UCLA Public Health Magazine - Fall 1988 by UCLA Fielding School of Public Health

11 I t is extremely gratifying and thrilling to step into the halls of Congress and find UCLA public health graduates there," says Dr. Ruth Roemer. "The more I see of our students in these influential positions, the more convinced I am of the impact our school wields in the national health arena," adds Dr. Roemer, an adjunct professor of health law who is immediate past president of the American Public Health Association. Teaching public health students to analyze problems, administer programs, interpret laws and promote sound policy is the goal of the UCLA School of Public Health, a leader in the field. Informed faculty and students from the School help to create everything from the blueprint to the finished structure of our national health policy. Faculty and doctoral research helps to put public health policy on a solid foundation. In AIDS research, for example, in health insurance and indigent care, and in the health problems of homeless children, their findings are shattering misconceptions and furthering the knowledge of these issues among people who can do something about them. Insights from the classroom and from research then lead to other activities in which the School participates, Dr. Roemer points out. Community service projects immediately come to mind, especially the School 's leadership role in AIDS education.

So every now and then it's off to Sacramento or to Washington, where UCLA faculty and graduates consult with legislators or testify before Congress, their ideas helping to form the basis of legislation against smoking, or for national health insurance. And close to home, they lend their expertise to business and government on issues like the revival of Cal OSHA, for example. Never missing an opportunity to make a difference, "The School also influences health policy through active participation of students and faculty in organizations like the APHA (American Public Health Association)," says Dr. Roemer. Still, the structure of health policy is forever undergoing improvements. And the School gives valuable input to those as well, one recent instance being the regional hearings hosted by the School in January to set national health promotion and disease prevention objectives for the year 2000. It's on such wide ranging involvement of faculty, students and graduates that we've chosen to base this issue of UCLA Public Health. The theme: How the School of Public Health influences the building and implementation of public health policy. The following pages will take you with the people of the School, from the halls of power to the doorsteps of the very public our health policy is designed to serve. â&#x20AC;˘

Dratti11.1 lhe Blueprii: 1nnuenci11.1 Health Policies

UCLA Public Health

Volume 7, Number 2

Access to Health Care: A Growing Crisis

Two faculty studies discover that millions of Californians aren't getting the health care they need.

Dr. Stephen Keith: Behind the Scenes in Formulating He alth Po licy

As the health policy adviser to Sen. Edward

Kennedy, a School of Public Health alum is working to help determine the best ways to serve the health needs of the nation.

Pie cing Toge ther the Puzzle: Health Policy for the Homeless

Facu lty researchers are documenting the extent of health problems among homeless children and trying to figure out ways to develop policy

Solid Silver Memories from the School's First Doctoral Graduate

Dr. Virginia Clark reminisces about what it was like to become the first person to graduate with a Ph.D. from the School of Public Health back in 1963.

New s

18 AIDS Project Updates 19

Pro ject Updates

Faculty Notes

Alumni News

Alumni Notes

Dean's Message

UCIA Public Health is published by Health Sciences Communications, UCLA Public Communications/Public Affai rs, for the UCLA School of Public Health. It is issued twice a year fo r the alumni, facu lty, staff and friends of the School.

Charles E. Young, Chancellor Abdelmonem A Afifi, Dean Michael T. McMan us,As.siStant Vice Chancellor, Public Communications Rich Elbaum, Director, Health Sciences Communications Editor: ]on Marmor Writers: Jon Marmor, Fran Tardiff Art Director: Juliet Beynon

Designer: Jackie Morrow Illustration: Michael Cressy, cover. Editorial Board: Dr. A A Afifi, Dr. Snehendu Kar, Dr. Susan Scrimshaw, Dr.John Froines, Peggy Convey, Rhona McNally, Al Shen, Rich Elbaum.

ÂŠCopyright 1988 by The Regents of the University of Californ ia. Permission to reprint any portion of UC/A Public Health must be obtained from the editor. Contact UCLA Health Sciences Communications, 1100 Glendon Aven ue, Suite 1501, Westwood Center, Los Angeles, Californ ia 90024. (213) 206-1960.

Fall 1988

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UCLA PUBLIC HEALTII FAU 1988

Access to Health Care: A Growing W Crisis By ]on Marmor

hen California state officials wanted to find out the status of access to health care for Californians, they turned to a leader in the field - the UCLA School of Public Health. With the financial support of the California Policy Seminar, two research teams from the School of Public Health headed by Dr. E. Richard Brown, associate professor of behavioral sciences and health education, studied two major topics: - Is health care accessible to medically indigent adults? - How many Californians have no health insurance? The results made headlines. The first study, "Assessing Indigent Health Care Needs and Use of County Health Services," examined how well counties - Los Angeles and Orange counties in particular - have fulfilled their state mandate to care for the health of medically indigent adults. The UCLA researchers found that medically indigent adults in California may have serious problems obtaining necessary medical care under county health programs. The second study, "Californians Without Health Insurance", found that a shocking 5.2 million Californians - 22 percent of the state's population under 65 years of age - had no health insurance of any kind in 1985.

Some Alarming News Among the eye-opening findings made by Dr. E. Richard Brown's study on Californians who lacked health insurance were: - Half of the 5.2 million uninsured Californians work for a living. - More than one million adults who worked full time for the entire year had no health insurance. - One-fourth of all the Californians who lacked health insurance were children of workers. - More than 1.5 million children are uninsured. Thirty percent of all children in Los Angeles County had no health insurance for the entire year. - One-fourth of all the Californians who lacked health insurance had incomes three times the poverty level or greater - $33,000 for a family of four in 1985.

Medi-Cal reforms reduce access to health care In 1982, as part of major cutbacks and reform in state health care programs, the State of California transferred about 250,000 medically indigent adults from the Medi-Cal program to county responsibility At the same time, the state provided the counties with about 70 percent of the money Medi-Cal would have spent on the care of this population. Data examined by Dr. Brown and former graduate student Dr. Michael R. Cousineau "suggest that the transfer of medically

indigent adults from Medi-Cal to county responsibility has reduced the access to medically necessary care for some lowincome persons," Dr. Brown says. The researchers found that the medically ind igent population received substantially less care in the county programs than they would have been expected to get had they remained in the Medi-Cal program. For example, in Los Angeles County, hospitalization of indigent patients was 19 percent less than expected in the fiscal year 1982-83, and 22 percent less the following year.

Data on outpatient visits were not available for all Los Angeles County facilities , but the limited data that were available suggest a similar pattern for clinic visits. In Orange County, inpatient care also was less than expected - 15 percent below the expected level in 1983-84 and 16 percent less the following year. Physician visits in Orange County were dramatically less than expected - only one-fourth the expected volume for medically indigent. The volume of outpatient visits in Orange County was 78 percent below the expected level in 1983-84 and 73 percent below the following year. The findings of the UCLA study were confirmed by a study by UC Irvine Medical Center researchers, who, using clinicbased methods, found similar patterns of lack of access to health care. Medically indigent adults are single adults and married couples between the ages of 21 and 65 whose medical bills exceed their ability to pay. They include the working poor and many county general relief recipients. The researchers also concluded that county health services need to improve their data services. "Although these systems may meet internal management needs," the study says, "they do not permit proper evaluation of county fulfillment of state mandates. " More funding is needed from the state, along with a commitment from the counties to bring data management systems to an acceptable level, the researchers say. "State and local governments can be held accountable to meet the health needs of their communities only if adequate data are available by which to assess their efforts," Dr. Brown says. Californians with no health insurance

This study, released to the California Legislature and members of the California congressional delegation, generated headlines throughout the state by reporting that 21.6 percent of the state's nonelderly population had no private health insur-

UCIA PUBLIC HEALTH FAll 1988 -~:::::::::::::::::;:;:::::::::::::

ance, no Medicare and no Medi-Cal coverage for 1985. "The 5.2 million Californians who were without any type of health insurance coverage throughout 1985 are at substantial risk of being unable to obtain necessary health care," Dr. Brown says. "When they do get health care, they are likely to add to the fiscal burdens of county and state programs for the medically indigent and community health providers." Some of the most significant findings of the study were: - Half of uninsured Californians work for a living. More than one million adults work full time for the full year and still have no health insurance coverage. Another fourth of the uninsured are the children of workers. - More than 1.5 million children are uninsured. In Los Angeles County, 30 percent of all children remain uninsured during the entire year.

- The lack of health insurance is not just a problem of the poor. Low-income people are about twice as likely to be uninsured as upper income people. But one-fourth of all uninsured people in the state have incomes three times the poverty level or greater - $33,000 for a family of four in 1985. The landmark report by the UCLA School of Public Health was developed by Dr. Brown; Dr. Robert Valdez, assistant professor of health services; Dr. Hal Morgenstern, associate professor of epidemiology; and researchers Tom Bradley and Chris Hafner. It found that the groups at especially high risk for being uninsured included children, young adults, older women, lower-middle income groups, Latinos and those living at or near the poverty line. "Those who have no coverage, including those who have chronic illness or serious symptoms, are less likely to see a physician and get proper medical care," says Dr. Valdez. The number of people in the United States without health insurance has risen dramatically over the last decade. In 1977, for example, 13 percent of the U.S. population under 65 had no insurance. By 1985, that number rose to 17.6 percent, the study found. Locally, the UCLA researchers found that Los Angeles and San Diego counties had the largest percentages of uninsured people among the 20 largest metropolitan areas in the United States, although Kern, Fresno and Ventura counties also had high rates of people with no insurance. "Lack of health insurance creates financial burdens on health care providers and government," Dr. Valdez says. "This impacts everyone. When someone who doesn't have insurance goes to the hospital, it means everyone has to pay for it in terms of higher insurance premiums or higher fees. " In the 1984-85 fiscal year, California's hospitals reported $1.1 billion in bad debts and charity care to people without insurance. Of that amount, $550 million in

uncompensated care was reported by California's county hospitals. "This problem is likely to worsen as the number of AIDS patients, including those who are medically indigent, increases during the next few years," Dr. Brown warns. Medi-Cal clearly provides an important measure of protection for those lowincome people who apply and qualify for it. But while California's eligibility for the program is more generous than most states' policies, "even Medi-Cal's restrictions on eligibility are apparent in the large percentage of people living at or near the poverty line who are completely uninsured," Dr. Brown said. The UCLA researchers analyzed data from the March 1986 Current Population Survey, conducted by the U.S. Bureau of the Census. The March population survey provides information about work experience, income, family structure, migration and other characteristics, such as health insurance coverage. Widespread news media interest throughout the state and nation resulted from the studies, and that grabbed the attention of legislators, state agencies and other organizations concerned with health care. The Democratic leadership in the Legislature and the Deukmejian Administration in California accepted the findings of the UCLA School of Public Health study as a definition of the magnitude of the problem of the uninsured in the state. At the request of state leaders, Dr. Brown and his colleagues are now preparing a new study that would examine the California population's health insurance coverage, need for health care, and costs of care, and would also determine the extent to which California employers offer health insurance to their employees and the problems they have in doing so. The objective of these studies will be to evaluate the effeaiveness and costs of a variety of public policy options for solving the problems of health insurance coverage. â&#x20AC;˘

UClA PUBLIC HEALTII FAll 1988

••••••••••••••••••••••••••••••••••••••••••••••••••

Dr. Stephen Keith: Behind the Scenes in Formulating Policy By ]on Marmor

hen Sen. Edwa(a Kenned J(D-Mass.) preparep to teStify before Congi;ess on a health pbUcy bill such as ·~ national health insurance, he is counting on a UCLA School of Public Health graduate for the crucial behind-the-scenes work. When Kennedy does anything regarding health policy, he turns to his health policy counsel, Dr. Stephen Keith, M.S.P.H. '82 in health services. Dr. Keith, 35, a former pediatrician who served on the faculty of the Charles R. Drew Postgraduate Medical School and the UCLA School of Medicine, is one of five of Kennedy's health staff members on the Senate Labor and Human Resources Committee, which Kennedy chairs. As health policy advisor to Kennedy, Dr. Keith is responsible for all public health issues with which the senator is involved. "It's exciting to be working with the people who can influence the direction of providing health care resources to the population," Dr. Keith says. Dr. Keith's responsibilities cover the gamut: all Food and Drug Administration issues, biotechnology, basic medical research. He prepares legislation for Kennedy, helps form position papers, writes speeches and deals with constituents, both from Massachusetts and the nation, as well as lobbyists in the health care system and members of other agencies and committees. It's a job that is demanding yet extremely satisfying. Knowing his work could greatly benefit millions of people is well worth the 14-hour workdays, Dr. Keith says. "I do miss the full-time involvement of pediatrics," says Dr. Keith, who taught pediatrics at UCLA from 1982-87. "That was very fulfilling. But in this capacity I can help so many more children." Working on Kennedy's staff is one very powerful place from which he can do that. g "Because Sen. Kennedy is a leader in ";:l ~ health care issues, I'm at the forefront of v policy decisions," Dr. Keith says. "It is a ~ challenge because of all the other groups ~ involved in getting legislation passed, such

..................................................... UCLA PUBLIC HEALTH FAIL 1988

as lobbyists, other governmental agencies, the public." As one of two physicians on Kennedy's staff of health care advisors, Dr. Keith brings a valuable perspective to the formulation of policy, since he has experience in the nuts and bolts of health care delivery. Thus, his recommendations carry a lot of weight with the senator, with whom he meets at least once a week. "I understand the clinical impact of the programs we discuss and programs that are already in place," Dr. Keith says. Dr. Keith has been very involved in Kennedy's major issue, national health insurance. More than 37 million Americans have no health insurance. A recent study conducted by Dr. E. Richard Brown, associate professor of behavioral sciences and health education in the UCLA School of Public Health, revealed that 21.6 percent of all Californians, more than 5 million, lacked health insurance. (See article this issue.) "This is a major crisis," says Dr. Keith, who is working behind the scenes on a bill that would mandate employers to provide

health insurance to at least 24 million employees and members of their families. Another issue Dr. Keith spends a lot of his time on is AIDS. "Providing a better federal response to AIDS, with funds for research and education, is absolutely essential," he says. Choosing health care as a career was only natural for Dr. Keith, the son of a Chicago pediatrician. Dr. Keith, who was born in Battle Creek, Mich., and raised in Chicago, earned his M.D. from the University of Illinois after earning a bachelor's degree in black studies from Amherst College in Amherst, Mass. Desiring to move to the West Coast, he completed a residency in pediatrics at the UCLA School of Medicine before spending two years as a Robert Wood Johnson clinical scholar at UCLA. While at Illinois, the health policy bug bit him. Dr. Keith, who yearned to work in the nation's capital, got the chance to do some consulting at the U.S. Department of Health and Human Services. He decided the way to prepare for the vital area of policy formation was to pursue an MSPH at

the UCLA School of Public Health, which is renowned for its influence in health policy. Shortly thereafter, he joined the faculty at Drew and the UCLA School of Medicine, studied business and did some research at the UCLA/Rand Center for Health Policy Study Last year, he got the opportunity to join Kennedy's staff. "Access to health care, distribution of physicians, these issues are so vital," says Dr. Keith, the father of two. "I had to get involved. I saw my role in a policy sense instead of patient care. Patient care is satisfying, but there is something special about being able to have a larger impact." Of course, being involved in the political arena means Dr. Keith deals with conflicting viewpoints that make it difficult to pass bills that provide adequate health care. He mentions AIDS as an example. "It gets frustrating when there are people in government saying that AIDS patients should be quarantined or those in high-risk groups deserve the disease," he says. Dr. Keith has been involved in a number of projects, including the recent reauthorization of the National Health Service Corps, the Centers for Excellence in Minority Health Education legislation, the Biotechnology Competitiveness Act of 1987 and legislation to reauthorize Titles of the Public Health Service Act concerning health manpower and nursing education. "It's always exciting, seeing how policy is formed, because so much is at stake," says Dr. Keith. "Knowing I may help people who really need access to health care is the most satisfying part of it all. " â&#x20AC;˘

Sen. Edward Kennedy makes a point during a Senate hearing as his health policy adviser, Dr. Stephen Keith, looks on.

UCLA PUBLIC HEALTII FAll 1988

Piecing Together the Puzzle: Health Policy ''Of ''' f J.e i:~~::s:~:no~bt~~t ~~~l~f~~t~i~eless It Homeliess

children? Not much. Thus, it's not surpris-

;~~a~:\~ei~~nl~~~ in that

But that may not be the case for very long. The UCLA School of Public Health and the UCLN Rand Center for Health Policy Study are undertaking a study that will provide government and health care officials some new insights about the extent and magnitude of health care problems suffered by homeless children and their families. "This research will greatly change the way people think of homeless people," says Dr. David Wood, M.P.H. '82, UCLNRand Health Services Research Postdoctoral Fellow and project director. "The results will shatter a lot of myths and conceptions. It will provide public officials with a new paradigm about family function and move their thinking in a new direction."

By ]on Marmor

"In the past," says Dr. Robert Valdez, assistant professor of health services at the UCLA School of Public Health and principal investigator of the project, "much of the previous research tried merely to document the size of the homeless population or enumerate limited health concerns. "What we're doing now is establishing the extent of health problems due to homelessness among homeless children by comparing them with other very poor children." This project - conducted with the assistance of graduate students Al Shen, Harold Goldstein, Denise Roth, June Coleman and Frank Peters from the UCLA School of Public Health - has received support from the Janss Foundation, the UCLA School of Public Health, the Center for Health Policy Study and most recently from the State Assembly's Office of Research. Homeless families have become the fastest growing segment of the homeless population, according to the U.S. Conference of Mayors. Of the 40,000 to 60,000 homeless people who live in the Los Angeles area, as many as 20,000 to 40,000 are children in families who have no place of their own every night. Among the many misfortunes homeless families face , poor physical health is one of the most visible, surpassed perhaps only by problems in securing shelter and adequate nutrition. While it is accepted that homelessness is a great stress to families and children, little

UCLA PUBLIC HEALTH FAll 1988

is known about the health needs of those children or how well these families function. Some statistics are available on the social forces behind the increase in homelessness - such as low-income housing unavailability and diminishing levels of public assistance benefits - but once again, little is known of the causes or effects of homelessness on the family, says Dr: Valdez. The study - the first comprehensive and comparative look at the physical, social and psychological well-being of the homeless child - will provide information to answer such questions as: Who are the homeless families' What additional health burden do homeless children bear? Are disfunctional families more or less likely to become homeless? What precipitates a spell of homelessness' What health and social service resources are available to them? What are the health problems of homeless children and families? The UCLA team interviewed more than 200 homeless families in shelters and agencies. As a comparison, 200 families on welfare, with stable housing, were interviewed. The UCLA team is seeking to find out if children of homeless families are sicker

and have more acute illnesses, more chronic illnesses, and developmental and educational problems. Researchers also want to know if children of families without stable housing suffer more from anxiety and depression than children who live in stable housing. Shen, 24, in the final year of his master's studies in population and family health, conducted about 100 interviews with homeless and welfare families. At shelters in downtown and East Los Angeles - shelters run by the Red Cross and Para Los Niiios - he talked to families from all backgrounds and from across the country. Many of these families, he says, were extremely poor and had not been seen by a doctor or dentist for some time. "No one has documented these problems before," says Dr. Wood, 33, who earned an M.D. in 1982 from the UCLA School of Medicine and finished a pediatrics residency at UCLA in 1985. "The public knows that homelessness is a problem. "But they need to know what it means in very real terms how these homeless children are affected. We need to raise their consciousness about a problem that is spreading fast into the lower middle class." Dr: Wood leaves no stone unturned in his quest to inform the public. Already, he has taken his message to the media in a big way He's been interviewed by the Los Angeles Times, the Chicago Tribune and

CBS-TV's "West 57th Street" news magazine show. Documenting the health needs and problems of families who don't know where they will sleep one night to the next has been a time-consuming, heart-wrenching process for the UCLA researchers. But they face other problems, such as trying to tear down old stereotypes that unfairly characterize the homeless. The typical homeless family isn't composed of the stereotype of aged men, suffering from either alcoholism or mental illness. Rather, the family could be from any walk of life, and definitely includes women and children. "We can help motivate and facilitate changes," says Shen, who has done much volunteer work with such organizations as the Venice Family Clinic. "There's such a need to help organize health care for the underserved populations." "Studies like this may be a piece of the puzzle," says Dr. Wood. "It provides information on which policy can be based." Ongoing research into major problems like homelessness can make leaders aware and bring about changes that are essential to promote good health. And the UCLA School of Public Health is at the forefront, contributing with the best in research and information to help form such critical policy. â&#x20AC;˘

UCLA PUBLIC HEALTH FALL 1988

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Âˇ

Solid Silver Memories from the Sc/Joo/~ First Doctoral Graduate

By Fran Tardiff

he School of Public Health celebrates a silver anniversary this ummer: It was 25 years ago that the first doctoral graduate proudly wrapped her hands around the degree that said: Virginia Ann Clark has been granted a Ph.D. in Biostatistics from the University of California, Los Angeles, School of Public Health. Dean Lenor S. Goerke's signature was at the bottom. The year, 1963, also brought Dr. Clark an appointment as lecturer on the School faculty So if anyone can polish up those solid silver recollections of two-and-a-half decades of the doctoral program at the School, it's Dr: Virginia Clark, now a professor of biostatistics. She was happy to do just that for UCLA Public Health.

Dr. Clark: Yes. It was much more informal and very easy to take courses from other people outside your own group. It was so small, we were all in a building no bigger than one of the floors in the School now. There was one lunch room so you virtually had lunch with everyone. Whatever projects were going on, whatever people were interested in, you probably heard about it and could just informally get in on it, offer your help, or somebody could ask for advice from other students or faculty.

UCLA PH: What was the biggest difference

ment like?

in the School then, compared to now?

Dr. Clark: Originally we were in a temporary building left over from World War II. Then we moved to what is now Campbell Hall, where the Home Economics Department was housed. (See article, Winter '85-'86 UCLA Public Health). That department was dissolved and moved to the Davis campus. But we were fortunate to retain some of the excellent nutrition faculty from home economics. Dr: (Roslyn) Alfin-Slater and Dr: (Marian) Swendseid came to public health at that time.

was one person. Environmental health was like that; we had one health educator, one of this and one of that. UCLA PH: Was there an advantage to the

small size?

UCLA PH: What was the physical environ-

Dr. Clark: At the time I graduated there were so few of us, about eight students in the same group (biostatistics). Things were definitely smaller then. We only had about 12 to 15 faculty total in the School. I was fortunate; in the group I went into there were three excellent biostatistics faculty When I joined, that brought the biostatistics faculty to four. But in many groups there would be only one faculty member: So what is now a division, in the early '60s

The School was housed in a World War l/vintage building in 1963 (top) but now has a modern home.

UCLA PUBLIC HEALTH FAIL 1988

Public health researchers who bad to use big, bulky computers (right) now use state-ofthe-art personal computers

Chapman. It was one of the first of its kind around the country: He enrolled more than 1,500 men from the L.A. City Service workers and followed them for 20 years, trying to determine what causes coronary heart disease. We were able to determine from those studies the effects of cholesterol and high blood pressure on heart disease; we got a line on the real risk factors. And this important work, which may have helped reduce the prevalence of heart disease, began in the 1960s. The shift to interest in cancer came later, and now, of course, we're seeing the money put into AIDS because of its terribly high death rate among young adults. UCLA PH: What issues were doctoral

students concerned with in those early '60s? Dr. Clark: Many of us had hope that national health insurance would be achieved. And for a short period there, it looked possible. But that faded and with the present administration, there just isn't the funding. UCLA PH: What about disease? Was there a big medical issue like AIDS?

Dr. Clark: One of the major issues was heart disease. The School had the Los Angeles Heart Study conducted by Dr.John

UCLA PH: What advantage did students have 25 years ago that they don't have now?

Dr. Clark: We had much better traineeships. They were federal traineeships that gave us tuition plus stipends for living expenses - it was something glorious like $3,000 a year. You wouldn't get wealthy on it, but in essence it was available to every student. And it wasn't a loan; you didn't have to pay it back. To have all your tuition paid was a tremendous boon, especially to students in a private institution. Now, the amount of stipend money from the government is so low that we can only help some students, and often only help with tuition. It's not like 25 years ago when

a student could get through school and into the field without any debts. UCLA PH: How have things improved?

Dr. Clark: We have acquired a larger group of faculty and students that enables the School to perform research projects that were too large or complex for us previously. There now is a wealth of technical expertise in the School. Also, I would have to say advances in computerization. The university had a computer center back then, an IBM machine in what is now the AGSM (Anderson Graduate School of Management). Then, a large computer center was started down in the medical school. Both of those centers were available whenever we wanted to use them for no charge. But it was awkward in the sense that we had to use kt!y punch cards. If you made a mistake you would have to punch the whole card over again and you wouldn't get a printout right away like now. You put the cards in a file and the operator would run all the jobs, which could take a couple days. Then if you found you had made a mistake - maybe a comma was punched wrong - you had to run it again. You can imagine how aggravating that was when you were in a hurry for a class or for an investigator.

UCLA PUBLIC HEALTH FAll 1988

Styles of dress and hair have changed since 1963 (left) to the campus of today (below)

Now it's so much better using the PCs or terminals, it's a richer environment because you have a choice. If it's a smaller problem, put it on the PC; if it's a big problem, we have larger computers here and at other universities that we can use. UCLA PH: Why are you glad you got your doctorate here?

Dr. Clark: It was a great opportunity for me to come here. It was an excellent school then and I think it has improved vastly. There is much more emphasis on research now than when I was a student. Of course, there's a lot more money available in research so we're doing studies that would have been hard to do 20 years ago because they wouldn't have been funded at that level. For instance, to study AIDS, we'll probably have three or four major AIDS studies here over the next couple years, any one of which will be bigger than the heart study I mentioned earlier. UCLA PH: How does that benefit the doctoral student today?

Dr. Clark: It benefits the student because faculty always like to bring students into a study and let them use the data. Recently, I worked on a depression study with Dr. Carol Aneshensel. Four or five doctoral students have gotten their dissertations out

of that one study. They have taken some section of it and used the data for their doctoral research. So the more of these studies a school has going, the more doctoral students it can support and the more interesting it is for them. Also, faculty can sometimes give students research assistant jobs on a study and that helps the student financially as we! I. UCLA PH: What else has had a significant impact on the doctoral program here?

Dr. Clark: Getting the Ph.D. in public health. We've had that degree program since 1974. That was a very good move because it allowed us to train people both for a professional career in public health and for an academic career. The Dr.P.H. is comparable to an M.D. or doctor of engineering degree; it qualifies people to operate as a high level professional in public health. The Ph.D. is an academic degree. A person who wants to go into teaching or straight research would go for the Ph.D. in public health. It took a long time to get the proposal for the degree through. People just couldn't grasp what a Ph.D. in public health was, that there is a research and teaching component to the field of public health. Finally, we were successful in getting it through, and it has raised our status among schools of public health.

--Since Dr. Clark received her doctorate, the School has added not only the Ph.D. in Public Health, 1974, but also the D.Env. , Doctor of Environmental Science and Engineering, authorized in 1982. The School has graduated 436 doctoral students, and currently, there are 206 students enrolled in the various doctoral programs. -

UCLA PUBLIC HEALTH FAU 1988

News

Health Objectives for the Year 2000

arlier this year, the UCLA School of Public Health was the regional site for hearings of national importance. Nothing less than the future direction of public health and the health of our citizens was being discussed. Called the "Health for the Nation: Year 2000 Project," the hearings, sponsored in part by the U.S. Public Health Service and the Institute of Medicine, were aimed at setting national health objectives for the rest of the century A wide range of individuals influential in the public health arena, including UCLA School of Public Health faculty, testified at the UCLA Faculty Center Jan. 22-23. At this and six other hearings being held across the country through November, those testifying directed their comments to 16 categories of appropriate and attainable health promotion and disease prevention objectives. Among them were: AIDS prevention and detection, controlling cancer, improved family planning, reducing smoking, preventing drug and alcohol abuse,

improved maternal and infant health, and occupational safety and health. "The fact that the Public Health Service and IOM chose UCLA as a hearing site is a recognition that our School is an important center for the study of public health policy," said Dr. Abdelmonem A Afifi, dean of the School. "We were very pleased to host a forum for such important policysetting matters." Besides the UCLA School of Public Health, sponsors of the hearings were the U.S. Public Health Service, the Institute of Medicine; Department of Health Services, State of California; the Charles R. Drew University of Medicine and Science, and the Henry J. Kaiser Family Foundation. Testimony from UCLA School of Public Health faculty included comments on "The Value of Medical Care for Health Promotion" by Dr. Milton I. Roemer, professor emeritus of health services. The point of his remarks: Access to professional medical care is relevant to prevention. For example, he said, "Education and advice from a doctor can affect lifestyle - smoking,

continued on page 15

UCLA PUBLIC HEALTH FAU 1988

alcohol use, contraception, exercise, diet, stress - more effectively than most skillful mass media messages. "Yet some 35 to 40 million Americans do not have economic access to physicians or skilled health professionals through health insurance, Medicare or Medicaid," Dr. Roemer said. Dr. Lester Breslow, professor emeritus of health services and former dean of the School, turned his attention to combating chronic disease, the maintenance of health in older citizens and to minority health, especially in the black population. "The poorer health record among blacks generally, compared to other groups in the United States, is a national disgrace," Dr. Breslow said. Cancer mortality among blacks is 25 percent higher than in whites, he noted. Coronary heart disease and smoking are also up in the black population and survival rates from disease generally are down compared to the white population. Dr. Breslow also pointed out that the National Institutes of Health have initiated their own goal-setting objectives that

should be joined with the results of these hearings to make up the overall public health agenda. The Institute of Medicine will synthesize the information from the seven hearings and other testimony. The Public Health Service will then use that synthesis as a basis for developing public health objectives for the year 2000, to be presented to the public in a national meeting in 1990. This documentation of the hearings will be circulated to agencies, schools and institutions across the nation. It is hoped that this information will provide a framework of model goals for a wide variety of groups: hospitals and other health providers, voluntary health organizations, schools, employers and community agencies. The process is also a chance for the nation to follow up and expand upon the objectives set in an earlier program - the 1990 Health Objectives for the Nation first presented by the surgeon general in 1980.

Dr. Laura Lake honored as "Woman of Achievement"

charging the city neglected to conduct a required environmental impact report for an office building project in the Westwood area. The California Supreme Court subsequently affirmed the ruling that the city had failed to follow the California Environmental Quality Act of 1970, which requires environmental impact reports when a project is considered to have significant adverse effects on the environment. As the result of the suit, Dr. Lake says the project developer scaled down his project at the site of the former Ship's coffee shop at the corner of Wilshire Boulevard and Glendon Avenue and added amenities such as parking and a postal station. Groundbreaking on that project took place in February. Dr. Lake is also a co-founder of a committee called "Not Yet New York," a citywide group of citizens who are concerned about land-use topics. She also led the drive to have the controversial LANCER trash incinerator project scrubbed. Dr. Lake helped found Heal The Bay, a group concerned with the environmental protection of Santa Monica Bay, and is director of the Los Angeles League of Conservation Voters.

r. Laura Lake, adjunct assistant professor of environmental and occupational health sciences, was named winner of a "Woman of Achievement" award by Women For, a prestigious Los Angeles women's political action committee. Dr. Lake was honored for her work "as an international scholar of environmental policy implementation in recognition of work in environmental issues" at the banquet held Sept. 16 at the Beverly Hil ls Hotel. Women For, which has honored such women as Jane Fonda, former California Chief Justice Rose Bird and actress Julie Harris, recognized Dr. Lake for a number of projects with public health impacts she has directed. As president of the Friends of Westwood, an ad-hoc group of 800 families concerned about land use in the West Los Angeles area, Dr. Lake led a successful lawsuit against the city of Los Angeles last year,

Dr. Ruth Roeme r delivers president's address at APHA Annual Meeting

r. Ruth Roemer, adjunct professor of health law, delivered the president's address at the 115th American Public Health Association Annual Meeting in New Orleans last October. The theme of the meeting at the New Orleans Convention Center was "Health Care: For People or For Profit." Dr. Roemer served as president of the APHA last year. Her speech, "The Right to Health Care: Gains & Gaps," focused on the progress made in the United States and the challenges facing government and health leaders, such as ending the arms race, the effect of nuclear testing on the environment, and the need for national health insurance. About 400 people attended the annual joint reception Oct. 19 sponsored by the School and the UC Berkeley School of Public Health held in conjunction with the APHA meeting. And about 40 alumni and friends of the School were on hand for a special breakfast at the Montelone Hotel sponsored by the Dean's Council. A number of faculty and students from the School made presentations during the 3 112 day conference, which drew 8,100 participants and observors. The School's exhibit featuring information for potential students and other public health officials drew a lot of attention, according to assistant dean Peggy Convey. The APHA is the largest and oldest organization of public health workers in the world, with some 50,000 indivudual and organizational members. As the preeminent organization in the field of public health, the APHA is at the forefront of a wide range of issues such as AIDS policy, education policy, and environment and health professions. The APHA's scientific arm devotes resources not only to research, but also toward helping the APHA develop stands on issues that are vital to public health practice and policy formulation. The APHA's advocacy arm is an action board and government relations committee through which members exercise their influence in the political arena, such as building support for catastrophic health insurance or against aid to the contras in Nicaragua.

UCLA PUBLIC HEALTH FAll 1988

Dr. J. Michael McGinnis named 1988 Lester Breslow Distinguished Lecturer

he benefits of programs in disease prevention and health promotion were highlighted by 1988 Lester Breslow Distinguished Lecturer Dr. ]. Michael McGinnis in his talk at the Faculty Center on March 10. Dr. McGinnis, a deputy assistant secretary for health and director of the Office of Disease Prevention and Health Promotion, spoke on "Economic Distortion in the Allocation of Social Resources." Dr. McGinnis, assistant U.S. surgeon general, emphasized that disease prevention and health promotion programs are quite effective even though there is no financial way to measure their impact. Dr. McGinnis is responsible for qverseeing policy development and coordination of disease prevention and health promotion activities of the five agencies of the U.S. Public Health Service: the Alcohol, Drug Abuse and Mental Health Administration; the Centers for Disease Control; the Food and Drug Administration; the Health Resources and Services Administration; and the National Institutes of Health. Dr. McGinnis, who holds an M.D. and master's degree in international relations from UCLA, and a master's in public policy from Harvard, serves on numerous national and international committees. He has published widely on health policy, disease prevention and health promotion, and management strategies in health and medical education. The Lester Breslow Lectureship is hosted annually by the Alumni Association of the UCLA School of Public Health. It is supported by a gift from the Raymond and Betty Goodman Foundation and the Graduate Students' Association. It is named for Dr. Lester Breslow, professor emeritus of health services and former dean of the UCLA School of Public Health. Dr. McGinnis offered a student seminar in the afternoon prior to his lecture. During his talk, he also described the structure of the Public Health Service and career opportunities in the field of public health. The lecture was followed by a reception.

1988 California bond issue supports UCLA growth

hree major construction and renovation projects on the UCLA campus will benefit directly by passage of a $600 million bond issue, which will be submitted to California voters in November. Money made available through passage of the 1988 Public Higher Education Capital Facilities Bond Act is also earmarked for the other UC campuses, as well as most campuses of the California State University and California Community Colleges systems. The UCLA projects are the addition and upgrading of facilities for chemistry and the biological sciences, completion of academic space within the Fowler Museum of Cultural History, and working drawings for the upgrading and expansion of the School of Engineering and Applied Science facilities. The 1988 bond act, approved by the Legislature and the governor, authorizes the

Health care systems compared in Sanville-Delta Omega Lecture

omparing health care delivery systems in Britain and the United States was the topic of the SanvilleDelta Omega Lecture, delivered on May 24 in the Faculty Center on campus. Dr. Philip R. Lee, d irector of the Institute for Health Policy Studies at University of California, San Francisco, spoke on "Public Health as Social Justice: British and American Approaches to Health Services." He recently returned from Britain, where he spent two months studying the British health care system. The lecture was sponsored by the Richard Sanville Memorial Fund and the

New UCLA logo

n official UCLA logo was unveiled by Chancellor Charles E. Young last summer. "Distinguished by a stylized representation of Royce Hall, we feel the logo portrays the University's traditional qualities of academic excellence as well as a strong modern look. With widespread use , it is my hope that it will project a consistent, recognizable visual image of this campus to its many publics," Chancellor Young says.

State of California to sell $600 million in general obligation bonds, with the money to be allocated over a two-year period. General obligation bonds are a prudent way for the state to raise money for the building needs of public higher education, according to Jesse Huff, the state's director of finance. California now allocates less than two percent of its revenues to pay off debts, compared to the national average of four percent for all other states. Enrollments at all UC campuses have increased steadily, and those numbers are forecast to increase further still. In addition, UCLA, along with other major universities throughout the nation, is experiencing a long-range shift from the social sciences to the natural sciences and engineering. That requires more laboratories and sophisticated facilities. But even without such changes, many buildings need major renovations after decades of wear and tear and to meet more stringent standards for fire and earthquake safety and for access by the handicapped.

Iota Chapter of the Delta Omega Society, the national honorary society for public health. Dr. Lee, a professor of social medicine at UCSF, served as the top health care official in the Lyndon B. Johnson administration. The Richard Sanville Memorial Fund was established by his wife Jean and close friends following his death in 1971. Jean Sanville was an associate clinical professor in psychiatry and behavioral sciences at UCLA Her late husband earned a master's degree in public health and had a devoted interest in population and family health. This year was the first year the Iota Chapter of Delta Omega joined with the Richard Sanville Memorial Fund to cosponsor the lectures.

The new logo was designed by the Creative Services unit of the UCLA Department of Public Affairs. It will be printed on UCLA publications, brochures, and printed materials, as well as on vehicles, signage, banners and the like.

UCLA PUBLIC HEALTH FAll 1988

Epilepsy Foundation honors Dr. Scrimshaw, Anna Long

r. Susan Scrimshaw, professor of population and family health, and former graduate student Anna Long, M.P.H. '82 in population and family health, received the Epilepsy Foundation of America's Special Recognition Award for their contributions to the Transcultural Epilepsy Demonstration Project in Miami. Dr. Scrimshaw and Ms. Long studied cultural minority beliefs about epilepsy in Dade County They found that some minorities tend to believe that epilepsy has some origin in spirit possession or unnatural causes. She said that epilepsy, because of its supposed supernatural causes, was a hidden condition in Miami's Haitian community. The study found that individuals with epilepsy in the Haitian community were often isolated and feared by those aware of their condition. Dr. Scrimshaw found that all three ethnic groups had developed their own terminology for describing epileptic fits, such as "attaque," "spells," "fits" and "ma! cadie." All three ethnic groups also believed that emotional trauma and stress could trigger seizures. Cubans and Haitians mentioned that they sought treatment by herbalists for seizure disorders that were uncontrolled by prescribed medication. In all 43 Cuban, Haitian and black families in the greater Miami area were interviewed. Armed with their findings, Dr. Scrimshaw, Ms. Long and the rest of the research

Dean Afifi hosts first Washington, D.C., alumni reception

pproximately 40 UCLA School of Public Health alumni in the Washington, D.C., area attended a reception hosted by Dean Afifi at the Radisson Park Terrace Hotel on April 19. The reception, held in conjunction with the annual meeting of the deans of the .Association of Schools of Public Health, was the first such occasion for alumni in the area. For many graduates, it was also

Dr. Susan Scrimshaw and.former graduate student Anna Long are presented with awards from the Epilepsy Foundation ofAmerica during a ceremony in Florida last October.

team helped revamp radio spots, pamphlets, and television spots to educate the ethnic groups, in their own terminology, about the disorder. Dr. Scrimshaw and Ms. Long received the award at the Epilepsy Foundation of America national conference held Oct. 30 at the Sonesta Beach Hotel in Key Biscayne, Fla.

their first opportunity to talk with Dr. Afifi in his capacity as dean and to hear his plans for the School's future. Dr. Afifi stressed the importance of a strong connection between the School and its alumni, and expressed his hope that the School would be able to call upon graduates for help in such areas as student and faculty recruitment, job placement, and fund-raising . With the success of this first outreach event, the School plans to host other alumni gatherings as Dean Afifi travels to other major cities in the United States. â&#x20AC;˘

UCLA PUBLIC H EALTH FAU 1988

Education programs

AIDS Project Updates

Dr. Gary Richwald, assistant professor of population and family health, is studying "Behavioral and Educational Intervention Models for Populations at Increased Risk of HIV Transmission." The team of Dr. Richwald, Dr. Morisky, and Dr. Paul Abrainson, associate professor of psychology at UCLA, will assess stress on employees of the AIDS prevention programs and look at case studies of AIDS prevention behavioral educational interventions by state-funded community programs. Contact number: (213) 825-8508.

Minority attitudes Dr. Rina Alcalay, assistant professor of behavioral sciences and health education, is analyzing information from the State Data Program at UC Berkeley about AIDS and attitudes towards homosexuals among blacks, Hispanics and whites in California. Contact number: (213) 206-1238.

AIDS in Brazil Dr. Roger Detels, professor of epidemiology, is principal investigator on a collaborative project with the Federal University of Sao Paulo, Brazil, to study the epidemiology of HIV infection in Brazil. The study wil 1 focus on transmission, major risk groups, and natural disease in an area in which several variants of HIV-1 exist. Working with him are Dr. Barbara Visscher, professor and division head of epidemiology, and Dr. Peter Lachenbruch, professor of biostatistics. Contact number: (213) 206-2837.

History of AIDS Dr. Detels is also continuing his study on "The Natural History of AIDS." Focus of this phase of the study is to determine what proportion of men infected with HIV will go on to develop clinical AIDS. Behavioral, viral, immunologic and genetic factors will be studied. He is also looking at the frequency with which the central nervous system is involved. Working with him are Dr. Visscher; Anne Coulsen, adjunct lecturer and research epidemiologist; Dr. Virginia Clark, professor of biostatistics and biomathematics; and Dr. Hal Morgenstern, associate professor of epidemiology. Contact number: (213) 825-6229.

Condom study Dr. Detels is principal investigator on another ongoing study, "Primary Prevention Trial of Barrier Contraceptives Against HTIV-III (HIV) Infection." This trial will test the efficacy of condoms and spermicides in preventing infection by HIV, the AIDS virus, and other sexually transmitted diseases, as well as in preventing the development of clinical AIDS among persons already infected with HIV Contact number: (213) 206-2837.

Eye infections Dr. Curtis Eckert, associate professor of nutritional sciences, is working with Dr. Gary Holland, assistant professor of ophthalmology in the School of Medicine, to study retinal opportunistic infections in AIDS. The study will focus on the selective

Services for minorities Dr. Richwald is also working on a "Minority AIDS Need Assessment in Los Angeles County" to determine the level of need for increased counseling and medical services for minorities in the county The project is vE being carried out with the assistance of the ;; Minority AIDS Project-Los Angeles. Joining :r: Dr. Richwald on this study are Dr. Robert Valdez, assistant professor of health services, and Dr. Rosina Be cerra, professor of social welfare at UCLA. Contact number: lodging of cytomegalovirus in the retina, (213) 825-8508. which is brought on by AIDS and can cause blindness. Contact number: (213) 825Premarital testing 8429. Dr. Richwald is also conducting a study exploring issues surrounding premarital Mortality rates screening for HIV antibody among marJaines E. Enstrom, associate researcher, riage license applicants in Los Angeles is doing periodic calculation of studying County Contact number: (213) 825-8508. AIDS incidence and mortality rates in California among population groups at False negatives study high and low risk for developing AIDS. Dr. Charlotte G. Neu mann, professor of Contact number: (213) 825-2048. population and family health and pediatrics in the School of Medicine, is helping AIDS in Britain direct a study on serum samples from 247 households in rural Embu in Nairobi that Dr. Carl Hopkins, professor emeritus of were checked for the HIV-1 antibody. Test health services, is working on a project positives were followed by other tests that titled "The British Response to AIDS" with were negative. The project is to understand Dr. Lydia Temoshok of the Department the false negatives. Blood samples from a of Psychiatry at the University of California, large Nairobi maternity hospital were also San Francisco. The study of the individual, checked. Working with Dr. Neumann are group and societal response to the epidemDr.Jaines Cherry, professor of pediatrics ic is a replica of a study done in New York, at the School of Medicine and Dr. Tom San Francisco and London. Contact numKuhls, a former research fellow in the ber: (213) 825-2594. Department of Pediatrics' Division of Adolescent prevention Infectious Diseases at the School of Medicine. Contact number: (213) 825Dr. Donald Morisky, assistant professor 0251. of behavioral sciences and health educa-

tion, is working on a project titled "AIDS Prevention Among Adolescent Pimps and Prostitutes in Hollywood" with the Children of the Night Shelter in Hollywood. The project utilizes some students from a theatrical agency who act out roles and situations typically encountered by this high-risk group. Children of the Night is a youth shelter where adolescents spend up to two weeks receiving medical care, counseling and participation in the AIDS prevention program. Contact number: (213) 825-8508.

Cost of hospital c are Dr. Stuart 0. Schwe itzer, professor of health services, is working with Dr. Gwen wn Servellen of the School of Nursing on a study of the cost and quality of care given to AIDS patients in special care and mainstream hospital units. Contact number: (213) 825-7491. â&#x20AC;˘

Project Updates

Child survival in Pakistan and Lapland Dr. DerrickJellife, professor of population and family health, is conducting a child survival program in Pakistan. He also conducted a study on traditional child rearing in Lapland. He collaborated with Patrice Jellife, lecturer in the School of Public Health. Contact number: (213) 8254053.

Medicaid programs Dr. Phoebe A. Lindsey, assistant professor of health services, is studying how case management is being implemented among 13 demonstration sites involving Medicaid programs in 10 states. She is also studying second surgical opinion programs and programs of inpatient hospital preadmission review among state Medicaid agencies. This study is under the auspicies of the Rand/UCLA Center for the Study of Health Care Financing. Contact number: (213) 206-6322.

Birth outcomes Dr. Susan Scrimshaw, professor of population and family health, is co-principal investigator on a project to study the extent to which ethnic group differences in birth outcome are affected by substance use and abuse and psychosocial factors among lowincome black, Caucasian and MexicanAmerican women. The study is also designed to gather data on why women use prenatal care, what life problems they experience during pregnancy and who helps them with their responsibilities. Principal investigator is Dr. Ruth E. Zambrana from the School of Social Welfare. The project is funded by a grant from the National Center for Health Services Research. Contact number: (213) 825-8708.

Prenatal care behavior Dr. Scrimshaw and Dr. Rina Alcalay, assistant professor of behavioral sciences and health education, are working on an assessment of prenatal care behaviors in Mexico and development of mass communication and education strategies. The project is funded by the International Center for Research on Women. Contact number: (213) 825-8708.

Wisdom teeth extraction Dr. Stuart 0. Schweitzer, professor of health services, is studying the small area variation in extraction rates and complica-

UCLA PUBLIC HEALTI-l FAU 1988

Groundwater supply

tions for third molars (wisdom teeth). He is also conducting a study on whether antibiotics should be given to patients with artificial hip joints to prevent the possibility of infection from dental care spreading to the joint. Principal investigator is Dr. Jed Jacobsen, professor of dentistry in the School of Dentistry. Contact number: (213) 825-7491.

Dr. Lake is also working on a project funded by the UC Water Resources Center studying groundwater supply due to contamination. Contact number: (213) 8250726.

Sexual assault Dr. Judith M. Siegel, associate professor of behavioral sciences and health education, is conducting an epidemiologic study of lifetime prevalence of sexual assault among a representative sample of Hispanics and non-Hispanic whites in Los Angeles County. The research examines the mental health status of the assaulted, the relationship of resistance to assault outcome, and the influence of talking with o~ers on adjustment to assault. Working with her are Dr. Susan Sorenson, assistant research epidemiologist; Dr. Jacqueline Golding, assistant research psychologist; and doctoral student Judith Stein.

Smoking in the workplace Dr. E. Richard Brown, associate professor of behavioral sciences and health education, is conducting a survey on the attitudes of workers toward workplace smoking policies. Working with him are Dr. Alfred Marcus, associate director of the Jonsson Comprehensive Cancer Center at UCLA and Dr. William McCarthy, also of the ]CCC. Contact number: (213) 8255491.

Californians without health insurance

Selenium in drinking water

Dr. Brown also is starting additional research on Californians without health insurance (see article this issue), a study of California residents who have no health insurance, no Medicare and no Medi-Cal eligibility. Working with him are Dr. Robert Valdez, assistant professor of health services, and Dr. Hal Morgenstern, associate professor of epidemiology. Contact number: (213) 825-5491.

Dr. Jane Lee Valentine, associate professor of environmental and occupational health sciences, is preparing a health assessment document for various forms of selenium chemical contaminants found in drinking water. Working with her are Dr. Peter Lachenbruch, professor of biostatistics, and Bahram Faraji, an assistant researche[ โ ข

Health care competition Dr. Glenn Melnick, assistant professor of health services, is researching the effects of increased health care competition on hospital expenditures, efficiency and access to care. The project is funded by the U.S. Department of Health and Human Services and The Robert Wood Johnson Foundation. Contact number: (213) 825-5147. c.... 0

Carbon water filters

.~ b

Dr. William Glaze, professor of environ- 6"' mental and occupational health sciences, is ti co-principal investigator on a project ~ studying the possibility of using granular c: activated carbon to filter water for contami- 0 .ยง

nants. Working with him is Dr. Laura Lake, adjunct assistant professor of environmental and occupational health sciences. Contact number: (213) 825-0726.

Groundwater contamination Dr. Lake is also working on a study looking at contaminants that are byproducts of clean-up of contaminated groundwater supplies. Working with her are Dr. Doug MacKay, assistant professor of environmental and occupational health sciences, and Dr.John Froines, associate professor of environmental and occupational health sciences. Contact number: (213) 825-0726.

UCLA PUBLIC HEALTH FAU 1988

Faculty Notes Dr. Rina Alcalay, assistant professor of population and family health, published "Health Education Perspectives in Latin America" in the journal of Health Promotion, 1988; She also co-authored "The End of the IUD as a Contraceptive Choice" in Contraception, 1988; and "From Theory to Action in Health Communication Campaigns" in Public Communication Campaigns, 1988. She presented a speech on "Patterns of Mass Media Use Among Hispanic Smokers: Implications for Community Interventions" at the International Communication Association Meeting in New Orleans in May, and "Non-Availability of the IUD as a Contraceptive Choice for ,Hispanic Women" at the American Public Health Association meeting in New Orleans last October. Dr. Ralph R. Frerichs, professor of epidemiology, published an editorial in the journal of Tropical Pediatrics, Vol. 34, 1988, on the use of computer-assisted rapid survey methodology to determine immunization coverage in rural Burma. The rapid survey allows researchers to conduct valid surveys in underdeveloped countries where doing regular surveys would be impossible due to technical and logistical problems. He also is using computer-

Alumni News

assisted rapid surveys in his role as temporary advisor to the Special Program on AIDS for the World Health Organization. He also was appointed as Ralph Sachs Visiting Scholar at UC Berkeley School of Public Health, March 21-25. Dr. Phoebe A. Lindsey, assistant professor of health services, recently completed a three-year Pew Memorial Trust Fellowship for Health Policy Studies awarded through the RancVUCLA Center for Health Policy Study. She also published the article "State Coverage for Organ Transplantation: A Framework for Decision making" in the journal of Health Services Research, Vol. 22, No. 5, 1988. Dr. Susan Scrimshaw, professor of population and family health, was a panelist in the Smithsonian Institution-National Institute of Child Health and Human Development public forum on "Child Health in the

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21st Century: Problems and Priorities," held Oct. 5 in Washington, D.C. Among the topics discussed was "What will be the leading cause of infant and child mortality in the year 2000?" Dr. Laura B. Lake, adjunct assistant p rofessor of environmental and occupational health sciences, was appointed to the advisory committee of the Metropolitan Water District's Source Reduction Research Partnership Project. She also spoke on "Consequences and Principles of Development" at the conference "Assessing Development Risk and Solutions to Growth Management Constraints" Oct. 2122 in Los Angeles. Dr. Lawrence R. Ash, professor of epidemiology, had his lab manual 'Parasites: A Guide to Laboratory Procedures and Identification" published in April 1987 by the American Society of Clinical Pathologists Press. Dr. Albert Chang, associate professor of population and family health, authored the article "Increased Safety Belt Use Following Education in Childbirth Classes" in the September 1987 issue of Birth. He also presented a paper on "Care for Children With Mild Illness: Some New Programs" at the Regional Head Start Health Promotion Conference in Albuquerque, N.M., in January. •

Top students honored at Alwnni Association meeting

Ira Alpert elected to UCLA Foundation Board of Trustees

ix students were selected from the School of Public Health to receive the 1988 UCLA School of Public Health Alumni Association's Outstanding Student Awards. The honored students are: - Douglas Cave, health services - Drew Di Giovanni, behavioral sciences and health education - Carolyn Drews, epidemiology - Lucy Pennington, population and family health - Cheryl Rock, nutritional sciences - Karen Weber, environmental and occupational health sciences The awards were presented at the annual UCLA Public Health Alumni Association meeting, held June 2 at the Velvet Turtle restaurant in West Los Angeles. Dr. Ruth Roemer, immediate past president of the American Public Health Association, was honored for her life-long achievements in public health. She spoke on "Future Challenges for Public Health."

ra Alpert, B.A., '64, M.S.P.H. '66 in health services, has been elected to a two-year term on The UCLA Foundation Board of Trustees. Alpert, president of Alpert Enterprises, a Beverly Hills-based firm that manages convalescent homes in the Los Angeles area, is president of the Wilshire Foundation, a non-profit charitable foundation headquartered in Encino that supports health care agencies and programs. Alpert, a member of the Dean's Council, played a key role in the establishment of the Leon ]. Tiber, M.D., and David S. Alpert, M.D. Chair in Medicine in the UCLA School of Med icine. The $1 million endowed professorship is named in memory of the two physicians who founded Midway Hospital in West Los Angeles.

UCLA PUBLIC HEALTH FAU 1988

Dean's Council continues strong

he Dean's Council is continuing to make progress after a banner fiscal 1986-87 year. Last year saw the number of donors double and a record income of more than $28,000 in support of the School of Public Health. This year's goal was set at an ambitious $35,000. A 10 percent higher rate of participation and a corresponding increase in donations are hopeful signs of another successful year. Two loyal alumni, Raymond D. Goodman, M.D. '44, M.P.H. '72, and Frank P. Matricardi, M.P.H. '72, Dr.P.H. '77, once again co-chaired the Dean's Council efforts. Goodman founded the Dean's Council in 1977 and has chaired it since its inception. Dr. Matricardi, a health services alum, is vice president of planning for Maxicare Health Plans Inc. in Los Angeles. His wife, Diana Bonta, is also a graduate of the UCLA School of Public Health. She earned her M.P.H. in population and family health in 1975. Membership in the Dean's Council may be obtained for a donation of a minimum of $100. Categories of membership are: $2,500 $1,000 $600 $300 $100

Benefactor Patron Sponsor Sustaining Individual

Contributions to the Dean's Council support the School in many ways. Funds have been used as seed money for the development of research projects, to assist in faculty recruitment, to send students and faculty to professional meetings where

they present research reports, and to sponsor d istinguished lecturers for presentations to professional and community groups. All contributions are tax-deductible and should be made payable to The UCLA Foundation. Please send your contribution to the School of Public Health Dean's Council, P.O. Box 24209, Los Angeles, Calif., 90024. For further information, please call Birgitta Granberg at (213) 8255119.

Dr. Raymond D. Goodman (left), chainnan of the Dean's Council, joins Dean A A A{ifi and Dr. Frank P. Matricardi, co-chair ofthe Dean's Council, during a May reception. The Dean's Council is coming offa banner y ear in which the number ofdonors doubled

William A. Benbassat hosts reception for Dean Afifi

bout 80 people turned out last June for a reception and dinner in honor of Dr. Abdelmonem A. Afifi's appointment as dean of the UCLA School of Public Health. The reception was held in the Bel Air home of alumnus William A. Benbassat, M.S.P.H., '74, Dr. P.H. '76, in behavioral sciences and health education. Benbassat is president of Reliable Health Care Systems of Los Angeles. Dean's Council members, donor faculty, corporate supporters, and major donors attended the function. Benbassat has been a School supporter and member of the Dean's council.

Alumni directory marches on

any alumni have already received telephone calls from the Harris Publishing Company, publishers of our official Alumni Directory. The purpose of the telephone contact is to verify the information alumni provided on the directory questionnaires and information held on alumni records. At the same time, telephone representatives of the publishing company are inviting alumni to buy personal copies of the directory.

The directory is tentatively scheduled for release in June or July. If you are interested in ordering a copy and have not heard from the publisher by May 1, you may contact the publisher directly at the following address: Customer Service Department Bernard C. Harris Publishing Company, Inc. 3 Barker Avenue White Plains, NY 10601 (914) 946-7500

Wilshire Foundatio n gift honors Afifi

he Wilshire Foundation made a gift of $1,000 to the Dean's Council in honor of the appointment of Dr. Abdelmonem A. Afifi as dean of the School. The Wilshire Foundation is an Encinobased non-profit charitable foundation that supports health care agencies and programs. Ira Alpert, B.A. '64, M.S.P.H. '66 in health services, is president of the Wilshire Foundation. â&#x20AC;˘

UCLA PUBLIC HEALTH FAll 1988

Alumni Notes Betty F. Lenthall, M.S. '57 in health education, is enjoying retirement in San Gabriel, Calif. She had been the director of health services for Alhambra city schools before she retired in 1982. 0. Brnce Dickerson, M.P.H. '66, left his position as corporate director for health and safety at IBM to open Dickerson Associates Inc., a New Canaan, Conn.-based firm that offers companies an array of health services, with a special emphasis on occupational and environmental programs. He is also president-elect of the American Academy of Occupational Medicine, which has 700 specially certified experts in occupational medicine. Arthur Norman Scotney, M.P.H. '68 in health education, moved back to London after working 25 years outside the United Kingdom, including two at UCLA. Burton B. Milburn, B.S. '62, M.P.H. '66, Dr.P.H. '71 , is manager of safety, health and environmental affairs for Hughes Aircraft Company support systems in Long Beach, Calif. E. Catherine Moron ey, M.P.H. '67 in environmental sciences and occupational health, Dr.P.H. '71 in environmental sciences and occupational health, is a consultant for a retirement and extended care facility in Victoria, B.C. She also is a member of the board of the Greater Victoria Hospital Society. She spent 12 years working for Los Angeles County's Occupational Health Service before moving to Canada to serve as administrator of the retirement and extended care facility. LarryD. Lisenbee, M.P.H. '72 in behavioral sciences and health education, was recently appointed as budget coordinator for the city of San Jose. Constance Blair Bertholf, M.P.H. '72 in population and family health, is an associate professor in the College of Nursing and Health Sciences at the University of Alaska at Anchorage. She is also pursuing a Ph.D. in nursing at the University of Colorado School of Nursing and expects to complete her doctoral wo rk in 1990. Peggy da Silva, B.S. '76 in health education, was recently appointed d irector of community education at Children's Hospital of San Francisco. Prior to moving to San Francisco , she was the health educator for the Tri-County Health Department in the Denver area and won an award from the Colorado Public Health Association for her participation in a clean air task force set up by the CPHA. She also recently published the article "Medications, Behavior and the Elderly: A·Continuing Education Program for Board and Care Facility Operators" in Gerontology and Geriatrics Education.

Dr. Ke nneth Kizer, M.P.H. '76 in epidemiology, was appointed to the AIDS Vaccine Injury Compensation Po licy Review Task Force by Gov. George Deukmejian. Kizer is director of the California Department of Health Services, a post he has held since 1985. Kizer also was selected for the prestigious Toll Fellowship Program, sponsored by The Council of State Governments.

Neill F. Piland, M.P.H. '70, Dr.P.H. '79 in health services, is the director for health services and education at Lovelace Medical Foundation in Albuquerque, N.M. He won the 1987 Lovelace Medical Foundation Scie ntific Research Award and is the principal investigator on a project entitled "Community Intervention for Heavy Smokers," funded with a $4.3 million, eight-year grant from the National Cancer Institute.

Matt Weintraub, B.S.P.H. '74, M.P.H. '76 in

Joel D. Miller, M.P.H. '79 in behavioral sciences and health education, is assistant vice president of field services for the American Heart Association's Greater Los Angeles Affiliate.

environmental health, recently left the office of the Chief Administrative Officer for Los Angeles County to become personnel director for the city of El Monte. Robe rt Nugent, M.P.H. '76, was awarded his Ph.D. in epidemiology from the Johns Hopkins School of Hygiene and Public Health. Marilyn D . Farber, M.P.H. '70 in community health education, Dr. P.H. '77 in epidemiology, is an assistant professor of epidemiology in ophthalmology at the University of Illinois in Chicago. She is the principal investigator for a study to determine contributing risk factors in retinal eye diseases. The project is being funded by a five-year, $670,000 grant from the National Eye Institute. Ellen R. Eiseman, M.P.H. '78 in behavioral sciences and health education, is director of management training for Management Sciences of Health, a Bostonbased no nprofit health organization that works with underdeveloped countries. Su san Solarz, M.P.H. '78 in environmental health, is senior hazardous materials specialist in the toxic substances control division of California Department of Health Services. She works in the North Coast Region.

Nina Vassilian, M.P.H. '81 in behavioral sciences and health education, is health educator for immunization programs for the Los Angeles County Health Department. Walter Orzechowski, M.S.P.H. '81 in planning, is program administrator for nursing for the Lake County Health Department in Chicago. Neeltje Marianne Mack, M.S.P.H. '81 in epidemiology, is an industrial hygienist with TRW Inc., Space and Defense Division, in Redondo Beach, Calif. Elisa Wolfe, B.S. '82 in consumer health information and education, is an attorney for the California Department of Corporations Enforcement Division, where she handles litigation involving violations of Knox-Keene Health Care Service Plan Act · of 1975. She also published the article "Noncontracting Health Care Provider v. Open Panel Health Care Service Plan Enrollee: Who Should Bear the Loss of Unpaid Medical Bills When an Open-Panel Knox-Keene Health Care Service Plan Becomes Insolvent" in a recent issue of the Whittier Law Review Gary B. Gertler, M.P.H. '83 in epidemiology, is an associate in the Health Law Department of McDermott, Will & Emery, a Los Angeles law firm. His practice focuses o n hospital-physician relations with an emphasis on joint ventures, corporate, regulatory and policy issues. He authored "Brain Birth: A Proposal for Defining When a Fetus is Entitled to Human Life Status" in the Southern California Law Review and is co-author of State Laws and Regulations Governing Preferred Provider Organizations, a study organized by the Rand Corporation for the U.S. Department of Helath and Human Services and the Federal Trade Commission. Peter J. Wood, M.P.H. '85 in environmental and occupational health sciences, is an associate hazardous materials specialist for the California Department of Health Services' toxic substances control d ivision. He has just begun evaluating the effectiveness of various biodegredation treatment techno logies used in remed iating soils contaminated with hazardous waste. •

Dean's Message

UCLA PUBLIC HEALTH FAll 1988

his issue highlights the School's involvement in and contributions to an important aspect of life in this country - the setting of health policies. Such policies attempt to amelio rate existing p roblems, and anticipate emerging ones in order to minimize their impact. Two relevant problems are currently in the news. The first concerns the plight of the homeless, particularly those living in America's large cities. The other relates to the 15 percent of Americans who do not have health insurance. Articles in this issue describe some of the research projects conducted by faculty and students of the School. These projects attempt to quantify the extent and consequences of both problems as well as identify possible solutions. Such efforts form the research basis upon which health policies and legislatio n can be built. On that front, several of the alumni of our School are hard at work in Washington, Sacramento, and other cities, at the offices of legislators, health departments and other health-related organizations. The alumni profile in this issue deals with one such person, Dr. Stephen Keith. He serves on the staff of Sen. Edward Kennedy as adviser on health matters. From that vantage point, he is d irectly involved in the formulation of federal health policies. On the third front, the School hosted hearings related to setting national objectives for the nation in the health p romotion and disease prevention for the Year 2000. These hearings are part of the process that will lead to updating the 1990 objectives, a blueprint for an important part of this country's research and service activities over the last decade. When completed, the Year 2000 objectives will be a large piece of the updated agenda for public health research in the last decade of the 20th century: Reminiscences are part of what Virginia Clark gives us in her interview appearing

in this issue. I started my career in public health here in 1965, shortly after Dr. Clark's graduation. And I, too, have some very fond memories of the cozy and exciting beginnings of our School. But, like it or not, we are in the major leagues now with a new set of challenges and rewards. For example, we have been searching for 12 new facul ty, approximately

the same number of total faculty when Dr. Clark was a student. Two of these searches have resulted in hiring Dorota Dabrowska and Nathanie l Schenker as our newest assistant professors in biostatistics. The remaining searches are at various stages of completion and we hope to announce several other new appointments in the next issue of UCLA Public Health.

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Dr. Abdelmonem A. Afifi

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