Moment of Reckoning THE WORST PANDEMIC IN A CENTURY. A LONG-OVERDUE CONFRONTATION WITH STRUCTURAL RACISM. AMERICA FACES TWO PUBLIC HEALTH CRISES. NOW WHAT?
DEAN’S MESSAGE
THIS YEAR HAS BROUGHT TWO SEISMIC PUBLIC HEALTH EVENTS. One, the worst pandemic in more than a century, has laid bare our nation’s decades-long failure to adequately invest in public health. The other, a long-overdue reckoning with structural racism, casts a harsh light on an ongoing moral failing that has stained our society for centuries — with consequences that are magnified by COVID-19. Although we know that few professions can match the impact of public health, in normal times many of our efforts fall under the radar — our focus is on health promotion and disease prevention, and it can be hard for people to recognize what has kept them from becoming sick. But COVID-19 has put public health squarely in the spotlight, and Fielding School faculty and alumni continue to serve as trusted leaders through their research, community partnerships, civic engagement, and training, and by keeping the public informed. A team of faculty and students produced “Breaking the Chain of Infection,” a regularly updated web information portal about COVID-19 prevention presented in six languages, and our faculty experts have been featured in more than 8,500 news stories, ensuring that accurate, timely, and responsible information is shared. Critical efforts led by Fielding School faculty have made regular COVID-19 testing available to frontline health care workers and first responders, while research addressing important questions about physical, mental, and emotional repercussions of the coronavirus will continue to inform policy. Through the California Connected COVID-19 Virtual Training Academy, our faculty, students, and recent alumni are co-leading the effort to train thousands of new contact tracers for California. The structural racism that is so deeply entrenched in our society since its earliest days represents a public health crisis of much longer standing, providing fuel for the inequities so central to the health disparities that persist. It is clear that we in public health must be more proactive in not just documenting racism’s harmful effects, but in dismantling the forces that perpetuate them. In this issue you will hear from Professor Chandra Ford, founding director of FSPH’s Center for the Study of Racism, Social Justice & Health. The center’s important work has been at the forefront of ensuring that racism is understood as a public health issue. Our magazine also features the voices of faculty experts on xenophobia in the age of COVID-19 and how structural racism is contributing to the disproportionate impact of the pandemic. As our field of public health moves front and center during these historic times, we at the Fielding School are committed to using our platform to contribute to the changes that will produce a healthier and more equitable society.
Ron Brookmeyer, PhD Dean
The UCLA Fielding School of Public Health Magazine
SEPTEMBER 2020
CONTENTS 28
26
12
10
FEATURES
MOMENT OF RECKONING 04 Q&A Chandra Ford addresses racism and COVID-19 07 Pursuing Justice Students effecting change 10 Meeting the Moment Informing the public and tracking exposures 12 ‘Which Death Do Black Men Risk — COVID-19 or Police Shooting?’ Structural racism’s impact on the pandemic response 14 On the Front Lines of a Global Pandemic Alumnus leads in Singapore
16 In Pandemics, More Than Viruses Spread Spikes in xenophobia and racism demand attention 21 Equal Time COVID-19 underscores need for global human rights 22 Workforce in Progress Training contact tracers 24 Sending the Right Message Communication is key in public health emergencies 26 Viral Lessons What we’ve learned
OTHER FEATURES 28 Confronting an Escalating Health Emergency New FSPH climate change center focuses on solutions 30 ‘Mustard Seeds’ in Full Bloom Reflecting on 30-plus years of training public health leaders for China 32 Electing to Serve FSPH alumni use politics to make a difference
DEPARTMENTS 35 School Work 36 Faculty Honors & Service 37 Bookshelf 38 Transformative Investments
Visit us online: ph.ucla.edu
Follow us on social media @UCLAFSPH
PHOTOGRAPHY & ILLUSTRATION Jane Houle Photography: Dean’s Message, p. 38. iStock Photo/t_kimura: TOC: dominoes and mask; p. 26. iStock Photo/tuachanwatthana: TOC: doctors; p. 11. Jorge Villalba and Frozen Shutter Photography/iStock Photo: TOC: fire; pp. 28-29. Unsplash/Ehimetalor Akhere Unuabona: TOC: BLM; pp. 12-13. Unsplash/Thomas De Luze: pp. 2-3. AP Photo/Steven Senne: pp. 16-17. © 2020 by the Regents of the University of California: Advancing Equality: How Constitutional Rights Can Make a Difference Worldwide: pp. 21, 37. iStock Photo/plej92: pp. 22-23. Unsplash/Yassine Khalfalli: p. 24. © 2020 Taylor & Francis Group, LLC: Practical Multivariate Analysis, Sixth Edition (2020): p. 37: Abdelmonem Afifi book cover. © 2018 American Society for Clinical Pathology (ASCP): Human Parasitic Diseases: A Diagnostic Atlas: p. 37: Lawrence R. Ash book cover. © Jones & Bartlett Learning, An Ascend Learning Company, LLC: Balgrosky, J. A.: Understanding Health Information Systems for the Health Professions: p. 37: Jean. A. Balgrosky book cover. Annual Reviews: p. 37: Jonathan E. Fielding book cover. © American Public Health Association: Racism: Science & Tools for the Public Health Professional: p. 37: Chandra Ford book cover. © Springer Nature Switzerland AG: Handbook of Socioeconomic Determinants of Occupational Health: From Macro-Level to Micro-Level Evidence: p. 37: Jian Li book cover. © Springer Nature Switzerland AG: “Concepts and Social Variations of Disability in Working-Age Populations.” Chapter in Handbook of Disability, Work and Health: p. 37: Jian Li chapter in book cover. © IWA Publishing: Taste and Odour in Source and Drinking Water: Causes, Controls, and Consequences: p. 37: Mel Suffet book cover. © Springer Nature Switzerland AG: HIV/AIDS in China: Epidemiology, Prevention and Treatment: Zunyou Wu and Roger Detels book cover. COURTESY OF: Chandra Ford: pp. 5, 19. Natalie Bradford: p. 7: Bradford. Millicent N. Robinson: p. 7: Robinson. Taylor B. Rogers: p. 8: Rogers. James Huynh: p. 8: Huynh. Anna Hing: p. 9: Hing. Ezinne Nwankwo: p. 9: Nwankwo. Anne Rimoin: p. 10. Vickie Mays: p. 12: Mays. Tan Tock Hospital: p. 14: hospital. Angela Chow: p. 15. UCLA FSPH: p. 18. Nina Harawa: p. 20. Hongtao Hu: pp. 30-31. Mai Vang: p. 32. Cricel Molina de Mesa: p. 33. Jamie Cassutt-Sanchez: p. 34. Janae Hubbard: p. 35.
MOMENT OF RECKONING This is the year everything changed. A novel coronavirus, SARS-CoV-2, made its way to every corner of the planet, bringing an ever-mounting toll of illness and death as it transformed everyday life in ways previously unthinkable. And beginning in May, people in every part of the U.S. — and many parts outside it — donned masks and took to the streets in protest of the systemic racism that allowed the police killings of George Floyd, Breonna Taylor, and many others before them. But make no mistake: These historic events did not occur in a vacuum. Public health experts have known a pandemic like COVID-19 was inevitable, and had warned of the perils of failing to support the public health infrastructure necessary for a proper response. The uprising following the latest police killings was in fact a long-overdue confrontation with the structural racism that has infected American society for centuries — with vast implications for the health and well-being of Black, Indigenous, and other communities of color. So in one sense, this is the year everything changed. But 2020 might better be framed as the year historic developments forced a moment of reckoning with our inadequate investment in public health and failure to dismantle the foundations of a society built on racism. At a moment when we face two public health crises, the following pages highlight some of the ways Fielding School faculty, students, alumni, and staff are making a difference.
Ron Brookmeyer, PhD Dean
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UCLA Fielding School of Public Health Website: ph.ucla.edu
MAGAZINE STAFF Carla Denly Executive Editor & Asst. Dean for Communications
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UCLA Public Health magazine is published by the UCLA Fielding School of Public Health for the alumni, faculty, students, staff, and friends of the school. Copyright 2020 by The Regents of the University of California. Permission to reprint any portion must be obtained from the school. Please send requests to communications@ph.ucla.edu.
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U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E
EDITORIAL BOARD Haroutune K. Armenian, MD, DrPH Professor-in-Residence, Epidemiology; Thomas R. Belin, PhD Professor, Biostatistics; Pamina Gorbach, DrPH Professor, Epidemiology; Moira Inkelas, PhD Associate Professor, Health Policy and Management; Marjorie Kagawa-Singer, PhD, MN Professor Emerita, Community Health Sciences; Cathy Lang, PhD Director for Research Administration; Adjunct Assistant Professor, Community Health Sciences; Michael Prelip, DPA Professor and Chair, Community Health Sciences; Beate Ritz, PhD Professor, Epidemiology and Environmental Health Sciences; May C. Wang, DrPH Professor, Community Health Sciences; Elizabeth Yzquierdo, EdD Assistant Dean for Student Affairs; Adjunct Assistant Professor, Community Health Sciences; Zuo-Feng Zhang, MD, PhD Associate Dean for Research; Professor, Epidemiology; Yifang Zhu, PhD Associate Dean for Academic Programs; Professor, Environmental Health Sciences; Frederick Zimmerman, PhD Professor, Health Policy and Management; Lori S. Pelliccioni, JD, MPH '96, PhD '02 President, Public Health Alumni Association ph.ucla.edu
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MOMENT OF RECKONING
Racism, Policing, and COVID-19
Amid a pandemic that has disproportionately hit communities of color and nationwide protests in response to racialized policing, the founding director of FSPH’s Center for the Study of Racism, Social Justice & Health weighs in.
BEFORE THE CURRENT NATIONAL RECKONING with structural racism, Chandra Ford had been making the case that public health professionals and academics must do more to confront an issue that fuels health disparities and acts as a formidable barrier to optimal health. Ford, Fielding School professor of community health sciences, is the founding director of FSPH’s Center for the Study of Racism, Social Justice & Health and co-editor of “Racism: Science & Tools for the Public Health Professional,” a 2019 book in which researchers and community organizers — including 10 FSPH faculty, doctoral students, and alumni — explain how various forms of racism impede health and recommend strategies people in public health can use to address the problem. Ford spoke with FSPH’s UCLA Public Health magazine about the historic events of 2020, her center’s work, and where we go from here. 4
In what sense do you see the uprising that began after the police killings of George Floyd and Breonna Taylor as a public health issue? A: First, I view this protest against policing in a broader sense than the Black Lives Matter issue. What I see is an effort to preserve white supremacy in the face of major threats to it — and by white supremacy, I don’t mean simply a group that has white skin and a dominant role, but a whole set of principles, philosophies, and structures of inequality that help to keep some groups marginalized and other groups central to the flow of resources and power within our society. That Black people routinely experience being both innocent of any crime yet victimized by racialized policing has become more visible. And public health allows us to recognize that a body lying in the street with no physical life left in it represents the final stage of the life course, but that there are also many intermediate
U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E
health outcomes that individuals experience. If someone has an adverse encounter with police and doesn’t die, but later starts practicing behaviors that lead them to develop cardiovascular disease or problems with substance use, their death record won’t say anything about policing, but in fact it might be tied to that experience. Mental health challenges include worrying about how to teach one’s children to survive in a hostile social environment, as well as the physical health consequences of exposures to everyday microaggressions of racism. It’s not just death, but the threat of it as well as living in a toxic climate in which one’s life is devalued that keep people from attaining optimal health. For all these reasons, racialized policing is absolutely a public health issue. What role does structural racism play in the higher rates of COVID-19 and
poorer COVID-19 outcomes being experienced by racial and ethnic minority communities? A: There are so many ways in which racism is relevant, and there is not enough research in this area. We know, for instance, that implicit biases exist among health care providers. Whether a person receives COVID-19 testing doesn’t just come down to access; other considerations may include what was their experience the last time they went to the health care provider? In addition, particular groups of people are more likely to be exposed by virtue of the type of job they have. African American women make up a large percentage of nurses and nursing aides whose work requires them to be intimately involved with people who are sick with coronavirus or other conditions. Yet, we don’t often think about other frontline workers such as cafeteria and janitorial staff. From research, we know that the physiological stress tied to chronic exposure to racism is in part related to the level of agency a person can exercise to address the social exposures. So, for instance, a doctor and a housekeeper may have similar levels of exposure to patients with COVID-19 in a hospital, but the doctor can make decisions that the housekeeping person can’t about what they will or will not do, and what kinds of protections they require.
RIGHT: CHANDRA FORD
What is the major focus of your center in addressing COVID-19 inequities? A: We formed the COVID-19 Task Force on Racism & Equity in March, and have built an interdisciplinary, inter-institutional collaboration that has sought to reach out to the public, public health agencies, and policymakers to explain how, based on our knowledge of how racism and
other forms of social inequality work, we are very concerned about disproportionate rates of COVID-19 in socially marginalized communities. Recently, the task force launched a study to capture the experiences of racial and ethnic minorities during the COVID-19 pandemic. We will be conducting virtual focus groups as well as follow-up interviews to understand how everyday lives are affected by this pandemic, and what people need in order to trust the health care system and access the resources that are available. In addition, we will analyze social media data to explore how these things are happening on a real-time basis.
You received the 2019 Faculty Teaching Award from FSPH’s Public Health Student Association, and master’s and doctoral students play active roles in your center. What is it about teaching and mentoring students that is so important to you? A: Our students really are phenomenal. To my knowledge, this center was the first in the country to focus explicitly on racism as a public health issue. One of the purposes is to create a space where students from diverse disciplines, and with different interests and approaches, can do research, scholarship, and public
health community engagement in ways that are both bold and rooted in public health science, theory, and pedagogy. It’s not just that they protest; rather, the ways in which they go about pursuing justice and equity reflect the highest caliber of what our school has to offer. By coming together, we build more than any of us could accomplish alone, and we can all push one another to more sophisticated levels in carrying out our work, while serving as a supportive intellectual community. Recently I was looking at some pictures from our center, and as I looked at one it dawned on me that this was a group of eight to nine doctoral students of color advancing original work on racism and health. I felt butterflies as I thought about how rare that is in our nation, and in that moment I knew we were beginning to accomplish what I had hoped for with this center. What compelled you to take on the role of co-editor for “Racism: Science & Tools for the Public Health Professional”? A: I felt very privileged when APHA Press invited me to lead that project at the suggestion of Derek Griffith of Vanderbilt University, whom APHA Press had initially invited. For as long as I’ve been doing this work, I have felt like few people appreciate that addressing racism should be a central part of the work of public health, not something on the field’s margins. Racism impedes the achievement of equity and health for all. I felt a professional responsibility to move the scientific and other information about racism out into the broader field so that public health professionals working on the field’s front lines could make a difference by addressing it not only within society, but also as it operates within our field. 6
What are some concrete actions public health institutions should be taking to combat racism? A: The first thing is naming racism explicitly. This is changing over time, but it’s difficult for me to think of another risk factor where people who study it are routinely told that it’s inappropriate or impolite to name it, even when one is presenting empirical findings about it. We also need to work on truly hearing the perspectives of Black, Indigenous, and other communities of color, and valuing them by allowing them to exercise equal power as partners in research collaborations, rather than treating their contributions as mere footnotes. And we must invest in our students of color in ways that make our educational institutions places where they can thrive. There are simple, practical steps that public health professionals can take to address racism in our society. But, we also have to look in the mirror and really see our imperfect selves. What do you hope comes from this period of reckoning with structural racism? A: I’m looking to see that the people who have been involved with this work over the long haul are the ones who are directing the kinds of structural changes we need. There are individuals who have been championing these struggles for a long time. If those kinds of folks are not central to the efforts to solve the problem, I will be skeptical about the depth of the commitment to real structural change. I’m also concerned about the disproportionate focus on egregious overt forms of racism without actually doing the underlying work needed to become a fully equitable society. I start one of the courses I teach by saying that the purpose is to
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“Racism impedes the achievement of equity and health for all.”
get us beyond thinking simplistically that “racism is bad.” In the current climate, critical race theorists worry about how easy it is to point to white supremacists in the streets as indicators of “bad racism,” while at the same time ignoring the more nuanced ways in which structural racism persists, guaranteeing the preservation of white supremacy and reinforcing the exclusion of people of color. I don’t think the solution is one that will come by next year, and I would be suspicious if it did. The way critical race theorists understand racialization is that the appearance of equity can be weaponized in ways that silence those most impacted by racism, dismissing any concerns they raise about their continued experiences with underlying inequality. My focus is not on the outcomes of this moment, but on the process. I don’t know what the right outcome should look like — the ideal world might look very different from what any of us has conceptualized. But I’m optimistic because I am committed to taking one good step each day. I have faith that others will join my colleagues and me on that path — and through that process we will get to something that is far better than what any of us right now can imagine.
MOMENT OF RECKONING
PU RSU I N G J USTIC E Six Fielding School students who are active members of FSPH’s Center for the Study of Racism, Social Justice & Health discuss what motivates their academic work and how they hope to make a difference.
NATALIE BRADFORD, MS
scholarship and organizing that
In one of the book’s appendi-
can challenge its reality, I study
ces, I describe three communi-
PhD Student, Health Policy and Management
structural racism’s relationship
ty-based anti-racism projects.
WHEN I WAS IN HIGH SCHOOL,
to health policy and health care
Each project includes policy
inequities.
change as a strategy to address student
racism
my family and I moved a dozen
researcher at the Center for the
equity.
times.
moves
Study of Racism, Social Justice
The
escalated
series
after
of
my
As
a
graduate
and
One
of
advance my
health
goals
is
to
younger
& Health, I contributed to and
sister was hit by a car. Many
served as the project manager
only a public health issue; it is
of the rehabilitation services
for the recently published book
also a health care and health
demonstrate that racism is not
she needed were not available
“Racism: Science & Tools for the
policy issue. With an eye toward
in our neighborhood. At the
Public Health Professional.” The
that goal, my dissertation uses
time, I did not understand why.
book — drawing on decades of
critical race theory to examine
Why do predominantly Black
public health research, prac-
the relationship between racial
neighborhoods
tice, and activism — makes it
residential segregation and the
tend
to
lack
access to quality and affordable
clear that racism is a public
expansion of community health
health care? To understand this
health issue that is neither new
centers under the Affordable
question and contribute to the
nor an aberration from the past.
Care Act.
MILLICENT N. ROBINSON, MSW, MPH PhD Student, Community Health Sciences HEALTH HAS ALWAYS BEEN
unfavorable physical and mental
Health
A PASSION OF MINE, particu-
health outcomes due to racism,
hosted by the center in Febru-
Conference
that
was
larly mental health among Black
sexism, classism, and other fac-
ary. I am grateful to have been
women. This commitment was
tors. Additionally, dominant con-
provided an opportunity to lead
born from witnessing the impact
ceptualizations of health within
in facilitating a space that not
of stress-related chronic health
the U.S. are Eurocentric, and typ-
only highlighted, but also hon-
conditions
in
ically do not consider the experi-
ored, the work, perspectives,
my family. I obtained training in
ences and perspectives of Black
and contributions of community
among
women
psychology to understand men-
women. To address this, my
members.
tal health more broadly. Sub-
work examines the links between
the conference planning com-
sequently, I completed training
chronic stress, racism, coping,
in social work and public health
and health, while centering the
to understand the connections
experiences of Black women.
I now serve as coordinator
between mental and physical
Public health has provided me
of the Center for the Study of
oppressive systems and disman-
health.
with the tools to explore these
Racism, Social Justice & Health. I
tle structural inequities has been
relationships
chaired the 2020 UCLA Minority
transformative.
Black
women
experience
from
a
popula-
Many
members
of
mittee are student affiliates of tion-based perspective.
the center. To be surrounded by peers who also work to disrupt
ph.ucla.edu
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TAYLOR B. ROGERS, MPH PhD Student, Health Policy and Management
JAMES HUYNH, MA, MPH ’19 PhD Student, Community Health Sciences IN COLLEGE, I WANTED TO PURSUE MEDICINE to become
a
neurosurgeon
and find a cure for Parkinson’s disease — the disease that had taken my paternal grandfather from me. But taking ethnic studies courses and being involved with student organizing for workers’
and
immigrants’
rights changed my trajectory. In particular, learning SHORTLY
AFTER
STARTING
tionally, I want to mentor the
from the radical activism of
MY FIRST JOB in human ser-
next generation of researchers,
queer communities of color
viously the interim center
vices and behavioral health for
especially scholars of color, to
in California helped me find
coordinator, and am now the
Baltimore County, I grew frus-
continue the work toward dis-
a sense of purpose and
coordinator for our COVID-
trated that my training, skill set,
mantling oppressive systems,
belonging in committing to a
19 Task Force on Racism &
and work scope were limited
which I plan to do as a gradu-
life of transformative justice.
Equity. In these roles, I feel
to individual behavior change
ate of this doctoral program.
In my pivot to public
immense privilege to work
and ignored the ways in which
The UCLA Center for the
health, I study how pro-
with
an
interdisciplinary
oppressive systems and struc-
Study of Racism, Social Justice
cesses of racial capitalism
team
of
scholar-activists
tures such as racism operate in
& Health has been my intellec-
(i.e., the racialized extraction
who approach public health
the background and hinder the
tual home since I began my
of people, labor, resources,
with critical anti-oppression
ability for Black people to live
doctorate in the fall of 2018.
and land) and heterosex-
perspectives.
their best, most productive, and
Under Dr. Chandra Ford’s men-
ist patriarchy affect queer
fulfilling lives. This led me to
torship, I chaired the Planning
communities of color. I also
pursue my MPH in Health Equity
Committee for the Minority
study how these communi-
from the University of Maryland,
Health Conference at UCLA in
ties foster cultures of health
College Park, and begin my PhD
2019 and was the past-chair of
in
in Health Policy and Manage-
the committee in 2020. I have
practices
ment at the Fielding School.
also served as a consultant for
organizing. By using a com-
Black Coalition Fighting Back
munity-based participatory
Serial Murders.
research approach, I seek
The ways health researchers, health care practitioners, and
their
kinship-making and
grassroots
frontline staff are trained reflects
Working with Dr. Ford and
to help queer communities
structural forms of racism. I
the center provides a regular
of color address structural
hope to raise racial conscious-
reminder that I and other stu-
forms of social, political, and
ness among these groups to
dent affiliates belong in this
economic precarity.
improve health and health care
space, and that our expertise
outcomes for Black people and
is needed — especially now,
Study
other marginalized communities
in the middle of the COVID-19
Justice & Health, I was pre-
to achieve health equity. Addi-
and racism pandemics.
8
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At the Center for the of
Racism,
Social
how the field applied theories from across disciplines to address racial health inequities. My specific interest is in examining how understudied forms of structural racism, such as voter suppression,
ANNA HING, MPH PhD Candidate, Community Health Sciences AS
AN
UNDERGRADUATE
produce
racial
health disparities. With the center, I’ve become involved
with
the
COVID-19
Task Force on Racism & Equity. While this task force began with a focus on the pandemic, it has shifted to also address the
I
ongoing crisis of police brutal-
at first glance seem unrelated
studied psychology and anthro-
ity. My role has been to contact
to health, it has been incredibly
pology,
me
policymakers to help them think
rewarding to see how the center
to think about the health con-
about anti-racist solutions to
has worked with policymakers
sequences
which of
prompted
interpersonal
these two pandemics. COVID-19
and
structural
has disproportionately harmed
strate
violence. I became most inter-
Black and Brown people, and
directly
ested in how structural inequal-
the center is actively calling
of some of the most vulnera-
ity led to health inequities, and
attention to these inequities and
ble California residents. In the
began thinking about the role of
working to create solutions to
future, I hope to use the skills
structural racism. I then chose
mitigate their increased vulner-
developed from this experience
to pursue a master’s, and sub-
ability.
to continue to bridge public
discrimination
sequent
and
public
As I study the impact of pol-
health because I appreciated
doctorate,
in
icies, such as voting, that might
practitioners how
these
influence
to
demondecisions
the
health
health research and practice to move toward health equity.
EZINNE NWANKWO, MPH PhD Student, Community Health Sciences MY
LAGOS,
public health as an undergraduate
ous projects and working with Dr.
NIGERIA, and my family’s immi-
CHILDHOOD
IN
at San Francisco State University,
Chandra Ford and her colleagues
gration to San Francisco served as
I began to tie the unfair distribu-
to develop and submit the pro-
the catalyst I needed to ask bold
tion of opportunities, resources,
posals. I find this work meaningful
questions. Our move from famil-
and political power to inequities
because it will establish continuity
iar hardships to new challenges
in health. My interest in the study
in the center’s anti-racism efforts
revealed that oppression and the
of racism and health allows me to
and ensure that future students
fight for justice are globally linked.
focus on how structural determi-
have access to the center for years
This discovery sparked my inter-
nants, which are often assumed
to come.
est in connecting the social and
to be too removed to have mea-
In the long term, I envision a
economic conditions in which we
surable impacts, shape our health
career in which research, commu-
grow up and live to health.
and well-being.
nity engagement, and policy play
These realizations began as
My work at the Center for the
a central role. For me, this can take
family’s
Study of Racism, Social Justice
many different forms, but a future
experiences, but when I took a
& Health focuses on identifying
that foregrounds anti-racism work
course on structural inequities and
funding opportunities for vari-
is paramount.
reflections
about
my
ph.ucla.edu
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MOMENT OF RECKONING
Meeting the Moment FSPH infectious disease expert Anne Rimoin has responded to COVID-19 by actively engaging with the news media and public officials, and launching a study that could produce critical insights.
ANNE RIMOIN
10
IN LATE DECEMBER of last year, Fielding School epidemiology professor Anne Rimoin was planning one of her regular trips to the Democratic Republic of the Congo (DRC). An internationally recognized expert in emerging infectious diseases, Rimoin founded the UCLADRC Health Research and Training Program 16 years ago as a collaboration with government and university partners to build the local capacity to conduct highimpact infectious disease research in low-resource, logistically complex settings. Then, in early January, Rimoin began reading about an emerging disease in Wuhan, China, that would upend her plans. As COVID-19 grew from a local public health emergency to a global pandemic, Rimoin found herself in heavy demand, sharing her expertise as a staple
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on major television news programs and in numerous print and radio outlets. Local officials sought her counsel, including members of the Los Angeles City Health Commission, where she presented in March, and Los Angeles Mayor Eric Garcetti, with whom Rimoin collaborated on a public service announcement for Angelenos. But Rimoin’s most profound impact is likely to come from her role in conceiving an initiative to test and track the exposure of health care workers and first responders to COVID19. The COVID-19 Rapid Response Initiative is conducting monthly serologic screening of the health care workers and firefighters who have enrolled in the study, as well as biweekly testing for asymptomatic or pre-symptomatic infection. The study is headed by Rimoin and Dr. Grace Aldrovandi of the David Geffen School of Medicine at UCLA (DGSOM), and includes a multidisciplinary team of researchers from both FSPH and DGSOM. Health care workers are especially vulnerable during rapidly evolving pandemics, with reported infection rates as high as 20% in some countries — a level that would cripple the health care system in Los Angeles. “How can we expect our health workforce to be protecting us if we’re not doing everything that we can to protect them?” Rimoin says. “This is the best way we can understand how to keep our health system functioning, and be able to allay the fears of health care workers, who are putting their lives on the line every day.”
Dr. Ashley Gray, a pediatric hematology fellow at Ronald Reagan UCLA Medical Center’s Mattel Children’s Hospital who is enrolled in the study, is one of those health care workers. “Peace of mind is something a lot of us would like to have right now and many of us struggle with on a daily basis,” she says. Beyond protecting those on the front lines of the pandemic response, the study could produce invaluable insights on key issues such as why many people are infected but don’t experience symptoms, whether people can become infected more than once, whether the presence of antibodies in a person’s system confers immunity, and, if so, how long such immunity lasts. “It’s really important that we better understand asymptomatic infection and immunity, and health care workers and first responders are populations that are likely to be highly exposed to people with COVID-19,” Rimoin explains. “Health care workers are often impacted by infectious disease, and COVID-19 is a prime example.” The COVID-19 Rapid Response Initiative has received substantial support from philanthropists and city officials alike (for more on the philanthropic support, see page 38). In April, the Los Angeles City Council voted unanimously in support of a motion that could lead to financial support for the study from the city. “The ability to be nimble in doing research early in a pandemic is critical,” Rimoin says. “I am excited to have this opportunity
RIMOIN’S COVID-19 RAPID RESPONSE INITIATIVE IS TESTING AND TRACKING THE EXPOSURE OF HEALTH CARE WORKERS AND FIRST RESPONDERS — TWO ESPECIALLY VULNERABLE GROUPS — TO COVID-19.
to apply my skill set, and to work with this incredible team of researchers, to obtain data that can help to guide evidence-based public health policies in the months and years ahead.” As Rimoin and her colleagues have embarked on the research, Rimoin has continued to make time to share her expertise with the public by way of the media — she has been quoted and/ or her expertise referenced in more than 2,000 media stories. “As academics, we often underestimate the importance of communicating information to the public through the media, but that can make a big difference — particularly during this pan-
demic, when it’s so critical for people to have accurate information that they can act on to protect their health and the health of the larger community,” Rimoin says. “With that in mind, I have tried to use a variety of media platforms to explain what COVID-19 is and how to mitigate risk.” Having spent much of her career partnering with government and academic leaders in the DRC to build the public health infrastructure needed to respond to emerging infectious diseases, Rimoin believes the United States’ COVID-19 experience has underscored the perils of declining public health funding in this country.
“The big lesson that we should take away from this pandemic is that we can’t wait for an emergency to invest in public health,” she says. “We have lacked a national strategy, we have been behind on vaccines and therapeutics, and testing has been hard to lift up, all as a result of a long period of insufficient funding for the public health and scientific research infrastructure. Hopefully we have learned that it really is about an ounce of prevention being worth a pound of cure — that we need to invest during the times when it seems like infectious diseases aren’t important, so that we’re ready when something like this hits.”
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’WHICH DEATH DO BLACK MEN RISK— COVID-19 or Police Shooting?‘
Fielding School professor Vickie Mays explains how structural racism has played a role in the response to COVID-19 — and in the decisions of many to accept a level of risk in the process of demanding change.
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SO FAR, THE YEAR 2020 has seen two major historic events — the public health crisis brought on by the COVID-19 VICKIE MAYS pandemic, and the massive nationwide protests against structural racism following the police killings of Breonna Taylor and George Floyd and inaction in response to the shooting death, captured on video, of Ahmaud Arbery by two white residents.
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Vickie Mays, a Fielding School professor of health policy and management, has focused on their intersection. Structural racism is contributing to the disproportionate impact of the pandemic in Black communities and the reticence of some Black men to wear masks, she notes; at the same time, Mays says, the calculation that racism is a far greater life-and-death health concern than COVID-19 has played a role in the decisions of many to join the protests, despite the risks associated with large gatherings.
Mays has worked with members of the Congressional Black Caucus, as well as the White House and the American Psychological Association, on legislation to require better data on the race, ethnicity, and social risk factors of people vulnerable to the pandemic. She has also conducted research on the data needed to create better models for predicting the spread of COVID-19, in order to reduce the number of infections and deaths in Black communities. “While the media has reported that Blacks are disproportionately infected,
hospitalized, and dying from COVID19, little has been provided on resources specific to the Black community,” says Mays, who, in addition to her FSPH faculty position, is a professor of psychology in the UCLA College and director of the UCLA Center on Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions. “The portrayal of COVID-19 implies that Blacks, because of their poor health status, will get the virus and die,” she adds. “Yet, little is focused on the role of labor practices in which Blacks in America work in occupations and places more likely to put them at risk to being infected. Rarely do we hear about the numbers of Black Americans who work in essential jobs, provide them personal protective equipment, and thank them for being our bus drivers, the maintenance cleaners in the hospital, the workers in the meat plants and many other jobs at which they work, often with no sick days or ability to work from home. Rarely are we hearing about the fact that Blacks in the U.S. are twice as likely as whites to not have running water or indoor plumbing in order to wash their hands frequently.” Mays, who recently was among the featured speakers for “COVID-19: The Battle to Save Black Lives,” a virtual town hall about the health, economic, and social impacts of the pandemic on Black communities sponsored by the Minority Health Institute, says better race/ethnicity data on COVID19 is needed to ensure that adequate planning and prevention resources are allocated where they are needed. “Black Americans are at high risk for COVID-19 based not just on their health disparities, but disparities that exist based on a lack of health care resources, the ability to respond to stay-at-home orders, effective isolating at home because of the lack of space in their living quarters, or a lack of income that allows them to purchase goods only for a few days at a time, requiring more store visits,” Mays says. The recommendation by the U.S. Centers for Disease Control and
Prevention that people wear masks in public to prevent the spread of the coronavirus raised an issue for Black men, Mays notes: whether covering their face would reduce one risk while increasing another — the chance of being viewed suspiciously and targeted by police and security personnel. “Which death do Black men risk? COVID-19 or police shooting?” Mays says. “We have African American men who have been dragged out of stores, who have been ordered by police and store guards to pull their masks down or take their masks off.” A Rutgers University study published last year found that approximately 1 in 1,000 Black men and boys in America could expect to die at the hands of police in their lifetime — a public health crisis that prompted many to calculate that attending demonstrations to demand change was necessary, even during a pandemic. “There are people who are willing to risk getting this virus because the issue of Black men getting killed is so real in the community,” Mays says. “They know the risk of COVID-19 is there, but the social justice issue is too important. And in some cases, people have determined that the greater risk is getting killed by police.” Mays believes leaders must acknowledge the role racism plays related to the pandemic response, from the targeting of Black men wearing masks to the lack of systematic data collection on the race of those infected, which works to the detriment of rapid and effective prevention efforts. She notes that bias plays out in actions as fundamental as the treatment of essential workers of color. “People were making masks and buying masks for health care workers, but they didn’t give those things to the janitors cleaning up,” Mays noted in an interview with STAT published in June. “They didn’t give those things to the bus drivers.” A key lesson policymakers should draw from the pandemic, she concludes: “We are all connected. The extent to which we allow members of our society to be unequal is the extent to which we endanger the health of all.” ph.ucla.edu
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ON THE FRONT LINES OF A GLOBAL PANDEMIC In Singapore, Fielding School alum Angela Chow is playing a key role in a response whose early success drew international praise.
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THE 1,600-BED, ACUTE CARE TAN TOCK SENG HOSPITAL, WHERE FSPH ALUM ANGELA CHOW HEADS THE DEPARTMENT OF CLINICAL EPIDEMIOLOGY, TREATS THE MAJORITY OF CONFIRMED COVID-19 CASES IN SINGAPORE.
AS THE GLOBAL COMMUNITY grappled with the COVID-19 pandemic early in 2020, one country that stood out as an exemplar of the impact a coordinated and proactive public health approach could have in containing an emerging infectious disease outbreak was Singapore, where Fielding School alum Angela Chow (PhD ’14) serves at the forefront of the response. Singapore reported its first COVID19 case on Jan. 23 and more soon followed — initially through travelers arriving from Wuhan, the capital of China’s Hubei province, where the outbreak originated. But Singapore’s public health response was swift — including canceling all inbound flights from Wuhan; imposing strict quarantines and restricting the movement of individuals who had recently been
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in affected areas; taking immediate steps to map the transmission of the novel coronavirus through polymerase chain reaction testing and tracing of contacts of people found to be infected; and amplifying campaigns to promote safe distancing, as well as personal and public hygiene strategies designed to reduce transmission. Collectively, these actions resulted in a much flatter rate of case growth in Singapore during the early weeks of the pandemic than in European nations and the U.S. The early response drew praise from World Health Organization Director-General Tedros Adhanom Ghebreyesus, who on March 10 lauded Singapore’s “all-of-government approach,” bringing the resources of multiple sectors to bear on the pandemic.
“We have had a highly coordinated effort, involving not just the health sector but many other sectors, all contributing based on their expertise,” Chow says. As an example, she cites the law enforcement community’s role in assisting with the contact tracing, based on its investigative know-how. Chow has played a key part in Singapore’s response through her work at Tan Tock Seng Hospital (TTSH), where she heads the Department of Clinical Epidemiology, and at the National Centre for Infectious Diseases (NCID), where she is director of the National Public Health and Epidemiology Unit. The NCID is a national referral center built for managing emerging infectious disease cases, with 330 beds — though it ramped up to nearly double its capacity after the first COVID-19 cases. TTSH, which is co-located with NCID, has been supporting and augmenting NCID with human resources and other assistance. Although Singapore experienced a spike in new infections in mid-March, Chow has been consistent in leading teams in conducting active surveillance of patients seen in the hospital’s emergency room for suspected COVID-19, as well as participating in activity mapping and contact tracing of confirmed cases — identifying close contacts to be followed up by Singapore’s Ministry of Health for quarantine. Her team also performs active fever and health surveillance on more than 10,000 staffers at the hospital — referring those who are sick for medical attention and, when necessary, screening for COVID-19 — along with telephone surveillance fol-
“There is tremendous satisfaction in knowing that this work will prevent people from getting infected.” — Angela Chow, PhD ’14
low-up until their recovery and return to work. “We work to ensure that our frontline colleagues remain well and adequately protected with the required personal protective equipment while attending to patients, for the safety of staff, patients, and visitors,” Chow says. Chow notes that Singapore’s public health system was prepared for COVID19 in part because of steps taken during and after the 2002-03 SARS epidemic, including expanded testing capacity for new viruses and beefed-up epidemiological surveillance. “Many of the systems had been strained, but as a result of SARS, we now have epidemiological teams within hospitals that are not only doing health care epidemiology, but also taking on an expanded role when it comes to outbreaks in the community, including greater involvement in contact tracing,” she explains. Chow, who was part of the national response to the SARS epidemic as assistant director in the Singapore Ministry of Health’s Division of Communicable Diseases, says COVID-19 presents challenges unlike those of SARS. “COVID19 is much more transmissible, and the way it rapidly moves through countries and throughout the globe has meant that information changes by the day, which made it very challenging to keep pace with the contact tracing and activity mapping during the containment phase,” she says. If SARS represented a turning point for Singapore’s public health system, the experience also represented a pivotal moment in Chow’s career. She grew up in Singapore and was trained as a physician, with the intention of treating patients. Though Chow enjoyed clinical practice, she decided she could make more of an impact working at the population level, so she undertook a preventive medicine residency as a public health specialist with the Ministry of Health. Initially her focus was on health promotion and prevention of noncommunicable diseases, but that soon changed. “With SARS, I was doing shoe-leather epidemiology in communicable diseases, and I realized that was the direction I wanted to take,” Chow says.
ORIGINALLY TRAINED AS A PHYSICIAN, CHOW WAS PART OF THE NATIONAL RESPONSE TO THE 2002-03 SARS EPIDEMIC AND DECIDED TO CONTINUE HER WORK IN EPIDEMIOLOGY BECAUSE OF THE POTENTIAL FOR GREATER IMPACT.
In 2010, Chow took a two-year leave from her position at TTSH to begin her doctoral studies at the Fielding School. “I wanted to increase my knowledge and skills in epidemiological methods, and the Fielding School is very strong in that area,” she explains. Under the supervision of her adviser, Dr. Onyebuchi Arah, and his colleagues in FSPH’s Department of Epidemiology, Chow learned not only state-of-the-art tools of the profession, but also approaches to education and mentorship that continue to serve her in her current departmental leadership capacity, and as an associate professor teaching public health and epidemiology at the Saw Swee Hock School of Public Health at the National University of Singapore and the Lee Kong Chian School of Medicine. After completing her written and qualifying exams in 2012, she spent the next two years finishing her Fielding School PhD studies in Singapore before returning to FSPH in 2014 to successfully defend her dissertation. The FSPH doctoral training has continued to inform Chow in her efforts at the leading edge of Singapore’s COVID-19 response. “What we’re doing now requires long hours of painstaking work, particularly when we are following up on every activity and person our patients have been in contact with,” she says. “But there is tremendous satisfaction in knowing that this work will prevent people from getting infected.” ph.ucla.edu
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In Pandemics, More Than Viruses Spread Throughout history, racism and xenophobia have spiked during public health emergencies, underscoring the importance of proactive countermeasures.
AS THE NOVEL CORONAVIRUS pandemic took hold early this year, it sparked another type of contagion — one that, Fielding School experts note, is not at all novel in the context of public health emergencies. In this case, because of COVID-19’s origins in Wuhan, China, Asian Americans were the targets of much of the misinformation, stigma, and vitriol in the United States. A 22-year-old Asian American student told the Los Angeles Times of the fearful looks directed her way whenever she coughed. Other news outlets reported on Asian American children experiencing harassment at school. Well before the stay-at-home orders, Chinatown stores and restaurants were said to be empty. AntiChinese memes and derogatory jokes circulated online. In late March, the FBI warned of a surge in hate crimes endangering Asian American communities. STOP AAPI Hate, the Los Angeles-based, community-led effort to track hate crimes that was established in March, received nearly 1,500 reports of COVID-19 related discrimination from Asian Americans across the country in its first month. ph.ucla.edu
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“What we need to do is combat racism and xenophobia not just during public health emergencies, but all the time.” — Gilbert Gee
These and other incidents of racism and xenophobia — in some cases with malice, in others born out of fear and ignorance — underscore the importance of public health efforts to communicate effectively about what is and isn’t known about an emerging infectious disease, alongside proactive actions to fight misinformation and stigma targeting certain communities. “The absence of information can lead to irrational fears and a tendency for some people to play into existing stereotypes,” says Gilbert Gee, FSPH professor of community health sciences, whose research has focused on conceptualizing and measuring racial discrimination, and in understanding how discrimination is connected to physical illness. As the unfolding pandemic has demonstrated, the racism that pervades American society also drives how the pandemic affects Black, Indigenous, and other marginalized communities. These communities are among the hardest hit, in part because many hold jobs or live in circumstances that make physical distancing difficult or impossible, or due to, for example, historical and ongoing housing segregation — in the case of Native Americans, displacement to reservations — that helps explain why these communities experience disproportionate burdens of the underlying chronic conditions, such as asthma, known to increase risk of severe disease and death. “The problem is not simply that this virus exists; the problem is it is transmitted among people and along paths carved by the inequalities that already exist in our society,” said Chandra Ford, founding director of the Fielding School’s Center for the Study of Racism, Social Justice & Health and professor of community health sciences, in addressing the inaugural meeting of the new City of Los Angeles Civil and Human Rights Commission on the issue of structural racism and the COVID-19 pandemic in June. COVID-19 has invoked stereotypes dating back more than a century, to the so-called yellow peril — the racist trope that people from East Asia were disease-ridden and a threat to Americans. And Gee points out that although much of the focus has been on Asian Americans, there are 18
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spillover effects to other racialized minority groups falsely characterized as spreading disease. “I’ve seen people say that this is the ‘Corona beer virus,’ and that it shows why we need to build a wall at the Mexican border,” Gee says. Racist and xenophobic memes and sentiments are amplified in an era in which social media has become so deeply embedded in the culture, he adds. There is a long history of racism and xenophobia intensifying during emerging infectious disease outbreaks, Gee notes. In Europe, Jews were scapegoated during the bubonic plague of the 14th century. Irish immigrants were blamed for the typhoid outbreak in the U.S. and Canada in the mid-1800s. More recently, racist and xenophobic slurs and actions were directed toward Haitian Americans during the early years of the HIV epidemic in the 1980s, toward Chinese Americans in response to the 2003 SARS epidemic, toward Mexican Americans during the 2009 H1N1 pandemic, and toward West Africans during the Ebola outbreak that began in 2014. Gee points out that science and medicine have been used to support bogus arguments that certain groups are inferior throughout American history, starting with efforts to justify slavery. “There was a twisted logic that people from Africa were biologically constituted to kill themselves off or were lazy, and that white slave owners were actually saving them by having them do manual labor,” Gee says. “That was part of the rationale in our more recent past for preventing interracial marriage and promoting eugenics policies — the idea that the white race would degenerate.” Although these notions have been resoundingly rejected by modern medicine, Gee says, they have left an enduring legacy that racialized groups have fundamentally different biologies, which contributes to stigmatization and discrimination during public health crises. “We can learn a great deal from what has happened in the past,” Ford says. “What we are seeing today is not unique to COVID-19, or to the experiences of people from Chinese ancestry.”
Ford notes that as a result of the stigmatization that occurred during the HIV epidemic, there continue to be high levels of mistrust among people in the very communities where improving access to services is critical. While science denialism such as the outright rejection of any scientific evidence regarding vaccines or climate change does exist, Ford has seen racism-related mistrust take the form of beliefs that the government was withholding an HIV cure. “These conspiracies come from very legitimate concerns, based on historical experiences,” Ford says. “But such beliefs can make it more difficult to achieve public health goals.” Ford makes two other points. First, racial stereotyping by the public is only one of the ways racism operates in an epidemic. Racial thinking within the scientific community at a particular time reflects racist assumptions circulating in society during that period, she explains. Historically, the scientific community has contributed to those perceptions by, for instance, conducting research based on hypotheses in which racist assumptions are inadvertently embedded. Also, Ford says, stereotyping does not occur simply because a particular group has elevated rates of disease. “While this certainly exists, the stereotypes nearly always predate the conditions, and more often, a group is stereotyped if any evidence emerges that can be used to reinforce or extend existing bias, even if the evidence must be distorted to do so,” she says. The novel nature of COVID-19 and other emerging infectious disease outbreaks provides especially fertile ground for racist and xenophobic actions and beliefs, Gee says. Particularly in the early stages, when so much is unknown, some people will look for a scapegoat. “There is a tendency to associate diseases with certain kinds of people, whether it’s the culture of the country from which the disease originated, or racialized and marginalized communities,” Gee explains. “We don’t see the same sorts of reactions to chronic diseases that can’t be transmitted from one person to another,” says Nina Harawa (MPH ’95, PhD ’01), an FSPH professorin-residence of epidemiology whose work focuses on epidemiologic and behavioral interventions related to HIV prevention and treatment, predominantly in African American and incarcerated populations. “This fear surrounding an infectious disease, combined with ignorance, often leads to stigmatization.” In the case of HIV, the early association with certain groups contributed to the problem, Harawa notes. The disease caused by the virus was initially referred to as gay-related immunodeficiency, or GRID, which exacerbated levels of discrimination and stigma for a population already experiencing homophobia. The public health consequences when certain groups are stigmatized extend beyond the targeted populations. With HIV, Gee notes, the fear of stigma had the effect of discouraging at-risk individuals from getting tested or seeking treatment, likely contributing to greater transmission of the virus. Similarly, discrimination against a group of people in an emerging infectious disease outbreak such as COVID-19 can hinder public health efforts to conduct the testing and
surveillance necessary to combat its spread. “If someone who is Chinese has a cough and worries that their doctor or people on the street are going to discriminate against them, they may hide,” Gee says. For the targets of racism and xenophobia during a public health emergency, research has documented negative impacts on both mental and physical health. Gee notes that multiple studies have found that the chronic stress response when people experience discrimination can have physiological as well as psychological consequences. “This is something we should all be concerned about,” he stated in a March address to members of the Los Angeles City Health Commission, which advises and makes recommendations to the Los Angeles City Council. “All our efforts to combat discrimination and encourage people to be more empathetic and friendly to each other and avoid discrimination, and call that out, are important not only as a civil rights issue but as a public health issue as well.” Gee, Ford, and Harawa laud the proactive messaging from public health and other leaders since the outset of COVID-19. “The anti-stigma messages were very much a part of early responses to the pandemic,” Harawa says. “You saw it on government websites and hear it from officials — they recognized the need to incorporate that into the response from the beginning.” For better or worse, Harawa notes, the tone of the messages coming from the public health community can have a significant impact on the public response. “Part of the problem is that in the past, public health practitioners, along with others, have at times attributed these types of outbreaks to some sort of moral failing,” she says. “For example, immigrant communities have been blamed for living in unsanitary conditions, as opposed to focusing on the larger socioeconomic context of why that is.”
“As the pandemic expands … we must move quickly to ensure the needs of the most vulnerable members of society are not overlooked.” — Chandra Ford
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“We don’t see the same sorts of [racist and xenophobic] reactions to chronic diseases that can’t be transmitted from one person to another.” — Nina Harawa, MPH ’95, PhD ’01
Public health leaders can also send powerful messages through their words and actions. In February, before the widespread institution of physical distancing orders, New York City officials sought to counter unwarranted fears and stigma against Chinese Americans by getting photographed dining in Chinatown. More broadly, taking cues from the World Health Organization and U.S. Centers for Disease Control and Prevention, public health officials have encouraged the use of neutral terms to describe the current pandemic, such as COVID-19, as opposed to terminology with the potential to stigmatize, such as “the Chinese virus” or “the Wuhan virus,” which political leaders including President Trump have at times used. Harawa worries that such characterizations not only invite discrimination and stigmatization, but also could discourage countries from being open about potential emerging outbreaks in the future. “Some people say it is simply being accurate to label a disease along with its origins — for example, people point to the ‘Spanish Flu’ and Middle East Respiratory Syndrome, or MERS,” Gee says. “But those diseases were named prior to 2015, when the World Health Organization issued a guidance document saying that going forward, we should use neutral nomenclature. Thus, using ‘Chinese virus’ because of similar terminology in the past is not justified.” Under Ford’s leadership, the faculty, postdoctoral scholars, and students of FSPH’s Center for the Study of Racism, Social Justice & Health have begun developing a strategic plan. In early March, well before racial/ethnic disparities in COVID-19 were identified, they began sounding the alarm to policymakers that the pandemic was likely to impact Black, Indigenous, and other marginalized populations (such as incarcerated persons) disproportionately, though Ford notes there was little response at the time. The center established the COVID-19 Task Force on Racism & Equity on March 15, a collaborative endeavor co-chaired by Ford and Bita Amani of Charles R. Drew University, to ensure that efforts to contain the pandemic prioritize marginalized populations and issues of equity. 20
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“As the pandemic expands, taking root in the U.S. and elsewhere, we must move quickly to ensure the needs of the most vulnerable members of society are not overlooked,” Ford says. As in all of its work, Ford notes, the center will follow three guiding principles, drawn from the scholarship on the impacts of racism on the nation’s health of Dr. Camara Phyllis Jones, a physician and epidemiologist at Morehouse School of Medicine who is past president of the American Public Health Association and a member of the center’s executive board: Value all individuals and populations equally; provide resources according to need; and recognize and rectify historical injustices. “We want to promote the importance of allocating resources in a manner that isn’t just trying to lift all boats, but making sure that we reach people who are either in boats that have holes in them, or don’t even have a boat,” Ford explains. “And we need to recognize and address the suspicions and mistrust based on past experiences. For those of us in public health, modeling equity in our work will be critical to making sure that we’re able to reach those who are most vulnerable — both in terms of addressing their needs, and in making it possible for them to trust and be collaborators in the process.” Gee agrees that public health leadership in fighting against the racism and xenophobia that tend to spike during emerging infectious disease outbreaks is critical, and can make a difference. He encourages everyone not to remain silent when they witness someone making a racist comment. “Remind them that we are up against a germ, not other people,” Gee says, adding that individuals who experience discrimination should be urged to report it, in order to raise awareness of the problem and ensure that it gets the attention it warrants. It is not simply about changing people, he notes, but also institutions and policies. “Unfortunately, I would predict that when COVID-19 is behind us and the next disease emerges however many years from now, we will see the same thing,” Gee says. “What we need to do is combat racism and xenophobia not just during public health emergencies, but all the time.”
MOMENT OF RECKONING
Heymann’s expertise on sick leave policies globally led to appearances on Public Radio International’s “The World” program
Equal Time The COVID-19 pandemic has underscored the significance of the work of FSPH’s WORLD Policy Analysis Center in spotlighting which countries guarantee key human rights.
and KTLA television in Los Angeles. In addition, Heymann and WORLD senior legal analyst Aleta Sprague published a commentary in The Hill advocating for a national cohort of preventive health workers to roll out each element of the federal COVID-19 strategy. “People have been warning about an outbreak like this for years, but now is not the time to look backward,” Heymann says. “It’s the time to look forward, and ask what we can do, right now, to improve our response for the rest of this pandemic, so that we’re never so unprepared again.”
DR. JODY HEYMANN has devoted her career
The long view Heymann’s team brings to
to advocating for vulnerable and marginal-
issues of human and constitutional rights,
ized populations around the world through
including those as basic as the right to health
her public health and policy expertise and
and health care, is clearly demonstrated in
scholarship. As founding director of the
“Advancing Equality: How Constitutional
Fielding School’s World Policy Analysis Cen-
Rights Can Make a Difference Worldwide,”
ter (WORLD) and a distinguished professor
co-authored by Heymann, Sprague, and
of public health, public affairs, and medi-
WORLD principal research analyst Amy
cine at UCLA, she has led an unprecedented
Raub. Released in January 2020, the book
effort to expand the evidence on what works
analyzes the scope and impact of core social
to improve population health and economic
and economic rights in 193 countries.
outcomes across countries. Now, as the COVID-19 pandemic plays out around the world, the importance of her team’s work has become that much more apparent. WORLD seeks to promote equal opportunities across the globe by identifying the most effective national policy approaches to advancing health, equity, and well-being. By improving the quantity and quality of globally comparative policy data available and working in partnership, WORLD provides
“The pandemic sheds light on inequalities that we haven’t successfully addressed.” — Dr. Jody Heymann
policymakers, researchers, and the public with tools for taking action to strengthen policies and their implementation. One such policy is paid sick leave, which
“The pandemic makes plain the impor-
proved especially critical as COVID-19 first
tance of ensuring that both preventive
spread through workplaces. As Heymann
health care and treatment are equally acces-
notes, some of the countries without strong,
sible to all,” Sprague says.
comprehensive policies faced among the highest early infection rates.
As the book recounts, around the world, constitutional health rights have provided a
“The pandemic sheds light on inequali-
powerful tool for advancing public health.
ties that we haven’t successfully addressed,
The U.S., however, lacks a right to health.
as well as on which countries have adopted
Heymann notes that it’s also critical to have
key social protections for everyone in their
strong protections against discrimination.
society,” Heymann says. “The U.S., Italy, and
“What the data show is that COVID is
Iran are among the countries that lacked
making existing health disparities worse,”
paid sick leave from day one. It’s not the
Heymann says. “Beyond a right to public
only reason you get infection spread, but it
health, we need to ensure that constitutions
is a factor.”
clearly guarantee equal rights to all.” ph.ucla.edu
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MOMENT OF RECKONING
WORKFORCE IN PROGRESS THROUGH THE TRAINING OF COVID-19 CONTACT TRACERS AND CASE INVESTIGATORS, THE FIELDING SCHOOL IS HELPING TO PREPARE THOUSANDS OF INDIVIDUALS WHO WILL MEET A CRITICAL NEED IN REDUCING THE VIRUS’ SPREAD.
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AS
EASE
recent graduates have been hired to serve as
RESTRICTIONS and emerge as safely as pos-
CALIFORNIA
PREPARED
TO
training facilitators, including in such key roles
sible from shelter-in-place orders imposed
as program coordinator and training manager.
early in the COVID-19 pandemic, one of the
“The threat of COVID-19 remains high. If
major unmet needs was for more personnel
we want to safely begin reopening our society,
trained to perform the tasks fundamental to
we need to have certain public health mea-
infectious disease control, including contact
sures in place, including a significant increase
tracing, case investigation, and administra-
in our ability to trace new infections,” says
tion. To effectively relax California’s stay-at-
Ron Brookmeyer, dean of the Fielding School.
home orders, it was estimated that 10,000 to
“This large-scale training program with our
20,000 new contact tracers and case inves-
colleagues here at UCLA, and at UCSF and
tigators would need to be trained — individ-
the CADPH, will allow us to begin that effort to
uals to help to ensure that, as newly infected
expand and strengthen our public health work-
people are identified, their close contacts are
force.” Alina Dorian, FSPH associate dean for
traced and quarantined to reduce the spread
public health practice and for equity, diversity,
of COVID-19 and prevent major outbreaks.
and inclusion, is leading the team with Michael
The Fielding School is helping to meet this
Prelip, professor and chair of FSPH’s Depart-
critical need through its role in the California
ment of Community Health Sciences, and Eric
Connected COVID-19 Virtual Training Acad-
A. Bullard, dean of continuing education and
emy, co-led by the California Department of
UCLA Extension.
Public Health (CADPH), UCLA, and UC San
The training academy is a central part
Francisco (UCSF), which is training thousands
of California Connected, the state’s con-
of individuals in multiple counties through-
tact tracing program and public awareness
out the state. The comprehensive pandemic-
campaign, which aims to ensure that trained
response training program at UCLA is being
individuals are working with people who test
managed
positive for COVID-19 and their close con-
through
a
strong
partnership
between FSPH and UCLA Extension, and
tacts to secure access to confidential testing,
involves faculty and staff from both campus
health care, and other services designed to
units. Approximately 35 FSPH students and
prevent the virus’ spread.
U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E
“We are all eager to get back to work and
hands-on training facilitators. “This is a great
tracers will be to prevail upon asymptom-
play, and that’s why we’re asking Californians to
opportunity for our current students and new
atic individuals who have come into con-
answer the call when they see their local pub-
alumni to put their FSPH education into prac-
tact with someone who tested positive for
lic health department reaching out by phone,
tice by contributing in a meaningful way to this
COVID-19 of the importance of quarantining
email, or text,” Gov. Gavin Newsom stated in
once-in-a-lifetime public health response as
for 14 days. “These contact tracers will need
a news release announcing California Con-
we quickly ramp up to handle this emergency,”
to become trusted forces, for the benefit of
nected’s launch May 22. “That simple action
Prelip says. Adds Dorian: “These students and
all of us as we seek to mitigate the spread of
of answering the call could save lives and help
alumni are bringing in the expertise they have
this virus,” Dorian says. “Success in training
keep our families and communities healthy.”
obtained through their lived experiences in
this new workforce of contact tracers can go
UCLA’s comprehensive multi-day training
their own communities and applying that to
a long way toward moving us closer to pre-
program started in May, with an initial cohort
this training program in a way that adds sig-
COVID levels of normalcy.”
that included approximately 550 current
nificant value.” In addition, FSPH students and
Prelip, whose experience also includes
public employees with applicable skills, such
recent graduates have been hired to join the
disaster and emergency preparedness, has
as language abilities and up-to-date back-
UCLA campus contact tracing team, an effort
used training techniques in his work that
ground checks.
Dorian and Prelip are helping to facilitate.
are similar to what is being employed in the
Offered free of charge, the COVID-19
Dorian notes that the skills necessary for
Virtual Training Academy takes participants
contact tracing are well known, and that the
with Dorian that a strong system of testing,
through the basics of public health and epi-
techniques have been employed success-
tracing, and investigation makes it easier to
demiology, along with the specifics of case
fully in public health campaigns for decades.
reduce restrictions that have been imposed to
investigation and contact tracing. Trainees
“We regularly use contact tracing to contain
mitigate the spread of the novel coronavirus.
learn about cultural sensitivity and confidenti-
communicable diseases, and we scale it up
Prelip and Dorian expect the training pro-
ality, as well as interviewing skills and working
during outbreaks,” says Dorian, an expert in
gram to continue throughout 2020, and pos-
with diverse populations. The program fea-
disaster relief, health education, and health
sibly well into 2021. “This isn’t going to be one
tures state-of-the-art, high-quality e-learning
systems management who has led emergency
round of training — we are going to need to
modules, along with skills-building role-plays,
response teams in Kosovo, Haiti, and Peru.
train large numbers of people over time and
observation, and feedback.
“We use it for tuberculosis, sexually transmit-
adjust as conditions and factors change,” Pre-
Recent Fielding School graduates and MPH students entering their second year of the program have played a key role as
COVID-19 Virtual Training Academy. He agrees
ted infections, and measles. It’s a public health
lip says. “There is a tremendous amount of
measure that is tried and true.”
work that lies ahead, but this is the responsible
One of the major challenges for contact
path forward.” ph.ucla.edu
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MOMENT OF RECKONING
Sending the Right Message
The ability of officials to clearly and credibly communicate during a pandemic can go a long way toward determining the success of containment and mitigation efforts, FSPH experts say.
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IN ANY PUBLIC HEALTH EMERGENCY, conveying clear, accurate, and timely information to the affected population is important. But that information, along with the trustworthiness and credibility of the officials delivering it, is crucial during an emerging infectious disease outbreak, say two Fielding School experts in public health communication. The high-stakes nature of public health crisis messaging is on full display in the COVID-19 pandemic, in which the population has been asked to make enormous sacrifices and change its behavior. These measures are taken for people to protect themselves and their loved ones, but also their community and the society at large by slowing the spread of a highly transmissible virus. In this case, the ability of public health leaders to communicate the necessary actions and to persuade individuals, families, and communities to take them can go a long way toward determining the success or failure of containment and mitigation efforts. “Many public health disasters are local, such as an earthquake or a foodborne outbreak, and in those scenarios the people who are directly affected tend to be motivated to take what you’re saying seriously,” notes Deborah Glik, FSPH professor of community health sciences. “In this case, the problem is diffuse; it’s everywhere. You can’t see it, feel it, or touch it. In their daily lives, most people are focused on actions that benefit themselves and those close to them, but in this type of emergency we are also appealing to everyone’s sensibility about collective safety and well-being.” Meeting the challenge, Glik says, requires a high level of credibility — a status earned by government and public health officials who exhibit empathy, openness, honesty, and dedication as well as competence and expertise. Dr. Neal Baer, a television writer/ producer and former FSPH faculty member who has studied how to reach popular audiences with health messages, says the early federal response to COVID-19 was hampered by mixed messages about the importance of protective
measures such as physical distancing, as well as statements about aspects of the response, such as the availability of testing, that turned out to be false. “Above all, you need accuracy and trust for public health messaging to be effective in a crisis,” Baer says. “We haven’t always seen that with our response to COVID-19, and that’s been a real problem. These inconsistencies and inaccuracies erode trust and make it more difficult to get people to take desired actions.” Officials disseminating public health messages are doing so in a much different environment from even a decade ago, notes Glik, who has worked with local, state, and federal agencies on risk communication. While traditional approaches such as news conferences
“Especially in the era of social media, it’s … much easier for misinformation to spread.” — Deborah Glik
remain vital, the messengers also need to reach populations in nontraditional venues that have become information sources, including online engagement and social media. “The fact that a disaster or crisis is newsworthy means it’s not a problem for public health and health care agencies getting out messages,” Glik says. “But especially in the era of social media, it’s also much easier for misinformation to spread.” One public health lesson that evolved out of the aftermath of 9/11, she notes, is the importance of having a team dedicated to monitoring and countering misinformation. “That effort is even more critical today,” Glik says. Beyond the content of written and verbal communications, Baer says it’s crucial for the officials delivering public health messages during a crisis to model the desired behaviors. “We know from research, for example, that what people see on television affects public health behavior,” he explains. “When teens see
smoking on TV, they’re more likely to smoke. We don’t show people dying by suicide on television because we know that tends to increase suicidality.” Early on, Baer laments, White House Coronavirus Task Force briefings featured officials shaking hands and standing in close physical proximity to one another, sending the wrong message to viewers. Baer notes that when delivered properly, public health communications can help to tamp down anxieties. “It’s always about the story,” he says. “People are moved by emotion, and panic is caused by uncertainty.” Glik points out that although the COVID-19 pandemic may seem unprecedented in recent times, the basic tenets of effective communication in a public health emergency still apply. Those are outlined in the U.S. Centers for Disease Control and Prevention’s Crisis and Emergency Risk Communication (CERC) program. CERC outlines several types of narratives. What Glik refers to as the “a-list” messages involve basic information about survival: explaining the threat, who is at risk, and what people can do to prevent harm or seek assistance. Another set of messages lay out the public health actions being taken. Officials should discuss anticipated future steps and timelines, even if that includes an acknowledgement of what remains unknown, Glik says. She stresses that all of the key messages should be mapped out in advance so that every spokesperson is on the same page, and should be delivered with empathy, along with an acknowledgement of the fears and hardships that impacted populations are enduring. At a time when so much attention is focused on public health, a pandemic or other crisis also presents an opportunity to educate the population about the need to adequately support public health in non-crisis times. “Most people don’t appreciate the importance of public health until there’s an emergency,” Baer says. “We need to capitalize on the renewed recognition of public health’s value to ensure that the field is sufficiently funded and the threats we identify are appropriately addressed.” ph.ucla.edu
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MOMENT OF RECKONING
VIR A L LES S ONS The COVID-19 pandemic has underscored the importance of investing in public health while shining a harsh light on societal weaknesses. Fielding School faculty experts weigh in on what we have learned so far, and how we can do better.
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U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E
DR. DAVID EISENMAN, Fielding School professor-in-residence of community health sciences and director of FSPH’s UCLA Center for Public Health and Disasters, says the COVID19 pandemic has revealed critical areas in which the U.S. has fallen short. “Disasters shine harsh lights on society’s weaknesses,” he says. “This pandemic exposes problems in the U.S. that compound each other: an abdicated federal leadership, an absent social safety net, and a tenuous sense of social cohesion. But disaster models don’t fit the pandemic. This crisis will be with us for years. In that way it’s more like climate change: global, messy, and unequal in its effects.” •• The pandemic has also underscored the interconnectedness of nations. “Our ability to conquer COVID-19 and future pandemics depends on unity and interdependence,” says Dr. Robert Kim-Farley, professor-in-residence of epidemiology and community health sciences. “We must quickly act when there are outbreaks, epidemics, and pandemics affecting peoples of other countries and recognize that we are all striving to build a healthier United States and a healthier world by supporting international efforts and institutions to usher in a new era of collective response.” •• “Successfully confronting a global pandemic requires global cooperation, a coordinated response, and mutual respect by all nations,” says Dr. Roger Detels, distinguished research professor of epidemiology. “Regional, national, and international politics are the enemy of a
successful global response. Unfortunately, in the absence of international coordination and cooperation, some countries, including the United States, have had devastating epidemics while other countries have been able to blunt the epidemic by initiating intervention strategies early.” •• Other FSPH faculty point out that the pandemic has laid bare societal conditions that continue to fuel health disparities. “COVID-19 has put the spotlight on the fatal impacts of health care inequities on vulnerable communities,” says Arturo Vargas Bustamante, FSPH associate professor of health policy and management. “Latino and Black residents have been contracting the virus and dying at disproportionate rates because of their increased exposure and inability to access quality care and testing. With swift policy change, telehealth could transform access and reduce inequities, while potentially improving quality of care and lowering costs.” •• “Workers who were previously invisible to much of society are now making headlines, receiving well-deserved accolades, but that is not enough,” says Linda Delp, adjunct associate professor with FSPH’s Center for Occupational and Environmental Health and director of UCLALOSH (Labor Occupational Safety & Health Program). “The COVID-19 crisis has magnified the cracks in our worker health and safety system that relegate many working-class, people of color, and immigrants to hazardous jobs where they confront exposure to the coronavirus. Crowded
work environments, lack of protective gear, and production pressures contribute to the spread. Worker health is public health — and we must do more to ensure workers are treated as essential, not expendable.” •• Vickie Mays, FSPH professor of health policy and management, notes that preparedness for a pandemic or other public health crisis must not overlook the mental health needs of the affected population. “African American communities are experiencing the worst mental health consequences from the pandemic not because of poverty and compromised health, but because of our societal neglect of a culturally specific mental health preparedness response,” says Mays, a psychologist who, in the aftermath of Hurricane Katrina, spent five years as part of a response and resiliency team that helped to rebuild New Orleans’ mental health infrastructure. “We learned after Hurricane Katrina that the most prepared and reliable group to whom we can turn for an immediate response are religious leaders trained in pastoral care, pastoral counseling, and mental health interventions.” •• Chandra Ford, professor of community health sciences and founding director of FSPH’s Center for the Study of Racism, Social Justice & Health, notes that the legacy of racism in the U.S. can be clearly seen. “The structural nature of racism illuminates and exacerbates links between the historical imperialism that dispossessed Indigenous Americans of their land and the capacity of
people on reservations today to contain COVID-19,” Ford says. “It magnifies tensions between the relatively recent model minority myth and the long-standing xenophobia that has always characterized U.S.-China relations. It shows that racism against Black, Indigenous, and people-of-color communities is heightened, not lessened, in moments of crisis.” •• Not all of the lessons have to do with the pandemic response. For Yifang Zhu, an FSPH professor of environmental health sciences and associate dean for academic programs, one of the takeaways from the initial stay-athome period undertaken by major cities is the dramatic impact major societal changes can have on air quality. “In public health, we know prevention is better than cure,” Zhu says. “It’s cheaper and safer to prevent people from catching and spreading the coronavirus than to treat huge numbers of severe cases. Similarly, in air quality management, it is much better to cut down on emissions to reduce exposures than to deal with various adverse health consequences. We can take actions to improve our air quality and live in a more sustainable world, where technologies and policies come together to bring us cleaner energy, and where we don’t need a loss of life and wealth to make it happen.” •• Dr. Zuo-Feng Zhang, FSPH professor of epidemiology and associate dean for research, believes COVID-19 has served as a reminder that the fundamental tools of epidemiology, while essential, are not sufficient to respond effec-
tively to an infectious disease outbreak. “This pandemic has taught me that my knowledge of disease etiology and epidemiology isn’t enough, for example, to be able to evaluate the social and psychological impacts of the lockdown of Wuhan city, or how critical it is to educate the public through social media,” says Zhang, a physician epidemiologist from China who has continued to conduct cancer epidemiology research both in the United States and in his native country since coming to the U.S. more than three decades ago. “Our existing knowledge and experience might not be sufficient to facing the challenge of new emerging infectious diseases; we will need to constantly learn more and adapt as the world changes.” •• For Dr. Richard Jackson, an FSPH professor emeritus of environmental health sciences who has served as California’s state health officer as well as director of the U.S. Centers for Disease Control and Prevention’s National Center for Environmental Health, the pandemic has exposed the pitfalls of public health underfunding. “The public health infrastructure has been so starved over the years that it was frayed,” Jackson says. “It’s important that public health leaders use this as an opportunity to fix that infrastructure. We need to fund public health schools and invest in our next generation of leaders — including individuals who are skilled at data collection, know how to work with hospital electronic medical records, and can support real-time tracking of the health status of the population during these outbreaks.”
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CLIMATE CHANGE CONTINUES to wreak havoc on the health of the planet and its inhabitants. “This is an escalating health emergency,” says Dr. Jonathan Fielding, distinguished professor-in-residence in FSPH’s Department of Health Policy and Management. “And every bad decision we make in how we manage our natural and built environments escalates our risks in both the short and long term. We need to take advantage of every opportunity to blunt the many adverse effects of climate change so that our planet will continue to
support health and a satisfactory quality of life for the coming generations.” The new UCLA Center for Healthy Climate Solutions (C-Solutions), based in the Fielding School of Public Health, will focus on protecting human health from the harmful effects of climate change by identifying, evaluating, and disseminating information on solutions that strengthen the ability of communities to adapt to its effects and slow its impact. “While climate change is a risk we all share, we don’t share it equally,” Fielding says. “It disproportionately
CONFRONTING AN ESCALATING HEALTH EMERGENCY
The new FSPH-based UCLA Center for Healthy Climate Solutions will work with policymakers on strategies for protecting human health against a growing threat.
affects low-income people, people of color, and those with chronic conditions, exacerbating existing health inequalities.” For that reason, the center’s research and policy advocacy will prioritize actions that particularly benefit those most vulnerable to the changing climate’s impacts, while working with community groups and policymakers to shape the broader conversation about the negative effects of climate change on human health. Faculty from the Fielding School and other parts of the UCLA campus will participate in the center, which is co-directed by Fielding, who served as director and health officer of the Los Angeles County Department of Public Health for 16 years, and Michael Jerrett, professor in FSPH’s Department of Environmental Health Sciences and an internationally recognized expert on the health effects of climate change. Fielding points out that climate change can no longer be viewed as a distant threat; its health impacts are already visible and are rapidly worsening. In major cities in the U.S. and around the world, more frequent heat waves are resulting in increased illnesses and deaths. Hotter and drier conditions have significantly increased the risk of wildfires, with dire consequences already experienced in California. Warmer ocean temperatures have increased the severity of hurricanes and tropical storms, causing not just flooding but also higher levels of anxiety, depression, and post-traumatic stress disorder. Much of the initial focus of C-Solutions is on excess heat and wildfires. “Those are the areas in which the scientific evidence is highly certain,” Jerrett says. “Both have a great deal of salience for California and the American West, but they are also resonating globally, with wildfires tearing apart Australia and Portugal, and heat stress in places like Mumbai, India, making it dangerous to conduct construction and agricultural work during the day.” W hile many scientists and policy analysts are focused on the long-term threats of climate change, C-Solutions will seek to build community resilience by identifying and promoting measures
“Climate change is the most important issue for our collective future, and the greatest opportunity for public health to make a difference.” — Dr. Jonathan Fielding
aimed at increasing the ability of populations to effectively adapt to the changes already occurring. Fielding points out that this approach will also assist in the area of mitigation — efforts to reduce carbon dioxide emissions by curbing fossil fuel consumption and limiting the release of methane through modified agricultural and land-use practices. C-Solutions will also focus on maximizing the public health benefits of climate change adaptation and mitigation. For example, a program such as largescale tree planting cools urban areas, but substantial research also suggests this process, the “greening” of an area, can benefit physical and mental health. Jerrett notes that many strategies to mitigate or adapt to climate change’s effects come with important public health co-benefits, such as the E Line (Expo), the 15-mile light rail line that runs between Downtown Los Angeles and Santa Monica. “Undertaking a major public transit and active transportation initiative like the Expo Line, which expands light rail while also establishing designated bike paths beside it for most of the route, not only reduces CO2 emissions, but brings ancillary benefits through increased physical activity and reduced air pollution,” Jerrett says. “Even if people are just walking an extra 10 to 15 minutes a day to the train, that can have beneficial public health effects considering that the majority of U.S. adults don’t get the recommended level of physical activity.” Similarly, reducing the dependence on fossil fuels and moving toward a system based on renewable energy would result in significant public health co-benefits from improved air quality. Worldwide, air pollution accounts for approximately 9 million deaths each year from heart conditions, strokes, lung cancer, and other health issues. “The estimates show that we would save about 1 million lives a year if we moved to a more sustainable energy system,” Jerrett says. Highlighting these and other co-benefits is an important part of making the public health case for the steps needed to combat the effects of climate change. The new center is partnering with
the office of Los Angeles Mayor Eric Garcetti, who chairs the C40 Cities Climate Leadership Group — consisting of nearly 100 major cities around the world that are working together to take aggressive actions against climate change — to help calculate the public health co-benefits of proposed transportation initiatives. “Los Angeles is a city that tackles our toughest challenges by tapping into the innovation and creativity in our own backyard, and this UCLA center will help us build a safer, cleaner, and more equitable city and world,” Garcetti said. Beyond the work with the Los Angeles mayor’s office, the center will identify leading resilience-building practices and assist legislators, public health departments, and other leaders in making the evidence-based case for implementing them. As part of that effort, the center has begun an analysis of the policies enacted by C40 cities. “Our vision is to become a clearinghouse for ideas so that policymakers and the public can see what’s working and what isn’t,” Jerrett says, “and to support adoption of policies and programs that clearly make a difference.” Fielding, a national public health leader who recently co-chaired Healthy People 2030, which set national objectives for improving the health of all Americans over the course of this decade, says his involvement in establishing the center reflects his belief that there is no greater public health priority. The massive changes prompted by the COVID-19 pandemic — from the sharp rise in people working from home to the movement of many cities to devote more of their streetscapes to pedestrians and bicyclists — have shown the possibilities of a less carbon-intensive society, he notes. “Climate change is the most important issue for our collective future, and the greatest opportunity for public health to make a difference,” Fielding says. “We need to make it clear that many of the public health effects are being felt today, and that these effects will continue to become more severe if we don’t act immediately and decisively. Once that’s better understood, everyone can become part of the solution.” ph.ucla.edu
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‘Mustard Seeds’ in Full Bloom FSPH Professor Emeritus Virginia C. Li witnessed the results of more than three decades of Fielding School training of scholars who returned home to China to make a difference.
DURING HER VISIT to China in fall 2019, Virginia C. Li was reminded of a biblical phrase: “If you have faith the size of a mustard seed, you shall move mountains.” Li, a professor emeritus at the Fielding School, estimates that she has made 100 trips to her native country since 1974, when she went back for the first time, more than a quarter-century after moving to New York City with her family at the age of 13. Most of those trips have been in her capacity as a teacher and researcher, working on issues such as reducing contraceptive failure in family planning and a successful effort in tobacco control through a crop-substitution program aimed at tobacco farmers. After Li’s professional commitments on the fall 2019 trip, she took the opportunity to visit approximately a dozen FSPH alumni and former visiting scholars whom she had mentored, going back as far as the mid-1980s. “These men and women have all gone on to make major contributions to China as senior health scholars and administrators, as well as movers shaping programs, policies, and services,” Li says. She credits Dr. Roger Detels, FSPH distinguished research professor of epidemiology and dean emeritus, with planting the “mustard seeds” that have, in Li’s view, figuratively moved mountains in China. In 1985, when Detels was the Fielding School’s dean, he opened the door for eight visiting scholars from the Nanjing College for Population Programme Management and the provin30
HONGTAO HU, A FIELDING SCHOOL VISITING SCHOLAR IN 1985-86, WITH FSPH PROFESSOR EMERITUS VIRGINIA C. LI DURING LI’S VISIT TO BEIJING, CHINA IN NOVEMBER 2019.
cial agencies under the National Family Planning Commission of China to come to FSPH, with the support of the United Nations Population Fund (UNFPA). Their paths to studying in the U.S. had been blocked, Li says, after Congress suspended funding for UNFPA because of its support of China’s family planning program, which included abortion. Before long, it wasn’t just eight individuals coming to the Fielding School from China but dozens, including both visiting scholars and master’s and doctoral students — many of them supported by the UCLA/Fogarty AIDS International Training and Research Program, which was established under Detels’ leadership in 1988. “Since that time, China has made giant leaps in advancing the physical, mental, and social well-being of its people in cities and villages,” Li says. And the Fielding School, she notes, has contributed greatly by preparing midlevel Chi-
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nese public health professionals and academics to become leaders in health policy, research, and practice, with major impacts on HIV/AIDS control, family planning, and reproductive health in China and beyond. Li shared her reflections on five of the individuals she caught up with during her late-2019 visit: Hongtao Hu (visiting scholar, 1985-1986): Hu went on to serve as director general of the Department of International Cooperation in the former National Population and Family Planning Commission of China from 2010 to 2013, providing leadership in the implementation of an international collaborative project promoting quality of care in family planning and reproductive health. The project, which introduced informed choice and removal of birth targets, greatly contributed to the changes in China’s national population and family plan-
ning policies from a demographicdriven approach to one that was people-centered, rights-based, and service-oriented. Dr. Xiaoming Sun (visiting scholar, 1985-1986): As a professor and vice president of Nanjing College for Population Programme Management, Sun’s research has focused on population studies, public health, and behavioral sciences. He helped to improve migrant workers’ well-being in a project piloted in the economic development zone of the eastern China city of Changzhou. Promoting migrant workers as peer educators, the project’s success led to its adaptation in cities nationwide by the China Family Planning Association. Passionate about quality and equity in reproductive health and family planning for women and men of all ages, Sun has devoted much of his career to improving these service systems throughout rural and urban China.
Dr. Zunyou Wu (MPH ’92, PhD ’95): Wu served as the director of China’s national HIV/AIDS program from 2015 to 2017, overseeing the development of the country’s HIV/ AIDS response and working closely with international organizations and experts to raise awareness, develop a strategy, obtain funding, and implement solutions. His research, often in collaboration with Detels, contributed to scientifically informed policies to prevent HIV infection among vulnerable groups such as sex workers, people who misuse drugs, migrants, and men who have sex with men. Wu is now the chief epidemiologist for the Chinese Center for Disease Control and Prevention, where he has played a key role in the country’s response to the pandemic of SARS-CoV-2, the virus that causes COVID-19, and is also an adjunct professor in FSPH’s Department of Epidemiology. Wei Guo (visiting scholar, 20062007): For more than a decade, Guo played a key role in managing China’s HIV surveillance system at the National Center for AIDS/STD Control and Prevention, where he collaborated with international experts to lead a countrywide HIV epidemic estimation program, as well as designing national cohort studies across nine provinces involving men who have sex with men, sex workers, and people who use drugs. In 2018, Guo became the strategic
information adviser at UNAIDS China, where he has continued to support the country’s HIV evaluation and response. During the COVID-19 pandemic, Guo, together with UNAIDS colleagues, supported government and community partners to ensure people living with HIV in Hubei province could access HIV-related services. Yan Li (PhD ’08): Armed with her PhD in epidemiology, Li returned to the Guangdong Provincial Center for Disease Control and Prevention and was promoted to vice director, then director of the Institute for HIV/AIDS Control and Prevention. Li has also played an important role in China’s response to the COVID-19 pandemic in Guangdong province, the most populous province in the country, with 30 million migrants among its more than 113 million people. Virginia Li estimates that she has advised and mentored nearly 40 FSPH students and visiting scholars from China during the course of her career, and not just academically. “I wanted to make sure they received rigorous training, but that they also learned about American culture and society,” she says. “I would take them sightseeing on weekends and have them to my home for meals. I am so proud of the difference they made after returning. And when I see them, they all tell me how grateful they are to have had the opportunity to study at our school.”
A 1985 PHOTO OF CHINESE VISITING SCHOLARS WHO WERE THEN STUDYING AT THE FIELDING SCHOOL, INCLUDING DR. XIAOMING SUN (FOURTH FROM LEFT) AND HONGTAO HU (SECOND FROM RIGHT).
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Electing
TO SERVE Three Fielding School alumni decided to run for political office to improve their hometown communities — with public health as the cornerstone of their winning campaigns.
MAI VANG (MPH ’11) says the idea of running for public office hadn’t occurred to her when she left her hometown of Sacramento in 2008 to enroll in the Fielding School’s joint MPH/MA in Asian American Studies program. But through her graduate education, Vang — the eldest of 16 children born to Hmong refugee parents from Laos — grew determined to return to make a difference for her community, both from outside and within the political system. She was elected to the Sacramento City school board in 2016, and is now in a November runoff to become a member of the Sacramento City Council. In endorsing Vang’s grassroots candidacy before the primary election in March, the Sacramento Bee’s editorial board called her a “powerhouse” and a “change agent.” A public health education might seem like an unconventional path to take to becoming an elected official. But Vang, along with two other Fielding School alumni who also returned to their hometowns and ran successful campaigns, can think of no better preparation. 32
“We need more elected officials who understand the importance of health and policy so we can change conditions for communities to be healthier.” — Mai Vang, MPH ’11
“I have friends telling me that my master’s in public health is so critical right now, in a global pandemic,” Vang says. “I tell them that was true even before. What we do every day touches public health. We need more elected officials who understand the importance of health and policy so we can change conditions for communities to be healthier.”
AFTER SERVING ON THE SACRAMENTO CITY SCHOOL BOARD, MAI VANG IS IN A NOVEMBER RUNOFF FOR A SEAT ON THE SACRAMENTO CITY COUNCIL.
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Vang had just finished her undergraduate education and was working in the office of Rep. Eleanor Holmes Norton as a Barbara Jordan Health Policy Scholar when Norton told her about UCLA’s joint master’s-degree program in public health and Asian American studies. Vang entered the program that fall and quickly knew she had found her calling. “I remember Professor Marjorie Kagawa-Singer explaining that public health is about changing conditions so that people can make healthier choices,” Vang says, referring to one of her FSPH mentors, currently a research professor at the Fielding School and interim director of the UCLA Asian American Studies Center. “I thought, ‘That’s exactly what I want to do.’” Upon returning to Sacramento after completing the program, Vang began working as a policy associate for a nonprofit organization. “I was analyzing health data, and I could see that communities were struggling,” she recalls. “So I started organizing — to ensure our voices were heard and that disenfranchised communities were at the table and involved in the political process.” Vang drew on her education when she co-founded Hmong Innovating Politics: “What I had learned at UCLA is that every policy decision is a public health decision. If we want to change social conditions, our communities need to show up at the polls, put political pressure on elected officials, and/or run for office.” She continued to organize as a member of the school board, while using her influence as an elected official to recognize the root causes of students’ and families’ struggles and to seek ways to remove barriers to their success — another tenet rooted in her public health and Asian American studies education. Vang says she decided to run for a city council seat only after she knew a parent organizer who would fight for the same principles was poised to replace her. In the March primary Vang captured 47% of the vote in a five-person race; if victorious in November, Vang says, she intends to draw on her public health education to guide her actions on the council.
CRICEL MOLINA DE MESA DURING HER SCHOOL BOARD CAMPAIGN, WITH HUSBAND KHALIL DE MESA AND DAUGHTER TEIA DE MESA.
A DESIRE TO BRING a public health perspective to the Woodridge, Illinois, district where her daughter goes to school — and where she once matriculated — led Cricel Molina de Mesa (PhD ’12), a teaching associate professor in DePaul University’s Department of Health Sciences, to run successfully for a seat on the Woodridge School District Board of Education. Molina de Mesa grew up in the Chicago metropolitan area, raised by parents who were immigrants from the Philippines. “They faced quite a bit of racism living in predominantly white communities,” Molina de Mesa says. “As a result, trying to understand the immigrant experience has always been a driving force for me.” She attended Loyola University Chicago as a psychology major and had planned to go to medical school, but decided on a different course after a senior-year field project studying a mental health partial hospitalization program for older adults. “That experience changed my life,” Molina de Mesa says. “It raised so many questions for me about where these individuals would go from there, who would take
care of them, and who was paying for this. From that point on, I became interested in aging from the standpoint of public health, policy, and advocacy.” While pursuing her MPH at the University of Illinois at Chicago with a focus on gerontology, she met Steven P. Wallace, FSPH professor of community health sciences, who was conducting research with one of her mentors. Molina de Mesa knew that Wallace, with his policy-oriented expertise in both aging and immigrant health, would make the ideal adviser for her doctoral studies. “The perspective I gained on issues of community advocacy and equity through my time at the Fielding School and my work with Steve Wallace continues to shape what I’m doing today,” she says. With her husband and daughter, she moved back to her childhood neighborhood of Woodridge. At DePaul, Molina de Mesa’s research focuses on improving the health of aging populations and addressing health disparities. And since being elected to the school board in April 2019, she has focused on issues such as mental health and equity. “My Fielding School education taught me to look at health from a population standpoint and to focus on prevention, and I hope to bring those ideas to the district,” Molina de Mesa says. “It’s a proactive approach to improving the lives of groups, not just individuals.” She adds: “My public health background shapes pretty much everything I do. In the work I’m doing on the school board, it shapes the questions I ask and the initiatives I am most interested in pursuing.”
“On the school board, [my public health background] shapes the questions I ask and the initiatives I am most interested in pursuing.” — Cricel Molina de Mesa, PhD ’12 ph.ucla.edu
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JAMIE CASSUTT-SANCHEZ WAS ELECTED TO THE SANTA FE CITY COUNCIL IN 2019.
IN SANTA FE, NEW MEXICO, JAMIE CASSUTT-SANCHEZ (MPH ’14) ran for a seat on the city council in 2019 on a platform steeped in public health, with a slogan she says she took from her FSPH education: All policy is health policy. Her campaign resonated with Santa Fe voters — in a three-way race for an open seat, she captured 57% of the vote. Cassutt-Sanchez had a long-standing interest in health and wellness, and enrolled in the Fielding School’s MPH program in the Department of Community Health Sciences to pursue her interest in nutrition and childhood obesity prevention. But as she started her coursework, her ambitions took a sharp turn. Whether she was learning about the impact of food policies such as the federal farm bill on rates of obesity in a course taught by FSPH adjunct associate professor Marion Taylor Baer, or about the impact of discriminatory policies such as redlining on the health outcomes of African Americans in a course taught by Chandra Ford, FSPH professor and founding director of the 34
Center for the Study of Racism, Social Justice & Health, Cassutt-Sanchez was taking away the same message. “It struck me that some of the basic challenges we have in public health come down to structural racism, poverty, and other factors that need to be addressed at the policy level,” she says.
“People typically associate policymakers with political science and law, but public health is actually a phenomenal background for this position.” — Jamie Cassutt-Sanchez, MPH ’14 “These larger forces affect the ability of families to have affordable housing, child care, access to healthy food, and so many other things that make a difference in health outcomes. I realized that policy was going to be important
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for me, and that eventually I would want to look into running for office.” Her time came several years after graduating with her MPH. Following the birth of Cassutt-Sanchez’s son in August 2018, she and her husband decided to raise him in Santa Fe, where Cassutt-Sanchez had grown up. She had planned to stay home for about a year before seeking a position with the county or state health department. But when one of the city councilors in her district stepped down, Cassutt-Sanchez decided to run for the seat. She made improving the health of the community’s residents the cornerstone of her campaign, and won decisively. Cassutt-Sanchez believes her public health education gives her an invaluable vantage point for tackling issues of importance to her community. “People typically associate policymakers with political science and law, but public health is actually a phenomenal background for this position,” she says. “I think we would be better off with more public health professionals in policymaking positions.”
SCHOOL WORK Janae Hubbard Joins FSPH as Equity, Diversity and Inclusion Program Manager
WELCOMING NEW FACULTY LARA CUSHING, assistant professor of environmental health sciences, leads research addressing social inequalities in exposure to environmental hazards, and race and class determinants of environmental health disparities.
JANAE HUBBARD HAS JOINED THE FIELDING SCHOOL as equity, diversity and inclusion program manager. Before joining FSPH, Hubbard worked for the Los Angeles LGBT Center as senior program manager for children, youth, and family services, where her duties included managing programs and services for homeless youth — including drop-in services, emergency shelter, transitional living, and employment programs. The agency has more than 100 staff members and serves more than 1,500 clients annually. Hubbard previously served as associate director of multicultural affairs and social justice programs for Columbia University’s Office of Multicultural Affairs, where she directed campuswide diversity and inclusion events for students, faculty, and staff. Hubbard holds a master of social work degree from the Silberman School of Social Work at Hunter College in New York, and earned her undergraduate degree in African American Studies at UCLA, where she was a four-time letter winner in women’s basketball and led the Bruins to three straight NCAA tournaments (1998, 1999, and 2000).
DANIEL EISENBERG, professor of health policy and management, conducts research into how to invest effectively and efficiently in the mental health of young people. He serves as principal investigator on the national “Healthy Minds Study” of college students. POURAN D. FAGHRI, adjunct professor of environmental health sciences, is a physician whose work has included identifying psychosocial and environmental risk factors at the workplace as well as developing and evaluating models for integrating health promotion with workplace injury prevention. ANDREW HOLBROOK, assistant professor of biostatistics, applies his expertise in Bayesian and computational statistics to public health issues, including geographic spread of viruses and early detection of Alzheimer’s disease. MIRIAM MARLIER, assistant professor of environmental health sciences, examines the interactions between environmental change and public health using remote sensing data.
HONOR ROLL 2019 The UCLA Fielding School of Public Health is pleased to honor our alumni, friends, students, staff, and foundation and corporate partners whose generosity strengthens our school and keeps us at the forefront of public health education. Please visit ph.ucla.edu/ honorroll2019 to view the 2019 Honor Roll.
PAUL DLUZNIEWSKI, adjunct assistant professor of epidemiology, focuses on the role of epidemiology in drug development. His research addresses the development and use of therapies for cardiovascular and metabolic diseases, including atherosclerotic cardiovascular disease and heart failure.
For more information visit us at: ph.ucla.edu
MATTHEW MIMIAGA, professor of epidemiology, conducts cohort studies and randomized controlled trials of biobehavioral interventions for HIV prevention, substance abuse and mental health problems, and global public health. KIRSTEN SCHWARZ, associate professor of environmental health sciences and urban planning, is an urban ecologist working at the interface of the environment, equity, and health. XI ZHU, associate professor of health policy and management, studies micro and macro organizational behaviors in health care delivery systems, including the structures, strategies, and change processes in health care teams and organizations. ph.ucla.edu
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FACULTY HONORS & SERVICE Onyebuchi A. Arah received the 2019 Academic Council Chairs Award for Mid-Career Leadership in the Academic Senate from the UCLA Systemwide Academic Senate.
Chandra Ford received the 2019 Paul Cornely Award at the annual Health Activist Dinner, and the 2019 Faculty Teaching Award from FSPH’s UCLA Public Health Student Association.
Sudipto Banerjee received the 2019 George W. Snedecor Award from the Committee of Presidents of Statistical Societies.
Patricia Ganz delivered the Connie Moskow Memorial Lecture at the 2019 Lynn Sage Breast Cancer Symposium.
Thomas R. Belin received the Long-Term Excellence Award from the Health Policy Statistics Section of the American Statistical Association and delivered the Lowell Reed Lectureship for the Applied Public Health Statistics Section of the American Public Health Association.
Gilbert Gee received the 2019 Paul Cornely Award at the annual Health Activist Dinner and the C. Doris and Toshio Hoshide Distinguished Teaching Prize in Asian American Studies at UCLA, and was named a Pioneer in Minority Health & Health Disparities by the National Institute of Minority Health & Health Disparities. He was appointed to a National Academies of Sciences, Engineering, and Medicine committee; the Robert Wood Johnson Foundation’s 2020 Steering Committee for Sharing Knowledge to Build a Culture of Health; FEC Chair for UCLA Asian American Studies; and as interim senior editor for AAPI Nexus Journal: Policy, Practice, and Community.
Anne L. Coleman received the Bonnie Strickland Champion for Children’s Vision Award from the National Center for Children’s Vision and Eye Health and was elected president of the American Academy of Ophthalmology. Catherine Crespi was named a fellow of the American Statistical Association in 2019. Roger Detels was keynote speaker at the Countering COVID-19 videoconference sponsored by the China Association for International Exchange of Personnel. David Eisenman contributed to the National Academies of Sciences, Engineering, and Medicine’s Public Health Emergency Preparedness and Response Science Framework. Susan Ettner was appointed UCLA interim dean of graduate education.
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Sander Greenland was named one of the world’s most influential scientific researchers in 2019 by the Web of Science Group. Ron D. Hays was named one of the world’s most highly cited researchers yearly between 2015 and 2019 by Thomson Reuters and Clarivate Analytics and one of the world’s most influential scientific researchers in 2019 by the Web of Science Group. Felicia Hodge received the Frank C. Dukepoo Award from the Native Research Network at the annual National Native Research Training Initiative.
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Steve Horvath received the 2019 Schober Award from the Martin-Luther University of Halle-Wittenberg, Germany, and was named one of the world’s most influential scientific researchers in 2019 by the Web of Science Group. Michael Jerrett was named one of the world’s most influential scientific researchers in 2019 by the Web of Science Group, was appointed to the Review Committee of the Health Effects Institute, and was reappointed to the editorial committee of the Annual Review of Public Health. Robert Kaplan received the Elizabeth Fries Health Education Award, sponsored by the CDC Foundation and the James F. and Sarah T. Fries Foundation. Martin Lee was named a fellow of the Institute of Biomedical Sciences in the United Kingdom. Gang Li received the 2019 Outstanding Service Award from the International Chinese Statistical Association. Jian Li received the 2020 Kammer Merit in Authorship Award from the American College of Occupational and Environmental Medicine. Mark Litwin was named one of the top doctors in Los Angeles between 2018 and 2020 by Los Angeles Magazine. Elizabeth Rose Mayeda received the 2020 Brian MacMahon Early Career Epidemiologist Award from the Society for Epidemiologic Research. Vickie Mays received the 2020 Senate Service Award from the UCLA Academic Senate.
André Nel was named one of the world’s most influential scientific researchers in 2019 by the Web of Science Group. Anne Pebley was appointed to the National Academies of Sciences, Engineering, and Medicine’s Committee on Population and the Board of Governors for the Panel Study of Income Dynamics. Ninez Ponce received a Health Services Research Impact Award from AcademyHealth and the Don T. Nakanishi Award for Outstanding Engaged Scholarship from the UCLA Asian American Studies Center, was recognized as a 2019 Asian Health Services Honoree, and was appointed to the Board of Scientific Counselors of the National Center for Health Statistics. Thomas Rice received the 2020 John M. Eisenberg Excellence in Mentorship Award from the Agency for Healthcare Research and Quality and was invited by AcademyHealth to deliver the Annual Uwe Reinhardt Lecture at AcademyHealth’s 2020 Annual Research Meeting. Anne Rimoin was named a fellow of the American Society of Tropical Medicine and Hygiene and was recognized as a “trailblazer” by PBS Southern California for her research in infectious diseases. Linda Rosenstock received a Distinguished Alumni Award from the Johns Hopkins University Alumni Association. Marc A. Suchard was named one of the world’s most influential scientific researchers in 2019 by the Web of Science Group.
BOOKSHELF May Sudhinaraset received the Changemakers in Family Planning Award from the Society of Family Planning. Mel Suffet was named a 2020 fellow of the International Water Association. Paula Tavrow was selected as a winner in the WHO/IBP and Knowledge SUCCESS call for implementation experiences on high impact practices in family planning. Stephanie Taylor received the 2019 Health Services Research & Development Health System Impact Award and was appointed chair of the VA Scientific Merit Review Panel on Sociodeterminants of Health; member of the Congressionally Directed Medical Research Program’s Chronic Pain Management Research Program Programmatic Panel; member of L.A. Care’s Technical Advisory Committee; and member of the NIH HEAL Initiative Scientific Review Panel. Steven Teutsch contributed to the National Academies of Sciences, Engineering, and Medicine’s Public Health Emergency Preparedness and Response Science Framework. Dawn Upchurch was elected to serve as section councilor for the Integrative, Complementary and Traditional Health Practices Section of the American Public Health Association. Steven P. Wallace received the 2019 Arthur Cherkin Award from the UCLA Multicampus Program in Geriatric Medicine and Gerontology. May Wang received the 2019 Food & Nutrition Section
Excellence in Dietary Guidance Award from the Agency for Healthcare Research and Quality. Robert Weiss was named a fellow of the International Society for Bayesian Analysis and of the Institute of Mathematical Statistics. Kenneth Wells received the 2019 Advocate Award from the Psychiatric Education and Research Foundation; the 2019 Innovator Award from UCSF; and the 2019 Department of Psychiatry’s Lifetime Teaching Award from UCLA. Wells was appointed chair of the National Academy of Sciences Committee to Evaluate Specific Programs in the Comprehensive Addiction/ Recovery Act. Elizabeth (Becky) Yano was appointed a principal investigator for the PROVEN Coordinating Hub to Promote Research Optimizing Veterancentric EHR Networks. Frederick Zimmerman was named president of the Interdisciplinary Association for Population Health Sciences and a 2019 expert member of the WHO’s Strategic Meeting on Social Determinants of Health. He serves on the Healthcare Expenditure Collaborative, a committee of the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Population Health Improvement.
KEEP IN TOUCH
Practical Multivariate Analysis, Sixth Edition By Abdelmonem Afifi, Susanne May, Robin Donatello, and Virginia A. Clark
Human Parasitic Diseases: A Diagnostic Atlas By Lawrence R. Ash and Thomas C. Orihel
Understanding Health Information Systems for the Health Professions, First Edition By Jean A. Balgrosky, MPH ’80
Annual Review of Public Health, Volume 41 Edited by Dr. Jonathan Fielding
Racism: Science & Tools for the Public Health Professional Edited by Chandra L. Ford, Derek G. Griffith, Marino A. Bruce, and Keon L. Gilbert Fielding School contributors: Gilbert C. Gee, Héctor E. Alcalá, Adrian M. Bacong, Natalie Bradford, Anna Hing, Rebekah Israel Cross, Brittany N. Morey, Goleen Samari, and Mienah Z. Sharif Advancing Equality: How Constitutional Rights Can Make a Difference Worldwide By Dr. Jody Heymann, Aleta Sprague, and Amy Raub Handbook of Socioeconomic Determinants of Occupational Health: From Macro-Level to MicroLevel Evidence Jian Li, section editor and chapter author; Johannes Siegrist, co-author
“Concepts and Social Variations of Disability in Working-Age Populations.” Chapter in Handbook of Disability, Work and Health By Johannes Siegrist and Jian Li
Taste and Odour in Source and Drinking Water: Causes, Controls, and Consequences Edited by Tsair-Fuh Lin, Susan Watson, Andrea M. Dietrich, and Mel Suffet
HIV/AIDS in China: Epidemiology, Prevention and Treatment Edited by Dr. Zunyou Wu, Yu Wang, Dr. Roger Detels, Marc Bulterys, and Jennifer M. McGoogan ph.ucla.edu
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TRANSFORMATIVE INVESTMENTS
Promoting a Real-Time Response Four philanthropic foundations acted expeditiously to enable a Fielding School-led study that provides a vital service to L.A.’s frontline health workforce and urgently needed data on COVID-19.
AIDS HEALTHCARE FOUNDATION
“I was impressed with Dr.
want our health care workers
partners at UCLA to explore
(AHF) President Michael
Rimoin,” Weinstein says. “Her
to take care of us, they need
opportunities for rapid response
Weinstein was watching HBO’s
expertise and grasp of the enor-
to know who among them is
to the growing pandemic.
“Real Time with Bill Maher”
mity of the public health threat
infected yet asymptomatic,
on Feb. 28 when he saw an
that COVID-19 presents, partic-
and who was sick and possibly
mitted to screening L.A.’s frontline
interview that compelled him
ularly to health care providers,
acquired immunity. When we
health workforce for as long as
to act.
was considerable.”
discovered that Dr. Rimoin
possible to ensure their health
and Dr. Aldrovandi were up to
and safety and to gather scientific
exactly that, we rushed to help.”
evidence that guides plans for
Anne Rimoin, professor of
AHF was joined early by a
Rimoin and her team are com-
epidemiology at the Fielding
group of key funders that helped
School, was sharing her insights
launch the study led by Rimoin,
on the COVID-19 pandemic.
along with colleagues at FSPH
Foundation and the Steven &
recovery. “Each foundation in this
There were fewer than two dozen
and the David Geffen School of
Alexandra Cohen Foundation
extraordinary group of funders
known cases in the U.S. at the
Medicine at UCLA (led by Dr.
amplified this early seed funding
truly shares our sense of urgency
time, and the nation’s first con-
Grace Aldrovandi), to test and
and created considerable
and vision for this initiative,”
firmed COVID-19 death wouldn’t
track the exposure of health care
momentum, propelling the
Rimoin says. “They understand
be reported until the next day.
workers and first responders to
UCLA Health pilot and ramping
the service we are providing
But Rimoin, an internationally
COVID-19 (for more on the study,
up the first-responders arm
speaks to our collective sense
renowned expert on emerging
see page 10).
of the study, which launched
of humanity, while the research
The Shurl and Kay Curci
social engagement and economic
infectious diseases, recognized
The Elizabeth R. Koch
with the L.A. County Fire
underscores the importance of
that these numbers were likely
Foundation joined AHF in
Department in May. Both
our collective investment in public
to quickly escalate. And when
making an early gift that was
foundations sought ways to
health, the study of emerging
Weinstein heard her speaking
instrumental in launching
support COVID-19 research and
infectious diseases and, ultimately,
about the burgeoning pandemic
the study at UCLA Health in
service through a proactive
our survival.”
and a study she hoped to conduct
early April. “Most of my work
philanthropic approach: The
on COVID-19 transmission among
is in helping people manage
Curci Foundation reached out
can support the COVID-19 Rapid
health care workers, he took steps
emotional pain, and the stress
directly to Rimoin, and the
Response Initiative, please
to ensure that AHF’s financial
that health care workers were
Steven & Alexandra Cohen
contact Matt Terhune at:
support would make Rimoin’s
under was clear and urgent,”
Foundation connected with
mterhune@support.ucla.edu,
important work possible.
Elizabeth Koch says. “If we
existing faculty research
or call (310) 206-6521.
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