SUMMER 2021
OUR PATH FORWARD The challenges we face demand public health solutions.
DEAN’S MESSAGE
AS THE FOG BEGINS TO LIFT on the most deadly pandemic in more than a century, we in public health are left to confront the reality that at home and abroad, communities face unprecedented challenges to their health and well-being — challenges that transcend a pandemic that has taken millions of lives while inflicting devastating physical and mental health impacts. COVID-19 exposed the shortsightedness of our nation’s decades-long underinvestment in public health infrastructure, and even as we continue to grapple with this pandemic, we must move urgently to be better prepared for the inevitable epidemics and pandemics to come. But COVID-19 has also cast a harsh light on problems that imperiled the health of our communities long before the novel coronavirus began to spread, and will continue to wreak havoc well after this pandemic has receded. From early on it has been clear that the heaviest burden of COVID-19 is felt in low-income communities and communities of color, a reflection of structurally reinforced inequities in income, education, housing, healthcare, and other fundamental determinants of health. The pandemic’s disproportionate impact on Black, Indigenous, and people of color communities, combined with the increased attention to, and protests of, police brutality against these communities, brought about a long-overdue reckoning with structural racism. In April, the U.S. Centers for Disease Control and Prevention declared racism a serious public health threat — an affirmation that public health must not merely document its harmful effects, but dismantle the forces that perpetuate them. In the U.S., the challenges underscored by this trying chapter come at a time when we face an epidemic of gun violence, and voting rights for many hang in the balance. We must recognize that these, too, are public health problems — as is the existential crisis posed by climate change, which is affecting the health of populations everywhere, including in our own backyard. There’s no downplaying the magnitude of these and other threats to the public’s health, and no one expects that we will solve them easily or quickly. But there is also ample reason for hope. Public health has brought us safer workplaces and healthier foods. It has saved lives by increasing seat belt use and reducing smoking. Public health eradicated smallpox, and in 2021, one of the largest vaccination campaigns in history is helping to get us to the other side of this pandemic. We are an evidence-based field, guided by research on what works. But, as we have learned from the selflessness and determination displayed by the public health leaders battling COVID-19, structural racism, and the other daunting problems we face, we’re also guided by hope and humanity. This issue of our magazine features a sampling of the incredible work of our UCLA Fielding School community in bringing public health solutions to some of the greatest challenges of our time — driven not only by the science, but by hope, humanity, and a foundational trait of our field, saying yes to being an active part of the solution.
Dr. Ron Brookmeyer Dean
The UCLA Fielding School of Public Health Magazine
SUMMER 2021
CONTENTS 17
14
30
04
07
FEATURES 04 Viral Communications Students spread COVID-19 prevention messages to limited-English-speaking communities 07 No Shelter From the Storm Reaching L.A.’s growing homeless population during a pandemic 10 COVID-19’s Toll on California’s Latinos Work ethic ‘rewarded’ with high death rates 12 It’s a Pandemic. They’ve Got Answers. Alumni build online resource
14 Promoting Public Health for the LGBTQ Population Research, partnerships will pave the way 17 Making Voter Suppression a Public Health Issue Political agency and health 18 Air on the Side of Justice Fielding Chair addresses environmental inequalities
DEPARTMENTS 24 Net Gain for Healthcare Administration New online degree program 26 Teaching Moments An integrated, case-based introduction to the field 28 Remembering Steve Wallace Beloved FSPH professor left enduring legacy
20 Holding the Door Open FSPH prof. pays it forward
30 Brilliant Mind, Kinder Heart Student reflects on mentor
22 Taking Aim at Gun Violence A shift toward prevention
31 Prepared to Act Students’ COVID-19 response
32 School Work 34 Faculty Honors & Service 35 Bookshelf 36 Grants & Contracts 38 Transformative Investments
Visit us online: ph.ucla.edu
PHOTOGRAPHY & ILLUSTRATION Parko Polo: front cover. Jane Houle Photography: Dean’s Message; p. 11: retail worker. Pexels/Anna Shvets: TOC: hands with gay pride flag; p. 14. Samuel Braslow: TOC: tents; p. 7. Chrissy Hampton: pp. 2-3, back cover. Getty Images: Kevork Djansezian/Stringer: p. 8. iStock Photo/NNehring: pp. 10-11: farmworkers. AP Images/Morry Gash: p. 17: voting line. Unsplash/Chris LeBoutillier: pp. 18-19: smokestack. Pexels/Kat Wilcox: p. 23. iStock Photo/Ipopba: p. 25. iStock Photo/Prostock-Studio: p. 26: hands. 123Rf/Katk1a: p. 33: COVID-19. COURTESY OF: Multilingual COVID Information Project: TOC: text collage; p. 4: text collage. Anna Hing: TOC: Anna Hing; p. 17: Anna Hing. Iris Y. Guzman-Ruiz: TOC: Dr. Steve Wallace with Iris Y. Guzman-Ruiz; p. 30. Jane Lee: p. 4: Jane Lee. Tram-Elayne Nguyen: p. 5. Dome Lupac: p. 6: Dome Lupac. Nathayle López: p. 6: Nathayle López. Dr. David Hayes-Bautista: p. 10: Dr. David Hayes-Bautista. Dr. Paul Hsu: p. 10: Dr. Paul Hsu. Dr. Malia Jones: p. 12: Dr. Malia Jones. Dr. Alison Buttenheim: p. 12: Dr. Alison Buttenheim. Dear Pandemic: p. 13. Dr. Matthew Mimiaga: p. 16. Dr. Lara Cushing: p. 18: Dr. Lara Cushing. Dr. Gerald Kominski: pp. 20-21. Dr. Leah Vriesman: p. 24. Consuela Abotsi-Kowu: p. 26: Zoom with students. Dr. Steve Wallace: pp. 28-29. Becca Woofter: p. 31: Becca Woofter. Anna Bratcher: p. 31: Anna Bratcher; assisting people experiencing homelessness. Dr. Elaine Batchlor: p. 32: Dr. Elaine Batchlor. Dr. Ellen Alkon: p. 32: Dr. Ellen Alkon. Dr. William C. Hinds: p. 32: Dr. William C. Hinds. Dr. Kenneth Wells: p. 33: Veteran Journeys. Cynthia Beard: p. 38: Cynthia Beard. © 2021 Emily K. Abel: Sick and Tired: An Intimate History of Fatigue: p. 35: Emily K. Abel book cover. © 2020 by Hachette Book Group, Inc.: VRx: How Virtual Therapeutics Will Revolutionize Medicine, 1st Edition: p. 35: Brennan Spiegal book cover. © 2021 by the Board of Trustees of the Leland Stanford Junior University: “Federal Policies and Health.” Chapter in Immigrant California: Understanding the Past, Present, and Future of U.S. Policy: p. 35: Ninez Ponce book cover. © World Health Organization 2020: Health Systems in Transition: USA: p. 35: Thomas Rice book cover. © Academic Press 2021: Health Insurance Systems: An International Comparison, 1st Edition: p. 35: Thomas Rice book cover. © 2021 Springer Nature Switzerland AG: ASPC Manual of Preventative Cardiology: p. 35: Nathan D. Wong book cover. Karen Toffler Charitable Trust: p. 38: illustration.
OUR PATH FORWARD Long overlooked and underfunded, public health moved into the spotlight last year, as COVID19 demanded expertise and solutions while underscoring the importance of investing in infrastructure to prepare for future outbreaks. But while COVID-19 captured much of the focus, other problems festered. Worldwide protests brought attention to centuries-long structural racism in the U.S. and beyond, the results of which are substantial inequities in education, income, housing, access to quality healthcare, and other key determinants of health. After a relative respite during the worst part of the pandemic, the return of mass shootings nearly every day in America reinforced the reality that an epidemic of gun violence imperils the mental and physical health and well-being of much of the population. And there is no respite from the climate crisis, an existential threat already wreaking havoc with the health of communities in the U.S. and around the world — and, as with the other crises, disproportionately felt in disenfranchised communities. The UCLA Fielding School continues to play a critical role in everything from generating research that informs sound policy to preparing students who will lead the way in effectively addressing these and other societal problems — because at FSPH, we know that the challenges of our time demand public health solutions.
Dr. Ron Brookmeyer Dean
Rent Control Creative Design Direction
UCLA Fielding School of Public Health Website: ph.ucla.edu
MAGAZINE STAFF
Brad Smith Writer & Contributing Editor
Manage Your Subscription: ph.ucla.edu/subscriptions
Anna Elgart Visuals Coordinator
Follow the Fielding School on Social Media: @UCLAFSPH
Eileen Si Production Assistant
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 2021 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.
Carla Denly Executive Editor & Associate Dean for Comms. and Marketing Dan Gordon Editor & Writer 2
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 Emeritus, 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 Senior Associate Dean for Academic Programs; Professor, Environmental Health Sciences; Frederick Zimmerman, PhD Professor, Health Policy and Management; Nayelie Benitez Santos and Maria Matta Co-Presidents, Public Health Student Association; Lori S. Pelliccioni, JD, MPH '96, PhD '02 President, Public Health Alumni Association
ph.ucla.edu
S U M M E R 2 02 1
3
VIRAL COMMUNICATIONS ent-driven Multilingual Since early in the pandemic, the stud social media to spread COVID Information Project has used limited-English-speaking clear and compelling messages to ia. communities in Southern Californ
MPH STUDENT JANE LEE (ABOVE) SAYS HER PARTICIPATION IN THE MULTILINGUAL COVID INFORMATION PROJECT (MCIP) HAS TAUGHT HER THE IMPORTANCE OF CUSTOMIZING COMMUNICATIONS TO THE INTENDED POPULATION.
4
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
WHEN COVID-19 FIRST BEGAN TO SPREAD across the U.S., Fielding School MPH student TramElayne Nguyen worried about her parents, first-generation immigrants from Vietnam. “They were getting a lot of confusing information about what they should do and whether or not the pandemic was serious,” Nguyen recalls. “I could see that there was no clear, digestible, unbiased information for members of the Vietnamese community.” Nathalye López noticed that despite the large population of Spanish speakers in Los Angeles, people like her parents with limited English-speaking skills were challenged to sort through messages that were sometimes conflicting, other times laden with medical jargon. “I also worried about undocumented people, who tend to have fewer resources,” López says.
Nguyen and López are among a group of Fielding School MPH students who, with guidance from FSPH faculty and input from public health agencies and community-based organizations, have led the Multilingual COVID Information Project (MCIP) — a campaign that uses social media and other platforms to provide public health messaging related to COVID-19, with an emphasis on reaching limited-English-speaking communities in Southern California. MCIP (www. covidinfo.ph.ucla.edu) delivers messages in English, Spanish, Chinese, Korean, and Vietnamese. As the pandemic unfolded, Dr. Anne Pebley, the Fred H. Bixby Chair and professor in FSPH’s Department of Community Health Sciences, found that among the students she advises — many of whom come from
limited-English-speaking immigrant families — concerns about access to reliable information were all too common. “These students were talking with their family members about masks, hand-washing and physical distancing, but their families were also seeing all kinds of wild and inaccurate information,” Pebley says. “And what was accurate was often technical and not particularly easy to read.” With funding from the FSPH Office of the Dean, Pebley enlisted several faculty colleagues to help support a mostly student-run initiative, in collaboration with TranslateCovid.org — a joint project of the UCLA Asian American Studies Center and the Fielding School (co-led by two FSPH faculty members, Drs. May Wang and Gilbert Gee) that compiles and shares in-language and translated COVID-19 resources in more than a dozen languages. Nancy Nguyen was among the MPH students who embraced the MCIP. “With the onset of the
pandemic, I wasn’t sure what role I could play as a public health student,” she says. “But I could see my family getting a lot of misinformation from both social media and their social groups — things like, if you cut up red onions and leave them around the house, it will kill the COVID virus coming in. I thought this would be a great opportunity to tap into my knowledge of the Vietnamese community and do my part.” Pebley believes the initiative derives its power from the fact that the students running it are bilingual, bicultural, and rooted in the communities they seek to reach. (Along with TramElayne Nguyen, Nathalye López, and Nancy Nguyen, the core MCIP student members have included Tamar Galindo, Jane Lee, Aiyi Huang, Carlin Soos, Andreina Gómez, and Dome Lupac; other students have pitched in as needed.) “They have really taken the initiative to build this project and make it accessible to everyone,” Pebley says. The MCIP students have also brought their creativity and social media savvy to the project. In regular meetings, MCIP students and faculty discuss long-term strategy as well as messaging for that week. The students craft social media posts, design infographics, and create videos, all of which are vetted by the
faculty experts for their content. “At first, we relied a lot on re-sharing messaging from TranslateCovid.org, the Centers for Disease Control and Prevention, and community-based organizations, in some cases translating or making it more digestible for our audiences,” Nancy Nguyen explains. “Then, once we built our social media presence, we brought more of our own creativity and personal experiences, thinking about how to reach people in fun ways.” Much of the messaging has focused on guidelines for preventing COVID-19 transmission through appropriate mask-wearing, physical distancing, and hand-washing, as well as guidance tied to upcoming holidays and other events commonly celebrated in immigrant communities. As the vaccine rollout got underway, MCIP began a campaign to promote the immunizations and how they could be obtained, provide guidelines for post-vaccine life, and address vaccine hesitancy and myths. In addition to consulting with faculty, the students worked with communitybased organizations and the communications team at the Los Angeles County Department of Public Health to fine-tune the messaging content and approach. “It’s been really helpful to connect with people who work closely with these communities and then develop content based on their input,” says Tram-Elayne Nguyen, who has led the way in creating videos posted on TikTok, the social media platform that has gained substantially in popularity
INSPIRED BY TIKTOK’S SOARING POPULARITY AMONG YOUNG AUDIENCES, MPH STUDENT TRAM-ELAYNE NGUYEN (ALSO PICTURED AT LEFT) CREATED VIDEOS INCORPORATING PUBLIC HEALTH MESSAGES SUCH AS THE ONE ABOVE, WHICH ADDRESSED MENTAL HEALTH AND COVID-19 FATIGUE IN VIETNAMESE, SIMPLIFIED CHINESE, KOREAN, AND SPANISH.
ph.ucla.edu
S U M M E R 2 02 1
5
over the last year, particularly among youth. The lighthearted videos, incorporating public health messaging into songs that are trending at the time, have covered topics ranging from guidance on mask-wearing, social greetings, and holiday celebrations to pandemic-related advice on self-care activities, virtual dating, and safe sex. MCIP team member Jane Lee says the project has taught her the importance of tailoring communications to the intended audience. “There are no graphics that will be universally received in the same way,” she says. “I quickly found out that messaging that might be humorous to one individual might come across as bleak and/or irrelevant to another.” That’s true not just when it comes to different languages and cultures, but across social media platforms. For example, Instagram and TikTok tend to reach younger age
MCIP STUDENT PARTICIPANTS (L. TO R.) DOME LUPAC AND NATHALYE LÓPEZ
6
groups, whereas Facebook is best for reaching older members of the targeted communities. Members of the MCIP team found, though, that while younger family members are more likely to be English speakers, they seek non-English social media posts that they can use to educate parents and other older members of their community. “Social media is such a great way to reach various audiences because it allows you to test different methodologies at very little cost,” Lee says. “By creating a variety of posts, we were able to identify different elements of graphics that made them more appealing and engaging — whether it’s ways of framing a message, colors, shapes, pictures, or density of words.” In addition to the social media campaign, through its website, MCIP provides printable infographics and social media posts for use by community organizations and health agencies. For interested community members who don’t use social media, the infographics and videos are delivered via
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
“ A lot of communities tend to be forgotten in emergencies. Sometimes it takes members of that community to make sure they’re protected, including identifying barriers to accessing the COVID-related resources.” — Nathalye López
email. The project has also collaborated with a student group at the Johns Hopkins Bloomberg School of Public Health to make COVID-19 information available through text messaging for those who sign up. Some of the MCIP students and faculty members have also presented in community settings. For Nathalye López, one of the highlights of her involvement with the project was the opportunity to give a COVID-19 prevention talk, in Spanish, at the high school she attended. “A lot of communities tend to be forgotten in emergencies,” López says. “Sometimes it takes members of that community to make sure they’re protected, including identifying barriers to accessing the COVID-related resources.” It’s difficult to quantify how many community members MCIP has reached given the nature of social media, where posts are shared, retweeted,
and forwarded, as well as the additional exposure the group’s content has received through publicity from organizations such as the Los Angeles County Medical Association, the Mexican Consulate in Los Angeles, and several social services agencies. MCIP also conducted a marketing campaign on Facebook targeted to limited English speakers that reached approximately 40,000 people. The MCIP students say they have gotten as valuable of an education as they’ve given. “The project has helped me appreciate public health as a field that is multidisciplinary and inclusive of so many interests and endeavors, while solving critical issues to bring about positive change,” Jane Lee says. “I’ve learned how powerful health communications can be, and the importance of clear, consistent, and timely messaging,” Nancy Nguyen says. “This isn’t going to be the only major public health event of our lifetime, and as public health professionals we can use this experience to promote health equity by reaching the communities that are, unfortunately, the most affected by a crisis such as a pandemic.”
NO SHELTER FROM THE STORM FSPH’s Randall Kuhn is part of a research team using a first-of-its-kind platform to learn more about the COVID-19 experience of Los Angeles’ growing homeless population. HOW HAVE THE MORE than 66,000 homeless people in Los Angeles fared during the SARS-CoV-2 pandemic? “ People are isolated and lonely,” says Dr. Randall Kuhn, associate professor of community health sciences at the UCLA Fielding School of Public Health and a social demographer who studies homelessness. “They’ve experienced a disruption of safety-net services, including the places where they can get even the most basic things. When you close every Starbucks and library, as well as mass transit, it’s going to have a big impact. Those of us who live in houses or apartments hunkered down during the pandemic, but what if you have no place to hunker down?” While it’s easy to draw certain conclusions, Kuhn notes, specific data on COVID-19 cases, hospitalizations, and deaths is much harder to come by because of the absence of systematic tracking of homeless individuals and their health. In Los Angeles and other cities, fewer COVID-19 deaths have been recorded in the homeless population than expected, but Kuhn and other experts have suggested there may be significant undercounting. To be sure, living outside provides some measure of protection for homeless individuals from COVID-19, given that the fresh air disperses virus-containing droplets. It’s also
easier to remain physically distant, especially since many housed citizens already avoid homeless people. “In one sense, if there were ever an infectious disease not to hit homeless people especially hard, it would be COVID-19,” Kuhn says. “But if we’re calling it a victory for it to be no worse among homeless people than the general population, that’s not much of a victory. All we’re saying is that whereas most infectious diseases are five, 10, or 100 times worse among homeless people than among the general population, this one is no worse. “But the fact is that it is worse. It’s becoming clearer that once you account for age, homeless people are two to four times more likely than housed people to die of COVID-19. Homeless people are younger on average, but because their bodies have been worn down by their living situation, they don’t do as well with the disease as housed people of the same age.” COVID-19 deaths are just the start. Beginning in March 2020, when the World Health Organization declared the novel coronavirus outbreak a global pandemic, the number of recorded monthly deaths among homeless individuals rose sharply in L.A. County — by about 30% over the same months in prior years. “We know that half of those additional deaths are attributable to drug overdose,” Kuhn says. “We
ph.ucla.edu
S U M M E R 2 02 1
7
don’t know what the other half are attributable to. But if we can’t say whether this dramatic increase is due to additional deaths of despair, untreated heart conditions, or undiagnosed COVID, we’re in a bad situation.” The uncertainty is symptomatic of a larger problem that Kuhn and his collaborators are attempting to address. “The homeless population is understudied, and it’s a voiceless population that wants to be heard,” Kuhn says. He explains that there is no shortage of qualitative research giving narrative accounts of the lived experiences of homeless individuals. But public policy is more often made on the basis of quantitative studies, and the vast majority of those use administrative databases that track entries and exits into systems and the use of resources. While this data is useful, questions about health tend to be incidental, and not specific enough to draw policy conclusions. “There was a series of articles last year about the prevalence of mental illness among homeless people in L.A. — that maybe it’s 15%, maybe it’s 50%,” Kuhn says. “The point is, we’re not using validated measures, and our data are all based on whenever we happen to see the client, but what about the months when they’re not seen? What about the time between when you became homeless and when you were first seen?” The lack of reliable data on the health of the homeless population makes it hard to obtain support for policies to address it — or, as Kuhn puts it, “No data, no solutions, no justice.” In collaboration with partners at USC and Akido Labs, Kuhn recently launched the Homeless Research Data Collaborative. At the heart of the effort is a first-of-its-kind platform 8
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
using mobile phones to build reciprocal relationships with people who experience homelessness and to better understand their lives via monthly online surveys. “Most homeless people in L.A. County have a mobile phone, and for those who do, mobile phones are lifelines in ways that those of us who are housed cannot begin to imagine,” Kuhn explains. As a proof of concept, Kuhn’s group invited homeless individuals to enroll in the monthly survey, which also includes an interface designed to engage with them and help meet their needs, in partnership with a trusted service provider, the Venice Family Clinic. The survey questions are COVID19 focused, covering symptoms as well as pandemic-related impacts such as disruptions in medical care, food insecurity, isolation, and depression. Starting in February, the collaborative was in the field with a pilot study surveying homeless individuals about their willingness to get vaccinated for COVID-19. The researchers found that nearly half (46%) of the survey respondents expressed some form of vaccine hesitancy compared with below 30% of the general population, indicating a need for targeted education to overcome both fears and the lack of information for some of L.A. County’s most at-risk residents. Separately, Kuhn and his colleagues are in the process of enrolling 800 people for a larger study of homeless individuals as they transition to permanent supportive housing — a strategy that combines affordable housing assistance with support services that address the needs of chronically homeless individuals. The study provides smartphones and financial incentives for remaining in the study, which surveys participants monthly in an effort to better understand the risk of COVID-19 in supportive housing. “A strength of these platforms is their flexibility, which allows us to get new data each month,” Kuhn explains. “We can take the temperature of how a population is doing, especially under threat, and as new needs emerge, we can measure those.” Among the high-priority questions the collaborative hopes to address: What are the health costs of long-duration homelessness, and how can permanent supportive housing be improved to address the approximately 5%-10% who leave and become homeless again each year? Kuhn believes mobile phones carry great potential for researchers and service providers alike in better reaching and meeting the needs of the homeless population. “Even if you don’t have a phone, you will know someone, or be in an encampment with someone who has one,” he says. Ultimately, he notes, the flow of information can be reversed, so that homeless individuals are providing information, assessments, or updates of their status and needs. “Given the vulnerabilities people have before and while they’re homeless, the only solution is to treat them with humanity and seek to engage and follow them,” Kuhn says. “You can’t have a caseworker assigned to you for life, but potentially you can have an app assigned to you for a very long time so that if you’re losing your hold on what you’ve gained over the last few months or years, there are opportunities to reclaim that.”
Homelessness affects wide swaths of the population — including college students. Jessica Richards, a PhD student in FSPH’s Department of Community Health Sciences, is exploring the underlying patterns of housing insecurity and homelessness among UCLA undergraduate and graduate students. Richards conducted interviews with 13 students who have experienced one or more indicators of homelessness, such as sleeping in an unsheltered location. She has found that while students overall are remarkably resilient, housing insecurity negatively affects their physical health, mental health, and academic performance. Importantly, administrative policies can exacerbate student housing insecurity. For example, placing a housing-insecure student in academic distress on academic probation can jeopardize not only their scholarship, but also their education, which is their only source of housing. “I believe that health is a basic human right,” says Richards, who told all interviewees about basic needs services on campus and directed them to the UCLA Basic Needs COVID-19 Resource Guide. “I chose to focus my research on homelessness because housing is health, and the right to health cannot be separated from the right to housing.” A lex Lawton (MPH ’20) was drawn to FSPH by his interest in serving vulnerable populations. He joined Kuhn’s research team as a student and continues to work with Kuhn as a research associate. “It’s hard to walk anywhere in Los Angeles without seeing people who are experiencing homelessness, and I don’t think most people have a good understanding for how they end up in that position,” Lawton says. “Participating in this research has helped to humanize this population for me — to see the complexities of the situation and how easy it is to end up in that position, especially during a pandemic.” More than 64,000 homeless people have been housed over the last three years in L.A. County, according to the Los Angeles Homeless Services Authority (LAHSA). But more people become homeless each day than are housed, and as of 2020 there were 66,436 homeless people in the county, according to the Greater Los Angeles Homeless Count — a 13% rise from the previous year’s count. In the short term, Kuhn says, more money, resources, and innovative solutions are needed to increase the stock of housing in the county, which currently is enough to provide shelter for roughly 25% of the homeless population. The pandemic introduced new ideas, including Project Roomkey, a collaborative effort of the state, county, and LAHSA to secure hotel and motel rooms for vulnerable homeless people. Measure H, the quarter-percent increase in sales tax passed by L.A. County voters in 2017, provided an ongoing revenue stream to support strategies to combat homelessness, although significantly more expenditures are needed, Kuhn says. But short-term solutions aren’t sufficient. “We’re never going to stop the inflow of homelessness until we address the housing-supply issue and the issues of poverty and systemic racism,” Kuhn says. “Without getting to the root causes, these problems will continue.”
“ WE’RE NEVER GOING TO STOP THE INFLOW OF HOMELESSNESS UNTIL WE ADDRESS THE HOUSING-SUPPLY ISSUE AND THE ISSUES OF POVERTY AND SYSTEMIC RACISM.” — Dr. Randall Kuhn
ph.ucla.edu
S U M M E R 2 02 1
9
COVID-19’s Toll on California’s Latinos In a series of studies, two UCLA Fielding School faculty members reveal that the ‘reward’ for a strong work ethic has been the highest death rates during the pandemic. LATINOS CONSTITUTE 39% OF CALIFORNIA’S POPULATION, and since March 2020 they have held many of the essential jobs that kept Californians well fed and functioning during the COVID-19 pandemic. Unfortunately, according to research led by two UCLA Fielding School faculty members, their “reward” has been the highest rate of COVID-19 infections and deaths in the state, with significant disparities between Latinos and non-Hispanic whites across all age groups. Many of the factors fueling these gaps relate to inequities in key social determinants of health such as employment, housing, and access to quality healthcare, according to the analysis of the researchers — Dr. David Hayes-Bautista, FSPH professor of health policy DR. DAVID and manageHAYES-BAUTISTA ment and distinguished professor of medicine at the UCLA David Geffen School of Medicine, and Dr. Paul Hsu, FSPH assistant professor of epidemiology. These inequities are exacerbated DR. PAUL HSU by a “one-sizefits-all” approach in which protective measures have been issued during the pandemic that haven’t worked as well for the Latino 10
population as for the non-Hispanic white population, Hayes-Bautista says. In a report issued earlier this year, the researchers noted that COVID-19 death rates in the six months from July 2020 to January 2021 were between two and seven times higher among the state’s Latinos than among non-Hispanic whites, depending on the age group, with the disparities remaining relatively constant throughout the six-month period. Among individuals 80 and older, the death rate for Latinos was more than twice as high as for non-Hispanic whites; for those 65-79, it was more than four times as high. The Latino death rate was nearly six times the rate for non-Hispanic whites in the 50-64 age range; more than seven times the rate in the 35-49 age group; and more than five times the rate among individuals ages 18-34. COVID-19 has had greater opportunities to infect Latino households compared with non-Hispanic white households in two ways, Hayes-Bautista and Hsu have found. For one, they note, a strong work ethic contributes to Latino households having more wage earners, on average, than non-Hispanic white households. This means that Latino households have had more adults leaving the house every day, who could then be exposed to coronavirus-positive clients and co-workers during work hours and bring the infection home. In addition, Latino families have more children per household than non-Hispanic white families, increasing opportunities to spread infections to family members even among those who are asymptomatic. Because they typically have more wage earners and more children, Latino households contain nearly one more person than
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
non-Hispanic white households. Latinos are also overrepresented in many essential worker categories, from farmworkers who provide California’s food to construction workers who build the state’s houses, all while exposing themselves to the potential for infection. “Office-based wage earners have been able to minimize their exposure to coronavirus infection by sheltering at
“ With more exposure to the coronavirus, coupled with less access to care, Latino essential workers have had higher case rates, and higher death rates.” — Dr. David Hayes-Bautista home and working online,” Hayes-Bautista says. “But Latinos are overrepresented in occupations that require wage earners to leave their homes and interact with co-workers and clients, such as farmworkers and grocery store clerks.” Hayes-Bautista notes that Latinos in the
U.S. have created the equivalent of the world’s eighth-largest economy through hard work and larger families. Yet these very elements also make Latinos especially vulnerable to COVID-19. Hayes-Bautista and Hsu have also concluded from their analyses that in many cases, the public health messaging regarding protective measures recommended to reduce exposures has been easier to implement in affluent, non-Hispanic white communities than in Latino communities. “Latinos are more likely to work in the types of industries that don’t pay high wages and don’t offer health insurance,” Hayes-Bautista says. “Those individuals can’t just unplug their laptops and work from home. They had no recourse but to stay at work, which helped to keep the state functioning and helped them feed their families.” He notes that in households in which one or more members need to isolate at home because of exposure to the coronavirus or a positive test, the public health guidance calling for one bedroom and bathroom per person isn’t generally feasible when multiple people are living together in a small apartment.
ABOVE AND BELOW: LATINOS ARE OVERREPRESENTED IN MANY ESSENTIAL WORKER CATEGORIES, INCLUDING THE FARMWORKERS WHO PROVIDE CALIFORNIA’S FOOD AND INDIVIDUALS WORKING IN RETAIL AND AT
adequately protect their employees. “Farmworkers, meatpacking workers, grocery store clerks, and nursing home attendants are also essential workers,” Hsu says. “But as they worked shoulder to shoulder in the fields or checked out customers’ shopping carts, they were not provided personal protective gear until late in the pandemic. With more exposure to the coronavirus, coupled with less access to care, Latino essential workers have had higher case rates, and higher death rates.” Hayes-Bautista believes it is imperative that public health leaders and policymakers draw lessons from the experience of California Latinos during COVID-19 and address shortcomings both for the current pandemic and for the epidemics and pandemics to come. “The strong Latino work ethic is seen in the fact that Latino households have more wage earners than non-Hispanic white households,” he says. “However, when they have to work more exposed to the coronavirus than white-collar workers, when they are paid very little for their hard work, when they are less likely to be offered health insurance,
GROCERY STORES.
Complicating matters was what Hayes-Bautista describes as a “preexisting disconnect,” relative to non-Hispanic whites, between the state’s Latino population and the healthcare system, stemming from less access to a regular source of healthcare and the shortage of Latino and Spanish-speaking physicians. Hayes-Bautista and Hsu point out that early in the pandemic, a physician’s order was typically required for individuals to receive COVID-19 testing, which made it difficult for those who were uninsured or couldn’t easily access a physician to receive a test, potentially contributing to more infections among people who were unaware they had contracted the virus. In addition, many industries in which Latinos are overrepresented failed to
when they are less likely to find a doctor who can speak Spanish, it is no wonder that working-age Latinos have higher case rates and death rates than the general population. COVID brought a lot of preexisting inequities to a head.” ph.ucla.edu
S U M M E R 2 02 1
11
It’s a Pandemic. They’ve G t Answers. After finding their expertise in demand, two FSPH alumni launched the popular Dear Pandemic website and social media resource, where a team of scientists who call themselves “Those Nerdy Girls” dispense practical, evidence-based responses to inquiries on all aspects of life during COVID-19.
WHEN DR. MALIA JONES (MPH ’08, PHD ’12) SENT AN EMAIL to friends and family on March 5, 2020, with her insights about a looming pandemic, she couldn’t have known what would follow.
MALIA JONES (MPH ’08, PHD ’12)
A social epidemiologist at the University of Wisconsin-Madison who studies how infectious diseases spread through populations, Jones had intended to advise the people in her circle what was likely to unfold over the next few weeks, as well as offer practical tips on how they could protect themselves now that community spread of the novel coronavirus was occurring around the world. But her email went viral. It was posted on Facebook and shared some 100,000 times, with Jones’ email address attached. USA Today published an adapted version as an op-ed. Suddenly Jones’ inbox was being flooded. “I was receiving hundreds of questions per hour from people looking for answers on what the risk really was 12
and how to understand all these new words that were flying around,” Jones says. Just when she thought things couldn’t get more surreal, Jones was invited to appear on the popular “Dr. Phil” television show. Wondering how best to handle the barrage of inquiries, Jones contacted Dr. Alison Buttenheim (PhD ’07), an associate professor at the University of Pennsylvania School of Nursing. A behavioral scientist who focuses on infectious disease prevention, Buttenheim shares Jones’ interest in overcoming vaccine hesitancy. Since graduating from the UCLA Fielding School — both with the same doctoral adviser, Dr. Anne Pebley, the Fred H. Bixby Chair and professor in FSPH’s Department of Community Health Sciences — Buttenheim and Jones had become friends and frequent research collaborators. Buttenheim, whose social media posts were also attracting considerable attention, suggested they coordinate their efforts and post all of the answers to the questions coming their way in one publicly accessible space. Jones and Buttenheim launched Dear Pandemic on Instagram on March 10, 2020, the day before the World Health Organization declared the SARS-CoV-2 outbreak to be a pandemic. Three days later Dear Pandemic was on Facebook, and its mission — “to educate and empower individuals to successfully navigate the COVID-19 information overwhelm” — found an audience that has continued to grow. After a mutual acquaintance declared in response to an early Facebook post, “For the
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
rest of the pandemic, I’m just going to listen to those nerdy girls,” Jones and Buttenheim had found their handle. More than a year later, Dear Pandemic has logged hundreds of searchable posts spanning the gamut of pandemic-related concerns. Jones and Buttenheim have recruited a team of more than 30 public health professionals and academics — all women, the majority of them doctorally trained — with wide-ranging expertise who volunteer their time to craft layfriendly, evidence-based responses to reader inquiries, as well as posts interpreting the latest developments for public consumption. The messages, delivered with humor and compassion, are reaching an audience the two academic co-founders continue to marvel over. Two Facebook accounts, one in Spanish, recently crossed 100,000 followers between them. Many more are exposed via Instagram, Twitter, LinkedIn, or through a subscription to the Dear Pandemic e-newsletter. The website (dearpandemic.org)
ALISON BUTTENHEIM (PHD ’07)
attracts approximately 40,000 visitors per month. And that’s to say nothing of the people who hear from “Those Nerdy Girls” via shares, retweets and forwards, or the devotees who wear T-shirts and masks with the Dear Pandemic logo.
“ I was receiving hundreds of questions per hour from people looking for answers on what the risk really was and how to understand all these new words that were flying around.” — Dr. Malia Jones A key to Dear Pandemic’s success is the connection Jones, Buttenheim, and their colleagues have with their readers — many of whom, Buttenheim says, are women bearing much of the family decision-making load. “For those who follow us we have established this ‘nerd node of trust’ that makes us a go-to when they’re looking for information,” Buttenheim explains. “People find us relatable and trustworthy,” Jones adds. “They know we’re going to give the best information available, without any spin. We try to keep it fun and lighthearted, and when the topic isn’t fun and lighthearted, we’re real about all the feels that go along with it.” Beyond the trust and relatability is the practical nature of the advice coming from the Dear Pandemic team. “It’s become clear to me through this experience that most people have difficulty taking general guidance and applying it to their situation, and we can get much more specific and practical than the CDC or public health departments can,” Jones says. “It’s one thing to say, ‘Wear a mask,’ but people enacting that guidance want to know things like which mask, where can they get one for their 6-year-old, do they need to wear it outdoors, and does it matter how many
people are around?” Not surprisingly, the focus of the questions Dear Pandemic followers have submitted has shifted with the evolving pandemic. “At the beginning people mostly wanted us to translate the science and epidemiology to tell them what was going on,” Buttenheim says. “Then there were questions on practical lifestyle guidance — this very specific thing is happening in my life, is it safe? The other pieces that have emerged are the mental wellness and coping with the pandemic, and the infodemiology — how can I be a good information consumer, less susceptible to misinformation and disinformation? And how can I fight the misinformation I see in my own social network?” More recently, she notes, inquiries have revealed the persistence of myths that fuel vaccine hesitancy. The experience of the last year-plus has informed the academic work of the Dear Pandemic team. “We’re all now very keen to produce scholarship about this as a public health intervention, which we’ve seen it as all along,” Buttenheim says. She and her colleagues are looking into using machine-learning and language-processing techniques on Dear Pandemic posts and comments to learn how themes changed over time. “I see lots of both scientific research potential and real-world impact potential from Dear Pandemic,” Jones says. “I’m excited about future projects that will emerge directly from this.” A s public health experts, Jones and Buttenheim never dreamed they would be reaching such a large audience, but both say they have long been interested in communicating public health science to the broader population, and hope to build on what they’ve started. “In a very
IN MARCH 2021, DEAR PANDEMIC INCLUDED THE ABOVE INFOGRAPHIC WITH A RESPONSE TO A QUESTION ABOUT FAMILIES WITH VACCINATED ADULTS AND UNVACCINATED CHILDREN SOCIALIZING.
real way, being part of Dear Pandemic is also an intervention for us as individuals and professionals,” Buttenheim says. “We have drawn on each other for emotional support and scientific input, and have gained both insights and wonderful connections.” “All along, we’ve been building this ship while we’ve been sailing it,” Jones says. “It’s been a ton of work, but imagining the last year without this team doesn’t bear thinking about. I don’t exactly know what the destination is, but we plan to continue this in some form.” ph.ucla.edu
S U M M E R 2 02 1
13
14
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
Promoting Public Health for the LGBTQ Population A new FSPH center will partner with community groups and policymakers to develop and implement evidence-based strategies that advance the physical and mental health of sexual and gender minorities.
FROM THE HIGHEST COURT in the land to the court of public opinion, the last two decades have been marked by swift, fundamental progress, both in LGBTQ legal rights and in U.S. society’s embrace of the LGBTQ population. But barely more than 50 years after the uprising at New York City’s Stonewall Inn catalyzed the gay-rights movement, sexual and gender minorities remain at elevated risk of violence, victimization, discrimination, and other substantial threats to their quality of life. And amid the ongoing struggle for social and legal justice, LGBTQ individuals disproportionately face physical and mental health problems — often related to the historic and continuing trauma, discrimination, and stigma. “Both here at home and around the world, LGBTQ populations have a higher prevalence and incidence of life-threatening physical conditions, mental health challenges, and certain chronic and infectious diseases, along with significant barriers in accessing and maintaining healthcare and treatment,” says Dr. Matthew Mimiaga, a Fielding School professor of epidemiology widely known for his work with sexual and gender minorities. Under Mimiaga’s leadership, FSPH has established the UCLA Center for LGBTQ Advocacy, Research & Health, or C-LARAH, to promote the health of sexual and gender minorities through research, training, and partnerships with the LGBTQ community, community-based organizations, public health officials, and policymakers in Los Angeles and beyond. C-LARAH (larah is derived from the Latin “hilaris,” meaning cheerful — signifying health, well-being, resilience, and being a proud member of the LGBTQ community) develops and implements evidence-based strategies that address both the physical and mental health needs of LGBTQ
individuals while working closely with its local, national, and global partners. Mimiaga, recently recruited to the Fielding School from Brown University, has worked for years with LGBTQ populations at the intersection of HIV, substance use, and mental health, and conducts research internationally in Asia, Africa, Latin America, and Eastern Europe, as well as in the U.S. He has developed and tested psychosocial treatments for substance use disorder, as well as biobehavioral interventions aimed at decreasing HIV acquisition and transmission by encouraging the use of recommended antiretroviral medications for both prevention and treatment. Mimiaga also has close ties to leading LGBTQ organizations in Los Angeles and nationwide, and with Los Angeles being home to one of the world’s largest LGBTQ populations, C-LARAH is particularly well situated to join forces with a slew of highly regarded local organizations that serve and advocate for sexual and gender minorities. One Los Angeles-based partner is The Trevor Project, a nonprofit organization that provides suicide-prevention and crisis-intervention services for LGBTQ youth. The organization’s CEO and executive director, Amit Paley, welcomes the advocacy resources and interdisciplinary research expertise C-LARAH will bring to the LGBTQ community. “I’m excited for the UCLA Center for LGBTQ Advocacy, Research & Health to help shape policies that directly impact the lives of LGBTQ young people,” Paley says. “Limited LGBTQ-inclusive research, plus the lack of systematic data collection on LGBTQ communities, can make it even more difficult to address the unique mental health challenges of LGBTQ youth and the obstacles to care that they face. The Trevor Project recognizes a clear need for greater investment ph.ucla.edu
S U M M E R 2 02 1
15
DR. MATTHEW MIMIAGA, A PROFESSOR OF EPIDEMIOLOGY WIDELY KNOWN FOR HIS WORK WITH SEXUAL AND GENDER MINORITIES, HEADS THE NEW FSPH CENTER.
in advocacy and research that can better inform public policies that support the needs of LGBTQ youth. We look forward to working with the center to educate policymakers, advocate for LGBTQ youth, and provide unique insight into their mental health.” C-LARAH will provide training and mentorship opportunities for graduate students and postdoctoral fellows to support the growing demand for public health research that benefits vulnerable sexual and gender minorities. The center’s plans include establishing a postdoctoral fellowship program and a certificate program in LGBTQ health, as well as awarding pilot funding to researchers so that they can generate initial data that can then be used in applications for larger government and foundation grants. Mimiaga says financial support — through center and training program grants from the National Institutes of Health; federal and foundation-funded research grants; and private donor and endowment gifts — will be a key factor in the center’s success. In March, a team led by Mimiaga received an $8.8 million grant from the National Institute of Allergy and Infectious Diseases to conduct a nationwide study aimed at reducing the spread of HIV among young transgender women through the use of a mobile app. The app, LifeSkills Mobile, allows high-risk women who are unable to participate in face-to-face interventions due to geographic and socioeconomic barriers to easily access comprehensive HIV-prevention information and strategies. For Mimiaga, the Fielding School appointment marks a return to the city where he was born and raised. He was initially drawn to research in HIV prevention after a close friend was diagnosed with HIV at age 16 in the early 1990s. “I saw his day-to-day struggles taking antiretroviral therapy, which had terrible side effects at the time,” Mimiaga recalls. “And I saw the stigma and discrimination he experienced from being HIV-positive and knew I wanted to be involved in work that addressed that.” In the years since, Mimiaga has built a reputation as a leading researcher in the areas of HIV prevention and sexual and gender minority health, working in both academic and community settings. He has authored more than 350 peer-reviewed scientific journal articles, book chapters, and commentaries as a faculty member at Brown and, prior to that, at Harvard. He has a 20-year research partnership 16
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
and is currently an affiliated senior research scientist with The Fenway Institute in Boston, an interdisciplinary center for research, education, training, and policy development to optimize health for sexual and gender minorities and those affected by HIV. Much of Mimiaga’s research has involved assessing the efficacy of psychosocial and biobehavioral interventions designed to decrease HIV risk by addressing mental health problems such as depression and trauma, substance use disorder, and access to prevention programs and medical care, including the uptake and adherence to antiretroviral medications for treatment and prevention. Ongoing studies are focused on sexual and gender minority populations, some of which include transgender women; adolescents and young adults; gay, bisexual and other men who have sex with men; and street-based male sex workers and internet escorts. In addition, Mimiaga’s research has led to two novel HIV prevention interventions that are now part of the Centers for Disease Control and Prevention’s Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. At the Fielding School, Mimiaga will also co-lead the Multicenter AIDS Cohort Study, or MACS. Dr. Roger Detels, principal investigator of MACS and an FSPH distinguished professor of epidemiology, has directed MACS at UCLA since 1984; in that time, more than 7,000 gay and bisexual men have been enrolled in the study, which has produced groundbreaking findings on the epidemic.
“ As a member of the LGBTQ community, I know what it’s like to experience discrimination and fear around my sexual identity. I look forward to the impact C-LARAH will have in training future generations of scientists interested in conducting LGBTQ public health research.” — Dr. Matthew Mimiaga “As a member of the LGBTQ community, I know what it’s like to experience discrimination and fear around my sexual identity,” Mimiaga says. “It’s extremely rewarding to be involved in work that is making a difference in the lives of historically marginalized members of society. I look forward to the impact C-LARAH will have in training future generations of scientists interested in conducting LGBTQ public health research and holistically serving sexual and gender minorities through all social determinants of health and justice.” To donate to C-LARAH, please visit giving.ucla.edu/FSPHmag
MAKING VOTER SUPPRESSION A PUBLIC HEALTH ISSUE Through her research, FSPH doctoral candidate Anna Hing is showing why the field must combat anti-democratic efforts that disproportionately affect communities of color.
health will encourage more
professor who recently received
health professionals to combat
a grant to establish an anti-
voter suppression efforts.
racism center within the School
Along with her own disserta-
of Public Health. In addition
tion research, Hing has worked
to Gee, Hing has worked
with Gee on a study examining
closely with Dr. Chandra Ford,
the health impact of the migra-
professor of community health
tion process by comparing the
sciences and founding director
health of Filipino migrants to the
of the FSPH-based Center for
U.S. with that of their peers who
the Study of Racism, Social
remained in the Philippines. She
Justice & Health, where Hing has
also co-authored a study with
been an active member. “I am so
Gee and colleagues IN THE FIRST LEGISLATIVE
program knowing she wanted to
from UC San Francisco
SESSIONS following the historic
study structural racism’s impact
and Harvard that found
voter turnout in the 2020
on health, but uncertain about
a precipitous rise in
election, lawmakers in 47 states
the specifics. Her focus crys-
coronavirus-related
introduced bills making it harder
tallized when she took a course
tweets with anti-Asian
to vote, according to New York
taught by Dr. Gilbert Gee,
hashtags in the week
University’s Brennan Center for
FSPH professor of community
after then-President
Justice. These and other efforts
health sciences, in fall 2016. “He
Donald Trump tweeted
are widely viewed as dispropor-
pressed us to think about new
about “the Chinese
tionately affecting communities
ways of operationalizing struc-
virus” on March 16,
of color.
tural racism,” Hing recalls.
2020 — against the
“This was at a time when we were
warnings of public
seeing voter suppression around
health experts. “So
the presidential election — voter
often, people think, ‘It’s
ID laws and people waiting in
just words,’ but seeing
line for up to six hours in neigh-
what has played out in the last
fortunate to have had the men-
borhoods of primarily people
year shows that increased hate
torship of Dr. Gee and Dr. Ford,
of color, while people in white
speech can lead to violence,”
and to have collaborated with
neighborhoods were voting in 15
Hing says.
amazing students at the center,”
After completing her PhD,
Hing says. “My understanding of
incredibly salient that public
Hing will begin a postdoctoral
racism has been challenged and
health wasn’t talking about.”
fellowship at the University of
strengthened through the dis-
Minnesota working with Dr.
cussions I’ve had, and it’s made
Rachel Hardeman, an associate
me a better researcher.”
minutes. I saw this as something
Besides preventing people from weighing in on the officials ANNA HING
“ If communities of color are unable to elect leaders who will advocate for the policies that benefit them, it’s going to continue to marginalize people who are already marginalized.”
they want to advocate for them, voter suppression, like
Voter suppression isn’t
other forms of discrimination,
generally seen as a public health
may contribute to physical
issue, but UCLA Fielding School
and psychological stress — in
doctoral candidate Anna Hing
part by sending a message to
says it should be. “In public
certain groups that their voice
health we talk about social
isn’t valued, says Hing, whose
determinants of health — the
PhD dissertation considers
impact of where you live, work,
how voter suppression as a
and play,” Hing says. “If com-
mechanism of structural racism
munities of color are unable to
exacerbates health disparities.
elect leaders who will advocate
Hing, who was invited to discuss
for the policies that benefit
her research as part of a recent
them, it’s going to affect those
Harvard panel on the political
social determinants and con-
determinants of health, hopes
tinue to marginalize people who
that contributing to greater
are already marginalized.”
awareness of the connection
Hing entered FSPH’s PhD
between voting inequality and
FOLLOWING THE 2020 PRESIDENTIAL ELECTION, 47 STATES INTRODUCED BILLS MAKING IT HARDER TO VOTE. SUCH EFFORTS DISPROPORTIONATELY AFFECT COMMUNITIES OF COLOR.
ph.ucla.edu
S U M M E R 2 02 1
17
With her appointment to the newly created Fielding Presidential Chair in Health Equity, Lara Cushing will illuminate the evidence for and health consequences of social and racial inequalities in harmful environmental exposures. GROWING UP an hour north of the U.S.-Mexico border in Tucson, Arizona, in the 1990s afforded Dr. Lara Cushing a vantage point that set her on a trajectory to her current position, as an assistant professor of environmental health sciences and the newly appointed Jonathan and Karin Fielding Presidential Chair in Health Equity at the UCLA Fielding School of Public Health. The U.S. Border Patrol DR. LARA CUSHING launched Operation Safeguard in Nogales, Arizona, in 1995, a sharp escalation of borderenforcement efforts, just as the newly enacted North American Free Trade Agreement (NAFTA) was taking effect and the peso had been devalued. “The border became heavily militarized, and it was hard not to see the stark 18
contrast on the other side of the barriers built during my childhood,” Cushing recalls. “At the same time, NAFTA resulted in the development of a lot of industry on the Mexican side of the border — maquiladoras [factories in Mexico run by foreign companies, with no tariffs and lower environmental standards]. All of that was formative in opening my eyes to the connections between environmental health and social justice concerns. And now, as a new parent, that work has become personal as I think about what type of legacy I want to leave for the generations to come.” At the UCLA Fielding School, where Cushing joined the faculty in 2020, her research focuses on issues of environmental justice, including the evidence for and health consequences of social and racial inequalities in environmental exposures in U.S. communities. “Over the last half-century, we have made progress in many areas in terms of reducing levels of harmful pollution in our air and water,” Cushing says. “But
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
even as overall levels of pollution have gone down, the gaps in exposure experienced by Black, Indigenous, Latinx, Asian, and other communities of color as compared to white communities persist. We have lacked both a coordinated, effective federal response to climate change and a coordinated, effective reckoning with racism in the U.S. To me, these factors are linked and must be studied together to understand how racism produces environmental health disparities and ultimately seek remedies that can jointly advance sustainability and equity goals.” Using geographic information system mapping and social and environmental epidemiology methods, Cushing has investigated exposures related to oil and gas drilling, the existence of “heat islands” in urban areas, and the cumulative impacts of multiple pollution sources in disadvantaged neighborhoods on reproductive and other health outcomes. She was part of a group that issued a 2021 study showing a higher rate of preterm births among Latina women living near oil and gas wells in south Texas where drillers burn off excess natural gas as part of hydraulic fracturing (fracking) techniques. Her work has also pointed to the disproportionate impact of climate change on low-income populations. Cushing coauthored a recent study projecting that as many as 24,500 affordable housing units in the United States will be exposed to coastal flooding by 2050, triple the number of units at risk only 20 years ago.
Cushing looks to maximize the impact of her work in several ways. She has investigated the racial justice implications of specific environmental programs and has put forth analytical frameworks to assess the cumulative impacts of environmental and social stressors on health in order to sharpen regulatory decision-making around environmental justice. Cushing also partners with community-based organizations to help ensure that her research addresses the most salient questions and that the results are poised to make a difference. “Los Angeles has so many grassroots organizations doing amazing work at the intersection of environmental and racial justice,” Cushing says. “I hope to use this chair to help deepen existing research partnerships and develop new ones that can help to address the sustainability and equity challenges faced by communities in L.A. and beyond.” The endowed chair was established by Dr. Jonathan Fielding, a national public health leader and distinguished professor-in-residence at the Fielding School, and Karin Fielding, also a longtime public health advocate, to support the work of an early-career faculty member who is developing innovative ways to solve persistent health disparities and strengthen the school’s role as a leader in advancing health equity. “The persistent health disparities based on where people live, learn, work, and play — the social determinants of health — can and must be addressed by the next generation of public health
leaders, and that is why we deemed it essential, in establishing an endowed chair, that it be devoted to health equity,” Jonathan and Karin Fielding said in a statement about Cushing’s appointment. “At the same time, environmental issues, particularly the health effects of climate change, represent an existential threat that we must urgently address through public health research and policy. Lara Cushing’s work at the intersection of the environment and social justice is exactly what this endowment was intended to support, and we are pleased that she will set the standard as the first Fielding Presidential Chair in Health Equity.” Traditionally in academia, endowed chairs are awarded to senior investigators who have established a long track record. The Jonathan and Karin Fielding Presidential Chair in Health Equity, which carries a five-year term, is unusual in its mission of supporting talented early-career faculty members — providing them with the discretionary funding that can advance work poised to make a major impact on issues of health equity. The University of California provided matching funds for this endowed chair as part of The Presidential Match for Endowed Chairs initiative launched in 2014 by then-President Janet Napolitano to strengthen UC’s efforts to attract top-flight faculty. “Often, early-career faculty feel pressured to pursue projects that have the best chance for funding rather than taking risks on research that they are most passionate about, and with the potential
to have the greatest effect,” says Dr. Ron Brookmeyer, dean and distinguished professor of biostatistics at the UCLA Fielding School of Public Health.
“ Even as overall levels of pollution have gone down, the gaps in exposure experienced by Black, Indigenous, Latinx, Asian, and other communities of color as compared to white communities persist.” — Dr. Lara Cushing
“We are very fortunate to have the support of visionary public health champions in Jonathan and Karin, who understand the value of providing the wherewithal for rising stars such as Lara Cushing to explore questions fundamental to some of the greatest public health challenges of our time.” Says Cushing: “I feel like I’ve hit the jackpot in terms of dream jobs. And with that I feel I have a responsibility to make sure the resources associated with this endowed chair are put to work making a tangible difference to advance environmental justice and protect the health of communities on the ground.”
Holding the Door Open → At the end of a career dedicated to expanding access to healthcare, Gerald Kominski has established a scholarship to provide first-generation college graduates with the same financial support that paved the way for his work. AS HE NEARED RETIREMENT after more than three decades on the Fielding School faculty, Dr. Gerald Kominski knew what he wanted to leave as part of his legacy. During his 32 years at the school, Kominski, a professor in the Department of Health Policy and Management and senior fellow at the FSPH-based UCLA Center for Health Policy Research (CHPR), has been a leading voice in California and nationally on issues related to healthcare reform and expanding access to care, including the expected and actual impacts of changes under the Affordable Care Act (ACA). He co-led the development of the California Simulation of Insurance Markets (CalSIM) model, which is used by Covered California, the state’s ACA-creDR. GERALD KOMINSKI ated health insurance marketplace, to forecast eligibility, enrollment, and expenditures under the landmark law; prior to that, he was vice chair of the 20
Cost Impact Analysis Team of the California Health Benefits Review Program, which assesses proposals by the state legislature to expand mandated insurance benefits. Kominski was FSPH’s associate dean for academic programs from 2001 to 2008, and CHPR director from 2012 to 2018. None of that would have been possible, Kominski says, without the sacrifice and encouragement of his mother and father, whose formal education stopped at sixth and ninth grade, respectively, and the fellowship support that enabled him to earn a PhD in public policy analysis from the University of Pennsylvania. With his own experience in mind, upon his retirement in June, Kominski is returning the favor. Once fully endowed, the Gerald F. Kominski Health Policy Fellowship will be awarded each year to an entering MPH health policy student who, like Kominski, is a first-generation college graduate. “I know firsthand the many challenges faced by students who are the first in their families to graduate from college and then seek a graduate degree,” Kominski explains. “I also know the profound impact financial support can have for these students. I wanted to create a fellowship that would make it easier for students to focus on a career in health policy and not have to start their career with substantial debt.” Kominski was one of four children raised in Baltimore by parents who grew up in poverty during the Great Depression. College hadn’t been an option for either parent, and both worked hard to ensure that their children would attend college and lead better lives. Kominski was only 6 when John F. Kennedy ascended to the nation’s highest office, but the charisma of the newly elected president captured his imagination. Watching the massive March on Washington and other pivotal events of the civil rights movement awakened in him a passion for social justice that would shape his career aspirations. Those aspirations crystallized when Kominski was an undergraduate at the University of Chicago. “I saw healthcare as a moral issue — the idea that we should treat people equally based on their medical condition, not on their
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
KOMINSKI AT HIS COLLEGE GRADUATION WITH HIS PARENTS, JOHN AND MARIE, WHO WERE DETERMINED FOR THEIR SON TO RECEIVE THE HIGHER EDUCATION THEY NEVER HAD.
insurance status,” he says. “Health policy seemed to be one way to correct some of the inequality in our society.” With the fellowship support that allowed him to enter Penn’s PhD program, Kominski got involved in research evaluating a pilot program in New Jersey to fundamentally change the Medicare payment system, using what are now known as diagnosis-related groups to determine reimbursement levels for hospital care. When the federal government adopted the New Jersey experiment as the basis for national reform, Kominski’s dissertation work left him ideally situated to transition from the doctoral program to a position on the staff of what would become the Medicare Payment Advisory Commission. He spent three-anda-half years developing evidence-based policy recommendations that led to changes in the hospital payment program before concluding he wanted the research independence associated with academia. Kominski joined the FSPH faculty in 1989. For much of the next decade, he worked on research aiming to strengthen public insurance programs — Medicare, Medicaid, and workers’ compensation — through various economic incentives for paying hospitals and healthcare providers. But as the landscape in California and nationally began to shift in favor of universal coverage, Kominski increasingly focused on meeting the needs of advocacy groups and policymakers for data to better understand the cost and eligibility impacts of proposed reforms.
By the time the ACA was enacted in 2010, Kominski and colleagues at UC Berkeley had received funding to develop CalSIM, and would soon begin a partnership with Covered California to produce semiannual estimates that continue to guide the program’s planning and outreach efforts.
news media and at community meetings on issues related to the ACA and healthcare reform. “The people of California pay my salary, so I’ve always felt I should make myself broadly available to speak where invited,” he says. Just a few years after Kominski was first inspired by JFK, President Lyndon B. Johnson signed into law two of the most significant social programs of the last 60 years, Medicare and Medicaid. Kominski points out that Medicare was intended by its authors to be a first step toward the U.S. joining much of the rest of the world in ensuring universal health coverage. While that goal has proved elusive, he remains optimistic. “We’ve seen more movement in the last decade than in the previous four decades,” Kominski says. “The Affordable Care Act was the most significant piece of health legislation in terms of expanding coverage since the enactment of Medicare and Medicaid, and California has built on that as a foundation. With roughly 30 million people uninsured
“ We’re seeing a new generation driven to tackle the systemic inequalities in our system and not accept the status quo. Supporting this next generation of students at the Fielding School feels like a wonderful investment.” In recent years, Kominski has dedicated himself to initiatives that assist policymakers in making informed decisions as they seek to expand coverage. With his UC Berkeley colleagues he is actively engaged in the California Health Policy Research Program, bringing together frontline policy advocates and academic policy researchers in the state to outline the options and how they can be most effectively informed by data analyses. Kominski has also been a regular presence in the
we still have a long way to go, but we’re now talking about Medicare for All, a universal single-payer system. There is a lot of opposition, but also broad public support for universal coverage, and the pressure to expand access isn’t going to go away just because it’s a difficult problem to solve.” Kominski draws much of his optimism from his students, and sees the Gerald F. Kominski Health Policy Fellowship as the ideal way to repay the support he received. “My students have always kept me on my toes,” he says. “And now, we’re seeing a new generation driven to tackle the systemic inequalities in our system and not accept the status quo. I feel privileged to have benefited from a fellowship in graduate school that allowed me to go on to a challenging and fulfilling career during a time when our country has experienced some of the greatest health policy advances. Supporting this next generation of students at the Fielding School feels like a wonderful investment.” To donate to the Gerald F. Kominski Health Policy Fellowship, please visit giving.ucla.edu/FSPHmag JUST BEFORE THE COVID-19 PANDEMIC, KOMINSKI AND HIS WIFE, LAURIE KOMINSKI (RIGHT), HOSTED STUDENTS FOR A DINNER AT THEIR HOME.
ph.ucla.edu
S U M M E R 2 02 1
21
TAKING AIM AT GUN VIOLENCE Though the epidemic of firearm deaths in the U.S. has long been viewed through a criminal justice lens, two UCLA Fielding School professors who are studying the issue say it must be tackled through prevention strategies.
GUN VIOLENCE ISN’T JUST A CRIMINAL JUSTICE ISSUE, it’s a public health issue, says Dr. Michael Rodriguez, a professor of community health sciences at the UCLA Fielding School and family medicine at the David Geffen School of Medicine at UCLA. Rodriguez has been studying gun violence for more than 25 years. He and Dr. Ninez Ponce, UCLA Fielding School professor of health policy and management and director of FSPH’s UCLA Center for Health Policy Research, recently received a grant to explore the issue in California, where about 3,000 people died by gunfire in 2019 — 54% of them by suicide. “Gun violence kills people,” Rodriguez says. “It also injures many more people and maims people and provides them with disabilities for life. These are health impacts. By recognizing 22
that guns are causing these health impacts, we recognize that it’s a health problem. Once we recognize it as a health problem, we can think about it the way we do other health problems.” Rodriguez points to COVID-19 as an example of what a public health response looks like. Once the deadly nature of the virus was understood, doctors, scientists, and the community at large looked for ways to mitigate the threat. They mapped and studied the virus, developed effective vaccines, investigated potential treatments, and outlined personal and collective interventions to help stop the spread of the disease. “It’s the same way with guns,” Rodriguez says. “We can look at what’s going on. We can look at what are the risk factors. We can look at what we can do to reduce the gun violence in sensible ways and then implement
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
them.” Previous gunlence, especially among at-risk violence reduction efforts, communities.” such as outlawing specific Until recently, federal weapons, resulted in a drop in funding for gun-violence deaths and injuries, he says. research was limited by a The three-year grant, 1996 congressional proviwhich Rodriguez and Ponce sion that prevented the U.S. received in 2020 from the Centers for Disease Control philanthropic National and Prevention from using Collaborative on Gun Viopublic funds for studies that lence Research, will support “advocate or promote gun research on gun ownership control.” Congress clarified and attitudes among underthe law in 2018, and allostudied groups represented in the population-based California Health Interview Survey (CHIS), which annually surveys more than 20,000 residents across California. Ponce, the principal investigator of CHIS, considers the gun-violence epidemic in the U.S. to be even more than a public health issue. She calls it a “humanrights crisis.” “It’s the leading cause of pre— Dr. Michael Rodriguez mature death in the United States, killing 38,000 people and causing nearly cated $25 million the follow85,000 injuries each year,” ing year to study gun safety, she says. “That’s more than splitting the funds between 100 deaths and more than the CDC and the National 230 wounded every day.” Institutes of Health. Preventing death, disabilAccording to the CDC, ity, and injury from firearms more people were killed will require research and data by firearms than by traffic on what interventions might accidents in the U.S. in 2019: be most effective. “One of the nearly 40,000. Motor-vehicle pillars of public health is presafety, too, has benefited vention,” Ponce says. “These from public health research preventable deaths and over the years, as studies injuries fuel researchers and led to seat belt mandates and advocates to produce actionother regulations that signifiable data to promote policies cantly reduced car-accident and programs that reduce vioinjuries and deaths.
“ GUN VIOLENCE KILLS PEOPLE. IT ALSO INJURES MANY MORE PEOPLE. ONCE WE RECOGNIZE IT AS A HEALTH PROBLEM, WE CAN THINK ABOUT IT THE WAY WE DO OTHER HEALTH PROBLEMS.”
Rodriguez and Ponce will focus their research on young adults, veterans, immigrants, and members of the LGBT community. “We suspect there may be more people who own guns in these categories than we thought, because of the fear many of them have and the persecution many of them have experienced,” Rodriguez says. “Unfortunately, while fear frequently drives people to get a gun, with the thought that having that gun will increase their safety, the reality is that a handgun in the home increases the risks for homicide and for suicide in that home.” Veterans are at high risk of suicide from self-inflicted gunshot wounds, Ponce notes, and are more likely than other U.S. residents to own a firearm. According to a 2019 report by the Department of Veterans Affairs, the suicide rate is 1.5 times higher for veterans than for non-veterans, and firearms were the method in 70% of male veteran suicide deaths.
In addition, guns were the leading cause of death among children and teens in 2019, according to the Coalition to Stop Gun Violence. The aim of the UCLA Fielding School professors’ research and other public health explorations of gun violence is to inform public policies, Rodriguez says, adding that public sentiment already favors increased gun-safety measures. Multiple polls show that a majority of Americans, including a majority of gun owners, support such policies as universal background checks and allowing a judge to remove guns from people at risk of hurting themselves or others. Rodriguez says he hopes to see gun safety addressed with the same nonpartisan energy as the opioid epidemic. “Republicans and Democrats are coming together to find sound ways to provide information about opioids, to provide laws to protect the public,” he says. “Everybody in the
public knows that opioids are dangerous — they’re dangerous and let’s do something about it. Same thing we should be doing with guns: Get together with those we elect and help create safer environments.” Ponce notes that the United States has more guns and more gun deaths than other high-income countries. The loss isn’t only in lives, but in dollars, with gun violence costing the U.S. more than $280 billion annually in medical care, criminal-justice costs, employer costs, and work loss. “Building research and data on gun violence enables policymakers and advocates to make strides toward gun-violence prevention,” she says. “It’s even more critical now, with all of the tragic events happening around the nation and with racial tensions amidst the pandemic, which has been fraught with devastating losses.” Despite near-daily mass shootings in the U.S., Rodriguez remains hopeful
that thoughtful research on firearms and the damage they inflict can generate enough public and political support to change laws and ultimately protect people from unnecessary injury and death. “I’ve seen it work,” says Rodriguez, whose research as a postdoctoral fellow at Stanford University contributed to the movement to outlaw cheap, low-caliber guns known as Saturday night specials, resulting in a statewide ban in 1997. He believes sound research can inspire a similar movement nationwide. “Just like with tobacco, with opioids — we’ve got to change this around, and we can do it,” he says. “We can do it because people want things to be different. And I think we, in the health professions, can help advise on what it is we need to do to help make our communities and our homes safer.” —By Sandy Cohen, adapted from an article published by UCLA Health. ph.ucla.edu
S U M M E R 2 02 1
23
A Net Gain for Healthcare Administration FSPH’s online MHA degree program meets a growing need in a rapidly changing landscape. AS THE POPULATION INCREASES and a large portion of the current workforce reaches retirement age, the demand for highly skilled health management professionals in California and nationally is projected to grow substantially. To help meet that demand in a rapidly changing healthcare landscape, the UCLA Fielding School of Public Health has introduced an online Master of Healthcare Administration (MHA) degree program. The MHA degree — the first offered in the University of California system — equips early- and mid-career healthcare professionals with skills in areas such as finance, strategic marketing, quantitative problem solving, and analytics; moreover, the flexibility of the online platform affords them access to a Fielding School degree program regardless of geography, while they continue to work full time. DR. LEAH VRIESMAN According to the federal Bureau of Labor Statistics, the ranks of medical and health services managers in the U.S. will increase much faster than the average for all occupations in the decade between 2019 and 2029 — from approximately 422,300 to more than 555,000. “As healthcare grows, experts in administration, operations, and analytics will be an important element supporting the clinical side of the industry,” says Dr. Leah Vriesman, professor in FSPH’s Department of Health Policy and Management (HPM) and executive director of the new program, which welcomes its first class this summer. But the field of healthcare administration isn’t just growing; it’s also transforming in ways that require new skill sets. “As advances in healthcare information technology change the ways providers use data, there will be an increased demand for experts in healthcare administration and lead24
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
ership, and as healthcare moves into new forms of delivery, such as tele-functions, it will get no less complicated,” says Vriesman, head of HPM’s executive education programs and co-director of the school’s UCLA Center for Healthcare Management. “These and other developments create enormous opportunities to start or advance a rewarding career in a field that impacts people’s lives.” Although Vriesman expects that the new program will draw most heavily from the Southern California region, it will also appeal to professionals in distant and rural communities, where historically there has been a vast unmet need. “Advanced educational opportunities in this industry have been limited in these areas due to geographical barriers,” Vriesman says. “We educate healthcare managers in our urban areas, but we don’t do as good of a job reaching rural and semirural communities. We see this new Master of Healthcare Administration degree program as an opportunity to go beyond our usual geographic area to help address that need.” Vriesman notes that the MHA program will prepare graduates to succeed in any healthcare setting — within hospitals, health — Dr. Leah Vriesman systems, community clinics, and nursing facilities, as well as biopharmaceutical companies, large physician group management organizations, public agencies, insurance companies, and health technology businesses. “This degree was once very specific to working in hos-
“It’s important that healthcare administrators understand community health and social determinants of health, and not just treat healthcare as a business.”
pitals,” Vriesman says. “Increasingly, the industry is a rich tapestry of settings. It’s becoming more complex with more career pathways, and we want to ensure that we’re training future administrators who understand all of the components of the healthcare industry.” Reflecting the breadth of knowledge required of today’s healthcare administrators, the Fielding School’s MHA curriculum emphasizes both quantitative and qualitative skills. “We have more data than ever before — including financial, operational, electronic medical record, and quality-and-safety data — and our administrators require skills in interpreting and presenting it in order to be good leaders,” Vriesman says. “But the interaction with the patient also must be an important part of the conversation. We need people with good communication skills and emotional intelligence, who understand that now more than ever, it’s the patient who is at the center of everything we do.” The program combines conceptual knowledge with hands-on experience. “Students will expand their professional networks and consult with healthcare organizations on projects,” Vriesman explains. Capstone projects require students to work with a healthcare organization in their community in solving a real-world problem. Vriesman stresses that all of the program’s content is grounded in public and population health concepts. “We take the public health part of our mission very seriously,” she says. “It’s important that healthcare administrators understand community health and social determinants of health, and not just treat healthcare as a business. Our faculty are public health experts who specialize in healthcare management.” As the MHA was developed, FSPH sought input from practitioners in the field — a group Vriesman refers to as
the program’s stakeholders. “They are the purchasers of our product, which is well-trained graduate students,” Vriesman says. “So it’s important to learn from them what they want in a high-quality healthcare administrator.” A professional advisory council will continue to provide guidance as the program develops. The new program is a welcome development for healthcare executives such as Thomas Priselac, president and CEO of Cedars-Sinai Health System. “Affordable, high-quality healthcare and an equitable healthcare system are only possible if those leading and operating the delivery system have the necessary skills to develop and operate organizations aligned with that vision,” Priselac says. “The UCLA Fielding School’s new MHA program will play a critical role in educating tomorrow’s delivery system leaders. The online nature of the program will enhance accessibility by potential students, thereby responding to the urgent need for a master’s-prepared leadership workforce.” An important element of the online program is the access it provides — not just to professionals in rural areas, but also to those in Greater Los Angeles and beyond for whom a commute to the UCLA campus would be difficult, as well as to students who would be unable to complete a graduate program without the ability to continue working full time. The online MHA combines asynchronous activities, such as lecture videos and reading assignments, with weekly opportunities to interact live with peers and instructors. The two-year program also includes two required on-campus immersions. “This online MHA opens up access to professionals who would not otherwise be able to come to UCLA and the Fielding School,” Vriesman says. “That’s one of many things we’re very excited about.” ph.ucla.edu
S U M M E R 2 02 1
25
Teaching
The UCLA Fielding School’s PH 200 course, which started in 2019, introduces first-year MPH students to the fundamentals of public health through a casebased approach that addresses real-world topics through the lens of the school’s five departments. WHEN STUDENTS ENTER the UCLA Fielding School of Public Health for their MPH education, they choose one of five academic departments: Biostatistics, Community Health Sciences, Environmental Health Sciences, Epidemiology, and Health Policy and Management. But the multidisciplinary nature of public health demands that no matter what the area of focus, the successful professional be well versed in all five. “When our MPH graduates get public health jobs, they don’t work in silos,” says Dr. Yifang Zhu, professor of environmental health sciences and senior associate dean for academic programs at the UCLA Fielding School. “They collaborate with colleagues and need to be able to speak the language of people in 26
other public health disciplines, and appreciate the perspectives public health professionals in those disciplines bring to the table.” The school’s desire to present first-year MPH students with an introduction to the foundations of public health from an integrated perspective — in which faculty representatives from each of the five departments teach on the same public health issues and students from each department work together to address them — provided the impetus for PH 200A and 200B, a course now taken by all MPH students in their first two quarters at FSPH. Designed by an interdepartmental faculty team, the curriculum is delivered through a mix of traditional lectures and active-learning, case-based classroom discussions and presentations.
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
Moments Before the integrated core curriculum, which was first offered to students in the 2019-20 academic year, students took separate introductory courses from each department, with limited opportunity for interactions with students in other departments. “Previously, we received feedback from students and alumni that they would appreciate more opportunities to interact with students outside of their home department,” Zhu notes. “This course allows them to experience a wider range of perspectives, and to see how those perspectives
come together in real-world public health scenarios.” “Our students are going to work in multidisciplinary teams in their careers, and so it’s very helpful to have them doing that from the beginning of their public health education,” says Dr. Karin Michels, professor and chair of FSPH’s Department of Epidemiology, who co-chaired the PH 200 series with Zhu in 2020-21. “And by working on FOR ONE COURSE ASSIGNMENT, STUDENT GROUPS PLAYED THE ROLE OF STAKEHOLDERS RECOMMENDING A HEAT RESILIENCY PROGRAM TO A BUDGET-STRAPPED CITY COUNCIL.
a specific problem with students who have chosen other concentrations, they learn to appreciate other disciplines within public health.” Michels estimates that about half of schools of public health use an integrated model to teach the foundations of the profession, but what differentiates the UCLA Fielding School’s approach from many others is the emphasis on casebased teaching. Each quarter, three case studies are introduced — for 2020-21, topics involved the trans-fat campaign in New York City, the Affordable Care Act, e-cigarettes, arsenic mitigation in Bangladesh, COVID19, and climate change. For each case, one of the course’s five instructors serves as the lead and presents the background, and then each of the other instructors teaches on the salient issues from their vantage point. As an example, for COVID-19, students learned from the biostatistics perspective about the design of vaccine trials and how to interpret the results, such as what it means to be 95% effective. They took in key epidemiological concepts
used to monitor progress against the pandemic. From the community health sciences side, they explored the social determinants involved in which communities are most disadvantaged. They learned about the role of the environment in the transmission of the disease, and the importance of variables such as air pollution and masks. And from the health policy and management angle, they learned about considerations involved in the healthcare response, and in establishing policies for COVID-19 testing and vaccine prioritization. For the 2020-21 series, every case was taught through the lens of systemic racism. “We’re framing the materials in a story,” Michels says. “For example, instead of explaining how you design a case-control study and what biases you look for, we first describe the problem and then discuss the types of studies you might design to resolve the problem, which allows the students to learn by doing.” At the end of each case, multidisciplinary teams of students present as if in a public health setting. In the climate change module, student teams played the role of stakeholders delivering input on the heat resiliency program they would recommend to a budget-strapped
“This course allows [students] to experience a wider range of perspectives, and to see how those perspectives come together in real-world public health scenarios.” — Dr. Yifang Zhu
city council. “The students created video presentations that were highly polished, creative, and informative,” Zhu says. “It really added to the learning experience for everyone.” “Most students enter FSPH with a good idea of what they want to study, and it becomes easy to stay within your department and around other like-minded people as you go through the MPH program,” says Consuela Abotsi-Kowu (MPH ’20), who was the lead teaching assistant for PH 200 in 2019-20 and full-time course coordinator in 2020-21. “The value of this course is that it brings students into spaces with others who don’t necessarily approach public health the way they do, and allows them to learn from each other as they tackle public health issues.” Abotsi-Kowu says an added benefit, particularly
given that the 2020-21 course was delivered over Zoom, was that it fostered communication among new FSPH students, both during the group projects and in the chat function of the online platform. Through frequent interactions involving students from disparate locations — including some who were abroad — a sense of community was forged. “As a new student, despite being on Zoom, the group projects, breakout rooms, and office hours in PH 200 provided opportunities to connect with professors and students across FSPH departments early on in the program,” says Geneva Vogelheim, an MPH student in the Department of Health Policy and Management. “In addition, the case format allowed us to apply lectures to real-world public health issues and understand how each of our disciplines work together to provide solutions.” ph.ucla.edu
S U M M E R 2 02 1
27
Remembering Steve Wallace Though his loss is deeply felt by the UCLA Fielding School community, the FSPH professor and tireless champion for health equity left an enduring legacy.
AS A CHILD, Dr. Steve Wallace listened to his grandfather’s stories about coming to the U.S. through Ellis Island and his father’s memories of growing up in the immigrant neighborhood of Boyle Heights, California. “But it was an undergraduate summer internship in 1977, at a community health center where most of the patients were recent immigrants from Mexico, that sparked his interest in an academic approach to the study of immigration, and evolved into a storied career,” according to Dr. Ninez Ponce, professor of health policy and management at the UCLA Fielding School and director of the FSPH-based UCLA Center for Health Policy Research (CHPR). 28
In a loss deeply felt by the UCLA Fielding School community, Wallace died in March at the age of 63. His legacy endures in the legions of people he touched through his work as a beloved colleague, teacher, mentor, researcher, and tireless champion for health equity. “For many of us, Steve was a model for all that is possible in training, service, teaching, and mentorship,” Dean Ron Brookmeyer, distinguished professor of biostatistics, stated in a letter to the FSPH community, adding that Wallace “moved through life with the utmost integrity and humanity.” “Steve’s door was always open to everyone — students, early-career faculty members, and the rest of us,” said Dr. Michael Prelip,
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
professor and chair of FSPH’s Department of Community Health Sciences. “He was there to listen, ask the right questions, give the best advice, make you laugh, and be the absolute best friend and colleague. He was the complete package. He supported so many of us in so many ways, and often when we didn’t even know it.” An internationally renowned scholar on health, health disparities, and health policy involving older adults, immigrants, and communities of color, Wallace served as a professor of community health sciences at the UCLA Fielding School for 31 years, including six years as chair of the department and five as vice chair. As a CHPR associate director for 25 years,
he was essential to the center’s success, Ponce said. Wallace developed new approaches to assessing the economic security of older people through the California Elder Economic Security Standard Index, a tool that measures the actual cost of basic necessities for older adults, which was adopted into law in California, was used by the World Health Organization in its 2020 Decade of Healthy Aging report, and will be used in California’s master plan on aging. He led teams that enhanced community organization capacity to advocate for better air quality in neighborhoods, and established resources for Los Angeles neighborhoods to increase smoke-free rental housing.
In both his research and fieldwork, Wallace worked to better understand the dynamics of social inequality and how it impacts health equity, as well as how policy and community approaches can improve health equity. “Steve is widely recognized for introducing concepts such as the social determinants of health into discussions of health and social care for Latino and immigrant populations, the elderly, and other vulnerable populations long before such ideas became mainstream,” Brookmeyer said. Wallace received numerous honors for his work, including a lifetime achievement award from the American Public Health Association Aging and Public Health Section in 2018 and the chair’s citation for service in 2017. He earned a Fulbright fellowship to conduct research and lecture in Chile, and in 2018, received the Mario Gutierrez Champion of Migrant Health award from the Health Initiative of the Americas.
WALLACE (FRONT ROW, RIGHT), A RECIPIENT OF THE INAUGURAL MARIO GUTIERREZ CHAMPION OF MIGRANT HEALTH AWARD AT THE HEALTH INITIATIVE OF THE AMERICAS’ ANNUAL MIGRATION AND HEALTH SUMMER INSTITUTE IN 2018, WAS ALSO A BELOVED COLLEAGUE TO MANY INDIVIDUALS OUTSIDE OF UCLA.
with making a difference. “It was always about what he could do to address social injustices; what he could do to address the inequities that plague humanity; what he could do to help others,” wrote Dr. May Wang, professor in FSPH’s Department of Community Health Sciences. “And he did this with grace, compassion, humility, and wisdom.” In his efforts to effect change in health and healthcare policy for immigrant and elderly populations, Wallace often wrote letters to editors and op-eds for local and national newspapers. He testified at state legislative hearings and in other forums, —Dr. Ron Brookmeyer and his research informed state laws. Wallace was also committed to increasing the Yet on an online tribute diversity of the public health page, one colleague noted workforce. He served as that Wallace was less condirector of a National Insticerned about accolades than tutes of Health/National
“ For many of us, Steve was a model for all that is possible in training, service, teaching, and mentorship.”
Institute on Aging-funded coordinating center that mentors promising scholars from underrepresented groups who pursue careers in aging-related research. In February of this year, he co-authored an editorial in the American Journal of Public Health outlining priorities for the Biden administration in taking an equity-focused approach to immigration reform, as well as issuing a call to action for researchers and advocates to work together toward the goal of improving immigrant health and policies. But perhaps Wallace’s greatest legacy is his influence on the hundreds of students he mentored who have gone on to successful careers as researchers in immigrant health, older-adult health, and health disparities. Many of the doctoral students Wallace trained now hold tenure-track faculty positions and director roles at major centers. Wallace always found time for all students, Brookmeyer noted — even those from other universities who were simply interested in the field.
On the tribute page, Goleen Samari (MPH ’10, PhD ’15), who benefited from Wallace’s mentorship as an FSPH student, wrote of how she tries to emulate Wallace’s approach in her current position as an assistant professor at the Columbia Mailman School of Public Health. “I’ll never forget how he would reach out when he spotted a new article or op-ed of mine just to say that he was proud of the work I was doing,” Samari stated. “He always paid attention and, simply, not everybody pays attention. I, too, try to pay attention because of Steve.” Wallace’s family invites contributions to the Steve Wallace Fellowship Fund at the UCLA Fielding School of Public Health, which intends to continue Wallace’s commitment to mentoring first-generation students to become leaders in advancing public health policy.
To donate to the Steve Wallace Fellowship Fund, please visit giving.ucla.edu/FSPHmag ph.ucla.edu
S U M M E R 2 02 1
29
Brilliant Mind, Kinder Heart An FSPH doctoral student recounts the many ways — both personal and professional — the late Dr. Steve Wallace set her on the path to success. By Iris Y. Guzman-Ruiz, MPH ’17
I MET PROFESSOR STEVE WALLACE IN 2015 when I was a first-year MPH student in the Department of Community Health Sciences — he was my MPH academic adviser, and later became my PhD mentor. We developed important papers and policy briefs on Latino and immigrant health during the six years we worked together, and he was always generous with his time, providing substantive feedback on my writing and ideas. In addition to his mentorship, Steve helped me secure funding for school. I worked closely with Steve on the Research on ImmiGrant HealTh and State policy (RIGHTS) project. He had a brilliant mind and an even kinder heart. Steve respected and valued every single person at the table, from senior faculty members to graduate and undergraduate students to community health workers. And he was passionate about improving the health of the populations we studied and collaborated with. Often, he’d turn to the quietest member on the project to ask about their opinion, ensuring 30
everyone’s voice was heard and incorporating everyone’s feedback into the project. I miss our daily interactions, especially our serendipitous encounters in the kitchen at FSPH’s UCLA Center for Health Policy Research. Steve was more than just my academic adviser; he was my greatest advocate in the PhD program. During my first year, I took a leave of absence to care for my mom after she was diagnosed with cancer and was undergoing intensive treatment. Steve not only gave me the space I needed to care for her, but he did so with empathy. He went out of his way to ensure that I wouldn’t lose my health insurance by going on leave. Steve cared about the well-being of all of his students. When the COVID-19 pandemic forced everyone to isolate, he created a virtual social community for all of his advisees to connect and feel a true sense of belonging. He called it “Happy Hour” — we met monthly to share and reflect on our experiences in the program and with COVID-19 in general. I talked to Steve the day before he unexpectedly passed away. We dis-
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
cussed my projects and creating an accountability system for writing. He cared deeply about my success and gently guided me along the path from student to independent researcher. I cannot express how thankful I am for Steve’s mentorship these past six years. I encountered many setbacks, and could not have done as well as I did without his support. While I can’t imagine finishing the PhD program without him, Steve set me up for success. He opened opportunity structures critical for my advancement, including access to networks that would otherwise be inaccessible to me. Steve left a lasting impact on me both personally and professionally, and I am proud to continue his work with the same care and compassion he showed. Iris Y. Guzman-Ruiz, MPH ’17, is a PhD student in the UCLA Fielding School’s Department of Community Health Sciences and a graduate student researcher at FSPH’s UCLA Center for Health Policy Research. She is the project coordinator for the center’s RIGHTS project.
PREPARED TO ACT As the magnitude of the COVID-19 pandemic became clear, two FSPH doctoral students felt compelled to contribute to the public health response. The students describe how their UCLA Fielding School education equipped them to make a difference, and what they learned from their experiences.
ANNA BRATCHER, MSPH PhD Candidate, Epidemiology AT THE BEGINNING OF THE PANDEMIC, I listened to the 8 p.m. cheer for healthcare workers every day. I would awkwardly stand in front of my living room window and feel like I wasn’t in the right place — I wished I were out there, making a difference. I went into public health to help people, so when a call for volunteers went out, I was eager to pitch in. Since then, I have assisted the Housing for Health division of the L.A. County Department of Health Services in its COVID-19 response for people experiencing homelessness. I have had the
BECCA WOOFTER, MPH PhD Student, Community Health Sciences AS THE CORONAVIRUS PANDEMIC BEGAN during my first year as a doctoral student in public health, I hoped for an opportunity to serve my community. That opportunity came in the form of the COVID-19
opportunity to get out in the community, volunteering at testing events and vaccination clinics. I was even welcomed into the strategic side of the response, assisting with designing studies and ensuring a data-driven approach. I have already learned many things in this role, but the most interesting lesson has been the distinction between “helping” and
Virtual Training Academy (VTA), a joint
“serving.” When I listened to the 8 p.m. cheer, I had an urge to help
effort among the Fielding School and Exten-
— a vague impulse to swoop in and make things better according
sion at UCLA, UC San Francisco, and the
to my definition of that word. It wasn’t until I had been to a few
California Department of Public Health to
in-person events that I realized I was actually there to serve. No
train contact tracers and case investigators
one on skid row needs me to survive; they are already doing that.
to respond to COVID-19 in the state.
Instead, I needed to approach this work by identifying specific areas
Two months into the pandemic, I was
where I can contribute. I have found that my
invited to participate alongside UCLA
best contribution is through applying epide-
and UC San Francisco graduate students
miology to specific needs, such as assessing
and professors, as well as state health
rapid-testing machines and quantifying
department employees. As a member of the VTA, I coached state
exactly how many individuals are unsure of
government workers, many of whom had no background in public
receiving the vaccine.
health, through the contact tracer and case investigator scripts. We
In this way, FSPH has given me the tools
used small-group exercises to teach contact tracers the basics of
needed to truly serve the community. The
COVID-19 preventive health behaviors, motivational interviewing,
data analysis skills I have gained through
resource referrals, and consideration of the needs of callers they
courses and research at the UCLA Fielding
might encounter. We also provided training for groups and institu-
School have allowed me to bring valuable epidemiology expertise
tions outside of California, including sessions for contact tracers and
to the table. Through my FSPH education, the vague desire to help
case investigators in Guam.
my neighbors has been sharpened and focused into something
The VTA formation happened quickly to respond to the pandemic, with our training modules growing over time — adapting as
more real: the ability to collaborate with a population to serve its public health needs.
the pandemic progressed and in response to participant feedback. I was also able to apply my own research interests to create a training module for the needs of immigrant communities in California. This work required an unusual combination of academic expertise in epidemiology and the interpersonal skills to successfully motivate trainees and facilitate group exercises. I leveraged my MPH in epidemiology and time as a teaching assistant, as well as my extracurricular experience serving on a peer-counseling hotline and facilitating training sessions on sexual violence awareness. Through the VTA, I also met dozens of dedicated and enthusiastic public health professionals and saw firsthand the intersection of public health policy and health behaviors. When the days were long and emotionally taxing, these colleagues and the VTA leaders were supportive and reinforced how important this work was for our community. I am grateful for the opportunity to have contributed to the COVID-19 response in California through the VTA, and will use this experience to inform my future work in public health.
ANNA BRATCHER (LEANING DOWN, WEARING PURPLE), HOUSING FOR HEALTH STAFF MEMBER NICOLAS LEACHMAN AND COLLEAGUES PROVIDE VACCINE EDUCATION ALONG WITH FOOD, WATER, AND CLEAN NEEDLES TO PEOPLE EXPERIENCING HOMELESSNESS, LEADING UP TO A POP-UP VACCINE CLINIC EVENT IN RESEDA, CALIFORNIA.
ph.ucla.edu
S U M M E R 2 02 1
31
SCHOOL WORK
MLK Community Healthcare CEO and FSPH Alumnus Delivers Commencement Address DR. ELAINE BATCHLOR (MPH ’90), chief executive officer of MLK Community Healthcare in Los Angeles, delivered the 2021 commencement address for the UCLA Fielding School of Public Health’s Virtual Commencement Celebration June 11. Batchlor leads a health system that includes Martin Luther King, Jr. Community Hospital (MLKCH) — a private safety-net hospital — as well as outpatient practices, the MLK Community Medical Group, a fundraising foundation, and community and population health programs located in South Los Angeles. She was instrumental in the development and start-up of MLKCH, which opened in 2015 as a private, nonprofit hospital with the mission of improving the health of one of the most underserved communities in the state. A member of the National Academy of Medicine, Batchlor is board-certified in both internal medicine and rheumatology. She has received numerous accolades over the years, including the Partners in Care Foundation’s Vision & Excellence in Healthcare Leadership Award and the Irvine Foundation Leadership Award, which recognizes “innovative, effective leaders whose breakthrough solutions to critical state challenges improve people’s lives, create opportunity, and contribute to a better California.” In addition to being a Fielding School alumnus, Batchlor serves on FSPH’s board of advisors.
In Memoriam: Drs. Ellen Alkon and William Hinds DR. ELLEN ALKON, professor emeritus in the UCLA Fielding School of Public Health, whose career as a public health specialist mirrored the growth of the discipline in the latter half of the 20th century, passed away in December 2020. A pediatrician by training with a lifelong passion for public health, Alkon held leadership positions in three local health departments. In Maryland she served as chief of school health for Anne Arundel County. In Minnesota she was director of maternal and child health, and she served as commissioner of health for the City of Minneapolis. From 1980 until her retirement, she served in the Los Angeles County Department of Health Services and the Los Angeles County Department of Public Health, holding the positions of medical director for public health and chief executive officer of the Long Beach Comprehensive Health Center, medical director of Public Health (West Area), and director of public health education for physicians. At the UCLA Fielding School, she taught the course “Issues and Problems in Local Health Administration” for two decades. 32
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. WILLIAM C. HINDS, an internationally renowned scholar on airborne particles and respiratory protection, and professor emeritus of environmental health sciences at the UCLA Fielding School of Public Health, passed away in May 2021. Hinds served as the first chair of the Department of Environmental Health Sciences after the school’s departmentalization in 1989. Over the years, he also served as director of the UCLA Industrial Hygiene Program, principal investigator and director of the NIOSH Southern California Education and Research Center, and co-director of the UCLA component of the NIEHS Southern California Environmental Health Center. His primary research area was fundamental and applied research related to aerosols and industrial hygiene controls of airborne contaminants, including respiratory protection. Hinds was a much beloved mentor to 11 PhD students, including senior associate dean for academic programs Dr. Yifang Zhu, and 33 MPH and MS students. Perhaps his best-known contribution was the seminal textbook “Aerosol Technology: Properties, Behavior and Measurement of Airborne Particles,” the first such text in the field.
UCLA FIELDING SCHOOL TEAM AIDS IN BUILDING COVID-19 RESPONSE “VETERAN JOURNEYS,” AN OPERA INSPIRED BY TRUE STORIES from research interviews, premiered in June with music and libretto by Dr. Kenneth Wells, UCLA Fielding School professor of health policy and management and director of the Health Services Research Center at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. Wells, a psychiatrist, has spent years working with veterans and their families who are seeking solace from trauma and mental health issues. This is his third opera on mental health themes to premiere at UCLA.
HONOR ROLL 2020 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/honorroll2020 to view the 2020 Honor Roll.
A UCLA FIELDING SCHOOL OF PUBLIC
Fielding School team has worked to enhance
HEALTH-LED TEAM that has played an
the nation’s capacity to control COVID-19
instrumental role in training thousands of
transmission through fundamental public
COVID-19 contact tracers and case inves-
health strategies. The team has provided
tigators in California since the start of the
technical assistance to Armenia’s Ministry
COVID-19 pandemic has expanded its work
of Health since early in the pandemic, and
to include collaborations with the Republic
continues to partner in the management
of Armenia and Andean Parliament.
of the National Contact Tracing Program
The California Connected COVID-19 Vir-
in collaboration with the ministry and the
tual Training Academy, which began in May
American University of Armenia’s Turpan-
2020 and continues to train individuals in
jian School of Public Health. The team also
multiple counties throughout the state in pan-
led the COVID-19 Training and Planning for
demic response techniques, including con-
the Andes, a partnership with the Andean
tact tracing, represents a partnership among
Parliament for the rapid buildup of lead
the UCLA Fielding School, UCLA Extension,
trainers and facilitators in the parliament’s
the California Department of Public Health,
five member countries: Bolivia, Colombia,
and UC San Francisco. The FSPH team is led
Ecuador, Chile, and Peru.
by Dr. Alina Dorian, associate dean for pub-
“In our work in California, Armenia, and
lic health practice, and equity, diversity, and
with the Andean Parliament, we are rapidly
inclusion, and Dr. Michael Prelip, professor
deploying a new public health workforce of
and chair of the Department of Community
individuals with little or no previous public
Health Sciences; it includes UCLA Fielding
health background,” Prelip says. “And for
School staff and approximately three dozen
each program, our focus is on ensuring that
students and alumni.
this new public health capacity can be used
In the Republic of Armenia, the UCLA
for health conditions beyond COVID-19.” ph.ucla.edu
S U M M E R 2 02 1
33
FACULTY HONORS & SERVICE Dr. Onyebuchi Arah has been elected by the membership of the Society for Epidemiologic Research to serve as the society’s president-elect (202122), president (2022-23), and past president (2023-24). Kevin Baldwin was named a fellow of the American Medical Informatics Association for 2020. Dr. Sudipto Banerjee was named a fellow of the American Association for the Advancement of Science in 2020 and was elected president of the International Society for Bayesian Analysis for the 202122 term. Dr. Roshan Bastani received the “100 in 100” achievement honor for women from UCLA Health. Dr. Ron Brookmeyer served on the National Academies of Sciences, Engineering, and Medicine Committee on An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies. Dr. Catherine Carpenter was named guest editor of a special issue of Nutritional Epidemiology on “Nutrients: The Role of Nutrition in the Prevention of and Recovery from Infectious Diseases.” Dr. Liwei Chen was named associate editor for the journal Trials and the journal Diabetes Research and Clinical Practice. Dr. Kristen Choi was named one of Forbes magazine’s “30 Under 30” for healthcare. 34
Dr. Anne L. Coleman received the “100 in 100” achievement honor for women from UCLA Health. Dr. Alina Dorian was named vice chair of the Los Angeles County Public Health Commission. Dr. Joann Elmore received the “100 in 100” achievement honor for women from UCLA Health. Dr. Daniel Eisenberg served on the National Academies of Sciences, Engineering, and Medicine Committee on Mental Health, Substance Use, and Wellbeing in STEMM Undergraduate and Graduate Education. Dr. Jonathan Fielding was a key member of the advisory board for the National Health Promotion and Disease Prevention Objectives for 2030 (Healthy People 2030). Dr. Chandra Ford received the Lifetime Achievement Award from the Association of Black Women Physicians, and the Outstanding Academic Title for 2020 from the American Library Association’s Choice magazine for a book, “Racism: Science & Tools for the Public Health Professional,” that she co-edited; and was an editorial adviser and guest editor of a special COVID-19 edition of the American Indian Culture and Research Journal.
influential scientific researchers by the Clarivate Web of Science Group. Dr. Nina Harawa received the “100 in 100” achievement honor for women from UCLA Health. Dr. Ron D. Hays was named one of the world’s most influential scientific researchers by the Clarivate Web of Science Group. Dr. Jody Heymann received the “100 in 100” achievement honor for women from UCLA Health. Dr. Felicia Hodge was appointed to the UCLA Academic Senate Council on Academic Personnel and the Southern Indian Health Center Advisory Board, as well as being named an honorary member of the Sigma Theta Tau International Honor Society of Nursing. Dr. Steve Horvath was named one of the world’s most influential scientific researchers by the Clarivate Web of Science Group. Dr. Michael Jerrett was named one of the world’s most influential scientific researchers by the Clarivate Web of Science Group, and was appointed to the Health Effects Institute Review Committee.
Dr. Patricia Ganz received the “100 in 100” achievement honor for women from UCLA Health.
Avram Kaplan received a special commendation for service from the State of California for volunteer work for the City of Carlsbad’s COVID-19 Vaccination Program.
Dr. Sander Greenland was named one of the world’s most
Dr. Robert Kim-Farley was appointed as a member of the
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
UCLA Bedari Kindness Institute for 2021 to 2024. Dr. Jian Li was named to the National Occupational Research Agenda’s Cancer, Reproductive, Cardiovascular, and Other Chronic Disease Prevention Cross-Sector Council. Dr. Jingyi (Jessica) Li was named to the MIT Technology Review’s “Innovators Under 35” List. Dr. Mark Litwin received the 2021 Sherman Mellinkoff Award from the David Geffen School of Medicine at UCLA. Dr. Vickie Mays received the 2020 Carl Taube Award for Lifetime Contributions to the Field of Mental Health from the American Public Health Association’s Mental Health Section; the American Psychological Association President’s Citation; and was named special adviser to the UCLA chancellor on Black life. Dr. Jack Needleman was appointed to the 2021 National Quality Forum All-Cause Admissions and Readmissions Standing Committee. Dr. Anne Pebley was named a member of the National Academy of Sciences/National Research Council Committee on Population. Dr. Ninez Ponce was named to the editorial advisory board of the journal Milbank Quarterly, to the board of directors for AcademyHealth, and to the AcademyHealth Advisory Group on Diversity, Equity, and Inclusion in Health Services
BOOKSHELF Research; she was also elected member of the National Academy of Social Insurance and received the 2020 Inaugural Data Equity Award from the Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL). Dr. Thomas Rice was named to the editorial advisory board of the journal Milbank Quarterly. Dr. Anne Rimoin received the Global Achievement Award from the Johns Hopkins Alumni Association. Dr. Beate Ritz was reappointed to the California Air Resources Board’s Scientific Review Panel. Dr. Linda Rosenstock received the “100 in 100” achievement honor for women from UCLA Health. Dr. Brennan Spiegel’s book, “VRx: How Virtual Therapeutics Will Revolutionize Medicine,” was named one of the top eight science books of 2020 by Wired magazine.
Committee for the American Industrial Hygiene Conference and Expo. Dr. May Wang was named to the National Advisory Committee of the Robert Wood Johnson Foundation’s Healthy Eating Research program. Dr. Nathan D. Wong was elected president of the InterAmerican Heart Foundation in December 2020. Dr. Weng Kee Wong was named a Yushan Scholar by the Taiwan Ministry of Education. Dr. Elizabeth Yano was named to the National Institutes of Health’s Steering Committee on Sex and Gender Differences for the NIH Vivian Pinn Symposium and to the Independent Review Commission on Sexual Assault in the Military.
Dr. Candace Tsai was named a member of the Threshold Limit Values for Chemical Substances
Sick and Tired: An Intimate History of Fatigue By Emily K. Abel
VRx: How Virtual Therapeutics Will Revolutionize Medicine, 1st Edition By Brennan Spiegel
Chapter: “Federal Policies and Health” in Immigrant California: Understanding the Past, Present, and Future of U.S. Policy By Ninez Ponce
Health Systems in Transition: USA
STAY CONNECTED WITH UCLA FSPH
Dr. Marc A. Suchard was named one of the world’s most influential scientific researchers by the Clarivate Web of Science Group, and one of his research articles was cited by the MIA Yearbook of Medical Informatics as a “Best Article.” Dr. Paul Torrens received the Lifetime Achievement Award from the Partners in Care Foundation.
Recent books by UCLA Fielding School of Public Health authors:
By Thomas Rice, Pauline Rosenau, Lynn Y. Unruh, and Andrew J. Barnes
Health Insurance Systems: An International Comparison, 1st Edition By Thomas Rice
SUBSCRIBE to our newsletter and magazine: ph.ucla.edu/subscriptions
ASPC Manual of Preventive Cardiology Edited by Nathan D. Wong, Ezra A. Amsterdam, and Peter P. Toth
ph.ucla.edu
S U M M E R 2 02 1
35
GRANTS & CONTRACTS
This section includes new grants and contracts awarded in 2019-20. Due to space limitations, only funds of $50,000 or more are listed, by principal investigator.
DR. RICHARD AMBROSE Restoring Rocky Intertidal Foundation Species Across California California Ocean Protection Council & University of California, Santa Barbara, $173,077 for four years Assessing Long-Term Changes in Species Abundances and Community Structure in Southern California Rocky Intertidal Habitats Department of the Interior Bureau of Ocean Energy Management & University of California, Santa Cruz, $100,000 for three-and-a-half years DR. HAROUTUNE ARMENIAN American University of Armenia Corporation/ American University of Armenia Funds for Dr. Armenian American University of Armenia Corporation, $72,591 DR. SUSAN BABEY 2017-2018 California Health Interview Survey Research Studies The California Endowment, $538,000 for two years DR. SUDIPTO BANERJEE Collaborative Research: High-Dimensional Spatial-Temporal Modeling and Inference for Large Multi-Source Environmental Monitoring Systems National Science Foundation, $199,993 for three years DR. LIWEI CHEN Reducing Disparities in Birth Outcomes: A Randomized Controlled Trial on Centering Pregnancy National Institute of Child Health and Human Development & Clemson University, $98,736 for three years Mindfulness Training for People With a History of Depression, Substance Abuse or Inactivity Greenville Health Authority Board of Trustees & Clemson University, $131,492 for four years DR. EMMELINE CHUANG Qualitative Research, Project Management and 36
Statistical Analysis - Task Order Department of Veterans Affairs, $700,000 DR. ROGER DETELS Los Angeles Clinical Research Site (CRS) for the Multicenter AIDS Cohort Study/Women’s Interagency HIV Study Combined Cohort Study National Heart, Lung and Blood Institute, $934,217 DRS. ALINA DORIAN AND MICHAEL PRELIP Pandemic Workforce Training Academy California Department of Public Health & University of California, San Francisco, $4,657,500 DR. DAVID EISENMAN A Market Assessment Study of the National Health Security Preparedness Index Robert Wood Johnson Foundation, $311,413 DR. PATRICIA GANZ A Model Clinical/Translational Research Program for Breast Cancer Survivors: A Focus on Cognitive Function After Breast Cancer Treatment The Breast Cancer Research Foundation, $250,000 A Randomized, Double-Blind, Phase III Trial of Paclitaxel/Trastuzumab/Pertuzumab With Atezolizumab or Placebo in First-Line HER2Positive Metastatic Breast Cancer National Surgical Adjuvant Breast and Bowel Project Foundation, $70,449 for five years DR. GILBERT GEE Longitudinal Study of Sleep Deficiency Mechanisms Among Filipino Migrants National Institute on Minority Health and Health Disparities, $2,591,876 for five years DRS. PAMINA GORBACH AND STEVE SHOPTAW MSM and Substances Cohort at UCLA Linking Infections Noting Effects (MASCULINE) National Institute on Drug Abuse, $126,000 DR. JULIA HECK Birth Outcomes Among Alpha-1 Families Alpha-1 Foundation, $75,000 for one-and-a-half years
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. JODY HEYMANN For Developing Actionable Data for Strategic Use by Civil Society and Other Actors to Accelerate Women’s Economic Empowerment William and Flora Hewlett Foundation, $750,000 Harnessing the Power of Global Data to Support Young Children’s Learning and Development: Analyses, Dissemination and Implementation Economic and Social Research Council & University of Oxford, $322,452 for four years DR. MARJAN JAVANBAKHT A Randomized Crossover Study to Evaluate the Efficacy of Antibacterial Mouthwash in Preventing Pharyngeal Gonorrhea Among a HighRisk Population National Institute of Allergy and Infectious Diseases, $364,741 for two years DR. MICHAEL JERRETT A Scenario Tool for Assessing the Health Benefits of Conserving, Restoring and Managing Natural Working Lands in California California Environmental Protection Agency, $396,000 for two years Powering Healthy Lives Through Parks Urban Institute & Prevention Institute, $65,000 Ambient Air Pollution and COVID-19 Disease Severity or Death Among Confirmed Cases in Southern California California Environmental Protection Agency - Air Resources Board, $607,967 for two years DR. GERALD KOMINSKI California Health Policy Research Program 20192021 The California Endowment & University of California, Berkeley, $137,000 for two years Impact of Over-the-Counter Availability of Emergency Contraception on Uptake, Pregnancy, and Births National Institute on Minority Health and Health Disparities & RAND Corporation, $112,212 for two years LIQIAO (VICKY) LI AND DR. YIFANG ZHU Evaluating the Impact of Key Parameters on Evaporation of E-Cigarette Aerosols UC Tobacco-Related Disease Research Program, $133,674 for two years DR. ELIZABETH ROSE MAYEDA Alzheimer’s Disease and Related Dementias in a Diverse Cohort of Asian Americans National Institute on Aging, $2,015,460 for threeand-a-half years Contributions of Educational Quality and Occupational Complexity on Inequities in Brain
Health and Alzheimer’s Disease National Institute on Aging & Kaiser Foundation Research Institute, $192,126 for four years DR. YING-YING MENG California Tobacco Control Program (CTCP) Priority Populations Initiative Evaluation California Department of Public Health, $2,499,959 for five years Particulate Matter 2.5 Acute Health Impacts on Work Loss Days California Environmental Protection Agency, $395,526 for two years DR. CORRINA MOUCHERAUD Economic Evaluation of Strategies to Address the Significant Cervical Cancer Burden in Malawi National Cancer Institute, $158,735 for two years DR. JACK NEEDLEMAN How Nursing Staff Skill Mix, Education and Experience Modify Patient Acuity-Based Estimates of Required Unit Staffing Department of Veterans Affairs, $75,901 for four years DR. ROCH NIANOGO The SMART-CV Study: Systems Modeling Approaches to Reducing Disparities in Cardiovascular Diseases National Institute on Minority Health and Health Disparities, $670,500 for four-and-a-half years DR. AKIHIRO NISHI Center for Prevention Implementation Methodology for Drug Abuse and HIV (Ce-PIM) National Institute on Drug Abuse & University of California, Irvine, $52,351 DR. NINEZ PONCE California Health Interview Survey (CHIS) California Children and Families Commission (First 5 California), $1,700,000 for two years; The California Endowment, $3,000,000 for two years; Kaiser Foundation Research Institute [Southern California], $675,000; California Mental Health Services Authority, $570,000 for three years; Kaiser Foundation Research Institute [Northern California], $675,000; California Healthcare Foundation, $988,739 for two-and-a-half years Barriers to Metastatic Breast Cancer Care in California UC California Breast Cancer Research Program, $100,000 California Health Interview Survey Tobacco Follow-On Studies California Department of Public Health California Tobacco Control Program, $1,000,000 for two-and-a-half years
DR. NADEREH POURAT BPHC National Program Performance Analysis Health Resources and Services Administration, $810,517 for two years DR. MICHAEL PRELIP Fielding School of Public Health: Undergraduate Public Health Scholars Program The California Endowment, $50,000 DR. ANNE RIMOIN Using Vaccinated and Survivor Populations of Filovirus Diseases to Inform Regulatory Science and Development of Next-Generation Vaccines and Other Medical Countermeasures Food and Drug Administration, $1,504,919 for two years Strengthening Pharmacovigilance Capacity in the Democratic Republic of Congo: Utilizing Archival Records to Assess Rates of Maternal Vaccination and Birth Outcomes of Interest Throughout Kinshasa Food and Drug Administration, $599,838 for two years Modeling Epigenetic Memory in Toxicity (MEMENTO) Department of Defense - Advanced Research Projects Agency (DARPA) & Duke University, $597,003 for two years Consortium for Immunotherapeutics Against Emerging Viral Threats National Institute of Allergy and Infectious Diseases & La Jolla Institute for Allergy and Immunology, $366,254 for two years DR. BEATE RITZ Understanding the Role of Gene-Environment Interactions in the Degeneration of Human Dopaminergic Neurons in Parkinson’s Disease Army Medical Research Acquisition Activity, $395,848 for three years EVI-3 Multi-Angle Imager for Aerosols (MAIA) NASA & Jet Propulsion Lab, $1,119,935 for seven years DRS. DAMLA SENTURK AND DONATELLO TELESCA Functional Data Analysis for High-Dimensional Biobehavioral Data National Institute of Mental Health, $1,792,606 for five years DR. MAY SUDHINARASET Changemakers in Family Planning: Reproductive Justice of Asians and Pacific Islanders Society of Family Planning, $60,000 for two years
DR. JENNIFER WAGMAN Alcohol Epidemiology and Pilot Intervention to Reduce Alcohol, IPV and HIV in Women in Uganda National Institute on Alcohol Abuse and Alcoholism, $177,879 for two years Estimating Mediation and Moderation Effects in HIV Incidence Prevention Trials National Institute on Drug Abuse & San Diego State University Research Foundation, $88,866 for four years Global Partnership to Prevent Sexual Violence on College and University Campuses Wellspring Philanthropic Fund, $250,000 for three years DR. STEVE WALLACE* Resource Centers for Minority Aging Research (RCMAR) National Coordinating Center at UCLA National Institute on Aging, $162,788 Social Determinant of Health Care Use by Youth in Latino Immigrant Families National Institute on Minority Health and Health Disparities & Drexel University, $1,658,662 for five years DRS. STEVE WALLACE* AND NADEREH POURAT SCAN Tele-Psychiatry Evaluation SCAN Health Plan, $508,000 for two years DRS. STEVE WALLACE* AND LOURDES GUERRERO Emerging Issues in Minority Aging Research National Institute on Aging, $250,000 for five years DRS. YIFANG ZHU AND YU GU Co-benefits of Climate Mitigation on Air Quality and Human Health in Los Angeles Los Angeles County - Department of Water and Power, $250,000 for two years DRS. YIFANG ZHU AND TIAN XIA Assessment and Mitigation of Wildfire-Induced Air Pollution UC Office of the President & University of California, Davis, $350,000 for three years DR. FRED ZIMMERMAN Quantifying Health Equity Within States Robert Wood Johnson Foundation & University of Wisconsin, $99,956 Evaluation Services Los Angeles County - Department of Public Health, $521,000 * Beloved FSPH professor Dr. Steve Wallace passed away in March 2021. To learn more about his work and legacy, see page 28. ph.ucla.edu
S U M M E R 2 02 1
37
TRANSFORMATIVE INVESTMENTS
‘Where Others See Risk…’ Through its partnership with the UCLA Fielding School of Public Health and other university programs, the Karen Toffler Charitable Trust is among the few philanthropic organizations focused on supporting innovative student research with the potential for high impact.
FOR UCLA FIELDING SCHOOL PhD student
Beard has worked with her adviser, Dr. Anne
Cynthia Beard, a once-in-a-century pan-
Rimoin, FSPH professor of epidemiology and
demic served as a call to action. “As a doc-
director of the school’s Center for Global and
toral student in epidemiology who is most
Immigrant Health, to launch a survey-based
interested in infectious diseases, I was itch-
study of education workers in a variety of
ing to use the skill set I had been building for
roles — from administration and special edu-
years to contribute to answering some of the
cation to maintenance and facilities manage-
most pressing questions about COVID-19,”
ment. The study aims to learn more about
Beard says.
how COVID-19 has affected essential-worker
With support from the Karen Toffler Charitable Trust (KTCT), Beard is gener-
populations, and the role of racial disparities in those differential effects.
ating findings with the potential to guide
Alvin and Heidi Toffler influenced political,
public health officials and policymakers in
military, and business leaders around the world
better protecting the health of workers at the
with their insights over decades as leading
Yoon, whose study seeks to better under-
highest risk of exposure to SARS-CoV-2. As
writers and futurists, and the KTCT continues
stand the impact of early-life environmental
the recipient of a 2021 Toffler Fellowship,
their legacy through its support of early-stage
exposures on breast composition in adoles-
THE KAREN TOFFLER CHARITABLE TRUST SUPPORTS
FSPH PHD STUDENT CYNTHIA BEARD
research with the potential for high impact. In
cence, and MS student Catherine Psaras,
2018, KTCT established the Toffler Scholar
who is evaluating the impact of the 2011/2012
Program and chose the UCLA Fielding School
maternal pertussis vaccination recommenda-
as its first partner. The program supports uni-
tions on infant mortality from pertussis in the
versity students who demonstrate innovative
U.S. “The Toffler Scholar Program is powering
thinking, research excellence, and a passion
our early-stage public health researchers to
for helping to solve some of the world’s most
innovate and problem-solve,” says Dr. Ron
intractable problems.
Brookmeyer, FSPH dean and distinguished
“Most traditional funding organizations
professor of biostatistics. “We are grateful for
see early-stage projects as too risky, and as a
the Karen Toffler Charitable Trust’s renewed
result, some of the most promising ideas stall,”
commitment to investing in the bright and
says Dr. Peter Katona, a KTCT trustee who is
promising minds at the UCLA Fielding School
a clinical professor of medicine at the David
of Public Health.”
Geffen School of Medicine at UCLA, an FSPH
Beard hopes to one day contribute to
adjunct professor, and chair of UCLA’s Infec-
global health security policies that will better
tion Control Working Group for COVID-19. “But
prepare the U.S. and other nations to detect
where others see risk, KTCT sees the potential
and respond to pandemics and other public
for profound impact and is committed to sup-
health disasters. “In a year that hasn’t pro-
porting the research of young scientists at this
vided much stability, the Toffler Fellowship
pivotal point in their careers.”
has taken a great deal of financial pressure off
Beard was one of three FSPH 2021 Toffler
of me and allowed me to devote more of my
Scholars chosen through a competitive sub-
time and energy to my studies,” she says. “It
HEALTH. IN 2018, THE PROGRAM CHOSE THE UCLA
mission process led by FSPH’s epidemiology
also gave me a sense of support and belief in
FIELDING SCHOOL AS ITS FIRST PARTNER.
department. The others are PhD student Lara
the value of the research I’m doing.”
UNIVERSITY STUDENTS CONDUCTING FUTUREFOCUSED, EARLY-STAGE RESEARCH WITH THE POTENTIAL TO HAVE A MAJOR IMPACT ON HUMAN
38
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
Ready to Lead At a time of unprecedented demand for public health responses to our greatest challenges, applications for admission to the UCLA Fielding School’s degree programs are up more than 30%. This talented and diverse pool of applicants includes future leaders who will guide us through the next pandemic, and toward a future of health equity. But once admitted, many need a fellowship in order to say yes.
To join us in supporting student fellowships and learn about other ways you can make a difference, please visit giving.ucla.edu/FSPHmag or call (310) 825-6464.
Nonprofit Org. U.S. Postage PAID UCLA
Box 951772 405 Hilgard Avenue Los Angeles, CA 90095-1772 www.ph.ucla.edu Address Service Requested
“NOT EVERYTHING THAT IS FACED CAN BE CHANGED, BUT NOTHING CAN BE CHANGED UNTIL IT IS FACED.” — James Baldwin
