UCLA Public Health Magazine - June 2002

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JUNE 2002

UCLA

PUBLIC HEALTH teaming with the community to create

A Sense of

UCLA

PLACE

School of

Public Health

Building stronger communities is now seen as key to promoting healthier populations...and all over L.A., the School is helping to lay the foundations.

Whether it’s the tobacco industry or the antiabortion lobby, Ruth Roemer has never backed down from a fight.

Why start now?

It may be the nation’s most pressing social problem. How prominent faculty and a landmark survey are shaping the debate on access to care.

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UCLA

PUBLIC HEALTH

Albert Carnesale, Ph.D. Chancellor

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

Julie Tisdale Pardi, M.A. Assistant Dean for Communications

Dan Gordon Editor and Writer

fe a t u r e s

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Martha Widmann Art Director

EDITORIAL BOARD Richard Ambrose, Ph.D. Associate Professor, Environmental Health Sciences

Roshan Bastani, Ph.D. Associate Professor, Health Services

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

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

Jeffrey Luck, Ph.D. Assistant Professor, Health Services

Hal Morgenstern, Ph.D. Professor, Epidemiology

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

Susan B. Sorenson, Ph.D. Professor, Community Health Sciences

Raphael Travis President, Public Health Student Association

Joyce A. Page, M.S.P.H., J.D.

UCLA

President, Alumni Association

School of

Public Health

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Alumni Hall of Fame: The First Nine Inductees

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A Sense of Place In partnership with communitybased institutions and activists, the School’s faculty, students and alumni are helping to build stronger neighborhoods. Also: Alumni in key positions at the L.A. County Department of Health Services.

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Ruth Roemer: The Fighting Type

Still Seeking Access to Care

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18

departments 24 RESEARCH Air pollutants and birth defects...burden of disease... local TV news coverage skews perception of risks... adjuvant therapy for longterm breast cancer survivors... workplace breastfeeding program targeting men... acculturation level and sex among Hispanic teens.

16 Now in her fifth decade at the School, she refuses to back down when it comes to using the law to protect and promote health.

Taking the M.P.H. to Another Degree

By combining public health with other professional or academic degree programs, students with overlapping interests are getting the best of both worlds.

Though conspicuous by its recent absence from the national political debate, the issue of access to care weighs heavily in the minds of public health researchers and advocates. Also: The California Health Interview Survey.

29 STUDENTS 30 FACULTY 32 NEWS BRIEFS 34 FRIENDS

ON THE COVER Dr. Antronette Yancey is one of numerous UCLA School of Public Health faculty who, along with students and alumni, are making a difference in communities all over Los Angeles. Yancey’s “Community Steps to Minority Fitness” takes place at two inner-city middle schools.

Cover photo by Yvette Roman.

PHOTOGRAPHY Yvette Roman / cover: Roemer, Brown; TOC: Sense of Place, Roemer, Access to Care; p. 2; pp. 6-7: Yancey; pp. 8-9: Saylor, IMPACT; pp. 10-11: Kersey; p.13: DHS building; p. 14; pp. 18-20: Venice Family Clinic; p. 22: CHIS Reed Hutchinson / TOC: M.P.H. Degree; p. 4: Hall of Fame award; p. 10: Compton class; p. 17: Ogiamien; p. 32: yoga; p. 21: Brown ASUCLA / cover: Halfon; TOC: Alumni Hall of Fame; p. 7: Halfon; p. 32: Shalala; p. 34 Courtesy of Janet Deland / p. 16 Courtesy of UCLA Center for Healthier Children, Families and Communities / p. 12: Hope Street Courtesy of Jared Diamond / p. 30 Courtesy of Gregory Stock / p. 30 Courtesy of the UCLA School of Public Health / pp. 29, 33, 36-37 Courtesy of the alumni / p. 13 Courtesy of the inductees / pp. 4-5 Courtesy of Wendy Slusser / p. 27

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 2002 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 THE COVER STORY OF THIS ISSUE is devoted to the School’s activities in the greater Los Angeles community. The School of Public Health has long relationships with many local individuals and organizations and we are committed to strengthening and improving these partnerships. This commitment is also articulated in the newly released strategic plan (available on our Web site at www.ph.ucla.edu). One of the strategic goals is to “Establish new and strengthen existing collaborative partnerships with a major focus on working with communities to improve health in greater Los Angeles.”

I am personally committed to facilitating collaboration between community partners and the School. Last summer, we held meetings with our community partners and received a great deal of useful input for the strategic plan and for improving our presence in the community. Since then, I have had follow-up meetings with many community leaders. I am pleased to announce that the School has recently received a grant from The California Endowment to strengthen our capacity to address disparities in health among underserved communities through teaching, research, service and advocacy activities. The Health Disparities Prevention Project will: • Strengthen academic-based research activities in health promotion and disease prevention among at-risk communities of color in Los Angeles, with a focus on physical fitness and wellness promotion, and begin identifying key determinants of disparities in chronic disease, mortality, and health care access; and • Improve training of health professionals, students, and other community health workers focused on reducing disparities of health status.

The School’s mission, also identified in the strategic plan, is to enhance the public’s health by “conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world.” One of our strengths is our student body, which is one of the most diverse among all schools of public health. We continue to work diligently to recruit students from many different backgrounds. As many of you know, one of the greatest difficulties is competing with private schools that can offer very

UCLAPUBLIC HEALTH

attractive financial packages to students. Not only do we as a public institution simply have less funds for recruitment, but we have the added complexity of Proposition 209 and the barriers it imposes. Nonetheless, we have innovative pro-

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grams to attract students to the field of public health, including a course offered at Compton Community College. The course is open to both high school and community college students, exposing them to the field of public health and how they can have a direct, positive impact on the communities in which they live.

In terms of our finances, I’m pleased to report that our annual expenditures, largely due to increasing success of our faculty in securing extramural funding, increased by 40 percent. This fiscal year, we have also increased the number of donors committing $5,000 or more by 64 percent over FY 00-01. I would also like to recognize a very generous gift from Ralph and Shirley Shapiro to assist us in achieving our new vision for the School.

In addition, this year’s Breslow Lecture saw record attendance as many faculty, alumni, and community partners turned out to hear Donna Shalala, Ph.D., President of the University of Miami and former Secretary of the Department of Health and Human Services during the Clinton Administration, discuss the unfinished health care agenda. At the same event, we honored the nine inaugural members of our Alumni Hall of Fame.

And last, but certainly not least, we are extremely proud of our 195 graduates entering the field of public health this year. As alumni they will continue to help us fulfill our mission of “Building healthy futures. In greater Los Angeles, California, the nation, and the world.”

Linda Rosenstock, M.D., M.P.H. Dean

TOTAL EXPENDITURES Grants and Contracts State-Generated Funds Gifts and Other Fiscal Year 00-01 = $33.5 million

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SANDERS

BONTÁ

CLARK

DANDOY

alumni hall of fame: the first inductees For Professional Achievement

The UCLA School of Public Health Alumni Hall of Fame was established this year to honor alumni 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. Here we list just a few of the achievements of the first nine inductees, who were recognized at the Breslow Lecture

UCLAPUBLIC HEALTH

and Dinner April 1.

DONNA BELL SANDERS, M.P.H. ’81 Sanders is a nationally recognized expert in the development of health education materials for populations with limited reading skills (plain language materials). At the California Family Health Council, she has helped develop more than 200 health education materials; edited hundreds of materials for public, community and private organizations; and helped to facilitate translations in more than 15 languages.

Having devoted much of her career to creating culturally and linguistically appropriate health education materials for public health clients in California and throughout the nation, Sanders also trains health professionals in the art of developing cutting-edge materials that are sensitively written and designed. She has a master’s degree in African studies as well as her M.P.H., and began her career as a health educator in the Peace Corps in the Republic of Niger, in West Africa.

DIANA M. BONTÁ, R.N., M.P.H. ’75, DR.P.H. ’92 Bontá currently serves as director of the California Department of Health Services. As head of one of the largest departments in California government, she directs a wide array of programs and services such as HIV/AIDS, environmental health, tobacco and communicable disease control, domestic violence, and Medi-Cal. Previously, she held a variety of positions, including head nurse of medical and pediatric units in hospitals in New York and Los Angeles, regional administrator of rural health programs for the State of California, deputy executive director of the Los Angeles Regional Family Planning Council, and director of the Long Beach Department of Health and Human Services.

Among many honors, Bontá has received the American Public Health Association’s Milton and Ruth Roemer Prize for Creative Local Public Health Work and the California Women’s Law Center’s annual Pursuit of Justice Award.

VIRGINIA A. CLARK, PH.D. ’63 The UCLA School of Public Health’s first doctoral graduate, Clark was also one of the first female biostatisticians in the United States. As a long-time faculty member at the School (currently emerita professor of biostatistics and biomathematics), she designed several courses, including Biostatistics 200A, which continues to follow her lead in bringing together students from every department in the School.

Clark has co-authored six influential biostatistics texts used worldwide, along with 89 peer-reviewed papers representing more than 35 collaborations with UCLA faculty. Indeed, her ability to distill statistics into terms easily understood by health professionals led to her involvement in a wide variety of projects, including the Los Angeles Heart Study.

SUZANNE E. DANDOY, M.D., M.P.H. ’63 Strong skills as both a physician and administrator have propelled Dandoy to many leadership positions in the public health arena. As director of Arizona’s and Utah’s state health departments and deputy commissioner for Virginia’s Department of Health, she became known for her innovative programs. For example, she developed a Utah program that became a model for other states – putting funds from cigarette taxes to use in expanding education for prenatal care.

Dandoy served as president of the American College of Preventive Medicine – one of the few women to head a national medical specialty society. She also served as first chair of the National Vaccine Advisory Committee, and as founding director of the M.P.H. program for Eastern Virginia Medical School.

Recently, she came out of retirement to teach epidemiology at the University of Arizona College of Public Health.

KENNETH W. KIZER, M.D., M.P.H. ’76 As president and CEO of the National Quality Forum, Kizer leads the national effort to improve the quality of American health care through a unique public-private partnership aimed at finding consensus among health care’s disparate stakeholders rather than through government regulation. Previously, he served for five years

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SHERROD

ALPERT

as under secretary for health in the U.S. Department of Veterans Affairs, during which he was the highest-ranking physician in the federal government and CEO of the nation’s largest health care delivery system. He is widely credited as being chief architect and driving force behind the greatest transformation of VA health care since the system was created in 1946.

Kizer was director of the California Department of Health Services for more than six years, chairman of the board of the California Wellness Foundation, and a senior faculty member at UC Davis and USC. JESSIE L. SHERROD, M.D., M.P.H. ’80 A self-described “trail-blazing cotton picker” from the Mississippi Delta, Sherrod graduated from Tougaloo College and Harvard Medical School, was a Robert Wood Johnson Clinical Scholar, and became a Fellow of the American Academy of Pediatrics. She served as health care epidemiologist/director of infectious disease control and prevention, and associate professor of pediatrics, at Charles R. Drew University and Los Angeles County Southwest Cluster for 10 years – leading the successful effort to decrease the nosocomial infection rate at King-Drew Medical Center by 50 percent in one year, which helped to rescue the facility from a threat of closure due to excess nosocomial infections.

Sherrod published a landmark study on “Compliance in Childhood Immunizations” (J Pediatrics, 1983) that created the cornerstone for developing national strategies to improve immunization compliance. As an advocate for children and women’s health, she has provided public education on women’s health issues, HIV/AIDS, immunizations, and the adverse effects of smoking. As an executive board member of the Los Angeles Pediatric Society, she initiated the movement to educate parents on violence prevention in pediatric office practices.

For Community Service

KATZIN

vate sources. He is also on the Board of Directors for the Woods Humane Society, and has volunteered for 24 years at the Los Angeles Free Clinic.

2003 ALUMNI HALL OF FAME CALL FOR NOMINATIONS

RAYMOND D. GOODMAN, M.D., M.P.H. ’72 A physician, educator and health consultant (Fellow of the American College of Physicians and the American College of Preventive Medicine), Goodman has served as medical director of several insurance companies and has chaired numerous national symposia on such issues as professional standards and health policy. He has provided health care consulting services to national, state, and county agencies and to more than 10 countries and 100 American corporations.

Goodman was founding president of the School of Public Health Alumni Association, founding chair of the Dean’s Council, and past president of the UCLA Chapter of Delta Omega. With his wife Betty, he established the annual Lester Breslow Distinguished Lecture and the first endowed scholarship fund for students in the School. Other community activities have involved positions of volunteer leadership with the Boy Scouts of America, Los Angeles County Museum of Art, Music Center, and Santa Monica Unitarian Universalist Community Church.

The Alumni Hall of Fame recognizes accomplishments of alumni in two categories:

CAROLYN F. KATZIN, M.S.P.H. ’88, C.N.S. A certified nutritionist and health educator who successfully intertwines her professional and community service careers, Katzin spreads the important message on the link between cancer and nutrition to the public through her presentations, through her Web site (www.cancernutrition.com), and through her books.

An outspoken advocate for healthy nutrition, Katzin is president of the Cancer Nutrition Center and a nutrition consultant for the new Center for Health & Healing at St. Vincent Medical Center. She serves as chair of the American Cancer Society’s California Division Nutrition and Physical Activity Initiative Team and as a member of the society’s national nutrition group. Katzin has been the nutritionist since 1985 for The Wellness Community, where she is a member of the Professional Advisory Board. She currently serves as chair of the School’s Dean’s Advisory Board.

PROFESSIONAL

— for alumni with outstanding career accomplishments in public health.

Accomplishments may include practice of the profession to advance public health, leadership in public health institutions or societies, and/or research and scholarly activities.

ACHIEVEMENT

COMMUNITY SERVICE

— for alumni who have volunteered time and talent in their communities in support of public health activities whether through civic, philanthropic, or public service activities.

Inductees into the Alumni Hall of Fame will be recognized at the 2003 Breslow Distinguished Lecture and Dinner.

Please access nomination forms at www.ph.ucla.edu and submit nominations no later than November 15, 2002.

Nominations received after November 15 will be considered for the following year’s awards. If you have questions about the nomination process or would like forms mailed to you, please contact the Office of Development and Alumni Relations for the School of Public Health at 310-825-6464 or by e-mail at publichealth@support. ucla.edu.

UCLAPUBLIC HEALTH

IRA R. ALPERT, M.S.P.H. ’66 Alpert, president and CEO of the Wilshire Foundation, Inc., a nonprofit organization involved in various aspects of long-term care, is chair of the Dean’s Council, leading the effort to raise valuable unrestricted funds for the UCLA School of Public Health. He is also actively involved as a member of the Dean’s Advisory Board and a board member of the UCLA Health Policy and Management Alumni Association.

For the broader UCLA community, Alpert serves as a member of both the Boards of Directors and Governors for The UCLA Foundation, the organization charged with raising support for the university from pri-

GOODMAN

hall of fame

KIZER

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IN

PARTNERSHIP

WITH COMMUNITYBASED INSTITUTIONS AND ACTIVISTS , THE

S CHOOL’ S

FACULTY, STUDENTS AND ALUMNI ARE HELPING TO BUILD STRONGER NEIGHBORHOODS .

A Sense of

PLACE

“We ’ ve had years of interventions that are individually focused, and once the resources are gone, the behaviors typically return to what they were before.

To make a long-term impact, you have to affect the environment.”

UCLAPUBLIC HEALTH

—Dr. Antronette Yancey

At Elizabeth Learning Center, a K-12 school in Cudahy, Calif., 500 parents each week attend adult education and parenting classes. Neighborhood children begin a cooperative nursery program at age 1; by the time they start school, they’ve had four years of preschool education and enrichment, including Head Start. A wide range of preventive and primary health care services is offered.

One of five pilot sites for UCLA’s Community Education and Resource Centers (CERC) initiative, the Elizabeth model is about more than just integrating health, education and social services, according to Dr. Neal Halfon, whose Center for Healthier Children, Families and Communities, based in the School of Public Health, has played a prominent role in the Elizabeth center’s recent reconfiguration. “It’s engaging the community’s families in their children’s lifelong learning trajectory,” says Mary View-Schneider, the center’s assistant director.

A second CERC site, Hope Street Family Center, is a collaboration between the UCLA center and the California Hospital Medical Center. Hope Street provides comprehensive child development and family support services for disadvantaged populations in the downtown Los Angeles area. Benefits for families enrolled at the center include home visits; early childhood education; licensed

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7 “We’re in a new era of public health in this country.

It’s a much broader healthpromoting agenda. The new model understands that your birth weight and the amount of nutrition you get in the first year of life is a strong predictor of whether or not you’re going to get heart disease.”

cover story

Dr. Antronette Yancey of the School’s faculty heads “Community Steps to Minority Youth Fitness,” a middle school-based program of increased physical activity and education about healthier diet for a population at high risk for Type 2 diabetes.

—Dr. Neal Halfon

UCLAPUBLIC HEALTH

child care; child development screening and assessment; medical, dental, and mental health services; parenting classes; adult education and vocational training; job placement; and youth services including tutoring, after-school programs, weekend activities and summer camp.

Halfon’s heard the question before: What do early childhood education, vocational training and the like have to do with public health? His answer: Quite a bit. “We’re in a new era of public health in this country,” he says. In the first era, the focus was on infectious diseases; in the second, the field also sought to tackle chronic diseases with interventions designed to reduce risk factors and promote healthy lifestyles. Now a third layer has been added, one Halfon refers to as “Health for All.” “It’s a much broader health-promoting agenda,” he says. “The new model understands that your birth weight and the amount of nutrition you get in the first year of life is a strong predictor of whether or not you’re going to get heart disease. It understands

that the amount that children are read to in the first year of life influences their vocabulary size at age 3, which influences their reading readiness at age 5, which influences their third-grade reading abilities, which influences their high school test scores and whether they get into college, which influences the kind of job they get, which influences whether or not they get Alzheimer’s disease.”

The Center for Healthier Children, Families and Communities is steeped in community-building work. Among others, there’s TIES for Adoption, an innovative model for moving foster children into permanent homes; the Proposition 10 School Readiness Program, in which experts at the center are providing technical assistance in the development of systems to ensure that children are cognitively, emotionally, and physically prepared to start school; and the Program for Integrated School and Community Solutions, a collaboration with eight school districts and community partners to integrate health and social services into the schools and assist the districts in launching comprehensive early childhood programs.

Chancellor Albert Carnesale launched the CERC initiative as part of a larger effort to increase UCLA’s presence in the Los Angeles region in a way that best serves people in the community. Dean Linda Rosenstock is strongly committed to such efforts, and the School’s new strategic plan identifies community partnerships in greater Los Angeles as a high priority. The “UCLA in L.A.” focus is nowhere better exemplified than in the School of Public Health, which has myriad faculty research and outreach efforts (far too many to mention in this space) designed to promote the long-term well-being of the community. Between its faculty, students and

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“Underserved patients tend not to access even services available to them. We knew we couldn’t just set up our services in Westwood and say, ‘Come to us.’

We had to go to them.”

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—Dr. Mark Litwin

UCLAPUBLIC HEALTH

Erin Wilson As part of her internship at Children’s Hospital in Los Angeles, Wilson has worked on City Project, an HIV prevention program for gay youths in the City of West Hollywood.

Wilson has evaluated the HIV prevention training component of the program, conducting interviews and holding focus groups with staff and the program’s youth participants; she also took part in organizing the most recent training session and youth training graduation.

“This is truly a communitydriven project,” she says.

“The youth developed it, and they want to sustain the project beyond the funding.

Everything’s done in the community, and the activities planned are those that are most salient to them.

For example, they wanted to hold rave parties, so we did raves.” Wilson and other project staff plan to disseminate the lessons learned in a variety of venues – in the hospital, to AIDS service providers in Los Angeles and to others interested in HIV prevention initiatives in the community, and at professional meetings.

alumni (see the accompanying sidebars), the School’s presence can be felt across virtually every neighborhood in greater Los Angeles, with initiatives ranging from the still-critical traditional approach of preventing the spread of disease to the broader “community-building” efforts of Halfon’s interdisciplinary center.

“Research strongly suggests that the environment in which children grow up affects their physical, psychological, and social development, and their opportunities and successes in life,” says Dr. Anne Pebley, Fred H. Bixby Professor of Population, Family and International Health at the School. “Unfortunately, most of that research has focused narrowly on the effects of family and home environment or school characteristics on children’s development and performance. Neighborhoods are another important part of a child’s environment, but have received considerably less attention.”

Pebley is director of the Los Angeles Family and Neighborhood Survey (L.A.FANS), which has collected data from a representative sample of 65 neighborhoods in L.A. County in an effort to address three issues: neighborhood, family and peer effects on children’s development; the impact of welfare reform at the neighborhood level; and residential mobility and neighborhood change.

Also active in the community is the Jonsson Cancer Center’s Division of Cancer Prevention and Control Research, based in the School. Initiatives include the Asian American Network for Cancer Awareness Research and Training – the first cancer prevention and control research initiative targeted specifically to Asian Americans; a partnership with the Greater Los Angeles Council on Deafness to conduct cancer prevention and control research among the deaf and hard of hearing, an underserved

M.P.H. student Elizabeth Saylor has been developing a community needs assessment for Project STOP, a program that brings gang violence suppression and prevention services to Lennox, Lawndale, and Saylor’s own community in Hawthorne (see page 9).

With Saylor are six students from Lennox Middle School who serve as peer mediators for the program.

and understudied cultural and linguistic minority population; and testing and implementation of interventions to help inner-city sixth-graders in the Los Angeles Unified School District (LAUSD) exercise more and eat more healthfully.

Identifying and reaching populations that are traditionally underserved can be challenging.

Recently, the California Department of Health Services awarded an unprecedented $50 million contract to UCLA to administer a statewide prostate cancer treatment program for indigent men who lack health insurance. “Underserved patients tend not to access even services that are available to them,” says Dr. Mark Litwin, associate professor in the schools of public health and medicine. “We knew we couldn’t just set up our services in Westwood and say, ‘Come to us.’ We had to go to them.”

The program, “IMPACT: Improving Access, Counseling and Treatment for Californians with continued on page 11

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Elizabeth Saylor

Beatriz Solis, M.P.H. ’96 Solis, a doctoral student at the School, is director of the Department of Cultural and Linguistic Services for L.A. Care Health Plan, a nonprofit HMO serving more than half a million people who participate in the Medi-Cal and Healthy Families programs.

L.A. Care created the department to ensure that its members – approximately half of whom speak languages other than English, and nearly 70 percent of whom are either African American or Latino – have access to all available services; and to improve communication between patients and health care practitioners. Workshops on cultural competence are offered to all participating practitioners, and recent seminars have addressed cultural and linguistic issues associated with barriers in access to care. “Providers with inadequate knowledge about language or culture can make bad diagnoses and prescribe the wrong treatment,” Solis says.

“Doctors need to be thinking about getting up-to-date knowledge about the language and culture of the patients they’re treating, along with such things as the latest technology.”

UCLAPUBLIC HEALTH

IMPACT: Improving Access, Counseling and Treatment for Californians with Prostate Cancer, is the nation’s most extensive state-led effort to battle prostate cancer, the second-leading cause of cancer death in men. The program, funded by the California Department of Health Services and directed by Dr. Mark Litwin, associate professor in the schools of public health and medicine, provides no-cost prostate cancer care to indigent patients. One of IMPACT’s key components is the provision of nurse case managers (including Barbara Clerkin, above) who coordinate patients’ care and ensure that they make, and keep, appropriate appointments.

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cover story

MAKING AN IMPACT WITH INDIGENT PATIENTS

Saylor, an M.P.H. student, has been developing a community needs assessment for Project STOP, a collaborative program that brings comprehensive gang violence suppression and prevention services to the Lennox, Hawthorne, and Lawndale communities.

The program, a partnership among Richstone Family Center; the Lennox School District; and the L.A. County Sheriff’s Department, Probation Department and District Attorney’s Office, seeks to maintain successful prevention and intervention efforts in Lennox and expand those efforts into Hawthorne (where Saylor lives) and Lawndale, as well as to build an effective coalition that promotes interagency coordination and communication among the three communities. Services provided include counseling, mentoring, after-school activities, parenting classes, community outreach and education, curfew and truancy enforcement, a specialized supervision program for gang probationers, and coordinated efforts to aggressively apprehend, prosecute and remove hard-core gang offenders from the community.

“This project has allowed me to use my existing knowledge and skills in community and family violence and prevention, while having the opportunity to become involved with a large-scale community project that has a significant impact on the community in which I live.”

Saylor says.

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Lynn Kersey, M.A., M.P.H. ’85

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Patricia Barreto, M.D. Barreto, a pediatrician and student at the School through the Robert Wood Johnson Clinical Scholars Program, is focusing on the problem of the nearly 1 million children in California who are eligible for public health insurance programs such as Medi-Cal and Healthy Families, but are not enrolled. In collaboration with the health insurance outreach workers at the Venice Family Clinic and Burke Health Center – free clinics for low-income, mostly Latino families (a population with particularly troubling enrollment rates) – Barreto is trying to reverse the trend.

Health IDEA (Health Insurance Identification and Enrollment Assistance) is based on the observation of the clinics’ health insurance outreach workers that if clinicians encouraged their patients to enroll in one of the programs, the patients would be more likely to do so. “In traditional medical training you don’t learn about things like access to care; it doesn’t fit neatly into the biomedical paradigm,” Barreto says. “But we know that having poor access to care, of which health insurance is a component, leads to poor health outcomes. So this is not just a financial problem.”

Kersey is executive director of Maternal and Child Health Access, which provides information, support, and technical assistance to health and social service organizations; assists individual women in achieving healthy pregnancies and obtaining quality health care for themselves and their children; and educates policy-makers and the public on the need to improve the health and social service systems for lowincome women and families.

Shortly after graduating from UCLA with master’s degrees in public health and Latin American studies, Kersey helped to establish the Downtown Los Angelesbased organization as a way to address what she saw as a “less than seamless” system for low-income pregnant women and newborn children. “Initially it was pregnant women giving birth in the hallways at L.A. County hospitals and waiting six weeks to six months to get prenatal care visits,” she says. “But as that started to be addressed, we knew there were additional, less visible problems in making sure that all of the health care needs of this population were met.” In the future, she hopes to expand Maternal and Child Health Access to become a more comprehensive parent- and family-support organization.

INTRODUCING A NEW CLASS OF STUDENTS TO PUBLIC HEALTH

In an effort to expose high school and community college students to the opportunities to make a positive impact on the communities in which they live through a career in public health, the School offered an introductory public health course at Compton Community College for the first time this spring. The course is taught by doctoral student Kynna Wright (inset, left), with assistance from M.P.H. student Daniel Craddock (inset, right).

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continued from page 8

Nancy Wongvipat, M.P.H. ’98 In 1998, a UCLA School of Public Health study headed by Drs. Charlotte Neumann and Wendelin Slusser surveyed more than 900 elementary students in LAUSD and found that 40 percent of the students were overweight or obese, and that on average the students were eating less than two servings of fruits and vegetables per day – significantly fewer than what is recommended by the U.S. Department of Agriculture. A year later, Slusser conducted an evaluation of a pilot project in LAUSD that placed salad bars in three elementary schools.

The troubling findings of the first study, combined with the encouraging results of the second, led to the LAUSD Nutrition Network evaluation project. Neumann and Slusser, along with faculty colleague Dr. Michael Prelip, are currently evaluating the district’s nutrition education programs and activities. Once the evaluation has been completed, the research team and the LAUSD Nutrition Network will collaborate with stakeholders – including teachers, parents, students, health and psychosocial services staff, administrators, and food service staff – to define the minimum criteria to be used for “Nutrition-Friendly” certification, modeled after the global Baby Friendly Hospital initiative that promotes infant breastfeeding facilities.

The soaring rate of Type 2 diabetes in children led another member of the School’s faculty, Dr. Antronette Yancey, to launch a pilot program, “Community Steps to Minority Youth Fitness,” based at two inner-city middle schools, one intervention and one control. Yancey is testing the impact of a program of increased physical activity and education about healthier diet on diabetes risk factors such as body mass index and cholesterol and blood pressure levels. While similar school-based interventions have been implemented in the past, most have taken place in relatively affluent neighborhoods with predominantly white populations. Yancey, with funding from the National Institute for Child Health & Human Development and working in close collaboration with the L.A. County Department of Health Services, was interested in whether such a program could be effective in a community with fewer resources and a population consisting mostly of

As manager of prevention programs at AIDS Project Los Angeles (APLA), Wongvipat has been responsible for developing, implementing, evaluating and managing prevention programs for people living with HIV and those at risk for HIV. Her many responsibilities have included developing culturally relevant programs; conducting needs assessments; program evaluation and quality assurance; and writing health education articles. “Involving the community in program planning and implementation is crucial for APLA,” she says. “We always engage our target population in the formative research phases of program development through focusgroup feedback, for example.” She notes that APLA is in the process of establishing an agency-wide community advisory board to provide ongoing feedback on APLA programs and services. In May, Wongvipat made what she called “an extremely difficult career decision” to leave APLA and accept a position as manager of health education for government programs (Healthy Families and MediCal) at Health Net – a position that provides an opportunity for her to make an impact at the state-wide level while serving lowincome populations.

UCLAPUBLIC HEALTH

Prostate Cancer,” has assembled a network of highquality care providers, nurse case managers, administrators, and specialists in education, outreach and evaluation to coordinate the delivery of no-cost prostate cancer medical care throughout the state.

Litwin estimates that once it’s fully operational, IMPACT will enroll up to 1,000 new patients each year.

Experts in nursing, nutrition, outreach, and health education have developed plans to educate communities about prostate cancer, including the importance of early treatment. “Most educational materials that are available for prostate cancer patients are geared toward educated upper- or middle-class individuals, and are not necessarily culturally or linguistically sensitive,” Litwin says.

With guidance from focus groups and the existing research literature, IMPACT staff are determining how best to reach the disadvantaged groups the program serves, and developing new materials better tailored to these populations.

11

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Lynn Kersey, M.A., M.P.H. ’85, heads Maternal and Child Health Access, which assists social service organizations, helps individual women with pregnancy and obtaining quality care for themselves and their children, and educates policy-makers and the public on the need to improve health and social service systems for low-income women and their families.

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Lisa Smith, M.P.H. ’94, Dr.P.H. ’00

Doris Estremera

UCLAPUBLIC HEALTH

Estremera entered the School looking to work with Latino immigrants. “I’ve always felt strongly about helping this marginalized, extremely vulnerable and hard-to-reach community,” she says. She found the right fit at the L.A. County Department of Health Services STD Program, where she is helping to develop a fotonovela for Latino immigrant day laborers. “Our goal was to provide a non-threatening, familiar, and appropriate means to discuss taboo and high-risk behaviors,” she explains.

Estremera’s team incorporated day laborers in creating the stories, design, and characters of the fotonovela.

Day laborers participated in focus groups, workshops, interviews, street outreach, and photo shoots on the streets and at local bars.

“The guys have embraced the fotonovela and made it theirs,” Estremera says.

“Discussing these issues with them is what gives me the energy and drive to continue working with this population in the future.”

Smith, a President’s Postdoctoral Fellow, is interested in community-based epidemiology and its role in the detection of STD/HIV, cervical cancer, and related health outcomes.

“Community-based epidemiology involves the community of interest in every stage of the research, and educates this community about the statistical and epidemiologic approaches to achieving positive health outcomes,” she explains. Her current projects include a collaboration with staff at T.H.E. Clinic on a study of the impact of vaginal douching on early detection of sexually transmitted diseases. Smith has also been assisting the staff on how to make the best use of the abundance of data it has collected from various studies. “Often they get grants that expire and they have all of these data points, and nobody knows what to do with them,” Smith says.

She recently submitted a grant seeking funding to conduct seminars to educate clinic staff and community health care providers and activists on how to interpret epidemiologic data. “This is all about empowering the community – to decide what its research is going to be, to enable the community to analyze its own data, and to be able to understand what the data means,” Smith says.

African American and Latino adolescents – the two groups disproportionately affected by escalating Type 2 diabetes rates.

Adequate physical activity and healthy eating can be particularly challenging for children who grow up in socioeconomically disadvantaged neighborhoods, Yancey notes. As schools face financial cutbacks and increasing pressure to raise test scores, physical education is being de-emphasized. In some cases, unsafe parks and the presence of gang activity leave fewer recreational opportunities in the neighborhood, at the same time that sedentary activities such as video games and computers are competing for kids’ attention inside. The most convenient and affordable eating choices are often at unhealthy fast-food establishments – which, in some neighborhoods, represent the only diningout options.

That’s why Yancey believes that, while changing the mind-set of children and their parents when it comes to exercise and nutrition is an important goal, at least as important are efforts to develop programs that effectively change the institutions in which people spend their time – to make schools, workplaces and neighborhoods, particularly in resource-constrained areas, more supportive of a healthy lifestyle.

“We’ve had years of interventions that are very individually focused, and we know that as long as you put the resources in, people will go to these classes or whatever is being offered, and they will be effective,” Yancey says. “But once that intervention is over, and the resources are gone, the behaviors typically return to what they were before. To make a long-term impact, you have to affect the environment.”

CREATING A HAVEN FOR FAMILIES BASED ON HOPE

Hope Street Family Center, a collaboration between UCLA’s Center for Healthier Children, Families and Communities (based in the School) and the California Hospital Medical Center, is a comprehensive resource center serving the downtown Los Angeles area. Benefits for enrollees include home visits; early childhood education; licensed child care; child development screening and assessment; medical, dental and mental health services; parenting classes; adult education and vocational training; job placement; and youth services including tutoring, after-school programs, weekend activities and summer camp.

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It’s the nation’s largest county health department, serving 10 million people covering 4,000 square miles at a time of limited resources. In its efforts to fulfill its public health mission, the Los Angeles County Department of Health Services (DHS) is led by a UCLA School of Public Health faculty member – Dr. Jonathan Fielding, who serves as the county’s director of public health and health officer – and a large contingent of UCLA School of Public Health alumni. In all, more than 60 graduates of the School hold positions with DHS. Among them: LAURENE MASCOLA, M.D., M.P.H. ’81, chief, Acute Communicable Disease Program. Mascola heads a program that conducts surveillance and controls outbreaks for as many as 70 diseases and disease syndromes in L.A. County.

Her program also trains federal Epidemic Intelligence Service officers for the Centers for Disease Control and Prevention – a traineeship that Mascola herself went through beginning in 1982. Mascola had completed her pediatric residency and was prepared to subspecialize in pediatric gastroenterology when she took more than a year off to travel abroad. "It was then that I realized that in most parts of the world, people were dying of very simple things, and that public health was what was needed to get the most bang for the buck," she says.

ROSA PECHERSKY, M.S.W., DR.P.H. ’83, administrator, Public Health Laboratory. Pechersky oversees the daily business operations of one of the largest public health laboratories in California, providing support for the county’s disease control and environmental health activities. The laboratory, which has a staff of 130, serves all DHS facilities on matters of public health specimen testing. As part of the effort, a bioterrorism lab has been funded by the Centers for Disease Control and Prevention for the past three years; following 9/11, CDC increased its appropriation to DHS by approximately $24 million to expand the department’s bioterrorism effort, including the Pubic Health Laboratory infrastructure. Previously, Pechersky served as manager of public health contracts and grants for DHS. ROBERT SETTLAGE, M.D., M.P.H. ’69, medical direc-

INGRID LAMIRAULT, M.P.H. ’83, director, Office of

Ambulatory Care. Lamirault is responsible for developing policy recommendations on the delivery of ambulatory care services in the county’s facilities and obtaining funds to assist in the delivery of those services. She also runs the department’s public-private partnership program, a $60 million effort in which DHS contracts with community clinics and other private providers to deliver primary, specialty and dental care.

Lamirault served as director of DHS’s Tobacco Control Program from 1988 to 1998.

Mascola

Pechersky

CHERI TODOROFF, M.P.H. ’88, director, Immunization

Program. Todoroff’s program seeks to increase the percentage of L.A. County children who are appropriately immunized, and to prevent the occurrence of vaccine-preventable diseases. The program conducts surveillance for such diseases, coordinates investigations of outbreaks, and provides professional education and training. Contracts with community clinics, community-based organizations and WIC agencies ensure the delivery of pediatric immunization services; the program also distributes vaccine doses to health care providers and school-based clinics to immunize uninsured or underinsured children. Todoroff supervises 80 full-time employees, including 10 UCLA School of Public Health alumni. "You can count on the graduates who come out of UCLA to have an excellent foundation in public health theory and practice," she says.

DENNIS BAUER, B.S. ’71, M.P.H. ’72, compliance officer, Office of Managed Care. Bauer ensures that the office which runs Community Health Plan, the county’s Medi-Cal managed care program, complies with rules, regulations and audits put forth by the state Department of Managed Health Care and Department of Health Services. A 30-year DHS employee, he has also served as assistant director in the Office of Ambulatory Care and associate hospital administrator for LAC+USC Medical Center.

MARC STRASSBURG, M.P.H. ’72, DR.P.H. ’81, chief, Web Informatics Division. Strassburg recently moved from being DHS’s chief epidemiologist to a newly created position in which he oversees the Internet activities of the department – developing information on public health issues and resources for the DHS Web site (www.ladhs.org), which is visited by about 100,000 people per month. "It’s very different from my traditional work as an epidemiologist, but the attraction is in making all of the research that I and others have been doing for 20-plus years much more available," he says.

Strassburg, who has also taught at the School for 15 years, has previous experience in smallpox eradication – expertise that is being tapped on county bioterrorism preparedness committees.

Settlage

Lamirault

Todoroff

Bauer

Strassburg

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tor, Sexually Transmitted Disease Program. In his current capacity, Settlage plays a major role in the continuing medical education program and credentialing process for clinicians working in the 13 county-affiliated STD clinics. As a member of the STD program’s senior staff, he is also involved in policy and program directions. "I like working with people – nurses and public health investigators and physicians and pharmacists – to develop, maintain and improve organizations," he says. Settlage, medically trained as an ob/gyn, has worked at DHS for 31 years, starting as director of the Maternity and Infant Care Project.

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UCLA SPH Alumni Play Important Leadership Roles in Operations of L.A. County Department of Health Services

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N OW

IN HER

FIFTH DECADE AT THE

S CHOOL ,

SHE REFUSES TO BACK DOWN WHEN IT COMES TO USING THE LAW TO PROTECT AND PROMOTE HEALTH .

Ruth Roemer:

The Fighting Type Here she is contributing her wisdom at a national

meeting of MergerWatch, a group concerned with how the marriage of religious and non-sectarian hospitals is affecting reproductive health. There she goes to Paris for the 9th World Conference on Tobacco or Health, playing an instrumental role in the WHO’s decision to launch the first international convention on tobacco control. Now she’s back in her office, banging away on her manual typewriter as she writes yet another letter of recommendation for a student. “I’ll have someone who’s an expert put it on the computer,” she explains.

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She uses her computer for e-mail, but hasn’t mastered spacing or attachments.

Who has time? In her fifth decade as a stalwart member of the UCLA School of Public Health faculty, Ruth Roemer continues to be here, there and everywhere, taking on Goliaths no less than the tobacco industry and anti-abortion lobby. At 86, she seems not to have slowed a step, leaving admirers challenged to find a better description than “tireless advocate,” which, in Roemer’s case, seems to fall short.

She was born Ruth Joy Rosenbaum in Hartford, Conn., during World War I, the first of two girls.

Her father, a plant pathologist, died at age 37 of a bacterial infection following the extraction of a tooth, leaving Ruth’s mother with two young children and limited means. The family settled in Milford. “It was a Republican town,” Ruth recalls, smiling. “My family was sort of socialist, and I certainly was a radical.”

She also was a stellar student, gaining entry into Cornell University, where her father had gotten his Ph.D. Ruth majored in English and planned to teach. But upon graduation she toured Europe with the American Student Union. It was the summer of 1936, and the clouds of fascism were all over Europe.

“I came back knowing I had to do something relevant to the social conditions of the United States, which

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“If you can do a piece of work, and not long after it’s finished, get action that improves the lives and health of people, that’s for me.”

—Ruth Roemer, J.D. Professor Emerita

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abortion law reform in California in 1967, six years before Roe v. Wade.

She would make her mark in many other ways in the ensuing years: with analyses of the functions, education and regulation of health personnel; as an ardent campaigner for fluoridation of public water supplies in California and worldwide; with an early’70s study examining the gap between the advanced technology available to curb pollution and the application of this technology to protect people’s health and living conditions; and, for the last two decades, with seminal work in tobacco control that started with a world review of tobacco control legislation, carried out for the World Health Organization and first published in 1982. That compilation and analysis proved helpful to the many countries grappling with tobacco control policies. Since then, Roemer has presented at international tobacco control conferences on five continents. In 1996, she was invited

by WHO to prepare a document, in collaboration with attorney Allyn Taylor, that helped launch WHO’s first international convention on tobacco control. The treaty, which is currently being negotiated by 160 countries, will include guidelines on legislation as well as protocols for such issues as advertising, smuggling and taxation.

In the midst of all this activity there was the year (1987) she served as president of the American Public Health Association (an experience Roemer describes as “thrilling”), countless publications and a mantle-full of awards, including the APHA’s prestigious Sedgwick Memorial Medal, the UCLA Public Health Student Assn.’s Faculty of the Year Award and, most recently, the Beverlee A. Myers Award, presented by the California Department of Health Services to Ruth and her late husband Milton.

It’s difficult without Milton, she confides. Yet she presses on. With a faculty colleague, Dr. Barbara Berman, Roemer recently submitted to WHO a document entitled “Strengthening Enactment, Enforcement, and Evaluation of Tobacco Control Legislation.” Along with her tobacco work, the activities that keep her especially busy involve students. Many current and former students seek her advice. And Roemer teaches every quarter – a health law class in the fall, a course on public health ethics that she co-teaches in the winter, and a seminar for undergraduates on public health law and policy in the spring. She also helped shape a new course aimed at giving a public health perspective to premed students and other undergraduates.

“I guess the reason I’m here at age 86,” Ruth Roemer says, modest as ever, “is that I find it bracing to be with young people, and perhaps to help them.”

faculty profile

was just coming out of the Depression, and this terrible threat of fascism in the world,” she says.

“So I walked over to the [Cornell] law school and asked if they would take me.”

But she didn’t walk away from the literary world empty-handed. As an undergraduate, Ruth competed for the editorship of the Cornell Journal of Opinion with fellow student Milton Roemer. “Our faculty advisory committee decided to try co-editorship,” she recalls. “They joked that the co-editors would have to work closely together, but wouldn’t necessarily have to get married to do it.” Fatal words. “I had never met anyone like Milton before,” Ruth recalls. “He was taking all of these biological sciences and planning on a very strenuous career, and yet he was poetic, with a wonderful eye for art.” They married in 1939, on the day Hitler marched on Poland. Their 62-year union, which lasted until Milton’s death last year, was arguably public health’s most fruitful. “My contribution is really nothing compared to what Milton did,” Ruth insists.

That says a lot about her husband, because as a pioneer in health law, Ruth Roemer’s contributions have loomed large.

Her entry into public health was somewhat fortuitous. Roemer was a labor lawyer through the 1940s and 1950s, as her husband’s peripatetic profession took them on more than a dozen moves. One of their last stops was back in Ithaca, N.Y., where Ruth returned to Cornell Law School to work as an associate to Professor Bertram F. Willcox. There, she participated in a landmark study of the law governing the state’s admissions to mental hospitals. Her research with Willcox resulted in a book, Mental Illness and Due Process, that called for a transformed system in which decisions on admitting patients to mental hospitals would become initially medical, rather than legal, matters, with subsequent periodic legal reviews. Less than two years after the book was published, the New York State Legislature passed unanimously the law recommended by the study – and Roemer had found her career calling. “My feeling was that if you can do a piece of work, and not long after it’s finished, get action that improves the lives and health of people, that’s for me,” she says.

The same year the book was published, in 1962, the Roemers – who now had a son, John, and a daughter, Beth – made their final move, to Los Angeles and the UCLA School of Public Health faculty. With barely enough time to unpack, Ruth Roemer delved into one of the most controversial issues of the day. She became the principal organizer and vice president of the California Committee on Therapeutic Abortion, formed to provide public education and leadership in reform of California’s century-old abortion law. Her group spearheaded

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COMBINING

PUBLIC HEALTH WITH OTHER PROFESSIONAL OR ACADEMIC DEGREE PROGRAMS , STUDENTS WITH OVERLAPPING INTERESTS ARE GETTING THE BEST OF BOTH WORLDS .

Taking the M.P.H. to Another Degree Students Double Up in Concurrent Programs

“As I learned more about it, I saw this great avenue of law, policy and health opening up. Going to school for both a J.D. and an M.P.H. would be niche training that would put me right where I wanted to be.”

—Katherine Deland, J.D., M.P.H. ’01

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Above: Katherine Deland (second row, fourth from left) at this year’s World Health Organization conference in Jaipur, India.

Katherine Deland

found herself at a crossroads.

After getting her undergraduate degree in biochemistry and working as a scientist for a year, she decided bench work wasn’t for her. Shifting gears, she did an internship with the public defender service in Washington, D.C., and found she loved the law. But as she prepared to enter law school at UCLA, she wasn’t comfortable with the thought of leaving science behind.

In public health, she found the best of both worlds. “As I learned more about it, I saw this great avenue of law, policy and health opening up,” she says. “Going to school for both a J.D. and an M.P.H. would be niche training that would put me right where I wanted to be.”

At the time, the School of Public Health had no J.D./M.P.H. program, “but was very willing to talk to me about doing it,” Deland says. In 1997, she embarked on her pursuit of the two degrees. Four years later, she had them.

As the value of a public health degree becomes more evident to graduate students from a wide variety of disciplines, the number of concurrent degree programs offered by the School is growing (see the accompanying list). “The fact that we can cooperate with other schools and departments to develop a program in which students can have two professional or master’s degrees in a shorter period

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CONCURRENT DEGREE PROGRAMS: J.D./M.P.H. M.A./M.P.H. (Area Studies) African Asian American Islamic Latin American

M.B.A./M.P.H.

is on track to have her M.P.H. by December.

Ogiamien’s ultimate goal is to run a nonprofit organization that delivers health promotion and AIDS prevention programs in English-speaking West Africa. “Having both degrees will open doors and give me the credibility that I need to move in different circles,” she says.

Matthew Gerlach (M.P.H. ’81, M.B.A.) can attest to the value of a concurrent degree program.

“It’s helped me establish a level of credibility within organizations in very short order,” says Gerlach. As a senior vice president at Kaiser Permanente, Gerlach is service area manager for the San Fernando, Santa Clarita and Antelope valleys, responsible for overseeing the operations and forming strategic plans with Kaiser’s medical group partners in that region. “I’m able to bring to bear not only the degrees, which look good on the résumé, but the actual experience and knowledge behind those degrees,” Gerlach explains.

“I find I use both the M.P.H. and the M.B.A. It’s a good combination.”

Gerlach believes the opportunity to learn about hospital administration from more than one educational perspective was particularly useful. Others have found similar advantages to the dual-degree approach. “The real benefit is that the knowledge from the two programs plays off of each other,” Deland says. In her last two years, she explains, she was writing papers on health law that would not have been possible without the knowledge she gained from both sides of the campus. Deland’s association with the School of Public Health was also instrumental in helping her secure an internship at the WHO, where she is currently serving as a legal officer for the Framework Convention on Tobacco Control while pursuing a Ph.D. in health law at the Johns Hopkins School of Public Health.

Reflecting on the experience of going through two rigorous programs at once, Deland quips: “It was totally brutal. I never slept, I was cranky all the time, and my family couldn’t wait for spring 2001 to come.

But the outcome is that I’ve distinguished myself in a way that is eye-catching. Now, as far as job prospects, I get a lot of attention from people in many different fields. That’s very gratifying.”

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of time than if they obtained those degrees separately is very appealing to students who have overlapping interests,” says Dr. Gerald Kominski, associate dean for academic programs.

For example, many graduate students in area studies programs have an interest in the health of the populations they’re studying and have been attracted to the School, which now offers concurrent M.A./M.P.H. degrees for students in African studies, Asian American studies, Islamic studies and Latin American studies. “It’s a nice balance,” says Jill Lopez, a student in the M.A./M.P.H. in Latin American Studies program who hopes to use her dual degrees to address reproductive health issues in Latin America.

Adesuwa Ogiamien was an undergraduate at UCLA majoring in sociology when she began working for Dr. Jonathan Fielding, professor of health services at the School of Public Health and director of public health for L.A. County. “I discovered this discipline I had known nothing about,” says Ogiamien, who had been planning to go to law school. As she was learning more about public health, she read a Time magazine article about the devastation of HIV/AIDS in Africa. After talking with faculty at the School and searching the Internet to learn about jobs available through the World Health Organization and United Nations, she decided to abandon her law school ambitions in favor of concurrent master’s degree programs in African studies and public health.

“I want to be part of the change,” says Ogiamien, who has already recieved her M.A. in African Studies and

“Having both degrees will open doors and give me the credibility that I will need to move in different circles.”

—Adesuwa Ogiamien, M.A./M.P.H. student

M.D./M.P.H.

D.Env. (Environmental Science and Engineering)

Ph.D. (Molecular Toxicology)

UCLAPUBLIC HEALTH

INTERDEPARTMENTAL DEGREE PROGRAMS:

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18 Though conspicuous by its recent absence from the national political debate, the issue of access to care weighs heavily in the minds of public health researchers and advocates.

Still Seeking Access to Care

Grappling with a Problem that Won’t Go Away

“National surveys

UCLAPUBLIC HEALTH

have shown that most Americans believe people can get coverage, or that the uninsured get care when they need it.

But we have plenty of information to suggest that that’s not true.”

—Dr. Ronald Andersen

Ten years ago this fall, Bill Clinton and Al Gore were voted into the White House with what seemed to be a clear mandate to enact national health care reform, including a mechanism for universal coverage.

After a campaign in which every candidate including the incumbent President had argued, to varying extents, for an overhaul of the U.S. health care system, it was a time of high hopes for public health professionals and academics who viewed access to care – or lack thereof – as the nation’s foremost public health problem.

But the high hopes of 1992 were soon dashed by the resounding defeat of health care reform in Congress, as the United States remained the only developed country not to ensure access to health care through guaranteed coverage.

Ten years later, few politicians talk of universal coverage – despite ample evidence that the problem is in some ways worse now than it was a decade ago.

Today the number of uninsured Americans is estimated at 39 million. In California, the proportion of people who are uninsured is as high as, or higher than, it was 10 years ago, according to Dr. E. Richard Brown, professor at the School and director of the UCLA Center for Health Policy Research (housed in the School of Public Health with ties to the School of Public Policy and Social

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What does it mean to be without health insurance in the United States? Dr. Ronald Andersen, the Fred W. and Pamela K. Wasserman Professor of Health Services at the School, has been a leading researcher on the issue of access to care for more than 30 years

ACCESS FOR CHILDREN Children with special health care needs ranging from behavioral or emotional disorders to chronic medical conditions such as asthma can face the added burden of difficulty accessing a pediatric specialist, particularly if they are in managed care or public insurance programs. Dr. Moira Inkelas is identifying the barriers to primary and specialty care among this population of children, as well as the processes that managed care plans and public programs can use to facilitate access. “These children might get to a specialist at some point, but they may not be worked up early enough to ensure that treatment is most effective,” she says.

“Some kids are sent to adult specialists rather than pediatric specialists. There is concern that these kids don’t get the same quality of care.” Among the problems are Medicaid reimbursement rates in California that remained flat for about 25 years, creating a shortage of specialists in the state who serve this vulnerable population.

UCLAPUBLIC HEALTH

Research), which has become the quasi-official source for information on health insurance coverage in California, as well as being a major provider of national analyses.

Meanwhile, storm clouds loom ahead. “The recent period of economic growth resulted in a trend toward increasing coverage and declining uninsurance rates,” Brown says. But with the current economic downturn, he expects the next set of data to show that the trend has been reversed. “Health insurance costs are rising rapidly,” he says. “We have every reason to think that this will lead to employers cutting back on benefits, reducing eligibility, and shifting costs to employees, all of which results in more people with jobs not having coverage – despite the fact that the primary way to get coverage in this country is through employment. The situation continues to be bad, and I don’t see too many politicians lined up to address the problems.”

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The nonprofit Venice Family Clinic provides comprehensive primary health care at no cost for people with no other access to such care.

and is currently serving on an Institute of Medicine committee, “Consequences of Uninsurance.” He points out that, despite the “safety net” in place to treat acute conditions, individuals without insurance are more likely to forego preventive services, from the developmental checkups of childhood to cancer screenings for adults; and to delay care for a problem until it becomes acute, whether it’s an ear infection that sends a child to an emergency room or a chronic condition such as asthma, diabetes or hypertension that festers out of control.

“When people don’t have any kind of attachment to a health care provider, we find that they use less care relative to their needs, and they’re more likely to experience acute episodes of chronic conditions that aren’t being monitored or controlled,” Andersen explains. “The uninsured are not simply young and healthy people; they’re people in need.

We’re finding considerable indication that the lack of insurance is a substantial detriment to health status.”

But having coverage, while extremely helpful, doesn’t remove all barriers to care. Efforts to contain or shift costs have imposed higher co-insurance payments and deductibles. “Even among the insured, income makes a difference in whether people see a doctor or follow up with care,” Andersen notes.

Soaring prices for prescription drugs cause many people not to take prescribed doses, or to delay or forego refilling their prescriptions. There are also non-economic barriers. Geography can be a key factor – research by Andersen and Brown indicates that low-income people who live in areas without community clinics are less likely to see a doctor or take their children to one. Cultural barriers, language barriers, lack of knowledge and low educational attainment all have been shown to play a role in limiting access to appropriate care.

“There are people who face systems that are not very user-friendly,” says Brown. For individuals not used to being assertive with bureaucracies, he explains, the managed care system can be difficult to negotiate. “Some people are more likely to take at face value the statement, ‘I’m sorry, your referral hasn’t been approved,’” Brown says. “Those who can negotiate these bureaucracies more effectively know that you persist. You call up again, demand to speak to a supervisor and get your doctor involved.

Otherwise you might not get the care you need.”

If one word can sum up the problems plaguing the U.S. health care system, Brown argues, it’s fragmentation. “We don’t have a health care system in the United States,” he says. “What we have are a lot of

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ACCESS FOR PEOPLE WITH AIDS As part of a team of UCLA and RAND researchers on the national HIV Cost and Services Utilization Study, Dr. William Cunningham has helped to define important barriers to care as well as factors that increase the likelihood that people with HIV will get the care they need, including the importance of providing supportive social services.

“The health care system is designed to treat people with acute illnesses through hightech interventions, and with more immediate outcomes,” says Cunningham. “AIDS is different in that it is a chronic disease that has high mortality.

We have good treatments, but they’re not perfect treatments,

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different health care programs, competing health plans and individual coverage options that don’t form a system.” Indeed, he adds, public coverage programs were fragmented by design, as a way to extend eligibility to various groups such as pregnant women and children from low-income families; the result is a patchwork system in which members of the same family can belong to different programs, and eligibility categories are confusing and fraught with gaps.

The system’s fragmentation also hinders cost-containment efforts, Brown notes. Unlike other industrialized countries, the United States has no effective mechanism for government, employers, unions and health care providers to work together in a coordinated fashion in managing the growth of health spending, Fragmentation also applies to the care U.S. health consumers receive. “Providers are mostly on their own,” Brown says. “There are often communication problems between providers, and a lack of coordination of care.” This becomes a particular problem for people with chronic health conditions, he adds, since effectively managing those conditions often involves a network of systems for diagnosis, treatment, disease management, and personal and family support.

Brown explains that although he and his colleagues haven’t abandoned the goal of universal coverage, the political barriers to enacting sweeping reform necessitate finding ways to get there through incremental progress. The best example is the State Children’s Health Insurance Program (SCHIP), the federal-state program created in 1997 to cover children whose parents can’t afford private insurance but whose income makes them ineligible for Medicaid.

Says Brown, whose center has consulted in the development and implementation of Healthy Families, California’s SCHIP: “The best way to make progress in the current political climate is to seize opportunities to expand programs and meld them into more coherent systems.”

and they have to be sustained.

The people who get the disease have myriad social problems, and doctors alone are not well equipped to deal with those. Better integration of social services with medical services is a very

UCLAPUBLIC HEALTH

promising avenue.”

Another kind of fragmentation exists on the very question of how access to care is defined. “Access means different things to different people,” says Andersen. In the general public, misconceptions abound. “National surveys have shown that most Americans believe people can get coverage, or that the uninsured get care when they need it,” Andersen says. “But we have plenty of information to suggest that that’s not true.” Many don’t realize that the vast majority of uninsured individuals work or are members of working families, he notes. “And the fact is, if you don’t have coverage provided by your employer, and insurance costs $5,000 to $12,000 a year or more, then even if it’s available, priorities such as

food, clothing and shelter have to come first.”

There’s also disagreement among public health researchers and professionals, Andersen notes. Some view access as the opportunity to attain personal health services; others look at it as the actual use of the services; still others believe it’s getting appropriate services according to the individual’s needs. Andersen sees it as a combination of the three. “We need to define the dimensions of access more clearly, so that we have a common ground when talking to other researchers, policy-makers or the public,” he contends.

How to define access and its dimensions is something Andersen has pondered for much of his career.

In Changing the U.S. Health Care System: Key Issues in Health Services, Policy and Management (John Wiley), edited by Andersen with contributions from many of the School’s faculty, the following definition is proposed: Access is the actual use of personal health services and everything that facilitates or impedes use of these services. It’s the link between health services systems and the populations they serve.

Access means not only getting to service, but also getting to the right services at the right time to promote improved health outcomes.

Successful health policy in improving access to care depends not only on conceptualizing access, but also on the development of effective access measures, Andersen says. Such measures can help to predict use of health services, promote social justice through equity and utilization of health services by various groups, and enhance the effectiveness and efficiency of health services delivery. Among the basic access indicators: whether one has seen a physician in the past year; whether children have received recommended immunizations; number of hospitalizations for conditions that would be preventable with good

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21

“We don’t have

ACCESS FOR THE ELDERLY

a health care system in the United States.

What we have are a lot of different health care programs, competing health plans and individual coverage options that don’t form a system.”

The shift in Medicare from

—Dr. E. Richard Brown

feature

primary care, such as complications from diabetes, asthma or hypertension; and the extent to which emergency rooms are used for primary care. A universally accepted definition and agreed-upon measures of access would enhance researchers’ ability to shed light on many issues in which better access would mean improved health, says Andersen, who believes the research priorities for the field should include finding new ways to promote successful birth outcomes through greater access, doing more to increase the use of vaccinations, and developing better systems to monitor quality of life for people with chronic conditions – an area in which major disparities have been found related to gender, ethnicity, income and insurance status.

“There’s a lot of emphasis today on reducing health disparities,” he says. “We can emphasize the public health model of health promotion and disease prevention to a greater extent, improving the health of vulnerable population groups without bankrupting the country. It’s the right thing to do to promote equity in delivering services relative to people’s needs.”

Andersen says the work of the Institute of Medicine committee on which he serves has confirmed that providing coverage for the uninsured must be the nation’s top health priority. “I don’t know when we’ll get to universal coverage,” he says. “But there are a number of encouraging state programs offering coverage now to people who didn’t have it before. With the downturn in the economy, the vulnerability is hitting home with more people. And in the long run, employers may increasingly see the benefits of national programs.”

a system emphasizing fee for service to one of managed care changes the dynamics as they relate to access.

Dr. Steven Wallace is examining the impact of this shift on low-income minority elders.

“We’ve found a significant improvement in many measures of access to care, but for Latinos – particularly those whose first language is Spanish – there are problems related to the quality of the interactions they have with the system,” he says. Issues of access and equity in longterm care are also important, Wallace adds. Minority elderly use nursing homes at a substantially lower rate than whites; the question is whether the cause of this discrepancy is cultural, socioeconomic or discrimination.

UCLAPUBLIC HEALTH

Given the dramatic changes in both the health care system and the political landscape, the fall of 1992 now seems quite distant. In the last 10 years, managed care has become predominant, leading to improvements in access while creating new concerns. “Managed care has provided the opportunity to have a system that integrates the various sources of care that people require,” Andersen says.

“It looks at people and populations in a larger context; that is, how do we promote health rather than just treat an acute illness? On the other hand, there is a concern about the financial incentives on the part of organizations and practitioners to limit service.”

Is access to care better or worse in the United States than it was a decade ago? The answer depends on one’s point of view, Andersen says. Those looking for positives can find them in the expanded coverage provided through public programs such as Medicaid and SCHIP, as well as other safety-net providers of community health services. But negative developments aren’t hard to find either, from the cutbacks in employer-sponsored health insurance to the rise in access-related health disparities.

“It’s important to recognize that we have made progress,” says Brown. “But there is still a great deal of work to be done.” Brown and his colleagues at the Center for Health Policy Research regularly produce analyses on access as it affects specific demographic groups, from women, ethnic minorities, and immigrants to single men and adults who have trouble finding insurance due to pre-existing chronic conditions. “Each of these groups has a different situation that needs to be understood,” Brown says.

Researchers, he adds, can play a role in helping to ensure that the issue of access to care doesn’t disappear from the political radar screen. “Each time we do a study, it reminds people of the scope and magnitude of this problem,” Brown says. “We give data to policy-makers and advocates that helps them understand who’s affected and who is falling through the cracks, as well as what opportunities exist to help those people get coverage and access to the care they need.”

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Largest-Ever Ongoing State Health Survey: CHIS Puts State, County Health Needs into Sharper Focus

22

And now, what you’ve all been waiting for…

No one made that statement when the UCLA Center for Health Policy Research and its collaborators rolled out the first findings from the landmark California Health Interview Survey (CHIS) in May. But it certainly would have been fitting.

Ever since CHIS was established nearly three years ago as the nation’s largest-ever ongoing state health survey, beneficiaries – including local health departments, state health agencies, community health centers, hospitals, health plans, advocacy groups, funding agencies, and health researchers – have anxiously anticipated results that will provide statewide and local-level estimates on topics pertaining to health conditions and access to care, for major racial and ethnic groups as well as a number of smaller ethnic groups.

“CHIS was the result of years of trying to develop useful data for policy and planning in California both at the state level and locally, since counties have a great deal of responsibility for public health and meeting the needs of low-income uninsured people,” says Dr. E. Richard Brown, professor in the School of Public Health, director of the Center for Health Policy Research and principal investigator of CHIS. “State and local health planners and policy-makers have had a great desire for information to give them an understanding of the depth of a health problem, its magnitude, and the key groups it affects, so that they can develop effective interventions for prevention and treatment, and know how best to

Left to right: Dr. Charles DiSogra, director of the California Health Interview Survey (CHIS) at the UCLA Center for Health Policy Research; Sue Holtby, senior research scientist at the Public Health Institute; Dr. Jeff Luck, CHIS co-principal investigator and a faculty associate at the Center for Health Policy Research; Dr. Peter Abbott, chief of the Office of County Health Services at the California Department of Health Services; Dr. E. Richard Brown, principal investigator of CHIS and director of the UCLA Center for Health Policy Research; and Dr. Ninez Ponce, CHIS coprincipal investigator and a senior researcher at the Center for Health Policy Research.

allocate resources.”

A collaborative project of the Center for Health Policy Research, the California Department of Health Services and the Public Health Institute, CHIS will survey, by telephone, approximately 55,000 randomly selected households every two years on a wide range of health issues. Results of the first survey are being released in various forms between May and September of this year. Funding for the first two-year cycle, totaling $11.6 million, came from the California Department of Health Services, The California Endowment, the California Children and Families Commission, National Cancer Institute, Centers for Disease Control and Prevention, and Indian Health Service.

CHIS surveys adults, adolescents and children (through reports from their parents) on a variety of topics, including general physical and mental health status, chronic conditions and their impact, health-related behaviors, and questions about access to and use of health services, including health insurance coverage. The design and large size of the sample give health planners, policy-makers, counties and communities a picture of the health and health care needs of populations that is much more detailed than ever before.

“In the past, we had statewide survey data, but the samples were just not large enough to break results down by county in any reliable way,” says Dr. Charles DiSogra, the survey’s director. “If counties wanted information about their specific population, they had to fund their own survey. Some did that, but, since everyone asked different questions and conducted their surveys at different points in time, there was no means of comparison. With CHIS we have a much larger sample, resulting in much

UCLAPUBLIC HEALTH

greater precision. The sample has been designed specifically to provide the ability to break the data down into California’s major race and ethnic groups and into smaller geographic areas that other surveys have been unable to capture. In every sense, this will better inform policy-makers about where some of the areas of greatest need exist.”

Brown notes that in designing the survey, the center had two major objectives. The first was to capture the disparate needs of California’s diverse populations – those of immigrants and non-

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23 and university researchers to advocacy groups and state and local

of rural and urban areas, and various ethnic and racial groups –

agencies. “We regard CHIS as a public service,” Brown says.

in ways not achieved by previous surveys. The second was to col-

“It’s not our data; it’s data that’s in the public domain, and we take

lect a large enough sample that individual counties of a certain

very seriously the commitment to disseminate it and make it

size would get statistically significant data on their residents. (Small

user-friendly.”

counties, with fewer than 100,000 population, are aggregated with

Results from the 2001 survey are being made available

neighboring counties to reach minimum sample size.) To achieve

on the CHIS Web site (www.chis.ucla.edu) and in a variety of

these goals, CHIS oversampled small rural counties and certain

printed reports. Technical assistance is being offered to individuals,

ethnic population subgroups.

agencies and organizations to help them conduct their own

This enables CHIS to paint some of the first pictures of

analyses with CHIS data. In addition, an online data query system,

the health status and needs of distinct subgroups that have typically

called “Ask CHIS,” which can be accessed on the site, enables

been lumped together as “Asian American and Pacific Islander”

requesters to obtain estimates tailored to their needs. “Ask CHIS”

due to small samples in past surveys, for example. These groups

represents the next generation of online systems, and will provide

include Vietnamese, Koreans, Japanese, South Asians, Filipinos

a simple, user-friendly way for anyone, anywhere, any time to

and Cambodians. A special supplemental sample conducted as

obtain CHIS estimates. “Instead of facing, potentially, hours of sta-

part of CHIS also provides meaningful health-related information

tistical analysis, users can choose variables from an interactive

on a large sample of the state’s American Indian/Alaskan

menu and the system will, within seconds, present them with an

Native population.

accurate table of results that they can view on the screen or down-

To ensure that the survey would truly represent the state’s

load for further use,” says Dr. Jeff Luck, co-principal investigator

diversity, the center took unprecedented measures in the cultural

who led the development of the system. “We expect this system to

adaptation and translation of the CHIS questionnaire. Two sets of

make the results available to a much wider variety of users – peo-

bilingual/bicultural reviewers from approximately 10 language and

ple who wouldn’t otherwise be able to download the data set and

cultural groups, as well as education specialists, reviewed the

do all of the manipulations required.”

CHIS questions. CHIS was administered in six languages: English,

“CHIS is really groundbreaking in every respect,” says

Spanish, Chinese, Vietnamese, Korean, and Khmer (Cambodian).

Brown. But, as the rewards of his center’s three-year effort are

“There are a lot of populations, both English-speaking and non-

reaped in the form of data analysis and dissemination to an audi-

English speaking, that are not traditionally reached by surveys,”

ence that has long yearned for such information, there is no time

says Dr. Ninez Ponce, a co-principal investigator on the study who

to relax. The work on CHIS 2003 is already well under way.

oversaw the process. “A truly representative population-based survey ensures that everyone has an equal chance to be included, and that there is no cultural or linguistic bias in the results.”

The cultural and linguistic adaptation process is only one example

feature

immigrants, individuals from all socioeconomic levels, residents

California Health Interview Survey results and information are available at www.chis.ucla.edu.

The first release of data from the 2001 California Health Interview Survey (CHIS) examined the prevalence of asthma in California, the prevention and management of asthma symptoms, and the consequences of poorly managed asthma.

CHIS results are being released in various forms between May and September of this year.

of how CHIS went the extra mile in ensuring that the survey is both representative of the communities of California and of value to the users of the data. Leaders of organizations and agencies throughout the state – more than 150 individuals in all – advise CHIS on policy and technical issues. An advisory board, consisting of senior officials from government agencies, health organizations and advocacy groups, counsels on policy issues related to survey content, sampling strategy, and the dissemination of results. Technical advisory committees provide input on content and methodology, along with the multicultural and linguistic survey approaches.

It all adds up to an enormous challenge for the faculty and full-time CHIS staff members at the Center for Health Policy Research, along with their collaborators at the California Departtracts with an outside firm for the data collection.)

“One of the things I feel proudest about with this survey is the process of involving constituencies in its design and development,” says Brown. In turn, CHIS has invested a great deal of resources in disseminating the data to its constituencies, from policy-makers

UCLAPUBLIC HEALTH

ment of Health Services and Public Health Institute. (CHIS con-

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24

research highlights

UCLAPUBLIC HEALTH

RISK FOR ABNORMALITY BY EXPOSURE LEVEL

Exposure to Common Air Pollutants Early in Pregnancy Puts Fetus at Greater Risk for Congenital Heart Defects IN THE FIRST COMPELLING EVIDENCE that air pollution, even at the levels currently found in Los Angeles, can play a role in causing birth defects, researchers from the School and the California Birth Defects Monitoring Program have found that exposure to two common air pollutants may increase the chance that a pregnant woman will give birth to a child with certain heart defects.

A research team headed by Dr. Beate Ritz, an epidemiologist at the School, matched air pollution monitoring information regularly collected by air-quality officials at 30 locations in the Los Angeles region with information on Los Angeles-area babies from the California Birth Defects Monitoring Program, a program funded by the California Department of Health Services that collects comprehensive information about structural birth defects in partnership with the March of Dimes Birth Defects Foundation.

When exposed early in their term, pregnant Los Angeles-area women living in regions with higher levels of ozone and carbon monoxide pollution were as Odds Ratios for Ozone and much as three times as likely as women in areas with the cleanest air to give Pulmonary Artery and Valve birth to infants who suffered serious heart problems, Anomalies including conotruncal heart defects, pulmonary artery/valve defects and aortic artery/valve defects.

Many of these babies face open-heart surgery 9.5 before age 1. The researchers discovered that the 8.5 risk is highest for women exposed to elevated amounts of the pollutants in the second month of 7.5 pregnancy – when the heart and other organs begin 6.5 developing.

“These findings show that there are more health 5.5 problems caused by air pollution than solely asthma 4.5 and other respiratory illnesses,” says Ritz. “There seems to be something in the air that can harm 3.5 developing fetuses.”

2.5 Ritz suspects that the “something” might not be carbon monoxide or ozone. Rather, it’s possible that 1.5 these pollutants serve as proxies for some as-yetunidentified chemical or chemicals that spew out <1.07 1.07 - <1.99 1.99 - <2.86 >2.86 of the tailpipes of motor vehicles. “There might be air AVERAGE SECOND MONTH OZONE EXPOSURE toxics and fine particles or other secondary pol(parts per hundred million) lutants that occur alongside carbon monoxide and ozone, but which we don’t measure routinely or know about,” says Ritz. “Those things may pose health risks we don’t yet understand.”

Several other studies, including one by Ritz, have linked air pollution to premature delivery and low birth-weight. Says Ritz: “I think our latest study, together with all of the other studies indicating that the fetus can be affected by pollution, suggest that we need to find ways to reduce traffic-related exhaust.”

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25

CHRONIC ILLNESSES, DRUG AND ALCOHOL DEPENDENCE, violence, and unintentional injuries produce a substantial burden of disease in Los Angeles County – a much greater burden than is reflected by mortality and morbidity rates, according to a study by researchers from the Los Angeles County Department of Health Services and UCLA Center for Health Policy Research, based in the School.

The report employed a new method to assess the total burden of disease and injury among L.A. County residents. The Global Burden of Disease method combines premature mortality (measured as years of life lost) and morbidity (years lived with a disability) into a single measure of burden, disability-adjusted life years (DALYs).

Using that method, the researchers found that several conditions, including alcohol dependence, depression, drug dependence, and osteoarthritis, have a burden of disease not adequately captured by mortality rates because of the large number of Coronary heart disease years of disability associated with Alcohol dependence these conditions. Other conditions, Homicide/violence including injuries from motor vehicle crashes, HIV/AIDS, and suiDepression cide, have a greater burden of Diabetes mellitus illness than measured solely by Osteoarthritis crude mortality rates, due in large Lung cancer part to the considerable premature Emphysema mortality associated with these Alzheimer’s/other dementias conditions.

HIV/AIDS Significant variations exist in

research

All Things Considered, Chronic Disease, Addiction, Violence and Injury Produce Greater Burden than Thought

Proportions of Years of Life Lost (YLL) to Years Lived with a Disability (YLD) for Selected Leading Causes of Disability-Adjusted Life Years in Los Angeles County

YLL YLD

40,000

60,000

80,000

UCLAPUBLIC HEALTH

Cirrhosis the leading causes of DALYs across gender, race/ethnicity and geoSelf-inflicted injury graphic regions within the county.

Asthma Homicide/violence is the second Breast cancer leading cause of DALYs in males, while only the 24th-ranked cause in 20,000 0 females. African Americans have YEARS the highest age-adjusted DALYs per 1,000 population of any ethnic group, while Latinos and Asian Americans have lower DALY rates than whites. Most of these ethnic differences are attributable to differences in premature death as measured by years of life lost, according to the study’s authors. However, African Americans also have higher rates of disability, as measured by years lived with disability.

The study aimed to “provide additional perspective on how to assess burden of disease and injury, and advance the public discussion about how and where to allocate public health resources to most effectively address the diverse health needs of the county’s residents,” the authors wrote. “The findings confirm previous results regarding the major health problems facing the county, while highlighting the significant impact of other public health problems that are often underestimated.”

The research team included Drs. Gerald Kominski, Jeffrey Luck, and YeeWei Lim from the Center for Health Policy Research, along with a group from the L.A. County Department of Health Services including Dr. Jonathan Fielding, director of public health for the county and professor at the School; Dr. Paul Simon, an adjunct member of the School’s faculty; and Dr. Alex Ho, an alumnus of the School.

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Perception of Risk Is Skewed by Local TV News; Coverage Underestimates Some Threats, Inflates Others

26 Number of Injuries and Deaths in Los Angeles by Cause, and Percentage Covered in Local TV News, November 1996 and March and May 1997

Motor vehicle traffic accidents Accidental poisonings Falls Fires Suicides and self-inflicted injuries Homicides and assaults Legal interventions

IN THE FIRST EPIDEMIOLOGICAL STUDY of its kind, researchers from the School’s Southern California Injury Prevention Research Center have concluded that television news in Los Angeles skews viewer perception of actual threats to life and limb, which could lead to unwarranted anxiety over some risks while masking the danger of others.

Their study, published in the Western Journal of Medicine, found that local TV newscasts in late Deaths % covered Injuries % covered 1996 and early 1997 reported 48 percent of the actual traumatic deaths occurring in Los Angeles 216 63.9 2,231 9.0 County. Meanwhile, just 3 percent of traumatic injuries attracted coverage. Nearly all traumatic 129 3.9 816 3.6 deaths by homicide, air travel, fire, natural or envi56 12.5 6,696 0.2 ronmental factors, and law-enforcement activity drew coverage, accounting for 66 percent of all 14 100 90 57.8 traumatic deaths in the news, while constituting just 31 percent of actual traumatic deaths in the 188 5.9 1,296 0.5 county. In contrast, deaths due to motor vehicle 307 97.7 1,772 21.0 crashes were portrayed about a third less than actual occurrence, and all other causes of trau2 100 21 33.3 matic death — such as accidental poisoning, falls and suicide — were portrayed in much lower proportion to their actual occurrence.

“The primary focus of local news is on events with high visual intrigue, such as air crashes and homicides,” says Dr. David McArthur, the study’s lead author. “Stories about deaths and injuries with lesser visual content — suicides, falls, accidental poisoning — are rarely shown.”

McArthur’s team analyzed 1,134 news broadcasts from nine L.A. stations to determine the likelihood that various incidents resulting in injury or death would be reported. In reporting stories involving non-fatal injuries, local TV news crews covered about one in five assaults resulting in hospitalization. Meanwhile, injuries due to fires and water travel were portrayed proportionally more often than any other cause of injury. Underrepresented injuries included accidental poisonings, motor vehicle non-traffic events, falls, natural or environmental factors, near drownings, and injuries related to falling objects, machinery, explosions or electricity.

“Deaths and injuries are rarely presented on local TV news with any background information or context,” McArthur says. “What’s being reported is so out of balance with the true nature of the proportions that the real statistics come as quite a shock.”

This places additional demands on health-care professionals to uncover and correct a variety of misunderstandings and misapprehensions by patients and families, especially when talking with younger children, McArthur says. It also presents public health educators with an uphill battle to affect the nature of injury prevention efforts.

UCLAPUBLIC HEALTH

Adjuvant Therapy Leads to Increased Physical Function for Long-Term Breast Cancer Survivors, Study Finds LONG-TERM BREAST CANCER SURVIVORS report excellent quality of life many years after treatment, but the use of chemotherapy and tamoxifen in addition to surgery may result in decreased physical functioning over time, according to a study published in the Journal of the National Cancer Institute.

The study, one of the largest examining quality of life in long-term breast cancer survivors, could influence the way doctors treat women with very small

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tumors, says Dr. Patricia Ganz, senior author of the paper and director of the Division of Cancer Prevention and Control Research, based in the School.

“The question has been asked: Should every woman, even those with very small tumors, receive chemotherapy or tamoxifen or both after surgery?” Ganz says. “I think, in light of this research, the answer may be no. This study shows there are some subtle costs to be paid with adjuvant therapy. But the only place this would carry any weight would be in women with tumors less than a centimeter in size.”

Ganz and her team of researchers focused on 763 disease-free women in Los Angeles and Washington, D.C., who were an average of 6.3 years out from breast cancer diagnosis. The women filled out 42-page questionnaires seeking information on such quality of life issues as physical functioning, social functioning, pain, mental health, vitality, sexual desire and function, and body image.

Whether women who have small tumors removed really need additional therapy has sparked debate in recent years. There is a substantial benefit to additional, or adjuvant, treatment with chemotherapy and/or tamoxifen in women with tumors larger than a centimeter, or in patients whose cancer has spread to the local lymph nodes. However, for very small tumors, the risk of recurrent cancer is so low that the potential short- and long-term toxicity of the treatments may play a role in decision-making, Ganz says.

Prior to this study, it was generally accepted that adjuvant treatments did not diminish long-term quality of life and physical functioning, so doctors often were not concerned about late effects when they recommended adjuvant therapy to their patients. But Ganz’s study indicates that women who receive these treatments may have a significant decline in physical functioning compared with breast cancer survivors who did not receive these treatments. Women who received chemotherapy also had more sexual discomfort and vaginal dryness.

On the other hand, the study showed that emotional and social functioning did not deteriorate over time in any of the survivors.

27

research

Workplace Lactation Program Aimed at Males Enhances Participation, Breastfeeding Duration

A corporate-sponsored lactation program targeting fathers resulted in 69 percent of the program’s infants still breastfeeding at six months, well above the national average of 22 percent.

UCLAPUBLIC HEALTH

A CORPORATE-SPONSORED LACTATION PROGRAM targeting male employees led to a successful breastfeeding experience for the mother and baby, a study by researchers from the UCLA schools of public health and nursing concluded.

The results, published in the Journal of Human Lactation, showed the viability of a full-time on-site lactation program in a business setting. Since 1990, the Los Angeles Department of Water and Power (LA DWP), a public utility company, has offered the program to its fathers-to-be.

From July 1995 through December 1996, 128 of 331 eligible men and their partners participated in the program, which consisted of either two 45-minute group classes or approximately one hour of individual instruction. Along with the classes, participating fathers received a free breast pump rental, a double-pumping breast pump kit and instruction from a lactation consultant.

When comparing the six-month enrollment in 1995 to the 12month enrollment of 1996, the researchers – including Drs. Wendy Slusser and Linda Lange from the School of Public Health and Rona Cohen from the School of Nursing – saw a 13 percent increase in the percentage of participation among all men whose partners had babies. Sixty-nine percent of the infants in the program were still breastfeeding at six months – well above the 1996 national average of 22 percent. The average breastfeeding time for infants in the program was eight months. Only 4 percent of the infants stopped breastfeeding at one month or sooner. continued on next page

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continued from previous page “The father plays a critical role in the decision of whether an infant is breast fed, and so through education of the fathers, families have a better chance to start and to continue to breastfeed,” says Slusser. “There couldn’t be a better place than the work site to offer breastfeeding education for fathers.”

According to Cohen, who as a trained lactation consultant ran the LA DWP program, the infants are not the only ones to benefit from corporate lactation programs. Corporations offering breastfeeding-support programs will benefit from their employees having healthier babies in reduced infant health care costs, reduced absenteeism due to a sick infant and increased productivity at work because their babies are healthy.

research

28

Level of Acculturation Influences Risk of First Sex Among Hispanic Teens in L.A. County, Survey Concludes HISPANIC TEENS IN LOS ANGELES COUNTY are at greater risk of having their first sexual experience if they are more acculturated, according to a UCLA School of Public Health study headed by Dr. Dawn Upchurch, which also found that risk of first sex for the county’s Hispanics increases when teens don’t live with both biological parents, and when they live in neighborhoods with lower densities of other Hispanics.

Upchurch and colleagues analyzed data from a longitudinal survey of stress and mental health conducted with Los Angeles County youths, focusing on a representative sample of 497 ado4.66 lescents self-identified as Hispanic or Latino. Their findings were published in the Journal of Marriage and the Family.

“Onset of sexual activity is a significant turn3.05 ing point in the lives of adolescents, and this study provides support for the hypothesis that the sexual behavior of Hispanic teens is shaped by the social and cultural environments in which they live,” says Upchurch.

Traditional Hispanic cultural values that influence sexual relationships include the cultural concepts of machismo – gender role socialization emphasizing family responsibility and honor for Boys, Boys, men; and marianismo – women’s traditional roles Spanish English of care-giving, virginity, and obedience to men.

These traditional values include a sexual double standard, Upchurch says, that is manifest by older ages (on average) of first sex for girls than for boys.

The study found that among more acculturated Hispanic teens (defined as whether the participant elected to be interviewed in Spanish or English), the effect of gender on risk of first sex was smaller than among less acculturated teens, indicating that acculturation reduces the sexual double standard. Hispanic girls interviewed in English were 2.15 times more likely to have had sex than those interviewed in Spanish. Hispanic boys, whether acculturated or not, were at higher risk for first sex than Hispanic girls.

Living in a neighborhood with a lower density of other Hispanics was found to significantly increase risk of first sex, “suggesting that Hispanic teens in these neighborhoods are not only more acculturated themselves, but are also living in environments that facilitate social and cultural exchange, resulting in higher risk of sex,” Upchurch concludes. “The findings from this study suggest that acculturation occurring at the individual, family, and neighborhood levels influences Hispanic teens’ risk of becoming sexually active.”

Relative Risk of Having First Sex Among Hispanic Adolescents Ages 12-19, Based on Gender and Language in Which the Respondent Chose to Be Interviewed

5.0

RISK OF FIRST SEX

4.0

3.0

2.0

1.0

2.15

1.00

0

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Girls, Spanish

Girls, English

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2002 student awards American Association for the Advancement of Science Fellowship Catherine Taylor Community Health Sciences American Society of Civil Engineers, Edmund Friedman Young Engineer Award for Professional Achievement Emmanuel “Chris” Liban Environmental Science and Engineering Fred H. Bixby Doctoral Fellowships Vilma Enriquez-Haas Community Health Sciences Ritesh Mistry Community Health Sciences Anita Yuan Community Health Sciences Celia and Joseph Blann Fellowship Michelle Wilhelm Epidemiology Michele Wood Community Health Sciences

California Program on Access to Care Research Grant Kevin Heslin Health Services Chancellor’s Fellowship Megumi Kano Community Health Sciences Adrienne Katner Environmental Science and Engineering Zhanna Kirpnick Molecular Toxicology Xiaoyan Liao Environmental Health Sciences Menghua Tao Epidemiology Conacyt Fellowship Angelica CastanedaJimenez Environmental Science and Engineering Eleanor J. De Benedictis Fellowship in Nutrition Dean Garrett Community Health Sciences Constance Gewa Community Health Sciences

Dean’s Outstanding Student Award Patricia Barreto Community Health Sciences Guadalupe Chapa Environmental Health Sciences Gayathri Sellakumar Health Services Henry Tam Epidemiology Xiaowei Yang Biostatistics Dissertation Year Fellowship Michelle Anghera Environmental Health Sciences L.S. Goerke Memorial Award Mia Hashibe Epidemiology Raymond Goodman Scholarship Yunda Huang Biostatistics Lu-May Chiang Biostatistics

NOTABLES A group of UCLA public health and medical students won the prestigious 2002 HHS Secretary’s Award for Innovations in Health Promotion or Disease Prevention.

The students – including Kevin Riley (M.P.H. ’01), currently a doctoral student in sociology; Koy Parada, a doctoral student at the School; and current M.P.H. students Sundip Karsen, Nina Tayyib, Heather Tindall, and Marcella Flores – were awarded first place in the Interdisciplinary category and $7,500 for the student-guided “UCLA/GWHFC Mobile Clinic Project,” implemented by UCLA students and the Greater West Hollywood Food Coalition to provide social and medical services to the homeless and transiently housed in Hollywood. HHS Secretary Tommy Thompson presented the award to the students in a ceremony in Washington, D.C. in June.

Cathy Taylor, a third-year doctoral student at the School, was selected for the prestigious American Association for the Advancement of Science internship program in which graduate students are placed with various media outlets in an effort to improve news media coverage of science and research. Taylor will work with Good Morning America in New York City this summer.

Health Policy and Management Alumni Association Scholarship Sonya Gabrielian (2001 Awardee) Gorden Hein Memorial Award Christian Shinaberger Epidemiology Kellogg Health Policy Fellowship Alek Sripipatana Community Health Sciences Dr. Ursula Mandel Scholarship Crystal Keeler Community Health Sciences Maternal and Child Health Nutrition Leadership Traineeship Carissa Reeder Community Health Sciences Maxicare Fellowship Yee-Wei Lim Health Services Jinnie Rhee Health Services National Institute of Child Health and Human Development Pre-doctoral Training Fellowship in Population Research Laura Chyu Community Health Sciences Julia Prentice Community Health Sciences NIMH HIV/AIDS Predoctoral Training Grant Dallas Swendeman Community Health Sciences

Tony Norton Memorial Fellowship Alev A. Brown Environmental Health Sciences Ann G. Quealy Memorial Fellowship in Health Services Heidi Cho Gayathri Sellakumar Linda Tolbert Ruth F. Richards Outstanding Award Michelle Anghera Environmental Health Sciences Tamara Capretta Health Services Luohua Jiang Biostatistics Veronica Setiawan Epidemiology Nina Tayyib Community Health Sciences Roemer Fellowship for Dr.P.H. Studies in Health Services Ming-Yu Cheng Judith Connell Shaheen Kassim-Lakha Will Rogers Memorial Scholarship Katharine Hayward Community Health Sciences Charles F. Scott Fellowship Anthony Distefano Community Health Sciences Wayne SooHoo Fellowship Na He Epidemiology Samuel J. Tibbitts Fellowship Yifang Zhu Environmental Health Sciences University of California Institute for Mexico and the United States Fellowship Guadalupe Chapa Environmental Health Sciences University-wide AIDS Research Program Grant Kevin Heslin Health Services

UCLAPUBLIC HEALTH

Vonthanak Saphonn (left) and Hongjie Liu (right), two postdoctoral trainees in the UCLA/Fogarty AIDS International Training and Research Program, were selected as finalists in the Global Development Network Research Medal Competition, open to citizens and/or permanent residents of developing countries. The students submitted research papers in the category of HIV/AIDS and Delivery of Health Services. Saphonn is a physician from Cambodia; Liu a public health physician from Anhui, China.

Graduate Opportunity Fellowship Eddie David Environmental Health Sciences Shahed Ghanimati Epidemiology Mark Guerrero Community Health Sciences Angela Han Epidemiology Margaret Krudysz Environmental Health Sciences Mercedes Perez Community Health Sciences Vanessa Shaw Community Health Sciences Victoria Walton Community Health Sciences

students

Abdelmonem A. Afifi Fellowship Yasser Aman Health Services

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faculty DR. JARED DIAMOND, a celebrated scientist whose list of prestigious honors includes a Pulitzer Prize, has joined the UCLA School of Public Health faculty.

“Public health issues are among the most important issues in the world today, and one of the two or three most important determinants of the wealth of nations,” says Diamond, who continues as a member of the School of Medicine’s Department of Physiology, where he has served since 1966. “The public health approach has great advantages over the medical approach – it is much cheaper to prevent diseases in large numbers of people than to cure diseases in one person at a time after they get sick. I have long supported the goals of public health and look forward to working to advance the field.”

Diamond was educated at Harvard and went on to receive his Ph.D. from Cambridge University.

His research contributions in physiology, population biology, evolution and ecology have been celebrated with many of science’s top awards, including the National Medal of Science, the Tyler Prize for Environmental Science, and Japan’s Cosmos Prize.

He won the 1998 Pulitzer Prize for general nonfiction for his book Guns, Germs, and Steel: The Fates of Human Societies.

With the joint appointment, Diamond expects to teach, mentor students, and collaborate with faculty at the School.

“Dr. Diamond’s stature in the field and his phenomenal body of research will be a huge asset to the School,” says Dean Linda Rosenstock. “We are extremely fortunate that he has decided to call our School his second home.”

Dr. Jared Diamond

UCLAPUBLIC HEALTH

DR. GREGORY STOCK, director of the UCLA School of Medicine’s Program

Dr. Gregory Stock

on Medicine, Technology, and Society, has joined the School of Public Health faculty. Stock has a doctorate in biophysics from Johns Hopkins University, and an M.B.A. from Harvard. His program explores critical technologies poised to have large impacts on humanity’s future and the shape of medical science, with the goal of bringing about a broad public debate on these technologies and their implications, leading to sound public policies. Stock recently edited Engineering the Human Germline: An Exploration of the Science and Ethics of Altering the Genes We Pass to Our Children, and wrote Redesigning Humans: How Technology Will Redefine the Human Form and Character.

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honors DR. SUSAN COCHRAN was invited to serve as a member of the Social Sciences, Nursing, Epidemiology and Methods (2) Study Section of the National Institutes of Health’s Center for Scientific Review.

DR. JOHN FROINES received a commendation from Gov. Gray Davis recognizing his “outstanding record of leadership and service” to the State of California.

DR. DEBORAH GLIK was named chair of the American Public Health Association’s largest section, Public Health Education and Health Promotion.

DR. MARJORIE KAGAWA-SINGER was the honoree and keynote speaker at the Herbert W. Nickens Memorial Lectureship Luncheon, held at the 8th Biennial Symposium on Minorities, the Medically Underserved & Cancer.

DR. DONALD MORISKY recently completed a three-year appointment on the Science Council of the American Public Health Association and has been appointed to serve on the APHA’s Joint Policy Committee.

DR. LINDA ROSENSTOCK received the 2002 Kehoe Award of Merit from the American College of Occupational and Environmental Medicine for her service and contributions to the field of occupational medicine. She was also elected secretary of the Society of Medical Administrators, and named co-chair of the Institute of Medicine’s Committee on Educating Public Health Professionals for the 21st Century.

DR. FRANK SORVILLO was appointed chief of public health records and research for Public Health Programs at the Los Angeles County Department of Health Services.

DR. JANE VALENTINE is president-elect of the American Water Resources Association.

DR. STEVEN WALLACE was elected chair of the Gerontological Health section of the American Public Health Association.

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

Encyclopedia of Public Health, edited by Lester Breslow. MacMillan Reference USA. The first encyclopedia of its kind, a four-volume set written for lay readers will serve as a valuable reference for high schools, community colleges, and public libraries as well as professionals in public health and related fields. The encyclopedia’s 900 entries were written by subject experts.

Also included is a collection of essential writings and statements about public health, and an annotated bibliography.

Encyclopedia of Foods: A Guide to Healthy Nutrition, edited by experts from Dole Foods, the Mayo Clinic, and UCLA including the School of Public Health’s Gail Harrison. Academic Press.

Provides an overview of the basic principles of nutrition; reviews the role of nutrition in the prevention and treatment of obesity, hypertension, diabetes, coronary artery disease, osteoporosis and cancer; details the content of hundreds of foods; and discusses supplements, antioxidants, phytochemicals, functional foods, and new food technology.

Oxford Textbook of Public Health (Three-Volume Set), edited by Roger Detels, James McEwen, Robert Beaglehole and Heizo Tanaka. Oxford University Press.

Comprehensive review of the field. Volume 1: The Scope of Public Health; Volume 2: The Methods of Public Health; Volume 3: The Practice of Public Health. Authors of individual chapters include UCLA School of Public Health faculty members Detels, Lester Breslow, Ruth and Milton Roemer, Jeff Luck, Ralph Frerichs, Frank Sorvillo, James Greenwood and Dean Jamison.

Child Rearing in America: Challenges Facing Parents with Young Children,

by Neal Halfon, Kathryn Taaffe McLearn and Mark A. Schuster. Cambridge University Press.

Using the first national survey on parents with young children, the authors present new information about what parents do, the economic and social challenges they face, and the resources they use to improve their children’s health and development.

Theory-Based Data Analysis for the Social Sciences,

by Carol S. Aneshensel. Pine Forge Press.

In response to the erosion of the prominence of social theory in data analysis by the current emphasis on computer-generated statistical techniques, presents a method for bringing data analysis and statistical technique in line with theory.

UCLA School of Public Health Strategic Plan.

Describes the vision and mission of the School, and outlines five strategic goals to support them.

UCLAPUBLIC HEALTH

DR. MEL SUFFET received the American Water Works Association’s A. P. Black Research Award, in recognition of his research in the field of organic contaminants and taste and odor problems in water, and his over a quarter-century of contributions to the water supply community.

bookshelf

faculty

DR. CAROL S. ANESHENSEL, with co-editor Jo C. Phelan, won the American Sociological Association, Mental Health Section’s 2001 Best Publication Award for Handbook of the Sociology of Mental Health (New York: Kluwer Academic/Plenum, 1999).

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news briefs

bioterrorism web sites In the aftermath of Sept. 11 and the ensuing anthrax attacks, the School’s Department of Epidemiology has created two popular Web sites focusing on bioterrorism. The first (www.ph.ucla.edu/epi/bioter/bioterrorism.html) offers a broad overview, with daily summaries of news articles on six candidate diseases. The view is through the eyes of an epidemiologist, although much of the content comes from daily newspapers. Nearly 4,600 visitors tallied more than 34,000 total visits in April alone. The second site (www.ph.ucla.edu/epi/ bioter/detect/antdetect_intro.html) presents the anthrax outbreak of 2001, including clinical descriptions of the cutaneous and inhalational anthrax cases and deaths that occurred late last year. The site provides epidemiologic details on many aspects of the anthrax field investigation, along with graphs of onset times. Both sites are maintained by Dr. Ralph Frerichs, a professor in the department.

DR. DONNA SHALALA was the guest speaker at the 2002 Breslow Lecture and Dinner in April. Shalala, President of the University of Miami and former Secretary of the U.S. Department of Health and Human Services during the Clinton Administration, spoke on “Healthcare: The Unfinished Agenda” before a record turnout at the annual alumni event.

2002 leadership award to alum FRANK MATRICARDI, M.P.H. ’72, Dr.P.H. ’82, received

the Venice Family Clinic’s 2002 Irma Colen Leadership Award in recognition of his service to the Venice Family Clinic, the largest free clinic in the United States. Matricardi, who has 25 years of expertise in the areas of managed care, health care policy and management consulting along with extensive experience at all levels of the legislative process, is a 16-year member of the clinic’s Board of Directors.

UCLAPUBLIC HEALTH

PLEASE REMEMBER You are a lifetime member of the UCLA School of Public Health Alumni Association (PHAA) 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.

doctors without borders In July, the School will sponsor “Access EXPO,” a traveling exhibit by Doctors Without Borders/ Médecins Sans Frontières (MSF) designed to raise awareness about the chronic lack of access to essential medicines in poor countries.

The interactive audiovisual exhibit, housed in a converted 48-foot trailer, will be placed on campus at Bruin/Ackerman Plaza July 9-11, and will be open to the public (at no charge) from 10 a.m. to 6 p.m. Visitors will learn about patients who suffer from infectious diseases including malaria, tuberculosis, kala azar, HIV/AIDS, and sleeping sickness. “Many of the 14 million people who die from these diseases each year, 90 percent of whom live in the developing world, die unnecessarily because treatment is not available to them,” explains Nicolas de Torrente, executive director of MSF-USA. “In some instances, the medicines are either too expensive or ineffective, while in other cases the medicines are highly toxic, have gone out of production, or do not exist.”

For more information, call (310) 277-2793 or visit the Doctors Without Borders Web site at www.doctorswithoutborders.org.

“Stress Management” was the theme for Public Health Week at UCLA, sponsored by the Public Health Student Association and held April 1-7 to coincide with National Public Health Week. UCLA students had the opportunity to participate in a variety of activities designed to promote health awareness, including yoga (right), a meditation workshop, a salsa lesson, and a speech by an expert in stress management.

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sph a center for public health preparedness

IN MEMORIAM

news briefs

The UCLA School of Public Health has been designated as a federal Center for Public Health Preparedness by the U.S. Department of Health and Human Services. Earlier this year, HHS Secretary Tommy Thompson announced that $20 million was being made available in FY 2002 to fund a nationwide network of Centers for Public Health Preparedness, administered by the Centers for Disease Control and Prevention and linking schools of public health, state and local health agencies as well as other academic and community health partners. The funding is part of the bioterrorism appropriations signed by President Bush in January.

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At the signing of a MEMORANDUM OF UNDERSTANDING among the UCLA School of Public Health, the Belize Ministry of Health, and the University of Belize to develop and implement joint training and research endeavors between the three institutions, (left to right): Dean Linda Rosenstock; Yvonne Smith, Treasurer, American Nursing Community; Jose Coye, Belize Minister of Health; Dr. Osman Galal (obstructed from view), UCLA School of Public Health; and Roy Young, Belize Consul General.

GALE WINTING, former associate dean of the

School, died Jan. 26 of a heart attack at age 53. Winting earned a degree in psychology from UCLA in 1971 and a master’s degree in divinity at the American Baptist Seminary of the West, along with a master’s in psychology from California State University, Los Angeles. He served as a marriage and family counselor for the Salvation Army and St. Joseph’s Hospital, and later joined the Long Beach Department of Health and Human Services, where he became chief of staff and operations. He continued his career as vice president for administration and strategic planning at the United Way of Greater Los Angeles, before being recruited by then-Dean Abdelmonem A. Afifi in 1991 to serve as the School’s associate dean. “He was a remarkable man of integrity and dedication for what he did,” Afifi said, “and had a wisdom we all wish we had.” Winting is survived by his wife, Christina; two children, Vincent and Christian; and his mother, Julia.

DR. CARL HOPKINS, a biostatistician who served as professor in

the UCLA School of Public Health from 1964 to 1980 and associate dean of the School from 1971 to 1974, died Feb. 4 at the age of 90. Born in Seattle, Hopkins graduated from Dartmouth and went on to earn an M.P.H. from Johns Hopkins University and a doctorate from Harvard. In addition to serving as a statistical consultant on many studies, he conducted research on the organization, financing and evaluation of health services.

For the third consecutive year, a team from the UCLA School of Public Health’s Department of Health Services won the COLLEGE BOWL competition, featuring participants from health administration and policy programs in Southern California. The UCLA team, which defeated USC in the final round by a score of 140-0, included (l. to r.): Linda Surapruik, Jimmy Wannares, Gayathri Sellakumar (team captain), and Formosa Chen.

S A V E

T H E

D A T E

UCLA SCHOOL OF PUBLIC HEALTH RECEPTION

DR. ALFRED KATZ, a long-time member of the School’s faculty, died

Monday, November 11, 2002, 6:00 – 8:00 pm Wyndham Philadelphia at Franklin Plaza Horizons Ballroom During the Annual Meeting of the American Public Health Association November 9 – 13, 2002 Philadelphia, Pennsylvania

UCLAPUBLIC HEALTH

in December at the age of 85. Born in Auckland, New Zealand, Katz earned a master’s degree in psychology and a doctorate in social welfare, and joined the UCLA faculty in social welfare and public health in 1958. He was a leader in the field of selfhelp, organizing the first international self-help conference in 1979 and serving as editor of the first major journal dedicated to the field. He also published the first national study of hemodialysis issues, in 1971.

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leadership giving THE SCHOOL IS PLEASED TO RECOGNIZE the generous alumni, friends and corporate and foundation partners whose cumulative gifts to the UCLA School of Public Health total more than $50,000. Their sustained support has helped the School achieve its nationally and internationally recognized stature.

$1,000,000

AND

ABOVE

FRED H. BIXBY FOUNDATION ALDO DEBENEDICTIS WALTER AND HELGA OPPENHEIMER THE CALIFORNIA ENDOWMENT THE CALIFORNIA WELLNESS FOUNDATION THE ROBERT WOOD JOHNSON FOUNDATION $500,000 - $999,999 AMERICAN CANCER SOCIETY INC. ASSOCIATION OF SCHOOLS OF PUBLIC HEALTH CALIFORNIA HEALTHCARE FOUNDATION COMMONWEALTH FUND HENRY J. KAISER FAMILY FOUNDATION THE JOHN A. HARTFORD FOUNDATION, INC. U. S. BORAX INC.

$250,000 - $499,999

$50,000 - $99,999

ANNETTE BLANN LIVING TRUST BESTFOODS INC. INSURANCE INSTITUTE FOR HIGHWAY SAFETY MARCH OF DIMES BIRTH DEFECTS FOUNDATION MAXICARE HEALTH PLANS INC. THOMAS AND ELIZABETH PLOTT RAND CORPORATION THE FORD FOUNDATION THE WILLIAM AND FLORA HEWLETT FOUNDATION THRASHER RESEARCH FUND FRED AND PAMELA WASSERMAN RICHARD AND GWEN WEISMAN ROBERT AND MARION WILSON WORLD AIDS FOUNDATION NATIONAL INSTITUTE OF HEALTH

IRA R. AND MARSHA L. ALPERT AMERICAN CANCER SOCIETY CALIFORNIA DIVISION INC. AMERICAN FOUNDATION FOR AIDS RESEARCH AMERICAN INSTITUTE FOR CANCER RESEARCH AMERICAN OCEANS CAMPAIGN INC. AMGEN INC. ARCO FOUNDATION INC. ASSOCIATION/AID TO CRIPPLED CHILDREN LESTER AND DEVRA BRESLOW CIGNA FOUNDATION EGYPTIAN CULTURAL AND EDUCATIONAL BUREAU GLORIA GALVEZ-CARLISLE RAYMOND AND BETTY GOODMAN GLADYS A. EMERSON ESTATE MAX FACTOR FAMILY FOUNDATION TERRY AND SHARON HARTSHORN HEALTH RENEWAL RESEARCH FOUNDATION DERRICK JELLIFFE LESTER MEIS MERCK AND COMPANY INC. MERCK RESEARCH LABS NATIONAL DAIRY COUNCIL NATIONAL MARCH OF DIMES BIRTH DEFECTS FOUNDATION NUTRITION FOUNDATION INC. A. HENRY SCHUYLER, JR. GURDON AND MARY ANN SMITH SIMPSON AND SIMPSON BUSINESS AND PERSONNEL SERVICES INC. THE DANA FOUNDATION THE DOW CHEMICAL COMPANY THE KENNETH T. AND EILEEN NORRIS FOUNDATION

$100,000 - $249.999

UCLAPUBLIC HEALTH

Dean Rosenstock visits with Steve and Janet Kahane at the annual UCLA School of Public Health major donor dinner.

ALZHEIMER'S ASSOCIATION LOS ANGELES AMERICAN CANCER SOCIETY INC. AMERICAN HEART ASSOCIATION ARCO CONRAD N. HILTON FOUNDATION COUNCIL FOR TOBACCO RESEARCH U.S.A. INC. DOLE FOOD COMPANY, INC. ROBERT DRABKIN JUVENILE DIABETES FOUNDATION INTERNATIONAL AMBASSADOR AND MRS. LESTER B. KORN LOS ANGELES COLLEGE OF CHIROPRACTIC MERCK AND COMPANY, INC. MILBANK MEMORIAL FUND PUBLIC HEALTH FOUNDATION ENTERPRISES PUBLIC HEALTH INSTITUTE MILTON AND RUTH ROEMER SCHISTOSOMIASIS RESEARCH PROJECT MEDICAL SERVICE CORP INTL RALPH AND SHIRLEY SHAPIRO THE DAVID AND LUCILE PACKARD FOUNDATION THE DORIS DUKE CHARITABLE FOUNDATION THE UPJOHN COMPANY SAMUEL AND AUDREY TIBBITTS WALLACE GENETIC FOUNDATION INC. MICHAEL WEISMAN PAUL WEISMAN WESTERN CONSORTIUM FOR PUBLIC HEALTH WESTRECO INC. WILSHIRE FOUNDATION INC

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honor roll 2001

35

friends

THE SCHOOL THANKS ALL OF ITS DONORS for their financial support. The following list acknowledges gifts made to the UCLA School of Public Health from January 1, 2001 to December 31, 2001. 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. It is important to us that we acknowledge your gift properly. Please let us know of any omissions or errors in listing your name or gift, by calling (310) 825-6464.

$25,000

AND

ABOVE

FRED H. BIXBY FOUNDATION CALIFORNIA HEALTHCARE FOUNDATION MAX FACTOR FAMILY FOUNDATION RAYMOND D. GOODMAN AND BETTY J. GOODMAN CONRAD N. HILTON FOUNDATION THE CALIFORNIA ENDOWMENT THE CALIFORNIA WELLNESS FOUNDATION THRASHER RESEARCH FUND WORLD AIDS FOUNDATION/NATIONAL INSTITUTE OF HEALTH

$10,000 - $24,999 AVENTIS FOUNDATION BLOCK MANAGEMENT, INC. ANNIE E. CASEY FOUNDATION CEDARS-SINAI MEDICAL CENTER ENVIRONMENTAL DEFENSE CENTER THOMAS E. EPLEY AND LINNAE ANDERSON JERRY AND LORRAINE FACTOR FOLEY AND LARDNER SUSAN G. KOMEN BREAST CANCER FOUNDATION ORTHO-MC NEIL PHARMACEUTICAL PRICEWATERHOUSE COOPERS LLP A. HENRY SCHUYLER, JR. TENET HEALTHCARE FOUNDATION THE DAVID AND LUCILE PACKARD FOUNDATION THE JOYCE FOUNDATION THE STREISAND FOUNDATION

$5,000 - $9,999

$1,000 - $4,999 ROSLYN ALFIN-SLATER ASPEN ENVIRONMENTAL GROUP BEATRICE BLAU ZEIGER AND IRVING ZEIGER LESTER AND DEVRA BRESLOW CALIFORNIA ATHLETIC TRAINERS ASSOCIATION CAP GEMINI ERNST & YOUNG U.S. LLC CEDARS-SINAI MEDICAL CARE FOUNDATION CENTER FOR CORPORATE INNOVATION CONSULTANTS FOR PATHOLOGY & LABORATORY MEDICINE BRUCE N. DAVIDSON JAMES E. ENSTROM EQUITABLE REAL ESTATE MGMT. GROUP FABER FAMILY FUND/CALIFORNIA COMMUNITY FOUNDATION DANIEL P. GROSZKRUGER PAUL HASTINGS JANOFSKY & WALKER LLP HEALTHCARE PRACTICE ENHANCEMENT NETWORK INC. HOAG MEMORIAL HOSPITAL PRESBYTERIAN IMPACT ASSESSMENT, INC. IOWA FOUNDATION FOR EDUCATION, ENVIRONMENT AND THE ARTS

LEONARD D. AND NANCY P. JACOBY ESQ. JENNIE JING JENQUEST STEPHEN W. AND JANET A. WELLS KAHANE CAROLYN F. KATZIN L.A. CARE HEALTH PLAN KENNETH E. LEE POPULATION COMMUNICATION GILLESPIE ANDREA E. PORTENIER THOMAS M. AND JODY J. PRISELAC LEE BAILEY AND LINDA ROSENSTOCK SALINAS VALLEY MEMORIAL MARJORIE KAGAWASINGER JAMES H. SHINABERGER RICHARD E. AND PATRICIA SOLOMON SINAIKO

$500 - $999 ASSOCIATION OF AMERICAN MEDICAL COLLEGES RONALD ANDERSEN CHARLES ARONBERG PAULA CARABELLI CEDARS-SINAI IMAGING MEDICAL GROUP CHILDRENS HOSPITAL OF LOS ANGELES SHELDON E. COHEN JOHN E. AND ANNE H. COULSON SAM W. DOWNING STEVE DUVALL LYNNE A. EMMA JEFFERY E. AND MARTHA M. FLOCKEN RONALD C. FORGEY TOMAS AND PATRICIA A. GANZ DAVID GITTELMAN MICHAEL GOLDSTEIN FARHAD A. HAGIGI JIM M. KADA NATHAN KAPROFF LAMAR J. KERLEY GERALD KOMINSKI ALAN T. LEFOR LITTLE COMPANY OF MARY HEALTH SERVICES ANTONIO F. MACHADO NANCY J. MONK MARC D. AND JOANNE L. MOSER EDWARD J. O'NEIL ORTHO BIOTECH INC. JOYCE PAGE

THOMAS H. RICE PATRICIA K. RITTER LISA B. SHAW SHELL OIL COMPANY FOUNDATION ATSUKO SHIBATA STEPHEN SHORTELL THE CAMDEN GROUP VERIZON FOUNDATION VHA WITT/KIEFFER FORD HADELMAN AND LLOYD MEL AND NANCY ZIONTZ

$250 - $499 TAKAMARU ASHIKAGA JOAN BARANOV MICHAEL BELMAN SUSAN BLACKWELL THERESA BYRD CALIFORNIA ASSOCIATION OF HEALTH PLANS CRAIG ACOSTA RANDALL ESPINOZA JONATHAN FIELDING LINDA GARDNER JOEL GEIDERMAN DENISE GLOBE ALISA GOLDSTEIN DANIEL E. AND ROCHELLE S.GREEN HARLAN H. HASHIMOTO PHYLLIS E. HAYES-REAMS JOE W. AND DIANA W. HILBERMAN SUSAN D. HOLLANDER MARK J. HOWARD HEALTHCARE PARAGON INTERNATIONAL INFANT DEVELOPMENT ASSOCIATION ROBERT A. JACKSON JDS UNIPHASE CORPORATION SUSAN KLEIN THOMAS S. KLITZNER AND RENEE J. MESHUL LORNA G. LAPARAN ANNE C. LAWLER JAMES J. LOFTUS ANN G. MAHONY NANCY R. MANN GREGGORY D. MANSUR MILDRED MASSEY LEONARD E. AND MELODYE T. KLEINMAN HAL MORGENSTERN NIEL S. NATHASON THANH-HAI NGUYEN NELLY A. NIGRO

STANLEY C. OPPEGARD DONNA PERREIRA EDWARD POSTLETHWAIT PREMIER PHYSICIAN SERVICES PROGRESSIVE HEALTHCARE SYSTEMS LORI RICHARDSONPELLICCIONI RIVERSIDE COMMUNITY HOSPITAL PAUL ROSSMAN RSK MGMT INC. MARK SCHLUCHTER MIRIAM SCHOCKEN ROBERT SCOFIELD JR. KATHRYN D. SCOTT JUDITH M. SIEGEL JERALD F. SIGALA FOREST S. TENNANT JR. THE MARBLEHEAD GROUP LLC MANUEL VANEGAS LAW OFFICES OF STEVEN M. WEST GRAEME A. AND VIVIAN R. WILLIAMS ARTHUR M. AND JUDY A. WINER

$100 - $249 ALEXANDER M. ADELEKE HUGO A. ALMEIDA IRA R. AND MARSHA L. ALPERT CARLOS A. ALVARADO RICHARD F. AMBROSE AMERICAN PUBLIC HEALTH ASSOCIATION MARTHA A. ANDOM SANDRA ARONBERG SHARON A. ASHLEY DONALD W. AVANT JR. EVA G. BAUDIN ROBERT N. BECK PATTI J. BENSON MICHAEL K. BERRY LOUIS B. BERSIN ROY P. BETANCOURT BEVERLY HOSPITAL MICHELLE A. BHOLAT JEANNE BLACK BLUMBERG RIBNER INC. RALPH G. BRINDIS ELLEN M. BROMS RICHARD AND MARIANNE P. BROWN HAROLD V. BROWN RODNEY C. BRUCE DAVID M CARLISLE

UCLAPUBLIC HEALTH

ABDELMONEM AND MARIANNE AFIFI IRA R. AND MARSHA L. ALPERT AMGEN INC. ASSOCIATION OF UNIVERSITY PROGRAMS IN HEALTH ADMINISTRATION LEONARD I. AND JOAN G. BEERMAN FRANK S. AND CAROL O. BIONDI BLUE CROSS OF CALIFORNIA COALITION FOR CLEAN AIR ROBERT J. DRABKIN ELI LILLY AND COMPANY

LAWRENCE FELDMAN AND JO K. KAPLAN ALAN V. AND SUSAN F. FRIEDMAN FOUNDATION FOR ACCOUNTABILITY GLAXO WELLCOME INC. HEALTH BENCHMARK, INC. AMBASSADOR AND MRS. LESTER B. KORN WALTER AND HELGA OPPENHEIMER PACIFICARE BEHAVIORAL HEALTH PHARMACEUTICAL RESEARCH & MANUFACTURERS OF AMERICA FDN. RUTH J. ROEMER ROTH FAMILY FOUNDATION MARIAN E. SWENDSEID TENET HEALTHCARE CORPORATION PAUL R. TORRENS DAVID AND VICKI WALKER WILSHIRE FOUNDATION INC.

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UCLAPUBLIC HEALTH

MARY E. CARR LORRAINE J. CARTER MANUEL CASTELLANOS JR. WILLIAM B. CASWELL CHEVRON U.S.A. INC VIRGINIA A. CLARK DOUGLAS B. CLARKSON RICHARD J. COHEN JR. JODI COHN LONNIE T. COLE COOPERATIVE PURCHASERS CAROLYN M. CRAVERO JULIE E. CRONER OLIVIA A. CROOKES SABBIR A. DADABHAI PETER C. DAMIANO TERESA K. DAVID DARYL V. DICHEK DAVID L. DICKSON CONSTANCE E. DUNBAR OLIVE J. DUNN HELEN M. DUPLESSIS KRISTINE A. EDWARDS SAM ELROD AGNES K. EUBANKS RUTH B. EVANS JANET L. FAHEY DANIEL FAIRLEY DAVID FARABEE THOMAS B. FARVER JEAN S. FELTON ROLLINGTON FERGUSON

DANIEL J. FINK PAUL M. FLEISS FELICIA A. FLORES-WORKMAN DANIEL A. FORER BETSY FOXMAN JONATHAN E. FREEDMAN ANN P. GARBER-RIMOIN CHERYL K. GATES EMILE M. GAUVREAU ROBERT P. GHIRELLI CAROL J. GILBERT ELI GLOGOW GOLD GIFTS OF LASTING DISTINCTION SUSAN R. GOODGAME LAURIE R. GOODMAN GOOD SAMARITAN HOSPITAL ANDREA D. GRAHAM MARK E. GRANOFF GREATER PACIFIC MEDICAL MANAGEMENT JOHN G. GRIFFITH MARILYN W. GRUNZWEIG JAMES E. HADEN LYNN D. HAGERMAN ANN S. HAMILTON SARAH H. HARLAN NANCY K. HAYS HEALTH PRO ASSOCIATES HEALTH SERVICE EXCHANGE INC. MARIA A. HERNANDEZ

Gerald and Lorraine Factor, 2002 recipients of The Dean's Award for outstanding achievement, leadership and contributions to the UCLA School of Public Health.

GRETCHEN C. HEYMAN WILLIAM HINDS HORACE W. AND EDYTHE HINKSTON ELISE M. HOLLOWAY GORDON D. HONDA MEI J. HSU PHALEN G. HUREWITZ PATRICIA J. IALONGO LARRY H. IIDA JOHN D. IVIE MARTHA JEFFERSON HOSPITAL LISA A. JEWETT RUSSELL D. JOHNSON JOHNSON & JOHNSON CONTRIBUTION FUND KAREN R. JOSEPHSON KENNETH E. JOSLYN KAISER PERMANENTE HERMAN AND ROSE KATTLOVE VICTOR H. KENNEDY HARVEY D. KERN DIANA L. KIEL DONALD AND MARILYN E. KILLIAN KINDRED HEALTHCARE OPERATING INC. NANCY J. KINGSTON ANNETTE W. KLEEMAN COREY E. KLEIN AIMEE KRESTON TI-LIN KUO AND SHIAW-FEN FERNG DARA R. KURTZ LA COUNTY DEPT. OF HEALTH SERVICES LA VIDA MEDICAL GROUP JOSEPHINE H. LAI LAKESHORE CURRICULUM MATERIAL COMPANY BARBARA LANGLAND-ORBAN TERI P. LAUENSTEIN LAUGHLIN FAMILY TRUST PAULINE T. LE ISAIAH C. LEE JU H. LEE MARTIN L. LEE TERRENCE LEE RUTH T. LEONG STEVEN S. LEWIS ZHIYUAN LIU MARIAN J. MANOCCHIO MAXINE G. MANTELL RICHARD B. MARCINIAK JON B. MARSHACK JANE E. MARTIN FRANK P. MATRICARDI AND DIANA M. BONTA DIANA MATSUSHIMA PATRICIA S. MAYSENT DONALD A. MC CALLUM GARY M. MEUNIER HILDY B. MEYERS MILLER & HOLGUIN PACIFICARE OF CALIFORNIA PFIZER INC. U S PHARMACEUTICALS GROUP PROACTIVE PATIENT SERVICES

SEDGWICK DETERT MORAN & ARNOLD SIERRA VALLEY MANAGEMENT SERVICES ORGANIZATION INC. SOUTHERN CALIFORNIA PUBLIC HEALTH ASSOCIATION THE SAN FRANCISCO FOUNDATION COMMUNITY INITIATIVE FUNDS THE TIMES MIRROR FOUNDATION THRIFTY MANAGEMENT SERVICES TRW FOUNDATION JOHN & DOROTHY RICE TRUST W. M. KECK FOUNDATION WASHINGTON MUTUAL FOUNDATION MATCHING GIFT PROGRAM WORKING PARTY FOR CHILDREN WILLIAM W. LEYHE MARYSIA MEYLAN FRANK MEZA AND FAUSTINA NEVAREZ JEAN L. MICKEY MITCHELL MILLER ADRIENNE D. MIMS GABRIELLA M. MIOTTO DAVID S. MOEHRING RUTH A. MOHR DAVID M. MOSEN IRENE C. MUNETON ROBERT A. MURRAY CRAIG G. MYERS DENISE MYERS CASSANDRA J. NDIFORCHU RICHARD F. AMBROSE AND BOBETTE J. NELSON JOHN F. AND ANN B. NEWPORT SHARON L. NICHOLS WILMA P. NICHOLSON ROBERT P. NUGENT LILLIAN O'BRIEN DELORES V. OLAMBIWONNU LARRY K. OLSEN PAMELA A. OSTER NEEVILLE O. AND LYNN OSTRICK VALENTINE R. OTUECHERE CHARLES E. PADILLA PATRICIA H. PARKERTON JOHN W. AND CATHERINE G. PERCY KATHYE PETTERS DIANNE L. PHILIBOSIAN CARL E. PIERCHALA ROBERT J. PLOURDE SCOTT P. POLANSKY AND JENNIFER H. ULIN CLYDETTE L. POWELL MICHAEL D. PROFIT STELLA M. QUAN SHANE QUE HEE ALIREZA RABIZADEH EMILY RAMICONE DANIEL N. RASTEIN MARILYN A. RAY IRENE REALYVASQUEZ ALLEN H. REED

JOSHUA REILLY AND LISA A. RUSSELL KENNETH J. RESSER SHIRLEY W. RICH JEAN RICHARDSON ELENA V. RIOS JOANNE S. ROBINSON CHRISTINE D. ROGEN DOLORES B. ROSS MARTY P. ROSS CURTIS J. ROZAS DELIA RUIZ JOSHUA G. AND LISA RUSSELL KARINN B. SAMMANN KENNETH P. AND LESLIE H. SATIN SUSAN M. SAZER LINDA M. SCHAEFFER GERALDINE SCHICK ANTHONY H. SCHIFF STUART O. SCHWEITZER THOMAS D. AND ELISA A. NICHOLAS SEDGWICK FRANK S. AND HYUN J. SEO GERTRUDE SHERMAN ROBIN B. SHERMIS BRIAN T. AND JEANETTE E. SHERRINGTON DONALD L. SHUBERT STEVEN R. SIM JAMES B. SIMPSON MARTI S. SLAWSON GARY J. SLOAN CLIFFORD J. SMITH DANIEL F. SMITH JASON AND KELLY M. SMITH WILLIAM E. SMITH, JR. SUSAN SORENSON DAVID M. SOULELES HOWARD M. AND ROBIN D. STANILOFF IRMA H. STRANTZ DENNIS W. STRUM SUSAN M. SULLIVAN ANNETTE M. SWEZEY JAMES B. TEHAN DAVID B. TILLMAN CITRON AND GENEVIEVE TOY BRIAN J. VAN DER LINDEN SUEBELLE S. AND DAVID S. VERITY NANCY B. WALLIS ALBERT B. AND LINDA S. WANG LESLIE A. WIDROW-DERBIN CHRISTINA J. WITSBERGER JEFFREY A. AND ROSALIE M. WOLF BARRY J. AND JUDITH S. WOLSTAN JENNIFER S. WORTHAM LAUREL A. WRUBLE CHIERI YAMADA MATT W. YEAGER ELEANOR D. YOUNG JENNY YU BENJAMIN D. ZABLOCKI LEE AND JANET B. ZUSMAN

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FIRST CENTURY SOCIETY First Century Society members are alumni, faculty, staff and friends who have made provisions for UCLA in their Will, Trust, or other planned giving arrangements.

With generosity and foresight, the following members have designated the School of Public Health as a beneficiary: ANONYMOUS LESTER & DEVRA BRESLOW ANNE & JOHN COULSON RALPH FRERICHS ROBERT & DIANA GHIRELLI RAYMOND & BETTY GOODMAN FLORENCE HOPKINS GERALD KOMINSKI DAVID KRASNOW LESTER & GENEVA MEIS JEAN MICKEY HELGA & WALTER OPPENHEIMER JEANNETTE OREL ANNE REHER-LIVIO GURDON & MARY ANN SMITH SUEBELLE & DAVID VERITY

PERPETUATING OUR LEGACY BEYOND OUR LIFETIME is a goal many of us share. You may not be aware that alumni and friends of the UCLA School of Public Health have an opportunity to make a gift that is not only a lasting contribution to the School but also a simple and proven technique for securing a lifetime income and minimizing taxes. A Charitable Gift Annuity is both a gift and a life-income arrangement. When a donor enters into a gift annuity agreement with the UCLA Foundation, he or she receives a lifetime income and at the same time makes a charitable gift that can be designated to the UCLA School of Public Health. In return for a gift of cash or property, the UCLA Foundation agrees to pay one or two beneficiaries selected by the donor a fixed, lifetime dollar amount.

The donor is also entitled to an immediate income tax charitable deduction the year the gift is made.

Helga and Walter Oppenheimer, two of the School’s most generous benefactors, chose to make their $1 million gift through a Charitable Gift Annuity. As Mr. Oppenheimer recently stated: “As you advance in age, you don’t want to deplete all of your income while you are alive. That’s where a gift that takes effect when you die is advantageous.”

A charitable gift annuity is only one of many ways to make gifts to the UCLA School of Public Health. Many other gift arrangements also enable a donor to make a gift while retaining income from the asset. Each arrangement offers unique advantages, allowing donors to tailor their gifts to meet their unique personal financial and philanthropic goals.

Planned gifts can be made during a donor’s lifetime. They also can be made in a donor’s will or living trust, designed to take effect only after the donor’s death. The appropriate arrangement for each donor varies according to the donor’s age, the type of assets being used, and the donor’s own financial needs and goals.

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friends

gifts that give back to you

Walter Oppenheimer

For more information on how you can combine your philanthropic wishes for the UCLA School of Public Health and personal financial planning, please contact Joanne Clarey at (310) 825-6464 or jclarey@support.ucla.edu.

CAMPAIGN UCLA SCHOOL OF PUBLIC HEALTH Faculty $ 1,576,435 Students $ 2,092,806 Discretionary $ 1,985,586 Capital $ 37,191

Progress Toward Goal as of April 30, 2002

UCLAPUBLIC HEALTH

Program/Research $ 17,072,985

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Commencement

2002

Dr. Helene Gayle, the featured speaker at the School’s 2002 Commencement, is senior advisor for HIV/AIDS with the Bill and Melinda Gates Foundation.

Gayle accepted the newly created position last September to help steer the activities of the foundation in combating HIV and related diseases worldwide.

Previously, she had served since 1995 as director of the Centers for Disease Control and Prevention’s National Center for HIV, STD, and TB Prevention.

UCLA

UCLA

PUBLIC HEALTH School of

Public Health

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

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UCLA