Advances - Fall 2011

advances Fall 2011

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

Notes from the Field Students travel far and wide to get hands-on public health experience

> Minnesota’s Cardiovascular Edge >B anking Blood in Tanzania > F orget Pity. Take Action! > S pinning Childhood Obesity

Fall 2011

from the dean School of Public Health Leadership

Debra Olson Associate Dean for Education William Riley Associate Dean for Strategic Partnerships and Relations Beth Virnig Associate Dean for Research Mary Ellen Nerney Assistant Dean for Education Operations

contents

Bernard Harlow Head, Division of Epidemiology and Community Health 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 Kristin Stouffer Managing Editor Martha Coventry Contributing Writers Nicole Endres Lindsey Heffern Art Direction Cate Hubbard Design cat7hubb@gmail.com Advances is published by the University of Minnesota School of Public Health. To submit comments, update your address, or request alternative formats email sphnews@umn.edu.

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Dear Friends, This is our seventh annual “Notes from the Field” issue of Advances, where we profile the SPH students who are working abroad on the hands-on component of their graduate studies—the field experience. As you’ll read in the pages ahead, our students are engaged in helping to find solutions to some of the thorniest health issues facing our world today. And they are doing so in collaboration with nongovernmental organizations and other locally based groups that help the students connect with the communities they’re serving.

Our cover photo comes from Molly Emerick, a student in our Environmental Health Sciences program who did her field work in India. The young girl pictured lives in the slums of Mumbai, as do all of her schoolmates. Molly was charged with launching a school-based program to decrease malnutrition, a formidable obstacle in not only the health of the children but also in their ability to attend school and to learn. If this pilot project goes well, it could be replicated in other schools throughout India.

Apropos to our global-themed magazine, I am writing this column on a flight to India, where I—along with other University of Minnesota colleagues—will meet with health leaders outside of Bangalore to advance partnerships aimed at training workers in a host of clinical and public health practices.

The work our school is doing in Minnesota, our country, and around the world, fulfils the promise of the Morrill Land-Grant College Act of 1862. Federal legislation granted each state tens of thousands of acres of land to help fund institutions of higher learning. The bill’s sponsor, Vermont Congressman Justin Smith Morrill, and others envisioned the act as a way to assure that education would be available to all people, regardless of social class.

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

Departments

2 Commitment Brings Change

8 Research News

News vehicles shape views on obesity; Minnesota and health insurance costs; preventing COPD episodes; and more.

10 school News

3 Notes from the Field: Exploring the global field experience

As we embark on a relatively new era of global health, I think it’s important to keep this nearly 150-year-old land-grant mission in mind. We continue to be a university strongly connected to our home state and its people. But we are also a university that is increasingly committed to advancing the education and wellbeing of all people, everywhere.

Yours in health,

Features

Kathryn Nelson’s first experience in Africa changed her life: She started her own foundation devoted to sustainable development in Kenya’s Western District.

Middle photo by Darin Back, Illustration by Alison Seiffer

Mary Story Senior Associate Dean for Academic and Student Affairs

Bradley Carlin Head, Division of Biostatistics

Photo by richard anderson

John Finnegan Dean

Thirteen second-year MPH students went abroad this summer to test their public health chops on the ground. They returned even more committed to their chosen field.

12 ‘Catching’ the Global Health Bug

Her SPH global health classes set her dreaming, now Amy Becker LaFrance spreads the message that all our lives— and our health—are interconnected.

New kids on the blog; the president pays a visit; SPH gets learning lab; and more.

15 alumni News

Banking blood in Tanzania; Gaylord W. Anderson Leadership Award and Alumni Service Award winners; and class notes.

What are those things?

The funny little squares you see all over the place—and now in this magazine—are called QR (for quick response) codes. You scan them with your smartphone and are instantly taken to a web page.

(You may need to download a code reader for your phone.)

If you’re reading about the gala and want to hear Michael Specter’s keynote speech, just scan the QR code. Curious about President Kaler’s tour of SPH? Watch the video by scanning the code on page 10.

No worries if you don’t have a smartphone. You can do these same things by going to your computer and entering the provided web address.

advances.umn.edu/f11 1

Commitment brings change Kathryn Nelson doesn’t just dream of sustainable development, she makes it happen.

She calls me the girl with the black heart.

Black, like her skin, my Kenyan sister says. Black, like her.

I came to Kenya as a naïve journalist believing that Africa, like so many of my colleagues had said, was solely full of suffering and hate.

And, yes, I did see much pain. I was stationed at the Mt. Elgon refugee camp in Kenya in 2007 and I witnessed atrocities at the hands of greedy governments, selfish Westerners, and self-righteous religions. But out of this pain came possibilities.

I had worked as a reporter for most of my career, seeking to cover wars and disasters, going where many of my peers wouldn’t go. I had volunteered in the slums of Mexico, ventured off to remote villages in Costa Rica, and lived among the relatives of the desaparecidos in Argentina. But my time in Kenya forever changed the way I thought of development, humanitarian aid, and my personal place in this life.

At Mt. Elgon, I handed out clothing and other items that would only last through the season. This was not what development should be, I thought. Kenyans don’t need our pity offerings; instead, we need to work together.

So, one rainy night in July, my host father and I cofounded the Nafula Foundation, an organization focused on sustainable development in the Western District of Kenya.

We imagined medical clinics staffed by local citizens, schools run by honest and passionate community workers, lush fields of ever-growing crops that didn’t waste away every year.

Now, in its fourth year, the Nafula Foundation is gaining momentum. We have a small farm run by citizens of Chebukwa village. We have clean water from a system installed by a group of University of Minnesota students.

We have a school, which is being revamped to accom­ modate more students. Most importantly, we have come together to make positive change.

So, yes, I am the girl with the black heart. As my Kenyan sister says, we are just the same.

ller Melissa Mue Rudolf r ce en Sp and O outside WH in headquar ters rland. ze it Sw a, Genev

from the Exploring the global field experience

Kathryn Nelson is featured in the SPH video series “My Life” at advances.umn.edu/f11/nelson.

2 University of Minnesota School of Public Health

Photo by Darin Back

athryn Nelson is a freelance journalist and student in K SPH’s community health education program.

They are bright, curious, and determined—in short, they have what the world needs in budding public health professionals. This summer for their required field experience, many second-year MPH candidates took these qualities far afield; others used them closer to home.

Thirteen students jumped into a foreign culture. Although they prepared for that leap in their classes, they had to think creatively and improvise once on the ground. As Maternal and Child Health student Julia Shumway puts it, “we learned as we went along.”

Their education was enhanced by the wisdom of local people and of seasoned colleagues. And their time abroad left these students even more committed to the public health path.

Many of the following quotes come from the students’ blogs at advances.umn.edu/f11/notes. On that site, you can read more about their travels and about the best way to eat a mango, the beauty of Uganda’s Sipi Falls, and Chinese hospital pharmacies. advances.umn.edu/f11 3

Notes from the Field The Geneva connection

both were unaware of the nutritional value of the food they consume,” she says.

The stakes are high for Emerick’s research—if data show that these interventions improve school performance and attendance, the children could continue to receive vitamin supplementation. What’s more, the nutrition awareness materials and parent/student curriculum she helped create could be used in the entire school and perhaps in Teach for India schools throughout the country.

Nurses are crucial for success Students from Molly Emerick’s school in Mumbai.

in the midst of the Horn of Africa [drought] crisis, conflict in Libya, and ongoing [humanitarian] efforts in Côte d’Ivoire, Democratic Republic of Congo, and Liberia.”

Providing a better start The slums of Mumbai could hardly be further from the glittering city of Geneva.

When Molly Emerick arrived, they were almost too much for her. It was hard to reconcile the conditions in wealthy parts of the city, where she lived, with those in the slums, where she worked in a Teach for India school. (Teach for India puts committed Indians into poverty-stricken areas for two-year teaching fellowships.) At this school, children were often tired and many were consistently absent because of illness. Malnutrition was considered the culprit.

Emerick implemented three interventions for a class of 8- to 11-year-old children that she hoped might make a difference: health education, vitamin supplementation, and parent education.

“After speaking with students and their parents, it was evident that Colin Gerber is using a tippytap, a hand-washing device that can be built in about 10 minutes from bits and pieces found around a village.

4 University of Minnesota School of Public Health

Avantika Chaudhary worked in Beijing at the Dong Fang Hospital, which practices both traditional Chinese and Western medicines. Her challenge was to find a way for this inner-city hospital to attract more patients. After nearly three months of research, she concluded that it should strengthen and develop its nursing department.

“In my opinion, the majority of the care is imparted by nurses, and they can greatly affect a patient’s perception of the hospital,” she says.

Chaudhary found that nurses in China work long hours, are poorly paid, and stay on the lower end of the hospital hierarchy.

With few opportunities for promotion or recognition, they feel unappreciated.

Chaudhary introduced Dong Fang to the international Magnet Recognition Program that sets standards for first-rate nursing care and awards accreditation for meeting those standards.

“I don’t know if Dong Fang will be able to make its Magnet journey in the near future, but I am going to do my best to introduce them to the value in implementing some of its nursing standards,” says Chaudhary.

Changing long-held behaviors When Colin Gerber arrived in Bulamagi, Uganda, he found “almost no latrines, no

Colin Gerber offers his advice for tracking down the right field experience at advances.umn.edu/f11/gerber.

Lucy Cosgrove, Marie Wilson, and Julia Shumway (left to right) with some residents of a shantytown called a batey.

Photo of Colin Gerber By Jonathan Kalan

The World Health Organization (WHO) is such a significant force in global health that Melissa Mueller doesn’t think “anyone can intern at WHO and not have it impact their future studies or career plans.” In Geneva, Mueller focused on a paper describing the bacterial infection leptospirosis identified during an outbreak of pneumonic plague in Africa. Using WHO data and guidance from her preceptor, Mueller continues to collaborate on the paper.

“Writing a scientific paper for a leading health journal has been a huge challenge,” she says. “When published, it will be my greatest professional accomplishment from this field experience.”

Joining her at WHO was Spencer Rudolf. He interned with the Health Action in Crisis Cluster, where he analyzed postdisaster assessments and made recommendations for future reports.

What surprised them both was discovering that WHO is not above the political and financial challenges faced by any nongovernment organization or non-profit. But as support from donor nations declined and morale dropped at WHO, Rudolf noted that “team functionality remained intact, even

trash pits…no taps for hand washing; people using unprotected wells…no one using mosquito nets; and water treatment pills unavailable at local stores.”

Gerber was there with the Uganda Village Project, a rural community health improvement organization. As the water and sanitation resource person, one of his jobs was to go house to house doing surveys. “I learned such valuable phrases as ‘Katulabe ku toi-yo?’ that essentially translates as ‘May I see your toilet?’” Gerber says. “On such ground is international understanding built.”

He also conducted “sensitizations,” or learning sessions, to introduce new healthy behaviors. He occasionally got glimpses of success.

“I went back to schools where we conducted hygiene days to verify the presence of a second tippy-tap (see photo on facing page) and to see how the students used them,” he says. “In both cases, they swarmed over the taps to wash their hands. At one school, the sanitation prefect, a hard-working teenager named Robert, had redesigned our tippytap to make it sturdier and less likely to fall down. It’s little signs like these that make this work worthwhile.”

the Dominican Republic with the Batey Relief Alliance (BRA). BRA serves impoverished people, mostly Haitians, who live on the Haiti/Dominican Republic border in former sugar cane plantation shantytowns called bateyes.

The three of them visited homes to survey water quality, sanitation, and skin and diarrheal diseases. Cosgrove speaks Spanish, so she asked the questions; Shumway and Wilson took notes on the dwellings and their surroundings to help make associations between the environment and illness. Eventually, they created a profile of community health and living conditions in the batey communities.

Given the hardships residents face, their efforts to adhere to the advice of community health promoters made an impact on the three students. “[Batey residents] followed the best practices of chlorinating their drinking water and taking time and care to assure their children’s produce was washed from clean sources,” says Cosgrove. “They used their knowledge to control potential dangers to their families’ health.”

The effort to do what’s best

On her way to Sulaco in north central Honduras, Therese Genis thought about the ethics of international volunteer

Lucy Cosgrove, Marie Wilson, and Julia Shumway got their field experiences in

Trusting her intentions

Reflections from the Field We must be humble when we work in these places. We can bring general expertise, some experience, and extra labor, but without knowing the local language or how to proceed properly in the cultural context, we may as well attempt to construct a house blindfolded.

—Colin Gerber, Uganda

You cannot help everyone. I was told before my trip that there will be times you will have to turn people away and it will be heartbreaking...and it was. But the quicker you come to terms with this, the easier it will be. This sounds very harsh, but it is true.

—Myah Walker, Nigeria

People are the same wherever you go.

We all eat, sleep, dream, and laugh at poop jokes. I don’t believe any parent wants to see their kids die. No one wants to drink polluted water or go to bed hungry.

—Kate JohnsTon, Tanzania

advances.umn.edu/f11 5

Notes from the Field Stateside Students More than 95 MPH candidates chose to have their field experience in the United States. Below are three; to see where other students worked, go to advances.umn.edu/f11/stateside.

Bobbie Conradt did her field experience with the Massachusetts Department of Public Health, helping agencies find local products to fulfill a state nutrition mandate for purchased foods and beverages.

Paul Takahashi, a student in the Executive Program in Public Health Practice and a Mayo Clinic physician, spent time at the Department of Planning in Rochester, Minn., to help improve the city’s transit options.

At the New York City Department of Health and Mental Hygiene, Megan Mueller worked in the city’s farmers markets helping low-income residents learn how to get adequate amounts of fruits and vegetables in their diets.

service. It had been a topic in three of her SPH classes, especially when discussing a 1968 talk by Ivan Illich called To Hell with Good Intentions. Illich maintained that Western volunteers in developing countries do more harm than good and disempower local people.

Genis was never quite sure what to think about his ideas, but when her group arrived at its hotel, community members surrounded the volunteers. “They embraced us, fed us, and told us how happy they were to see us,” says Genis. “And in that moment, my good intentions felt right.”

In Sulaco, Genis served as public health support for a four-year endeavor by the University’s chapter of Engineers Without Borders to improve the water system for nine communities in rural Honduras. She conducted hands-on conservation and sanitation seminars and explained how a municipal water system works, all the while developing a love of the place, with all its quirkiness.

“The other night, one of the engineers and I started playing a ‘how many unusual things will walk by the front door’ game,” she writes in her blog. “We had a piglet, a 2-year-oldgirl by herself, a three-legged dog, a chicken,

Kate JohnsTon about to demonstrate how to use kanga cloth to purify water.

6 University of Minnesota School of Public Health

a small boy on an adult-sized bike with two other kids chasing him, and a cow. Come to think of it, I guess none of these things is actually that unusual here in Sulaco.”

Old cloth, new purpose Like many SPH students, much of Kate JohnsTon’s work in Tanzania, as part of a Pennsylvania State University project, revolved around clean water. Knowing that sari cloth could filter out the plankton that cholera bacteria attach to, she showed villagers how to fold local cotton kanga material to get the same results. She also presented other options and their relative value in protecting against cholera infection.

JohnsTon says that her first year at SPH gave her “new ears” as she explored the public health situation in the Pwani region along the Indian Ocean. “For example, when I was talking to a doctor about the unintended consequences of mandatory HIV testing, I had [SPH professor] Lynn Blewett on my shoulder saying ‘pay attention, this is where policy meets practice,’” she says.

Kate found something else new, and unexpected, during her stay—total acceptance by the Tanzanian people.

“I had always been told that as a mixedrace person, I needed to be clear that Africa wasn’t ‘my’ country, and I didn’t belong there—usually while also being told to go back there, because I wasn’t allowed to claim America either,” she says. “What struck me most in Tanzania was that people my age and older would simply ask me, in all sincerity, ‘Why don’t you come home?

This is your place.’”

Building trust Jessica Vig went to Sierra Leone to develop, implement, and monitor a maternal and child health curriculum for school-aged girls. Doing this kind of work with girls in America would be hard enough, but Jessica found a way to relate to these students half a world away. “[I became] a trusted adult to whom they could ask questions, share information, and exchange ideas,” she says. “[This connection] was my greatest accomplishment and the thing I will miss most in leaving.”

The girls were in the Young Scholars of Sierra Leone Program that is part of West

African Medical Missions. In family planning discussions, Vig was surprised to learn that the girls were unaware of readily available self-administered pregnancy tests. By not getting early confirmation of a pregnancy, they missed out on essential antenatal care.

As in many of the countries SPH students visited, relationship building is crucial in Sierra Leone. “Without the support of key stakeholders, nothing will move forward,” Vig says. “Earning trust and support is the first priority before any other steps can be taken to improve the health of a community.”

Communication is vital When Myah Walker arrived in Nigeria, she was struck by the magnitude of environmental health issues.

“The sewage system was one of the most apparent hazards,” she says. “It consisted of shallow trenches along each side of the road where urine, feces, rainwater, etc., would run. There was no drainage system for these trenches. Either the contents would slowly seep into the earth or overflow into the streets during the rainy season.”

Walker worked with the African Community Health Initiative (ACHI), which conducts clinics and provides health education in poorly served rural areas. After learning the challenges of this effort, she devised ways that ACHI could be more organized and efficient, then worked to convey her ideas to her Nigerian partners.

“It took me the entire trip to begin to master a more effective way of communication, but I will be well prepared for my visit next year,” she says.

Walker’s final project for graduation will involve recommending improvements for ACHI’s 2012 intern program and designing a maintenance protocol for patients between clinic visits.

Lessons learned in Pacuan What surprised Denice Tracy most during her field experience in Pacuan, a small mountain village in the Philippines, was how the people there guage their well-being.

“They measure their wealth in the relationships they have,” says Tracy. “Even though they are extremely poor and very hard working, they would never hesitate to share their time, food, and small gifts.”

g Scholars of Sierra Leone program Jessica Vig with women from the Youn

As an RN and an MPH candidate, Tracy examined four areas during her field experience, among them was occupational health and safety issues for health care workers.

Tracy spent time with Lilibeth Bulabon, a midwife who works for the Filipino government, and discovered that she and her co-workers had no plastic gloves, and it was hard for them to properly dispose of used needles. Fortunately, Tracy had brought along 12 boxes of gloves and 500 special syringes, where the needle retracts after an injection or a blood draw.

Arriving back in Minnesota, Tracy found herself inspired by the people she met in Pacuan and vowed to “spend more ‘in-person’ time with my family and friends.”

And she has started to do what other students found essential in the cultures they experienced: To acknowledge every person you pass, to smile, and to say hello.

.

One of the clients at an African Community Health Initiative Clinic with Myah Walker, right.

Vaccines? Check!

As part of her field experience, MPH student Denice Tracy created an informational brochure to help students prepare for their field experience abroad.

See it at advances.umn.edu/f11/ brochure.

Denice Tracy, center, is about to set off to see patients and deliver medications higher up the mountain.

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research news

News coverage shapes views of childhood obesity

Carrying unhealthy behaviors into adulthood

If you think you know how to address the problem of childhood obesity, take a look at how you get your news.

Sarah Gollust, assistant professor in the Division of Health Policy and Management, led a recent study that looked at how various news sources framed the issue of childhood obesity between 2000 and 2009.

The study found that television news was most likely to see individual behavior changes as the answer to childhood obesity, while newspapers pointed to system-level changes as the solution.

“Our finding suggests that people who mainly get their news from TV—the majority of the population—may be less supportive of policy strategies to prevent obesity, like regulating the food industry, than those who read print newspapers,” Gollust says. “If they believe obesity is largely an individual’s problem to solve, they are not likely to rally behind public policy efforts.”

Gollust and her colleague did not look at why there was such a division in the coverage. They also noted that news interest in the childhood obesity epidemic began to wane around 2007.

Adolescents who engage in dieting and extreme weight control behaviors are at increased risk for continuing their use during young adulthood, a recent Project EAT study shows. These findings suggest that disordered eating behaviors are not just a “passing phase,” says Dianne Neumark-Sztainer, head of Project EAT (Eating Among Teens and Young Adults) and a professor of epidemiology.

In the late 1990s, the project surveyed a wide range of boys and girls about their dietary and physical activity habits. Ten years later, a study led by Neumark-Sztainer looked at the current behaviors of

Common antibiotic reduces COPD flare-ups

Employer health insurance costs rising; coverage declining in state

• ESI covered 81 percent of the non-elderly in Minnesota in 1999/2000. Ten years later, it covered only 71 percent.

8 University of Minnesota School of Public Health

• The loss of ESI hit poor Minnesotans the hardest: Coverage among non-elderly with incomes below about $44,000 for a family of four decreased from 44 percent to 34 percent.

• The decline in ESI was partially offset by an increase in public insur­­ance coverage (from 8 percent to 15 percent), but the rate of uninsurance also increased (from 7 percent to 9 percent) in Minnesota.

• Nationwide, insurance costs rose during that decade for employ­ ers and employees. In 2008/2009, the average annual premium for ESI coverage was $4,528 for private-sector workers with single coverage—an increase of 82 percent above 1999/2000 premiums.

For family coverage, premiums increased 75 percent over the same time, for a national average annual cost of $11,208 in 2008/2009.

See the report and fact sheets for each state at advances.umn.edu/f11/esi.

Illustrations by Alison Seiffer

Health insurance is one of the best perks of any job. Most employersponsored health insurance (ESI) covers preexisting conditions and employees pay a small percentage of the cost of coverage (on average, about 20 percent for single coverage and 27 percent for family coverage).

But in Minnesota and nationwide, fewer people are getting the benefits of ESI, according to a report from the U’s State Health Access Data Assistance Center (SHADAC), directed by Lynn Blewett, professor in the Division of Health Policy and Management.

The study, sponsored by the Robert Wood Johnson Foundation, shows ESI coverage declining, enrollment in public health insurance rising, and insurance premiums increasing in Minnesota and across the country over a 10-year time period (1999-2009). Key findings include the following:

about 2,300 of them, divided by gender and by age.

Although the prevalence of certain activities varied slightly in these groups, extreme weight control behaviors, including the use of diet pills, laxatives, and self-induced vomiting, increased for all age groups and for both males and females.

“Dieting, unhealthy weight control behaviors, and binge eating increase risks for both eating disorders and obesity,” says NeumarkSztainer. She advises that interventions aimed at preventing disordered eating begin early and continue into young adulthood.

COPD—chronic obstructive pulmonary disease—refers to a group of conditions that block airflow in the lungs, like chronic bronchitis and emph­ysema. It is the third leading cause of death in the United States.

When symptoms flare up in what’s called a COPD exacerbation, a person suffers increased breathlessness, along with added issues like wheezing, fever, and coughing. According to professor of biostatistics John Connett, until now there haven’t been many good ways to prevent or treat these exacerbations.

Connett was second author and lead statistician of a recent NIH-funded study that examined whether the antibiotic azithromycin could reduce the frequency and severity of the COPD flare-ups. In a double-blind study, participants with COPD received either azithromycin daily for a year or a placebo, in addition to their usual care.

The results were encouraging.

“The azithromycin group had fewer exacerba­tions and they had them later in the year, on average,” says Connett.

“Other treatments will address the symp­ toms and help the person feel and breathe a little bit better. This [arythromycin regime] actually prevents some flare-ups. It’s good news for the physicians and patients in the COPD community.“ The study’s next goal is to discern which patients stand to benefit most from azithromycin and how and why this antibiotic is beneficial.

Keeping our cardiovascular advantage Minnesotans have a lower risk of heart disease than the general population according to recent findings from the Minnesota Heart Survey, a study of cardiovascular risk factors led by Lyn Steffen, associate professor of epidemiology.

But why?

“We think, from looking at these study findings, that what explains this difference in the cardiovascular mortality rate is that [some] risk factor levels are lower in Minnesotans,” says Steffen. Compared to national averages, Minnesotans smoke less and have healthier blood pressure levels.

How long the Minnesota advantage will last is unknown. Calorie intake has increased since the study was launched in 1980 and now 26 percent of Minnesotans qualify as obese—a high risk factor for cardiovascular disease. Steffen recommends that we pay attention to all the things that put us at jeopardy, and we can begin by simply improving our diets—adding more whole grains, fruits, and vegetables—and eating fewer calories.

Real food for real kids Watch Jamie Stang, epidemiology associate professor and nutrition expert, show how parents can pack healthy school lunches…and skip the Go-Gurt.

View the video at advances.umn.edu/f11/stang.

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school news

Beth Virnig’s 14-year-old son likens her new position as associate dean for research to a point guard.

“He’s right,” says Virnig, previously the chair of the Public Health Administration and Policy program. “Like the point guard on a basketball court, my job is to identify and distribute opportunities, anticipate where the game is going, and help the team be successful.”

Virnig wants to encourage research at SPH, not get in the way.

Part of her job is to choose the best projects and match them up with the right people, creating teams where everyone is intellectually engaged in the work—her definition of collaboration. Most likely those teams will have a strong interdisciplinary bent.

“A diversity of opinions and strengths leads to opportunities,” she says. This has been Virnig’s preferred way of working as she forged a career in exploring medical care outcomes, especially in cancer care, by linking massive data sources.

Her relentless curiosity and clear love of research must now be coupled with developing policies and procedures, which may not be the most fascinating part of her job, she admits.

Luckily, her predecessor, Judy Garrard, laid a solid foundation for her as senior associate dean for academic affairs and research.

“ Like the point guard on a basketball court, my job is to identify and distribute oppor­ tunities, anticipate where the game is going, and help the team be successful.”

“There are incredible complexities in this job,” says Virnig.

“Judy sorted those out and created a strong research management infrastructure. I can now build on her efforts and take this job to the next level.”

That next level includes a push to increasingly connect and form relationships with colleagues all over the globe.

“John Finnegan and [University president] Eric Kaler are really seeing globalism as part of the U’s central mission,” says Virnig. “I’m not asking every single faculty member to become a global researcher, but we need to expand that aspect of our work. It’s part of a well-rounded school of public health.”

10 University of Minnesota School of Public Health

New ‘chief cheerleader’ for the University On September 22, Eric Kaler officially became the president of the University of Minnesota, coming back to the place where he received his chemical engineering PhD in 1982. By all accounts, he is thrilled to be here.

The former provost and senior vice president for academic affairs at Stony Brook University in New York, Kaler has jumped into his new duties with a smile on his face and unabashed enthusiasm for the job. “I’ve now become the chief cheerleader for the University,” he says. At the beginning of his tenure, his highest priorities are sharpening the University’s focus on what it does best and ensuring access.

John Himes

At an orphanage in Almaty, Kazakhstan, an aide sits with a child at a feeding station.

SPH professor helps orphans get critical nutrition Professor Pat McGovern (PhD ’93) explains her work with the National Children’s Study to President Eric Kaler and Karen Kaler during their SPH visit.

“It’s critically important that the barriers to the students who do not have the financial means to come to the University be as low as possible,” he says.

To achieve what he calls a healthy “excellence-to-cost ratio,” Kaler believes that the University must concentrate on its firstrate programs to help it manage expenses, improve the education it offers, and increase its national standing as a public university.

For Kaler, robust health sciences programs are essential if the University is to realize its academic potential.

“There is no top-flight public institution that doesn’t have a strong leadership position in academic health,” he says “We can’t succeed without the Academic Health Center being excellent.”

Watch a video of President Kaler and his wife, Karen, visiting SPH at advances.umn.edu/f11/kaler.

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Photo by Paula Keller

Beth Virnig in play as associate dean for research

“ These kids have the right to be healthy. That’s the summum bonum, the highest good.

Most have just never had anyone to advocate for them.”

pidemiology professor John Himes has spent more than four decades helping vulnerable children receive adequate nutrition. Without the right nutrients in the early months for brain and body development, children may never catch up to their peers.

Himes gives his time to the SPOON (Supply and Provide Overseas Orphans Nutrition) Foundation, created by two U.S. mothers who had adopted Kazakh children challenged by nutrient deficits. These mothers originally founded SPOON to give a better start to the 48,000 institutionalized children in Kazakhstan, and now the organization is expanding its reach.

With the Kazakh Academy of Nutrition, Himes designed a study that is the first in the country—and in all of Central Asia—to explore the nutritional needs of institutionalized children.

“The orphanages in Kazakhstan are not grim like those that were shut down in Romania,” he says. “They are run by wellintentioned people, but no one follows even outdated nutrition standards.”

The study observed children 6 to 24 months old and randomly assigned their orphanages into four groups: one was the control, the second received a vitamin/ mineral supplement, the third ate a new nutrition-enriched diet, and the fourth got both the supplement and the special diet.

Himes followed the groups for nine months, which for undernourished children, he says, is long enough to make a difference.

The Kazakh Ministry of Health has committed to consider changing the nutrition policies in all its orphanages based on the study’s findings, says Himes.

In December, Himes will represent SPOON in Kazakhstan to report the results at a

national news conference.

Himes is also leading a second SPOON study funded by a multi-year grant from the Joint Council on International Children’s Services. This study will look at orphaned children’s nutritional needs in many countries, starting in China, Vietnam, and Mexico, and develop training tools to help caregivers better understand and meet those needs.

Orphaned children around the world—143 million of them—face the psychosocial and health problems that come with being institutionalized, says Himes. They shouldn’t have to deal with the damages of poor nutrition.

“These kids have the right to be healthy,” he says. “That’s the summum bonum, the highest good. Most have just never had anyone to advocate for them.”

advances.umn.edu/f11 11

school news

school news ‘ Catching’ the global health bug

A showroom for innovative education Mayo D327 is no ordinary classroom.

Gone are the podium and rows of tables and chairs—and along with them, the lecture-and-notes model of education that traditionally was found there.

The classroom reopened fall semester as the Mercy Learning Lab, a redesigned and re-equipped facility that includes larger tables meant to promote discussion and teamwork as well as a high-tech hub that controls, among other things, a wireless large-screen HD projector and an ITV for global video conferencing.

The new space, named in recognition of Mercy Health System, was made possible by a $275,000 gift from the health system and Mercy president and CEO Javon Bea, a 1978 alum of the University of Minnesota School of Public Health’s Master of Healthcare Administration program.

Bea says he’s excited by the didactic, inter­active atmosphere the lab creates for students.

“The electronics of this classroom really let the students get engaged not only with their professors, but also with each other,” he says. “They really are going to better simulate the way problem solving occurs in the corporate environment. As a result, the students’ level of knowledge and critical thinking ability will increase as well. They will be even more prepared for the work environment than they are today, and that is exciting to me.”

For MPH alum Amy Becker LaFrance, this contagion is a good thing.

12 University of Minnesota School of Public Health

The Mercy Learning Lab isn’t the health system’s first connection to the University’s MHA program. Over the last 22 years, Mercy has provided administrative fellowships to more than 35 MHA graduates—and Bea has hired every one of them afterward.

“I’m always impressed by how well prepared they are when they arrive and by their enthusiasm to dive right in and put their knowledge to work at Mercy,” he says of MHA program graduates. “It truly is a testament to the great health care administration

program. Providing these fellowships has been a win-win situation for our fellows and for Mercy.”

And for Bea, it feels good to open doors for new graduates, just as alumni did for him and his classmates.

“We have a tight-knit family at the MHA program,” he says. “It’s a tremendous pro­gram, and I’m excited to provide this tech­nology to enhance learning for future students.”

This year another crop of students are eager to share their SPH experiences.

Thank you, Ashley, Bryan, Dylan, Elise, Kristen, Nancy, and Vidya for signing on!

photo of javon Bea by Scott Streble

Amy Becker LaFrance (MPH ‘06) worked at SPH as a project director for the Center for Infectious Disease Research and Policy (CIDRAP) and as an instructor for International Project Planning and Management.

Mercy Health System and Mercy president and CEO Javon Bea, a 1978 MHA graduate.

Meet the new bloggers!

photo by Gualbert Thombiano

The police officer at the Ouagadougou International Airport visa counter was reviewing my application last February and asked in French, “Madame, what is your profession?”

“Public health,” I replied. She cocked an eyebrow and said, “That is not a profession.” Her disdain was clear even though French is my second language.

I tried again, saying I was the country director for a U.K.-based nongovernmental organization called Development Media International that is conducting a mass media-based child survival project in Burkina Faso. Finally, she let me enter the country.

Even in my native English, this work can take some explaining.

My path to Burkina Faso started with my MPH degree. I studied and wrote about infectious diseases. This helped me to appreciate how all health is interconnected, especially today. A downside of affordable plane travel, imported foods, and trendy household pets is that germs from anywhere in the world can affect us more easily now than ever.

“Global health” might sound exotic, but it is a part of everyday life, no matter where we live.

The SPH global health classes set me to dreaming.

The instructors had worked all over the world, and their projects sounded challenging, fulfilling, and fascinating. When I was offered the opportunity to work in Burkina Faso, I took it.

My current job has similarities to my U.S. public health work. I’m managing a team focused on reaching people with life-saving information. We will develop entertaining, behaviour-changing announcements and create interactive radio programs with health themes.

My co-workers teach me new things about this amazing place every day. And instead of a leisurely bike ride along the Mississippi, my morning commute now may include jaywalking cattle herds, donkey carts, runaway sheep, swarms of scooters, wrongway bicycles, and witch doctors hawking cure-alls.

If that sounds more fascinating than off-putting, let me offer a diagnosis: You may have already been bitten by the global health bug.

Learn more these students and read their posts at advances.umn.edu/f11/bloggers.

advances.umn.edu/f11 13

school news

alumni news

CIDRAP turns 10

Class notes Kelly Coleman (PhD ’05) has been named a Distinguished Scientist at Medtronic, one of only nine such honorees in a company of 45,000 employees. He serves as Medtronic’s chief toxicologist and is also an SPH adjunct assistant professor of toxicology.

Matt Doyle (MPH ‘09) received an American Veterinary Medical Association Congressional Science Fellowship.

Congressional science fellows serve for one year in Washington, D.C., as scientific advisors to members of Congress.

Jane Duncan (MPH ‘04) recently re­­joined HealthPartners Research Found­ ation as a research network manager.

Gala draws record ticket sales The biggest crowd ever for the Alumni and Friends Scholarship Gala brought a festive spirit and an outpouring of good will to the event.

Thanks to ticket sales and donations, the SPH scholarship endowment is now worth more than $230,000, and when awards are given to students, the President’s Scholarship Match will double the amount.

Keynote speaker Michael Specter, staff writer for The New Yorker and author of Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives, challenged guests to examine how science influences—or more to the point, doesn’t influence—their thoughts on issues like GMOs and integrative medicine.

During the evening, SPH dean John Finnegan, on behalf of the SPH Alumni Society Board, presented the school’s Gaylord W. Anderson Leadership Award to Robert Hiller and Bernard Harlow (see page 16), two leaders in the field of public health.

HealthEast Care System and United­Health Group sponsored the gala, which the SPH Alumni Society Board supported and planned.

Pamela Jo Johnson (MPH ‘99, PhD ‘04), director of healthcare equity research at Allina Hospitals and Clinics, was chosen to participate in the yearlong Disparities Leadership Program designed to tackle racial and ethnic disparities in health care and led by the Disparities Solutions Center at Massachusetts General Hospital.

Photos, top left, clockwise: From left to right: Buchi Akpeh, Toteh Atairu, Chelsea Georgesen, and Dustin Nelson; John Amuasi (MPH ’07), right, talks with Remi Douah; Some Gala Planning Committee members (left to right), Angie Lillehei (MPH ’85), Deb Lasher (MPH ’98), Michelle Lian-Anderson, Cynthia Kenyon (MPH ’03), and Carrie Klumb (MPH ’10); Former SPH dean Lee Stauffer (MPH ’56), center, with Bernard Queneau, left, and University regent Carl Platou (MHA ’51).

Listen to Michael Specter’s keynote address; read an interview with him; and see more gala photos at advances.umn.edu/f11/gala.

14 University of Minnesota School of Public Health

Libby Jensen (MPH ’11) was named the outreach program coordinator at Hennepin County Medical Center working in strategic development and business development.

Photo by Darin Back Gala Photos by Paula Keller

The University founded the Center for Infectious Disease Research and Policy (CIDRAP) on September 4, 2001. Seven days later, this new initiative took on immediate significance.

“We hoped to spend more of our time trying to make sure things like [the anthrax attacks that followed September 11] would never happen,” says director Michael Osterholm. Instead, CIDRAP quickly ratcheted up its public health preparedness efforts.

Over the past 10 years, the center has substantially expanded its work. Under Osterholm’s leadership, CIDRAP developed innovative models for mini­mizing the rippling effects of a bioterrorist strike or pandemic, like breakdowns in energy and food supply chains. Because such vital elements are globally interconnected, CIDRAP engages national and world leaders to put critical preparedness policies in place, and it has brought international prominence to issues of infectious disease, food safety, and public health threats.

CIDRAP has become a trusted source and a powerhouse of public health information and expertise. Its astoundingly comprehensive website logs a million page views each year. The center is also an integral partner of the U.S. government’s BioWatch program and home to the NIH-supported Center of Excellence for Influenza Research and Surveillance.

Looking ahead, Osterholm stresses that CIDRAP will continue to be a driving force in addressing the interrelated nature of pubic health issues and in forging policies to get the best preparedness measures in place before they’re needed.

Elizabeth Klein (PhD ’07), assistant professor of health behavior and health promotion at Ohio State University, recently published a study in the Journal of Public Health Management Practice showing that Twin Cities’ smoking bans did not lead to job losses at bars and may have helped create more jobs at restaurants.

Chris Laszcz-Davis (MS ’73) has won the Alice Hamilton Award from the

National American Industrial Hygiene Association. The award is presented to a woman who has made a definitive, lasting impact in the field of occupational and environmental hygiene.

Katie McKenzie (MD/MPH ’11) won first place for her poster presentation at the recent American Academy of Family Physicians research symposium.

She presented her MPH project, “The Current State of Care Provided to Sexual Assault Victims in Rural Minnesota Emergency Departments.”

Larissa Minicucci (MPH ‘04), assistant professor of veterinary population medicine, will serve as co-director of the Veterinary Public Health Residency Program in which veterinarians gain specialized clinical training in veterinary public health practice.

Jennifer O’Brien (MPH ‘08) is the new administrative director of the Deborah E. Powell Center for Women’s Health.

The center promotes, facilitates, and disseminates University of Minnesota research on behalf of women’s health.

O’Brien previously served as the adolescent health coordinator for the Minnesota Department of Health.

Patricia Ohmans (MPH ’91) was given a Bush Leadership Award. As a Bush Fellow, Ohmans will focus on Frogtown Gardens, a non-profit organization she co-founded and leads. A central project is a new park on 13 vacant acres in the middle of St. Paul’s Frogtown neighborhood providing active recreation, a nature sanctuary, and a working urban farm.

Lisa Pogoff (MPH ‘85), a continuing education specialist in SPH’s Centers for Public Health Education and Outreach, has been elected to the University/Faculty Senate. The senate

is among the most active shared governance systems in the country among large research universities.

Ahmed Javed Rahmanzai (MPH ’08), a Fulbright scholar from Afghanistan, contributed to the development of the first National Strategy for Improving Quality in Healthcare for the Ministry of Public Health of Afghanistan. The program was launched in April in a ceremony that included the Afghan deputy minister of health, members of the Afghan parliament, and representatives from other national and international organizations.

Stephanie Triplett (MHA ‘09), an industrial engineer with the New England Engineering Resource Center, entered a nationwide employee innovation contest and was awarded a $650,000 grant from the Department of Veterans Affairs. Her submission proposed a way to significantly reduce email waste at the VA and ensure that providers receive timely critical patient or organization information.

Bailus Walker, Jr. (PhD ‘75), professor of environmental and occupational medicine at Howard University College of Medicine, received the President’s Award from Breathe DC, a United Medical Foundation program dedicated to the prevention and control of res­pir­­atory disease through education and advocacy.

D.I.Y. Access class notes and make your own entry at advances.umn.edu/f11/classnotes.

advances.umn.edu/f11 15

alumni news Honoring Gaylord W. Anderson Award recipients “Robert’s honesty and Shortly before Robert Hiller respect for people were passed away in August, SPH hallmarks of his leadership dean John Finnegan visited style,” said Finnegan. “He him at his home. He told was a keen listener who was him that he had received able to synthesize complex the Gaylord W. Anderson information and then act on Leadership Award, a it. And he encouraged people singular tribute for an SPH to leave their turf issues at graduate who has made an the door.” enduring impact on the Finnegan honored another field of public health.

Gaylord W. Anderson At the 2011 Alumni Leader­­ship Award winner and Friends Scholarship Robert Hiller (MS ’58) that night, Bernard Harlow.

Gala, Finnegan presented After receiving his MPH the award, named for in epidemiology, Harlow completed his the school’s first dean, to Noreen Hiller doctorate and went to Harvard, where he on behalf of her late husband. He told the served as a faculty member for 18 years. “Six crowd of Hiller’s extraordinary work to years ago, I decided it was time for Bernie create, as special assistant commissioner at to come home,” said Finnegan. Harlow the Minnesota Department of Health, the returned to SPH to head the Division of state’s first public health system that fully Epidemiology and Community Health and integrated local public health agencies. to build on its long tradition as one of the Hiller’s success led to the landmark piece of best groups of its kind in the world. legislation, the Community Health Services While engendering an enormous Act of 1976.

SPH grads receive the University of Minnesota Alumni Service Award

“ Robert’s honesty and respect for people were hallmarks of his leadership style.“

Two School of Public Health graduates—Janny Brust and Gayle Hallin—have received the University of Minnesota Alumni Service Award that recognizes outstanding alumni for their volunteer service to the University.

John Finnegan

amount of quality research, Harlow also encourages others and allows them to shine.

He has a history of offering students first author­ship of co-written papers and has mentored dozens of students and junior faculty members.

“We might want to attribute Bernie’s seemingly endless supply of energy to a healthy life, full of good eating habits and physical activity,” Finnegan said. “But I would argue that a desire to make a difference is at the core of what drives him.

And he does it all with a kind-hearted, compassionate leadership that embodies the legacy of Gaylord Anderson.”

Janny Brust (MPH ’87), left, and Gayle Hallin (MPH ’77), 2011 Alumni Service Award winners.

SPH graduates help Tanzania bank blood

Welcome aboard!

On the African continent, 20 percent of the blood supply is HIV-infected and there is not enough blood, period, to meet demand.

“In Africa, there is a long-held tradition where people whose family members have had transfusions replenish the blood supply,” says Natalia Espejo. Espejo and Sam Lee, both 2011 MPH graduates, are helping one country—Tanzania—increase

The SPH Alumni Society Board is happy to have seven new members: • Shelly Espinosa (MPH ‘99) • Haudy Kazemi (MHA ‘08) • Larry Kuusisto (MS ‘10) • Lara Lamprecht (MPH ‘99) •M eghan Mason (MPH ‘10 and PhD candidate) • Charles Oberg (MPH ‘84)

Gaylord W. Anderson Leadership Award winner Bernard Harlow (MPH ’77), center, with Rick Person (MPH ’83), left, and dean John Finnegan.

16 University of Minnesota School of Public Health

Photo by Paula Keller

They will join their colleagues to promote a lifelong partnership between the school and its alumni.

Photo Above by Paula Keller

• Charlotte Sortedahl (MPH ‘07)

Learn more about the Alumni Society Board and how to become involved as a volunteer at advances.umn.edu/f11/alumni.

Janny Brust began her career as a clinic manager at Children’s Hospital, then enrolled in graduate school at SPH, receiving her MPH in 1987. Currently, she’s director of medical policy and community affairs at the Minnesota Council of Health Plans.

As a part of the SPH Mentor Program for two decades, Brust has worked with more than a dozen aspiring public health leaders. “Mentors are able to learn about new areas of research and study from the student,” she says. “And some of these mentor/mentee relationships develop into long-term friendships.”

Brust served as president of the SPH Alumni Society and the Minnesota Public Health Association, was active in the SPH Council of Past Presidents, and received two SPH Community Partner Star awards.

Gayle Hallin says that her positive experience during under­ graduate and graduate school (she received BA and RN degrees, and an MPH in 1977) is a primary reason she stays connected with the University. She has served as the president of the School of Nursing’s Alumni Society and was honored as one of its 100 Distinguished Nursing Alumni. Hallin is the former health services director for UnitedHealth Group and serves on the U of M Alumni Association’s National Board, helping expand its influence in keeping alumni in touch with their school.

“ In Africa, there is a long-held tradition where people whose family members have had transfusions replenish the blood supply.”

the amount of healthy blood available to those in need.

With a grant from the President’s Emergency Plan for AIDS Relief (PEPFAR), they are working with Tanzania’s National Blood Transfusion Service (NBTS). Lee is in Dar es Salaam training blood bank staff and donor recruiters; Espejo is in Minneapolis helping ensure continued funding and project success. She acts as cross-cultural interpreter between what happens in the field and what is expected in Washington.

“We have to constantly make adjust­ ments in our work in Tanzania, and I need to report and explain those to PEPFAR,” she says. “For example, what we can do in the capitol with technology changes when we take the program to NBTS’s seven hubs around the country.”

Lee and Espejo make up one of two SPH teams trying to increase blood supplies and donation standards in the developing world. In Afghanistan, Terri Konstenius,

director of SPH’s International Blood Programs, is overseeing training of medical personnel and is the operation leader for both projects. You can learn more about the Afghanistan efforts at advances.umn.edu/ f11/bloodbanks.

Sam Lee (MPH ’11), right, with Efespar Nkya, director of Tanzania’s National Blood Transfusion Service.

advances.umn.edu/f11 17

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every child deserves a healthy life.

In August, a newborn Minnesota baby began his journey with the largest and longest investigation of the health and development of America’s children. The National Children’s Study (NCS) will follow 100,000 children and their families for 21 years to learn how genes, the environment, and even fetal life play a role in increasingly common conditions like diabetes, asthma, obesity, and autism. School of Public Health professor Patricia McGovern leads the Ramsey County NCS study center, one of 105 in the United States chosen to contribute data to this ground-breaking exploration that may change the way we understand chronic illnesses.

Learn more about the National Children’s Study and the role of SPH at centers.nationalchildrensstudy.gov/umn.

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