UCLA Public Health Magazine - June 2008

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JUNE 2008

UCLA

PUBLIC HEALTH Confronting a Workforce Crisis

Everyone wants cancer cures, but isn’t it better not to get cancer at all?

Public health leaders such as Roshan Bastani are on the task.

Lisa V. Smith loves nothing more than preparing her SPH students to become her colleagues at the L.A. County Department of Public Health.

As a clinician in rural Thailand, he felt powerless to effect change.

As a UCLA-trained epidemiologist, his work will affect the health of millions.

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UCLA

PUBLIC HEALTH

Gene Block Chancellor

Linda Rosenstock, M.D., M.P.H. Dean, UCLA School of Public Health

Sarah Anderson Assistant Dean for Communications

John Sonego Assistant Dean for Development and Alumni Relations

features

Dan Gordon Editor and Writer

Martha Widmann Art Director

E D I TO R I A L B OA R D Richard Ambrose, Ph.D. Professor, Environmental Health Sciences

Roshan Bastani, Ph.D. Professor, Health Services Associate Dean for Research

Thomas R. Belin, Ph.D. Professor, Biostatistics

Ralph Frerichs, D.V.M., Dr.P.H. Professor, Epidemiology

F. A. Hagigi, Dr.P.H., M.B.A. Associate Professor, Health Services

William Hinds, Ph.D. Professor, Environmental Health Sciences

Moira Inkelas, Ph.D. Assistant Professor, Health Services

Michael Prelip, D.P.A. Adjunct Associate Professor, Community Health Sciences

Lisa Dooley and Lindsay Gervacio Co-Presidents, Public Health Student Association

Christopher Mardesich, J.D., M.P.H. ’98 President, Alumni Association

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The Preemptive War on Cancer: Heading Off a Leading Killer Before it Strikes Much attention is paid to the need for breakthroughs in cancer treatment. But in the fight against the soon-to-be-leading cause of U.S. deaths, public health is playing an equally critical role.

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Lisa V. Smith: Bringing New Recruits to Her Epidemiological Cause She does important work at the L.A. County Department of Public Health, but is equally passionate about teaching and providing opportunities for SPH students to become future colleagues.

Smith: ng New ts to Her miological

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Help Wanted: Public Health Faces a Workforce Crisis

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Alumni Hall of Fame: the 2008 Inductees

in every issue 23 RESEARCH

34 12 A new report underscores the strains on the system as a shrinking pool of trained professionals attempts to tackle an increasingly daunting set of challenges

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Global Partnerships: Faculty Work with Alumni to Promote International Health For many of the school’s graduates working to improve conditions overseas, relationships established with their professors continue to pay off.

Fruits and vegetables for WIC participants...salad bars in schools...NSAIDs and Parkinson’s...undocumented Latinos’ use of health services...quality of prostate cancer pathology reports... art as incentive for increasing African American study enrollment.

28 STUDENTS 31 FACULTY 32 NEWS BRIEFS 35 FRIENDS ON THE COVER In an era of immense public health challenges, a new report finds that the workforce is ill-equipped to take them on. Examining the looming crisis and what needs to be done. Photo courtesy of ASPH.

PHOTOGRAPHY ASUCLA / TOC: Hall of Fame; p. 33: Breslow Lecture Reed Hutchinson / cover: Bastani, Smith, Thammawijaya; TOC: Smith; p. 4: Bastani; p. 10: Smith; p. 18: Detels; p. 28: Jackson; p. 29: Thammawijaya; p. 31: Afifi; p. 32: Detels; p. 33: Clark, Godwin

Alex Berliner © Berliner Studio/BEImages / p. 33: Vuitton Martha Widmann / p. 25 Courtesy of Dr. Beth Glenn / p. 6 Courtesy of Dr. Pamina Gorbach / p. 19 Courtesy of Dr. Fred Hagigi / p. 20 Courtesy of Dr. Donald Morisky / p. 21 Courtesy of Dr. Ralph Frerichs / p. 22 Courtesy of Dr. Antronette Yancey / p. 27 Courtesy of UCLA School of Public Health / p. 2; p. 31: bookshelf; p. 32: Armenian, Beijing Forum; p. 33: Kagawa-Singer; p. 34; back cover

Getty Images © 2008 / TOC: partnerships; p. 9; p. 15: water quality; p. 16: teenage smoking; p. 18: partnerships iStockphoto © 2008 / p. 7; p. 23 Punchstock © 2008 / TOC: cancer, help wanted; p. 4: cancer; p. 8; pp. 12-13; p. 15: asthma; p. 16: weighing;

School of Public Health Home Page: www.ph.ucla.edu E-mail for Application Requests: app-request@admin.ph.ucla.edu UCLA Public Health Magazine is published by the UCLA School of Public Health for the alumni, faculty, students, staff and friends of the school. Copyright 2008 by The Regents of the University of California.

Permission to reprint any portion must be obtained from the editor. Contact Editor, UCLA Public Health Magazine, Box 951772, Los Angeles, CA 90095-1772. Phone: (310) 825-6381.

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dean’s message YOU CAN’T READ A CURRENT NEWSPAPER without being confronted with alarming statistics about the financial challenges faced nationwide and here in California. Governor Arnold Schwarzenegger’s initial budget proposal called for a 10 percent cut to the University of California budget for next year. Current negotiations may restore some of the funding; however, of particular importance to the UCLA School of Public Health is the elimination of support for public health enrollment growth at a critical time for our field.

“Confronting the Public Health Workforce Crisis,” a new report released by the Association of Schools of Public Health, confirms what we’ve all suspected: The public health workforce is facing a crisis. By 2020 we will require an additional 250,000 public health professionals in this country, about one-third of the number of workers needed to meet our vital public health functions.

Our current public health workforce – including physicians, nurses, epidemiologists, environmental and infectious disease specialists – is struggling to keep up with an increasingly complex array of challenges. These professionals are at the forefront working to ensure clean air and water, safe food and workplaces, and preventing infectious and chronic diseases. But even more important, they are relied on to confront dramatic new threats, many brought about by globalization, including emerging infectious diseases, health effects of climate change and threats of disasters ranging from a terrorist act to another hurricane the magnitude of Katrina.

The estimates of this looming crisis are sobering at face value, yet do not reflect that 23 percent of the current public health workforce will be eligible to retire in the next five years. Nor do they include the increased need for American public health professionals to address the global public health workforce crisis faced by the developing world.

For California, it is estimated that the current public health workforce will need to increase by nearly 50 percent, adding 27,000 new workers. Just last year the University of California system recognized its critical role in addressing this shortage, recommending a more than doubling of UC graduate public health educational capacity.

We know public health interventions work. One need look no further than the feature on faculty efforts to prevent cancer (see page 4) to illustrate

UCLAPUBLIC HEALTH

the profound impact public health can have on individual health and the health

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of communities as a whole. Public health interventions save lives – and money.

Here are a few examples:

2007-2008 DEAN’S A DV I S O RY B OA R D

als. After all, this workforce crisis isn't really about the “public” – it is a threat to

Ira R. Alpert * Lester Breslow Sanford R. Climan Edward A. Dauer Michele DiLorenzo (Chair) Robert J. Drabkin Gerald Factor (Vice Chair) Michael R. Gardner Dean Hansell Alan Hopkins * Cindy Harrell Horn Stephen W. Kahane * Carolyn Katzin * Carolbeth Korn * Jacqueline B. Kosecoff Kenneth E. Lee * Richard D. Lipeles * Edward J. O’Neill * Monica Salinas Fred W. Wasserman * Pamela K. Wasserman * Cynthia Sikes Yorkin

each of us as individuals, our families and our communities. Fortunately, this one

*SPH Alumni

Childhood Immunization: For every dollar spent on childhood immunization, $29 is saved in prevention of medical costs, prevention in work loss by parents and prevention of lost earnings from disability.

Seatbelt Usage: In the last 26 years, safety belts have prevented 135,000 fatalities and 3.8 million injuries, representing a savings of $585 billion in medical and other costs.

Tobacco Cessation: Tobacco is the leading preventable cause of death in the United States, killing more than 400,000 people a year. The total cost of medical services for smokers amounts to $50 billion annually, with another $50 billion in lost wages.

Simply put, investing in our work earns healthy returns.

While UC efforts to expand public health training have been placed on hold, there is still momentum for a national solution. Projections indicate that an initial federal investment of about $30 million annually would put the country on the right track to satisfy the demand for highly skilled public health profession-

can be solved, and at the cost of tens of millions of dollars, it is a relative bargain…one I don’t think we can afford to miss.

Linda Rosenstock, M.D., M.P.H. Dean TOTA L E X P E N D I T U R E S Grants and Contracts State-Generated Funds Gifts and Other Fiscal Year 06-07 $53.1 million

UCLAPUBLIC HEALTH

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4 M UCH

ATTENTION

IS PAID TO THE NEED FOR BREAK THROUGHS IN CANCER TREATMENT.

B UT

IN THE FIGHT

AGAINST THE SOON TO - BE - LEADING CAUSE OF

U.S.

DEATHS , PUBLIC HEALTH IS PLAYING AN EQUALLY CRITICAL ROLE .

The Preemptive War on Cancer: Heading Off a Leading Killer Before it Strikes

Within a few years, based on current trends, cancer will

UCLAPUBLIC HEALTH

surpass heart disease to become the leading cause of death in the United States.

“When an important scientific discovery is made, it doesn’t automatically translate to the population, and it’s only when a technology is adopted at the level of entire communities that you can really have an impact on population health.”

— Dr. Roshan Bastani

Considerable attention is rightfully paid to the search for improved cancer treatments. But often overlooked is public health’s vital role in the cancer fight – past, present, and future.

It’s been estimated that more than half of cancers are preventable by taking advantage of what is known about behavioral strategies such as not smoking, limiting sun exposure, and engaging in physical activity and healthy eating.

“When you look at the decline in lung cancer deaths among men, that’s not because of better treatment; it’s because of tobacco control efforts,” says Dr. Patricia Ganz, professor in the UCLA schools of public health and medicine and director of the Division of Cancer Prevention and Control Research, based in the School of Public Health.

Ganz, a medical oncologist who has spent her career both treating cancer patients and engaging in pioneering research and advocacy on issues of quality of care and cancer survivorship, believes medicine and public health are equally important combatants in the fight. “But people only know when they get a disease, not when it was prevented – which is what public health does,” she says.

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5 particularly focusing on the elimination of cancerrelated disparities.

While it’s true that on an individual level, it’s impossible to be able to say with certainty that public health was responsible for saving a life that would have otherwise been taken by cancer, at the population level it is easy to see the public health impact – and because of the long lag between smoking onset and the development of lung cancer, that impact will be measured in even greater numbers going forward.

When the U.S. surgeon general first warned of the link between tobacco and lung cancer in the 1960s, it wasn’t enough to persuade large segments of the population to quit. Public health campaigns at the policy level – including bans on advertising, restrictions on smoking in public spaces, and increased tobacco taxes used to educate people against smoking’s harmful effects – have made more of an impact, and the health rewards from recent declines in tobacco usage will be reaped in the years ahead.

“When an important scientific discovery is made, it doesn’t automatically translate to the population,” Bastani says, “and it’s only when a technology is adopted at the level of entire communities that you can really have an impact on population health.”

Successfully bringing important cancer discoveries into the community – be they prevention strategies, early screening techniques or treatment advances – is its own science. “It’s not as if we can say, ‘We now have this screening method, it’s good for you,’ and then everyone goes out and gets it,” Bastani explains. “It takes public health research to determine the most effective and efficient means to bring these advances to different populations, and it takes multi-level strategies – at the policy level, the community level, and even with physicians, since just because they have the information doesn’t mean they will use it effectively, or at all.”

As an example, Bastani and Ganz often point to one of public health’s biggest success stories in the fight against cancer. Cervical cancer was the leading cause of cancer death among women in the United States in the first half of the 20th century, affecting young women in particular. In addition to the many deaths from the disease, there were severe quality of life prices paid by the survivors: Ganz recalls that when she was training to become a physician she would see women in their 30s and 40s who had

Erin Hahn, M.P.H. ’06 Among the questions cancer survivors face once they have completed their treatment: Will it have longterm effects? What do I do next? “Most survivors receive excellent cancer care,” says Hahn, “but they can have problems accessing appropriate post-treatment care, which can then contribute to poor outcomes.” Hahn is program director of the UCLA-LIVESTRONG Survivorship Center of Excellence (COE), which is working to fill this gap in care by providing survivorship consultations for patients who have completed active cancer treatment. The focus of the consultation is the creation of a survivorship care plan that summarizes treatment and makes recommendations for managing long-term and late effects.

“These care plans will help to ensure that the growing population of survivors, currently estimated to be more than 12 million in the United States, will receive appropriate follow-up care, focusing on disease prevention and health promotion,” Hahn explains. The COE is also involved in several survivorship research studies, and has formed community partnerships that will help it to evaluate different models of survivorship care. Hahn, who is particularly interested in coordination of care for cancer survivors, will be entering the doctoral program in the school’s Department of Health Services in the fall, enabling her to study these questions more closely.

UCLAPUBLIC HEALTH

Public health’s task in fighting cancer has been made more daunting by its success in other realms.

In the United States, the population is growing considerably older, in part because of public health efforts in recent decades that have reduced deaths from communicable diseases and promoted healthier lifestyles. Since age is a leading risk factor for the development of most cancers, it stands to reason that a graying society will see an increased incidence of the disease. Among the challenges in attempting to buck that trend: identifying strategies for prevention and early detection (when the disease is most treatable), promoting their adoption by all communities, and ensuring that the best treatments based on available evidence are provided to all cancer patients.

All of these are efforts being led by public health.

Epidemiology – a core public health discipline – is the science that has sounded the first warning bells on the links between smoking and cancer, between environmental toxins and cancers, and, more recently, on the association between obesity, lack of physical activity and the risk for a host of cancers. In the last decade, the field of molecular epidemiology has emerged, studying genetic patterns and geneenvironment interactions to further pinpoint cancer risks and prevention strategies. Dr. Zuo-Feng Zhang, professor at the school, and other leaders in the burgeoning field are looking into the genetic predisposition that determines why some smokers get lung cancer and others don’t, for example.

Once those risk factors are identified by epidemiologists, and even when basic and clinical researchers have brought a new treatment or earlyscreening method to fruition, it takes public health efforts to ensure that the advances in knowledge and technology are translated into changes at the community level. That means identifying and helping to overcome barriers to the adoption of cancerpreventing behaviors in specific communities, and it means ensuring that where medical advances are made, those advances are realized by all communities.

“In medicine, people are talking a lot about translational research – from the bench to the bedside to the community,” says Dr. Roshan Bastani, professor and associate dean for research at the school, co-director of the SPH Center to Eliminate Health Disparities, and associate director of the Division of Cancer Prevention and Control Research.

“Public health is at that critical juncture of bedsideto-community. Ours is not a passive approach, because if we wait for people to walk in the door of the clinic when they’re sick, we’ve lost that opportunity for prevention.” Bastani, a social psychologist, has devoted her career to translating evidence-based cancer prevention and control to the community,

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cer:

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Denise Woods, M.A.

UCLAPUBLIC HEALTH

Last fall, the school’s Center to Eliminate Health Disparities received a five-year, CDC-funded Center of Excellence in the Elimination of Disparities (CEED) grant. Woods, a second-year Dr.P.H. student, is participating in the CEED initiative, which addresses disparities in heart disease, stroke and cancer among African Americans, Latinos, and Asians by disseminating organizational-level evidence, practice-based physical activity, and nutrition strategies with a focus on cultural traditions. The focal point will be program activities in two organizational settings in which most people spend a large portion of their days: the workplace and school sites. “To achieve sustainable change at an organization level in at-risk communities, it is imperative to spark advocacy to influence policies and regulations that promote healthier eating and active living,” Woods says. “Work done through the CEED will allow rigorous evaluation of the impact of promising strategies on the practices and policies of organizations, the physical activity and nutrition behaviors of individuals, as well as the health status of the participating communities.”

undergone radical pelvic surgeries that included removal of the bladder and part of the bowel. The advent in the 1940s of the Pap smear, which detects precancerous lesions and treatable early cancers, barely made a dent until 20-30 years later, when public health efforts to promote its widespread adoption in diverse populations finally took hold.

Dr. Lester Breslow, a professor and dean emeritus of the school and former public health director for the State of California, was an early proponent of the dissemination of cervical cytology testing. Today, cervical cancer is uncommon in the United States and relatively few women die from the disease.

Similarly, Bastani notes, a contributor to recent declines in breast cancer mortality is the increased use of mammography to screen for early disease – an advance that has resulted from such public health approaches as the implementation of policies to ensure low-cost or free mammograms for women who can’t afford them, community-based education and successful efforts to get more physicians to recommend mammograms to their patients.

Public health has also made a major impact in reducing or eliminating a number of cancer-causing environmental exposures such as radiation and certain toxins in the workplace, as well as secondhand tobacco smoke, Ganz adds. But she points out that most cancers have little to do with environmental toxins. For example, breast cancer is the leading cancer for women in the United States, prostate cancer is the leading cancer for men, and colorectal cancer is third among both sexes. For these, there are no environmental agents known to play a role; instead, the challenge in reducing their incidence is to affect behaviors, such as promoting healthier eating and regular physical activity, as well as screening for early detection.

Colorectal cancer currently represents a major opportunity for public health to make an impact using the paradigm that was successful for cervical cancer. An effective screening technology exists, but colorectal cancer incidence and mortality remain high because it has not been widely adopted.

“We know colon cancer is a disease of aging that arises from small growths in the colon called polyps, that as these growths slowly mature they turn into cancers, and that if we remove these polyps, they don’t have a chance to grow into cancers,” Ganz says.

“If we could get everyone over age 50 to be screened for colon cancer, we could bring it down to levels similar to what we see in cervical cancer. That’s our big challenge right now, with only 30-40 percent of

the population over age 50 having been screened.”

The new human papillomavirus (HPV) vaccine represents another recent medical breakthrough whose potential will be realized only through successful public health efforts. The vaccine, which can prevent infection with the most common types of HPV that cause cervical cancer, is approved for girls and young women between the ages of 9 and 26.

But there are barriers to be overcome – psychological, social, cultural and economic. Bastani and her research group are currently collaborating with the Los Angeles County Office of Women’s Health on research to understand and reduce such barriers.

Various peer-reviewed analyses in the last quartercentury have indicated that diet and physical activity are related to approximately one-third of the prema-

ture mortality from cancer. With unhealthy eating practices and sedentary lifestyles reaching epidemic proportions in the United States and much of the developed world, “there is increasing consensus that if you want to reduce cancer risk in a population you have to pay attention to obesity,” says Dr. William McCarthy, associate professor at the School of Public Health, who has spent much of his career pursuing public health strategies to reduce smoking and promote healthy eating and physical activity.

Obesity is now believed to be a more important influence on cancer risk than the level of specific micronutrients such as antioxidants, notes McCarthy, who has long been interested in educating populations on the benefits of whole-food approaches, including eating more fruits and vegetables, as a way to reduce cancer risk. “At least 20 percent of cancers in the United States could be postponed or totally avoided if we achieved a healthy waistline, and eating more fruits and vegetables is an important strategy to achieve that,” McCarthy says.

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Soultana Haftoglou,

“If you want to reduce cancer risk… you have to pay attention to obesity,” says Dr. William McCarthy, who says California’s law establishing nutrition standards for foods and beverages sold at schools marked a turning point.

M.P.H.

Jennifer Tsui, M.P.H. Tsui, a first-year doctoral student at the school, works with Dr. Roshan Bastani and her team on a project to develop an HPV vaccine program for low-income women who call the Los Angeles County Office of Women’s Health Information Hotline. “Education and awareness about cervical cancer and the HPV vaccine are especially important for women served through the hotline because many are from communities with low rates of cervical cancer screening, barriers to health care services, and limited access to accurate health information,” Tsui explains.

The work gives Tsui an opportunity to combine her research interests in underserved populations and chronic disease prevention among underserved populations with her previous experience in cancer screening disparities and HPV vaccine introduction.

“The HPV vaccine is a unique area to focus on within cancer control because of the multiple social, political, and financial aspects that come into play when addressing the delivery of this new health product,” says Tsui, who hopes to pursue a career in health disparities research focused on policy and system-level change to improve the access to health services and quality of health care for underserved populations.

UCLAPUBLIC HEALTH

Obesity contributes to the development of many cancers, and negatively affects cancer survivorship.

Haftoglou, a doctoral student at the school, works with Drs. William McCarthy and Lillian Gelberg on an intervention to reduce cancer risk among Latinos. The project targets low-income, Spanishspeaking Latino patients at the Venice Family Clinic, offering four telephonebased lifestyle counseling sessions over a two-month period. Culturally appropriate material is used and phone sessions are conducted in Spanish. As a lifestylechange counselor, Haftoglou promotes increased consumption of fruits and vegetables as well as creative ways to become more physically active. She helps the participants set realistic goals, acting both as their coach and cheerleader, in an effort to help them make sustainable lifestyle changes.

“We don’t just want the program to work, but for participants to adopt and maintain life-long healthy dietary and physical activity habits,” she says. To facilitate the lifestyle changes, the participants are given a “gym-in-the-bag,” including a pedometer, a folder with dietary guidelines, stretchbands, and an exercise DVD. The ultimate effectiveness of the intervention will be determined by an experimental test of serum carotenoid levels, which are considered an indicator of fruit and vegetable consumption.

feature

In efforts to promote healthier lifestyle choices, McCarthy has focused to a large extent on children. In the mid-1980s he testified twice before Congress on the need for more government oversight over cigarette advertising, pointing to ads designed to appeal to adolescents. Since 2000 he has served as the chief evaluator for California’s In-School Tobacco Use Prevention Education Program.

He was principal investigator of a federal grant that evaluated California’s SB 19, a first-of-its-kind state law that established nutrition standards for foods and beverages sold on school campuses in an effort to combat the growing problem of childhood obesity. McCarthy believes SB 19 marked a turning point, and that there is now national recognition of the importance of promoting healthier eating among school children.

McCarthy has also teamed with another UCLA School of Public Health faculty member, Dr. Antronette (Toni) Yancey, on community-based research interventions designed to increase physical activity in target populations. At the heart of several of these efforts are 10-minute, structured exercise or Instant Recess breaks. Yancey, co-director with Bastani of the school’s Center to Eliminate Health Disparities, has created several culturally targeted DVDs and is teaming with McCarthy to incorporate the 10-minute exercise bouts into daily workplace routines. These movement breaks are one of several “push” or “opt out” strategies, like walking meetings and nearby parking restrictions, designed to make the fit choice the easy choice. “The idea is that exposing people to a small amount of exercise in this captive setting will be a stimulus for lifestyle changes outside of work,” McCarthy explains.

In April, Yancey kicked off a multi-year fitness initiative in conjunction with the San Diego Padres baseball organization and The California Endowment.

As part of the FriarFit initiative, the Padres have added healthier food options to

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Alison K. Herrmann,

UCLAPUBLIC HEALTH

M.S. Herrmann, a first-year doctoral student, serves as project director of the UCLA Korean Healthy Life Project, a Division of Cancer Prevention and Control Research study focused on increasing hepatitis B screening among Korean Americans. Capitalizing on the fact that a majority of Koreans attend church on a regular basis, the randomized trial, headed by Dr. Roshan Bastani, is held at churches both inside and outside of Los Angeles’ Koreatown.

Herrmann and others on the project team have met regularly with members of the Los Angeles Korean American community to gain a comprehensive understanding of the types of heath messages that would be most salient. The feedback obtained was used to develop pilot materials, which were then revised after a series of focus groups. Thus far, nearly 200 eligible church members have participated in a smallgroup discussion session in association with the project.

After two additional years in the field, Herrmann looks forward to the opportunity of sharing the results of this work and hopes to provide an evidence-based tool for use in the prevention of hepatitis B and liver cancer.

“Working in this capacity is providing me with the opportunity to take concepts directly from the classroom to the field,” she says.

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Jammie Hopkins, M.S. Hopkins, a first-year doctoral student interested in chronic disease prevention in multicultural populations, works on research led by Dr. Antronette (Toni) Yancey that promotes physical activity and healthy nutrition to reduce cancer risk. “Instead of focusing on individuals, our research targets socially enriched organizational units such as worksites, churches, and schools in an attempt to influence ‘captive audiences’ of individuals who are most likely to be sedentary and have poor nutrition habits,” he explains. The goal of the current project, WORKING (Working Out Regular Keeps Individuals Nurtured and Going), is to explore and test culturally salient strategies geared toward modifying organizational culture to include regular physical activity and healthy nutrition within the organization’s normal conduct of business.

By securing administrative buy-in from leaders within the organizations; providing training, resources, and technical support to worksite “champions”; and stimulating mechanisms of social support and norm change, the researchers hope to encourage individuals within these organizations to develop innovative, sustainable wellness policies and practices. “If physical activity and healthy nutrition options are made easily accessible and ‘normal’ in environments where individuals work and socially convene, people will be more likely to adopt these positive behaviors and spread the word to their families and communities,” Hopkins says.

Addressing the gaps between the care known to be most effective and what patients receive could make an even bigger impact than better treatments, says Dr. Patricia Ganz. concession stands. Ten-minute Instant Recess fitness breaks are being held in the parking lot prior to Sunday Family Day home games, with fans taken through fitness moves by a CD featuring star Padres players Trevor Hoffman and Adrian Gonzalez and Hall of Fame outfielder Dave Winfield. These CDs will also be used in San Diego public schools, which are working with FriarFit on a comprehensive physical activity program, including visits from current and former Padres players, tools and resources for teachers, and participation incentives for children.

The link between diet and cancer risk has been established for some time, but more recently a growing body of evidence strongly suggests that physical activity confers benefits when it comes to preventing many cancers, including cancers of the breast, colon, endometrium, lung and kidney, Yancey says, adding that the benefit appears to be independent of that coming from the weight loss.

Physical activity also contributes an indirect protective influence by assisting in weight management.

Efforts to fight cancer by promoting healthy behaviors, whether related to tobacco use, diet and exercise, or screening, are particularly important in ethnic minority and other low-income populations, given the disparities that exist.

“There are a lot of factors related to the social environment that can make it difficult for people in these communities to follow behaviors that they might know at an individual level are healthier,” says Dr. Beth Glenn, an assistant professor at the school. These populations are likely to have less access to cancer screening services, safe places to exercise, and grocery stores with fresh produce, she notes. Financial and cultural barriers also contribute to the disparities.

Glenn works with Bastani on research aiming to find ways to close these gaps. Bastani leads a current study that collaborates with churches in Los Angeles-area Korean neighborhoods to test an educational intervention designed to increase screening and vaccination for hepatitis B. Koreans have among the highest rates of hepatitis B infection, which can lead to liver cancer when

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address these issues by asking different questions and getting information to the communities more effectively.” Since it was first funded in 1999, the program has graduated 319 students, 72 of whom have gone on to doctoral programs.

When she began her career as an oncologist in the 1970s, Ganz’s focus was on treating individual patients. Today, she spends more of her time looking at the big picture.

A pioneer in the assessment of quality of life for cancer patients at a time when few were placing a high priority on the physical and psychosocial effects of cancer treatment, Ganz has devoted much of her time in the last several years to work in the policy arena on issues related to the quality of cancer care. She co-chairs the Cancer Quality Alliance, a group of stakeholders that includes representatives from government, professional societies, patient advocacy groups, certifying and accrediting organizations, the insurance industry, foundations, and others interested in improving quality of cancer care.

The group’s forthcoming publication Blueprint for Quality Cancer Care is designed to paint a picture of what constitutes high-quality treatment by presenting a series of case studies. Through the alliance and the American Society of Clinical Oncology, Ganz has also embarked on establishing performance measurements for cancer care as the first step toward a system of accrediting oncology practices.

“For cancer, unlike for many other diseases, we have many randomized controlled trials that tell us what the best treatment is, and we have guidelines that have been developed,” Ganz says. “But the implementation of these is less than satisfactory.

The performance measurements that we’re developing are focused on making sure patients get the right treatment.”

While much attention is paid to the need for better cancer treatments, Ganz believes that addressing the sizable gaps that exist between the care known to be most effective and what many patients are actually receiving has the potential to make an even bigger public health impact.

Similarly, Yancey argues that achieving success in promoting cancer-preventing behaviors should be high on the priority list in the cancer fight.

“Even when it’s successfully treated, cancer represents a huge disruption to an individual’s life – physically, emotionally, and financially,” she says. “If we can help someone not get cancer, that’s much better than coming up with any particular treatment.”

Cynthia M. Mojica, M.P.H. ’95, Ph.D. ’06 It is well documented that cancer incidence and mortality rates in the United States vary by race and ethnicity, with ethnic minority populations suffering from a higher burden of cancer than non-Latino whites. “Although we understand that ethnic minorities face barriers to early detection, diagnostic follow-up, and treatment, we have yet to adequately address the myriad factors – such as lifestyle, environmental risk, and health policies – that contribute to health disparities in cancer outcomes,” says Mojica, a postdoctoral scholar in the Division of Cancer Prevention and Control Research, based in the school. Mojica has been involved in a number of research projects aimed at eliminating these disparities.

Currently, she is managing a study to reduce health disparities in cardiovascular disease, cancer, and other diseases related to obesity among African Americans, Latinos, and Asian/Pacific Islanders by disseminating evidence-based practices and policies that incorporate physical activity and healthier food options into organizations throughout Los Angeles County and parts of Orange County. “We need to continue studying differences by racial/ethnic group and to develop and test interventions and policies that eliminate health disparities in cancer outcomes,” Mojica says. “Our growing ethnic minority populations deserve to live healthy, productive lives.”

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Kagawa-Singer also heads a program aiming to address the problem of disparities by increasing the pipeline of minorities in her field. The Minority Training Program in Cancer Control Research, a joint program of the UCLA School of Public Health and UC San Francisco Comprehensive Cancer Center with funding from the National Cancer Institute, seeks to increase ethnic diversity in cancer control research by encouraging master’s-level minority students and master’s-trained professionals to pursue a doctoral degree and a career in research.

“Despite all of the attention to cancer disparities over the last 15-20 years, we aren’t making much headway in reducing them, and in many areas they are actually growing,” Kagawa-Singer says.

“Researchers who come from the communities they’re studying are more likely to successfully

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untreated. A second major project aims to increase informed decision-making about prostate cancer screening among Latino men.

Dr. Marjorie Kagawa-Singer, professor at the school, notes that disparities abound in cancer.

African American women have a lower incidence of breast cancer than non-Hispanic whites but die at a rate that is approximately 30 percent higher.

New immigrants in the United States start with cancer rates that are lower than those of Americanborn descendants from their native countries, but with time their rates rise to mirror those of their host communities. Cancer rates are rising almost universally among Asian-Americans and Latinos.

Kagawa-Singer is principal investigator of the Los Angeles site of the national Asian American Network for Cancer Awareness Research and Training (AANCART), a National Cancer Institute initiative to decrease cancer disparities affecting AsianAmericans, who have the lowest rates of screening for preventable cancers of any ethnic group.

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10

Lisa V. Smith:

S HE

DOES

IMPORTANT WORK AT THE

L.A.

C OUNTY D EPART-

Lisa V. Smith loves to share her passion for public health

P UBLIC

in general and epidemiology in particular with anyone who wants to hear about it – whether it’s the

MENT OF

H EALTH ,

BUT IS

EQUALLY PASSION ATE ABOUT TEACH ING AND PROVIDING OPPORTUNITIES FOR

SPH

STUDENTS

TO BECOME FUTURE COLLEAGUES .

UCLAPUBLIC HEALTH

Bringing New Recruits to Her Epidemiological Cause UCLA School of Public Health students she teaches in the classroom and mentors in her position at the Los Angeles County Department of Public Health, or her neighbors in the South Los Angeles community in which she grew up and continues to reside.

Smith, an adjunct assistant professor of epidemiology at the school as well as an alumna (M.P.H. ’94, Dr.P.H. ’00), served as director of the Epidemiology Unit in the county’s Sexually Transmitted Disease (STD) Program from 2002 to 2006 before being appointed to her current position as chief of the Surveillance, Epidemiology and Evaluation unit of the county’s Division of Chronic Disease and Injury Prevention.

She speaks enthusiastically about what she and her colleagues have been able to achieve at both units.

As a part of the nation’s second-largest health department, L.A. County’s STD program oversees one of every 25 STD cases in the nation. Smith’s unit ran more than a dozen surveillance databases and projects, including the initiation of a rapid HIV testing program. At the newly created Surveillance Epidemiology and Evaluation Unit, Smith’s “small but mighty” staff of three serves as what she calls “accountants of health,” providing important data that inform others at the county in developing policy, particularly in the area of chronic disease. “The problem with chronic disease, as opposed to STDs, is that there are very few surveillance systems,” Smith explains. “With STDs, you have reports of gonorrhea, chlamydia, syphilis and others coming through, to give you a sense of what’s out there. You don’t have reports coming in that someone is obese, or that someone has hypertension, or has started smoking. But we need that to target individuals.”

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11 L.A. County’s. The practical, hands-on nature of the course has made it extremely popular, and Smith’s teaching excellence was recognized when she was named “Faculty of the Year” by the Public Health Student Association in 2006, the first year she taught SAS. Smith is equally committed in her efforts to interest young people from disadvantaged communities in pursuing public health education. In 1998 she received the UCLA Fair and Open Academic Environment award in recognition of her efforts to increase the diversity of the School of Public Health. She has logged countless hours conducting outreach with first-generation college students.

Many of these students share disadvantages that Smith herself felt as an undergraduate.

“When I was younger, I didn’t have any vision for what I wanted, so I didn’t maximize my opportunities,” she says. Although Smith later learned that others in her extended family had gone to college, she didn’t know it at the time. She graduated from Loyola Marymount University in 1979 with a degree in biology, knowing nothing about public health; it wasn’t until more than a decade later that she applied to the school’s M.P.H. program in the Department of Epidemiology, going on to receive her doctorate in 2000 and then a UC President’s Postdoctoral Fellowship.

Although she notes that more than one insurance agent has asked why she doesn’t consider moving to a more affluent community, Smith has no desire to leave South Los Angeles. “It’s important to me to be here because I am grounded, and this keeps me humble,” she says. “As a community-based epidemiologist, I spend time listening to the community before I develop surveys. You live here and you see why you can’t just preach to people to get fit – they aren’t spending a lot of time outside because there’s violence and safety comes first.

There’s obesity because you have ice cream trucks and street vendors coming around selling junk food.

Many residents don’t know that they should expect more and make better food choices.

“What I bring to public health is the ability to tell my colleagues what it’s really like here. And it’s not all negative like what’s shown on television.

I start redoing my house and other people do the same thing. People plant flowers. Our neighborhood starts to function like a community. It’s the funniest thing, but it’s effective.”

“I have students I’ve recruited who have passed me up at the county, who are now ranked higher than I am.

I’m proud that our students are doing so well!”

—Dr. Lisa V. Smith

UCLAPUBLIC HEALTH

To get information that’s not formally collected, Smith’s unit has begun to conduct rapid surveys and assessments on a variety of health-related matters, getting an immediate reading on such topics as the California Smokers’ Helpline telephone program, menu labeling in fast-food restaurants, and potential barriers to a county-wide trans-fat reduction campaign. Smith also provides important information in support of the county’s PLACE (Policies for Livable Active Communities & Environments) program, which promotes the development of healthier communities through policy changes.

But for all of her professional accomplishments, nothing makes Smith happier than successfully recruiting students to careers at the county. In both of her units, she has provided structured internships and has encouraged her students to apply; dozens have taken her up on it, and many were subsequently hired by Smith or her colleagues. “I have students I’ve recruited who have passed me up at the county, who are now ranked higher than I am,” she says, laughing. “I’m proud that our students are doing so well!” Smith, who rarely turns down invitations to discuss opportunities with students at career fairs or in classroom presentations, concedes that any estimate as to the number of UCLA School of Public Health students now working at the county whom she at one time assisted is probably low. “We have more than 40 departments,” she says. “Students can end up going anywhere and I don’t always know about it.”

She is a believer in the value of exposing the school’s epidemiology students to the “real world” experience of a local health department as a complement to the theory they’re learning at the school.

“I make sure they realize that what they learn in the classroom is the science, and when they get into the Department of Public Health, it’s a lot more art,” she says. “You have to know the foundation of epidemiology, and our school provides some of the best foundation theory in the country. But in the real world it can be messy – particularly when you’re dealing with stigmatized populations like people who have STDs. There is going to be missing data and there’s going to be some lying. You have to make the best of it, and at the county we are still able to do great work with not a lot of money.”

Learning to crunch numbers while dealing with difficult, “messy” data is one of the main lessons students take away from a course Smith has taught for the last three years, Computer Management of Health Data Using SAS Software. The course teaches students how to use the data processing system that is now widely employed in the business world and in many health departments, including

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faculty profile

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12 A

NEW REPORT

UNDERSCORES THE STRAINS ON THE SYSTEM AS A SHRINKING POOL OF TRAINED PROFESSIONALS ATTEMPTS TO TACKLE AN INCREASINGLY DAUNTING SET OF CHALLENGES .

Help Wanted: Public Health Faces a Workforce Crisis It could be argued that the health challenges facing the nation today and in the foreseeable future have never been more formidable. On top of the concerns about traditional public health functions such as ensuring water availability and quality, food safety, immunizations and the control of communicable diseases, there are a host of new problems to consider, from the rapid emergence and spread of new infectious agents to the increasingly ominous threats posed by disasters – both natural and man-made – and global climate change. The obesity epidemic imperils the nation’s health and cries out for more intense and effective public health interventions, and the aging population portends unprecedented strains on an

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already frayed health care system as the number of people living with chronic conditions soars.

But at a time when a robust public health effort is considered by many both in and out of the profession to be a top priority, a central ingredient to that effort – a well-trained, sufficiently sized public health workforce – is sorely lacking. A first-of-its-kind assessment conducted by the Association of Schools of Public Health (ASPH) concludes that the current public health workforce is inadequate to meet the health needs of the U.S. and global population, and projects that the situation will worsen without dramatic steps to increase public health training. To replenish the workforce and avert the crisis, schools of public health will have to train three times the current number of graduates over the next 12 years, the ASPH estimated.

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In its report, “Confronting the Public Health Workforce Crisis,” first presented at a Capitol Hill briefing in late February, the ASPH warned that the health of all Americans will be affected by the crisis unless there is an immediate influx of funding for recruitment and training of public health professionals. Between 1980 and 2000, the U.S. population increased by nearly 55 million but the public health workforce declined by 50,000, forcing public health

Public Health and chair of the ASPH Workforce Taskforce, which authored the report. “Unless we act now to recruit and train an additional 250,000 public health professionals, we will soon be ill-equipped to identify looming public health crises and respond decisively.”

Sub-fields that are particularly hard-hit by the shortage include public health physicians, public health nurses, epidemiologists, laboratory personnel, environmental health experts, health care educators, and administrators, though Rosenstock points out that public health professionals are needed across the board. Moreover, 23 percent of the current workforce – nearly 110,000 workers – is eligible to retire within the next five years. The ASPH also points to racial and ethnic disparities between the public health workforce and the populations it serves, as well as geographic maldistribution.

The situation is even grimmer in California.

A report released early last year by the UC Advisory Council on Future Growth in the Health Professions found that California lags behind other states in public health educational capacity; as a result, the state’s public health agencies are grappling with shortages in epidemiologists, environmental health scientists, and health educators, while the private sector is lacking in professionals trained in health services administration and management. In its report, “A Compelling Case for Growth,” the advisory group to the Office of the President, co-chaired by Regent Sherry Lansing and Provost Rory Hume, concluded that quality is an issue as well, given that only about 20 percent of California’s public health workforce has received formal training in public health. In light of these findings, UC developed a plan to more than

AN ESTIMATED 250,000 MORE PUBLIC HEALTH WORKERS WILL BE NEEDED BY 2020 double the number of graduate-level public health education slots by 2020. But that plan, which was to have begun implementation in 2008-09, has been shelved for now amid the state’s budget crunch.

The crisis is also being felt locally, says Dr. Jonathan Fielding, director of public health and health officer for Los Angeles County, and a professor at the UCLA School of Public Health. “There are categories of skilled people that we are having a hard time recruiting,” Fielding says. “We have an older workforce and a number of vacancies, and

UCLAPUBLIC HEALTH

workers to do more for more people with fewer resources. In order to have the same public health workforce to population ratio that existed in 1980, the report noted, more than 250,000 additional public health workers will be needed by 2020 – or about one-third the total necessary to combat new, evolving and emerging public health threats.

“Tackling the health implications of tobacco use, heart disease, obesity and physical inactivity, not to mention the threat of globally spreading infectious diseases, depends almost entirely on the availability of a well-trained public health workforce,” says Dr. Linda Rosenstock, dean of the UCLA School of

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14 trying to fill those vacancies is increasingly difficult because there aren’t enough trained people.”

One of the county’s most pressing areas of need is for public health laboratory professionals, particularly those with a microbiology background, Fielding says, noting that the lack of skilled workers in this area is even more glaring as the technologies become more sophisticated. Fielding’s department is also increasingly feeling the effects of shortages of welltrained epidemiologists, environmental health scientists, public health nurses, health educators and nutritionists. And more than just a shortage of numbers, Fielding adds, many among the workforce lack training in public health, and thus are not wellversed in the population-based approach that is at the heart of the profession.

Public health training is sorely needed in many private-sector settings as well. "In industry, I see very few people with public health backgrounds," says Josh Ofman (M.D., M.S.H.S. ’96), vice president of global coverage and reimbursement and global health economics at the Thousand Oaks, Calif.-based biotechnology company Amgen. "We need people

Compounding matters, global climate change is expected to disproportionately affect certain parts of the world where the public health problems are already the most severe. “Climate change is going to have huge impacts on public health in sub-Saharan Africa,” says Dr. Gail Harrison, professor of community health sciences at the school and director of the UCLA Global Health Training Program, a campuswide effort, based in the School of Public Health, that has begun offering certificates in global health to those who complete a specified series of courses and experiences. “There will be tremendous amounts of agricultural land lost to drought and to the rise in sea level, and the impact on malnutrition and on the distribution of infectious diseases is going to be substantial. We need to train people here who can work in developing countries as leaders, analysts, and technical advisors, but probably just as important, we need to help build capacity within those countries.”

The vital role played by public health and the success it has had over the last century in improving quality of life, increasing life expectancy, reducing infant and child mortality worldwide, and eliminating or reducing numerous life-threatening communicable diseases is well known to anyone in the profession.

MORE THAN 50% OF STATES CITE THE LACK OF TRAINED PERSONNEL AS A MAJOR BARRIER

UCLAPUBLIC HEALTH

TO THEIR PREPAREDNESS with a deep understanding of the interdependencies of the different elements of the health care system, from health care policy to health economics and the role of technology in these areas. People with that kind of training could make a big impact, both in helping their companies perform better and in improving the health care system."

The United States is not alone in this crisis, Rosenstock notes. A 2006 report by the World Health Organization pointed to more than 50 countries facing “crippling” public health workforce shortages. Sub-Saharan Africa, which represents 11 percent of the world’s population and 24 percent of the global burden of disease, has only 3 percent of the world’s health workers. In an era of globalization, the U.S. public health workforce is increasingly called on to help combat health threats that transcend borders. But at a time when greater demands are being placed on the United States to help build global public health capacity, the shortage at home is attracting public health professionals from poorer nations who might otherwise remain in their own countries, contributing to a “brain drain” that exacerbates the problem in the developing world.

Nor does anyone doubt that given the daunting challenges facing the United States and the rest of the world today, a strong public health infrastructure is as critical as it’s ever been.

But over the last several decades, that infrastructure – information systems, laboratory and surveillance capacities, and the public health workforce – has eroded. “There has been a lack of support at the local, state and federal levels as some people presumed we had ‘won’ and that the public health was taken care of,” says Rosenstock. “That’s part of the reason we saw a drop in the total workforce despite a growing population and a greater complexity of needs from 1980 to 2000.”

The ASPH isn’t alone among leading public health organizations in believing the current workforce is inadequate to meet the needs of the U.S. and global populations. The Centers for Disease Control and Prevention, American Public Health Association, Association of State and Territorial Health Officials and Institute of Medicine have also weighed in. Rosenstock notes that it’s not just insufficient numbers. “We all recognize that the current public health workforce does yeoman’s work, often against great odds,” she says. “These professionals are often shifted from one task to another depending on

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the needs of the moment, and too many of them haven’t been specifically trained in public health or don’t have the appropriate background for the demands placed upon them.”

If policy makers took public health’s role for granted in recent decades, few are doing that today, particularly in the wake of the two most visible public

THERE WERE 50,000 FEWER U.S. PUBLIC HEALTH WORKERS IN 2000 THAN IN 1980, DESPITE A POPULATION GROWTH OF 55 MILLION health crises occurring in the United States in this decade: the September 11, 2001 terrorist attacks and subsequent anthrax threats, and the fallout from Hurricane Katrina nearly four years later.

“Historically, it’s often in times of crisis that society recognizes the importance of public health and reinvests,” says Dr. Gerald Kominski, professor and associate dean for academic programs at the school and a co-author on the ASPH report. “What happened on and following 9/11 and Hurricane Katrina brought attention to the shortcomings in our disaster response plans and has served as a reminder of the potential consequences of inadequate preparation. As a result of these crises, we are now seeing increased awareness and concern about our ability to mount effective public health responses in a variety of other areas as well.”

Epidemiology has long been one of the bedrock disciplines of public health, but it is also one of the areas in which there are considerable shortages, Kominski says. And as sophisticated new techniques come online, the need for training of new professionals as well as updated training for the current workforce grows.

Indeed, the ASPH report concludes that the growing complexity of public health science necessitates that more specialists be trained in a number of public health sub-disciplines. Fielding concurs. “In every area of the workforce, we need to make sure people are able to keep up with a rapidly changing world,” he says.

“If someone graduated from a school of public health 15-20 years ago and hasn’t

"There are categories of skilled people that we are having a hard time recruiting. We have an older workforce and a number of vacancies, and trying to fill those vacancies is increasingly difficult because there aren't enough trained people."

— Dr. Jonathan Fielding, Director of Public and Health Officer, L.A. County Professor, UCLA School of Public Health

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“Tackling the health implications of tobacco use, heart disease, obesity and physical inactivity, not to mention the threat of globally spreading infectious diseases, depends almost entirely on the availability of a well-trained public health workforce.”

— Dr. Linda Rosenstock Dean, UCLA School of Public Health Chair, ASPH Workforce Taskforce

kept up with changes in the field, that’s a problem.” Genomics, gerontology and emergency preparedness are examples of sub-disciplines that are growing in importance for the public health workforce, and in which more training is needed, Fielding says.

Heading off the looming public health workforce crisis will require bold actions, Rosenstock argues, including an emergency plan to tap into interest in public health careers through recruitment, financial support and incentives that direct professionals where the needs are greatest. The ASPH taskforce called for creation of a U.S. Global Health Service to coordinate and centralize the nation’s efforts to assist internationally, and an ongoing initiative to understand current and future workforce needs.

The ASPH is also calling for an increased federal investment in public health education and training. Toward that end, legislation aiming to bolster the public health workforce has been introduced by Rep. Doris O. Matsui (D-Calif.). Her Public Health Workforce Development Act of 2008 (H.R. 5496) is the House companion to legislation introduced in the Senate last year (S. 1882) by Sens.

FOR CALIFORNIA, IT IS ESTIMATED THAT THE CURRENT PUBLIC HEALTH WORKFORCE WILL

UCLAPUBLIC HEALTH

NEED TO INCREASE BY NEARLY 50%, ADDING 27,000 NEW WORKERS Dick Durbin (D-Ill.) and Chuck Hagel (R-Neb.). Among other provisions, the bills provide for scholarship programs, loan repayment programs and grants to spur additional training to mid-career public health professionals.

Increasing public health educational capacity is particularly urgent, according to the ASPH’s analysis, which concluded that the nation’s 40 accredited schools of public health – which train approximately 85 percent of the nation’s public health professionals – will need to graduate three times as many public health workers over the next 12 years to meet the goal of 250,000 additional public health workers by 2020. “That will require more resources to fund students,

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17 attention is given to the shortages in human resources in public health and health care delivery, but the greater need is to build management capacity within these organizations,” says Dr. Fred Hagigi, director of Executive Education Programs in Healthcare Management and Policy, part of the school’s Department of Health Services. “The health care system will continue to struggle in the absence of an adequate number of managers and leaders who truly understand the turbulent landscape.”

UCLA has also taken steps to attract talented young people to the field by initiating a public

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resources to help develop a pipeline of students coming into the field, and opportunities that will ensure these students are successful, including partnerships with local, state and federal health agencies as well as the private sector and agencies in other parts of the world,” Rosenstock says. At the federal level, support for students in public health degree programs can come via mechanisms such as training grants, loan repayment and forgiveness programs, and service obligation grants, the ASPH taskforce noted.

While they continue to advocate for more federal and state funding to increase their capacity, public health schools such as UCLA’s are finding other ways to meet some of the workforce training needs.

One is through dual preparation – adding a public

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DESPITE REPRESENTING 11% OF THE WORLD’S POPULATION AND 24% OF THE GLOBAL BURDEN OF DISEASE, SUB-SAHARAN AFRICA HAS ONLY 3% OF THE WORLD’S HEALTH WORKERS AND COMMANDS LESS THAN 1% OF THE WORLD’S HEATH EXPENDITURES health minor at the undergraduate level; strong interest in the minor has led to consideration of a public health major being offered.

The increased interest in the profession among current college students is matched by the growing interest of employers in hiring them. “Government, industry and the public are all showing a greater appreciation for the role of public health,” says Diana Bontá (M.P.H. ’75, Dr.P.H. ’92), former director of the California Department of Health Services and currently vice president of public affairs for Kaiser Permanente’s Southern California region, which has become one of the leading employers of graduates of the UCLA School of Public Health. “Years ago, hospitals and health plans weren’t necessarily looking to hire people with an M.P.H.,” Bontá notes. “Kaiser is an example in which we realize that these graduates come in with skill sets that are crucial to our mission – the ability to do the data review, critical analysis, and work that has to be done for us to make decisions about what’s the best way to address community needs and serve populations at risk.”

With the growing appreciation of the importance of a strong public health workforce, Rosenstock hopes federal and state funders will recognize the value of strengthening training capacity. “We know that public health interventions – whether prevention of disease through vaccines or population efforts to combat smoking and obesity – are a wise investment,” she says. “Students have the will, our nation has the need, and we must make advances to reconcile the two.”

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health education component to students training in other health professions. UCLA PRIME, a new program offered through the medical school, is a fiveyear dual degree program in which medical students can also earn an M.P.H.; these students commit to working with underserved communities as physicians. Joint degree programs also continue to be offered at UCLA for students who wish to combine public health with medicine, nursing, dentistry, law or other degrees.

As she was studying for her master’s degree in nursing en route to becoming a nurse practitioner, Kynna Wright-Volel (M.P.H. ’99, Ph.D. ’06) concluded that a public health education would make her a much more effective clinician. Upon completing her nursing education she enrolled at the UCLA School of Public Health, where she went on to earn a Ph.D. “It gave me a different perspective on the community, on the issue of health disparities, and on how to work with health care systems,” she says.

“I no longer just look at the disease in isolation.”

Convinced that all clinicians can benefit from such dual training, Wright-Volel, now an assistant professor at the UCLA School of Nursing who teaches pediatrics, has encouraged all of her students and advisees to enroll in courses at the School of Public Health.

For working health professionals, the school continues to offer executive-style programs leading to an M.P.H. in either health services management and policy or health promotion and education.

These programs, scheduled on weekends and during the summer months, help to meet the training needs of the current public health workforce. “Much

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18 F OR

MANY OF

THE SCHOOL ’ S GRADUATES WORKING TO IMPROVE CONDITIONS OVERSEAS , RELATIONSHIPS ESTABLISHED WITH THEIR PROFESSORS CONTINUE TO PAY OFF.

Global Partnerships:

Faculty Work with Alumni to Promote International Health All around the globe, UCLA School of Public Health alumni are putting their degrees to work as they tackle the considerable challenges facing the developing world. But the influence of the school’s faculty can extend beyond

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the education they provided to these alumni when they were students.

“You develop a lot of very close relationships with amazing, highly committed individuals. To help them develop and to work with them in making a difference in their home countries has been fantastically rewarding.”

—Dr. Roger Detels

Many faculty members continue to mentor and collaborate with their students well past graduation, both from afar and via long-distance travel.

This on-the-ground education and partnership often results in – or results from – long-term relationships established between the school and institutions abroad in which there are regular exchanges of support, a concept increasingly referred to as “twinning.”

In some cases, long-standing relationships between UCLA School of Public Health faculty and institutions abroad lead to a steady flow of students coming to the school to train; other times it works in the opposite direction. “Often, students will come here from abroad without any previous connection, establish a close bond with a faculty mentor, and those ties stimulate an institutional relationship once the student has returned to his or her home country,” says Dr. Gail Harrison, professor of community health sciences and head of UCLA’s Framework Program for Global Health, funded by the Fogarty International Center as part of a national initiative to build global health research capacity through multidisciplinary programs.

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2007 Alumni Hall of Fame inductee Michele Yehieli (M.P.H. ’89, Dr.P.H. ’95) began collaborating with Dr. Osman Galal, professor of community health sciences, when he was serving as her doctoral advisor at the UCLA School of Public Health more than a decade ago, and the two have continued to collaborate in their efforts to promote health care reforms globally. Their work together began during Yehieli’s doctoral thesis, which examined women’s health among Ethiopian immigrants to Israel; since Yehieli’s graduation it has been a long-distance collaboration, with Yehieli on the faculty at the University of Northern Iowa, where she is now an associate professor. In 1996 Yehieli started the University of Northern Iowa Global Health Corps, which has provided culturally appropriate public health programs for more than 40,000 diverse and underserved persons throughout the United States, Africa, Eastern Europe, Asia, and the Caribbean, and has become one of the nation’s best university-based programs promoting health among immigrant and refugee newcomers.

In the spring of 2001, Galal and Yehieli, with the help of the United Nations Association of the USA’s Southern California Division, launched a two-year global health initiative focusing on the fight against infectious diseases, particularly HIV/ AIDS, malaria, and tuberculosis. A conference on “Why Worry About World Health” was held to address the issues and threats of diseases that have no borders, and to discuss the problem of global health inequities. Galal and Yehieli later created the International Journal of Global Health and Health Disparities, and continue to consult with each other in reviewing articles submitted for publication.

19 of the school’s prestigious Korn Award, is now an assistant professor of nutrition and global health at George Mason University in Virginia who regularly collaborates with Neumann on research planning and papers.

Other institutional connections are established by students. In the last decade, students of the Executive Master of Public Health (EMPH) Program in Healthcare Management & Policy have engaged in a variety of international efforts for their applied field projects, ranging from medical missions to building public health infrastructures, and from evaluations of delivery systems to implementation of quality and process improvement programs. One example of the international work involves EMPH students of Dr. Fred Hagigi, associate professor of health services and director of executive education programs at the school, who have undertaken efforts to optimize value in health care for children in Laos (officially known as the Lao People’s Democratic Republic).

According to the United Nations, Laos is among the countries with the lowest indicators of socioeconomic development. Infant mortality is high, and neonatal diseases and infectious diseases such as pneumonia and diarrhea are major causes of death in children 5 and under. Last summer, EMPH students Dr. Anthony Chang, Leslie Rabbitt and

Astou Coly, M.P.H. ’01, Dr.P.H. ’05 (left), a postdoctoral scholar at the school, has been mentored by Dr. Pamina Gorbach, associate professor of epidemiology, as she helps to develop behavioral components for clinical trials in Africa of microbicides designed to prevent HIV.

UCLAPUBLIC HEALTH

Sometimes it is the faculty who establish institutional connections while conducting research overseas. Dr. Charlotte Neumann, professor of community health sciences, has long-term mentoring relationships with a number of former students, most of them from African countries. For more than a decade, Neumann headed influential studies in rural Kenya on the impact of malnutrition on the energy and cognitive abilities of Kenyan schoolchildren, and on the effect of an intervention to add small amounts of meat to the diet. Thanks to funding from Neumann’s research projects, as well as from the United Nations University, many of the projects’ Kenyan collaborators and employees have come to the UCLA School of Public Health for graduate training. Neumann continues to collaborate with and advise a number of them, as many as 20 years later, including several who now have faculty positions in Nairobi, Kenya.

A recent graduate originally from Kenya, Constance Gewa (M.P.H. ’03, Ph.D. ’07), a recipient last year

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UCLAPUBLIC HEALTH

Chomchay Siboliban worked with public health leaders and pediatricians in the capital of Laos, Vientiane, to analyze health care data in an effort to determine how best to allocate limited resources using a “tactical health care portfolio optimization model.” Follow-up visits to Laos were planned to provide training to health care professionals that addresses the needs of the country’s expanding young population.

This summer, Hagigi and four of his EMPH students – Dr. Shant Shekherdimian, Darya Friedman, Tyler Huynh, Heili Kim, and Catherine Vu – are traveling to Armenia to work with a privatized hospital in developing a comprehensive business plan

Under the guidance of Dr. Fred Hagigi, associate professor of health services, students in the school’s Executive M.P.H. Program in Healthcare Management & Policy are working with public health leaders and pediatricians in the Lao People’s Democratic Republic to optimize health care for children.

designed to reduce inefficiencies, increase financial viability, and produce evidence-based care with an emphasis on primary care and prevention. In the nearly two decades since Armenia declared its independence from the Soviet Union, it has struggled with its transformation to an industrialized, capitalist country, and newly privatized hospitals have had a difficult time remaining open. The trip

by Hagigi and his students is being facilitated by Dr. Haroutune K. Armenian, a new member of the school’s faculty who has a long tradition of working to tackle global issues such as the long-term population effects of civil war and natural disasters (see New Faculty on page 32).

Elsewhere in the school, Dr. Pamina Gorbach, associate professor of epidemiology, has forged a close mentoring relationship with Astou Coly (M.P.H. ’01, Dr.P.H. ’05), a postdoctoral scholar.

Coly has spent the last year working with Gorbach’s Behavioral Epidemiology Research Group helping to develop the behavioral components for clinical trials in Africa testing microbicides designed to prevent HIV, through the Microbicides Trials Network. She has been responsible for running field studies of the questionnaires to be used in the trials, and has traveled to Malawi and South Africa to conduct them.

Gorbach has trained Coly in how to conduct these pilot tests, as well as providing guidance and supervision during the process. One of their efforts is now in the field and has enrolled more than 300 women, while the other two will be implemented soon.

Dr. Zuo-Feng Zhang has been active in working with former students to build China’s cancer epidemiology capacity. Last year, Zhang helped to organize a one-day symposium in molecular epidemiology of cancer in Guangxi Province. In March, Zhang spearheaded “Cancer Prevention as a Global Health Challenge,” a workshop held in Shanghai as a collaboration between the UCLA/Fogarty AIDS International Training and Research Program and the Fudan University School of Public Health.

Zhang continues to work with five former UCLA School of Public Health trainees from China who have returned to their home country to bolster cancer epidemiology. In April, with Zhang fostering the collaboration, Dean Linda Rosenstock and Qingwu Jiang, dean of the Fudan University School of Public Health in China, signed a memorandum of understanding to formalize teaching and research partnership between the UCLA and Fudan schools of public health.

Dr Donald Morisky, professor of community health sciences, has ongoing collaborations with five alumni whom he advised while they were doctoral students, and who now hold academic appointments at leading universities in Taiwan. In 2006, Morisky spent his sabbatical in Taiwan and was invited by each of the UCLA School of Public Health alums to conduct seminars for their students and faculty colleagues, and to teach graduate students at Taipei Medical University (TMU). He gave a presentation to community health workers and held a seminar for health promotion staff on tobacco and the 2007 tobacco control policy. Morisky also has an ongoing collaboration with Shu-Yu Lyu (Ph.D. ’96), associate professor at TMU who, with her husband Dr. Eugene Y. Peng, represented TMU during a 2007 visit to UCLA in which they signed a memorandum

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LEFT: Dr. Donald Morisky (center), professor of community health sciences, was invited to Taiwan to hold seminars by former doctoral students who now hold academic appointments at leading universities there. BELOW, l. to r.: Morisky, Dean Linda Rosenstock, Dr. Eugene Y. Peng and Shu-Yu Lyu (Ph.D. ’96) at the signing of a memorandum of agreement between the school and Taipei Medical University.

of agreement with UCLA School of Public Health dean Linda Rosenstock for a faculty and student exchange and research collaboration.

“Often, students will come here from abroad without any previous connection, establish a close bond with a faculty mentor, and those ties stimulate an institutional relationship once the student has returned to his or her home country.”

—Dr. Gail Harrison UCLAPUBLIC HEALTH

Perhaps the most robust example of enduring mentorship involves the UCLA/ Fogarty AIDS International Training and Research Program (AITRP), under the leadership of Dr. Roger Detels. Since its establishment 20 years ago, the program has provided master’s- and doctoral-level training to more than 140 health professionals from developing countries, most of them in Asia, who learn basic epidemiology and other public health fundamentals that help prepare them to return to leadership positions at home. After the students complete their education at UCLA, they return to their native countries for their dissertation. Detels is in close contact with the students during all phases of the projects, and continues to collaborate with many of them long after the dissertation is complete, particularly those engaged in research. Other UCLA faculty members have tapped into the network of Fogarty alumni when implementing their own research programs in these developing countries.

“We’re building capacity in these countries,” says Detels. “We tend to work with specific institutions in a given country, with the idea that we’re putting together a critical mass of well-trained individuals. We’re also building a network of qualified researchers, many of whom assist each other across national borders.

And finally, the research we do with students and graduates is mostly policydriven, helping these countries confront the AIDS epidemic and promote public health.”

In Southeast Asia and China, the UCLA/Fogarty AITRP continues to result in fruitful relationships. One of the program’s graduates, Chuleeporn Jiraphongsa (Ph.D. ’00), is now in a key leadership position with the Thailand Ministry of Public Health, as head of the Field Epidemiology Training Program (FETP). Her group, which conducts outbreak investigations in Thailand with activities similar in scope to the Epidemic Intelligence Service of the U.S. Centers for Disease Control and Prevention, includes several Thai physicians who were also trained at UCLA through the Fogarty program. Last summer, Jiraphongsa invited Dr. Ralph Frerichs, professor of epidemiology at the UCLA School of Public Health, to conduct a one-week workshop for the Thailand Ministry of Public Health on rapid epidemiological surveys – small, two-stage cluster surveys

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Right: Dr. Ralph Frerichs (center) was invited by Chuleeporn Jiraphongsa (Ph.D. ’00), head of the Field Epidemiology Training Program at the Thailand Ministry of Public Health, to conduct a one-week workshop on rapid epidemiological surveys, which Frerichs (also pictured below) helped to pioneer. of approximately 300 people that usually take less than a month to complete.

Frerichs helped to pioneer the methodology, which enables decision-makers in developing countries to obtain quick answers to questions about the health status and activities of people in their communities.

Most of the 30 participants were from Thailand, but eight attended from other countries in the region, including China, Cambodia, Malaysia and Timor.

Frerichs anticipates that there will be more rapid survey workshops in the future, perhaps involving other countries. Jiraphongsa hopes to bring Frerichs in for more training sessions with the regional FETP programs starting next spring.

Many of Detels’ most active current collaborations are with former trainees in China and Vietnam. The research of Detels and his trainees played a role in getting the Chinese government to decide within the last three years to implement a vigorous response to the HIV/AIDS epidemic; now the country has an active anti-HIV program in which it has rapidly scaled up in areas such as HIV testing, needle exchange programs and methadone maintenance programs for IV drug users, as well as treatment. Detels is collaborating with several of his former students who are helping to evaluate the effectiveness of these programs.

One student recently completed his dissertation evaluating the impact of the rapid expansion of methadone maintenance clinics. A second recently completed a study of risk factors for HIV transmission among sex workers in Guangdong Province. Two others are in Shanghai studying women migrants within China, another high-risk group.

In Vietnam, the epidemic has been confined mostly to injection drug users, but is starting to spread into the commercial sex worker population and into the population of men who have sex with men. Thus, while Detels and his former Fogarty trainees are evaluating a community-led program to reduce the incidence of new drug users, they are also trying to identify characteristics of Vietnam’s two newly vulnerable populations with an eye toward the development of effective intervention programs.

When Detels isn’t circuit-riding through the collaborating countries, he’s in regular email contact with his former protégés – a pastime shared by many of the school’s faculty. “This is like having a large family,” Detels says.

“You develop a lot of very close relationships with amazing, highly committed individuals. To help them develop and to work with them in making a difference in their home countries has been fantastically rewarding.”

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research highlights Subsidies to Increase Affordability Make Fruits and Vegetables Appealing Option for Low-Income Women

Fruit and vegetable intake has been shown to protect against a host of common chronic diseases, but low income is associated with lower intake, in part because fresh produce is expensive.

UCLAPUBLIC HEALTH

PROVIDING ECONOMIC INCENTIVES for postpartum women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) to purchase fresh fruits and vegetables resulted in an increase in fruit and vegetable consumption that was sustained six months after the intervention ended, a UCLA School of Public Health study found.

The findings, published in the American Journal of Public Health, contributed to the recent decision by the U.S. Department of Agriculture (USDA) to revise the WIC food packages to include, for the first time in its 35-year-history, fruits, vegetables, and whole grains, among other changes. Agencies in California must implement the provisions no later than October of 2009.

“This change to the WIC program will affect the health of more than 8.5 million people nationwide by offering them access to fresh fruits and vegetables,” says Dr. Dena Herman, adjunct assistant professor at the school and lead author on the study, which also included Drs. Gail Harrison and Abdelmonem Afifi from the school and Eloise Jenks, executive director of the Public Health Foundation Enterprises WIC program. “This is particularly important in an era of rising food costs, given that fresh produce is among the most expensive items to buy.”

Fruit and vegetable intake has been shown to protect against a host of common chronic diseases, but low income is associated with lower intake, in part because fresh produce is expensive. A recent study by UC Davis researchers found that a low-income family would have to spend up to 70 percent of its food budget on fruits and vegetables to meet USDA dietary guidelines.

Strategies to promote the choice of fruits and vegetables in low-income populations by lowering their cost relative to those of alternative foods have gained attention, but little research had been done on the effect of such strategies. The UCLA School of Public Health study measured the impact of separate interventions involving redeemable food vouchers, one for a farmers’ market and one for a supermarket, in more than 600 women enrolled for postpartum services at three WIC sites in Los Angeles. Farmers’ market participants increased their fruit and vegetable intake by an average of 1.4 servings per 1,000 calories a day, and supermarket participants by 0.8 servings per 1,000 calories a day; moreover, both increases were sustained six months after the interventions ended.

Because the WIC program was developed in the early 1970s, when there was much less appreciation of the relationship of intake of fruits and vegetables to chronic disease risk, the supplemental foods originally selected were those that provided nutrients most limited in the diets of pregnant and breastfeeding women, infants, and children up to the age of 5 at that time: calcium, iron, and vitamins A and C, as well as protein. With the forthcoming changes, more than $500 million will be made available nationwide, and $80 million in California, to assist low-income women to buy produce.

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School Salad Bars Increase Fruit & Vegetable Intake Among Children in Low-Income Households

Mean Daily Total Fruit and Vegetable Serving Frequencies Preand Post-Salad Bar Intervention in Three LAUSD Elementary Schools

HAVING A SALAD BAR AS A SCHOOL-LUNCH MENU OPTION can significantly increase the frequency of fruit and vegetable consumption by elementary school children living in low-income households, according to a study led by Dr. Wendelin Slusser, a member of the faculty of the School of Public Health and David Geffen School of Medicine at UCLA. The U.S. Department of Agriculture (USDA) has reported that only 36.4 percent of U.S. children ages 2-19 eat the recommended three to five servings of vegetables per day, and only 26 percent of children eat the two to four recommended daily servings of fruit.

The study, which included 337 second- through fifth-grade children in three low-income Los Angeles Unified School District (LAUSD) elementary schools participating in the USDA’s reimbursable lunch program, found a significant increase in the average intake of fruits and vegetables among these children. The findings were published in the journal Public Health Nutrition.

Prior to the intervention, which began in 1998, the children averaged 2.97 daily serving frequencies of fruits and vegetables; two years after the salad bar was added to the menu, they consumed an average of 4.09 daily serving frequencies. In addition, mean daily intakes of energy, cholesterol, saturated fat and total fat were significantly lower in the children after the salad bar was introduced in the schools compared with the intakes in the children before the salad bar was introduced.

“One of the major contributing factors to the high rate of overweight children in the United States is that they do not consume the daily recommended servings of fruits and vegetables,” says Slusser.

“Increasing the availability and accessibility to healthy foods is one way to improve children’s diets.

In turn, this sets up opportunities for kids to have repeated exposure to healthy food and positively impact their choices.”

The salad bar study was offered in conjunction with a nutrition educational component, including a school assembly to teach children about the proper etiquette of serving themselves salad and picking a well-balanced lunch, an artwork project, and visits to farmers’ markets or a farm.

UCLAPUBLIC HEALTH

NSAIDs May Reduce Risk of Parkinson’s Disease REGULAR USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) may reduce a person’s risk of Parkinson’s disease, according to findings reported in the journal Neurology by Drs. Angelika Wahner and Beate Ritz, both of the UCLA School of Public Health’s Department of Epidemiology.

The UCLA team reported that the use of common over-the-counter pain medications such as ibuprofen may reduce risk of Parkinson’s by as much as 60 percent. Women who regularly used aspirin lowered their risk of the disease by 40 percent, especially when duration of use was more than two years; men who used aspirin did not reduce their risk.

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The findings are supported by accumulating evidence of the role that inflammation in brain tissue plays in Parkinson’s. As part of the disease, patients lose brain cells that produce dopamine, an important chemical messenger. The death of these cells triggers an inflammatory response. Although the inflammatory response is in some ways a protective mechanism against injury to cells, it can also result in the injury and death of more dopamine-producing brain cells.

Because NSAIDs have anti-inflammatory effects and may be able to halt or slow the neuroinflammatory process in the brain, Ritz notes, they could reduce brain-cell death if taken during a relevant time period, and have some therapeutic value in the prevention or treatment of Parkinson’s disease. “If a person were taking NSAIDs at the time this process began,” she explains, “the drugs might dampen overactive immune responses and stop the vicious cycle leading to Parkinson’s disease.”

Further research, including clinical trials, is needed to determine if NSAIDs can prevent neurodegeneration in Parkinson’s and other neurodegenerative diseases. Doctors and patients should also be aware that NSAIDs are known to have serious side effects such as gastrointestinal bleeding and increased risk of heart attacks in high-risk individuals, Wahner notes. “Careful consideration of the potential costs and benefits of NSAID use is necessary,” she says. ”Until we know more, NSAID or aspirin use should not be recommended to patients for the prevention or treatment of Parkinson’s disease.”

Pre-diagnosis medication use is one of the many risk and/or protective factors being studied by Ritz’s UCLA Parkinson’s Environment and Gene (PEG) study in an effort to better understand the epidemiology of Parkinson’s disease. PEG is a populationbased case-control study that has enrolled nearly 1,000 newly diagnosed Parkinson’s patients, siblings and population controls in three rural Central California counties since 2001.

Because NSAIDs may be able to halt or slow the neuroinflammatory process in the brain, they could reduce brain-cell death if taken during a relevant time period, and have some therapeutic value in the prevention or treatment of Parkinson’s.

Undocumented Latinos Visit Physicians Less Often Than U.S.-Born Counterparts

UCLAPUBLIC HEALTH

UNDOCUMENTED MEXICANS AND OTHER UNDOCUMENTED LATINOS report less use of health care and poorer experiences with the health care system compared with their counterparts who were born in the United States and U.S.-born non-Latino whites, according to a UCLA School of Public Health study led by Dr. Alex Ortega, associate professor of health services at the school, and published in the journal Archives of Internal Medicine.

An estimated 8.4 million of the 10.3 million undocumented individuals in the United States are Latino, including 5.9 million from Mexico. “One recurrent theme in the debate over immigration has been the use of public services, including health care,” Ortega’s group notes. “Proponents of restrictive policies have argued that immigrants overuse services, placing an unreasonable burden on the public. Despite a scarcity of well-designed research into these questions regarding immigrants, use of resources continues to be a part of the public debate.”

Ortega and colleagues analyzed data from the 2003 California Health Interview Survey – one of the largest health surveys in the nation, conducted every two years by the UCLA Center for Health Policy Research, which is based in the School of Public Health. Their conclusion: “Low rates of use of health care services by

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Mean Number of Physician Visits in Past Year by Race/Ethnicity and Citizen/Documentation Status

Mexican immigrants and similar trends among other Latinos do not support public concern about immigrants’ overuse of the health care system.” Among the group’s specific findings: ■ Undocumented Mexicans had 1.6 fewer physician visits in the previous year than Mexicans born in the United States, while other undocumented Latinos had 2.1 fewer physician visits than their U.S.-born counterparts.

■ Undocumented Mexicans were less likely to have a usual source of care and were more likely to report negative experiences than Mexicans born in the United States.

■ Patterns of access to and use of health care services tended to improve when legal status changed from undocumented to green card or naturalized citizens.

■ Undocumented Latinos reported less difficulty obtaining necessary health care than U.S.-born Latinos. This seemingly counterintuitive finding could have occurred because this population is less likely to seek care than U.S.-born Latinos or because the U.S. health care system compares favorably to the systems in their home countries, the authors noted.

The results have implications for addressing health care disparities. “For example, worse health care experiences for undocumented Mexicans imply that efforts to improve processes of care need to address this specific vulnerable group,” the authors argue. “Strategies to improve the delivery of health care services to legally authorized immigrants and U.S. citizens, to the exclusion of undocumented individuals, will likely miss an opportunity to influence health care for the individuals most affected by inequities in health care access.”

UCLAPUBLIC HEALTH

Half of Pathology Reports Following Prostate Cancer Surgery Are Incomplete FOR AS MANY AS HALF OF PATIENTS undergoing surgery for localized prostate cancer in the United States, pathology reports are missing clinically important information, according to an analysis of a large, nationally representative sample of men who underwent the radical prostatectomy procedure.

In its 2005 report, Assessing the Quality of Cancer Care, the Institute of Medicine underscored the critical importance of accurate surgical pathology reports following radical prostatectomy for men with prostate cancer. Five years earlier, the College of American Pathologists’ Cancer Committee had endorsed a series of seven prognostic parameters that a high-quality radical prostatectomy pathology report should contain, including key factors such as the Gleason score (a prognostic indicator of the tumor’s aggressiveness); tumor size; surgical margin status; and the pathologic tumor, lymph node, metastases (TNM) stage according to the American Joint Committee on Cancer classification.

Seeking to determine whether pathologists across the United States conformed to the recommendations of their society, a team of researchers led by Dr. Mark S. Litwin, professor of health services in the UCLA School of Public Health and urology in the David Geffen School of Medicine at UCLA, and Dr. David Miller, a fellow in the Department of Urology, examined the completeness of a nationally representative sample of 1,240 surgical pathology reports drawn from 2000 to 2001. They found that compliance with quality indicators varied from 42 percent to 97 percent, depending on the indicator in question. The findings were reported in the journal Cancer.

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“While almost all the pathology reports included the tumor’s Gleason score and an indication of whether the surgical margins were clear, only three-fourths indicated whether the tumor invaded the prostate’s outer capsule; just over half included the TNM stage, an internationally recognized standard indication of tumor extent; and fewer than half reported the tumor size,” Litwin notes.

Standardized reporting has the potential to improve the reliability of pathologic data and, in turn, both the quality of clinical care and the validity of epidemiologic research in prostate cancer and other malignancies, Litwin adds.

Concludes Miller: “Based on our findings, the consequent inference is that enhanced communication and improved documentation may be fruitful targets for quality-improvement endeavors in the surgical management of men with prostate cancer.”

Black Art an Effective Incentive for Increasing African American Enrollment in Studies

The increased enrollment and survey return rates where the art incentive was offered, despite the relatively low rate of participants selecting the posters over the $10, suggests that the art influenced participation by creating a more culturally inclusive image for the study.

UCLAPUBLIC HEALTH

BLACK ART POSTERS may be able to serve as an effective low-cost incentive to address problems of low African American enrollment in large public health studies, research led by Dr. Antronette (Toni) Yancey, professor and co-director of the school’s Center to Eliminate Health Disparities, has found. Results of the study were published in the journal Preventive Medicine.

African Americans fare worse than many other populations on a number of key measures of health, and often the underlying causes of these disparities and/or how best to address them is not clear. “Under-representation of African Americans in public health research contributes to a lack of understanding of health disparities, and a paucity of culturally relevant solutions,” Yancey notes. “Larger numbers of participants among any ethnic group can enable researchers to capture disparities that wouldn’t necessarily be visible at the aggregate level in surveillance of an entire ethnic community, and to conduct the type of ethnic-specific subgroup analyses needed to design more effective intervention studies.”

Yancey conducted her research in conjunction with the Adventist Health Study, a National Cancer Institute-funded cohort study that had been struggling to approach its goal of recruiting 35,000 black participants at Adventist churches despite culturally targeted recruitment efforts. Aiming to improve enrollment and questionnaire return rates among black Adventists, Yancey’s group offered black art posters as either an alternative or in addition to the established $10 incentive.

When a choice was offered, the posters were selected over the monetary incentive by only 9.3 percent of the study participants returning questionnaires; when both the posters and the $10 were offered, half of the participants chose to take a poster.

Most significantly, questionnaire return rates were higher for the intervention churches (58 percent) than for the churches where the posters weren’t offered (40 percent). The rates of enrollment in the study were also significantly higher at churches that offered both the posters and the $10 than in churches where the art incentive wasn’t used.

The increased enrollment and survey return rates at black Adventist churches where the art incentive was offered, despite the relatively low rate of participants selecting the posters over the $10, suggests that the art influenced participation indirectly, by creating a more culturally inclusive image for the study, Yancey concludes.

“The initial cost of developing and promoting the art incentive, including duplication costs for posters, promotional fliers, and color ordering labels, was less than $10,000,” Yancey notes. “Although more rigorous evaluation of this recruitment strategy is needed, it appears that provision of incentives reflecting the cultural values of prospective participants is a cost-effective way of addressing a serious and longstanding challenge to public health research.”

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student profiles Yearning to “Get out and Make a Difference”

“I’ve followed my heart and I have no regrets. The cubicle life is definitely not for me – I’m constantly screaming to get out and make a difference.”

UCLAPUBLIC HEALTH

— Portia Jackson

PORTIA JACKSON DESCRIBES HERSELF as possessing an entrepreneurial spirit.

“Even within public health, I’m constantly challenging myself to reach for the opportunities that best reflect me,” says Jackson, who recently completed her first year of Dr.P.H. studies at the UCLA School of Public Health.

After completing her M.P.H. education at the University of Michigan, Jackson spent two years as a public health analyst with the Centers for Disease Control and Prevention as part of its Emerging Leaders Program. The experience, in which she rotated through half a dozen offices, whetted her appetite for public health practice but also showed her the difficulty many public health infrastructure programs have in obtaining sufficient funding. In embarking on her doctorate, one of Jackson’s goals is to explore ways in which public-private partnerships might be able to help fill some of these funding gaps. “There are a lot of corporations seeking to engage in socially responsible work but lacking the knowledge capital, and a lot of nonprofit organizations that have the right goals but lack the funding,” she says.

Jackson is also interested in helping philanthropic foundations and corporations develop health and educational programs that effectively address gaps in the local infrastructure. Since arriving at UCLA, she has been working for the UCLA/Johnson & Johnson Health Care Institute, based at the Anderson School of Management, to develop curricula on diabetes awareness, physical activity, and nutrition and use it to train Head Start directors who will disseminate the information to parents. Jackson plans to focus her dissertation on the impact of the curriculum on health and knowledge outcomes for parents and children.

The Head Start project has special significance for Jackson, who has seen several family members suffer and die from the complications of diabetes. It was the realization that this is a problem better addressed at the public health level that led to her decision, while an undergraduate at Stanford, to move away from pre-med studies and consider a public health career. Jackson, who was majoring in anthropology, had become fascinated by how beliefs, cultures, and environments shape people’s health practices and outcomes. She did a project on African American women living with sarcoidosis, a rare auto-immune disorder, and in getting to know women with the disease, found that their experience was about much more than the pathology.

“It was something that completely reshaped their lives,” Jackson says. “At that point, the landscape of health became much more than just the practice of medicine to me.” She also began to see her own family’s experience through a different lens.

“I concluded that prevention has to be a bigger focus – it’s too hard to wait until someone already has the illness,” she says.

Since deciding public health was for her, Jackson has been tireless in pursuing one opportunity after another to gain experience. “I’ve followed my heart and I have no regrets,” she says. “I’ve lived and worked in Chile twice, developed laboratory management programs in Honduras, worked with the state health department in Puerto Rico…my opportunities for impact have been incredible already. The cubicle life is definitely not for me – I’m constantly screaming to get out and make a difference.”

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From Clinical Practice to a Big-Picture Approach to Tackling Thailand’s Health Problems

“There were more patients coming in every day, every month, every year. As a clinician, I was helping them one by one, but it didn’t seem to make a difference in the population.”

— Panithee Thammawijaya

UCLAPUBLIC HEALTH

AFTER FIVE YEARS OF CLINICAL PRACTICE in rural Thailand – the last two as director of a community hospital in Chiang Rai Province, the country’s northernmost region – PANITHEE THAMMAWIJAYA was growing frustrated.

The province, heavily populated by refugees from bordering Myanmar and the Lao People’s Democratic Republic, was plagued by a poor hygienic environment, contributing to an endemic problem with infectious diseases such as HIV/AIDS. Although most of his friends were content to continue treating patients, Thammawijaya concluded that he could make more of an impact in public health.

“There were more patients coming in every day, every month, every year,” he says. “As a clinician, I was helping them one by one, but it didn’t seem to make a difference in the population. I realized it would be more effective to prevent people from getting a disease, and that being an epidemiologist – the backbone of public health – was a way I could do that.”

So Thammawijaya went through the two-year Field Epidemiology Training Program (FETP) at the Thailand Ministry of Public Health, then stayed on to work in the ministry’s Bureau of Epidemiology as a medical epidemiologist and FETP faculty member. In 2007, after a year in that position, he received a scholarship to further his education at the UCLA/Fogarty AIDS International Training and Research (AITRP) Program under the leadership of Dr. Roger Detels, professor of epidemiology at the School of Public Health.

The UCLA/Fogarty AITRP helps to build capacity at key institutions leading the fight against the HIV/AIDS epidemic in a number of Asian countries, including Thailand. The FETP, which conducts outbreak investigations in Thailand with a scope similar to the Epidemic Intelligence Service of the U.S. Centers for Disease Control and Prevention and also helps to train others in the region, includes several senior members who are UCLA/Fogarty alumni. “In addition to my own work as a medical epidemiologist I am training medical doctors from my country and from Lao, Cambodia, Vietnam and Indonesia,” Thammawijaya says. “I need the best epidemiological knowledge to do that, and that’s why I chose to come to UCLA.” Thailand was an important success story in the fight against HIV/AIDS, having responded swiftly at the outset of the epidemic to establish an early-warning “sentinel surveillance” system (with assistance from Detels and one of his former trainees) and implementing bold strategies such as requiring brothels to ensure condom use by every client. But the characteristics of the epidemic have changed over the last decade. “Ten years ago it was mostly confined to men who have sex with men and commercial sex workers, but now other parts of the population are getting infected, which makes our work more challenging,” says Thammawijaya.

Thailand is also dealing with emerging infectious diseases at the same time that old ones such as tuberculosis and malaria continue to cause havoc, and chronic health problems such as cardiovascular disease and obesity grow in severity.

Thammawijaya looks forward to returning to the FETP to apply the knowledge he is gaining at the school toward tackling these and other concerns. “We are very fortunate in our region to have the opportunity to study with Dr. Detels and the UCLA program,” he says. “It is making a big difference in our work.”

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2007-08 student awards Hagigi Fellowship in Health Services Finance and Management

Abdelmonem A. Afifi Student Fellowship Jocelyn Chen Community Health Sciences

Eric A. Morley Health Services

Agency for Healthcare Research and Quality Fellowship Catherine Acquah Emily Barrett Tanya Bentley Kannika Damrongplasit Michelle Ko Erum Nadeem Jeroen Van Meijgaard Roy Wada Health Services

Atlantic Richfield Company Fellowship Erica Halchak Tamanna Rahman Yelena Rivina Shirin Sadrpour Sayaka Takaku Environmental Health Sciences

Areta Luu Eric A. Morley Carissa Yung Health Services

Carolbeth Korn Prize Geoffrey Hoffman Health Services

CAROLBETH KORN PRIZE — Geoffrey Hoffman received the prestigious Carolbeth Korn Prize, given annually to the UCLA School of Public Health’s most outstanding graduating student.

Chancellor’s Prize Adam Jeffrey King Biostatistics Sherry Parrisa Solaimani Molecular Toxicology

Todd Bear Environmental Science and Engineering

Dean's Outstanding Student Award

Baer’s MCH Training Grant

Wenhua Hu Biostatistics

Nelida Duran Community Health Sciences

Beverlee Myers Fellowship Shana Alex Lavarreda Health Services

Joseph and Celia Blann Fellowship Janet Cummings Health Services Dhanalakshmi Thirumulai Epidemiology

The California Endowment Taureen Snow Biostatistics Jennifer Garcia Elvira Jimenez Community Health Sciences Khadeeja Abdullah Environmental Health Sciences Marie Sharp Epidemiology Portia A. Jackson Health Services

California Wellness Foundation Scholarships Molina Lourdes Epidemiology UCLAPUBLIC HEALTH

Health Services Alumni Association Scholarship

Erin Peckham Ximena Vergara Epidemiology

Chancellor’s Fellowship Jo Kay Ghosh Epidemiology

Anna-Loube Aaronson Community Health Sciences

William and Flora Hewlett Foundation Environmental Science and Engineering Program Stephen Estes Jane Curren Un Sam Ha Marc Philibert Alex Revchuk Victor Vasquez Environmental Science and Engineering

Khadeeja Abdullah Environmental Health Sciences

FLAS East Asian Studies Fellowship

Matt Wise Epidemiology

Melissa Withers Community Health Sciences

Anthony Chang Health Services

Foley and Lardner Fellowship in Health Services

Eleanor J. De Benedictis Fellowship in Nutrition

Dr. Ursula Mandel Scholarship Shana A. Lavarreda Health Services

Ann G. Quealy Memorial Fellowship in Health Services Jennifer Bastian Rachelle LaPointe Health Services

Quality in Graduate Education Shonali Choudhury Gergana Kodjebacheva Lourdes Molina Pamela Stoddard Community Health Sciences

Eugene Cota Robles Fellowship Angie Otiniano Community Health Sciences Demian Willette Environmental Health Sciences

Jennifer Bastian Justin Henderson Health Services

Nicole Ashley Terrell Sherry Parrisa Solaimani Molecular Toxicology

Raymond D. Goodman Scholarship

Victor Vasquez Environmental Health Sciences

Dissertation Year Fellowship

Sheena Sullivan Epidemiology

Wenhua Hu Xia Huang Biostatistics

Lily Altstein Biostatistics

Ruth Roemer Award in Social Justice

Maria Koleilat Loan Pham Kim Maria Pia Chaporro Community Health Sciences

Amy Carroll Laura Chyu Gabriel Garcia Community Health Sciences

Environmental Science and Engineering Program Endowment Calvin Kwan Environmental Health Sciences

Max Factor Family Foundation June Lim Community Health Sciences

Graduate Opportunity Fellowship Daniel Trong Hien Nguyen Biostatistics Uchechi Acholonu Briana Anisko Alike Wise Community Health Sciences

Graduate Research Mentorship Program Award Andrew Barnes Neetu Chawla Shana A. Lavarreda Tiffany P. Quock Health Services

Kelly Whitener Health Services

Milton and Ruth Roemer Fellowship in Health Services Gary Chovnick Nell J. Marshall Health Services

Monica Salinas Internship Fund in Latino and Latin American Health Courtney Burks Community Health Sciences

Charles F. Scott Fellowship Shana A. Lavarreda Health Services

Juneal Marie Smith Fellowship in International Nutrition Maria Koleilat Community Health Sciences

Wayne SooHoo Memorial Scholarship Robin Jeffries Biostatistics

Samuel J. Tibbitts Fellowship Jane Curren Environmental Health Sciences

SIB Training Grant in Integrative Biology and Mathematics Jennifer Aileen Tom Biostatistics

Toxic Substances Research and Training Program Fellowship Sudheer Beedanagari Sharah Kobylewski Shareef Nahas Aya Westbrook Lynn Yamamoto Molecular Toxicology

UCLA Affiliates Special Fellowship Pamela Stoddard Community Health Sciences Janet R. Cummings Health Services

UCLA Competitive Edge Nicole Ashley Terrell Molecular Toxicology

United States EPA Fellowship Meg Krudysz Environmental Health Sciences

Ursula Mandel Special Fellowships Suzanne Spear Community Health Sciences

Wilshire Foundation Endowment in Geriatric Medicine and Long Term Care Eric Morley Health Services Jocelyn Chen Rebecca Beattie Sophia Chen Community Health Sciences

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faculty honors DR. CAROL ANESHENSEL is the 2008 recipient of the Leo G. Reeder Award for Distinguished Contributions to Medical Sociology from the American Sociological Association. Leo G. Reeder was a member of the UCLA School of Public Health faculty at the time of his death in 1978.

DR. ALINA DORIAN was awarded the Medal of Gratitude from the president of the Nagorno Karabakh Republic for her public health leadership in a country that was decimated by war after declaring its independence from the former Soviet Union. The award is the highest civilian honor conferred by the government.

DR. JONATHAN FIELDING was named by Secretary of Health and Human Services Michael Levitt to chair the National Advisory Panel on the Nation’s Objectives for 2020. He was also named to the Public Health Advisory Committee of the California Department of Public Health, along with fellow faculty member DR. ANTRONETTE (TONI) YANCEY.

bookshelf

faculty

DR. EMILY ABEL received the Viseltear Award for outstanding book on the history of public health given annually by the Medical Care Section of the American Public Health Association. Abel’s book is entitled Tuberculosis and the Politics of Exclusion (see Bookshelf on this page).

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...recent books by UCLA School of Public Health authors

Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles,

by Emily K. Abel. Rutgers University Press.

Abel shows how the association of tuberculosis in Los Angeles with “tramps” during the 1880s and 1890s and Dust Bowl refugees during the 1930s provoked exclusionary measures against both groups. In addition, public health officials sought not only to restrict the entry of Mexicans (the majority of immigrants) during the 1920s but also to expel them during the 1930s. The book provides a critical lens through which to view both the contemporary debate about immigration and the U.S. response to the emergent global tuberculosis epidemic.

DR. GILBERT GEE received a Scientific and Technological Achievement Award from the U.S. Environmental Protection Agency for two 2007 papers.

DR. FRED HAGIGI received the 2007 Distinguished Lecturer Award from the UCLA Academic Senate Committee on Teaching. The award was one of three given for the campus in honor of excellence in teaching.

DR. VICKIE MAYS was elected to the American Psychological Association’s Board of Scientific Affairs and appointed to the Harvard School of Public Health Visitors Committee.

DR. JACK NEEDLEMAN was named an honorary Fellow of the American Academy of Nursing for the contribution of his research to understanding the impact of nurses on quality of care and the economics of nursing.

DR. CHARLOTTE NEUMANN received the UCLA James S. Coleman African Studies Center Honor for 40 years of teaching, research, and public service.

THOMAS PRISELAC received the National Healthcare Leadership Award from the National Center for Healthcare Leadership.

DR. LINDA ROSENSTOCK was appointed senior advisor for the X PRIZE Foundation’s Health and Healthcare Prize. She serves as president of the Society of Medical Administrators and is chair-elect of the Association of Schools of Public Health.

DR. ELIZABETH YANO received the VA Health Services Research & Development Research Career Scientist Award for accomplishments in research, mentorship and service.

UCLAPUBLIC HEALTH

DR. WENDELIN SLUSSER received the Beverlee A. Myers Award for Excellence in Public Health from the California Department of Public Health and the Department of Health Care Services.

DISTINGUISHED TEACHING AWARD — Dr. Abdelmonem A. Afifi, professor and dean emeritus, was the recipient of the inaugural Dean’s Distinguished Teaching Award in May. The award was created to recognize the best of the school’s faculty educators and was presented at the school’s annual 2008 Honors and Awards Reception. Afifi has been an integral part of the UCLA School of Public Health since 1965 – as a member of the biostatistics faculty, a department chair, and dean of the school from 1985 to 2000. He teaches courses in biostatistics to public health students and clinical research physicians, and doctorallevel courses in multivariate statistics and multilevel modeling. He has authored numerous publications, including two widely used books on multivariate analysis; has lectured around the globe; and has been honored by numerous national and international organizations.

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faculty

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new faculty DR. HAROUTUNE K. ARMENIAN has joined the UCLA School of Public Health faculty as professor in the Department of Epidemiology. Armenian was among the first to apply epidemiologic methods to study effects of civil war at the population level during the 1980s in Lebanon, and to study the long-term effects of an earthquake in Armenia during the 1990s, using casecontrol and cohort approaches. His most recent research includes the study of cancer within the multicenter AIDS cohort program and the study of psychopathology as a determinant of physical illness. He is president of the American University of Armenia and former director of the Master of Public Health Program at Johns Hopkins University School of Hygiene and Public Health. Armenian received his M.D. from the American University of Beirut School of Medicine, and his M.P.H. and Dr.P.H. from Johns Hopkins.

DR. LILLIAN GELBERG, UCLA professor of family medicine, has joined the faculty as a professor in the Department of Health Services. As one of the nation’s leading researchers on access and quality of care for homeless and vulnerable populations, she examines both the physical and mental health needs of Los Angeles County’s impoverished residents by using sophisticated statistical techniques along with innovative interviewing strategies.

UCLAPUBLIC HEALTH

DR. DINESH KHANNA has joined the faculty as assistant adjunct professor in the Department of Health Services. Khanna’s research focus is in assessment of health utilities in patients with arthritis, with a goal of understanding patients’ decision-making and incorporation of health utilities in large arthritis-related clinical trials. He is also assistant clinical professor of medicine and director of the UCLA Scleroderma Clinic.

DR. LISA RUBENSTEIN, a UCLA professor of internal medicine, has joined the faculty as a professor in the Department of Health Services. As director of the VA Health Services Research & Development Center of Excellence for the Study of Healthcare Provider Behavior and a practicing general internist and geriatrician, Rubenstein focuses on improving quality of care and patient quality of life.

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news briefs salon series prepares for second year The UCLA School of Public Health-sponsored salon series “Healthy Futures,” launched last fall, has brought dozens of the school’s faculty members, alumni, donors and friends together in intimate settings across Southern California for focused discussions on today’s leading public health issues.

The first year has featured discussions on cancer survivorship with Dr. Patricia Ganz, on the cost of health care with Drs. Gerald Kominski and Jack Needleman, and on stopping the next pandemic before it starts with Drs. Nathan Wolfe and Hilary Godwin.

The school is currently planning Healthy Futures salons for the 2008-09 academic year, beginning with a lunchtime event in September that will address the nation’s looming public health workforce crisis.

Anyone with suggestions for topics or who wishes to be included on the invitation list is encouraged to contact the Alumni Affairs and Development office at (310) 825-6464 or email Cheryl Difatta at cdifatta@support.ucla.edu.

sph invited to beijing forum Dr. Linda Rosenstock, dean of the UCLA School of Public Health, was invited to present on a panel on Diversity of Population Development and Health Security at the Beijing Forum, an annual international meeting in China, hosted by the public and private sectors to advance solutions to complex global issues.

Rosenstock’s presentation addressed the lack of investment in population health around the world, the increase in obesity and diabetes-related diseases, and the occupational hazards faced by the world’s 2.7 billion workers. She emphasized the need for increased efforts to prevent disease and disability, promote healthy environments and behaviors, and ensure the availability of high-quality, cost-effective health care in order to improve the health of millions at a time, rather than just one at a time.

DISTINGUISHED SCHOLAR LECTURE — Dr. Roger Detels was selected to deliver the school’s first Dean’s Distinguished Scholar Lecture in April, kicking off a new lecture series highlighting the work of distinguished faculty. Detels, dean emeritus and professor of epidemiology, began research in 1981 that evolved into the Multicenter AIDS Cohort Study, the longestrunning study of HIV. He has generated more than $100 million in grants since 1970 and has published more than 350 research articles. He is senior editor of the Oxford Textbook of Public Health.

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godwin new associate dean

COMMUNITY PARTNERSHIP AWARD — Dr. Marjorie KagawaSinger, professor of community health sciences at the school, received the Ann C. Rosenfield Distinguished Community Partnership Prize from the UCLA Center for Community Partnerships.

The campus-wide award recognizes Kagawa-Singer’s collaboration with Families in Good Health-St. Mary’s Medical Center to promote, through research and advocacy, early cancer screening among underrepresented Asian communities.

clark joins sph as asst. dean Dave Clark has joined the School of Public Health as assistant dean for student affairs. As the newest member of the school’s leadership team, Clark is responsible for overseeing the central student services office, including recruitment, admissions, graduate advising, retention and career services. Clark brings 14 years of experience in student affairs and college administration. He was formerly the dean of students at Pitzer College, a member of the Claremont College Consortium, where he provided leadership for the entire college’s student affairs division and the interface with sister institutions.

DID YOU KNOW?

news briefs

BRESLOW LECTURE — Paul Krugman, professor of economics and international affairs at Princeton University and an op-ed columnist for The New York Times, was the speaker at the 34th Annual Lester Breslow Distinguished Lecture. Krugman spoke on "Prospects for Universal Health Care" and also touched on 2008 presidential politics. The Washington Monthly called Krugman "the most important political columnist in America" and The Economist has heralded him as "the most celebrated economist of his generation."

Dr. Hilary Godwin, professor and chair of the school’s Department of Environmental Health Sciences, will become associate dean for academic programs effective July 1.

She replaces Dr. Gerald Kominski, who steps down after seven years to devote increased time to his research and return full time to the Department of Health Services.

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You are a lifetime member of the UCLA School of Public Health Alumni Association if you are a graduate of the UCLA School of Public Health and its executive programs.

If you would like more information about the activities of the Public Health Alumni Association, please call (310) 825-6464 or e-mail phaa@support.ucla.edu.

S AV E T H E D AT E UCLA SCHOOL OF PUBLIC HEALTH ALUMNI AND FRIENDS RECEPTION

During the Annual Meeting of the American Public Health Association, October 25-29, in San Diego Check the APHA schedule or stop by the UCLA School of Public Health booth for location information.

LOUIS VUITTON BENEFIT — Dean Linda Rosenstock (second from left) joins members of the Entertainment Industry Task Force (EITF) at a luncheon benefiting the school at the Louis Vuitton store in Beverly Hills. EITF members, from left, include Wendy Goldberg, Lynda Resnick, Hillary Mendelsohn, Cynthia Sikes Yorkin, Irena Medavoy and Cindy Horn. Sikes Yorkin and Horn also serve on the school’s Dean’s Advisory Board.

UCLAPUBLIC HEALTH

MONDAY, OCTOBER 27, 2008 6:30 – 8:00 pm Manchester Hyatt, Manchester Ballroom B

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alumni hall of fame: the 2008 inductees The UCLA School of Public Health Alumni Hall of Fame PREVIOUS INDUCTEES

was established in 2002 to honor alumni

Ira R. Alpert, M.S.P.H. ’66 Wendy Arnold, M.P.H. ’82 Stanley P. Azen, Ph.D. ’69 Donna Bell Sanders, M.P.H. ’81 Diana M. Bontá, R.N., M.P.H. ’75, Dr.P.H. ’92 Linda Burhansstipanov, Dr.P.H. ’74, M.P.H. ’72 Virginia A. Clark, Ph.D. ’63 Francine M. Coeytaux, M.P.H. ’82 Suzanne E. Dandoy, M.D., M.P.H. ’63 Paula Diehr, M.S. ’67, Ph.D. ’70 Mark Gold, D.Env. ’94 Harold M. Goldstein, M.S.P.H. ’89, Dr.P.H. ’97 Raymond D. Goodman, M.D., M.P.H. ’72 Richard A. Goodman, M.D., J.D., M.P.H. ’83 Nancy Halpern Ibrahim, M.P.H. ’93 Carolyn F. Katzin, M.S.P.H. ’88, C.N.S. Robert J. Kim-Farley, M.D., M.P.H. ’75 Kenneth W. Kizer, M.D., M.P.H. ’76 James W. LeDuc, Ph.D. ’77, M.S.P.H. ’72 Stanley Lemeshow, Ph.D. ’76 Angela E. Oh, J.D., M.P.H. ’81 Jean Le Cerf Richardson, M.P.H. ’71, Dr.P.H. ’80 Keith S. Richman, M.D., M.P.H. ’83 Pauline M. Vaillancourt Rosenau, Ph.D., M.P.H. ’92 Jessie L. Sherrod, M.D., M.P.H. ’80 Irwin J. Shorr, M.P.H. ’72, M.P.S. Stephen M. Shortell, M.P.H. ’68, Ph.D. Shiing-Jer Twu, M.D., M.P.H., Ph.D. ’91 Barry R. Wallerstein, D.Env ’88 Kenneth B. Wells, M.D., M.P.H. ’80 Zunyou Wu, M.D., Ph.D. ’95, M.P.H. ’92 Michele Yehieli, M.P.H. ’89, Dr.P.H. ’95

with outstanding career accomplishments in public health, as well as those who have volunteered time and talent in their communities in support of public health activities.

The 2008 inductees, recognized at the Breslow Lecture and Dinner on March 25, exemplify the school’s commitment to teaching, research and service.

BETSY FOXMAN

LINDA M. YU BIEN

BETSY FOXMAN, M.S.P.H. ’80, PH.D. ’83 For the last 21 years, Foxman has been at the University of Michigan, where she serves as professor of epidemiology and director of the Center for Molecular and Clinical Epidemiology of Infectious Diseases, and of the Interdisciplinary Training Program in Infectious Diseases. She is also editor-in-chief of the journal Interdisciplinary Perspectives on Infectious Diseases and a fellow of the Infectious Disease Society of America and of the American College of Epidemiology.

LINDA M. YU BIEN, M.S.P.H. ’79 Linda Yu Bien was inducted posthumously after she unexpectedly passed away on February 17 during a family vacation. A woman of extraordinary accomplishments, she was the chief executive officer of North East Medical Services (NEMS), a community health center with several clinics in San Francisco. Her tenure at NEMS lasted for 28 years. Dr. Joseph Wu, medical director at NEMS, accepted the award on behalf of her husband of 25 years, Alan Bien, and their sons Paul and Christopher.

UCLAPUBLIC HEALTH

Please access information on 2009 nominations at www.ph.ucla.edu/alumni_hall.html or call (310) 825-6464.

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honor roll 2007

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friends

THE UCLA SCHOOL OF PUBLIC HEALTH IS PLEASED TO HONOR our alumni, friends, students, staff, and foundation and corporate partners whose generosity strengthens our School and keeps us at the forefront of public health education. This Honor Roll gratefully acknowledges gifts and private grants made to the School from January 1, 2007, to December 31, 2007. Although space limitations allow only the listing of donations of $100 or more, contributions of every amount are of great importance to the School and are deeply appreciated.

GIFTS FROM INDIVIDUALS AND FAMILY FOUNDATIONS $250,000 - $499,000 EDWARD AND JOANNE DAUER $100,000 - $249,999 ALAN AND CINDY HORN DUANE S. MYERS $50,000 - $99,999 MONICA SALINAS $25,000 - $49,999 ROSLYN B. ALFIN-SLATER ROBERT J. DRABKIN DAVID AND CAROL RICHARDS $10,000 - $24,999 GERALD AND LORRAINE FACTOR STEPHEN W. KAHANE AND JANET A. WELLS-KAHANE LESTER AND CAROLBETH KORN JEANNE AND JOEL LEFF FOUNDATION, INC. LINDA ROSENSTOCK AND LEE E. BAILEY THOMAS AND JANET UNTERMAN FRED AND PAMELA WASSERMAN $5,000 - $9,999 DAVID CLARK AND SAMUEL J. ELIAS SANFORD R. CLIMAN AND LORRAINE W. TODD MICHELE DILORENZO FARHAD AND LATIFEH HAGIGI DEAN HANSELL AND JASON MURAKAWA JACQUELINE B. KOSECOFF AND ROBERT H. BROOK KENNETH AND CORNELIA LEE RICHARD AND AMY LIPELES JAMES MC DERMOTT AND DEBRA CINCOTTA EDWARD J. O'NEILL STUART AND SUZANNE SCHWEITZER PAUL R. TORRENS AND JACQUELYN F. KASTER

$500 - $999 CHARLES AND SANDRA ARONBERG LEONARD AND JOAN BEERMAN MATTHEW BERRY RODNEY AND JOANNE CORKER DONALD H. CRANE THOMAS AND PHYLLIS FARVER JONATHAN AND KARIN FIELDING RONALD C. FORGEY TOMAS AND PATRICIA GANZ ALISA M. GOLDSTEIN DANIEL AND ROCHELLE GREEN SUSAN D. HOLLANDER KAREN S. KIN MASAO AND KARLENE KOKETSU GAIL C. LARSON DONALD S. CHANG AND MARGARET H. LEE DIANA E. MAIER WILLIAM DAVID MEIERDING ALFRED AND CHARLOTTE NEUMANN

KENNETH J. RESSER MIRIAM SCHOCKEN STEVEN R. SIM CLIFFORD AND FROUKJE SMITH JOSEPH AND MARY SYIEK FREDRICK H. KAHN AND BARBARA R. VISSCHER $250 - $499 CRAIG AND GRACE ACOSTA IRA AND MARSHA ALPERT TAKAMARU AND PAMELA ASHIKAGA SHARON A. ASHLEY MARGARET AND ROBERT BECK MICHAEL AND LORNA BELMAN XAVIER SWAMIKANNU AND LAVEEZA BHATTI SUSAN K. BLACKWELL GERALD AND DIANA BOROK LINDA B. BOURQUE RALPH AND CLAIRE BRINDIS CELIA BYRNE SUSAN J. CARR KENNETH AND LINDA CHAN HE P. CHANG AND WEN LU ASIS CHATTOPADHYAY GLENN AND JUNA CHIANG JUDITH CONNELL RICHARD T. CORGEL AND JOAN OTOMO-CORGEL JOSEPH AND CAROLYN CRAVERO JULIE E. CRONER GUS AND HELEN DALIS KENNY DENG THOMAS H. RICE AND KATHERINE DESMOND DARYL V. DICHEK BERNICE EARLE JOEL AND VERNA ELLENZWEIG GAYLE ETIENNE JOHN FRANCES FARHOOD DOUGLAS P. FLOWLER RICHARD AND NANCY FREEMAN RICHARD J. HANCOCK HARLAN H. HASHIMOTO TIM AND BARBARA HEINZEL JOHN A. HIRSHLEIFER AND DONNIELLE SISTI DONALD AND CAROLYN HUNSAKER ROBERT M. KAPLAN HERMAN AND ROSE KATTLOVE

STUART A. GABRIEL AND JUDITH R. KATZBURG MARY A. KELLY NANCY J. KINGSTON LEONARD AND MELODYE KLEINMAN RALPH AND JUNE KUBO CALMAN KURTZMAN AND JANE R. RUBIN-KURTZMAN J. JACK AND VEI-VEI LEE REBECKA K. LEVAN SHAW-FENG AND LEEMIN LIN JON B. MARSHACK FRANK P. MATRICARDI AND DIANA M. BONTA RUTH M. MICKEY ALAN AND KIYOTO MILLER KYLE A. MURPHY ABOO NASAR NIEL AND MARGARET NATHASON SHARON L. NICHOLS NELLY A. NIGRO CORINNE L. PEEK-ASA DANIEL M. PELLICCIONI AND LORI S. RICHARDSONPELLICCIONI VINCENT S. PEREZ AND ANA M. SALAZAR-PEREZ JOSHUA A. REILLY AND LISA A. RUSSELL DAVID L. RIMOIN AND ANN P. GARBER-RIMOIN CHARLES AND HOORI SADLER TODD AND KARIN SAMMANN ANTHONY AND MARIAN SCHIFF GARY J. SLOAN AND BARBARA J. KOMAS PAUL E. SMOKLER VICKY I. CUEVAS-SOBSCHAK MICHAEL P. SOLES DENISE M. SPAULDING IRMA H. STRANZ CAROLE L. SUAREZ LINDA A. THOMAS CITRON AND GENEVIEVE TOY DAVID B. TILLMAN AND KAREN A. ZOLLER DIANE UNG HAZEL G. WALLACE SHEN AND FLORENCE WANG NILE EL WARDANI GRAEME AND VIVIAN WILLIAMS DANNY AND CAROL WONG HUNG-JU S. WU STEVEN AND DAYLE WRIGHT

It is important to us that we acknowledge your gift properly.

Every effort has been made to ensure the completeness and accuracy of this Honor Roll.

Please let us know of any omissions or errors in listing your name or gift by calling (310) 825-6464.

UCLAPUBLIC HEALTH

$1,000 - $4,999 ABDELMONEM AND MARIANNE AFIFI CHRISTY L. BEAUDIN LINDA B. BOLTON LESTER AND DEVRA BRESLOW EDWARD J. BROWN JEFFREY DRITLEY JAMES AND MARTA ENSTROM

STEVE GUTEKUNST ALFRED AND HAZEL HAYNES JOEY DEAN HORTON RAYMOND AND JENNIE JING CAROLYN F. KATZIN MARC AND JOANNE MOSER DAVID PORGES JEAN LE CERF RICHARDSON JACK AND CARISSA SCHLOSSER A. HENRY SCHUYLER, JR. BENEDICT AND JANICE SCHWEGLER ROBERT AND LYNNE SCOFIELD, JR. VERONICA J. SCOTT ATSUKO SHIBATA IRWIN J. SHORR RICHARD AND PATRICIA SINAIKO BART AND HARRIET B. SOKOLOW JOHN SONEGO AND MICHAEL ARDEN DIANA S. TEHRANI DONNA J. TESI TODD C. THEODORA DIANNE K. TOMITA AYAKO UTSUMI JOHN M. WORD

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UCLAPUBLIC HEALTH

36 $100 - $249 JAMES P. AGRONICK YASSER ABDEL-RAHIM AL-ANTABLY AND JUANITA B. GONZALEZ SUDHIR AND DIANE ANAND FREDERICK J. ANGULO JAMES AND DORIS ARTERBURN SHAROK AND ROSHAN BASTANI PATTI J. BENSON GEORGE AND ELLIE BERNARD MICHAEL K. BERRY JUDITH A. BJORKE WILLIAM C. BLAND SHARON AND MICHAEL BLASGEN KENNETH AND SANDY BLEIFER JOY T. BLEVINS ROBERT C. BOULLON BONNIE BRINTON MICHAEL S. BRODER JOHN C. BROWN AND DENISE L. PERPICH WAYNE AND SUZANNE BUCK RAFAEL AND CAROL BUITRAGO RAYMOND AND LISA BUKATY JOSHUA AND JENNIFER BURNAM BRANDY BURNETT WILLIAM AND ROSE CALVERT KATHLEEN C. CAPAROSO DAVID AND SYLVIA CARLISLE LIDIA M. CARLTON JANE P. CHAN ANNA G. CHEA CHENG-TAI CHEN HUNG AND ALICE CHU DOUGLAS AND SUSANNA CLARKSON DONELL COHEN JO ANN COHN WILLIAM HUNTER AND SANDRA CRAIG BONNIE J. DARWIN SULAGNA DE ELIZABETH C. DE LAMATER ANN M. DELLINGER KATHRYN P. DEROSE ROGER AND MARY DETELS MICHAEL DIEHR AND CAITLIN SEDWICK CHERYL DIFATTA PEGGY M. DA DILVA ROBERT DONIN D. PETER DROTMAN OLIVE J. DUNN STEVE DUVALL ELLEN R. EISEMAN SAM AND MEREDITH ELROD LYNNE A. EMMA ROBERT C. ENGUIDANOS ELEONOR G. EVANGELISTA SUSIE W. FAN THOS R. FARNHAM J. TIMOTHY FIVES MAUREEN M. FLANNERY RALPH FRERICHS AND RITA FLYNN

ANDREW AND LOURDES FORSTER HENRY AND CLAIR FORSTER JEFFREY E. FRIEDMAN AND GISELA LESIN PAUL FU HAWKIN WOO AND CONSTANCE HUIKONG FUNG ANABEL E. GARCIA JOANNA E. GASPAR MATTHEW S. GERLACH AND LINDA TESLOW-GERLACH ROBERT P. GHIRELLI JI Y. GIL ELIZABETH B. GLASER PETER AND HILARY GODWIN JOSEPH S. GOETZ SAMUEL AND GERTRUDE GOETZ ROBERTA RIVA H. GOLDMAN BERNARD H. GOLDNER DON SPETNER AND LAURIE R. GOODMAN JEAN M. GOODWIN KENNETH AND ANNE GRAHAM JANET C. GREEN MELVIN A. GREENSPAN JAMES M. GSTETTENBAUE AND LINDA L. YEN JOHN AND MICHINO GUSTAFSON ERIN E. HAHN NANCY R. HALL ANN S. HAMILTON HEIDI M. HEBSON MARY A. HENRY ANN M. HENSHAW DAVID E. HERNANDEZ NANCY A. HESSOL JOE AND DIANA HILBERMAN LEE H. HILBORNE WILLIAM HINDS HORACE AND EDYTHE HINKSTON JAMES AND MARYANN HOOK WILLARD M. HUNTER TAE AND JOYCE HWANG LETICIA IBARRA MOIRA INKELAS ROBERT AND MAY JACKSON DARIUS E. JATULIS KATHERINE M. JONES KENNETH AND JANET JOSLYN MATTHEW D. KAGAN AND SARAH E. ANDERSON SHABBIR A. KAHN JOSEF AND MARLENE KAMIENNY UYEN H. KAO NASIR AND SARAH KARAMAT AZAR KATTAN NEAL AND FRANCINE KAUFMAN HARVRY D. KERN EUGENE AND DEBORAH KENIGSBERG LESTER JACOBOWITZ AND DIANA L. KIEL PAULA KIRCHNER ALEXANDER AND JANET KIRKPATRICK PAUL A. KING

CHARLES AND ANNETTE KLEEMAN MARVIN KLEIN AND SUSAN KANOWITH KLEIN STANLEY C. KNAPP KELLY A. KNIESEL JOSHUA R. KOHRUMEL GERALD AND LAURIE KOMINSKI DAVID KRASNOW JOSEPHINE H. LAI NEAL HALFON AND JESSICA K. LAUFER PAUL AND HELEN LAUGHLIN SCOTT AND MICHELE LAYNE ALLEN L. LEE JOHN AND SANDY LIBBY ZHIYUAN LIU AND LILI WANG JESSICA S. LOUIE JEFFREY LUCK AND CAROLYN A. MENDEZ-LUCK KUNG-JONG AND JEN-MEI LUI JOHN AND CAROLYN LYTLE ELISSA A. MAAS ALTANGEREL MANAL MARIAN J. MANOCCHIO SIDNEY AND JOAN MARANTZ KATHERINE A. MARCELLUS LISA J. MARTIN JONATHAN AND MEGHAN MARTIN NANCY F. MCCALL DONALD A. MCCALLUM AND SANDRA J. KLEIN WENDY B. MCGRAIL DOUGLAS J. MEFFERT BHUPEN R. MEHTA BARBARA H. MERCURIO GARY M. MEUNIER HILDY B. MEYERS MARYSIA MEYLAN ROSS AND EVA MILLER JUAN AND EMILY MONTES HANNAH Y. MOORE DAVID J. MORRIS XZAHRA MOVAGHAR ROBERT A. MURRAY CRAIG G. MYERS CARRIE A. NAGY RAYMOND AND JANE NASSIEF JACK NEEDLEMAN IRINA N. NEMIROVSKY BENJAMIN AND ELIZABETH NEUFELD DONALD AND SORA NEWMAN PHYLLIS R. NORIEGA FELIX L. NUNEZ CHRISTINE K. OAKLEY NNEKA AND NDUKWE ODELUGA RYAN AND SAMANTHA OLSEN JORN OLSEN BARBARA M. LANGLANDORBAN WALTER J. ORZECHOWSKI KATHRYN A. OWENS FRANCIS AND GENELLE PALMER ERNESTO AND NORMA PARRA ANNE R. PEBLEY ELLA PENNINGTON

CATHERINE G. PERCY ROBERT AND EILEEN PLOURDE ROBERT NORDYKE AND NINEZ PONCE DAVID AND MICHELLE POPOWITZ STEPHEN AND MARCIA PRATT JOEL A. PEDERSEN DALE L. PRESTON ALVIN H. RANSOM KRISTIANA RAUBE MARILYN A. RAY CYNTHIA O. RECIO CORI D. REIFMAN IRWIN L. REINER ELENA V. RIOS RICHARD RIOS AND MARIA A. TORRES-RIOS ERIC AND LAUREL ROBJOHNS HENRY N. RODRIGUEZ BRYAN C. WEARE AND NAOMI S. ROSEN SHOLOM AND JANE ROSEN HOWARD AND JEAN ROSENFELD TAL AND DOLORES ROSS MARTIN AND LORRAINE ROSS CURTIS AND DOROTHY ROZAS WILLIAM I. ROTHBARD AND KATHRYN J. BRAUDE LARRY AND CHLOE RUBENSTEIN NORMA D. MARTINEZ-RUBIN ROBERT AND CONNIE SANCHIS ALAN AND ELIZABETH SANDLER KENNETH AND LESLIE SATIN DOROTHY M. SELESKI EMMA W. SCHWARTZ RICHARD AND MARY SHAKER JAMES J. SHEA BRANT AND ELIZABETH SHELOR HARSHAD AND BHARTI SHETH GALE F. SHRONICK JUDITH M. SIEGEL DANIEL F. SMITH AND MARGERY LACKMAN GARY AND MARY SMITH JEAN W. SMITH LISA V. SMITH REBECCA A. SMITH SAM S. SNYDER JOHN P. SOHL JULIE J. SONG GUY AND STELLA SOOHOO MITCHELL AND BILLIE SPELLMAN STEPHANIE SPOERL NICOLETTE P. SPOLTORE NICOLE L. STEN DANIEL J. STONE IRA S. STUDIN JUDY P. SY THOMAS S. SZAYNA AND LOUISE A. ROHRBACH JANE E. SZYMANSKI IRA AND HELENE SMITH THEODORE H. SWEETSER III AND JANE L. VALENTINE

GARY AND KAREN TAKA SORA P. TANJASIRI PAULA TAVROW TERRENCE K. TRAPP AND ROSALYN R. RIGUIS TRAPP DAVID AND RUTH TAYLOR SARAH L. THEIR WILLIAM AND DIANE THOMAS HEATHER C. TINDALL JEFFREY AND JOYTI TRUEMAN JANE H. TURNER G. MITCHELL TURK THOMAS AND CATHERINE TYRRELL PETER C. UTAS AND BARBARA L. BROIDE GUSTAVO A. VALDESPINO PAULA S. WILLIAMS-VALENCIA DAVID AND SUEBELLE VERITY LEAH J. VREISMAN DOROTHY E. VURA-WEIS STEVEN P. WALLACE SUZANNE T. WANTANBE ELOISE WATKINS ROBERT AND CARRIE WELCH GEORGE WENZEL SUSAN J. WERTHEIMER TARA J. WESTMAN MARY L. WILSON ARTHUR AND JUDY WINER THERESA WOEHRLE BARRY AND JUDITH WOLSTAN RICHARD SPOSTO AND FLORENCE L. WONG JANICE W. WOODS BERHANE WUBSHET KIMBERLY FU-JIA YANG FRANCIS N. LARYEA YEMOFIO ELEANOR D. YOUNG MICHAEL AND JACQUELINE ZAPF

WOULD YOU LIKE TO HONOR A FAVORITE FACULTY MEMBER? You may not know that you can make a contribution directly to any of the funds listed at the right.

Here is a list of some of the School of Public Health’s special funds and their purpose:

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FIRST CENTURY SOCIETY UCLA’s distinguished First Century Society honors alumni, faculty, staff and friends who have chosen to benefit UCLA through a will, living trust, charitable remainder trust, charitable gift annuity, retirement plan, or other estate planning arrangement. The members share a strong common bond of generosity that ensures the university’s continued excellence well into the future.

The School of Public Health gratefully acknowledges the philanthropic leadership and foresight of the following First Century Society members who have included the School of Public Health in their estate plans:

LESTER AND DEVRA BRESLOW MARYAN G. BUNGA ANNE AND JOHN COULSON ROBERT AND DIANA GHIRELLI RAYMOND AND BETTY GOODMAN JOANNE JUBELIER AND JAMES ZIDELL GERALD KOMINSKI DAVID KRASNOW ANNE SULLIVAN REHER LIVIO AND JOSEPH LIVIO JEAN MICKEY JEANNETTE OREL JOYCE PAGE JEAN SANVILLE GURDON AND MARY ANN SMITH SUEBELLE AND DAVID VERITY

$1,000,000 A N D A B O V E THE CALIFORNIA ENDOWMENT THE ROBERT WOOD JOHNSON FOUNDATION $250,000 - $1,000,000 BLUE SHIELD OF CALIFORNIA RESEARCH & EDUCATION FOUNDATION KAISER FOUNDATION HEALTH PLAN INC. L.A. CARE HEALTH PLAN THE BREAST CANCER RESEARCH FOUNDATION THE SUSAN G. KOMEN BREAST CANCER FOUNDATION $100,000 - $249,999 AMERICAN FOUNDATION FOR AIDS RESEARCH CHILDRENS HOSPITAL OF LOS ANGELES MEDICAL GROUP FRED H. BIXBY FOUNDATION MAGEE-WOMENS HOSPITAL, RESEARCH INSTITUTE & FOUNDATION MAYO CLINIC PREVENTION INSTITUTE RAND CORPORATION $50,000 - $99,999 TOYOTA MOTOR SALES U.S.A. INC. $25,000 - $49,999 INSTITUTE FOR BUSINESS & HOME SAFETY INSTITUTE FOR GAY AND LESBIAN STRATEGIC STUDIES, INC.

ABDELMONEM A. AFIFI FELLOWSHIP Created to honor faculty member and former SPH dean Abdelmonem Afifi, this fund is awarded to students who exemplify academic excellence in Biostatistics.

LESTER BRESLOW LECTURE FUND The Lester Breslow Fund supports the Breslow Lecture in honor of the internationally recognized professor emeritus and former SPH dean Lester Breslow. The lecture furthers the School’s educational mission each year via a special evening which includes a nationally recognized keynote speaker and the induction of the SPH Alumni Hall of Fame.

BEVERLEE MYERS FUND This fund was created by Dr. Myers’ widower in 2007 to honor his late wife. Beverlee Myers served for many years

$5,000 - $9,999 BLUE SHIELD OF CALIFORNIA CEDARS-SINAI MEDICAL CENTER ELECTRONIC DATA SYSTEMS CORPORATION JOHNSON & JOHNSON $1,000 - $4,999 ALLIANCE IMAGING, INC. ALVARADO HOSPITAL, LLC BLUE CROSS OF CALIFORNIA CERNER CORPORATION HEALTH NET, INC. IOWA FOUNDATION FOR EDUCATION, ENVIRONMENT AND THE ARTS LAKESIDE HEALTHCARE PRICEWATERHOUSECOOPERS LLP SEDGWICK DETERT MORAN & ARNOLD LLP THE CAMDEN GROUP THE SAVE THE EARTH FOUNDATION INC. UCLA MEDICAL CENTER UNIVERSAL CARE $500 - $999 AMERICA'S HEALTH INSURANCE PLANS CALIFORNIA ASSOCIATION OF HEALTH PLANS COURSE READER MATERIAL GREATER NEWPORT PHYSICIANS HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA

LITTLER MENDELSON, INC. MANATT, PHELPS & PHILLIPS, LLP SCHWAB CHARITABLE FUND ARONBERG FAMILY CHARITABLE FUND VANGUARD CHAR ENDOW PROGRAM THE FIELDING FAMILY CHAR FUND $100 - $499 ADVENTIST HEALTH CALIFORNIA ASSN OF HOSPITALS AND HEALTH SYSTEMS FIDELITY CHARITABLE GIFT FUND D. PETER DROTMAN FUND FIDELITY CHARITABLE GIFT FUND FORTUNE WISDOM GIVING FUND G. MITCHELL TURK, D.D.S., M.A.G.D., INC. H. P. CHANG, M.D., INC. KINDRED HEALTHCARE OPERATING INC. LAUGHLIN FAMILY TRUST MISSY CALVERT DESIGN MOLECULAR IMAGING MANAGEMENT, LLC MSO INC. RIVERSIDE COMMUNITY HOSPITAL SCHIFF & BERNSTEIN CORPORATION THE CHARLES SCHWAB CORPORATION WEST ANAHEIM MEDICAL CENTER WESTLAKE CONVALESCENT HOSPITAL

at the helm of the Department of Health Services and had great impact on the field of public health nationally. The award is given to a Department of Health Services student who exemplifies academic excellence and demonstrates an interest in social justice.

RUTH ROEMER AWARD Ruth Roemer was a nationally known public health advocate and an SPH faculty member for more than 40 years. As a lawyer and an educator, Roemer had a profound effect on public health policies and was an effective and tireless advocate for health issues worldwide. The award is given to an SPH student who exemplifies academic excellence and demonstrates an interest in social justice.

DEAN’S OUTSTANDING STUDENT AWARD Established by Dean Linda Rosenstock, this fund supports the most outstanding student in each of the five departments of the School of Public Health.

When giving, please make your check out to the UCLA Foundation and note the fund name in the memo section. Thank you!

UCLAPUBLIC HEALTH

HAGIGI FELLOWSHIP IN HEALTHCARE ACCOUNTING AND FINANCE The Hagigi Fellowship fund was created by Department of Health Services professor Fred Hagigi to support students who anticipate working in the healthcare accounting and finance field.

$10,000 - $24,999 FOLEY AND LARDNER WILSHIRE FOUNDATION

friends

CORPORATE AND FOUNDATION GIFTS AND GRANTS

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Commencement

2008 Dr. Jonathan Fielding, director of the Los Angeles County Department of Health, is the featured speaker at the school’s 2008 Commencement.

UCLA

PUBLIC HEALTH School of Public Health Box 951772 Los Angeles, California 90095-1772 www.ph.ucla.edu Address Service Requested

Nonprofit Org. U.S. Postage PAID

UCLA