jenny Breen has donned virtually every chef hat imaginable: restaurant owner, caterer, cooking instructor, mother, health advocate, and cookbook author. Through it all, she has promoted local, sustainable foods. From 1996 to 2001 it was a tenet of her Minneapolis-based Good Life Café and since then of her catering company. And it’s a notion at the heart of every lesson she brings to adults and kids alike as an instructor for the Minnesota Landscape Arboretum and the U’s College of Continuing Education. “It’s not satisfying for me to just be cooking,” says Breen, “I’ve always looked for a way to combine food and education, to give people skills to improve their health. . . . At some point, I realized I needed to learn more about how to do this.” So Breen applied to the master’s program in public health nutrition. She also successfully applied for a competitive fellowship through the Twin Citiesbased Bush Foundation. The fellowship means she can cut down on catering during the school year to focus on her studies. Breen plans to tap her network to build a coalition charged with changing food environments and food education. She’s already talked with a neighborhood clinic on offering cooking classes to families. And she’s working with contacts in St. Paul with the hope of launching a “Lunch Lady Boot Camp” to bring cooking back into school kitchens. Long-term goals include changing the way students themselves learn about healthy eating. “Standing in class and pointing to the food pyramid isn’t enough,” says Breen. “What if graduate-level nutrition students took culinary classes and courses on sustainable agriculture? What if high school students were taught about how to cook with ‘real’ local foods?” In the meantime, Breen’s lessons on preparing simple, seasonal foods may be reaching another audience—through yet another U connection. A cookbook she wrote years ago is under review at the University of Minnesota Press. The title? Cooking up the Good Life.

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alumni news Centennial celebration honors top 100 alumni To celebrate its 100th birthday, the University of Minnesota School of Nursing turned the spotlight on the alumni who have helped bolster the school’s reputation and impact. Out of some 8,500 living alumni, 100 were chosen for their accomplishments. And out of these 100, 19 count themselves as alumni of not only the School of Nursing, but the School of Public Health. Congratulations to: Jeannine Bayard (MPH ’77) John Borg (MPH ’76) Mary Lou Christensen (MPH ’76) Susan Goodwin Gerberich (MS ’78; PhD ’80)

Gayle Hallin (MPH ’77) Mary McDonald Hand (MS ’80) Zorada Hoge (MPH ’62) Rebecca Kajander (MPH ’88) Rozina Karmaliani (MPH ’94, MS ’97) Gretchen Musicant (MPH ’86) Barbara Vinson O’Grady (MS ’73) Debra Olson (MPH ’83) Hyeoun-Ae Park (MS ’86) Lucy Schwartz Sontag (BS ’52) Justine Speer (MS ’63) Susan Strohschein (MS ’80) Esther Tatley (MPH ’84) Eva Mae Vraspir (MS ’72) Mary Berger Wellik (MPH ’89)

Apply now to become an SPH alumni board member The SPH Alumni Society Board is seeking new members. Applications are being accepted until March 29. Members attend bi-monthly meetings, serve on a board committee, and are encouraged to mentor SPH students. Learn more at www.sph.umn.edu/alumni/board. Stay involved, stay informed Network with classmates, volunteer to mentor a student, or sign up for our alumni e-publications. You can decide how you want to connect to the School of Public Health. www.sph.umn.edu/alumni

Baldrige awards keep coming for SPH alumni For the fourth time, an organization led by an SPH alum has been awarded the Malcolm Baldrige National Quality Award. The prestigious award is given to a cadre of organizations annually by the President of the United States and is the nation’s highest honor for quality. Winners over the years have included AT&T, Cargill, 3M, and Boeing. One of the 2009 winners is Heartland Health, based in St. Joseph, Missouri, an organization led for more than 20 years by SPH alum Lowell Kruse (MHA ’67), until his retirement last year. Heartland is regarded as a leader in linking clinical care to community health. Kruse will bring his expertise to the SPH this spring as a visiting senior fellow. This makes four SPH alumni whose organizations have garnered a Baldrige. The others are: •R ichard Hastings (MHA ’77), Kansas City-based St. Luke’s Hospital, 2003; •R ichard Norling (MHA ’75), Premier, Inc., headquartered in San Diego, 2006; and • J avon Bea (MHA ’78), Janesville, Wisc.-based Mercy Health System, 2007 (the first Baldrige ever to go to an entire health system). “Four Baldrige awards in the past six years by our Master of Healthcare Administration alumni speak volumes about the quality of the MHA program itself,” says SPH dean John Finnegan. The MHA program is ranked second in the nation by U.S. News and World Report.

16 University of Minnesota School of Public Health

Class notes Sue Abderholden (MPH ’80) received the Luther Granquist Systems Advocacy Award from the nonprofit organization Arc of Minnesota. She also received a distinguished service award from the Minnesota Council of Child Caring Agencies. The awards recognize her advocacy on behalf of children and adults with mental illnesses. Deborah Caselton (MPH ’09) has become the country director for Uganda through WellShare International (formerly Minnesota International Health Volunteers). She takes over for Paige Anderson Bowen (MPH ’05) who is returning to WellShare’s Minneapolis headquarters as a technical advisor. Jill DeBoer (MPH ’90), Amy Becker LaFrance (MPH ’06), and Natalie Vestin (MPH ’07) have led an initiative to collect best practices around H1N1 response. The project, a partnership with the Association of State and Territorial Health Officials, can be viewed at www.CIDRAPpractices.org. The three are staff members of the Center for Infectious Disease Research and Policy at the U of M. Donald Hamilton (MHA ’70) has joined Parsons as vice president for the commercial technology group, where he will lead the consulting firm’s health care sector. Prior to joining Parsons, he served as the managing director of a global real estate firm’s health care practice. Kristina McElroy (MPH ’09) has been credentialed as a diplomate of the American College of Veterinary Preventive

Medicine. She is an epidemic intelligence officer with the Centers for Disease Control and Prevention in Atlanta, where she works in the Rickettsial Zoonoses Branch. She is also a Captain in the Army Reserves Veterinary Corps.

Maia Dock Seitz (MPH ’05) took a position as a community health specialist with the Hennepin County Public Health Department in Minneapolis. She is working on policy and environmental approaches to improve nutrition in workplaces and schools.

Anil Mangla (MPH ’08) recently met with delegations from Brazil and Columbia as chief lead epidemiologist for the Georgia Department of Community Health, Division of Public Health, in Atlanta. He also designed a clinical trial to improve lead poisoning screenings for children.

Tricia Todd (MPH ’94) received an award for her work as chair of the health administration section of the American Public Health Association’s annual meeting. Todd is assistant director of the Health Careers Center at the U of M.

Stacene Maroushek (MPH ’04) and Randy Mayer (MPH ’96) served on an Institute of Medicine committee that recently released a report on the need to increase prevention of Hepatitis B and C. Maroushek is a pediatrition at the Hennepin County Medical Center and on faculty at the U of M. Mayer is chief of the Bureau of HIV, STD, and Hepatitis at the Iowa Department of Public Health. John Oswald (MPH ’84, PhD ’00) accepted a senior health policy research position at the Centers for Medicare and Medicaid Services in Washington, D.C., where he will work on health reform initiatives. Over the past 28 years, he has worked at HealthPartners, the Minnesota Department of Health, and, most recently, UnitedHealth Group. Cheri Rolnick (MPH ’84) is the new chair of the Minnesota Cancer Alliance, a coalition to reduce the state’s cancer burden. She succeeds SPH associate professor DeAnn Lazovich who steps down as chair after a two-year term. Rolnick is associate director of research for the HealthPartners Research Foundation.

Wendy Wang (MPH ’09) has left Ecolab to start work as a toxicologist with H.B. Fuller in the global regulatory unit. The following SPH alumni have earned the Certified in Public Health credential after successfully completing the exam administered by the National Board of Public Health Examiners. This is the second year the exam has been offered. It tests knowledge in five core areas of public health. The 2010 exam will be administered August 6-28. Learn more at www.publichealthexam.org. Akway Cham (MPH ’06) Larissa Minicucci (MPH ’04) Kathleen Giesen Norlien (MS ’92) Kerri Elizabeth Sawyer (MPH ’08) Kristina McElroy (MPH ’09) Erin Roche (MPH ’09) Nicole Steege (MPH ’09) Wendy Wang (MPH ’09) Na Zhu (MPH ’09) Have news to share? Submit class notes to SPHnews@umn.edu.

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Upcoming events Alumni and Friends Scholarship Gala April 1, 5:30 p.m see page 10 Interdisciplinary Approaches to Reducing Health Disparities: Where to Go from Here April 23, 9:30 a.m. SPH Commencement Address from Georges Benjamin, executive director of the American Public Health Association May 17, 5 p.m. Public Health Institute May 24-June 11 see page 10 SPH Alumni Engagement Committee Career Event June 3, 5:30 p.m. Sign up for event notices— including news of upcoming alumni reunions—at www.sph. umn.edu/alumni/involved. Event details at www.sph.umn.edu.