UCLA Public Health Magazine - Fall 1980

Falll980 Magazine of the UCLA School of Public Health and the UCLA School of Public Health Alumni Association

B~IA

Publie Heg/~h

In this issue:

Ghana: "the UCLA ~onnection

Parting thoughts In leaving the office of Dean and reviewing the past eight years here, I think first of the more than 1,500 graduates during that time. About 500 more students are now pursuing studies that will enable them to join their colleagues in public health work. To hear from alumni, to know what they are doing, and to sense the contributions they are making to the field brings the greatest joy a professor or dean can have.

During these past eight years the faculty has doubled in size. More importantly, it has grown in academic strength and diversity. Several outstanding professors who were School leaders in the 1960s are, of course, still very active, and many more have joined them from various disciplines and backgrounds. New faculty recruits to the School quite regularly advance to tenure after being found highly qualified academically by both School and campus-wide colleagues. Along with more senior faculty, younger professors are already making substantial scholarly contributions and becoming excellent teachers. Preceptors in the field and volunteer faculty add to the strength.

The School is fortunate also to have a very competen t and dedicated staff. Their constant attention to detail and to completion of tasks constitutes an important factor in all that is achieved. Many of them devote all or a large part of their working lives to the School, with significant impact on what is accomplished there.¡ Organizationally, the 15 programs of the early 1970s have been consolidated into six divisions: Biostatistics; Behavioral Science and Health Education; Environmental and Nutritional Sciences; Epidemiology; Health Services; and Population, Family and International Health. At the same time, the School has taken on greater academic responsibility, including the Ph.D. degree in Public Health and the teaching of social and preventive medicine and epidemiology to students in the UCLA School of Medicine.

Looking outward, it is evident that the balance of this century will be an exciting time for public health. The eradication of smallpox from the world has raised the prospect of similar ventures against other important diseases that still afflict much of mankind. Parasitic conditions, aggravated by malnutrition, burden hundreds of millions of people in the world. The World Health Organization in its call, "Health for All by the Year 2000," foresees relief particularly from such illness in the next two decades.

Meanwhile, progress against the major diseases of industrial civilization is gaining momentum. Only three decades ago commonly termed "degenerative" or "diseases of senescence," the current diseases of the heart and blood vessels and cancer are now seen clearly as not being inevitable consequences of aging. During the 1970s, mortality from cardiovascular disease declined more than two percent annually. Except for the continuing and devastating results of cigarette smoking, we have been just about holding the line against cancer in spite of the new cancerigenic agents being introduced into the environment . The new understanding that many forms of cancer and cardiovascular disease arise out of social as well as biologic conditions of life is a significan t base for developing effective social means of control. Effects of excess alcohol consumption and violence are also coming to be recognized as public health problems that can be successfully attacked.

Prospects for great advances in public health during the remainder of this century and into the 21st are indeed bright. I am confident that the UCLA School of Public Health and its alumni will help realize those prospects.

Lester Breslow, M .D., M.PH., Dean UCLA School of Public Health

UCI.A Publie Heg/th Fall1980

4 The Danfa Project and the UCLA

connection 8 The benefits of breast-feeding

10 A tv pilot for aspiring ex-smokers 11 Lifestyles conference

13 UCLA and Walter Holland:

Learning from one another 14 Chinese Minister of Health visits

15 News

20 Alumni notes 21 Faculty notes

Editor: Nancy Naylor Associate e ditor: Penny Christianson Assistant editor: Neil Miller Alumni coordinator: Barbara Broide Staff consultant: Judith C. Angel Staff assistant: Judy Cramer Design: Roy T. S. Lee

COVER PHOTO: Ghanaian girl, with doll and headload: vaccination scar on left arm signals new e ra in health care for West African nation. Photo by Don Be lcher. OPPOSITE: Graceful metalwork fountain at SPH entrance is symbol of the School. Photo by Norm Schindler

The Danfa Project and the UCLA connection

Participation by the Ghanaian people in the Danfa Proiect brought this West African rural health and family planning proiect to a highly successful conclusion.

by Lester Sloan It was the beginning of the rainy season in Ghana, a time when spring showers nourished the tropical forest and ponds, and fed the coastal marshes that would breed the dreaded anopheles mosquito.

It was the pause after the dry equatorial winds blew across the rolling savannas of the north, carrying red dust south, bringing the desert closer.

The black and white crows with their one-note songs serenaded the graceful women going to market with baskets balanced atop their heads, while happy children soaped themselves at the watering places. In the trees, the blue lizards 4

trolled for insects, while below, the young men boasted about their new sons.

In Accra, the capital, politicians still talked about the coup that had removed Nkrumah from power a year before. It was during this season, in May 1967, in a cluster of villages off the main road just 20 miles from the capital, that a group of chiefs and elders poured libations on the ground and sacrificed a ram to the gods in a ceremony as old as Africa itself.

Thus, the Danfa Project was consecrated.

That the Danfa Comprehensive Rural Health and Family Planning Project had its roots in Ghana was a source of pride to Ghanaians

and to co-directors Dr. Alfred K. Neumann of UCLA's School of Public Health, Division of Population, Family and International Health, and Dr. Frederick T. Sai, Chairman of the Department of Preventive Medicine, University of Ghana Medical School. The two men had been classmates and coclass presidents at Harvard during the early '60s, so when they became co-directors of the Danfa Project, it was a continuation of that warm friendship and professional relationship. "It was literally a prime example of the value of old school ties," said Dr. Neumann.

The Danfa Project, with its focus on service, teaching, and research in rural primary health care, repre-

sents the fruition of plans set into motion during the 1960s by the government of Ghana. The project was initiated by the University of Ghana Medical School (UGMS) and has become the cornerstone of the medical school's program of teaching, development, demohstration, and research in rural health care.

Conceptually, the Danfa Project is a broad umbrella: it has a primary health-care delivery camponent (including preventive services such as immunization, nutrition, and education) and educates people in how to plant kitchen gardens and make better use of available foods. A low-cost primary health-care service component, a health-education component and a family-planning component are also part of the Danfa Project.

The government sought outside assistance to expedite the process, and in 1969 the United States Agency for International Development (AID) provided funds for a feasibility study from which a major Danfa contract resulted. In 1970 AID negotiated a contract with the University of California at Los Angeles' School of Public Health.

Just previous to that, Ghana published a white paper making family planning a national policy.

"It was a policy which every subsequent government has restated and supported," said Dr. Neumann, "and it had nothing to do with the Danfa Project. It was a Ghanaian idea that they had on their own. It wasn't that they had a population problem then, but they decided that if they didn't start doing something about the birthrate, one of the highest in Africa, and providing family-planning services, they would have a problem in the future.

"Among its pther responsibilities, the Danfa Project was asked to look into different ways of implementing the new family-planning policy. The family-planning portion of the project determined the nature of the research design," said Dr. Neumann.

In April1970, Dr. Neumann, UCLA co-director designate, and

Dr. Irvin Lourie, the physician who would become the UCLA chief of party, returned to Ghana for two weeks to facilitate the transition from planning to implementation.

Being a Baha'i, Dr. Neumann stressed that his respect for the customs and beliefs of other cultures is the backbone of his religion as well as his approach to his profession. "There are those who ¡are conceptually oriented to working from the center down to the periphery; there are others who begin at the periphery and work toward the center. I belong to the latter," he explained. "I've always been a grassroots person. What had to be emphasized in Ghana was that this was their show and that we were helping them do their thing."

Dr. Neumann put his grassroots orientation to work early in his career. His Master of Arts thesis in economics focused on the factors governing distribution of health resources in rural Wisconsin, where he later worked as a country doctor. "I did it-not because I had the vision of permanently being a country doctor, but because I wanted the experience," he said.

"I knew fairly early that I would go on and do precisely what I'm doing now."

Dr. Neumann broadened his grassroots character between 1965 and 1967 when he was project officer for the Functional Analysis Feasibility Study, Narangwal Village, Punjab, India. During that time he was responsible for operational research in rural healthservice organization and delivery and also organized a series of studies of indigenous medical practitioners, sharing responsibility for a staff of 35.

"What India did was confirm and further strengthen my beliefs in rural institutions and the importance of services for rural people, which are designed to improve the quality of their lives," he said. "I also see that in many primarily agricultural countries, the rural sector is the economic backbone. When governments neglect that rural sector, they suffer."

Ghana proved to be an excellent laboratory in which to put this philosophy and Dr. Neumann's experience to work. The southern border of Ghana lies five degrees north of the equator, along the coast of western Africa, and straddies the Greenwich meridian. The topography ranges from coastal marshes, fishing grounds, and a coastal plain in the south, to tropical rain forests and the savannas in the north.

Being very poor in fossil fuel and having no extensive mineral resources, Ghana supports its ten million mainly by farming. Cocoa is the most important crop, making up two-thirds of its exports and one-third of the world's production. On the banks of the world's largest man-made lake, Lake Volta, a hydroelectric generating plant, built with capital provided by AID, supplies power for reducing bauxite ore to aluminum.

More than 60 percent of the labor force makes its living in agriculture, usually by farming small plots or by working in cocoa and hardwood timber, the second major crop. A relatively small p~rcentage of the labor force works in the aluminum industry. The per capita income is slightly below $500 per year.

In this ethnically diverse country, where only one-fifth of the population has attended school, 100 languages or cultural categories exist, though English is the official language. The population is predominantly rural with threequarters of the people living in districts of 5,000 or fewer. In these rural areas, parenthood is a source of status among men, and the women, who are usually mothers at an early age, average seven to eight births apiece. That is one of the world's highest fertility rates, but it is partially offset by a high mortality rate, especially among children and childbearing women.

The population increase is about three percent per annum.

Coupled with the high fertility rate is the large proportion of Ghanaian young people, leading health officials to say the country 5

is poised on a "demographic transition." This occurs when, during massive population growth, there is also significant progress in controlling diseases associated with declining rates of fertility.

In the early '60s, health facilities were inadequate to deal with the country's needs, much less any future crises. Roughly 500 physicians were in Ghana- all foreigntrained- and mostly practicing in Accra and other population centers. There were approximately nine nurses or midwives per 100,000 inhabitants.

In the outlyipg areas there 'Were only 10,000 beds in a sparse network of governmental health posts, missionary, and company hospitals, including only two maternity hospitals in the entire country. Long distances and poor transportation meant long traveling in times of emergency.

But in 1962, Ghana turned its attention to developing in-country training facilities for physicians, health-center superintendents, and nurses. A group of 57 premedical students, all destined to receive their medical training in Ghana, entered the University of Ghana at Legan in 1962. At that time it was hoped they would complete their education at Legan under a cooperative arrangement with AID. Because of bureaucratic entanglements, Ghana's first class of m edical students (3 7 m en and 3 women) completed their training in makeshift facilities at Accra's Korle Bu Hospital, the nation's largest and most modern, and graduated in 1969.

Despite a good start, the country was running a distant second in the race to overtake its mushrooming health-care problems. But the government was addressing itself to these problems, and the Danfa Project was inaugurated to help solve them .

During the five years of the program, there w ere 3,743 family planning acceptors, 45 percent of whom were m en. The pill has been the most popular m ethod among women. It is estimated that the general fertility rate has fallen from 6

DL Alfred Neumann and DL S. Ofosu-Omaah of the Danfa Proiect.

226 to 178 per 1,000 women aged 15 to 49. In addition, after the start of the satellite clinics, the percent of the population living w ithin four miles of health services rose from 34 percent to 85 percent.

Duties and responsibilities of the UCLA team and the Ghan aians w ere outlined: the Ghan aians w ere to be responsible for providing and managing the health and familyplanning services; for training medical and paramedical personnel by using the service program s and the project's facilities; an d for organ izing and conducting the annual review sessions. T he primary assignment for UCLA was to research and evaluate the m ost efficient m eans of improving the health and reducing the fertility of the population, and to assist in the training of various health personnel.

The full-time faculty residen t in G hana and short-term consultants were recruited from the ranks of the University of California. Never were there m ore than six full-time UCLA staffers w orking in Ghana.

UCLA faculty resident in Ghana and short-term consultants included: Dr. Irvin M. Lourie, Chief of Party; Dr. Donald W. Belcher, Epidemiologist; Dr. Jerry Niswonger, Family Planning Specialist; Dr. David D . Nicholas, Family Planning/M CH Advisor; Dr. JoAnn Cannon, Health Educator; Dr. William B. Ward, Health Educator/ Anthropologist; Dr. Stewart N .

Blumenfeld, Health Systems Analyst; Mrs. Harriet S. Lourie, Administrative Assistant; Dr. Carl Hopkins, System s Design ; Ms. Olive Johnson, Health Information Systems; Dr. Pat Britt, Computer Systems Design and Programming;

is poised on a "demographic transition." This occurs when, during massive population growth, there is also significant progress in controlling diseases associated with declining rates of fertility.

In the early '60s, health facilities were inadequate to deal with the country's needs, much less any future crises. Roughly 500 physicians were in Ghana- all foreigntrained-and mostly practicing in Accra and other population centers. There were approximately nine nurses or midwives per 100,000 inhabitants.

In the outlyipg areas there were only 10,000 beds in a sparse network of governmental health posts, missionary, and company hospitals, including only two maternity hospitals in the entire country. Long distances and poor transportation meant long traveling in times of emergency.

But in 1962, Ghana turned its attention to developing in-country training facilities for physicians, health-center superintendents, and nurses. A group of 57 premedical students, all destined to receive their medical training in Ghana, entered the University of Ghana at Legon in 1962. At that time it was hoped they would complete their education at Legon under a cooperative arrangement with AID. Because of bureaucratic entanglements, Ghana's first class of medical students (37 men and 3 women) completed their training in makeshift facilities at Accra's Korle Bu Hospital, the nation's largest and most modern, and graduated in 1969.

Despite a good start, the country was running a distant second in the race to overtake its mushrooming health-care problems. But the government was addressing itself to these problems, and the Danfa Project was inaugurated to help solve them.

During the five years of the program, there were 3,743 family planning acceptors, 45 percent of whom were men. The pill has been the most popular method among women. It is estimated that the general fertility rate has fallen from 6

Dr Alfred Neumann and Dr S. Ofosu-Omaah of the Danfa Project.

226 to 178 per 1,000 women aged 15 to 49. In addition, after the start of the satellite clinics, the percent of the population living within four miles of health services rose from 34 percent to 85 percent.

Duties and responsibilities of the UCLA team and the Ghanaians were outlined: the Ghanaians were to be responsible for providing and managing the health and familyplanning services; for training medical and paramedical personnel by using the service programs and the project's facilities; and for organizing and conducting the annual review sessions. The primary assignment for UCLA was to research and evaluate the most efficient means of improving the health and reducing the fertility of the population, and to assist in the training of various health personnel.

The full-time faculty resident in Ghana and short-term consultants were recruited from the ranks of the University of California. Never were there more than six full-time UCLA staffers working in Ghana.

UCLA faculty resident in Ghana and short-term consultants included: Dr. Irvin M. Lourie, Chief of Party; Dr. Donald W. Belcher, Epidemiologist; Dr. Jerry Niswonger, Family Planning Specialist; Dr. David D. Nicholas, Family Planning/MCH Advisor; Dr. JoAnn Cannon, Health Educator; Dr. William B. Ward, Health Educator/ Anthropologist; Dr. Stewart N .

Blumenfeld, Health Systems Analyst; Mrs. Harriet S. Lourie, Administrative Assistant; Dr. Carl Hopkins, Systems Design; Ms. Olive Johnson, Health Information Systems; Dr. Pat Britt, Computer Systems Design and Programming;

Ms. Lily Sohrab, Computer Programming; Debra Boyd, Writereditor; and Dr. Alfred Neumann, Co-director and UCLA Principal Investigator. Dr. Neumann traveled to Ghana two to three times a year for ten years for project planning, general management, and re-evaluation, as well as to pursue his special interests in quality of care, traditional birth attendant training, and program cost.

The approximately 100 full-time Ghanaian staff was the responsibility of the Ghanaian co-director, Dr. Frederick T. Sai. Project goals and objectives were developed jointly by UCLA and UGMS, but the Ghanaian co-director's views prevailed in all matters relating to Ghanaians. Prospective staff for the UCLA team had to be approved by both co-directors, and every effort was made to promote genuine collaboration through joint UGMS-UCLA staffing of project committees.

A UGMS project budget was provided by AID, separate from UCLA, giving the medical school the authority to hire requisite Ghanaian staff under local personnel practices. Nearly all service costs and most training costs were borne by UGMS. All data generated by the project was available both in Ghana and at UCLA. "In implementing the project," said Dr. Neumann, "we did nothing without consultation with the villagers, and there were always Ghanaians meeting with Ghanaians. We of the UCLA group rarely went out to the village service situation. It was very important that this was a Ghanaian show. We were the supporting staff behind the scenes."

The approach was very positive.

"The Family Planning Program component was solidly based on a good educational and delivery program without any cash incentives or brownie points for anyone. It resuited in a family-planning acceptance and continuity rate in this part of rural southern Ghana that is on par with South Korea and Taiwan," he added.

What the Danfa Project people

emphasized when introducing modern family planning to the chiefs and elders was that it was a way of returning to the old custom of child spacing-but using modern methods.

Dr. Neumann related the following story to illustrate his point: "In the traditional Ghanaian culture it was considered a disgrace if a woman had a baby within two years after the birth of her last child. By adhering to this custom there was a natural spacing in the family. This was facilitated largely by polygamy in the old days."

Dr. Neumann pointed to other factors which contributed to the success of the Ghana/UCLA collaboration: continuity; a good staff consisting of veteran international health workers who addressed themselves to the needs that the host country's officials considered important; good colleagual relationships; and support from higher echelons in the host country, at UCLA, and at AID. In addition, Dr. Neumann added that the faculty in UCLA's School of Public Health collectively has more than 100 years of African experience. "The whole UCLA systern has a very strong international orientation," he said.

The Danfa Project is an important trailblazer in the way projects are developed. The impetus came from senior civil servants in Africa, and some of the important points of the project, such as a system of co-directors and Ghanaian/UCLA joint authorship of most papers that have been written about the project, have become general policy in AID. In the vital area of training, the Danfa Project helped further educate at least 2,364 physicians, nurses, medical students, traditional birth attendants, field workers, and paraprofessionals.

"Alll9 Ghanaians who came to the U.S. unde.r Danfa Project auspices for specialized training not available in Ghana returned. As far as I know," said Dr. Neumann, "there has been no 'brain drain.'"

Equally gratifying to Dr. Neumann is that following the successful

ten-year program, the Ghanaian government continued to support it. New staff positions were created within the UGMS Department of Community Health. "That is what we call institutionalization," said Dr. Neumann.

In addition, several Danfa-developed training manuals are accepted as official training manuals of the Ghana Ministry of Health. The project also helped lay the basis in the medical school for a postgraduate preventive- medicine training program. Particular attention was paid to sharing the results of the Danfa experience with health professionals and policymakers in Ghana and the rest of the world. A total of 50 professional published papers, 30 conference presentations, 11 monographs, four training manuals, and various progress reports came out of the Danfa Project.

"From the body of material gathered, more dissertations, theses, and training manuals will be written," Dr. Neumann said.

"And most importantly, it is promating consultation within the Third World.

"I have a personal motto," said Dr. Neumann. "I believe in giving people a hand up, not a handout."

Materials provided by: "Danfa Project, Summary Conclusions and Recommendations" and other reports contributed by the UCLA School of Public Health Division of Population, Family and Inter:nationa] Health, UniversityofCalifornia, Los Angeles, California, 90024.

7

The bene&ts of breast-feeding

by Juliette McGrew With machines replacing people in this Future Shock world, bottle-fed babies are starving for human milk.

"Human milk is a natural resource which has been disappearing, with profound consequences to nutrition, healing, contraception, and economics," says Dr. Derrick B. Jelliffe, professor of Public Health and Pediatrics at UCLA's Schools of Public Health and Medicine.

In 1979, Dr. Jelliffe received Finland's Triennial Wihuri Foundation International Prize in Science for his work in pediatrics. He and his wife, Patrice, a lecturer and associate researcher at the school, have played major roles in demonstrating the importance of breastfeeding and infant nutrition.

"The main goal is to motivate and persuade influential persons that there is a need for government policy which takes a fresh look at infant and maternal nutrition in general, and at the role of breastfeeding and human milk in particular," say the Jelliffes.

They further believe that educating the community on the benefits of breast-feeding, and sensitizing health and maternity services to the needs of the infant and mother, are effective ways in which to enlighten the public on the importance of breast-feeding.

In spite of the worldwide decline in breast-feeding, the Jelliffes find consolation in the numerous international and national organizations that are recognizing the benefits of this natural phenomenon As members of the World Health Organization, the International Union of Nutritional Sciences Committees, and coauthors of Human Milk In The Modern World, the Jelliffes speak with considerable authority. Under the auspices of the Agency for International Development's Nutrition Communication Service, they have traveled to T hailand, Burma, 8

Breast milk not only nurtures the child with more natural nutrients than cow's milk, but also promotes a closer relationship between mother and child.

and the Philippines, to discuss all aspects of infant-feeding.

"Recent studies," say the Jelliffes, "have shown that cows' milk or formula does not contain as high a nutrient content as does human milk."

The high nutrient content in human milk helps prevent allergies and minimizes infants' absorption of foreign proteins.

Another benefit is cost. Formula milk can cost the equivalent of 60%-80% of a basic family wage in an underdeveloped country.

A recent book, Lactation, Fertility and Workin g Women , edited by the Jelliffes, examines the issue, and particularly focuses on new mothers who work. "It's one thing for us to praise the benefits derived from human milk," they say, "but

how do we convince working women of those benefits?"

Available alternatives have been actively discussed among pediatricians recently. "For example," say the Jelliffes, "one approach is to develop some type of maternity benefit which is flexible, so that the benefits can begin a few weeks before delivery and continue for some time afterward.

"In other countries creches work. These are different from day-care centers in the sense that they are in or near the place of work. The mother brings the baby in and can feed the baby on the spot." However, creches may be logistically or economically impossible for some mothers, employers, or governments.

Nutrition, of course, is integral to the healthy development of young children and pregnant women. The Jelliffes act as nutrition consultants to different countries, but without imposing their views on the resident health-care professionals, or attempting to formulate health policies.

"The resident leaders know more about the local scene regarding child nutrition than we do. But

we have various ideas to contribute. We try to come up with some suggestions concerning policy which will promote breast-feeding, and will also promote the best use of locally available foods for feeding mothers and young children."

Three factors have contributed to the decline of breast-feeding in developing countries: (1) breastfeeding is no longer convenient for all women since a higher percentage of women have outside jobs; (2) the spread of Western ideas has resulted in bottle-feeding becoming common in less developed countries; (3) the promotion of formulas has had an influence in Third World countries. And health professionals and maternity services in many of these countries have made it difficult for a woman to breast-feed her infant. (Mother and baby are sometimes separated or the baby is bottle-fed whether the mother requests it or not.)

Slow in-roads to change those situations are being patiently constructed by the Jelliffes and their colleagues.

"The importance of breastfeeding for infants in developing countries is much greater than it is

for infants in affluent countries," they say. "We're particularly concerned with developing countries where bottle-feeding is often not possible because the formula is very diluted and frequently contaminated. The result is wasting and diarrhea, which may be extremely hazardous to the health of the infant."

But infants in affluent countries also receive more benefits from breast-feeding.

"Take average families in a country like the United States, who can afford to use the right formula.

They have reasonable home hygiene. They are literate and can follow the formula's instructions."

Consequently, there are fewer nutrition problems.

"But recent studies have shown," say the Jelliffes, "that there are many under-appreciated advantages of breast-feeding for this group, such as the warding off of infantile allergies and infections and the promotion of mother-child bonding."

Dr. and Mrs. Jelliffe will soon attend a conference in Valencia, Spain, for professors of pediatrics from the Mediterranean Basin, as well as conduct m eetings in Colombia and Nepal for native health workers.

"We are able to add a different slant because this is our particular field," they stress, but also note that there is no one solution to the nutrition problems of mothers and young children. 0

Dr Derri ck B. felliffe and his wife, Patrice, have played major rol es internationally in demonstrating th e importance of breast-feeding and good infant nutrition.

9

A tv pilot for asp i ring ex-s111okers

.

____

Prof. Brian Danah er broaden ed th e scope of his quit-smoking research by taking on challenge of mass television audience.

by Wayne Sage Using the nation's most powerful medium to combat what has been called this country's primary h ealth hazard was the challenge undertaken by Assistant Professor Brian Danaher, a clinical researcher in the Division of Behavioral Science and Health Education. A local television station offered him two five-minute segments of air time each night for a week last February. The spots were to be u sed to help viewers stop smoking.

The news programs on which the smoking-cessation segments appeared were seen by more than one million viewers each night.

Follow -up studies of viewers' 10

responses may provide new knowledge about the best ways to help large numbers of people kick the smoking habit.

"The station broadcast the program because of its altruism," says Danaher, "as well as because of its competition with other networks for viewers ." This unusual mixture of pursuit of profits and public health continued to gel as the program took shape. The station, KNXT (Channel2) of Los Angeles, became increasingly enthusiastic about competitive altruism and supported an extensive publicity/ promotion campaign to alert viewers to the show. At great expense, KNXT published two-page

program guides in local newspapers.

The scientific framework for the presentation was drawn from Danaher's own evaluations of what works and what doesn't work in smoking-cessation literature. His 1978 book, Become an Ex-Smoker, written with thencolleague Edward Lichtenstein, is a step-by-step manual of strategies designed to help smokers quit permanently. However, his previous smoking-cessation work in both clinical and occupational settings never provided such a huge number of participants.

"One of t he major findings in the scientific literature on compliance is the fact that the more

tasks you ask people to do, the fewer they are likely to do well," says Danaher. "We needed to recommend only a few strategies so that people would understand them and then do them well." One of the prime elements in this lessis-better strategy involved a wellknown newscaster who sincerely wanted to stop smoking. The popular reporter was a participant/ observer in a group of 13 persons who wanted to quit smoking.

Danaher himself directed the program as "the credible source" of guidance. The show was taped and then broadcast in five-minute segments during the week of February 18.

Among the strategies presented was a smoking diary in which participating viewers logged the cigarettes they smoked and noted how much they enjoyed each one.

This process helps people learn more about their smoking patterns. By referring to the diaries, viewers were able to determine the circumstances which triggered their smoking and what personal feelings, such as frustration or anger or boredom, were related to their habits. They could then develop alternate strategies for dealing with irritating influences. As an aid for staving off anxiety and the desire for nicotine, viewers were taught to slow their breathing during tense situations.

Viewers then attempted to alter their daily routines to reduce the temptation to smoke and drew up personal contracts for quitting to establish their determination in black and white. (The newspaper ads carried forms to be used as a guide while watching the program.) Finally, the spots offered brief vignettes of test-group members about their daily lives: commuting to work, socializing in bars-and trying to avoid smoking.

Little is known about the effectiveness of such media campaigns, but thanks to Danaher's efforts, more will be known in the near future. The National Cancer Institute, seeing a unique opportunity to evaluate a promising healthpromotion effort, has provided a

grant to assess the success of the program. And the National Institutes of Health has expressed an interest in using a variation of the taped program to deliver smokingcessation spots to some 300 smaller TV stations around the country.

Oddly enough, Danaher himself has never smoked, nor does he believe that ex-smokers are automatically qualified to be the best coaches for others who are trying to quit. "There are so many individual reactions to withdrawal from cigarettes that each person's experience is unique. You can draw inferences from ten individual stories, but the eleventh case may be very different. That's why scientific research is needed. You have to listen to people's experiences, but give a careful hearing to the literature on self-management, behavior change, and smoking control. And in a project such as this one, you have to also be sensitive to the way in which skills information is transmitted and received over the medium of television," he says.

Self-help materials, whether transmitted via television or through public health professionals, are only effective if a person wants to help himself. Although commercial smoking-cessation clinics are filling a void, they are long on promises but shy away from evaluating their claims.

That's where the public health professional should step in with his self-help materials.

"To stop smoking is a personal decision, but a lot more people would make that decision if they thought they could succeed," says Danaher. "The more available and effective the programs we have to offer people, the more likely they will be to take advantage of selfhelp materials. Too often, the role of the public health professional is seen as limited to providing information. Through scientific inquiry, careful evaluation, and innovative program development, we should be able to offer broader alternatives and better choices for larger numbers of people." 0

Lifestyles conference joins university, industry "Universities look very hypocritical, if you will, when we go out into the world and talk to industries about what they should be doing for their employees when we have no organized programs to help our own employees," said Dr. Paul Torrens, public health professor. "At this conference, we heard a lot of 'listen, practice what you preach.' Even more shocking is that the university spends so little time working with the students themselves to help them develop more healthy lives."

Such were some of the thoughts emanating from a June UCLA seminar entitled "The Role of Higher Education in Lifestyles for Health in the 1980s," which was attended by 30 prominent professionals from major industrial, insurance and health organizations; various local, state, and federal government agencies; and faculty from Stanford University, the universities of Minnesota, Oregon, and Texas, and UCLA. The purpose of this distinguished gathering was to digest ideas from many fields as to what can be accomplished in higher education toward altering lifestyles for health.

Initiated by Dr. Torrens; Dr. Jonathan Fielding, Director of UCLA's Center for Health I}nhancement, Education and Research; and Dr. Lester Breslow, Dean of the School of Public Health, the seminar proved positive in that it broadened heretofore narrow channels of communication between universities and industries.

Industries are perhaps a step ahead of the universities in realizing that preventive measures may be more effective than curative measures in dealing with the major chronic diseases in the United States such as h eart disease, cancer, and stroke. Altering lifestylescontrolling diet, promoting exercise, ceasing smoking, alleviating stress - is a major factor in the prevention of those diseases. That universities and industries are ll

aware of their need to work together toward that end was a vital consequence of the summer conference. "'Universities have to help us,' the industries were saying," said Dr. Torrens. "'We need the experience of the universities.' And industries have a lot to offer universities because people spend a great amount of time at work.

Academia, at least in the health sense, has had very little contact with the workers. Industries felt that universities had ignored companies, workers, and work sites so that there is a great distance between them ."

Traditionally entrenched in research, and the technical and scientific aspects of treating diseases already present, the universities have hovered on the periphery of action in chronic disease prevention.

"Action has come sometimes from fringe groups that are not so reputable, like some of the weight centers that promise all kinds of things and make people feel good because they are doing 'something,"' said Dr. Torrens. "Whether they have much validity is questionable."

The general public is slowly awakening to the fact that these private institutions are only partially fulfilling consumer needs, and the overburdened medical practitioner groans at the thought of pursuing the intricacies of preventive m edicine. That creates a void into which the combined efforts of universities and industries can step with renewed effectiveness. But first a groundwork must be laid through communication and distilling of ideas; h ence the birth of this summer's UCLA lifestyles conference.

Hazards do exist for the university in actively pursuing this matter, primarily in that its diverse and extensive goals may dilute its efforts, resulting in ineffectual, half-completed lifestyle modification programs. As Dean Breslow asks, does the university's many voices impede its credibility to the general public; and could the university's pursuit of lifestyle alteration truly aid the momentum 12

outside the "ivory towers?" These and other questions are still to be answered, but just the fact that they are being discussed is encouraging.

The UCLA Center for Health Enhancement, Education and Research is developing evidence that proper nutrition and exercise, stress control, and elimination of risk factors such as obesity, high cholesterol, and smoking play a vital role in "lasting well-being."

Operated under the direction of Dr. Charles R. Kleeman, Factor Family Foundation professor of medicine and nephrology, and Dr. Jonathan E. Fielding, professor of pediatrics and public health, the Center's residential program is the only one of its kind centered in a university.

The Center's 26-day residential program includes a diet very low in total lipids (between 15 percent and 20 percent of total kilocalories), low in cholesterol (less than 100 m g per day ), with not more than two grams of sodium. Melded with regular exercise and support groups, the program assists participants in major lifestyle modifications. Intraclueing the program to practicing physicians and industries could result in dramatic changes.

The Center provides UCLA students in the health sciences with a rare opportunity to learn m ethods of disease prevention and techniques of " wellness." Community goals of the Center include service to physicians and other health professionals and dissemination of n ews of its research findings to the general public. " The University's goal is toreplace the questionable claims of advocates and zealots of health fads with objective scientific evidence about what works and what doesn't," says Dr. Kleem an . " The Center is the ally of the practicing physician, intent on restoring prevention and health enhancement to the hands of the skilled and knowledgeable practicing physician."

Although the success of the Center cannot yet be gauged, there is no doubt that it is but the first step on a longer journey. The life-

styles conference was the second step, and a major one, especially as it gave UCLA an objective look at itself.

"It was suggested on several occasions during the conference that not only should the University teach more actively in the area of health promotion and disease prevention; it should practice what it preaches with regard to its own faculty, staff, and students by developing programs which enable them to work actively on their own health and lifestyle patterns," said Dr. Torrens.

As one member of the conference pointed out, " If you can't do this in a university, don't even bother trying outside, because you have the ideal situation in a university with the facilities and a captive audience for four years."

Another participant suggested that aiding people in developing healthier lifestyles could be as vital an inn ovation to chronic disease control as the discovery of penicillin was in the treatment of acute infections.

For two and a half days, participants offered and listened to such comments with enthusiasm. In summarizing the event, Dean Breslow thanked the attendees for being willing to share their experience and insights with their university colleagues. "This has been a most important conference," said the dean. "Perhaps a landmark event for this university. You have given us a vital and vigorous picture of the needs of the people of this country in the area of health promotion and disease prevention, and now it is up to us in the university to respond to the statement of those needs." 0

UCLA and Walter B ol land: Learning froiD one another

by Penny Christianson When Dr. Walter Holland first taught at UCLA in 1969, it was because "UCLA at that time was the closest model to the way that education in epidemiology should be undertaken," says the renowned English epidemiologist. "At UCLA, medicine, public health, and epidemiology have always been intertwined. That is very appealing to me."

Professional respect runs in both directions. After observing Dr. Holland at the School of Public Health during his summer seminar, the natural conclusion is that he loves teaching, as his students' attention reflected not only respect but a camaraderie, with good humor, as well. But, in spite of this satisfaction, he says, "I am not particularly dedicated to teaching. It is n,ot my priority.

"Research will have a far greater impact. First of all, you gain the respect of your peers through your research, not through your teaching. Many people do not appreciate that you really can't teach well unless you have done research.

The researcher doesn't believe in dogma, which is what the teacher is often trying to put forth.

"If I were purely a teacher, I would come to believe what I said.

As a researcher, I doubt everything and I don't necessarily believe everything that I say. That way I am capable of maintaining my sanity."

Dr. Holland crinkled his nose in a manner his students would recognize as reflective of his sense of humor.

One of the more interesting studies conducted by Dr. Holland focused on the question of whether Great Britain's mortality from respiratory disease was actually higher than in any other country. "We wanted to investigate whether that was true or not," says Dr. Holland.

Entitled Respiratory Disorders

DL Walter Holland, renowned British epidemiologist, brought both wisdom and humor to his summer seminaL

in United States' East Coast Tele phone Men, the study compared experience in the United States and Great Britain. Telephone workers represent comparable occupations on both sides of the Atlantic, where telephone men and postal workers aged 40 to 59 were studied.

Results of Dr. Holland's study revealed that "Americans have better lung functions than the British. People who lived in the dirtiest area, which was London, had the lowest levels of lung functions and highest levels of symptoms. Even in our country towns the levels of symptoms were higher than in Baltimore, the dirtiest American town we studied!"

Simply eliminating open fires in British homes enormously reduced that level of pollution in England to the point where smog episodes do not occur. Although Dr. Holland admits that America's pollution problem is more complex and not so easily resolved, he does agree that Los Angeles does not deserve its notorious nickname of 'smog city.' "Your smog causes discom-

fort but I think it is very difficult to determine if it causes any longterm effects," he says.

It is respiratory diseases in children that particularly interest Dr. Holland, who journeys to UCLA periodically to keep apprised of research techniques used here which can also be utilized in his homeland. His studies have revealed that cigarette smoking by the parent can influence bronchitis in the child through passive inhalation of the smoke during the first year of life. An episode of childhood bronchitis or pneumonia will often be followed by additional ones in later life.

Because Dr. Holland considers educating the adult parents an impossible task, he would rather seek to modify the cigarette itself. In England, he is presently battling with tobacco manufacturers to do just that. As for American tobacco growers? "Can't you pay them to not grow tobacco?" he asks.

Suggestions of such innovations pepper his lectures, but lectures are rather like performances, the Englishman says, during which the most a student can retain is 30 13

percent, or three facts. "After you learn three facts, you might as well go out for a cup of coffee."

But Dr. Holland's students do not go out for coffee except at designated breaks. In fact, upon the epidemiologist's first guest professorship at UCLA, he was impressed by the diligence with which American students came to class.

Only after some time was he aware that their loyalty stemmed at least partially from their fascination with his delightful British accent.

His instincts have served him well over the years, as respect for his research has pulled many more students into his classroom than any accent could. It has evolved into a mutual admiration society, as Dr. Holland gleans much from his work on the UCLA campus.

"It is difficult to gather new ideas in your own environment and to consider the relevance of the ideas," he says. "This gives me an opportunity to sit back and think."

The easy pace of the summer seminar facilitated space for that thinking to the extent that Dr. Holland wrote four papers during his first two weeks at SPH. Perusing Dr. Holland's impressive compilation of 179 published papers in his 14-page curriculum vitae reveals a distinguished and diverse record from Report of the Working Party on Computers in Medicine (1969) to Environmental Factors in Child Mortality in England and Wales.

His work is recognized and lauded with prizes and honors from his alma mater, the University of London, to Los Angeles. So it is not the accent that draws students, just as it is not the quietness of a summer campus that draws Dr. Holland to UCLA. "There is more inter-disciplinary communication between the departments, which is what I think the future requires, so it is an exciting place to be," he says. "It provides me with many extremely good ideas for what we might be able to do ourselves." 0

14

Chinese Minister of Health visits SPB Only in recent years has knowledge of modern China come into this country, and even then, it has been confined to an enterprising few. But now with seemingly locked doors and impenetrable ¡faces being replaced by welcome mats and probing questionsaccompanied by Pacific-spanning grins-Americans are participating in an unprecedented two-way exchange.

Nowhere has this been more apparent than on the UCLA campus, particularly in June when the Minister of Health of the People's Republic of China arrived. Among hosts and visitors, it is difficult to say who was scrutinizing whom more intensely.

On June lU and 11, as a reciprocity to former HEW Secretary Joseph Califano's visit last year, the Minister, Dr. Qian Xin Zhong, and several prominent physicians from China toured the Center for Health Sciences and were entertained in Dean Lester Breslow's home. Having accompanied Secretary Califano on his historic China tour, Dean Breslow was delighted to be the host.

All participants found the visit enlightening. A discussion of the mission and activities of the School of Public Health evoked interested response from a provincial health officer, as well as academicians in the visiting group.

Byron Backlar, assistant dean of administration for the School of Medicine, conducted the delegation on a whirlwind tour of the medical facilities.

Interest was piqued when a bio-medical librarian dialed a direct line to the National Medical Library in Bethesda, Maryland and requested a computer print-out of all materials written in Chinese on a specific type of blood-borne cancer. "The machine answered the question in hard copy and the

Chin ese Minister of Health Dr Qian Xin Zhong was honored at a dinn er party at the hom e of Dean Lester Breslow (right) , durin g a visit to the School.

Chinese were very impressed as the librarian handed it to them," said Dean Backlar. "They were amazed that it was connected to a computer 3,000 miles away."

An ultra-sound demonstration during which a pregnant woman chatted casually with the visitors while her live unborn fetus was projected on a screen similarly affected the entourage. But it was the duality of UCLA's roles as teacher and physician that aroused the most enthusiasm. Said Sue Fan, administrative assistant of UCLA China relations: "What especially impressed our guests was our way of combining the teaching and clinical aspects of medicine.

Our doctors have to teach and practice medicine as well. The research and the implementation of that research go hand in hand."

Such observations by the Chinese provide groundwork for the future exchange of teachers

.

j

and students: postgraduate students, who will be expected to enroll in degree programs; and practicing teachers for short-term sabbatical leaves and skill updating.

The Chinese are aware that many of their university graduates in recent years have been ill-prepared ¡ because of the Gang of Four, and that China was isolated from the world community of science and technology. This exchange program is an attempt to "catch up" with the rest of the world.

The program stretches West as well as East. During his visit, Minister of Health Dr. Qian invited SPH professor Dr. Robert Mahto visit China within the coming year to study methods of waste utilization for energy and to conduct seminars. "They have more than 7.3 million bio-gas generators in China," said Dr. Mah. "They are all small operations in communes used for heating and cooking. It is an energy-producing means of waste disposal, and China is more active in utilizing it than we are."

Dr. Mah's work in isolating bacteria for methane production affords a common ground with the Chinese, who are focusing on the application of mixtures of the organisms without really understanding their biology, just as engineers in this country do in waste disposal plants, said Dr. Mah. Obviously, they have something to learn from one another.

"Certainly there are different ways to solve problems and it's very probable that the Chinese have solved problems in a way that we would consider innovative," said Dean Backlar.

With continuing open-minded cooperation, SPH will play a role in health innovation on both sides of the Pacific in this on-going cultural and educational sharing.O

NEWS Looking at lifestyles "How Far Should a Society Go in Attempting to Influence the Lifestyles and Health Habits of Its Members?" was the subject of a special Medicine and Society Forum organized by the School of Public Health.

Participants were Drs. Kenneth Cooper, 1980 Regents' Lecturer and an international leader of the physical fitness movement; George Godber, former chief medical officer of the British National Health Service; Arthur Chung, professor of public health; and Paul Torrens, professor of public health, who served as moderator.

Discussion was enthusiastic and provocative. Panelists agreed that good health habits should be encouraged. However, they did not have any simple formulas for promoting lifestyles. Should healthy lifestyles be legislated? Who should determine what constitutes a healthy lifestyle? Isn't lifestyle a matter of individual choice? These were some of the issues raised.

Godber supported attempts to persuade people to avoid habits that have been proved detrimental to health, such as smoking, drinking, and inactivity. He would favor certain forms of legislation ("smoking by consenting adults only in private," for example) but he acknowledged the difficulty of such measures. "If we can't impose sanctions, then we must give a convincing message," he said.

Proponents must be able to demonstrate what can be gained by doing what they advocate.

"Ninety percent of premature deaths from heart disease, are preventable. We are killing ourselves," said Cooper, who developed aerobics, an exercise program to improve the cardiovascular system.

He feels an obligation to "help people help themselves, through education and motivation, not legislation." One way, he suggested,

is through incentives such as "super select" insurance for those who follow proven healthy habits.

How effectively a lifestyle can be promoted depends on circumstances, pointed out Chung, drawing on his observations in China.

"You can't talk health when the stomach is empty. Without the basic necessities, prevention is meaningless and health habits are hard to advocate."

Yet in a country like China, he noted, the government uses subtle coercion to get people to do what it wants. For instance, the sanitation campaign, a continuous effort to clean up the country, has become a "patriotic duty" with community rewards for compliance.

During audience discussion, Dr. Raymond Neutra, associate professor of public health, commented that public health is actually a matter of selectivity. A change in lifestyle does not eliminate death.

It only gives some people control over how they will die.

"If I exercise regularly and eat properly to avoid heart or liver disease, then perhaps I'll die of some rare collagen disease. Maybe it would be better to drop dead suddenly of a heart attack," he acknowledged.

Dr. Bernard Towers, sponsor of the forum, took up Neutra's challenge. "Happy people live longer.

And if we want to enjoy life by eating and drinking, don't lay a guilt trip on us! Just how far should we go in imposing lifestyles on others?"

Cooper's answer to that question toward the conclusion of the program: we should go as far as we can by making people aware of proper health habits early. He didn't think anyone would choose dying suddenly at 40 instead of living actively until age 65. "Physical conditioning offers quality as well as quantity," he said. "People live lives in which they feel good and look healthy for longer."

15

Dean's Council dinner features Chinese scholar The School of Public Health Dean's Council has increased its membership 100 percent since its inception in 1977-78, with 65 members contributing more than $7,500 to be used in areas not covered by other funding. On May 15, Dean Lester Breslow spoke of these funds at the Dean's Council dinner held at the Faculty Center.

"Although the funds may seem relatively small when you look at the total budget for the school (approximately $10 million annually), they do serve a useful purpose," he said. "They are free of restrictive guidelines, federal or state, but we must spend the money by university rules for school purposes."

Dean Breslow went on to enumerate several channels into which the funds had been funneled, such as purchasing books and materials for a newly established placement center for students and graduates of the school. Entertaining visiting congressmen and foreign dignitaries also constitute important ways in which these funds are being utilized.

One benefit of belonging to the Council is the dinner itself. On this occasion, Dr. Chang Kung-Lai, from the People's Republic of China, presented humorous and poignant comparisons between his homeland and the United States.

Dr. Chang is a visiting scholar in epidemiology at the School of Public Health. He finds Americans " independent, openminded, kind, and warm, more friendly and hospitable than I expected."

Dr. Chang emphasized the independence of Americans with an anecdote. "During class, the Chinese students sit quietly and take notes, asking no questions even if the professor asks for them.

But American students ask questions if they don't understand," he said. "And if the professor makes a mistake, the American points it out. I like the American students' reactions."

Other areas that impress Dr. 16

Dr. Raymond D. Goo Dr. Lawrence and Dr. ang Kung-Lai at the D ean 's Council dinner h eld in May at the Faculty Center.

Chang are the use of the University in the evenings for adult education classes and the accessibility of the University to all high school students (only two to three percent of Chinese go on to higher education, he said). "The technological advancement in the United States with widespread use of the computer is one of the most impressive things in this country," he added.

But not everything impressed Dr. Chang favorably. A lack of family closeness in this country seemed to distress him, as it is not unusual for as many as four generations to share peacefully the same living quarters in China, as Dr. Chang's family has done.

"The relationship between parents and children here is not as close as in China," he said. "I cannot say if this is bad, but I dislike it. Also, in China, without marriage, girls and boys never live together. It takes about two years to understand each other and then

you decide if you want to get married. That makes it work."

Encouraged before coming to UCLA by the Chinese Minister of Health to "just say the truth about what is going on in China," Dr. Chang indicated that the Chinese are acutely aware of the monumental problems in front of them, particularly in regard to the population, which has spurred officials to mandate only one child per couple. "One child is very good," said Dr. Chang. "Two not as good, three no way. It's a massive operation."

Dean's Council events inspire just such a meeting of the minds.

The Council is now becoming so successful that Dean Breslow suggested that a Council dinner be one of the first events for the new dean. He commended Judith Angel, coordinator of SPH alumni and development, for her efforts toward that success.

Students, Dean Breslow, and officers recognized at awards dinner Each year, the School of Public Health Alumni Association presents awards which recognize outstanding achievement in the School.

This year, at the reception and ceremonies which took place at the UCLA Faculty Center on Sunday, June 1, alumni, faculty, and students attended a program hosted by outgoing Alumni Association Vice President Peter Szyrkreni.

Following remarks by Dean Breslow and Dr. Ash, Alumni Association scrolls were presented to the outstanding students nominated as the top graduating student by each division. The students receiving awards were: Debra L. Cheyovich, Population, Family and International Health; Jane Sullivan, Health Services; Ann MacArthur, Behavioral Sciences and Health Education; Timothy L. McAuliffe, Biostatistics; Mary E. Pedersen, Nutritional Sciences; and Gayle C. Windham, Epidemiology.

The Bronze Medallion, the highest award of the SPH Alumni Association, was presented to Ann MacArthur. Dean Lester Breslow was presented with the SPH Alumni Association Outstanding Faculty Award for his countless contributions to the School.

The election of SPH Alumni Association officers was held during the meeting. Elected to serve for the 1980-82 term are : Barbara Broide, president; Paul Jarett, vice president; Karen Lewis Oatis, secretary; Ruth Silvia, treasurer; and Ray Goodman, M.D. M.P.H., member at large.

Join the Dean's Council Membership in the Dean's Council is $100 per annum. If you are interested in joining, contact Judith Angel or Judy Cramer at (213) 825-3901, 405 Hilgard Avenue, Los Angeles, CA 90024.

U.S. Surgeon General will speak on campus Surgeon General Julius Richmond, M .D. will speak at the James E. West Center on Monday, October 6, at 8 p.m.

Disease prevention and the promotion of health have been the major themes of Dr. Richmond's term as Surgeon General. He has also been instrumental in promating better medical services to disadvantaged segments of the population.

Dr. Richmond will be the first invited Lester Breslow Distinguished Lecturer, especially appropriate inasmuch as Dean Breslow is internationally known for research in health maintenance.

Career information day Many employers and some 200 students met together in a Career Information Day on May 16, to exchange information on career opportunities and recruitment.

According to Rob Grossbard, director of placement for the School, the evaluation responses from the student turnout indicated that they would unanimously desire Career Information Day to become an annual event. Student questioning was provocative and the response was highly enthusiastic.

Debra M. Ward, a student in Population, Family, and International Health, assisted in organizing the event, and spent much time over several months, along with other members of the organizing committee, to make the event a reality.

Dr. Cushner brings gover~entexperience

Dr. Irvin M. Cushner, professor of obstetrics and gynecology, has just returned from nearly two years of service as deputy assistant secretary for Population Affairs with the former Department of Health, Education and Welfare (presently HHS, the Department of Health and Human Services) .

Dr. Cushner's position was mandated by law and entailed advising the secretary and the Surgeon General on all matters pertaining to population and family planning.

Dr. Cushner intends to transmit his experience to his students. "I would like to teach them about the reality of setting policy in government," he said. "They have some strong views about how the world can be better, so I would like to provide them with a realistic view of what they can do as health professionals."

In addition to learning about policy setting, Dr. Cushner was educated as to the health priorities in the Carter administration (quality medical care for all), and where his field fits into HHS's priorities of comprehensive and single-site care with emphasis on primary versus specialized care.

Placement services Robert Grossbard, B.S., M.Sc., has been appointed director of placement for the School of Public Health. In addition to focusing on increased employment opportunities for public health graduates, Grossbard is planning a Career Speaker Series in the spring quarter.

Anyone wishing to advertise job openings or field placements should contact Robert L. Grossbard, director of placement, UCLA School of Public Health, Los Angeles, CA 90024.

Elizabeth Stern Memorial services for Professor Elizabeth Stern were conducted August 12. After establishing herself as an expert in the cytology of cancer, Dr. Stern joined the SPH faculty in 1963. Well-deserved recognition of her work came from local, national, and international fronts for her important contributions to epidemiology.

Contributions may be made to her memory to the Spastic Children's Foundation, United Cerebral Palsy.

17

Olive Johnson retires

Kenneth Cooper, world renowned authority on conditioning and author of Aerobics, made a winter visit to the School of Public Health as Regents' Lecturer. He made class presentations and discussed his research in cardiac rehabilitation and physical conditioning in a series of campus programs.

Dr. Schweitzer analyzes government policies Since March 1980, Stuart 0 .

Schweitzer, Ph.D ., has been working in Washington, D .C. in his new position as Senior Staff Member of the President's Commission for a National Agenda for the '80s, specifically on the panel of Government and the Advancement of Social Justice.

Dr. Schweitzer's position entails interacting with both legislative and executive branches on welfare, education, and civil rights' policies; considering their views, and presenting findings and recommendations to the President-Elect on December 31, 1980. He will then return to SPH. "I hope to gain a richer knowledge of policy options and strategies for implementation in the health field," says Dr. Schweitzer. "'I am recommending that w e reduce inequities in h ealth status and health services utilization.

The biggest area for disease prevention is in overcoming the discrepancies between poor and nonpoor, the white and n on -white. It doesn't rely on n ew scientific breakthroughs.''

Approved by the White House staff based on his background in health economics, Dr. Schweitzer is the only staff person on the 18

commission working on two different panels. The other one is "The American Economy," in which he will examine employment policy and the reduction of poverty.

Dr. Carl Hopkins retires from dedicated service For 16 years, Dr. Carl Hopkins served the School of Public Health, first as associate research statistician and then as professor in the field of medical care and health services. His work with the Medicare program led Mil ton Roemer, M.D., to say at his June retirem ent dinner: "Carl Hopkins gave the field scholarly and academic respectability, and he fortified the efforts of all his colleagues to rebuff attacks from the skeptics and the faint-hearted."

Dr. Hopkins recalls the establishment of the Public Health Ph.D. program in 1975 as one of his major accomplishments at UCLA. The retired professor also estimates that he was on 60 doctoral committees and chaired "at least 35."

Approximately six doctoral students will continue to receive the benefit of Dr. Hopkins' experience.

He also intends to teach courses at California State University at N orthridge and at UCLA Extension.

fust the fact that 80 of her former students initiated the surprise retirement party for Olive Johnson says a lot about her career, which spans nearly 20 years in the School of Public Health.

During that time, she established what has been called "one of the outstanding medical records' programs in the country."

So renowned is her ability that her program has received international acclaim, and similar ones have been organized in Liberia, Jordan, and Ghana (for the Danfa Comprehensive Rural Health and Family Planning Project, see story this issue).

In 1978, her work was acknowledged with the faculty Distinguished Service Award, presented by the School of Public Health Alumni Association.

Ms. Johnson's retirement party was unique in that the program followed the form of a medical record with "Admitting Diagnosis," "Consultation Report," "History," and " Physical Examination ." A skit of Olive's career was presented in "Progress Notes" by three of the alumni, while the "Discharge Plan" enumerated anticipated activities.

After actual retirement on September 30, Olive will continue her association with current students and alumni, teaching on a parttime basis.

International dinner has Mediterranean flavor On Sunday, April 20, the UCLA School of Public Health Alumni Association played host to a gathering of students, alumni, faculty, and friends for its annual International Dinner, at the James E. West Center. Congeniality w as the order of the evening. After a delicious Greek dinner and wine, the guests heard brief comments by Dean Lester Breslow and Alumni Association officers Eva Damski and Barbara Broide.

Olive Johnson retires

conditioning and author of Aerobics, made a winter visit to the School Public Health as Regents' LectureL He made class presentations and discussed his research in cardiac rehabilitation and physical conditioning in a series of campus programs.

Dr. Schweitzer analyzes government policies Since March 1980, Stuart 0.

Schweitzer, Ph.D., has been working in Washington, D.C. in his new position as Senior Staff Member of the President's Commission for a National Agenda for the '80s, specifically on the panel of Government and the Advancement of Social Justice.

Dr. Schweitzer's position entails interacting with both legislative and executive branches on welfare, education, and civil rights' policies; considering their views, and presenting findings and recommendations to the President-Elect on December 31, 1980. He will then return to SPH. "I hope to gain a richer knowledge of policy options and strategies for implementation in the health field," says Dr. Schweitzer. "'I am recommending that we reduce inequities in health status and health services utilization.

The biggest area for disease prevention is in overcoming the discrepancies between poor and nonpoor, the white and non-white. It doesn't rely on new scientific breakthroughs."

Approved by the White House staff based on his background in health economics, Dr. Schweitzer is the only staff person on the 18

commission working on two different panels. T he other on e is "The American Econ omy," in which he will exam in e employment policy and the reduction of poverty.

Dr. Carl Hopkins retires from dedicated service For 16 years, Dr. Carl H opkins served the School of Public Health, first as associate research statistician and then as professor in the field of medical care and h ealth services. His work with the Medicare program led Milton Roem er, M.D., to say at his June retirement dinner: "Carl Hopkins gave the field scholarly an d academ ic respectability, and h e fortified the efforts of all h is colleagu es to rebuff attacks from the sk eptics and the faint -hearted.''

Dr. Hopkins recalls the establishment of the Public Health Ph.D. program in 1975 as on e of his major accomplishments at UCLA. The retired professor also estimates that he was on 60 doctoral committees and chaired " at least 35."

Approximately six doctoral students will continue to receive the benefit of Dr. H opkins' experience.

He also intends to teach courses at California State University at Northridge and at UCLA Extension.

fust the fac t that 80 of her former students initiated the surprise retirement party for Olive Johnson says a lot about her career, which spans nearly 20 years in the School of Public Health.

During that time, she establish ed what has been called "one of the outstanding medical records' programs in the country."

So renowned is her ability that her program has received international acclaim, and similar ones have been organized in Liberia, Jordan, and Ghana (for the Danfa Comprehensive Rural Health and Family Planning Project, see story this issue).

In 1978, her work was acknowledged with the faculty Distinguished Service Award, presented by the School of Public Health Alumni Association.

Ms . Johnson's retirem ent party was unique in that the program followed the form of a medical record with "Admitting Diagno sis," " Consultation Report," "History," and "Physical Examination." A skit of Olive's career was presented in " Progress Notes" by three of the alumni, while the " Discharge Plan" enumerated anticipated activities.

After actual retirement on September 30, Olive will continue h er association with current students and alumni, teaching on a parttime basis.

International dinner has Mediterranean flavor On Sunday, April 20, the UCLA School of Public Health Alumni Association played host to a gathering of students, alumni, faculty, and friends for its annual International Dinner, at the James E. West Center. Congeniality was the order of the evening. After a delicious Greek dinner and wine, the guests heard brief comments by Dean Lester Breslow and Alumni Association officers Eva Damski and Barbara Broide.

UCLA and Denmark cooperate on health study A seminar on the international exchange of health research and information was held in July at the School of Public Health.

The seminar was conducted by Erik Holst, M.D., M.P.H., co-director of the Joint Center for Studies of Health Programs, and Patrici Sohl, M.D ., M.P.H., the Center's assistant director.

The program highlighted "Self Care," "Medical Ethics," and "Care of the Elderly," among other topics.

Established in 1974, the Joint Center was originally founded for interchange between UCLA and the University of Copenhagen's Institute of Social Medicine. It was felt that an interchange between the best of the American and Danish health systems could create a valuable input to health care development for all peoples of the world. The Joint Center's projects have attracted interest from an increasing number of universities and international organizations.

Such concerted approaches to specific research areas have encouraged liaison among experts in any given field, allowing new opportunities for a broader global view in the development and application of knowledge.

The Joint Center's research efforts currently fall into four main areas: "Fertility Behavior," "Self Care," "Medical Ethics," and "Care of the Elderly." The last named is the single largest new focus in the Joint Center, and is building toward a concerted effort by the United Nations with a target date of 1982 in problems related to health care of the edlerly.

Dr. Holst said that the Joint Center's studies of fertility behavior constitute one of the program's most successful ventures. "The Danish woman has become master of her own fate," he says. "She will only have babies if her partner situation, mental stability, and

DL Patricia Sohl and DL Erik Holst of the faint enter Programs conducted a special seminar at the School in fuly

economic situation will allow it."

The work included five projects on various aspects of the Danish experience following the 1973 liberalization of Denmark's abortion laws.

The Joint Center's scientific advisory panel includes UCLA public health professors Judith Blake, Milton I. Roemer, and Stuart 0.

Schweitzer. Other nations represented on the panel are England, Norway, Scotland, and Poland.

While the core operation of the Joint Center has been financed largely by the University of Copenhagen School of Medicine with assistance from the UCLA School of Public Health, grants for projects have been received from several foundations and memorial funds and from the U.S. National Institutes of Health.

Thousands visit SPH at campus open house On Sunday, June 1, UCLA's Center for Health Sciences opened its doors to some 15,000 visitors from the community who came to the campus to learn about the programs

and activities of the Center-and, as was intended, something about their own health.

The School of Public Health highlighted a number of its many ongoing projects. In one, researchers and educators worked with children in UCLA's University Elementary School to learn how they acquire h¡ealth-related habits and beliefs.

On the basis of their findings, a curriculum is being designed and evaluated that will teach children to take a more active role in decisions affecting their own health.

UCLA biostatisticians are documenting health problems that occur as a result of various environmental agents. Their work is adding to the scientific basis for setting standards of environmental pollutants to assist policy makers in balancing health priorities with those of future energy and industrial developments.

Other programs focus on procedures to insure more effective use of health personnel, protection treatment of individuals exposed to health hazards in the workplace, and better basic knowledge about nutrition. Other current programs of the School are highlighted in articles in this issue.

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NOTES Alumni George E. W. Ettima, M.P.H., Dr. P.H., '79, is now with the Los Angeles County Probation Department Special Treatment Program on Child and Psychiatric Services. He recently completed a doctoral research study on "Role Conflict Among Midwives and Traditional Midwives in Uyo Count y in Southern Nigeria."

Helen Harte, M.P.H., '79, is Patient Education Coordinator for Brotman Memorial Hospital in Culver City.

Bryan R. Luce, Ph.D., '79, has been appointed Senior Analyst in the Division of Health and Life Sciences in the Office of Technology Assessment for the Congress of the United States.

Roger A. Clemens, M.D., Dr. P.H., '78, is a Research Nutritionist for Carnation Research Labs, a member of the American Red Cross Board of Directors, and Chairman of the ARC Safety Committee's San Fernando Valley District.

Earon S. Davis, J.D., M.P.H., '78, is senior legal analyst at the Washington, D.C., office of Fred C. Hart Associates, Inc. He performs legal and policy analysis on issues related to environmental laws and regulation. C urrently, he is serving as project manager for a study on the impact of energy access routes on agricultural lands for the Department of Energy and is also involved with the first phase of a study of the impacts of the C lean Air Act for the National Commission on Air Quality.

Stephen Inkeles, M.P.H., '78, is a first-year resident in the Internal Medicine Residency Training Program at UC Irvine Medical Center.

AndrewS. Myers, M.P.H., '78, is Administrator of Horizon Hospital, Pomona, California.

Anthony H. Schiff, M.P.H., '78, is an Attorney at Law in Century City specializing in health care and hospital administrative law.

Barbara Broide, M .P.H., '77, was recently appointed by Governor Jerry Brown to the position of Public Member on the State Board of Food and Agriculture.

Brian P. Dolan, M.D., M .P.H., '77, is presently completing I V2 years as Medical Director of the Rock Community Health Center (Navajo N ation), an experiment in the integration of Western and Traditional Navajo medicine.

Richard J. Enochs, Dr. P.H., '77, recently stepped into a challenging administrative position in Mound Bayou, Mississippi's Delta Health Center. First priority for Dr. Enochs is to extend the economic founda tion of the Center and to coordinate efforts with a major m edical school to attract more professionals at the facility.

Lynda S. Holmstrom, M.P.H., '77, is active in cesarean childbirth education in Southern California. She founded C/BIRTH, Inc.,

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a cesarean birth association for support, education, and policy changes in cesarean childbirth.

Samuel C. Matheny, M .D., M.P.H ., '77, is currently Chairman of Family Medicine at University of Southern California School of Medicine.

Karen Lewis Oatis, M.P.H., '77, has joined the staff of the Western Regional Center in Inglewood and will be working as a bilingual social worker for the developmentally disabled.

Bharti H. Sheth, M.S., '77, is currently working as the Director of Data Analysis and Management at Maxicare in Hawthorne, California. They are presently working on a prenatal nutritional counseling research project.

Judy Tauscher, M.S., '77, was recently named Project Director for the Hemophilia Rehabilitation Center at Orthopedic Hospital in Los Angeles.

Julie G. Aldrich, M. P.H., '76, is Education Director of the American Cancer Society's L. A. Coastal Cities Unit.

Nancy P. Harris, M.P.H., '76, is Associate Regional Director of Family Planning International Assistance for North and East Africa, headquartered in Nairobi, Kenya.

Kenneth W. Kizer, M.D., M.P.H., '76, is completing his active duty naval obligation as the medical officer for Explosive Ordinance Disposal Group One, headquartered in Hawaii, and is returning to California for residency training in diagnostic radiology at UCSF. He was recently selected as " The Outstanding Junior Officer of H awaii" by the Honolulu Council of the Navy League and also received the RADM William S. Parsons Award for scientific achievem ent and technical progress by the Navy League of the United States.

Mark Robbins, M.P. H., '76, has joined Project Concern In ternational as Africa Program Director. He comes to Project Concern following three years as Associate Peace Corps Director for Public Health in Zaire.

Susan Giarratano, M.S.P.H., '75, is a student at the UCLA Graduate School of Education and is also employed as a lecturer in the Department of Health Science, California State University, Northridge.

Gregg A. Masters, M .P.H., '75, serves as Assistant Director of Weld County General Hospital in Colorado.

Terrance Collins, M.D., M .P.H ., '74, is Associate Professor of Community Medicine at the University of Alabama, Tuscaloosa.

DL Robert Montoya, M.P.H ., '74, is Director of the Health Professions Career Opportunity Program in the Office of Statewide Health Planning an d Development, which seeks to increase the number of minority students recruited, prepared, admitted, and trained in medicine, dentistry, and public health.

Irma B. Vyhmeister, Dr. P.H., '74, is a Professor of Nutrition with the Lorna Linda University's D epartment of Nutrition.

Ronnie Fisher, M.P.H., '73, is Coordinator of Programs and Services for the h andicapped at Los Angeles Trade-Tech College. Sh e is

involved with computer-aided instruction for the deaf, small-engine repair for the blind, and offset printing for multihandicapped persons.

Susan James LeGagnoux, M.P.H., '73, is a Program Specialist for the Maternal Health Program of the L.A. County Department of H ealth Services.

Virginia Benander, M.P.H., '72, was recently appointed Coordinator, District Nursing Services, L.A. Unified School District.

Jeff Fields, M .P.H., '71, is a Pharmaceutical Consultant with the California Department of H eal th Services' Surveillance and Utilization Review Branch.

Rosalyn Ann Hewertson, M.P.H., '71, is working as a health research consultant in London for BLAT Center for Health and Medical Education on a WHO-sponsored natural family planning study. She is also teaching short-term courses for Na tional Health Service employees at South west College.

Linda Kornfeld, Ph.D., M.P.H., '71, has recently m oved to Hawaii upon her return from two years in Japan. She would like to make contact with some old classmates.

Write her at 45-557 Liula Street, Kaneoke, Hawaii.

Ann A. Lorimer, M.P.H., '71, is Project Director at the UCLA Health Services Research Center.

Mary E. Agran, M.P.H., '70, provides business managem ent services to foundations, private schools, individuals, and small businesses and is also treasurer of the Docent Council, Los Angeles County Museum of Art. Louis E. Mahoney, M .D., Dr. P.H., '70, continues his duties as D irector of Public Health for San Bernardino County.

Harold H. Royaltey, M.D., M.P.H., '69, is Director of Community Health Programs for Project Hope, which n ow h as land-based programs in health manpower development and technology transfer involving community h ealth in Tunisia, Egypt, Brazil, Guatemala, Jamaica, St. Lucia, and Barbados.

DL Steven Feinberg; M .P.H., '68, is Director of Physical Medicine and Rehabilitation at Miami Valley Hospital in Dayton, Ohio.

Norman Scotney, M .P. H ., '68, Head of the H ealth Behavior and Education Department of the African M edical and Research Foundation in Nairobi, notes that a second revised edition of his Health Education Manual is planned for this year.

Katherine I. Goldsmith, Dr. P.H ., '67, is an epidemiologist with the Chronic D isease Section of t he California State D epartment of Health Services in Sacramento.

Michael Tarter, Ph.D., '64, is a Special Consultant on cancer epidemiology to the California Department of H ealth Services and is a Professor of Biomedical and Environmental Health Sciences at U.C. Berkeley.

Ben C. Gmur, Ed. D. '59, is Dean of the School of Fine and Applied Arts, California State University at Los Angeles.

Lee Zuzman, B.S., '52, is President of Rose Exterminator Company, Director of Nationa! Sanitation Consultants, and Chair-

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man of Sea Scout Ship 17.

I Elestia E. Shackelford, B.S., '48, a retired Los #

I

Angeles Unified School District Nurse, is presently Chairman of Andrus Volunteers at the Ethel Percy Andrus Gerontology Center at USC. Leland Chan, R.S., Dr. P.H., '76 is now chief sanitarian for environmental health management, of the Thrifty Corporation, in Los Angeles.

Jean LeCerf Richardson, Dr. P.H. '80, was honored by UCLA's Association of Academic Women as a Graduate Woman of the Year, one of only four on campus. For her dissertation, "Determinants of Adjustment to Laryngectomy Surgery," she interviewed 60 individuals six months to three years after removal of the larynx. She studied their social and psychological adjustment, as well as methods of communication. Dr. Richardson has also served as a consultant for a National Cancer Institute study at Columbia University, worked for the U.S. Food and Drug Administration, and taught at Cal State Los Angeles.

Kenneth W. Kizer, M.D., M.P.H., who was in practice in general, preventive, and undersea medicine in Mililani Town, Hawaii, completed his active duty Naval obligation as medical officer for the Explosive Ordinance Disposal Group One, headquartered in Hawaii. He served as president of the Hawaii Undersea Medical Association and was selected as Outstanding Junior Officer of Hawaii, 1979, by the Honolulu Council of the Navy League. He also was recently awarded the RADM William S. Parsons Award for scientific achievement and technical progress by the Navy League of the U.S. He promoted preventive and consumer-oriented medicine by writing columns for local newspapers. He returned in June to the mainland for residency training in diagnostic radiology at UCSF.

Faculty Dr. Gladys Emerson, professor Emeritus (Nutritional Sciences) was elected a Fellow of the American Institute of Nutrition.

Dr. Derrick Jelliffe and Mrs. Patrice Jelliffe (Population, Family, and International Health) have made three visits to Thailand, the Philippines, and Burma as consultants for the International Nutrition Information Service funded by USAID. They concentrated on the feeding of mothers and young children, the assessment of nutrition status, and training of primary health care workers.

Recent publications include Nutrition and Human Growth, edited by the Jelliffes, for Plenum Press, N.Y., and Lactation, Fertility and the Working Women, edited by the Jelliffes with P. Senanayake and F. Sai, for IPPF, London. He was a distinguished visiting professor for the University of British Columbia in March.

Jonathan E. Fielding, M.D., M.P.H., profes· sor of pediatrics in the UCLA School of Medicine and professor of Health Services in the School of Public Health,.has been appointed to the Governor's Council on Wellness and Physical Fitness. Within arecent five-day period, he also made presentations at the Institute of Medicine Conference on Evaluation of Health Promotion in the Workplace in Washington, D.C.; at the Risk and the Health of the Public Symposium at .the University of California at San Francisco; and at the Institute of Industrial Relations Conference at UCLA. Snehendu B. Kar (Behavioral Sciences/ Health Education) has authored several research publications, including" Attitudinal and Non-Attitudinal Determinants of Conception: a Cross Cultural Study," in Studies in Family Planning; "Factors in Consistency Between Attitudes and Behavior, Implications for Policies and Programs," in the International Quarterly of Community Health Education; and "Pregnancy RiskTaking Among Young Unmarried Women, for Patient Counseling and Health Education. He was also the principal investigator, for UNESCO, in Paris, of research for analysis of Cross-Cultural Field Trials of Communications Strategies in Family Planning in Venezuela, Kenya, Egypt, and the Philippines; and has been a consultant to many national and international organizations.

Alfred H. Katz (Population, Family, and International Health) was a scholar in residence this past spring at the Rockefeller Foundation Study and Conference Center in Bellagio, Italy. He is completing two books: Community Living for the Disabled, and a revision of his 1976 book, The Strength in Us: Self-Help Groups in the Modem World. He will be a major speaker at the First International Congress on Innovation of Care Delivery in Health, organized by the Dutch International University Working Group on Hospital Sciences, in Amsterdam, in October.

Alfred Neumann (International Health) is completing a book for the Oxford Press, Introduction to Health Management, and is also completing papers relating to the Danfa/Ghana Rural Health Project. In the summer of 1980, Dr. Neumann served as consultant to the government of Thailand regarding rural primary health care program development.

Edward S. Nugent has retired as assistant dean of the School to accept the position of chief project operations at Taif, Saudi Arabia. He is now working with Internationa! Medical Enterprises, the overseas arm of National Medical Enterprises, managing a $4 billion contract. His responsibilities include providing support to a 318 bed medical center, a 50-bed rehabilitation center, several clinics, and a Center for Health Services, soon to be completed.

Dennis D. Pointer, associate professor and director (Health Services management), has been recently appointed to the Task Force on Credentialling in Nursing by the board

of the American Nursing Assn. The group, chaired by Rheba de Tornyay, Ed. D., dean of the University of Washington School of Nursing, is charged with implementing recommendations of a study of nursing credentialling that resulted from a four-year project sponsored by the ANA. Dr. Pointer, also co-director of the UCLA program in nursing service administration, will serve as a member of the task force's executive committee.

Milton I. Roemer, M.D. (Health Services) was honored in May by the New York University Medical Alumni Association as the recipient of its Distinguished Alumnus Award in the Health Sciences. He presented the Henry E. Sigerist lecture at Yale University Medical School in February on "Medical Ethics and Education for Social Responsibility," to be published in the Yale fournal of Biology and Medicine. During the past year, he also served as chairman of the Committee on International Health of the APHA, which oversees APHA activities in developing countries throughout the world.

What's new? (with you?)

All alumni of the School of Public Health are encouraged to send news about their professional involvements, research activities, honors, or personal information for inclusion in the UCLA School of Public Health magazine, UCLA Public Health.

Send all relevant information, including degree, class year, and name of clivision, to: SPH Alumni Association UCLA School of Public Health Los Angeles, CA 90024

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ATTENTION! ALUMNI, FACULTY, AND FRIENDS Social Hour at the APHA Convention in Detroit You are cordially invited to join us for the UCLA School of Public Health Reception Monday, October 20, 1980 6-Bp.m.

To all alumni: If you or any of your SPH alumni friends have recently moved, please let us know your new address(es) so that we may update our files and keep you informed of SPH alumni and School events. Fill out the form and mail to: Assistant Dean of Student Affairs, UCLA School of Public Health, 405 Hilgard Ave., Los Angeles, CA 90024.

Name _____________________ Address: _________________

Kent Room of the Detroit Plaza Hotel We hope to welcome you there.

City, State, Zip: ______ _

Class Year: _ _ Degree: ____

Become a member now!

----------------------------------------------------------Yes, I would like to join the UCLA School of Public Health Alumni Association .

NAME ________________________________________________ DIVISION - - - -- - - -- - - - - - - - - - - - - - - DEGREE, CLASS YEAR ___ __ ADDRESS - - - -- - - - - - - - - - - - - - - - - - - - - - - - CITY _____________ STATE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ZIP _ _ _ __ Enclosed is my check in support of SPH Alumni Association activities for 1980-81.

Active Member:$ _______ Associate Member (student):$ ___ __ Contribution:$ _ _ __ I'm interested in serving on the SPH Alumni Association Council or Executive Committee. D Call me at (Phone) - - - - - - - -- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Please publish the following news notes:

Make checks payable to UCLA School of Public Health Alumni Association. Mail to UCLA School of Public Health , Los Angeles, CA 90024.

L-•••••••••••••••••••••••••••••••••·-----------------------

The UCLA School of Public Health Alumni Association has become a vital force in the School's activities. It exists to foster a better understanding and to promote fellowship among students, alumni, and the School.

Annual membership dues are $10 for active members (alumni, faculty, and staff) and $3 for students. Memberships are renewable annually on October 1.

Children of Ghana were photographed by Alfred Neumann, M.A., M.D., M.P.H., UCLA professor of public health, who was co-director of the Danfa Project, featured in article beginning on page 4.

UCLA Public Affairs, Alumni, and Development UCLA School of Public Health Alumni Association 405 Hilgard Avenue Los Angeles, California 90024

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