UCLA Public Health Magazine - June 2005

JUNE 2005

UCLA

PUBLIC HEALTH

UCLA

raising the bar for children’s health

School of

Public Health

She was a pioneer in quality of life and cancer survivorship.

Patricia Ganz envisions a future in which prevention renders these issues less salient.

Alum and faculty member Raymond Goodman has enlisted hundreds of retired health care providers to prepare to serve in case of a masscasualty disaster.

M.P.H. student Angela Marquez won an award normally given to physicians. Now she is learning how to make an impact in health care management.

UCLA

PUBLIC HEALTH

Albert Carnesale, Ph.D. Chancellor

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

Sarah Anderson Assistant Dean for Communications

Dan Gordon Editor and Writer

fe a t u r e s

Martha Widmann Art Director

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

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

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

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

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

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

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

Richard Hector, Eric Lai Co-Presidents, Public Health Student Association

Christopher Mardesich, J.D., M.P.H. ’98

UCLA

President, Alumni Association

School of

Public Health

4

TSUNAMI An Alum’s Up-Close Experience Seven months after going to work for USAID/ Indonesia, Lisa Kramer (M.P.H. ’03) found herself assisting in the recovery from the world’s largest natural disaster.

6 CHIS in the Community Holly J. Mitchell, CEO of the nonprofit child care and development organization Crystal Stairs, is one of countless health advocates benefiting from the California Health Interview Survey, based in the school.

1

Raising the Bar for Children’s Health

The Translational Work of Patricia Ganz

14 Alumni Hall of Fame:

the 2005 Inductees

in every issue 23 RESEARCH

10 By following up on the complaints of her cancer patients, she became a pioneer in quality of life and survivorship research. Her ultimate goal: not having to tell her patients they have cancer.

Children’s exposure to diesel school bus exhaust... film ratings and violent content...examining wellchild care...emotional distress from parent’s HIV-related death...smoking in the movies...physical inactivity among adolescents.

16 12

The Medical Reserve CORPS of Los Angeles Alumnus, long-time faculty member and retired physician Raymond D. Goodman is mobilizing other retired health care providers to help the county prepare for the worst.

Amid greater appreciation of the impact of childhood health and development on the long-term trajectory of individuals, more attention is being paid to the well being of society’s youngest.

28 STUDENTS 31 FACULTY 32 NEWS BRIEFS 34 FRIENDS

ON THE COVER They represent our nation’s future — and, we are realizing, the extent to which we promote their health and development today goes a long way toward determining their mental, physical, and emotional well being in adulthood. Cover photo: Getty Images © 2005

PHOTOGRAPHY Reed Hutchinson / Cover: Ganz, Goodman, Marquez; TOC: Ganz, Goodman; pp. 6, 7, 10, 12, 18, 21, 28-29, 31; p. 32: Olsen, Rimoin

ASUCLA / p. 2; pp. 14-15; p. 37 Lisa Hancock / pp. 17, 22 Yvette Roman / p. 35 Courtesy of Lisa Kramer, photos by Tim Gerhardson, U.S. Embassy in Jakarta / TOC; pp. 4-5 Courtesy of Leona Butler / p. 8 Courtesy of Michael Flood / p. 8 Courtesy of Holly Mitchell / TOC, p. 9 Courtesy of Kathleen Curtis, photo by Brandie Campbell / p. 9 Courtesy of Arthur Winer / p. 23 Rita Hayworth in “Gilda” (Charles Vidor, 1946). Preserved by the UCLA Film and Television Archive / p. 26 Courtesy of the UCLA School of Public Health / p. 13; p. 32: Boxer, Breslow; p. 33, back cover Getty Images © 2005 / TOC; pp. 16-17; pp.19-20

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 2005 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.

2

dean’s message FOR THE FIRST TIME IN TWO CENTURIES, the current generation of children in the United States could have shorter life expectancies than their parents. The main reason: obesity. Recent research shows that the consequences of obesity are wide-ranging and serious; not only is it a significant risk factor for diseases such as type 2 diabetes, heart disease, kidney failure and cancer, but it is contributing to the onset of these diseases at increasingly younger ages. Couple a remarkable increase in obesity with escalating chronic health care challenges such as asthma and autism, and we anticipate that for health reasons alone, many of our children will be unable to fulfill their potential.

In addition to confirming the importance of giving children a healthy start, a growing body of research indicates that much of what children experience in the early years shapes how they will live as adults. There is no question that creating an environment conducive to raising healthy children has consequences that extend for a lifetime.

Our school’s work in children’s health, some of which is highlighted in our cover story (page 16), tackles these issues head-on. Whether it’s seeking practical solutions to the rising epidemic of obesity and diabetes in children, or understanding the prevalence of sexual activity among teens, our faculty’s work is producing the latest scientifically based perspectives on policies and programs designed to help our children thrive despite current challenges.

One of our school’s core missions is to enhance the public’s health by training future leaders and health professionals. From the time our school was founded, our alumni have become leaders in all areas of the public health community: locally, nationally, and internationally. Several distinguished alumni are featured in this issue, from profiles of the five new inductees to our Alumni Hall of Fame (page 14), to a depiction of the activities of the Medical Reserve Corps of Los Angeles started by Dr. Ray Goodman (page 12) and an account from Lisa Kramer (M.P.H. ’03), who, working for the U.S. Agency for International Development in Jakarta, suddenly found herself utilizing skills gained during her M.P.H. education to assist with tsunami relief (page 4).

In addition to sharing their stories and successes, our alumni offer generous

UCLAPUBLIC HEALTH

financial support to the school, along with perhaps the most important gift of

3

2004-2005 DEAN’S A DV I S O RY B OA R D

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

Ira R. Alpert* Linnae Anderson Diana Bontá* Lester Breslow Sanford R. Climan Edward A. Dauer Michele DiLorenzo (Chair) Robert J. Drabkin Tom Epley Gerald Factor (Vice Chair) Michael R. Gardner Robert W. Gillespie Alan Hopkins* Cindy Harrell Horn Stephen W. Kahane* Carolyn Katzin* Carolbeth Korn* Jacqueline B. Kosecoff Kenneth E. Lee* Richard D. Lipeles* Edward J. O’Neill* Walter Oppenheimer Monica Salinas David Walker Fred Wasserman*

Dean

*SPH Alumni

all, their time. Serving as mentors to our current students, our active alumni offer realistic glimpses of career paths these students can take. They share their stories of how the work they do makes a difference in the world. They offer hope and promise to our students as they prepare to embark upon their own careers in public health during this exciting time for our field.

It is, indeed, an exciting time to be a part of public health. Our field is receiving unprecedented attention as the nation focuses on analyzing, evaluating and responding to ongoing and potentially new threats to our health and security. This increased awareness has created, and will continue to create, many new opportunities for public health educators and professionals.

It is with great pride that we send our graduates into the field of public health armed with skills, dedication and a profound sense of purpose. I am confident in their abilities to do great things.

TOTA L E X P E N D I T U R E S Grants and Contracts State-Generated Funds Gifts and Other Fiscal Year 03-04 $45.4 million

UCLAPUBLIC HEALTH

4 S EVEN

MONTHS

AFTER GOING TO WORK FOR

USAID/I NDONESIA , L ISA K RAMER (M.P.H. ’03) FOUND HERSELF ASSISTING IN THE RECOVERY FROM THE WORLD ’ S LARGEST NATURAL DISASTER .

TSUNAMI

An Alum’s Up-Close Experience In May 2004, Lisa Kramer (M.P.H. ’03) boarded a plane headed for Jakarta to begin her job as a Johns Hopkins University Health and Child Survival Fellow posted to the U.S. Agency for International Development

“The oppressive poverty in which young, old, addicts, fruit peddlers, pregnant women, shopkeepers and beggars exist continues unabated, and requires the same effort that is going into the tsunami relief and rebuilding.”

UCLAPUBLIC HEALTH

—Lisa Kramer, M.P.H. ’03

(USAID)/Indonesia. It was the fulfillment of a goal she had held since graduating from the UCLA School of Public Health the previous year. “I wanted to work in a developing country,” Kramer says. “Having lived in Papua New Guinea as Peace Corps volunteers, my husband and I wanted to return to development work and have our 8-year-old daughter and 5-year-old son experience life in a different culture.” Kramer’s main responsibilities were to include HIV/AIDS, tuberculosis and malaria prevention. She couldn’t know that in late December, the world’s most devastating natural disaster would add a new set of demands.

After seven months of intense work in Jakarta, Kramer was ready to spend a week’s vacation with her family in southern Thailand. They flew to Malaysia on the evening of December 25. The next morning, they boarded a plane bound for the Thai city of Phuket, their last stop en route to Khoa Lak, an hour to the north. About 15 minutes before landing, the pilot informed them that the airport had just closed because of an earthquake. After circling, the plane returned to Malaysia. Kramer and her family never made it to Phuket, and it would be a week before they could get a flight back to Jakarta. Kramer returned to an overwhelming situation. “Very little information was available as to what was happening in the Aceh province because the tsunami had wiped out all of the land

5 nets from the malaria program to Aceh and arranging for medical staff from the HIV/AIDS program to go on temporary duty in Aceh.

Kramer is quick to point out that the USAID was supporting large health programs in Indonesia prior to the tsunami, and the needs that prompted those programs have not disappeared. In February, she spent an evening with outreach workers in a slum area along the railroad tracks of central Jakarta.

Kramer and colleagues talked with injecting drug users about the dangers of HIV infection from sharing needles, and passed out bleach and referrals for heroin detox facilities. “One young man described to me his five attempts to stay off of heroin,” Kramer recalls. “Unfortunately, the lack of hope for anything better in his makeshift community and the escape that heroin provides always draw him back.”

Thus, in addition to taking on new demands related to the recovery, Kramer has continued to focus on HIV/AIDS, TB, and malaria programming.

“The oppressive poverty in which young, old,

Kramer (second from right), shown here assessing drug management at a Ministry of Health warehouse as part of a TB monitoring mission, began working for USAID/Indonesia in May 2004, a year after completing the school’s M.P.H. program.

UCLAPUBLIC HEALTH

addicts, fruit peddlers, pregnant women, shopkeepers and beggars exist continues unabated, and requires the same effort that is going into the tsunami relief and rebuilding,” she says. “The need in Aceh is tremendous and people from all over the world have risen to the challenge. Yet, this tsunami should serve as more than a call for an early warning system and for rebuilding devastated communities.

It should be a call to assist all in need.”

feature

lines and most of the mobile phone towers,” she says. “Government officials and staff were killed in large numbers, including more than two-thirds of the Ministry of Health staff. Few non-governmental organizations were active in Aceh after years of separatist conflict.”

USAID began emergency humanitarian assistance on December 26. With $2.3 million in immediate U.S. government support, the Indonesian Red Cross provided shelter, water, food and medical services. With another $3.5 million, the International Organization for Migration began transporting and delivering relief supplies such as water, food, plastic sheeting, generators, fuel and medicine to affected areas in Aceh and North Sumatra. Later, two USAID-chartered planes delivered thousands of water containers, jerry cans, and other relief supplies to Medan, including plastic sheeting to shelter more than 5,000 families. USAID and U.S. Embassy personnel on the ground in Banda Aceh and in Medan coordinated closely with the U.S. Military on logistics, especially to prioritize the delivery of relief items. The Indonesian Military assisted in loading all relief planes and accompanied U.S. helicopter sorties and trucks delivering relief supplies.

In the first few weeks, the area’s population experienced a small increase in tetanus and measles.

“Some people had been exposed to tetanus through injuries sustained during the tsunami and others suffered puncture wounds while combing through the wreckage searching for survivors or salvageable materials,” Kramer explains. Immunizations had not been well maintained in Aceh, so an immunization campaign began, mainly for measles, and serum for tetanus was shipped to the area.

USAID/Indonesia is now working toward the long-term recovery and reconstruction in Aceh and North Sumatra. Sanitation and clean water remain critical issues. “We all know that in an emergency, the top priorities of water, food and sanitation can’t be emphasized enough,” Kramer says. More than two months after the tsunami, some camps were still without latrines. On the positive side, Kramer notes, the provision of relief and medical assistance to Aceh immediately following the tsunami helped to prevent the disease outbreaks that many feared could have caused thousands of additional deaths.

The USAID has supported tsunami relief in many ways, Kramer reports, ranging from flying in and training midwives and coordinating the delivery of relief supplies to supporting a reference diagnostic laboratory providing mobile clinics. In the first few weeks after the disaster, Kramer worked with USAID/Indonesia health staff to coordinate what resources she could gather from existing programs, such as transferring 10,000 insecticide-treated bed

6

CHIS in the COMMUNITY:

California Health Interview Survey Has Become an Indispensable Tool

By painting in sharper and fuller tones a picture of the health of California’s diverse populations, the California Health Interview Survey (CHIS) has become an indispensable tool for state, federal and local public health agencies, community-based organizations, foundations and researchers. CHIS has identified previously unrecognizable problems and helped advocates illustrate the extent of known concerns. It has informed new policies and interventions designed to improve the health of vulnerable groups and expand access to the health care system; attracted national attention from health survey researchers and state agencies interested in duplicating the effort; and secured substantial public and private funding support.

“CHIS enables legislators and local advocates to highlight problems in their communities, and it gives local health departments and community clinics a way to quantify those needs and to plan policies and programs.”

UCLAPUBLIC HEALTH

—Dr. E. Richard Brown

And CHIS has surprised even its principal investigator with the breadth of its reach.

“We have seen many more applications than I ever anticipated,” says Dr. E. Richard Brown, professor in the School of Public Health and director of the UCLA Center for Health Policy Research, housed in the school and a collaborative effort with the School of Public Affairs. “And I’ve always been an optimist about its potential.”

The California Department of Health Services, National Cancer Institute, Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, universities and other research organizations used data from CHIS 2001 – the first of the biannual surveys – for studies on important health issues.

Community-based organizations have relied on CHIS findings to plan their activities, advocate for new policies, and bolster their applications for grant funding. CHIS data enable county health departments to measure their progress by comparing the health of a particular population with similar populations in other counties. The list of uses and users is enormous.

There are many keys to the success of CHIS, not the least of which is its ability to provide local-level data where previously there were none. Findings are broken down by county – and in some cases, smaller areas. In response to specific requests, for example, statisticians from the UCLA Center for Health Policy Research have applied small-area estimation techniques to CHIS data to provide reliable estimates for cities, legislative districts, and school districts.

“CHIS provides a picture of the population in these communities and the kinds of needs they have,” Brown says. “This enables legislators and local advocates to highlight problems in their communities, and it gives local health

7

CHIS data are applied all over California’s diverse geographic landscape – from the most rural to the most urban communities. Often-overlooked populations are included – from recent immigrants, many undocumented, to those who are typically left out of population surveys, or their responses not accurately captured, because of limited English proficiency. CHIS is administered in six languages. It also provides more adequate samples for several Asian and Latino ethnic subgroups and for American Indians whose numbers have traditionally been too small in population surveys to provide statistically valid information. Likewise, data are gathered on a wide range of health conditions, and on health insurance and access to services. And by asking a core set of questions every two years, CHIS enables users to analyze trends, or to combine data from more than one survey to lend more statistical power to studies of small population groups or areas.

The CHIS team invests substantial resources into making the information accessible to others as quickly as possible, through both its user-friendly

feature

departments and community clinics a way to quantify those needs and to plan policies and programs, as well as justifying their actions to the people to whom they are accountable.”

“CHIS is emerging as a uniquely powerful tool for epidemiologic studies of important health issues like asthma, diabetes, obesity, and access to health care,” adds Dr. John Kurata, CHIS director.

“The policy brief [on food insecurity in California] has been used by state and local agencies to bring essential services and programs to people in need of them.”

—Dr. Gail Harrison

relevant publications on key public health and health care issues and disseminates them widely in print and through its Web site (www.healthpolicy. ucla.edu). UCLA School of Public Health faculty, some of whom serve on CHIS advisory committees, have employed CHIS data in their studies, as have many other researchers.

The first survey, CHIS 2001, has already resulted in important changes that enhance the health and access to care for children and adults throughout California. Statewide, CHIS data are used to estimate the number of uninsured children and adults who are eligible for the public Medi-Cal or Healthy Families programs. State agencies and the Legislature rely on these estimates to better understand the magnitude of California’s large uninsured population and to plan and budget resources.

At the local level, CHIS 2001 results are used in many counties to document the need for, and to develop, new public-private expansion programs for children who don’t qualify for public programs.

*

Older Latinos in California have higher rates of fair and poor health, higher rates of diabetes, and more emotional difficulties than other elders in the state.

*

More than 6.5 million non-elderly Californians were uninsured at some time during 2003. While both adults and children lost employment-based health insurance coverage between 2001 and 2003, the uninsured rate for children decreased as a result of expanded enrollment in Medi-Cal and Healthy Families.

Community clinics and local health departments employ CHIS data to obtain local-level estimates of the uninsured.

Many of the First 5 county commissions – established to carry out the mandate of Proposition 10, which added a cigarette tax to fund education, health, child care and other programs for expectant parents and children through age 5 – have used CHIS data to justify the need for, plan and develop

UCLAPUBLIC HEALTH

online data query system, AskCHIS (linked on the CHIS Web site, www.chis.ucla.edu), which has amassed more than 6,000 registered users, and its data files for researchers and analysts. “AskCHIS democratizes data by providing instant access to customized results from CHIS,” says Dr. Jeffrey Luck, associate professor at the school and co-principal investigator of CHIS. “It means you don’t need advanced statistical training to get detailed, accurate data about California’s population for advocacy or fundraising.” The UCLA Center for Health Policy Research also uses CHIS data to produce policy-

8

new public-private expansion programs for uninsured children ineligible for Medi-Cal or Healthy Families. Asthma control agencies and organizations use CHIS data to track state- and local-level prevalence and to focus attention on prevention. State, county and local researchers rely on CHIS data to

track prevalence and to encourage prevention of diabetes, obesity, hunger, lack of physical activity, and other key public health problems.

A November 2002 policy brief and subsequent fact sheet on the number of Californians at risk for, or suffering from, hunger proved to be particularly powerful, leading to legislative action. Using CHIS 2001 data, authors led by Dr. Gail Harrison, professor in the School of Public Health, concluded that more than 2.2 million low-income California adults cannot always afford to put food on the table, and nearly one in three of these adults – 658,000 – experiences episodes of hunger. A number of advo-

Leona M. Butler | Chief Executive Officer Santa Clara Family Health Plan

Michael Flood | Executive Director Los Angeles Regional Foodbank

A not-for-profit, locally formed organization designed to provide affordable health coverage to lower-income residents of California’s fourth-largest county, the Santa Clara Family Health Plan established the Children’s Health Initiative in 2001 – a commitment to making sure all of Santa Clara County’s 72,000 uninsured children were covered. The 72,000 figure came from CHIS data. “The estimates were amazingly accurate,” says Butler. Using CHIS numbers, her organization determined that approximately one-fourth of the county’s uninsured children – 18,000 – were not eligible for the public Healthy Families or MediCal programs. To reach that population, the organization started Healthy Kids, which provides low-cost coverage to county residents under 18 with family incomes at or below 300 percent of the federal poverty level and who are not eligible for the public programs. Healthy Kids has enrolled 13,000 children; 2,000 more are on a waiting list. “CHIS data enabled us to show what was needed and successfully apply for funding,” Butler notes. Using these programs as models and CHIS as their source of population data, a dozen counties have implemented similar programs, and approximately 20 others are in the planning stages.

The substantial news-media coverage of a November 2002 CHIS policy brief on hunger and people at risk for hunger in California helped to raise awareness of the problem in a way that was extremely helpful for an organization such as Flood’s, which mobilizes resources in the community to fight hunger and its causes. “We found that the media and the public were surprised about both the extent of hunger and the fact that hunger exists in all geographic regions throughout Los Angeles County,” says Flood. Along with raising public consciousness, the CHIS data provided critical sub-county data on who is affected. “Los Angeles County is so large that the overall number of hungry and food-insecure people, while interesting, doesn’t give us enough information to know where we should be expanding services or starting new programs,” Flood explains.

“We had never been able to compare our service levels in a particular area with what the overall need is in that area.

Having these data enables us to make sure we’re targeting the areas that are most in need.”

*

UCLAPUBLIC HEALTH

Mexican immigrant adults are four times more likely than U.S.-born non-Latino whites to have no health insurance, and more than twice as likely to have no usual source of care.

*

cacy groups, including the Los Angeles Regional Foodbank and California Food Policy Advocates, seized on the data to lobby for legislation. AB 231, which expanded food stamp eligibility, twice referenced the CHIS findings. The bill was passed and signed into law. The CHIS data have also spurred county supervisors in Los Angeles and in parts of Central California to take action. “The policy brief has been downloaded from the Web site more than 50,000 times, and used by state and local agencies to bring essential services and programs to people in need of them,” says Harrison. “It’s a very gratifying example of the kind of impact that CHIS is having.” * from CHIS 2001 and CHIS 2003 data

Kathleen Curtis, Ph.D. | Director Central California Center for Health and Human Services California State University, Fresno

*

Assembly District (AD) 62 in San Bernardino leads the state in overweight and obesity, with 71% of adults having a body mass index exceeding the standard cutoff of 25. In contrast, 39% of adults in San Francisco’s AD 39 are overweight or obese.

Holly J. Mitchell | Chief Executive Officer Crystal Stairs, Inc. As CEO of one of California’s largest private, nonprofit child care and development organizations – Crystal Stairs facilitates care to approximately 25,000 children each day in South-Central Los Angeles – Mitchell accepted an invitation to sit on the CHIS 2005 Child Technical Advisory Committee, giving her the chance to offer input on aspects of the 2005 survey pertinent to child care utilization. “The staff at CHIS has been very accommodating in talking with us about questions that could help identify the unique child care utilization needs of California residents – addressing cost, affordability and other access issues,” Mitchell says.

“It’s a wonderful opportunity to learn in greater detail about the needs of families so that we can develop strategies for future programs.” Crystal Stairs has employed data from CHIS surveys in applying for grant dollars to support its outreach efforts, she notes, adding: “Through CHIS, budget-constrained advocates, child care planning bodies, as well as parent and provider groups, have access to high-quality data on child care needs and utilization.”

UCLAPUBLIC HEALTH

An ancillary unit of California State University, Fresno that has been developed to address some of the most serious health needs of the San Joaquin Valley through research, teaching and community service, the Central California Center for Health and Human Services houses both the Central California Children’s Institute and the Central Valley Health Policy Institute. Both, says Curtis, have used CHIS data almost daily since the fall of 2002. Center researchers relied extensively on CHIS in several San Joaquin Valley regional health indicator studies; in a county-specific ‘Report Card’; and in issue-focused reports on topics such as asthma, access to care, obesity and diabetes that used eight-county San Joaquin Valley data. By providing detailed, local-level data on the San Joaquin Valley population, CHIS helps researchers paint a clearer picture of the health of the region’s residents, Curtis says. “Previously we would look at California-specific data from national surveys, but those surveys tend to be infrequent and you never know where in California they were measuring,” she explains. “Data specific to our area, with sampling across age ranges and ethnic groups, is much more real and relevant.”

9

feature

Individuals with asthma living in areas with the highest annual ozone concentrations are approximately 30% more likely to experience daily or weekly asthma symptoms than those living in areas with the lowest ozone levels.

10

BY

FOLLOWING UP ON THE

COMPLAINTS OF HER CANCER PATIENTS , SHE BECAME A PIONEER IN QUALITY OF LIFE AND SURVIVORSHIP RESEARCH .

H ER

ULTIMATE GOAL : NOT HAVING TO TELL HER PATIENTS THEY HAVE CANCER .

The Translational Work of Patricia Ganz: From the Bedside to the Population In recent years,

much has been made of the importance of translational

researchers – scientists who convert basic laboratory findings into clinical therapies, a trajectory often referred to as “bench to bedside.” For the better part of the last two decades, Dr. Patricia Ganz has engaged in translational efforts of another sort – from the bedside to the population. An oncologist by training, Ganz has listened to her cancer patients’ complaints and followed up with actions that touch the lives not only of her

UCLAPUBLIC HEALTH

patients, but of thousands of others she’ll never meet.

The notion that a doctor should listen to her patients seems obvious; yet, Ganz was a pioneer in the assessment of quality of life in cancer patients – ultimately prevailing upon the National Cancer Institute (NCI) to include the measurement as an important component of clinical trials – at a time when the physical and psychosocial effects of treatment on these patients were taking a back seat. “Patients who would complain about how they felt were being told, ‘You should just be glad you’re alive,’ ” Ganz explains.

Compassion for cancer patients has guided Ganz’s work over the years, the last 12 of them as director of the Jonsson Cancer Center’s Division of Cancer Prevention and Control Research, based in the UCLA School of Public Health. Her influence has been recognized by the American Cancer Society, which in 1999 made her the first woman to receive its prestigious Clinical Research Professorship. The five-year professorship (renewed last year for another five), given to one or two individuals annually, supports the work of established investigators in mid-career who have made “seminal contributions that have changed the direction of clinical, psychosocial, behavioral, health policy or epidemiologic cancer research.” Last year, Ganz received the UCLA Alumni Association’s Professional Achievement Award.

studies to determine the prevalence of these symptoms, what was causing them, and how they could be prevented or treated more effectively. She conducted research to assist physicians in counseling breast cancer patients on the pros and cons of different levels of treatment, taking into account the side effects of the therapy. She was a founding member of the National Coalition for Cancer Survivorship.

“As I got further into studying the late effects of cancer and its treatment, I also became more interested in incorporating prevention and cancer control into my practice, because it would be far better never to have to tell somebody, ‘You have cancer.’ ” —Dr. Patricia Ganz

UCLAPUBLIC HEALTH

Realizing that continuing to make the impact she desired would require full-time research, Ganz joined the School of Public Health faculty in 1992.

The next year, she was appointed director of the Division of Cancer Prevention and Control Research. “As I got further into studying the late effects of cancer and its treatment, I also became more interested in incorporating prevention and cancer control into my practice,” she says, “because it would be far better never to have to tell somebody, ‘You have cancer.’ ” Among her many efforts, Ganz has been active in clinical trials for chemopreventive agents for breast and prostate cancers.

Among the targets of her prevention efforts are individuals at increased risk for hereditary cancers.

Approximately one in 10 cancers can be traced to inherited genes. Ganz started the UCLA Family Cancer Registry and Genetic Evaluation Program in 1997. The program is a vital resource for families who share altered genes that potentially place them at increased risk of inherited cancers. More than 600 individuals from high-risk families are enrolled, receiving genetic counseling, access to confidential genetic testing, and information on the latest cancer prevention trials. Participants answer questions about lifestyle and share blood and tissue samples that can be used in future studies – making the program a valuable repository for researchers, who can mine the registry for clues that could lead to earlydetection and prevention strategies.

It’s an exciting time for her field, Ganz says.

Much progress is being made, through cancer prevention has turned out to be a more formidable task than prevention in the field Ganz once considered entering. “Everyone asks when we’re going to cure cancer,” Ganz says. “But cancer results from many different types of exposures, so unfortunately we will need different prevention strategies for each type. Cardiovascular disease has a short list of risk factors and medications that are effective in reducing those risks – and look at the difference we make by controlling blood pressure and cholesterol. This is a successful prevention paradigm that resonates with my patients when I’m discussing the importance of chemoprevention trials in cancer.”

11

faculty profile

At the outset, the woman who would one day become a leading figure in cancer prevention, quality of life and survivorship issues had other plans: to become a cardiologist. It wasn’t until her clinical training at UCLA that she changed her mind. For the first decade of her post-training career, during which she became chief of hematology/oncology at the UCLA-San Fernando Valley Program, Ganz was content to see cancer patients, teach medical trainees, and do clinical research part time – though she dates her interest in public health’s populationbased approach to her first year as a student at the UCLA School of Medicine. “It was 1969, a time when there were a lot of anti-Vietnam War rallies on campus,” she recalls. “Although I was quite sympathetic to the protests, my form of ‘activism’ was choosing as an elective a community medicine course taught by Lester Breslow.” Breslow, who would later become dean of the School of Public Health as well as a colleague of Ganz’s in the Division of Cancer Prevention and Control Research, was emphasizing health interventions outside the hospital, something that was far less common than it is today – and an approach that Ganz found appealing.

By the early 1980s, Ganz had become concerned that the impact of cancer treatment on patients and their families wasn’t being adequately considered.

“I couldn’t just give patients a drug to shrink their tumor without looking at the big picture of how that was going to affect them,” she says. One setting where such issues were being considered was the emerging field of hospice care. Ganz started a unit at the UCLA-San Fernando Valley Program that dealt largely with pain and other symptoms as well as endof-life issues for patients with advanced cancers. But while running that unit, she began to wonder why patients had to be terminal before their symptoms were controlled and their psychological concerns addressed. “It became clear to me that beyond my treatment focus, I was interested in rehabilitating patients – helping them recover,” Ganz says. The NCI was just starting to fund demonstration projects on cancer rehabilitation, and Ganz began to work with like-minded scientists on pilot studies addressing the day-to-day impact of the disease and its treatment.

In 1988, Ganz used a sabbatical to educate herself on the social science tools that would enable her to assess patients’ quality of life. “I really felt that the patient and the patient’s family should be directing us where to go,” she says. Working with behavioral scientists, Ganz began following up on the complaints of breast cancer patients and survivors in areas such as cognitive difficulties, fatigue, sexuality and menopausal symptoms and management, designing

12

A LUMNUS ,

LONG -

TIME FACULTY MEMBER AND RETIRED PHYSICIAN

R AYMOND D. G OODMAN

IS

MOBILIZING OTHER RETIRED HEALTH CARE PROVIDERS

The Medical Reserve CORPS of Los Angeles

TO HELP THE COUNTY PREPARE FOR THE WORST.

Readying Reinforcements to Assist in an Emergency “I left private practice because I wanted to extend my services to communities rather than individuals, which is what public health is all about.

I’m now able to do that.

It’s been very rewarding.”

UCLAPUBLIC HEALTH

—Dr. Raymond D. Goodman

When he retired after 30 years as a physician in private practice, Raymond D. Goodman (M.D., M.P.H. ’72) wanted to apply his skills differently – serving communities rather than patients. A member of the school’s Alumni Hall of Fame (see page 15) who has also been on the faculty of the UCLA schools of public health and medicine since 1950 – he is currently an adjunct associate professor in the School of Public Health – Goodman was searching for a way to make a greater impact than he ever could from treating individual patients.

In November 2002, as he listened to a lecture on the public health response to the bioterrorist threat given by Dr. Ralph Frerichs, professor of epidemiology at the school, Goodman decided how he wanted to fulfill that goal. “The talk was not about what happens when several letters containing anthrax are distributed through the mail, but what might occur if there was an attack in Los Angeles with close to 200,000 casualties,” Goodman recalls.

Goodman was so impressed by the magnitude of such a disaster and the strain it would put on the area’s emergency response systems that he began to think about recruiting retired physicians and nurses who would be prepared to

recruited more than 100 to serve. Most recently, the MRC of Los Angeles has added a new component to its mission, providing public education programs on disaster preparedness.

For Goodman, the Medical Reserve Corps of Los Angeles has been a labor of love. “I’ve worked 24/7 on this for going on three years, with no pay,” he says, without a trace of regret.

He has been assisted by more than two dozen consultants, including School of Public Health faculty members Jonathan Fielding, Frerichs, and Steven Rottman, director of the UCLA Center for Public Health and Disasters, which hosts a Web site for the MRC of Los Angeles (www.cphd.ucla.edu/ mrc/).

Kim-Farley, who serves as the organization’s associate medical director, says Goodman has provided an invaluable service. “Dr. Goodman is a strong partner in the county health department effort to protect the citizens of Los Angeles in the event of

Then-Homeland Security Secretary Tom Ridge met with Goodman during a June 2004 visit to Los Angeles.

UCLAPUBLIC HEALTH

a bioterrorist attack or other public health emergency,” Kim-Farley says. “We have greatly appreciated his visionary leadership and the energy he has brought in working with our bioterrorism preparedness staff.” Goodman has also received national recognition: When then-Homeland Security Secretary Tom Ridge visited Los Angeles in June 2004, he met with Goodman to discuss some of the unique threats facing Los Angeles, preparation efforts, and the role of the MRC in assisting.

“I left private practice because I wanted to extend my services to communities rather than individuals, which is what public health is all about,” Goodman says. “I’m now able to do that. It’s been very rewarding.”

13

feature

serve as auxiliary responders. He raised the idea with Dr. Linda Rosenstock, dean of the UCLA School of Public Health, who put Goodman in touch with Dr. Robert Kim-Farley, a professor at the school who at the time was also consulting with the Los Angeles County Department of Health Services on its bioterrorism preparedness program.

“We were in the process of looking into how we would have a group that could help support some of our activities under a surge-capacity need following a bioterrorist attack or other emergency,” notes Kim-Farley, who now serves as director of communicable disease control and prevention for the county, with responsibilities that include bioterrorism preparedness. “We saw this as a very welcomed resource, especially in a time of great staffing need that would occur in an emergency setting.”

So, with the county’s support, Goodman started the Medical Reserve Corps (MRC) of Los Angeles.

Goodman obtained the names and addresses of retired physicians, nurses and physician assistants from the registry boards in medicine and nursing, and sent approximately 7,000 letters soliciting participation. More than 500 volunteers have enlisted.

The organization was recognized by the U.S. Office of the Surgeon General as part of the national Medical Reserve Corps, founded in 2002 to establish local teams of volunteers to strengthen the public health infrastructure and emergency preparedness.

The MRC of Los Angeles has developed protocols in three categories: Mobilize – recruit, enlist, educate and train; Alert – communicate via the chain of command, call to duty, and identify the nature of the disaster; and Deploy – assign the designated team(s) to the specified location(s) of the disaster.

The training program prepares volunteers for cooperation with community emergency response teams and disaster medical assistance teams, including police and fire departments; to participate in any community-based vaccination program and interview and identify those deemed appropriate to receive immunization according to the guidelines specified by the Centers for Disease Control and Prevention; and to participate in the distribution of medications from pharmaceutical stockpiles in accord with guidelines provided by the Los Angeles County Department of Health Services.

Goodman has also created an Interfaith Bereavement Council consisting of clergy from all major faiths and denominations who will be trained to provide spiritual assistance to those who are experiencing grief as a consequence of a disaster. Goodman has personally met with and received the endorsements of clergy from all major faiths, and has already

14

alumni hall of fame: the 2005 inductees The UCLA School of Public Health Alumni Hall of Fame was established in 2002 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. The 2005 inductees, recognized at the Breslow Lecture and Dinner on May 2, exemplify the school’s commitment to teaching, research and service.

Honorees are inducted into one of two categories: Community Service or Professional Achievement.

FOR COMMUNITY SERVICE

UCLAPUBLIC HEALTH

WENDY ARNOLD, M.P.H. ’82 A pioneering contributor to the fight against the world AIDS epidemic, Arnold founded the Peer Education Program of Los Angeles (PEP/LA) in 1990 to train multicultural youths as peer educators in HIV/AIDS prevention, and continues to serve as the organization’s president. PEP/LA reaches more than 6,000 youths and 500 adults annually in Los Angeles, with 25 programs across the United States and more than 9,500 teen peer educators and 3,500 trainers working in 22 countries in Asia, Africa, Europe and South America.

Despite the dramatic growth and far reach of PEP/LA’s efforts around the world, Arnold continues to take a hands-on approach to every satellite program that is established. She has focused her efforts on fighting the rising incidence of HIV/AIDS around the world, particularly among adolescents, and on elevating the care, compassion and hope of people who live with HIV/AIDS. Arnold has worked in large cities and small rural villages, along with everything in between. Most recently, a February trip to Uganda enabled her to travel three hours into the bush to conduct HIV/ AIDS prevention workshops in six communities throughout the country. Additionally, Arnold held peer education programs with prisoners so that they could begin to discuss issues around sex and health education and get tested for HIV/AIDS.

FRANCINE M. COEYTAUX, M.P.H. ’82 A leader with the skills to reach across borders and build bridges among local, national and international communities, Coeytaux is a founder of the Pacific Institute for Women’s Health, a nonprofit, Los Angeles-based organization dedicated to improving women’s health and well being locally and globally. As codirector, she was responsible for the development of the institute’s work on new reproductive technologies, including emergency contraception and medical abortifacients.

Prior to founding the institute, Coeytaux was an associate at the Population Council in New York, where she developed and oversaw the council’s activities in sub-Saharan Africa, helped establish its Ebert Program for Critical Issues in Reproductive Health, initiated a worldwide program to address the problem of unsafe abortion, and collaborated on the public introduction of Norplant and RU-486.

A public health specialist with 25 years of experience in developing and evaluating family planning programs, Coeytaux has worked to promote comprehensive reproductive health services, including abortion. She has published and lectured extensively, and is a founding member of the Reproductive Health Technologies Project, which tackles reproductive health issues where science, politics and the interests of women converge. She serves as a consultant to many organizations, including the World Health Organization, the Planned Parenthood Federation of America and numerous foundations.

15 LINDA BURHANSSTIPANOV, Dr.P.H. ’74., M.P.H. ’72 An educator and researcher whose advocacy for the health needs of Native Americans has made her one of the nation’s leading experts on cancer and Native populations, Burhansstipanov has called attention to issues of data collection and the complex roles of culture in disease perception, diagnosis, treatment and healing, and has played a decisive role in elevating and advancing public health measurement and understanding of the health needs of American Indians and Alaska Natives.

Burhansstipanov is director of Native American Cancer Research, a Native-owned nonprofit corporation that implements extramurally funded, culturally competent cancer prevention, education, training and research efforts among Native Americans, and provides support to community-based Native organizations in cancer control. She developed and served as program director of the National Cancer Institute’s Native American Cancer Research Program, and participated on the Executive Committee of the Intercultural Cancer Council and the Mayo Clinic’s Spirit of EAGLES Advisory Board, as well as several other national and local advisory boards and committees that promote research and programs to improve the health of Native Americans.

Her leadership, scholarship and commitment on behalf of these underserved communities have won widespread recognition, and her efforts are yielding increased attention to the unique cultural, social, economic and political aspects that must be addressed to improve health care and cancer control for the nation’s Native communities.

KENNETH B. WELLS, M.D., M.P.H. ’80 Lauded by his peers as the leading mental health services researcher in the United States, Wells, a professor in residence of psychiatry and biobehavioral sciences at UCLA’s Neuropsychiatric Institute and senior scientist at RAND, has earned recognition for his investigations of health systems organization, financing and clinical mental health care. His early work was the first to identify the disability associated with depression, opening the door to depression treatment as an important component of primary health care. Wells’ subsequent national study of quality improvement for depression demonstrated that providing specific education and care in the primary health setting was a cost-effective strategy for improving clinical outcomes for patients with depression.

In addition to his research, Wells is widely known for his leadership in training, serving as a research mentor to countless scholars throughout the country. He is director of the Faculty Scholars Program in Mental Health Services Research at UCLA and co-director of the Robert Wood Johnson Clinical Scholars Program.

Wells is chair of the Community Health Improvement Collaborative, a consortium to build infrastructure, resources and methods to support academic-community participatory partnership initiatives in Los Angeles County. He was the first recipient of the Young Investigator Award and more recently was honored with the Distinguished Investigator Award by the Academy of Health Services Research. In 2002, he was conferred lifetime membership as a national associate of the National Academy of Sciences, one of the highest honors accorded to an American scientist.

Please access information on 2006 nominations at www.ph.ucla.edu/alumni_hall.html, or call (310) 825-6464.

PREVIOUS INDUCTEES Community Service Ira R. Alpert, M.S.P.H. ’66 Mark Gold, D.Env. ’94 Raymond D. Goodman, M.D., M.P.H. ’72

Nancy Halpern Ibrahim, M.P.H. ’93

Carolyn F. Katzin, M.S.P.H. ’88, C.N.S.

Robert J. Kim-Farley, M.D., M.P.H. ’75

Angela E. Oh, J.D., M.P.H. ’81 Irwin J. Shorr, M.P.H. ’72, M.P.S.

Professional Achievement Stanley P. Azen, Ph.D. ’69 Donna Bell Sanders, M.P.H. ’81 Diana M. Bontá, R.N., M.P.H. ’75, Dr.P.H. ’92

Virginia A. Clark, Ph.D. ’63 Suzanne E. Dandoy, M.D., M.P.H. ’63

Harold M. Goldstein, M.S.P.H. ’89, Dr.P.H. ’97

Richard A. Goodman, M.D., J.D., M.P.H. ’83

Kenneth W. Kizer, M.D., M.P.H. ’76

Keith S. Richman, M.D., M.P.H. ’83

Pauline M. Vaillancourt Rosenau, Ph.D., M.P.H. ’92

Jessie L. Sherrod, M.D., M.P.H. ’80

Stephen M. Shortell, M.P.H. ’68, Ph.D.

Shiing-Jer Twu, M.D., M.P.H., Ph.D. ’91

UCLAPUBLIC HEALTH

JAMES LEDUC, Ph.D. ’77., M.S.P.H. ’72 A medical entomologist and globally recognized authority on SARS, hantavirus, Ebola, smallpox and other viral hemorrhagic fevers, LeDuc is director of the Division of Viral and Rickettsial Diseases at the Centers for Disease Control and Prevention, where he oversees critical areas of the nation’s public health infrastructure.

As an officer of the U.S. Army Medical Research and Development Command, LeDuc compiled a long published record of research on arbovirology and arthropod-borne diseases. He rose to chief of the Department of Epidemiology of the U.S. Army Medical Research Institute of Infectious Disease, where he promoted collaborative global research on rodent-borne hantaviruses and hemorrhagic fevers.

He joined the CDC in 1992; in his current position,

LeDuc has provided congressional testimony on combating bioterrorism, and his expertise in SARS, hantavirus, Ebola and smallpox places him at the forefront of the nation’s efforts to prepare for and deal with the disease threats that have emerged in the post-9/11 world.

Throughout his career, LeDuc has also dedicated himself to education and promoting the careers of younger scientists, particularly those from developing countries. He has been appointed to the adjunct faculty at such widely recognized institutions as the University of Texas School of Public Health and the Johns Hopkins Bloomberg School of Public Health, and has contributed significantly to enhancing the role of the American Society of Tropical Medicine and Hygiene in medical education.

hall of fame

FOR PROFESSIONAL ACHIEVEMENT

16 A MID

GREATER

APPRECIATION OF THE IMPACT OF CHILDHOOD HEALTH AND DEVELOPMENT ON THE LONG - TERM TRAJECTORY OF INDIVIDUALS , THE SCHOOL ’ S FACULTY, STUDENTS AND ALUMNI ARE WORKING TOGETHER ACROSS DISCIPLINES TO PROMOTE A NEW , MORE HOLISTIC APPROACH .

raising the bar for children’s Growing Emphasis on Optimizing Their Well Being

UCLAPUBLIC HEALTH

The long reach of children’s health – Children represent our nation’s future – they will create the families, power the workforce, and make American democracy work in the years ahead.

Their health today, important in its own right, also will have a profound effect on their health as adults.

a notion built on mounting evidence that physical, cognitive and behavioral

from Children’s Health, the Nation’s Wealth: Assessing and Improving Child Health.

Committee on Evaluation of Children’s Health, National Research Council, 2004.

clear. One in 10 children has a significant mental health impairment.

factors in early life influence outcomes decades later – suggests that there are few better investments for a society than in the health of its youngest members.

And yet, despite significant strides in the last half-century – infant mortality and morbidity from infectious diseases and accidents are down, children’s access to health care is up – there are worrisome trends and daunting challenges ahead.

In the United States, childhood obesity is at historic levels, with a related rise in diabetes. Asthma and autism are increasing for reasons that aren’t entirely

Moreover, there is a sense that children haven’t been well served by a health care system geared toward treating disease. “There is what amounts to a revolution under way in our understanding of what children’s health is about and what it means for the long-term health of the nation,” says Dr. Neal Halfon, professor in the UCLA School of Public Health and director of the school’s Center for Healthier Children, Families and Communities. “When it comes to our children,

“We now know that there are certain critical periods in a child’s life that have important implications for future functioning.”

— Dr. Neal Halfon

UCLAPUBLIC HEALTH

we need to shift from a system that emphasizes only preventing disabilities toward one that optimizes development and health. And we need to view health expenditures on children as long-term investments in their health capital.”

As a member of the Committee on Evaluation of Children’s Health of the National Research Council and Institute of Medicine, Halfon helped to draft Children’s Health, the Nation’s Wealth, a federally funded report requested by Congress. The report, released last October, suggests a new framework for measuring the health of children and provides a foundation for moving toward the type of life-course health development model that Halfon and others have advocated in recent years. “We’re viewing health as a dynamic process that develops over time,” Halfon explains. “It’s the idea that birth weight can influence cardiovascular disease risk decades later, that prenatal nutrition is associated with later-life diabetes and hypertension, that mental health problems can be traced to early childhood, and that many of the disparities that we now recognize in populations of older adults probably have their origins early in life.”

Some of the most dramatic recent evidence of the importance of early interventions on a child’s

17

cover story

health

life-course trajectory comes from studies showing the impact of a young child’s emotional, physical and intellectual environment on brain development.

“We now know that there are certain critical periods in a child’s life that have important implications for future functioning,” says Halfon. For example, he notes, researchers have found that children who spend their first three years in rich language environments enter their school years with four times the vocabulary of children who spend those years in poor language environments. “As a result,” Halfon observes, “the child with the higher vocabulary is much more likely to succeed in school, which makes him more likely to succeed later in life.”

In 1998, California voters responded to this emerging body of research by passing Proposition 10, which instituted a tax on cigarettes and other tobacco products to establish the California Children and Families Commission (“First 5”), which has created 58 county-based early childhood programs that integrate health care, child care, parent education and intervention programs for families at risk.

The Center for Healthier Children, Families and Communities has helped to evaluate First 5 at the state level and has consulted with programs in Ventura and Orange counties, as well as assisting in the planning for a federal initiative to improve early childhood systems at the state level. With early

18

“We’re following the trend in modern epidemiology to look at health from the life-course perspective, with the idea that some chronic diseases that occur later in life have an origin that can be traced to early childhood and even to fetal life.”

— Dr. Jørn Olsen

UCLAPUBLIC HEALTH

childhood systems-building becoming a “growth industry” in public health, the center now employs several of the school’s alumni who are leading the teams that are working with various county, state and national early childhood health initiatives.

At the federal level, an ambitious effort to understand the effects of environmental influences on the health and development of children in the United States is being planned. The Children’s Health Act of 2000 authorized a consortium of federal agencies to conduct the National Children’s Study, which is expected to follow more than 100,000 children – including more than 8,000 in Southern California – from before birth until age 21. Researchers at UCLA and other institutions will have the opportunity to study the impact and interaction of the environment, genetics, social factors and cultural influences, among others, in an effort to inform future interventions to improve children’s health.

The largest ongoing children’s cohort study is in Denmark and was founded by Dr. Jørn Olsen, who recently moved to UCLA to become chair of the School of Public Health’s Department of Epidemiology. The Danish National Birth Cohort Study, which Olsen continues to head, is following 100,000 children from fetal life into adulthood; the oldest children in the study are now 8. The focus is on finding early determinants for the most common childhood health problems, including obesity, asthma and other allergic diseases, and for behavioral condi-

tions such as attention deficit hyperactivity disorder.

“We’re following the trend in modern epidemiology to look at health from the life-course perspective, with the idea that some chronic diseases that occur later in life have an origin that can be traced to early childhood and even to fetal life,” Olsen explains. By continuing to follow this large cohort for decades, he adds, researchers might eventually be able to better understand associations between fetal exposures and later risks for cardiovascular disease, certain cancers, and mental disorders.

Olsen, who has been consulted in the planning of the U.S. National Children’s Study, hopes also to establish collaborations with UCLA faculty on research that uses data from the Denmark study.

One potentially important resource stemming from the Denmark cohort is a bio-bank built on blood samples taken from women twice during pregnancy, from the umbilical cord blood at delivery, and from the child at various ages. “There is much more that could be explored from this bio-bank than we could possibly follow up on ourselves, and UCLA has excellent facilities for studying gene-environment interactions,” Olsen says. “I’m hoping to engage faculty at the school and in other parts of the university to take advantage of this valuable resource.”

The rise in childhood asthma has been particularly vexing for researchers. “Much of the medical literature has focused on the role of genetics and environmental pollutants or aero-allergens,” says Dr. Alex Ortega, associate professor at the school. “But the evidence on genetics has been weak, and

“The symptoms of a panic attack are very similar to the symptoms of an asthma attack, and it’s possible that pediatricians are misdiagnosing panic attacks as asthma because they associate asthma, and not mental disorders, with children.”

— Dr. Alex Ortega

19 R.N., M.N.

The rising asthma rates in the U.S., and the disparities among populations living in the same neighborhoods, are not easily explained.

Kimberly Uyeda, M.D., M.P.H. ’01 The challenges in educating students of a large, urban school district are many, but to Uyeda, director of student medical services for the Los Angeles Unified School District, faculty member of the UCLA Center for Healthier Children, Families and Communities and former leadership trainee of the school’s Child and Family Health Program, none is as fundamental as the general deficiencies in the health of a significant number of the district’s students. “We all know healthy kids are better learners, but how do we raise test scores when there are still students who come to school with contagious disease, inadequately clothed and fed, and suffering from both physical and mental health problems?” Uyeda asks.

Addressing these basic health care needs is a tall order when more than 80 percent of the student population comes from lowerincome families, many speak a language other than English at home, and the uninsured rate hovers around 18 percent for school-aged children in Los Angeles. Innovative health initiatives have sprung from the school setting in LAUSD, including express enrollment into health insurance through the information provided on the school lunch application; school-based clinics; and bans on soda and junk food during school hours.

UCLAPUBLIC HEALTH

although the environment clearly plays a role, it doesn’t fully explain why there are significant disparities among populations living in the same neighborhoods.”

Ortega is particularly interested in disparities among children in three minority populations with similar forms of social disadvantage: Mexican Americans, who have asthma rates of 4-5 percent; African Americans, with rates of approximately 10 percent; and Puerto Ricans, whose asthma rates have been found to be as high as 18-20 percent on the mainland and upwards of 30 percent for those living in Puerto Rico. “Why is it that some kids are protected and some aren’t when they live in similar environments?” Ortega asks.

The answer, in part, could lie in the co-occurrence of asthma and mental health problems, Ortega suspects. He has begun a study examining how psychiatric disorders are a potential risk factor for asthma in children – and also whether such conditions, particularly anxiety disorder, are being mislabeled as asthma. “It appears that a large number of children who have panic attacks are being mismanaged – perhaps they should be on psychotropic drugs, not asthma medication,” Ortega says. In other work, he has found that a culturally defined Latino syndrome, ataque de nervios – triggered by acute stress and characterized by uncontrollable shouting and crying, trembling, palpitations and aggressiveness – is also closely associated with asthma attacks; Ortega is following up to determine the explanation for this association. He also recently found that the frequency of mental health problems in a parent is associated with a greater likelihood that the parent’s child will have asthma or asthma attacks.

A diagnostic bias in the health care system might also contribute to the discrepancy, Ortega suspects. His research has suggested that the higher prevalence of psychiatric disorders such as anxiety and depression among Puerto Rican children and adults might be partially attributable to differences in expressive styles, with cultural factors making Puerto Ricans more likely to respond to stressful situations in a way that leads to these diagnoses. In studies focusing on

Smith, a doctoral student in the Department of Health Services who is supported by the school’s Child and Family Health Leadership Training Program, recently directed the California Medical Home Project, a statewide, sevensite project aimed at increasing access to comprehensive services for children with special needs through the promotion of the medical home concept. This concept envisions the pediatric practice as a family-centered, community-based, accessible, and culturally effective coordination center for services.

“Children who have special health care needs due to chronic medical conditions have more difficulty obtaining health care than other children,” Smith explains. “The problem is particularly acute in California because of low payment rates to primary care physicians, a fragmented delivery system, and cultural and language diversity.” A statewide coalition was formed to address state policy and administrative barriers. Then, seven local coalitions received 18 months of funding to plan and implement community-based improvements, engaging key stakeholders in their work.

Third, a program office was established at Children’s Hospital Los Angeles to provide technical assistance to the local coalitions and convene them periodically to exchange knowledge.

The project succeeded in improving access to care, improving the quality of care in participating medical homes, and engaging parents as partners in the care of their children with special needs.

cover story

Kathryn Smith,

Ramesh Raghavan,

20

Raphael Travis, Jr.,

UCLAPUBLIC HEALTH

M.S.W. A former practicing clinical social worker, Travis was recruited to the school’s doctoral program in 2000 as a Child and Family Health Program leadership trainee, and is currently a doctoral candidate in the Department of Community Health Sciences. For 200405, he is a pre-doctoral fellow with the Association of Schools of Public Health and the Centers for Disease Control and Prevention, as well as a fellow with the National Consortium on Violence Research. He is also a staff research associate at the UCLA/RAND Center for Adolescent Health Promotion. Travis worked to integrate principles of positive youth development into his social work practice as a clinician in therapeutic behavioral health settings for adolescents in Maryland. His research interests include long-term investment in adolescent health and the cultural implications of positive youth development approaches to community services. He is exploring methods of creating a unified system of youth development and community-building strategies within localities to promote optimal adolescent and family health, particularly in communities of color.

“I hope to become a leader who contributes to shaping the regional and national agenda on adolescent and family health with an emphasis on long-term developmental health and social justice,” he says.

M.D., Ph.D. ’03 While a fellow at UCLA’s Pediatric Pain Program, Raghavan worked on the first meta-analysis of biobehavioral interventions for pediatric headache. The study marked a turning point.

“This was when I finally made the shift from a patient-focused clinician to a population-focused policy wonk,” Raghavan quips. “I realized that research that leads to policy change has the potential to affect the care of numerous children simultaneously – in contrast to changing things one child at a time, in the way most clinicians are accustomed to thinking about their work.”

At the UCLA/RAND Center for Adolescent Health Promotion, he spent three years working on a variety of projects, and was awarded a dissertation grant from the Agency for Healthcare Research and Quality to support his Ph.D. dissertation on health policies that affect the use of ambulatory mental health services for children in the child welfare system.

As policy director for the National Center for Child Traumatic Stress, a joint center between UCLA and Duke University, Raghavan currently works with 54 centers nationwide in promoting access to services and raising the standard of care for traumatized children through policy analyses, policy development, and advocacy. “Children exposed to trauma are poorly served by our silo-driven organization of mental health services,” Raghavan says.

“It’s enormously rewarding to work to effect change for such a vulnerable population.”

The majority of the U.S. health care budget goes toward high-tech management of chronic, degenerative, disabling diseases that affect older adults.

Puerto Rican children in New England and on the island of Puerto Rico, Ortega is looking at differences in symptom perceptions and expressive styles and seeking to determine whether these differences influence treatment.

“The symptoms of a panic attack are very similar to the symptoms of an asthma attack, and it’s possible that pediatricians are misdiagnosing panic attacks as asthma because they associate asthma, and not mental disorders, with children,” Ortega notes. “This is particularly problematic for minority children, who are much more likely to be exposed to social stressors, and who doctors are more likely to associate with asthma risk.”

Elsewhere at the school, Dr. Mark Schuster, professor of pediatrics and health services and founding director of the UCLA/RAND Center for Adolescent Health Promotion, is leading the Los Angeles site of “Healthy Passages,” a Centers for Disease Control and Prevention-funded study seeking to identify the causes of a wide variety of children’s health outcomes and health-related behaviors. More than 5,000 youths in Los Angeles, Houston and Birmingham, Ala., will be followed between the ages of 10 and 20 through interviews with the child and a parent and data from their schools and the communities in which they live; topics of interest include substance use, violence, injuries, physical activity, nutrition, physical and mental health, and sexual behaviors.

Schuster, who co-authored Everything You Never Wanted Your Kids to Know About Sex, but Were Afraid They’d Ask (Crown Publishing Group, 2003), is also leading a project funded by the National Institutes of Health to develop and evaluate a program, “Talking Parents, Healthy Teens.” The program aims to help parents improve communication with their adolescents, promote healthy adolescent sexual development, and reduce adolescent sexual risk behaviors. The program is unusual both because it is offered in worksites – an effort to reach a large number of parents easily – and for its focus on parents rather than adolescents. “We felt that if we could teach parents the skills needed to open up their relationship with their kids, we could have a longer-lasting impact,” Schuster says. In eight weekly lunch-hour sessions at worksites, parents learn communica-

Debra Lotstein, Only half of children in families with incomes below 100% of the federal poverty level are described by their parents as being in excellent health, vs. more than 80% of children with family incomes above 200% of the federal poverty level.

The proportion of Latino children reported to be in excellent or very good health (59.3%) is lower than for all other race/ ethnic groups.

About 202,000 children under the age of 6 are uninsured, representing 6.8% of the state’s young children.

More than one-fifth of young children diagnosed with asthma had an asthmarelated emergency room visit during the year. The rate was 33.7% for children ages 1-2.

In California households with incomes below the federal poverty level, approximately 46% of children age 5 and 25% of children age 2 drink soda daily.

tion skills, practice role plays, and take part in peer discussions. The program’s impact is currently being assessed in a randomized controlled trial.

Although teen pregnancy rates have declined in recent years, the prevalence of U.S. adolescents engaging in sexual activity – more than 60 percent of students have had intercourse by the time they finish high school and many are not using contraception, surveys indicate – continues to warrant serious concern about unintended pregnancies, sexually transmitted diseases and the emotional health of teens who experience sex before they’re ready, Schuster says. “Most parents are eager to share their values with their kids and to discuss issues related to sexual health, but they don’t know how,” he explains. “We help parents learn practical strategies for talking with their kids about sensitive topics, getting involved in their lives, providing appropriate supervision, and taking other steps to promote their kids’ health. We’re finding that the program makes a real difference.” Schuster is also studying the effect of California’s new paid family leave law – the first such law in the nation – on parents of children with special health care needs, who may have a particular need to take time off from work.

For California’s children with special health care needs, a fragmented service system adds to the burden. “There are multiple funding sources for their care, none of which tends to be very proactive or family-centered,” says Dr. Moira Inkelas, assistant

Fewer than half of parents (43%) read to their child daily.

Only 12.6% of Latino children ages 3-5 are enrolled in preschool, vs. 36% of African American, 32.1% of American Indian/Alaska Native, 28.9% of nonHispanic white children and 23.4% of Asian children.

“Most parents are eager to share their values with their kids and to discuss issues related to sexual health, but they don’t know how.”

— Dr. Mark Schuster

UCLAPUBLIC HEALTH

Source: The Health of Young Children in California: Findings from the 2001 California Health Interview Survey, by Moira Inkelas, Neal Halfon, Kim Uyeda, Greg Stevens, Janel Wright, Sue Holtby, and E. Richard Brown. For more on the California Health Interview Survey, based in the UCLA School of Public Health’s Center for Health Policy Research, see page 6.

As a resident in internal medicine and pediatrics, Lotstein became aware of the problems in the health and health care of young adults with chronic childhood conditions such as sickle cell disease, cystic fibrosis, spina bifida and congenital heart disease. “I noticed a gap that occurred as children with these conditions transitioned into adulthood,” she says.

“There were interruptions in their care as they were often unable to connect with appropriate adult-oriented providers. Some of them seemed to not have developed into adulthood in terms of work and social development.” Her public health education helped her to think about how she might further study this population. In partnership with the California Children’s Services (CCS) agency of San Bernardino County, Lotstein has concluded data collection and is analyzing results of a telephone survey of young adults with serious chronic medical conditions, looking at the assistance they received transitioning into adulthood and their adult health and related outcomes, as well as their access to the health care system. The project has informed Lotstein’s work as an assistant professor of pediatrics at UCLA and a researcher at RAND. She is now developing transition preparation programs for young adults with chronic conditions at UCLA, and planning future studies to look at ways of improving the transition practices of the CCS program statewide.

21

cover story

IN CALIFORNIA:

M.D., M.P.H. ’05

UCLAPUBLIC HEALTH

cover story

22

Rita Maldonado As an M.P.H. student in the Department of Community Health Sciences, Maldonado has learned about program planning and research; in her work as a graduate student researcher at the UCLA/RAND Center for Adolescent Health Promotion, she has seen these concepts in action.

Maldonado has participated most extensively in three of the center’s studies: “Talking Parents, Healthy Teens,” in which she has participated in the implementation and in data collection of research on an intervention to improve parents’ communication with their children on sexual matters; “Families Learning Together,” a school-based parent-adolescent communication program on sex and HIV, in which Maldonado was involved in the development of the intervention and the survey materials, and with recruitment, implementation and data collection; and the Children with HIV-Infected Parents Study, where she has contributed to the data analysis. After completing the M.P.H. program, she hopes to work with communities to create programs that address the needs of people with disabilities. “I believe that to reach the goals of inclusion and full participation that are expressed both nationally and internationally, we must take a population approach,” she says. “I look forward to applying what I have learned both at school and at the center toward that end.”

“There are multiple funding sources for [California children with special health care needs’] care, none of which tends to be very proactive or family-centered.”

— Dr. Moira Inkelas (center), pictured with Lisa Schoyer (l.), chief of family support at Los Angeles County Children’s Medical Services, and Dr. Kyra Samson, a trainee in the school’s Child and Family Health Leadership Program.

professor at the school. “As a result, parents and providers are often confused about the care for which the child is eligible, and referrals are often incorrect or not made in a timely fashion. Families are forced to try to figure out where they can get various kinds of services, and with multiple agencies involved and resources constrained, they’re put in a position of fighting to prove that they’re eligible.”

Inkelas and colleagues recently evaluated a project for the California HealthCare Foundation designed to improve health care for these children, with a particular focus on the nearly 175,000 who are part of the California Children’s Services (CCS) program. CCS pays for specialty health care services for children from birth through age 21 who have serious and often chronic medical conditions such as birth defects, HIV/AIDS, cerebral palsy, heart disease, cancer, and endocrine and metabolic disorders. The California Medical Home Project established a statewide policy coalition and seven countybased coalitions to improve community systems of services for the CCS population. The project produced effective strategies for better coordination and continuity of care.

“There are administrative procedures that can make it very difficult for people to access care,” Inkelas notes. A recent partnership between UCLA and the Los Angeles CCS program produced a survey of approximately 2,000 parents of children in the CCS program, focusing on access barriers and satisfaction with the program. Inkelas and colleagues found that while CCS has successfully

reduced financial barriers to care, significant delays in authorization and timeliness of specialty appointments continue to be problems. The survey identified issues of concern involving the transition of young adults, ages 18-21, from the CCS program to adult providers and insurance programs.

Inkelas and colleagues also devised a chartbook describing health care access for California children with chronic illnesses. Building on recently released federal data that defined children with special health care needs and provided national and state information on specialty care access, care coordination, and unmet health care needs, the chartbook provides new data on access to care for these children and compares the care received by California children with special health care needs with that received by special-needs populations in other states. The population-based survey found that California performs well below the national average, ranking among the bottom 10 states on a number of access measures.

“This study provides some of the first data supporting the policy concerns voiced by advocates for special-needs children in the state,” Inkelas says.

“These are some of the most vulnerable children, and as we learn more about the importance of childhood health and its impact on adult health, we learn about missed opportunities of the health care system to identify concerns in a timely fashion and address them in effective and efficient ways.

Public agencies with responsibility for severely affected children need to be more proactive in asking parents what they need and making sure they get the services they are authorized to receive.”

Halfon believes that “missed opportunities” is a theme that can be applied broadly when assessing the nation’s past efforts in children’s health. But he is encouraged by the emerging consensus calling for a reprioritization. “The system hasn’t been set up to promote optimal health and development of children,” Halfon says. “The majority of the U.S. health care budget goes toward high-tech management of chronic, degenerative, disabling diseases that affect older adults. A small percentage of children have severe disabling conditions, but approximately one in seven has special health care needs, and 30-40 percent function sub-optimally. Most of these kids just slide under the radar until they start having other kinds of problems as they get older.

Increasingly, we’re realizing that these problems could be prevented if we addressed them earlier.”

23

research

research highlights Children Riding Diesel School Buses Exposed to Elevated Levels of Diesel Exhaust Pollutants

Winer’s group used real-time instruments to measure the rapidly changing gaseous and particulate pollutant concentrations aboard commuting buses, and to measure pollutant concentrations at school bus stops and a school loading/unloading zone.

UCLAPUBLIC HEALTH

CHILDREN RIDING DIESEL SCHOOL BUSES are exposed to highly elevated levels of diesel exhaust pollutants compared with ambient air, according to a series of studies by Dr. Arthur Winer, professor of environmental health sciences in the UCLA School of Public Health, and colleagues from UCLA and UC Riverside. Approximately 70 percent of school buses in California are powered by diesel engines. In 1998 the California Air Resources Board declared diesel exhaust particulate a toxic air contaminant.

The research, published in five peer-reviewed journal articles over the past year, used an inert “tracer” gas injected into the exhaust pipes of school buses to demonstrate for the first time that commuting children are exposed to the pollution from their own bus, or “self pollution.” While self pollution occurred primarily with bus windows closed, the researchers found an additional impact when bus windows were open. By videotaping surrounding traffic, including the vehicle immediately ahead of their instrumented bus, they showed that following in proximity to other diesel school buses or heavy-duty diesel trucks correlated with large transient spikes in the concentrations of pollutants such as black carbon. Winer and colleagues found that these spikes in black carbon concentrations aboard the school buses were up to 20 times higher than average black carbon concentrations in Los Angeles away from traffic.

“We found that school buses tend to caravan for long periods of time, one behind the other, and fumigate the bus behind them,” says Winer. “Thus, cleaning up dirty diesel school buses offers a double benefit – reducing both self pollution and the impact a bus has on other nearby school buses.”

Winer’s group used real-time instruments to measure the rapidly changing gaseous and particulate pollutant concentrations aboard commuting buses, and also used these instruments to measure pollutant concentrations at school bus stops and at a school loading/unloading zone. They found that exposures during bus commutes were by far the most worrisome, not only because vehicle-related pollutants were highest on board buses but also because children spent much longer times commuting – up to three hours a day.

Winer notes that children are more susceptible to the harmful effects of air pollution than the average adult. “Children’s lungs are still developing, they have narrower airways and they have higher breathing rates,” he says.

Winer and colleagues found that using compressed natural gas instead of diesel fuel would afford the greatest reduction in exposure but that using traps for particulate control can also be effective. “Either way, we need to clean up these dirty diesel school buses to protect children’s health,” Winer says.

24

MPAA System for Rating Films Offers Parents Little Guidance on Violent Content, Study Finds

Acts of Violence Per Film by Rating: Range and Mean

NUMBER OF VIOLENT ACTS PER FILM

121

Range

Mean

101 81 61 41 21 1 PG

PG-13

Film Rating

UCLAPUBLIC HEALTH

While the average number of violent acts for each rating category increased from PG to PG-13 to R, the MPAA ratings failed to predict the frequency of violence in individual films. The ranges for PG and R films were remarkably similar.

PARENTS AND FILMGOERS who use the Motion Picture Association of America (MPAA) ratings system to gauge movie content receive little meaningful guidance related to violent content, according to a study led by researchers at the UCLA School of Public Health.

The study, funded by the Centers for Disease Control and Prevention and published in the journal Pediatrics, analyzed violent content in the 100 top-grossing films of 1994. The research team used an objective analytical model to study the relationship between rating, degree of violent content and industry labels used to explain the rating assignment.

The study found that while the total average number of violent acts for each rating category increased from PG (14 acts) to PG-13 (20) to R (32), the MPAA ratings failed to predict the frequency of violence in individual films. For example, PG films contained anywhere from a single act of violence to 97 acts of violence; the range for R films was remarkably similar, ranging from one to 110 acts. In addition, the three ratings categories failed to distinguish the amount of violent content for films listing violence as a primary reason for the rating and containing the highest level of explicit violence. Among these films, those with R R ratings averaged 62 violent acts, PG-13 averaged 55 and PG averaged 56.

“The movie industry’s rating system and its prose explanations frequently hide more offensive elements behind euphemistic and innocuous terminology,” says Dr. Theresa Webb, a researcher in the school’s Southern California Injury Prevention Research Center and study co-author. “This makes informed parental choice extremely difficult.”

“Objective content descriptions and measures of explicit violence are far better measures of big-screen violence than a film’s rating,” adds the study’s lead author, Lucille Jenkins, a researcher at the same center. “Parent and other organizations have been calling for meaningful content- rather than age-centered ratings for years, and now there is scientific evidence to support that argument.”

The study examined the primary factor in the supplemental content descriptions accompanying the rating of each film in relation to the actual violent content to determine if PG, PG-13 and R represent three distinct categories in regard to violence. To measure the seriousness of violent action, the researchers used a three-level scale ranging from pushing and chases without weapons to violent acts executed with deadly force. To rank the explicitness of the violent content, they used a four-part scale ranging from violence framed by the narrative but without action, to graphic bodily destruction or damage to a person.

These measures enabled the researchers to quantify each individual act of violence in each film.

Parents Satisfied with Quality of Well-Child Care, but Key Health and Development Issues Not Addressed WHILE A LARGE PERCENTAGE OF PARENTS are generally satisfied with the quality and content of care provided by physicians for their young children dur-

25

Sampling of Issues

research

ing well-child visits, for many parents, certain critical areas of health care and development are not being adequately addressed, according to findings from a first-of-its-kind survey of a nationally representative sample of more than 2,000 parents of infants and toddlers ages 4 months to nearly 3 years.

The National Survey of Early Childhood Health, conducted by the UCLA Center for Healthier Children, Families and Communities and American Academy of Pediatrics and published in a supplement to an issue of the journal Pediatrics, found that the vast majority of parents – 86 percent – believe well-child checkups are very important for their child’s health and development. Eighty-eight percent report adequate time with their provider during the last well-child visit, and 79 percent would recommend their child’s current physician to others. Parent satisfaction ratings were found to be strongly related to the content and quality of the care they receive, with satisfaction increasing when doctors took more time, provided more in-depth discussions about more topics, and provided more family-centered care.

But only 57 percent of parents reported their Adequate time in last well child visit 88% child ever having received a developmental assessment screening procedure to detect disabilEver received developmental assessment 57% ities that could compromise learning, social interactions and other important functions. While most parents are asked by their provider about smoking Counseled on importance of reading 62% in the household, fewer than half reported receiving advice on family or community issues that Counseled on guidance/discipline 44% might affect early childhood health, such as alcohol use and parent well-being. And, while 52 perAny unmet need for age-appropriate guidance 52% cent of parents reported reading to their young children on a daily basis as is recommended, the majority of parents who don’t read to their children 90 100 10 40 0 30 20 50 70 80 60 daily – 48 percent of all parents of young children PARENTAL ASSESSMENT OF WELL-CHILD CARE – said they would find it useful for pediatricians to discuss the importance of reading.

“This study comes at a time when our nation The National Survey of Early Childhood Health, is wrestling with the value of health care, the conducted by UCLA’s Center for Healthier importance of high quality care, and the very important role that healthy develChildren, Families and Communities, finds overall opment in the early years plays in life-long health, education and productivity,” satisfaction with care, but points to key areas not says Dr. Neal Halfon, professor in the UCLA School of Public Health, director of being well addressed. the Center for Healthier Children, Families and Communities, and co-author of the study. “There is good news in this study, but there are also a number of findings that confirm and corroborate other smaller and more localized studies that suggest the quality of early childhood health care is not what it should be and needs to be.”

Emotional Distress Highest for Adolescents Before, Rather Than After, Their Parent’s HIV-Related Death

UCLAPUBLIC HEALTH

FOR ADOLESCENT CHILDREN whose parents test HIV-positive and eventually die of HIV-related causes, the most vulnerable time is the period before, rather than after, parental death, according to a study by researchers in the UCLA School of Public Health and UCLA Neuropsychiatric Institute.

A total of 414 adolescents with HIV-positive parents receiving case management services at New York City’s Division of AIDS Services participated in the prospective study. Half of these adolescents experienced parental HIVrelated death during the six-year study period. The researchers – Professor of Community Health Sciences Mary Jane Rotheram-Boras, Professor of Biostatistics Robert Weiss and biostatistics doctoral student Susan Alber from the School of Public Health, and Dr. Patricia Lester from the Neuropsychiatric

26 Institute – compared these adolescents’ adjustment before and after their parent’s death with the adolescents whose parents did not die.

Publishing in the Journal of Consulting and Clinical Psychology, the authors reported that before parental death, the soon-to-be-bereaved adolescents had significantly more emotional distress, stressful life events and contact with the criminal justice system than did the adolescents whose parents did not die during the study. After parental death, these measures decreased to the point that they were soon indistinguishable from the non-bereaved adolescents. Depression levels increased shortly after parental death, but a year later, bereaved adolescents’ depression levels were comparable to the non-bereaved adolescents’.

“This study is unusual in that we were able to prospectively and repeatedly survey adolescents both before and after parental death,” says Weiss. “The effects of parental death on children are not often studied because it’s difficult to get a group together in advance of the death. It would have been easy to predict that the adolescents would be worse off after losing a parent than before, but that did not turn out to be the case.”

Adds Lester: “The focus is often on helping adolescents in the bereavement period following a parent’s death, but it appears that they experience the most anxiety and are at the most risk for problematic behaviors during their parent’s physical decline and emotional distress prior to death. These findings suggest that we need to recruit for and initiate family-based interventions soon after a parent is diagnosed, to help families develop positive coping skills and enhance parentchild communication and emotional regulation.”

Smoking in Movies Declined Modestly During 1990s

UCLAPUBLIC HEALTH

The decrease in on-screen smoking rates in the 1990s could be linked to changing norms about tobacco use, changes in policies within entertainment production companies, and possibly entertainment-industry responses to anti-tobacco consumer demands and consumer groups.

RATES OF SMOKING IN THE MOVIES declined modestly during the 1990s, mirroring the larger social trend of reduced tobacco use in the United States, according to a UCLA School of Public Health study published in the journal Tobacco Control.

A team that included Dr. Deborah Glik, professor of community health sciences, analyzed the content of the 50 most commercially successful films released each year from 1991 to 2000, measuring tobacco use – defined as any cigarette, cigar, and chewing tobacco use as well as the display of smoke and cigarette paraphernalia such as ashtrays, brand names, or logos – per minute of film. Glik and colleagues found that after rising in the early 1990s, there was an overall downward trend – but only a modest one. In R-rated films and dramas, smoking rates increased. In analyzing the predictors of smoking in films, the researchers found that whether a celebrity actor was an off-camera smoker was a major predictor of whether there was smoking in the actor’s film.

“The impact of the popular media on risky youth health behaviors engenders much debate in public health, and tobacco depictions in the movies are a case in point,” says Glik. “Some researchers report a direct connection between smoking depictions on screen and youth smoking. But while some have claimed that smoking rates in the movies continue to increase, generalizing this to a population-based effect is difficult, as smoking rates among youth have generally gone down over the past decade.”

The decrease in on-screen smoking rates noted by Glik’s group could be linked to changing norms about tobacco use, changes in policies within entertainment production companies, and possibly entertainment-industry responses to anti-tobacco consumer demands and consumer advocacy groups, the researchers suggest. But the decline is modest given extensive efforts to educate the entertainment industry on the issue, Glik says. Moreover, there is some evidence that smoking rates in films released in the years since 2000 have been on the rise, though it is unclear whether that is a short-term fluctuation or a longterm trend. Concludes Glik: “Monitoring, education, advocacy, and policy change to bring tobacco depiction rates down further should continue.”

27

research

State’s Teens Increasingly Inactive; Highest-Risk Groups Include Girls, Low-income Families, and Schools Not Offering Physical Education

PERCENTAGE OF ADOLESCENTS

DESPITE THE WELL-DOCUMENTED BENEFITS of regular physical activity, many California teens do not get regular physical activity or get no activity at all, according to a study by the school’s Center for Health Policy Research using data from the 2003 California Health Interview Survey. The study found that teenage girls, teens from low-income families, teens with no access to safe parks or open spaces, teens whose schools do not require physical education, and Latino, Percent of Adolescents Engaging Asian, and African American teens are particularly at risk. in No Physical Activity by Gender “California Adolescents Increasingly Inactive,” available as a policy brief on and Year, Ages 12-17, California the center’s Web site (www.healthpolicy.ucla.edu), reports that 75 percent of teenage boys and 67 percent of teenage girls participate in regular 2003 2001 physical activity. Inactivity among teenage girls 10% was nearly twice as high as was reported in the 2001 California Health Interview Survey. “Regular 9.2% physical activity” was defined as engaging in mod8% erate- to vigorous-intensity physical activity on most days of the week; “insufficient activity” meant teens were not meeting requirements for regular 6% physical activity; and “inactivity” was defined as getting very little or no vigorous or moderate phys5.3% 5.5% ical activity.

5.0% 4% The study also found that one-fourth of California adolescents have no safe park or open space near their home – and that physical inactivity is higher among these teens. One out of every 2% seven teens reported that physical education was not required at their school – and physical inactivity was nearly twice as high among these teens as 0% it was among teens whose schools require it.

Male Female There were differences in physical activity levels by race/ethnicity and income. Latino, Asian and Source: 2001 and 2003 California Health Interview Survey African American teens reported lower rates of regular physical activity than white teens. Among Asian groups, Chinese teens were the most active, Vietnamese the least active and Filipino teens slightly more active than Vietnamese. Inactivity was also nearly twice as high among teens in families with incomes below 200 percent of the federal poverty level ($37,620 for a family of four in 2003).

The 957,000 California teens getting insufficient activity, including 424,000 boys and 533,000 girls, are at greater risk for many serious chronic medical conditions. “The ultimate cost to society in terms of social security, Medicare, general health care, surgeries and hospitalizations later in life for these inactive kids is potentially enormous,” says Dr. Susan H. Babey, research scientist at the Center for Health Policy Research and lead author of the study. “It makes sense to invest in safe parks, playgrounds and school physical education programs now rather than to pay later for health problems that could have been prevented.”

UCLAPUBLIC HEALTH

28

student profiles She Leaves Her ‘Comfort Zone’ to Train in Fighting HIV

“Rather than following others, in Thailand we need to learn how to take our own body of knowledge and use that to inform practice.

By learning epidemiology, I can do that.”

UCLAPUBLIC HEALTH

—Warunee Punpanich

AS A PEDIATRICIAN PRACTICING in one of Thailand’s largest children’s hospitals, WARUNEE PUNPANICH reached a point after seeing so many HIV-infected patients that she decided merely treating them wasn’t enough.

Warunee’s facility, Children’s Hospital in Bangkok, has treated more than 1,000 cases of symptomatic HIV-infected children since 1989, with more than 4,000 cases of infants born to HIV-infected mothers. “These children are our future, and the response to the problem indicates how highly we value that future,” she says. “We have to regard every case of HIV infection that is diagnosed in a child as a failure of preventive measures in adults. I decided it was time to step out of my comfort zone and find a more efficient way to deal with this problem.”

Her response was to enroll in the UCLA/Fogarty AIDS International Training and Research Program, based in the School of Public Health. The program, founded and directed by Dr. Roger Detels, provides master’s- and doctoral-level epidemiology training to health professionals in Southeast Asia, China, and other parts of the world, helping to prepare them to return to leadership positions at their home institutions. At Children’s Hospital in Bangkok, which serves a mostly indigent population, Warunee will be the first physician fully trained in epidemiology.

“We are a very large hospital with lots of data about diseases and patients, but we don’t know how to make use of it,” she explains. “In this age of information overload, my colleagues and I didn’t have the proper skills to critically analyze the data and turn it into knowledge that would help give our children a better quality of life.” Instead, she says, the hospital’s clinicians tend to rely on knowledge gained from Western medical literature, which is not always applicable to their setting. “We have limited resources, so using the most expensive technology is often not an option,” Warunee says. “And the health problems are so much different in my country. Rather than following others, in Thailand we need to learn how to take our own body of knowledge and use that to inform practice. By learning epidemiology, I can do that.”

Warunee is near completion of her doctoral coursework and plans to return to Thailand this summer to complete her dissertation, which will explore factors affecting the quality of life and well being of HIVinfected children in Thailand. Among other things, she hopes to develop a model for when and how to disclose HIV diagnosis to a child. “A lot of HIV-infected children in Thailand now survive into adolescence, but many are unaware of their own diagnosis,” Warunee says. “It’s very painful for the parents to share this information, but it’s important because as the children get older we need to empower them to take full participation in the treatment process.”

She calls the UCLA School of Public Health program an “eye-opening” experience. “It has provided me with a new level of understanding of the role of the scientific method in generating a valid body of knowledge,” Warunee says. “In the pursuit of this knowledge, and through the network of important contacts I have made here with my colleagues from different countries, I hope to expand my perspective and contribute to making a difference through the application of evidence-based medicine and public health principles.”

29

“I was truly surprised that I would even be considered [for the Young Investigator’s Excellence Award]. I feel so grateful for the support and mentorship I have recieved.”

—Angela Marquez (with her supervisor and mentor, Dr. Jon Kobashigawa) UCLAPUBLIC HEALTH

ANGELA MARQUEZ WAS AN UNLIKELY PRESENTER at the 3rd International Congress on Immunosuppression Scientific Sessions last December, and not just because Marquez, then a first-year M.P.H. student at the UCLA School of Public Health, is only 26.

The meeting, co-chaired by Drs. Ronald W. Busuttil of UCLA and Peter J. Neuhaus of University Clinic Charité in Berlin, is geared toward transplant physicians.

Marquez, who presented on a protocol for weaning patients off of a potent immunosuppressant drug after heart transplantation as a way of reducing toxicity to the kidneys, never so much as went to medical school.

But as research coordinator at UCLA’s Foundation for Cardiovascular and Transplant Research, she played a leading role in a retrospective study of UCLA heart patients on the renal-sparing protocol – reviewing the charts, gathering the data, and analyzing it under the supervision of the study’s principal investigator, Dr. Jon Kobashigawa, medical director of the UCLA Heart Transplant Program. After submitting an abstract, presenting it at the meeting and answering questions from attendees, Marquez learned that she and a co-worker had become the first non-M.D./non-Ph.D.’s to win Young Investigator’s Excellence Awards.

“I was truly surprised that I would even be considered,” Marquez says. “I feel so grateful for the support and mentorship I have received from Dr. Kobashigawa and the other physicians at the foundation.”

Although she majored in history as an undergraduate at UCLA, Marquez was interested in science and health. She joined Chicanos/Latinos for Community Medicine (CCM), and through that organization took part in community health fairs and trips to Mexican border towns to provide basic screenings for conditions such as hypertension and anemia, and to measure blood glucose levels. At one of the group’s meetings, the Foundation for Cardiovascular and Transplant Research’s executive administrator and a heart transplant recipient spoke about the miracle of life-saving transplantation and the shortage of organ donors. Marquez was so moved by their presentation that, with two other CCM members, she co-founded UCLA Be Carded, an organ donor awareness organization that succeeded in convincing more than 600 people to sign organ donor cards at campus and community events during the two years that Marquez served as co-director.

Marquez also began working at the foundation, continuing as a research assistant after earning her undergraduate degree. When the foundation’s research coordinator left in May 2003, Marquez was offered the position; in that role, she oversaw the coordination of a study that led to her award, and co-authored five papers for peer-reviewed journals.

While working at the foundation, Marquez became friends with a co-worker who had a master’s degree in public health. “She told me about all of the opportunities available to someone with an M.P.H. and got me really excited about the field,” Marquez says. Marquez enrolled at the UCLA School of Public Health with a concentration in health services, her sights set on a management position in the health care industry.

“The transplant patients are amazing,” she says. “I have seen some patients in the hospital before their surgery and post-transplantation, and the difference is just breathtaking. I’ll miss that aspect, but by playing an integral role in an organization’s ability to provide quality health services in an effective and efficient manner, I will be able to reach a lot of people, which I find very appealing. The decisions you make in that position can have far-reaching consequences on access, quality of care and patient satisfaction.”

students

Award-Winning Student Seeks to Turn M.P.H. into Difference-Making Role in Health Care Management

2004-05 student awards

students

30

Abdelmonem A. Afifi Student Fellowship Natalie Drorbaugh Community Health Sciences Erin Rogers Health Services Agency for Healthcare Research and Quality Award Melissa Gatchell Erin Richardson Barbara Wentworth Health Services Atlantic Richfield Company Fellowship Fund Perla Atiyah Myranda Austin Adam Dost Hirohito Shimizu Environmental Health Sciences Cody Livingston Forrest Vanderbilt Environmental Science and Engineering Program Biostatistics Training for AIDS Research Erik Bloomquist Li-Jung Liang Yan-Jung Liu Lei Qian MyungShin Sim Fred H. Bixby Doctoral Fellowship Endowment Laura Chyu Claire Dye Jennifer Simmons Community Health Sciences Astuo Coly Epidemiology

UCLAPUBLIC HEALTH

Joseph and Celia Blann Fellowship Dallas Swendeman Community Health Sciences

California Endowment Scholarships Nathalia Allevato Shonali Choudhury Grace Lee Vanessa Shaw Community Health Sciences Kimberly Enard Raul Sobero Health Services California Wellness Foundation Scholarships Hector Lemus Miguel Marino Biostatistics Gloria Giraldo Rotrease Regan Yates Community Health Sciences Mirna Ponce Epidemiology Chancellor’s Fellowship Ning An Epidemiology Amy Carroll Community Health Sciences Hua Guo Biostatistics Jennifer Liebeler Environmental Science and Engineering Program Mitsuko Yamamoto Molecular Toxicology Dean’s Outstanding Student Award Juan Jia Biostatistics Kynna Wright Community Health Sciences Judith Olweny Epidemiology Eduardo Behrentz, Jr. Environmental Science and Engineering Program Ryan Olsen Health Services Dissertation Year Fellowship Hsin-Ju Hsieh Nan Zhang Biostatistics Chi Chiao Tzu Tsai Community Health Sciences Gretchen Coffman Danny Kim Environmental Health Sciences

Yan Cui Katherine Hoggatt Epidemiology Angelica CastanedaJimenez Lisa Sabin Environmental Science and Engineering Program Eleanor J. De Benedictis Fellowship in Nutrition Andrea Conner Constance Gewa Community Health Sciences Environmental Science and Engineering Program Endowment Eduardo Behrentz, Jr. Amy Hensley Jennifer Leibeler Cody Livingston Chad Nelsen Xueying Wu Hortense Fishbaugh Memorial Fellowships Marie Sharp Epidemiology Foley & Lardner Fellowships in Health Services Joshua Kohrumel Scott Scrymgeour L.S. Goerke Memorial Fellowship Katherine Hoggatt Epidemiology Raymond D. Goodman Scholarship Xin Huang Biostatistics Jennifer Erausquin Community Health Sciences Margaret Krudysz Environmental Health Sciences Ariel Braswell Health Services Graduate Opportunity Fellowship Miguel Marino Biostatistics Dahianna Lopez Donna Padilla John Tan Community Health Sciences Jackie Provost Biostatistics Health Policy and Management Alumni Association Scholarship Erin Hahn

Gordon Hein Memorial Scholarship Christian Shinaberger Epidemiology

Eugene Cota Robles Fellowship Jade Sasser Community Health Sciences

William and Flora Hewlett Foundation Environmental Science and Engineering Program Trust Fund Eduardo Behrentz, Jr. Maria Echarte Seong Jeong Lee Adrienne Katner Jennifer Leibeler Chad Nelsen Gang Qin Kyonga Yoon

Roemer Health Services Administration Fellowships La Shawnta Bell Jacqueline Tran Tracy Yee

Bette & Hans Lorenz Endowment Fund Amy Hensley Environmental Science and Engineering Program Xin Huang Biostatistics Kristin Yarris Community Health Sciences

Monica Salinas Internship Fund in Latino and Latin American Health David AlvaradoCopenhaver Luis Sandoval Community Health Sciences

Sam Lucas Scholarship Richard Hector Health Services Maternal and Child Health Grant Diana Farid Rekha Krishnankutty Community Health Sciences Nicole Garro Kyra Samson Kathryn Smith Health Services Max Factor Family Foundation Internship Program Katherine Vittes Community Health Sciences Ann G. Quealy Memorial Fellowship Endowment in Health Services Yelena Gimpleman Carla Howard Ruth F. Richards Outstanding Student Award Joshua Kohrumel Health Services Li-Jung Liang Biostatistics Aaron Plant Community Health Sciences Marie Sharp Epidemiology My Lan Tran Environmental Health Sciences

Will Rogers Memorial Scholarship Candace Coffee Community Health Sciences Christian Shinaberger Epidemiology

Phillip and Adia Siff Educational Foundation Scholarship Evan King Community Health Sciences Juneal Marie Smith Fellowship in International Nutrition Constance Gewa Community Health Sciences Wayne Soohoo Memorial Scholarship Gang Liu Biostatistics Kristin Yarris Community Health Sciences Ning An Epidemiology Samuel J.Tibbitts Fellowship Yasser Aman Health Services Toxic Substance Research & Teaching Program Fellowship Xioyan Liao Elizabeth Marshall Environmental Health Sciences Wilshire Foundation Endowment in Geriatric Medicine Shay Beider Lourdes Molina Community Health Sciences

faculty honors DR. LESTER BRESLOW received the first Lifetime Achievement in Public Health award from the New York Academy of Medicine.

DR. SUSAN COCHRAN was awarded the American Psychological Association’s 2004 Outstanding Achievement Award for significant contributions to the mission of the Committee on Lesbian, Gay and Bisexual Concerns.

DR. GAIL HARRISON has been serving on an Institute of Medicine committee charged with making recommendations for revisions to the food packages for the federal WIC program.

DR. GANG LI served on the scientific committee for the International Conference on Statistics, held in Hong Kong in June 2005.

DR. MICHAEL LU was awarded the 2004 American Public Health Association maternal and Child Health Section Young Professional Award, and selected to the Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes and the National Commission on Infant Mortality at the Joint Center for Political and Economic Studies.

DR. JØRN OLSEN is president-elect of the International Epidemiological Association.

DR. LINWOOD PENDLETON and his research collaborators at the Woods Hole Oceanographic Institution in Massachusetts received the National Oceanographic Partnerships Award from the National Oceanic and Atmospheric Administration for their work on the regional economic benefits of coastal ocean observing systems.

DR. SHANE QUE HEE received the American Industrial Hygiene Association’s “2004 Critic’s Choice” award for editing Biological Monitoring: A Practical Field Manual.

DR. LINDA ROSENSTOCK is president-elect of the Society of Medical Administrators. She was the 2004 recipient of the Rutherford P. Johnstone Award from the Western Occupational and Environmental Medical Association for outstanding service in the field of occupational medicine.

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

A Life in Public Health: An Insider’s Retrospective,

by Lester Breslow. Springer Publishing Company.

Highlights of Breslow’s life, from his early years to his military experience and his career as a pioneer in the field of public health. Breslow offers insights into the early days of a developing field, analysis of current trends, and recommendations for future directions.

Collapse: How Societies Choose to Fail or Succeed,

by Jared Diamond. Viking Press.

From the author of “Guns, Germs, and Steel,” this book looks at what causes some societies to collapse, and others to persevere, in the face of environmental, political, social, and geographical pressures, and what choices we can make now to avoid such a collapse.

Health Policy and High-Tech Industrial Development, edited by Marco R. Di Tommaso and Stuart O. Schweitzer. Edward Elgar Publishing.

The authors illustrate that the development of a country’s health industry not only improves the country’s health status, but also promotes an industry with relatively stable, high-wage employment, creates the potential for exporting goods and services, and produces scientific spillovers that will favorably affect other high-technology industries.

La Nueva California: Latinos in the Golden State,

by David E. Hayes-Bautista. University of California Press.

Traces demographic shifts in the Latino population of California since 1940, and looks at future trends. Provides a socioeconomic analysis of how these shifts have and will continue to affect Latinos’ views of themselves and their roles as Californians and Americans.

Textbook of Clinical Occupational and Environmental Medicine, Second Edition edited by Linda Rosenstock, Mark R. Cullen, Carl A. Brodkin and Carrie A. Redlich. Elsevier Saunders Textbook designed to aid in the detection, diagnosis and treatment of problems caused by occupational and environmental factors. Provides expert advice on clinical problems as well as the legal and regulatory issues faced by occupational and environmental medicine today.

UCLAPUBLIC HEALTH

DR. ANTRONETTE YANCEY received the California Public Health Associations’ first joint 2005 Health Promotion Award for her work in raising public awareness of the roles of physical activity and nutrition in chronic disease prevention.

bookshelf

faculty

DR. THOMAS BELIN is co-chair of the 2005 International Conference on Health Policy Research, the sixth biennial conference sponsored by the American Statistical Association’s Health Policy Statistics Section, which will be held October 28-30.

31

news briefs

faculty

32

professor ruth roemer receives dean’s award NEW FACULTY DR. JØRN OLSEN, a world-renowned researcher in the field of epidemiology, has come to the school as chair of the Department of Epidemiology. Olsen is co-founder of the Danish National Birth Cohort, a study that has followed 100,000 mothers and children from conception to early childhood to determine how this period influences health conditions in later stages of life. He also heads the Danish Epidemiology Science Centre, funded by the Danish National Research Foundation.

He has served as a consultant to the U.S. National Institutes of Health and its European equivalents in Norway, Sweden, Finland, Belgium and the United Kingdom. Olsen has authored more than 300 peer-reviewed publications in English and 42 publications in Danish. He is the author or editor of three textbooks on epidemiology and co-author of another four books. Olsen comes to UCLA from the University of Aarhus, Denmark, where he served as professor for the last decade.

DR. ANNE W. RIMOIN has joined the faculty as an associate professor in the Department of Epidemiology. Rimoin has extensive experience in infectious disease surveillance and epidemiology in developing countries, particularly in Africa and the Indian sub-continent.

She most recently worked as a co-investigator on a variety of studies related to maternal and child health in the Democratic Republic of Congo and Zambia. She currently directs a program to establish active disease surveillance for monkeypox and viral hemorrhagic fevers and a study of the epidemiology of human monkeypox in the Democratic Republic of Congo. Rimoin received her M.P.H. from the UCLA School of Public Health in International Health and Nutrition and her Ph.D. from the Johns Hopkins University Bloomberg School of Public Health in the Division of Disease Prevention and Control, where she serves as an adjunct assistant professor.

Adjunct Professor Emerita of Health Services Ruth J. Roemer, J.D., will accept the Dean’s Award for sustained and generous support at the school’s 2005 graduation ceremony. A devoted teacher and tireless advocate in the field of public health, Roemer has also been a generous supporter of the school. In 1994, she established, with her husband Dr. Milton I. Roemer, the Roemer Health Services Administration Fellowships Endowment. This fund provides fellowships to Dr.P.H. students in the Department of Health Services. Since her husband’s death in 2002, Roemer has continued to contribute generously in support of several school programs.

In recent months, Roemer has received several significant tributes. On January 13, the UCLA Public Health Alumni Association inaugurated the annual Ruth Roemer Lecture to honor her lifelong efforts to use the law to protect and promote health. On March 1, Kaiser Permanente presented her with a check to the school for $58,000 to support her ongoing work in tobacco control.

Most recently, Dr. Farhad (Fred) Hagigi initiated the Ruth Roemer Award, an annual scholarship that will support select second-year M.P.H. students who demonstrate commitment to the social justice and public health issues exemplified in Roemer’s work.

ALSO JOINING THE FACULTY:

UCLAPUBLIC HEALTH

LENORE ARAB Epidemiology BRUCE N. DAVIDSON Health Services ARAM DOBALIAN Health Services NINA HARAWA Epidemiology LEAH VRIESMAN Health Services ZUNYON WU Epidemiology

ALUMNI If you have jobs to offer graduating students, have information about student internships, or would like to talk about careers in your chosen area of public health, please e-mail phaa@support.ucla.edu.

Members of the PHAA Student Support and Alumni Networking Committee are planning student career events for the academic year 2005-06.

33

Dean Linda Rosenstock is assisting the Minneapolis-based Target Corp. chain of stores in educating the public on the problem of medication errors as Target rolls out its new prescription drug packaging and design system. Aimed at improving consumer safety, the new system makes information and warnings more visible and introduces a color-coding system to help individuals in multimember families clearly identify which medication is theirs.

“Improved consumer safety and increased quality of care are key driving forces to improving drug dispensing systems,” Rosenstock explains. “Each year in the United States, as many as 3 billion prescriptions are administered, which creates significant opportunities for error. Improvements in outpatient drug distribution are important steps in helping patients better understand and more easily use the medications their physicians prescribe.”

A recent survey conducted by Harris Interactive indicated that nearly six out of 10 U.S. adults have taken prescription medication incorrectly. The same survey found that among adults who rarely or never read their prescription information sheets, reasons include standard language that doesn’t vary from prescription to prescription, and information that is too wordy, overwhelming, complex and incomprehensible.

In lieu of compensation for Rosenstock’s participation in the effort, Target has donated $65,000 to the UCLA School of Public Health that the dean has designated for student support.

BRESLOW BIRTHDAY — Professor Emeritus Lester Breslow celebrated his 90th birthday at the UCLA Faculty Center March 17, surrounded by friends and family. Breslow remains active in the field, lecturing and publishing articles, along with a recent book (see page 31), and can be found in his UCLA School of Public Health office five days a week.

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

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

If you are not already receiving and would like to receive the SPH ALUMNI e-NEWS that brings information on events and people of special interest to alumni three times a year, please provide this information at publichealth@ support.ucla.edu.

UCLAPUBLIC HEALTH

BRESLOW LECTURE — At the 31st Annual Lester Breslow Lecture, held May 2, Sen. Barbara Boxer (D-CA) spoke about the current political and ideological influences on science and health. At the event, five new members were inducted into the UCLA School of Public Health Alumni Hall of Fame (see page 14).

news briefs

sph dean assists target in educating consumers on safe prescription drug use

34

honor roll 2004 WE ARE PLEASED TO HONOR the alumni, friends, students, staff, foundations and corporations whose generosity strengthens our school and keeps us at the forefront of public health education. This Honor Roll gratefully acknowledges gifts and private grants made to the UCLA School of Public Health from January 1, 2004, to December 31, 2004. Although space limitations allow only the listing of donations of $100 or more, contributions of every amount are of great importance to the school and are deeply appreciated.

GIFTS FROM INDIVIDUALS AND FAMILY FOUNDATIONS $250,000 - $499,999 CARL AND FLORENCE HOPKINS FAMILY TRUST $50, 000 - $99,999 RALPH AND SHIRLEY SHAPIRO $25, 000 - $49,999 MONICA SALINAS $10, 000 - $24,999 ROSALIND & ALFRED BERGER FOUNDATION, INC. EDWARD AND JOANNE DAUER ROBERT J. DRABKIN GERALD AND LORRAINE FACTOR RAYMOND D. AND BETTY J. GOODMAN

UCLAPUBLIC HEALTH

$5,000 - $9,999 IRA AND MARSHA ALPERT LEE BAILEY AND LINDA ROSENSTOCK MICHELE DILORENZO THOMAS EPLEY AND LINNAE ANDERSON STEPHEN W. KAHANE AND JANET A. WELLS-KAHANE AMBASSADOR LESTER B. AND CAROLBETH KORN EDWARD J. O’NEILL SAUL D. LEVY FOUNDATION PAUL R. TORRENS THOMAS R. WILLIAMS AND MARLA E. SCHLOM-WILLIAMS BILL WOOD

$1,000 - $4,999 ABDELMONEM AND MARIANNE AFIFI MICHAEL J. ALPER STANLEY AZEN AND JOYCE NILAND FRANK J. AND CAROL O. BIONDI ROBERT D. BLAIR E. RICHARD AND MARIANNE BROWN ALEXANDER S. CHAI AND MIMI C. YU JOHN AND ANNE COULSON BRUCE N. DAVIDSON JAMES AND MARTA ENSTROM GAROLD L. FABER ROBERT W. GILLESPIE JANET E. GREER ALAN HOPKINS THE HORN FOUNDATION IOWA FOUNDATION FOR EDUCATION, ENVIRONMENT AND THE ARTS LAURA JACOBS RAYMOND AND JENNIE JING TARA G. KAMRADT CAROLYN F. KATZIN GERALD AND LAURIE KOMINSKI KENNETH AND CORNELIA LEE RICHARD AND AMY LIPELES CHRISTOPHER J. MARDESICH AND EDEN KUSMIERSKY WILLIAM D. MEIERDING JOHN P. MONAHAN WALTER W. NOCE WALTER OPPENHEIMER LORI S. PELLICCIONI NEAL PORGMAN THOMAS M. PRISELAC KENNETH J. RESSER LEONARD D. SCHAEFFER BENEDICT AND JANICE SCHWEGLER ATSUKO SHIBATA IRWIN J. SHORR RICHARD E. AND PATRICIA J. SINAIKO GRANT G. SLATER GARY J. SLOAN MARIAN E. SWENDSEID PAUL S. VIVIANO $500 - $999 RONALD T. ASATO WALTER AND IDA ASATO JAMES D. BARBER LEONARD AND

JOAN BEERMAN JOY T. BLEVINS GERALD AND DIANA BOROK LINDA B. BOURQUE LESTER AND DEVRA BRESLOW JEFFERY AND MARTHA FLOCKEN RONALD C. FORGEY TOMAS AND PATRICIA GANZ DANIEL P. GROSZKRUGER JOE AND DIANA HILBERMAN SUSAN D. HOLLANDER JOSELITO S. IGNACIO ALLAN AND DOROTHY JONAS MASAO AND KARLENE KOKETSU DAVID KRASNOW LAURA C. LEVITON STEVEN AND DEBRA LEWIS BRYAN R. LUCE AND MARIE E. MICHNICH JOANNE L. MOSER MARC D. MOSER DOUGLAS R. PAIS THOMAS H. RICE AND KATHERINE DESMOND JACK R. SCHLOSSER MIRIAM SCHOCKEN STUART AND SUZANNE SCHWEITZER IRMA H. STRANTZ JOSEPH AND MARY SYIEK ELLEN THOMPSON FRED AND PAMELA WASSERMAN GRAEME AND VIVIAN WILLIAMS XIAOWEI YANG GREG L. ZEISLER ZHONGWEI ZHANG $250 - $499 RONALD M. ANDERSEN SHARON A. ASHLEY THOMAS R. BELIN AND ANNE L. COLEMAN KIMBERLY J. BRADLEY JIM R. BROWN LAWRENCE M. BRUKSCH PAULA A. CARABELLI SUSAN J. CARR ASIS CHATTOPADHYAY JO ANN COHN MARK E. COSTA MARY ELLEN K. COURTRIGHT DARYL V. DICHEK LYNNE A. EMMA RANDALL ESPINOZA DANIEL J. FAIRLEY

THOMAS AND PHYLLIS FARVER FRANCES L. FELDMAN JONATHAN AND KARIN FIELDING DANIEL J. FINK RALPH R. FRERICHS LAURA GELLER DAVID M. GITTELMAN ALISA M. GOLDSTEIN KENNETH AND ANNE GRAHAM DANIEL AND ROCHELLE GREEN JAMES E. HADEN FARHAD A. HAGIGI PHYLLIS E. HAYES-REAMS MARK J. HOWARD MING-YI HU AND TINA CHEN DEAN T. JAMISON DARIUS E. JATULIS AVRAM AND BETH KAPLAN JANET L. KIRKPATRICK COREY E. KLEIN SUSAN KLEIN LEONARD AND MELODYE KLEINMAN JENNIFER L. KOZAKOWSKI PETER AND ELLA LACHENBRUCH GAIL C. LARSON PETER S. LAUENSTEIN TERI D. LAUENSTEIN JOON LEE DONALD LORACK PREMLA MALIK-OLIVAR RICHARD B. MARCINIAK DENISE C. MATHES FRANK P. MATRICARDI AND DIANA M. BONTÁ KATHERINE L. MINNIUM NIEL S. NATHASON SHARON L. NICHOLS NELLY A. NIGRO AKIRA AND GRACE NISHIZAWA ROBERT NORDYKE RYAN K. OLSEN JOAN OTOMO-CORGEL JOYCE A. PAGE HOWARD G. PHANSTIEL NINEZ A. PONCE SHANE S. QUE HEE ROBERT R. RYGG JAIME G. SALAZAR KARINN B. SAMMANN KENNETH P. SATIN ROBERT SCOFIELD LISA B. SHAW BRIAN T. SHERRINGTON

BRAD SILLASEN LISA V. SMITH DAVID H. SOLOMON IRA S. STUDIN XAVIER SWAMIKANNU AND LAVEEZA BHATTI LINDA A. THOMAS DIANNE K. TOMITA CITRON AND GENEVIEVE TOY H. G. WALLACE ARTHUR M. WINER CATHARINA S. WONG ANTRONETTE K. YANCEY GARY L. YATES $ 1 0 0 - $249 BENJAMIN AARON EMILY K. ABEL HERBERT ABRAMS JOSEPH M. AFONG JAMES P. AGRONICK LESLIE M. ALEXANDRE RICHARD F. AMBROSE AND BOBETTE V. NELSON SANDRA ARONBERG JAMES D. ARTERBURN TAKAMARU ASHIKAGA ENKHJARGAL BADAMGARAV ROSHAN BASTANI CHRISTY L. BEAUDIN JOHN C. BECK MICHAEL J. BELMAN PATTI J. BENSON GERALD S. BERKE AND KAREN DUVALL MICHAEL J. BRENNAN BONNIE BRINTON DAVID BRODWIN AND DEBRA NIEMANN GREGORY S. BRODY GRETCHEN A. BROWN JAMES R. BROWN ELLEN BRZYTWA J. ERIC BUBBERS WAYNE AND SUZANNE BUCK MICHELLE R. BURTON DENNICE L. CALIHAN MICHELE L. CAMBOU MARIA D. CANFIELD DAVID E. CARDENAS MARTIN AND MARY CARR LORRAINE J. CARTER DONALD S. CHANG KYLE AND CHRISTINE CHIKUMA ALICE W. CHU FREDERICK AND JOANNE CLAREY

35 ROBERT A. MURRAY JORDAN E. MUST CRAIG G. MYERS ELIZABETH T. NASH JACK NEEDLEMAN SUSAN S. NIMMO GLEN AND MARY ODELL SAMUEL Y. OH STANLEY C. OPPEGARD JAMES R. ORECKLIN HENRY W. OSOWSKI NEVILLE AND LYNN OSTRICK ANITA J. OSTROFF PATRICIA H. PARKERTON ERNESTO O. PARRA CORINNE L. PEEK-ASA ELLA PENNINGTON DENISE L. PERPICH LAURA J. PETERSEN ROBERT S. PLOURDE SCOTT P. POLANSKY CLYDETTE L. POWELL PATRICIA POWERS STEPHEN R. PRATT JOEL J. PRELL BURTON PRESBERG ERIC AND LAUREL RABJOHNS KRISTIANA RAUBE MARILYN A. RAY JENNIFER A. RAYMOND LOREN D. REED JOSHUA A. REILLY AND LISA A. RUSSELL JEAN L. RICHARDSON ELENA V. RIOS SHARON R. ROBERTS HENRY N. RODRIGUEZ RUTH J. ROEMER ANA A. ROJAS HOWARD AND JEAN ROSENFELD CURTIS AND DOROTHY ROZAS SARA SADAKANE LARA M. SALLEE LISA A. SANFORD SUSAN M. SAZER LINDA M. SCHAEFFER MAREN T. SCHEUNER ANTHONY H. SCHIFF MARK D. SCHLUCHTER DAVID AND HOLLY SCHOLDER CHERYL E. SERVAIS EUGENE H. SEYMOUR ELESTIA E. SHACKELFORD LESLIE Z. SHAFFER RICHARD V. SHAKER JESSIE L. SHERROD MILDRED T. SHINTO KAY Y. SHISHIMA MICHAEL AND SUSAN SHORE GALE F. SHORNICK JEFFREY D. SIEGEL JAMES B. SIMPSON GARY AND MARY SMITH RONALD J. SMITH WILLIAM E. SMITH SVETLANA SMORODINSKY

GUY W. SOOHOO ISAAC J. AND ELKA SOUSSANNA DENISE M. SPAULDING NICOLETTE P. SPOLTORE RICHARD AND MILDRED STERZ JAMES M. STEWART CAROLE L. SUAREZ JOSEPH H. SUGERMAN SUSAN M. SULLIVAN CAROL E. SUTHERLAND THEODORE H. SWEETSER III AND JANE L. VALENTINE ROBERT L. SWEZEY JUDY P. SY SORA P. TANJASIRI DAVID B. TILLMAN DAVID E. TOSTENSON ROBERT AND JANET TRANQUADA JEFFREY AND JYOTI TRUEMAN THOMAS AND RACHEL TUGEND

JANE H. TURNER MARY F. VANDENBROUCKE MANUEL VANEGAS DAVID AND SUEBELLE VERITY ANNE F. WALONKER ALBERT B. WANG FLORENCE WANG ALAN J. WATSON SHERRI D. WEBB KENNETH B. WELLS AND M. CRISTINA BENSON TARA J. WESTMAN STANLEY AND DOROTHY WOLPERT JUDITH S. WOLSTAN DANNY Y. WONG FLORENCE L. WONG DAVID W. WRIGHT STEVEN AND DAYLE WRIGHT THOMAS WRIGHT CHIERI YAMADA HERMAN A. ZAMPETTI

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

Every effort has been made to ensure the completeness and accuracy of this Honor Roll. Please let us know of any omissions or errors in listing your name or gift by calling (310) 825-6464.

EVENING WITH JARED DIAMOND — In March, UCLA School of Public Health faculty member Jared Diamond (second from left) joined friends and supporters of the school for a book signing and discussion of his recently released New York Times best seller Collapse: How Societies Choose to Fail or Succeed (see page 31). The event was hosted at the home of Dr. Eddie Dauer, a member of the Dean’s Advisory Board, pictured above right with his wife Joanne Dauer (left), Diamond and Dean Linda Rosenstock.

UCLAPUBLIC HEALTH

JOHN D. IVIE DORA N. JAMES JUEL M. JANIS LARRY D. JECHA ELVIRA E. JIMENEZ KATHERINE M. JONES KENNETH E. JOSLYN GREGORY C. JUAREZ SUSAN KANOWITH-KLEIN MARVIN V. KANTER JULIE L. KANTROWITZ ROBERT KAPLAN SHAHEEN KASSIM-LAKHA HERMAN AND ROSE KATTLOVE NEAL AND FRANCINE KAUFMAN VICTOR H. KENNEDY ROBERT J. KIM-FARLEY NATSUKO J. KIMURA NANCY J. KINGSTON PAULA KIRCHNER LAWRENCE C. KLEINMAN JAMES J. KORELITZ AND ELIZABETH M. SLOSS YVONNE C. KRIENS JEAN P. LA COUR MARIE M. LA FARGUE MARGERY LACKMAN BARBARA M. LANGLAND-ORBAN JAMES AND CATHY LARSON HARRISON LATTA WENDY LAZARUS PAULINE T. LE MARTIN AND MARILYN LEE MICHAEL W. LEE PHILIP R. LEE TERRENCE LEE ALAN T. LEFOR STANLEY AND ELAINE LEMESHOW HOWARD H. LEVINE JOHN H. LIBBY J. ROBERT LISET ZHIYUAN LIU AND LILI WANG HERBERT L. LUNDBLAD SPENCER D. MAC NEIL GEORGE MACK ROBERTA E. MADISON MARK A. MALTZ ANA M. MARIN JON B. MARSHACK KATHRYN G. MARTI LISA G. MATRAS KERRY J. MATSUMOTO DIANA MATSUSHIMA SHERMAN M. MELLINKOFF GARY M. MEUNIER HILDY B. MEYERS MAX AND JEAN MICKEY RUTH M. MICKEY ROSS M. MILLER GABRIELLA M. MIOTTO JAMES A. MODECKI LINDA L. MORAGA EDWARD MULLEN CAROL M. MURDOCK

friends

WELDEN AND VIRGINIA CLARK DOUGLAS B. CLARKSON BRIAN L. COLE DAVID S. CORREIA MIRIAM P. COTLER OLIVIA A. CROOKES WILLIAM G. CUMBERLAND TERESA K. DAVID DEANE C. DEFONTES AND KATHRYN D. SCOTT ANN M. DELLINGER MARTHA J. DEMAREE KATHRYN P. DEROSE LAURIE S. DODSON BRIAN AND DIANA DOLAN ROBERT DONIN SAM W. DOWNING ESTHER DREIFUSS-KATTAN HELEN M. DUPLESSIS STEVE DUVALL JENNIFER K. EASTER KRISTINE A. EDWARDS PENELOPE L. EDWARDS CALLISHA ANN ELDRIDGE-BELL SAM ELROD ROSALIND ESSNER GERALD ESTRIN GAYLE ETIENNE JANET L. FAHEY HELEN H. FEDER STEPHEN A. FEIG EVE P. FIELDER DOROTHY FLEISHER FELICIA A. FLORES-WORKMAN MARY A. FOO JOAN M. FRIEDLAND JOHN P. FRIEL JOHN R. FROINES SONIA GALINDO JOANNA E. GASPAR ROBERT AND DIANA GHIRELLI CAROL J. GILBERT SAMUEL GOETZ BERNARD H. GOLDNER MICHAEL S. GOLDSTEIN MARIA D.GONZALEZ RICHARD A. GOODMAN CLAUDIA GRAHAM RONALD J. HALBERT NEAL HALFON JILL S. HARMATZ HARLAN H. HASHIMOTO ANN M. HENSHAW MARIA HERNANDEZ THOMAS J. HESSELMANN WILLIAM HINDS HORACE W. HINKSTON JOHN A. HIRSHLEIFER DAVID AND BETSY SWANSON HOLLINGER ELISE M. HOLLOWAY JAMES H. HUANG JACK H. HUDES DONALD AND CAROLYN HUNSAKER SOPON IAMSIRITHAWORN GWENDOLYN L. ISAACS

FIRST CENTURY SOCIETY CORPORATE AND FOUNDATION GIFTS AND GRANTS

36

$1,000,000 AND ABOVE AMERICAN CANCER SOCIETY INC. THE CALIFORNIA ENDOWMENT

SAVE THE DATE UCLA SCHOOL OF PUBLIC HEALTH ALUMNI AND FRIENDS RECEPTION MONDAY, NOVEMBER 7, 2005 6:30 - 8:00 pm Hilton Hotel During the Annual Meeting of the American Public Health Association, November 5 - 9, 2005 in New Orleans

Check the APHA schedule or stop by the UCLA School of Public Health booth for location information.

$500,000 - $999,999 THE ROBERT WOOD JOHNSON FOUNDATION THE SUSAN G. KOMEN BREAST CANCER FOUNDATION $250,000 - $499,999 THE JOYCE FOUNDATION $100,000 - $249,999 BREAST CANCER RESEARCH FOUNDATION CALIFORNIA HEALTHCARE FOUNDATION THE CALIFORNIA WELLNESS FOUNDATION NEVADA STATE HEALTH DIVISION RAND CORPORATION $50,000 - $99,999 BLUE SHIELD OF CALIFORNIA COMMUNITY TECHNOLOGY FOUNDATION OF CALIFORNIA HEALTH RESEARCH ASSOCIATION $25,000 - $49,999 THE ASSOCIATION FOR DRESSINGS AND SAUCES FRED H. BIXBY FOUNDATION WELLPOINT HEALTH NETWORKS INC.

$10,000 - $24,999 BLUE CROSS OF CALIFORNIA FOLEY AND LARDNER LLP GLAXOSMITHKLINE PLC LOS ANGELES REGIONAL FOOD BANK PACIFICARE HEALTH SYSTEMS, INC. THE PARKINSON’S INSTITUTE PFIZER INC. U. S. PHARMACEUTICALS GROUP PRICEWATERHOUSECOOPERS SPECIAL SERVICES FOR GROUPS $5,000 - $9,999 ACCENTURE FOUNDATION, INC. AMGEN INC. CEDARS-SINAI MEDICAL CENTER HEALTH NET, INC. KAISER PERMANENTE MCDERMOTT WILL & EMERY CHARITABLE FOUNDATION NORTHROP GRUMMAN LITTON FOUNDATION WILSHIRE FOUNDATION, INC. OTHER

ADVENTIST HEALTH AMGEN FOUNDATION INC. BRISTOL-MYERS SQUIBB FOUNDATION, INC. CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS

CALIFORNIA COMMUNITY FOUNDATION CHEVRON PHILLIPS CHEMICAL COMPANY LP CHEVRONTEXACO CORPORATION COURSE READER MATERIAL DEPARTMENT OF PREVENTIVE MEDICINE, KECK SCHOOL OF MEDICINE OF USC FIRST SECURITY LENDING GENENTECH, INC. HARRIMAN JONES MEDICAL GROUP HEALTH BENCHMARK, INC. HEALTHCARE PARTNERS LIMITED HOAG MEMORIAL HOSPITAL PRESBYTERIAN KAISER FOUNDATION HEALTH PLAN INC. L.A. CARE HEALTH PLAN THE MARBLEHEAD GROUP LLC MERCK COMPANY FOUNDATION PAUL, HASTINGS, JANOFSKY & WALKER LLP PFIZER FOUNDATION INC. PROGRESSIVE HEALTHCARE SYSTEMS RIVERSIDE COMMUNITY HOSPITAL SAINT VINCENT MEDICAL CENTER TENET HEALTHCARE FOUNDATION UNIHEALTH FOUNDATION

UCLA’s distinguished First Century Society honors alumni, faculty, staff and friends who have chosen to benefit UCLA through planned giving.

Planned gifts include gifts through wills, living trusts, charitable trusts, charitable gift annuities, retirement plans, or other estate planning arrangements.

With generosity and foresight, the following members have designated the School of Public Health as a beneficiary: LESTER AND DEVRA BRESLOW ANNE AND JOHN COULSON ROBERT AND DIANA GHIRELLI RAYMOND AND BETTY GOODMAN GERALD KOMINSKI DAVID KRASNOW JEAN MICKEY WALTER OPPENHEIMER JEANETTE OREL JEAN SANVILLE GURDON AND MARY ANN SMITH SUEBELLE AND DAVID VERITY

C A M PA I G N U C L A S C H O O L O F P U B L I C H E A LT H Cumulative Progress Through Fiscal Year 2004-05* SPH Campaign Goal: $31 M (148%) $50,000,000 $45,794,691

45,000,000 40,000,000

$37,969,674

35,000,000 $33,029,500 30,000,000 25,000,000 $23,336,915 20,000,000

$18,852,239

UCLAPUBLIC HEALTH

15,000,000 $12,364,174 $10,037,344 $ 8,165,239

10,000,000 5,000,000

$ 4,453,851 $ 1,969,479

0 FY 95-96 FY 96-97 FY 97-98 FY 98-99 FY 99-00 FY 00-01 FY 01-02 FY 02-03 FY 03-04 FY 04-05* *FY 2004-05 data is incomplete covering July 1, 2004 – April 30, 2005

alum shows appreciation with planned gift

friends

A DECADE BEFORE HE RECEIVED HIS M.P.H. from the UCLA School of Public Health in 1998, Dr. David Krasnow was already finding ways to give. He began by developing and implementing rural vision care programs for underserved populations in 12 Latin American and Asian countries. Krasnow, a successful Beverly Hills optometrist, continues to spend several months every year donating his time to that volunteer work; his efforts have helped to raise more than $11 million in supplies, equipment, and services benefiting more than 1 million patients.

A desire to be better equipped to serve was one of the reasons Krasnow entered the school’s M.P.H. for Health Professionals Program.

His appreciation for the valuable public health education he received prompted Krasnow to find ways to give back to the school. He currently serves as president of the UCLA Health Services Alumni Association, a support group of the school’s Department of Health Services. Krasnow leads the group’s efforts to raise scholarship funds and other forms of financial support for the department and school.

“I love being able to help our students complete their professional training in health services management and public policy,” Krasnow says. “The cost of quality education continues to rise at UCLA, as it does elsewhere. The limitations to what the state and the students themselves can provide mean that private support is urgently needed to fill the gap.”

Krasnow’s generosity goes beyond his volunteer role at the school. A year after completing the executive-style M.P.H. program, he made the decision to include the school’s executive program in Health Services Management in his estate plans.

“Making this gift is very satisfying, and I hope my example encourages others to do the same,” says Krasnow. “This commitment is another way for me to give back to the program and the school in gratitude for what was given to me.”

“Alumni, faculty and friends who include the UCLA School of Public Health in their estate plans demonstrate a commitment to the school’s continued success in improving public health locally and globally,” says Dean Linda Rosenstock. “We are deeply grateful for their generosity and foresight.”

37

ALUMNI DIRECTORY Alumni, it’s now easier to stay connected with the school!

Update your contact information at www.ph.ucla.edu/ alumni.html

For more information about planned giving arrangements, please contact the SPH Development & Alumni Relations Office at (310) 825-6464.

anne sullivan reher livio leaves proud legacy

UCLAPUBLIC HEALTH

ANNE MARIE SULLIVAN REHER LIVIO, widely known in Los Angeles for her lifelong dedication to helping individuals less fortunate than herself, died in February at the age of 89. As a great believer in causes of social justice, Reher Livio made provisions in her estate to create an endowed fund at the UCLA School of Public Health whose value is estimated to be more than $700,000. Once established, the Anne Sullivan Reher Livio Fund for the Health and Well-being of the Homeless will support, for generations to come, the school’s educational, research and public service initiatives that improve the health and well-being of society’s most underserved populations.

“There but for the grace of God go I,” she once said in explaining her devotion to helping the homeless population.

“And if I were in those shoes, I would want people to be compassionate, regardless of the circumstances that led me to be homeless.”

Reher Livio leaves behind a long record of community activism, public service, and cultural creativity. In the late 1940s she organized early support for the United Nations and eventually served as president of the United Nations Association (UNA) of Beverly Hills and vice-president of the UNA of Los Angeles. She was particularly proud of her role as a Catholic social activist in the 1950s and 1960s; for many years, her Westwood home served as the scene of heated debates on social issues and featured renowned social thinkers from around the globe.

Her bequest to the UCLA School of Public Health is a fitting testimony to her long history of social consciousness and her dedication to the city of Los Angeles. The school is grateful to carry on her vision of serving society’s most needy citizens through the work of its faculty and students.

Commencement

2005 Richard Jackson, M.D., M.P.H., state public health officer for the California Department of Health Services, is the featured speaker at the school’s 2005 Commencement.

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

Nonprofit Org. U.S. Postage PAID

UCLA