UCLA Public Health Magazine - Winter 1981

Winterl981 Magazine of the UCLA School of Public Health and the UCLA School of Public Health Alumni Association

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Publie Heal~h

Moving for-.Nard

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Publie Heal~h Winter 1981

As I finish my first year in the deanship, I reflect on the challenges and rewards that the year has brought. One of the rewards has been the pleasure of working with the faculty, staff, alumni and students to meet the academic and professional goals of the School of Public Health.

One of my goals for this first year has been to extend further the activities of the School of Public Health into the community. I have been pleased to see that this goal has been met in several ways with the help of the faculty: Paul Torrens, professor of health services, and Ellen Alkon, adjunct professor of health services and the medical director of the Western Area of the Los Angeles County Department of Health Services, have developed a Public Health Laboratory in the Western Area. Faculty and students of the School of Public Health are now working with the staff of the Western Area to develop additional health information about the area and to improve the distribution and quality of care to that community of two million people.

The School has been assigned a liaison officer from the Centers for Disease Control (CDC) to work with us in further expanding our interactions with the local, state and national public health agencies. Selection of the School for an assignment of the CDC officer was made after a review of competing applications from the other schools of public health.

In July, the School sponsored a statewide symposium on block grants which brought together health professionals from county, state and federal agencies and faculty from the University of California to discuss the impact of the shift in decision-making about federal health dollars from the federal to the state levels and the commensurate significant cuts in dollars allocated for public health programs.

In December, members of the faculty and I met with each of the Los Angeles County supervisors and their health deputies to acquaint them with the resources of the School which could provide technical input to help them in the decision-making process. We found the supervisors and their deputies to be interested and anticipate that our efforts will lead to further dialogues about public health in Los Angeles County.

In the coming year, we face many challenges. The field of public health is achieving greater recognition just as we are entering into a period of severe fiscal restraint. In the future, we can anticipate less support from the federal government, from the State of California, and from the University of California. But as the economy tightens in all areas, the importance of public health/preventive medicine will increase. We must react to this challenge by consolidating our strengths and improving our efficiency. Increasingly, we will need to find other sources of support.

We will need to explore the opportunities for developing appropriate collaborative projects with the private sector. Fortunately, the quality and commitment of the faculty should insure that we continue to compete successfully for research g:rnnts. The challenges are significant, but I believe that the faculty, staff, students and alumni of the School of Public Health will meet them.

Roger Detels, M.D., M.S., Dean UCLA School of Public Health

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Something's cooking with methane

5 The Venice Family Clinic: Real family spirit 7

Looking on the bright side with Chairman Ash

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Family planning

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Buckling down on buckling up

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Birth project

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Clearing the air

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Causes of depression

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Epidemiology epidemic

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Dean's Council News

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Alumni news

22 Alumni notes 23

Faculty notes

Published for alumni, faculty, staff and friends of the UCLA School of Public Health by UCLA Health Sciences Communications, Room 12-260, Center for the Health Sciences, Los Angeles, California 90024.

Director, Health Sciences Communications: Darlene Doriot Editor/ Writer: Judi Reich Faculty consultants: Lawrence R. Ash Juel M. Janis Alumni coordinator: Barbara Broide Director of Development: Judith C. Angel Design: Roy T.S. Lee

COVER PHOTO: Dr Dee Coady; adjunct professor of public health, examines Henry Gonzalez and his twin brother Jose at the Venice Family Clinic. See story page 5.

Photo by Norm Schindler.

INSIDE COVER: Is long-term exposure to smog detrimental to one's health? See story page 14. Photo by 'Turry O'Donnell.

50111.ething's cooking wvith 111.ethane It may be some time before we are

cooking with "seaweed gas," but research by Dr. Robert Mah, head of the Division of Environmental and Nutritional Sciences, may provide the basic knowledge needed for such an exotic idea.

"Seaweed gas" refers to the use of kelp to produce methane, which is the prime component of natural gas. A diverse group of researchers nationwide are involved in the so-called Kelp Project. They are investigating the possibility of harvesting giant kelp farms covering thousands of square miles which through fermentation would produce enough methane to help supply the natural gas needs of the country. This project is sponsored by the Gas Research Institute and j l is managed by General Electric. '"''..2:2: Groundwork has already been 0 Sl 0 laid for such a bold project. First, ,... since the 1930's waste water "' treatment plants have been using "''"f- pill.lll_..:...:....=-....

Dr. Robert Mah examines a fl.ame methane fermentation when produced by pure cultures of handling domestic sewage wastes. methane bacteria.

Methane is a by-product of this process and has been used in speHolland when the first methanocial generators to produce electricgen was isolated. Since that disity at the plants. covery, only seventeen species have Secondly, there already exists been identified by scientists. One a tremendous network of pipelines reason ~he list is so short, Dr. Mah for sending natural gas from one suggests, is because support for end of the country to the other. The basic research has been hard to find. pipelines are now used to transport With the Kelp Project and a natural methane gas, which Department of Energy grant spurcomes from natural gas pockets ring him on, Dr. Mah predicts that entrapped in the earth's core. after just one year of research he Finally, methane is a clean and his collaborators, doctoral stuburning fuel. When combusted, it dent Tom Ferguson and research produces only water and carbon associate Dr. Ida Yu, will probably dioxide. add several more organisms to The Kelp Project experimenthat list begun nearly thirty-five ters propose to use specific oxygenyears ago. sensitive and other bacteria to "Tom has isolated a methaneconvert the kelp to methane. producing organism that is the Dr. Mah has been asked to isolate fastest growing of all that have pure cultures of the methanebeen reported so far. And Dr. Yu producing organisms, which are must have a green- or I should called methanogens. say bacterial-thumb! She's made This challenge has enabled some great strides in isolating Dr. Mah to expand on the culture many new organisms that we alwork initially reported in 1947 in 4

ways suspected existed but no one had been able to identify," Dr. Mah says.

Since these bacteria live without oxygen, strict attention must be paid to its exclusion in the laboratory.

"The process really isn't hard, it just requires recognition of the necessity for an oxygen-free environment, and the know-how of what to do . .. there's a little art involved, too," Dr. Mah observes.

Dr. Mah's experiments with methane gas are not new. He recently completed a study with Southern California Edison in which he helped assess the efficiency of conversion of urban solid waste material into methane gas.

That study, and his present research, has attracted scientists from China to UCLA's School of Public Health. The Chinese are particularly interested in methane gas since their country has 7 million biogas generators which they use to produce fuel for cooking purposes. Two visiting scholars arrived at UCLA last year, one for seven months and one for two years, and another is expected next year.

Dr. Mah is also involved with the United Nations, working with the International Atomic Energy Agency in exploring the use of methane fermentation in developing countries.

He's enthused about his current involvement in basic and applied research of methanogens.

"It's important to learn more about the physiology and the types of organisms that are there and the basic implications of these organisms in reference to other living things," he says. "In the last five years we, as a scientific community, have been able to establish that these anaerobic (oxygen-free) organisms are different from all other living cells. They form what is pretty much now agreed upon as a third kingdom of living things." O

The Venice Fa111ily Clinic: Real fan1ily spirit

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Richard f arel, left, translates for Steve Maier during a consultation.

Lunch offers a well-deserved break for the Venice Family Clinic staff when the pizzas arrive at 4 p.m.

While the group eagerly eats the meal, it is evident that their spirits need no extra nourishment.

This diverse staff has come together with a single purpose in mind: to provide free primary medical care to low-income families. It is what they each add to that basic intention-their skills, enthusiasm and personalities- that has given the clinic its respected reputation in the community.

Richard Jarel alternately takes a bite of pizza and sketches delightful portraits of his fellow workers.

Richard first came to the clinic as a patient. Unemployed and with a broken leg, he was impressed with the people who treated him.

He's now clinic coordinator, a paid position of tremendous responsibility, and is considering

a career in public health.

Gathered around the lunch table with Richard are Martha Hierro, a pre-med UCLA student who wants to practice in the Hispanic community; Kendra Fleagle Gorlitsky, a physician's associate and director of the clinic's hypertension program; and Victor Herrera Lutz, a UCLA senior in theater and film. This is just a sampling of the paid and volunteer staff who each day treat the clinic's constant flow of patients. Whether an administrator, health professional or volunteer, all are made to feel a part of the family.

A multitude of physicians also serve the clinic throughout the year, but three might be considered anchors. First, there's Dr. David Swimmer. He's risen above his own handicaps and in many ways is an inspiration for patients and staff. He was buried under an av-

alanche a few years ago, so that now his right side is paralyzed and his speech impaired. He's able to communicate to patients with the help of staff members. Dr. Swimmer takes a bus from Santa Barbara every week to spend two days at the clinic. Another colleague is Dr. Darrell Burstein, a physician in private practice in Beverly Hills, who volunteers a morning and evening every week to provide free patient care in Venice.

And then there's Dr. Dee Coady, adjunct professor in both the schools of public health and medicine. She spends half the year in Los Angeles teaching and half the year engaged as a volunteer in international refugee and disaster relief projects. During her months at home, Dr. Coady spends every afternoon at the clinic as the staff pediatrician.

"Working in the clinic keeps 5

me in touch with the reality of what's happening in Los Angeles," says Dr. Coady who has been involved with the clinic since its beginning in 1970. "It's a chance for me to innovate and to apply what I have learned overseas to the clinic and vice versa."

Other UCLA physicians 1 involved as volunteers since the early days of the clinic include: Dr. Mayor Davidson, professor of medicine at UCLA who serves as the clinic's medical director and who is also director of the Diabetes Unit at Cedars-Sinai Medical Center; Dr. Charlotte Neumann, associate professor of public health and "'~ Cl pediatrics; Dr. Sheldon Greenfield, <: :r: associate professor of public health s; ~ and medicine; and Dr. Richard Steckel, professor of radiology and 0""<: ...........~~~~~~~~~~~~~---~~ director of the Jonsson Compreevenings reserved for an adult hensive Cancer Center. All are general medicine clinic. Thursday current or former members of the mornings are set aside for senior board of directors and are regular citizens, and Friday afternoon and volunteers. evening for a high blood pressure In the eleven years of its exisclinic. Other special services intence, the purpose of the clinic has clude cardiology, dermatology, ENT not changed, according to executive (ear, nose and throat), endocrinoldirector Meg Ross-Price, M.P.H. '72, ogy, optometry, neurology, ophthalwho has been at the helm for mology and orthopedics. The only nearly seven years. services not provided, since they "We are here to provide approare available to the disadvantaged priate, accessible and affordable elsewhere, are gynecology, family primary medical care to persons planning, pre-natal and routine who cannot obtain access to serwell-baby care. vices elsewhere," she says. "Another Patients usually hear about secondary, but important, purpose the clinic through word of mouth. is to provide teaching and educaThey drop in seeking help for a tion opportunities for faculty and specific ailment, such as an earstudents in the health sciences." ache or a cold. But after a routine Although not solely a UCLA medical check, the staff often venture, the clinic does have detect other neglected illnesses. strong financial, professional and "It's our chance to treat people sentimental ties to the University, who would otherwise slip through especially to the UCLA schools of the health care system," observes medicine, nursing and public Steve Maier who, along with the health. Last year, volunteers from other UCLA family medicine the University included ninetyresidents, spends a month treating one physicians and seventy-one patients at the clinic as part of graduate and undergraduate his training. students.

The Venice Family Clinic is The seven full-time and eleven located at 322 South Lincoln Blvd. part-time employees of the clinic in Venice. It is open five afternoons are supported by over 400 volunand evenings a week and offers a teers, half of whom help in fundwide range of services. A pediatrics raising. It is not surprising that clinic operates Monday through volunteers play such a vital role Thursday afternoons, with the since public service was the spirit 6

in which the clinic was founded.

In the 1960's, the Venice Health Council, an informal group of local residents and health professionals, recognized the need for a primary medical care facility for low income people in the Venice area. A member of that group was Dr. James Freed, the founder of the UCLA Dental Clinic. He provided space in his facility for a volunteer medical clinic during the evenings when dental services were completed. The dental clinic was, and still is, located in the same building on Lincoln Boulevard.

Eventually, some of the volunteers formed a non-profit organization to manage the rpedical clinic.

A UCLA graduate student was hired part-time, and her salary was paid through the Graduate Students Association, this being the first formal link with UCLA. The clinic continued to operate out of the dental facility.

In 1975, a state grant allowed the medical clinic to lease its own office space. When that money ran out, UCLA came to the rescue.

The University continues to contribute substantially to the clinic.

The clinic also receives medical and/or financial support from Saint John's Hospital, Santa Monica Hospital and Medical Center, the state and county health services departments, private practice physicians, third-party payers and private donors.

The feedback from the patients has been outstanding. Most donate money following their treatment to show their gratitude even though nearly 90 percent have yearly family incomes below the poverty level. Translators are always on hand for the great number who only speak Spanish. Last year, the clinic recorded over 8,000 patient visits.

The hands-on experience for students interested in health service is also invaluable. UCLA public health students have been an integral part of the clinic and many have been employed as clinic coordinators while enrolled in the School, says Meg Ross-Price.

The coordinator oversees the

day-to-day flow of the clinic from volunteer scheduling and staff direction to assisting with medical procedures and following up on complex referrals. Other public health students have conducted research projects through the clinic.

As Dr. Coady points out, the clinic is a natural extension of a public health or medical student's education.

"When students come up to me after a lecture and say they're really interested in community

medicine or international health, there's something I can offer them to do right now," she says. "My usual response is 'Why don't you come down and see the clinic this afternoon?' A lot of them show up and then they're hooked." D

Looking on the bright side wvith Chair111an Ash When Dr. Larry Ash discovered he could live in warm weather year round, he knew he would never return to his native Massachusetts.

His friends and colleagues might dispute his need for constant warmth, since they say it radiates naturally from within the man.

It's true. Even after spending a few hours with Dr. Ash one can't help but catch his contagious grin or free-flowing laughter. In his fifteen years at UCLA, Dr. Ash has endeared himself to faculty, staff and students alike. He came on board in 1967 as an assistant professor, worked himself up the ranks, and for the past three years has served in the demanding position of chairman and associate dean of the School of Public Health.

"I always feel I'm his biggest fan but when I mention Dr. Ash to someone down the hall they always say, 'Oh, he's so great,'" says Susie Al-Bayani, assistant to the chairman, who has worked with Dr. Ash for the past five years.

This isn't to imply that Dr. Ash is all fun and games, or someone who can be easily taken advantage of. He's a hard worker totally dedicated to his teaching, research and administrative duties.

He's a man of conviction, but he will listen to all sides of an issue with an open mind. What fuels his perennial cheerfulness is sheer delight in what he does.

"My philosophy towards work is that you give 150 percent," he says. "If you're going to be successful at what you do, you must make 7

a full-time commitment to it. But at the same time you should enjoy what you do. I enjoy parasitology, I enjoy being chairman, I enjoy teaching ... I couldn't envision any other career."

When asked to describe Dr. Ash's field of study, a non-parasitologist usually shrugs his or her shoulders and answers, "Worms!"

But that hardly describes the work to which he has devoted so much of his time over the years. "When I'm home at night reading an article or book on parasitology, some would say I'm working. But to me that's relaxation, that's fun," he quips.

At UCLA, his research has centered on worms, those that cause an extremely debilitating disease called filariasis, or elephantiasis by its more common name. The disease is transmitted to man by mosquitoes and results in obstruction of the lymphatic channels, thereby causing gross enlargements of parts of the body.

Filariasis is most often found in the tropics.

Dr. Ash is heralded by his colleagues for having adapted one of these filarial worms, Brugia, to a new host, the gerbil. Before this advancement, which enabled scientists to experiment with a small rodent, research was done on dogs, cats or monkeys, all of which are expensive and difficult to maintain in a laboratory.

"What his work did was to miniaturize the system and make it cheaper to work on filarial worms.

As a result, Brugia is probably the most worked on filarial worm in the world," observes Dr. John Schacher, professor of infectious diseases and assistant dean of academic affairs for the School.

Dr. Schacher's interest in his colleague's work goes back many years; back to when they were both doctoral students in parasitology at Tulane University in the late 1950's working under the guidance of Professor Paul C. Beaver. (Dr. Ash received his B.S. and M.A. degrees in zoology from the University of Massachusetts.)

Their class has remained ex8

DL Ash experiments with a gerbil in his laboratory He is renowned for introducing this small rodent as a host to study filariasis.

tremely close over the years. As a matter of fact, Dr. Ash has published a series of atlases with a former classmate, Dr. Tom Orihel, who now teaches at Tulane. T heir three -volume series, Diagnostic Medical Parasitology, is designed for classroom teaching, while their most recent Atlas of Human Parasitology is a self-study color atlas to be used in the laboratory to aid in diagnosis of human parasitic infections.

After receiving his Ph.D. degree in 1960, Dr. Ash spent several years teaching and working in the field before coming to UCLA. In particular, he studied a rat lungworm parasite (Angiostrongylus cantonensis) which causes a form of meningitis in man. Initially, he had worked with this worm in Hawaii and subsequently, for two years, he studied the epidemiology of eosinophilic meningitis in New Caledonia, a French territory located in the South Pacific off the coast of Australia. In 1967, Dr. Ash moved his young family to Los An geles and took over the work on filariasis begun by Dr. John Kessel at UCLA. Dr. Ash would like to rekindle

an interest in parasitology among students since fewer and fewer are choosing to specialize in it.

"One reason is that the number of job opportunities has diminished considerably. Parasitology is not a major problem in this country so many medical schools have practically deleted it from their curriculums," he reflects.

"This may work to our detriment if another war breaks out and troops are sent to developing countries and are exposed to parasitic infections. If you have physicians who know next to nothing about parasites, it becomes a problem."

Dr. Ash maintains a high profile in his specialty, actively participating in various parasitology organizations and serving on international panels and committees. He's most excited about his work as chairman of the Parasitic Disease Panel for the U.S. - Japan Cooperative Medical Science Program.

Adding his outside involvements to his administrative ones at the School gives Dr. Ash a full schedule. As chairman, he is responsible for such varied tasks as

reviewing the curriculum; recruiting, selecting and evaluating academic and staff personnel; making teaching assignments; preparing schedules of courses; overseeing student counseling; preparing the budget and administering financial affairs; and assigning departmental space and facilities.

"If I didn't enjoy juggling many different jobs at one time, this would be an impossible job," he says. "I think that's probably the single most attractive part of my work."

Dr. Ralph Ban; a professor at the School interested in medical entomology and mosquitoes in particular, has collaborated on research with Dr. Ash over the last fifteen years. He says of Dr. Ash: "He is one of the best organized people I know. He always has a timetable for doing things and he gets things done on time. That's probably the number one attribute of a good administrator."

This organizational skill carries over to his teaching. Assistant Dean Schacher observes: "Larry works at teaching. You'll never see him come to a lecture without a note and you won't find him lecturing off the top of his head." He adds that student evaluations of Dr. Ash's teaching are usually glowing. In 1976, Dr. Ash received the Award for Distinguished Service in Teaching from the School of Public Health Alumni Association.

One wonders if he has time for many outside interests.

"Not many," he says and then adds with a glimmer in his eye, "But I'm a big sports fan. As my wife would say, I would watch a tiddlywinks contest if it w as on television. I'm a big UCLA sports fan." It's a rare UCLA football or basketball game not to find Larry, wife Luana and daughter Leigh rooting in the stands. D

Fa1nily planning When family planning and population control programs became prevalent some thirty years ago, the popular belief was that if a country developed an effective contraceptive supply system and a significant number of clinics to distribute the devices, women would automatically pratice birth control.

After several decades of program experience in numerous countries around the world, it has become evident that increasing the supply of contraceptives is not always the best solution, says Dr. Snehendu Kai; professor of population, family and international health.

Dr. Kar suggests that demandor motivation for birth controlmust also be considered when designing a program

strategy. He submitted last May the final report of his eight-year study entitled "Field Trials of Family Planning Communication Strategies in Venezuela, Kenya and the Philippines" to UNESCO (United Nation's Educational and Cultural Organization). He is currently completing analysis on a similar project in Egypt.

Dr. Kar says every country can be placed somewhere on an " intervention continuum" when it comes to a national population/ family planning policy and program. At one end of the spectrum is a country which has no concerted program, and at the other end is a country which has an aggressive, perhaps coercive, policy of birth control.

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Policy planners often choose a point between these two extremes.

"To decide where a policy should fall on this continuum, planners must ask if there is enough willingness, motivation and need to use contraceptive methods," Dr. Kar explains. "If the answer is 'yes,' then perhaps the emphasis should be on a better contraceptive distribution system, better follow-up and better recruitment. Such a policy might focus on promoting the supply of effective contraceptive methods. " If, on the other hand, not enough people are at a stage where

"If you decide you're going to use a strategy to improve the demand, you must first ask if it is going to effect everyone equally," he says . "Then you must begin to determine what kind of intervention will be effective for which group."

Dr. Kar examined the relative cost-effectiveness of three strategies through which information about birth control is communicated: opinion leaders, satisfied users and health care providers.

Overall approval of contraception was highest in the Philippines, a bit lower in Venezuela and

A famil y clinic in the Philippines. Above photo and Kenyan woman on page 9 were taken by DL Snehendu KaL

they are willing to use the contraceptives available, then one must promote this willingness. Such a policy must focus on promoting the demand or motivation for contraception.''

Most often, Dr. Kar points out, an effective policy must strike a balance between promotion of demand and supply to suit the specific situation.

The task of improving motivation can be a very complex one since the response in each country will vary, Dr. Kar says. Further, the same results will not necessarily be realized within the same age or income group within the same country.

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much lower in Kenya, Dr. Kar says.

The sample size of women interviewed varied in each country, and men were included in the Philippine study.

According to Dr. Kar's research, the factors which have the strongest influence on contraceptive use are : personal contraceptive intentions; accessibility of contraceptive services; conjugal communication and the wife's decision-making power; the number of living children; and the social network and communication about family planning.

The results indicated that while these factors influence contraception significantly, the degree

to which each of these factors affected contraceptive use varied significantly among the three cultures and within each by demographic and economic backgrounds.

Dr. Kar, who grew up in India, became involved in the early 1960's with that country's population control program. He served as director of the Research and Evaluation Division of the Ministry of Health and Family Planning's Central Bureau of Health Education, which is the federal bureau responsible for education, research and evaluation of India's national health education program.

One disturbing reality was that even with the availability of free contraceptives and clinics, the acceptance rate of birth control methods in India was still very low.

Other developing nations soon began following India's emphasis on family planning and population control. Dr. Kar wondered if some of India's experiences could help others in designing or re-designing their programs.

In 1969, while teaching at the University of Michigan, Dr. Kar received a grant from the Agency for International Development of the U.S. State Department and seed money from the Ford Foundation to begin studying family planning in Venezuela. After a position paper was presented in 1974, UNESCO funded similar projects in Kenya, the Philippines and Egypt. Dr. Kar has been working with co-directors in each of these countries. He hopes the lessons learned from the research will be applied to each of these country's population and family planning programs.

"Now is the time to internalize and institutionalize some of the findings. We want to make the designs and methods available to other countries so they may benefit from our work," Dr. Kar says.

Dr. Kar expects to be busy for the next three or four years anal yzing the data he has collected and disseminating the experiences of the cross-cultural project. He observes, "As far as I'm concerned, this is just the beginning, not the end." D

Buckling do1Nn on buckling up ~

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Dr. Albert Chang secures sons Nicky, 1, and f effrey, 5, in the family car.

The new parents, with nervous excitement, prepare to take their baby home from the hospital. They have lovingly decorated his or her room and conscientiously ensured that the crib and toys are safe for the child's use.

As the parents receive last minute instructions from the doctors and nurses, they are careful to wrap their newborn in a warm blanket to protect his or her sensitive skin from the cold weather.

They finally climb into the family car, all three snug in the front seat with baby in mother's arms.

Despite all the other precautions they have taken, these parents have overlooked perhaps one of the most critical dangers threatening their child's liferiding unsafely in an automobile.

Most parents would not dream of failing to immunize their children against such preventable diseases as polio or measles. Yet, the vast majority fail to "immunize" their children against the number one cause of death and injury to children under the age of IS-automobile accidents.

Last year, more than 1,600 motor vehicle passengers in the United States 15 years of age or under were killed and more than 125,000 were seriously injured. In California, there were a reported 149 fatalities and 18,000 injuries in this age group. If a child restraining device such as a car seat or seat belt had been used, 85 percent of these deaths and 66 percent of these injuries could have been avoided.

In an attempt to increase public awareness of the impact the use of child restraining devices can have on reducing death and injury, the California Center for Child Passenger Safety was established last year at the UCLA School of Public Health. Under the direction of Dr. Albert Chang, the program is supported by grants from the National Highway Traffic Safety Administration of the U .S. Department of Transportation, through the California Office of Traffic Safety. The center serves as the statewide coordinator of all voluntary child passenger safety efforts.

The project is funded through

October, 1982. By that time, Dr. Chang hopes to significantly improve the attitudes of the people of California towards child passenger safety. He has quite a task since the center's surveys show that only 10 percent of the children in the state are properly secured when riding in cars.

"One of the goals of the center is to double the use of restraining devices for children," Dr. Chang says. "On the one hand, that doesn't seem like a lot since that means we are aiming towards 20 percent compliance. But reaching even that goal is not going to be easy.

"I was travelling recently through Indio, California, and out of curiosity I stood in an intersection to see how children were travelling in cars. I was aghast at the number of children riding in cars standing up, or with their heads sticking out of the window."

According to Dr. Chang, the preventive measure for the "epidemic" of deaths and injuries of children from car accidents is simple: use any of the more than 11

twenty models of restraining systems which meet national crash test standards. The center recommends infant carriers or convertible child safety seats for children from birth to one year old; child safety seats for toddlers ages one to four; regular lap belts or special crash-tested booster seats with harness for those over five; and adult belt systems for children over ten.

"I know that car accidents will happen," Dr. Chang says. "But we have the means to prevent the second collision-the human collision-when a person is thrown against or outside of the car."

During a sudden stop from thirty miles per hour, a 10-pound infant has a force of 300 pounds; and a 120-pound mother exerts a force of 3,600 pounds if she crushes her infant into the dashboard.

To educate the public about these frightening figures, Dr. Chang and his colleagues are attempting to reach all counties in the state and to encourage local volunteers to set up child passenger safety activities. The center has a staff of six. Besides the main office at UCLA, a branch office staffed by three professionals is located near the University of California at Berkeley. Dr. Chang, a pediatrician and public health specialist, is assisted at UCLA by Dr. Arline Dillman, an early child educator who serves as assistant director for the center, and Stephanie Tombrello, a social worker. The staff at the Berkeley office includes Esther Levy, a sociologist, Gina Gonzales-Baley, a health educator, and Deborah Barnes, a community organizer.

Dr. Chang observes that throughout the state private and public groups are interested in setting up child passenger safety programs, but they need guidance and coordination in their efforts. The center provides that assistance.

One of the counties covered

by Dr. Chang is San Luis Obispo. A women's medical auxiliary has already started a drive to educate the public about child passenger safety, but they are seeking a broader base 12

of support. Dr. Chang is helping them set up a community meeting which will include pediatricians, teachers, law enforcement persons, volunteers and other private citizens.

The center's staff has also helped conduct surveys for a San Bernardino County risk reduction project, and has set up patient education programs at hospitals which have maternity services.

One of the center's greatest successes to date has been the convening of a statewide conference last September at the UCLA School of Public Health. Approximately 200 child passenger safety advocates from California and other states attended the two-day conference.

On the political front, a bill is being drafted by California legislators which would require children under 5 years old to be safely transported in cars.

"If the legislation passes, we will have prepared the public for it," he reflects. "If it does not pass, at least we will have helped the public to be more aware of the problem and to act responsibly on their own."

Dr. Chang, the father of two toddlers, first became interested in child passenger safety after attending a meeting three years ago sponsored by the National Highway Traffic Safety Administration. He suggested that California set up a task force to try and increase the public's awareness of the problem.

He subsequently was appointed statewide coordinator when he received funding for the center.

The establishment of the center at UCLA has put California at the forefront of child passenger safety. As a result, Dr. Chang was asked to describe the state's efforts at the National Safety Congress held last October in Chicago.

He says of California's efforts, "It is our dream that, starting from the first ride home from the hospital, every child will be riding in automobiles safely." D

Birth project The miracle of birth can become even more of a mystery when a woman does not understand all that is happening to, and around, her. This can be especially true when the new mother-to-be experiences childbirth in a cultural

setting far different from the one for which her mother and grandmother prepared her.

Dr. Susan Scrimshaw, associate professor of public health, recognized this problem more than three years ago and initiated a study entitled, ''The Cultural/Medical Context of Birth in Hispanic Women." The purpose of the study is to improve communications between Hispanic mothers-to-be and their health care providers by analyzing cultural differences.

"Attitudes toward childbirth vary from culture to culture," Dr. Scrimshaw says, "and these differences can affect the way in which patients, doctors and nurses interact, making childbirth a more difficult experience. By improving communications we hope to alleviate some potential problems, such as prolonged labor, increased medication during labor and deliv-

ery and the need for more cesarean sections."

Now in its third year, the "Birth Project" has entered its major phase: the interviewing of 600 women of Mexican origin and descent experiencing their first births, and the observing of sixty births. In addition, at least 100 health care providers are also being interviewed about their backgrounds and perceptions of Hispanic patients. All this is being conducted through ten county prenatal clinics and the UCLA and Harbor-UCLA medical centers.

This data will help determine the extent to which the quality of the birth experience is affected by a woman's background, her attitude toward birth, her know ledge of the birth process, the involvement of

her family and friends and the attitudes of health care providers.

This phase of the project is being funded by the National Institute of Child Health and Human Development of the National Institutes of Health. Initial funding for the pilot research came from a career development award for UCLA junior faculty and a UCLA Biomedical Research Support Grant.

After the first stages of the "Birth Project," Dr. Scrimshaw and her researchers were able to reveal cultural disparities between women of Hispanic origin and their American health providers.

A real concern about childbirth among women born in Mexico,

for example, is that they will die during the delivery of the baby.

American doctors, on the other hand, consider maternal death only a slight possibility in this country's well-equipped hospitals.

Further, the researchers have discovered that Hispanic women have certain misconceptions about what the delivery itself will be like.

"Many women said they knew there would be pain. Some believed that labor would consist of two or three contractions, while others thought it would take days," Dr. Scrimshaw relates.

"Also, most Hispanic women believed that the greatest pain would be experienced during the actual moment of birth. The women found, instead, that the most painful time was during the last two centimeters of the opening of the cervix."

The study also found that many Hispanic women in U.S. hospital settings experience more fear during childbirth than their Anglo counterparts. Dr. Scrimshaw be-

lieves that this is because Hispanic women are not as familiar with the American medical setting.

"Not only the setting, but the language and culture are likely to be new and strange to them," she adds.

Anglo women, Dr. Scrimshaw notes, generally receive more information before their delivery than do their Hispanic peers. To correct this disparity, one of the research-

ers, Ruth Souza, a nurse practitioner, developed a booklet called "Comprension del Parto" or "Understanding Labor" as part of her master's degree project in public health. Illustrated with line drawings, the thirty-one page booklet describes in simple language what happens in labor and at birth and includes information about when a woman should come to the hospital. The book, published in both English and Spanish, is distributed free to expectant mothers scheduled to give birth at the UCLA or Harbor-UCLA medical center. Requests for reprints of the pamphlet have been received from hospitals throughout the country.

A similar pamphlet on cesarean section is being prepared by another M.P.H. graduate, Kathleen West, as a result of the project's finding that "some women leave the hospital never understanding why they had a cesarean section deli very."

To date, three masters essays have resulted from the "Birth Project" and seven other M.P.H. students and three doctoral students are presently engaged in substudies. Among them are: a study of catecholamine levels (a biological measure of anxiety) in pregnant women prior to, during and after

A series of drawings from Understanding Labor depicts the opening of the cervix during labOL

13

labor and delivery; a study of mother, father and infant bonding after delivery; and a longitudinal study on child development and care following the birth of the infants to the sixty women observed during labor and delivery. A doctoral student, Lynnel Goforth, is conducting a comparable study in the Yucatan, using the same research methodology developed

by Dr. Scrimshaw.

Dr. Scrimshaw's own first pregnancy four years ago inspired her to develop the "Birth Project."

"I then realized that if an Englishspeaking, Anglo woman working in the health field had to use considerable initiative to achieve satisfactory health care, what happens to women who do not even speak the same language or know the culture?" she asks.

Dr. Scrimshaw's background has bridged cultural gaps many times. She grew up in a bilingual/ bicultural setting in Guatemala (1949- 1961) where her father, Dr. Nevin Scrimshaw, was the first director of INCAP (Instituto de Nutricion de Centro America y Panama). Her mother is a nutritional anthropologist and has coauthored a paper with her on maternal management and infant mortality on a Guatemalan plantation.

The current "Birth Project" is the first of its kind to look into the childbirth experience of Hispanic women. Dr. Scrimshaw points out that this is surprising since the Los Angeles population is more than 30 percent Hispanic. The project has received wide media attention in both the English and Spanish press. Dr. Scrimshaw plans to eventually publish her findings in book form and to prepare more patient-education materials. D

14

Clearing the air

Weather forecasters nowadays not only let us know if it's going to rain or shine, but also if it's going to be safe to breathe the air. And now preliminary results from a UCLA School of Public Health study are confirming our fears that inhaling too much smog may be hazardous to our heal th.

The purpose of the on-going. study, started in 1972, by Professors Roger Detels, Frank Massey, Stanley Rokaw, Donald Tashkin and Anne Coulson, is to see if there are long-term effects on lung function due to chronic exposure to air pollution.

"There is mounting evidence that there may be adverse effects on lung function associated with long-term exposure to photochemical oxidants or to primary pollutants," Dr. Detels reports.

Dean Detels and his collaborators chose to study areas in four communities in the Los Angeles area, each subject to different levels of air pollution yet similar in population make-up: Glendora, Burbank, Lancaster and Long Beach.

Employing a variety of lung function tests, the researchers initially tested nearly 15,000 people in those four communities, making this probably the largest air pollution study ever undertaken.

After a respiratory questionnaire was administered, the participants underwent lung function tests including whole body plethysmography, the single-breath nitrogen test and spirometry.

The researchers are in the process of re-testing participants, five years after the original study,

to see if changes in the test results of the residents correlate with their exposure to air pollutants. The first set of re-examinations is expected to be completed in 1983.

The initial results suggest that persons living in Glendora, the area chronically exposed to the highest levels of photochemical oxidant pollution, had poorer results in the lung function tests when compared to their counterparts in Burbank and Lancaster.

Persons living in Lancaster, the area exposed to the lowest photochemical oxidants, had the best results. Photochemical oxidation is the most common type of pollution found in the Los Angeles area.

"There was remarkable agreement in results among people who had never smoked, light smokers and heavy smokers as well as between males and females. All had poorer breathing tests in the area exposed to high levels of photochemical oxidants," Dr. Detels observes.

Residents of Long Beach, where there is a high content of primary pollutants in the air, showed slightly better testing results than Glendora participants, but poorer results than those in the low pollution area. Unlike photochemical oxidants, primary pollutants-sulfur dioxide, hydrocarbons and particulates- are not common in most of Southern California and are most often found in cities like New York or London.

"This comparison suggests that exposure at place of residence to high levels of photochemical oxidants and other secondary

pollutants may be as harmful as exposure to the levels of primary pollutants seen in the Long Beach area which have been shown by previous investigations to have harmful effects," Dr. Detels adds.

A study of this magnitude has required the cooperation of experts from many disciplines.

"In a sense, I consider myself the orchestra conductor," Dr. Detels muses. "On the project, we have respiratory physiologists, biostatisticians, epidemiologists and people with an expertise in data management. We have also called on people with expertise in air pollution. Without this kind of cooperation we could never have done the study.

"I think this cooperation between the disciplines is why the UCLA Center for the Health Sciences is one of the outstanding centers in the world. There are very few places in the U.S. where this combination of expertise could be successfully brought together on a health problem."

Even at this stage, Dr. Detels says the study indicates a need to evaluate two important public health policies. The first one is to try and improve the quality of air in urban centers, particularly in those areas which are exposed to photochemical oxidants. The other policy which should be explored, according to Dr. Detels, is one in whieh more fonding is made available for long-term studies of all types. He says much of his time during the last ten years has been spent seeking new funding since few agencies are prepared to undertake studies for long periods of time. Original funding came from the National Heart Lung and Blood Institute which awarded similar grants to Yale and Harvard. UCLA is the only one to have continued the original project. Subsequent support was received from the National Institute of Environmental Health Sciences. Currently, the _, Environmental Protection Agency <:~ and the California Air Resource ~ Board are jointly funding the air b pollution study. D

Causes of depression Minorities, women and the poor are more prone to mental depression than are white, employed, married men, according to researchers at the School of Public Health.

A study of the prevalence of depression in Los Angeles County conducted by Drs. Ralph Frerichs, epidemiologist, Carol Aneshensel, sociologist, and Virginia Clark, biostatistician, was recently published in the American f ournal of Epidemiology The UCLA researchers hope their findings will lead to better understanding, treatment and perhaps prevention of depression.

A sample of 1003 adults in Los Angeles County was interviewed four times during a one-year period in 1979-80 to study depression in the general population.

"A significant aspect of this study is that the people interviewed were not first diagnosed as being clinically depressed," Dr. Frerichs stresses. "We're not necessarily studying people who are receiving professional help in an

office setting. What we're trying to look at is the pattern of this condition in the general community."

The subjects were asked how often they experienced certain feelings during the preceding week.

They responded to twenty items from "I felt sad" and "I thought my life had been a failure" to "I felt hopeful about the future."

Of a possible score of sixty, sixteen and above meant a person was classified as depressed. Nineteen percent of the sample group was classified as depressed.

The incidence of depression was greatest among Hispanics (27.4 percent) and least among whites (15 .6 percent) with blacks and other racial-ethnic groups at intermediate levels (21.8 percent and 21.2 percent).

Women were found to be twice as likely to be depressed (23 .5 percent) as men (12.9 percent) . While being married, employed and having children living at home greatly reduced the likelihood of depression for men, that didn't necessarily hold true for women.

Those 18 to 24 years of age, reported the highest rate of depression (2 7.4 percent) while those 45 to 64 years reported the lowest (16.3 percent).

Income was strongly related to depression, with more than 29 percent of those earning less than $8,500 a year having symptoms of depression, while only 9 percent of people with incomes of $25,000 or more were depressed. Furthei; the unemployed were twice as likely to be depressed than those with jobs.

The researchers are quick to point out that when income and employment are considered, neither race nor ethnic background were found to be significantly related to the presence of depression.

"These factors (low income and unemployment) contribute to depression and they just happen to be more common in certain 15

ethnic groups. Depression among minorities, then, is associated with low income, not with race," Dr. Frerichs explains.

The study has provoked interest among the media and other professionals. Four more research papers based on the original data are currently in press or print, and six others have been submitted for publication. The researchers have also applied for an extension of the project through 1986.

"We have been studying some of the factors that lead to depression," Dr. Aneshensel says. "Now we want to know what happens as a result of depression in your life. Does your marriage break up?

Do you lose your job? Does your health deteriorate?

"By having a long-term study, we're trying to have a clear picture of what the natural history of depression is-not only the factors that lead to it but the consequences as well."

One of those potential consequences of depression is physical illness, and recognizing this could help shape our country's social policies, Dr. Frerichs says. The study shows that the poor and unemployed are prone to depression, and that depressed people report a higher occurrence of physical illness. Dr. Frerichs is investigating the theory that during a recession when there is a reduction in income and a higher rate of unemployment, one might expect more people to be depressed and as a result of the strong association between depression and physical health, to seek health services. The government often pays for these services through Medi-Cal and Medicaid, especially for people with low income who are at high risk of depression.

"It would be in the government's interest to know what these interrelationships are," Dr. Frerichs says. "Once we can unravel how these factors interrelate, then we can begin looking for the weak links in the chain and start doing something to help people along the way." D

16

Epide1niology epide1nic

Inspecting mosquitoes used during experiments is Dr. Ralph Barr, center, with students Dora Menchaca and Kenn Fujioka.

Similar to a detective with a magnifying glass, an epidemiologist searches through mounds of data to discover the causes of diseases in populations. And just as a good detective graduates to more complex cases, today's epidemiologists are tackling more complicated diseases.

"The subject matter studied by epidemiologists has certainly expanded since the turn of the cen tury," observes Barbara Visscher, M.D., Dr.P.H., head of the Division of Epidemiology at the UCLA School of Public Health. "The focus has shifted from infectious diseases-although we still do study these-to chronic diseases. The latter are often difficult to study since there is seldom one overwhelming cause you can discover."

Unlike infectious diseases where an immunization program can often control an outbreak, prevention for chronic diseases often means changing life-styles and behaviors to reduce risk factors.

As a result, epidemiologists are constantly adapting new methodologies to investigate diseases

which range from cancer to illnesses induced by substances in the environment.

"These methodologies include designing and analyzing case control and cohort studies," Dr. Visscher says. Scientists may, for example, compare characteristics of a group of people who have a certain disease with a group who do not. Or a population sample may be observed over time to determine the effects of risk factors on the occurrence of a disease.

Dr. Visscher points to the link discovered between lung cancer and cigarette smoking as a prime example of the field's new influence on health.

"This causal association is making a big impact on the behavior of the population. Many people have stopped smoking and that's eventually going to be translated into a decrease in lung cancer," she says. "This is probably the first important chronic disease where the cause was discovered through epidemiologic studies."

The Division of Epidemiology is keeping pace with progress, but

at the same time is not ignoring its roots in infectious diseases. The School's 119 students presently enrolled in the division learn the basic principles of epidemiology and then specialize in either methodology or infectious diseases.

Their studies include designing, measuring and analyzing data and learning how to take surveys, examine hospital records, interview and develop original study models.

At a weekly coffee hour and seminar open to the entire division, doctoral students, faculty members and occasional outside speakers share their experiences from working in the field.

The main function of an epidemiologist is investigation and UCLA faculty members are no exception (see accompanying article).

It is by participating in research that students gain firsthand experience about epidemiologic processes.

Dr. Visscher says that, compared with other schools of public health, the scope of UCLA's research is one of the most diverse in the nation.

Some of the UCLA studies involve: occupational causes of cancer; the relationship of air pollution to respiratory health; pesticides and human health; evaluation of techniques used in the diagnosis of parasitic infections; the epidemiology of multiple sclerosis; measuring attitudes toward rape; and the health status of Hispanics.

Practical experience in studying infectious disease is offered to students through work with governmental agencies.

"Our students might work with the Los Angeles County Department of Health Services investigating a measles outbreak in various parts of the city. They might also try to find out whether a breakdown in the immunization program is contributing to the outbreak," Dr. Visscher explains.

She adds that Los Angeles is an ideal city for epidemiologists since a large, defined population base exists at the researcher's fingertips.

When Dr. Visscher came to UCLA in 1966, there were half a dozen students in the division. In 1973, the Division of Epidemiology

merged with the Division of Infectious and Tropical Diseases and has been growing steadily ever since.

One reason for this popularity, Dr. Visscher suggests, is the promisingjob market for epidemiologists.

Graduates of the M.P.H. and Dr.P.H. programs usually work for local, state and international health agencies or they find jobs with industrial/commercial companies who want an epidemiologist to study the health effects of their product or manufacturing process.

Those receiving M.S.P.H. or Ph.D. degrees usually undertake an academic career, work in governmental agencies or engage in some type of non-academic research.

Dr. Visscher observes, "The demand for epidemiologists is high now because policymakers are beginning to realize that our field has a lot to offer in terms of investigating what everybody now realizes are health problems in the ¡modern world." D

Through the magnifying glass The research in which the faculty of the Division of Epidemiology are involved is as diverse as the field itself: Lawrence R. Ash, Ph.D., professor and chairman of the School of Public Health, is a parasitologist particularly interested in filariasis and other infectious and tropical diseases.

A. Ralph Barr, Sc.D., professor, is studying the cytology and genetics of mosquitoes, as well as the population dynamics of arthropods and the epidemiology of arthropodborne disease.

Linda B. Bourque, Ph.D., associate professor, is currently looking at attitudes towards rape, motivation for persons seeking radial keratotomy, suicides in Sacramento County and head injuries in San Diego County.

John M. Chapman, M.D., M.P.H., professor emeritus, is conducting population studies on the distribution of cardiovascular disease.

Davida E. Coady, M.D., M.P.H., adjunct professor, is primarily interested in the control of infectious and nutritional disease in Third World countries but is also looking at community health programs in poverty areas in the United States.

Anne H. Coulson, reseacher/adjunct leeturer, is studying the effect of air pollution on health at birth, risk factors for ischemic heart disease and trauma and the health status of American men.

Roger Detels, M.D., M.S., professor and dean of the School of Public Health, has been involved in studies on multiple sclerosis, control of high blood pressure and chronic respiratory disease and air pollution (see story this issue).

Ralph R. Frerichs, D.V.M., M.P.H., DLP.H., associate professor, has been researching the epidemiology of mental depression (see story this issue), cardiovascular disease in L.A. County and ecological studies in the L.A. Basin. He's also interested in developing epidemiologic methods for health planners and policymakers.

Bruce Gillis, M.D., M.P.H., adjunct assistant professor, is interested in occupational medicine.

Sander Greenland, M.A., M.S.P.H., DLP.H., assistant professor, has made significant contributions to the development of new epidemiologic methodologies. One of his current projects involves the effects of diet and exercise on health.

Jess F. Kraus, M.P.H., Ph.D., professor, is interested in disease and injury from environmental and occupational related agents. He's studying neurotrauma, sudden infant death, childhood suffocations, pesticides, occupational cancer, suicide and transport injuries.

John H. Kurata, Ph.D., M.P.H., adjunct assistant professor, is also an epidemiologist for the Center of Ulcer Research and Education for the Veterans Administration Wadsworth Medical Center. He's interested in the epidemiology of chronic digestive and allergic diseases.

Thomas Mack, M.D., M.P.H., adjunct associate professm; is interested in cancer epidemiology, infectious diseases and epidemiologic methodology.

Louis E. Mahoney, M.D., DLP.H., adjunct associate professor, is involved in the organization of public health services, public health laws and regulations, health planning, emergency medical services and evaluation and planning and control of comm unicable diseases.

Susan Preston-Martin, Ph.D., adjunct assis tant professor, is primarily interested in cancer epidemiology.

John F. Schacher, Ph.D., professor, is interested in infectious and tropical diseases and currently is studying host-parasite relations in filarial diseases.

Gary H. Spivey, M.D., M.P.H., associate professor, is interested in environmental and occupational hazards including toxic waste dumps, coal-fired power plants, reclaimed waste water and Agent Orange.

Forest S. Tennant, JL, M.D., DL P.H., adjunct associate professor, is researching delivery models for low-cost medical care, methods and outcome of drug abuse treatment, addiction to medically prescribed narcotics and methods to facilitate participation in prevention programs.

Barbara Visscher, M.D., DLP.H., associate professor and head of the Division of Epidemiology, is interested in multiple sclerosis, genetic and infectious factors and epilepsy.

Telford Work, M.D., D.T.M., &. H., M.P.H., professor, has major interests in tropical disease problems, infectious disease in populations of developing societies, zoonoses, arthropod-transmitted diseases and arboviruses.

17

Her most recent project has been her involvement in encouraging faculty, alumni and other friends of the School to join the Dean's Council- a group that provides needed extra dollars to support special student, faculty and School projects. The fact that attendance at the Dean's Council Dinner in November was more than double what it had been the previous year was due in no small measure to Irene's efforts.

Irene's drea1n

Sixteen years ago, Irene Fundaun looked out from her office window in the Department of Preventive Medicine in the Center for the Health Sciences and watched construction workers pour concrete for the foundation of the new building for the UCLA School of Public Health. She delighted in this view as she witnessed the fulfill ment of the vision of her boss, the School's first dean, Dr. Lenor Goerke. Soon the young School would have a building to call its own.

Irene began at UCLA as a secretary for Dr. Georke and has advanced over the years to become an administrative assistant to the dean. Her employment has spanned twenty years and three deans.

"She knows and remembers everyone and everything. She is liked and respected by faculty and students alike. They feel comfortable talking with her about School problems," says the current dean, ::1 Dr. Roger Detels. "Unfortunately, I z cannot be available to everyone all g the time. Irene serves as another o;.. ear for me to hear faculty and stu- ~'i~~~~~~~~~~~:::~~_J dents. She calls on these conversaIrene Fundaun tions as well as her own insights in making suggestions and providing additional information to me Alumni hold a special place in in my attempts to respond to the Irene's heart. "When I first started needs and wishes of the faculty here the student body was small so and students. I don't know how we I got to know practically everycould operate without her." one," she remembers. "I appreciate Over the years Irene has asit now when the alumni drop by sumed the responsibility for many to see me. I think in some ways I different kinds of activities. Her am their link with the present." responsibilities in the Dean's For someone who has been office have varied with each adin one job for such a long time, ministration, but a sampling of her perhaps the one particularly outcurrent and past achievements instanding quality of Irene's is her elude helping with all the School's continued openness to new ideas. accreditation and campus reviews, You'll never hear her say, "But this working with the different school is the way we've always done it." committees, supervising the readHer only overriding concern is that ing room created by Dean Detels it be something that will benefit and maintaining a record of the the School and that it be something major documents about public that is done with a commitment health and the School. to excellence.

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18

NEWS Scholarships awarded Five students received $1,000 scholarships for the 1981- 82 academic year from the Golden State Minority Foundation.

The recipients are Adrianne Bass, Sherwood Crow and Dawn Evans of the Division of Health Services, and Rhonda Jean Jones and Rosalyn Riguis of the Division of Behavioral Sciences and Heal th Education.

The Golden State Minority Foundation, which receives and administers tax-deductible gifts, grants and contributions, provides scholarships to financially disadvantaged minority students in public health.

Minority recruitment center established An expanded recruitment and retention program has been established by the School to increase t he enrollment of minority and disadvantaged students. T he program is available through a new Counseling and Recruiting Center which is supported by a grant from the Department of Health and Human Services.

"The program is designed to identify, recruit and motivate minority and disadvantaged individuals who may qualify for admission to the School of Public Health, but may not be aware of the career opportunities that are available," says Josephine Alvarez, director of the center.

Services available through the center include academic counseling, assistance in preparing application materials, monitoring applicants to facilitate the admissions process, orientation of incoming minority and disadvantaged students in collaboration with the School's Minority Student Association and counseling and support during the transition to university life.

Three for one and one for all Saying "three schools are better than one" may be taking liberties with an old axiom, but this philosophy towards cooperative ventures is at the core of the Western Consortium for the Health Professions.

The schools of public health at UCLA, UC Berkeley and the University of Hawaii make up this consortium. According to Executive Director Joseph Hafey, "Traditionally, the goal has been to look at activities that can best be done jointly by the three universities which will provide education and services to people in the western United States. The board of trustees has expanded that to include international technical assistance."

T he consortium was incorporated six years ago. Under the new direction of UCLA's Dean Roger Detels who was recently elected president, the board of trustees is gearing up to boost consortium activities.

The consortium currently sponsors a variety of activities ranging from student and faculty exchange programs between the three campuses to organizing continuing education seminars for professionals. In addition, the consortium administers three major projects including the Western Center for Health Planning, which provides technical assistance to the federally -funded health planning agencies in the western regions; the Health and Population Manpower Development Projects in Bangladesh, which strives to improve the training component of the population and health delivery system in Bangladesh; and the Western N etwork for Education in Health Administration, which designs and implements professional development programs for administrators from a broad spectrum of health care services.

"The Western Consortium for Health Professionals has not yet reached its full potential to benefit faculty and students in the UCLA School of Public Health. Although

faculty in the Division of Health Services Administration are familiar with the consortium, there are many potential opportunities for faculty in the other divisions as well.

These can be realized by exp an sion of the consortium into new areas," Dean Detels comments.

The consortium is a non-profit corporation established by the regents of the University of California and the University of Hawaii.

The main offices are in San Francisco where Hafey oversees a staff of twenty who implement the projects approved by the board.

The board of trustees includes one dean and one faculty member from each school, one practitioner and one continuing education dean from either UC Berkeley or UCLA. Dr. Snehendu Kar represents UCLA along with Dr. Detels.

Hafey foresees unlimited possibilities for the consortium. "The schools have worked together now for six years and have developed a trust and an operating base," he observes. "In these times of dwindling financial resources, they are all coping with the same kinds of problems. The schools recognize

that they can be more effective in certain arenas if they work on problems together."

Job searching?

Job search workshops are being offered to students and alumni through the SPH Placement Office.

Upcoming workshops include Resume Writing, to be held Friday, February 26 from 1-2:30 p.m. in Room 41-268; and Public Health Job Search Strategy, to be held Friday, March S from 1-4 p.m. in Room 41-268. A brief tour of the Placement Office, with an introduction to its resources and services, is scheduled for Tuesday, March 2 at noon in Room 41-240A. In addition, the Placement Office encourages alumni interested in practicing their interviewing skills to arrange to videotape and critique a mock job interview session.

For additional information, contact Rob Grossbard, director of placement, at (213) 825-1886. Preregistration is necessary to attend any of the workshops.

GETTING THE WORD OUT about UCLA's School of Public Health were volunteers who manned an exhibition booth at the American Public Health Association's annual meeting in Los Angeles last NovembeL The booth, complete with a slide show and handouts, was well attended as were the more than forty scientific and professional presentations offered by UCLA faculty members at the national m eeting.

19

Block grant conference The UCLA School of Public Health hosted a Symposium on Block Grants last July 24-25, in anticipation of the significant changes the shift in federal policy would have on the distribution of federal dollars. The block grant approach proposed to minimize the federal role in the allocation of federal dollars by no longer designating certain programs for funding. Instead, states will be allowed to set their own priorities about how these dollars should be allocated.

The symposium, sponsored by the UCLA School of Public Health, the California Department of Health Services and Region IX of U.S. Public Health Service, Department of Health and Human Services, provided a forum for the discussion of many important health issues that will be of concern to the State of California in the coming years.

Keynote speakers included Beverlee Myers, director of the California Department of Health Services; Dr. Roger Detels, dean of the UCLA School of Public Health; and Dr. Sheridan Weinstein, regional health administrator of the U.S. Public Health Service.

Major recommendations of the symposium included development of an improved statewide health information system and establishment of a committee to advise the state on administration of block grants.

Transcripts of the proceedings of the symposium are available through the Dean's Office of the School of Public Health.

20

DEAN'S COUNCIL

Dr. Raymond Goodman, right, presents Assemblyman Arthur Torres with an honorary membership to the Dean 's Council.

A well-earned feast A festive dinner culminated last year's successful membership drive of the Dean's Council of the School of Public Health.

N early 100 guests, double the number from previous years, mingled with other faculty, alumni and friends at the Faculty Center last November. They listened to talks

by Dean Roger Detels and State Assemblyman Arthur Torres, chairman of the Assembly Health Committee. Dean's Council Chairman Dr. Raymond Goodman presented Assemblyman Torres with an honorary membership to the council.

Dr. Goodman also welcomed twenty new members to the group, bringing the total membership to 100. Dean's Council members give to the School annual taxdeductible gifts of $100 or more.

These unrestricted donations are

used by the dean to support and enhance appropriate projects at the School. Last year, the Dean's Council contributed $10,000 to the School. These donations helped support School membership in the U.S. -Mexican Border Health Association; a UCLA booth at the American Public Health Association's annual convention; an alumni follow-up drive by the Division of Health Services; a reception at graduation; and membership dues for UCLA students who joined Delta Omega, the national public health students' association.

In this coming year, the dean hopes to be able to involve Dean's Council members in more of the School's on-going activities and to utilize this group as a core group for exploring future sources of funding for the School of Public Health.

Anyone interested in joining the Dean's Council should contact Judith Angel at (213) 206-8226.

of public health," she recalls. "It seemed to me that professionals working in health care were not as involved as they might have or should have been in the political process."

Barbara enrolled as a generalist in the School of Public Health and in her second year trans£erred to the then new Program and Policy Analysis section of the Division of Health Services. Interested in School affairs, she was active in the Public Health Student Association and served as vice president for a year. In that office, she was frequently invited to participate in Alumni Association meetings and special events. It was then she "~ realized that alumni could do more c:i for the students. Barbara has <: s;l: not lost sight of this objective throughout her service to the ~ ~ 1---------------------1 Alumni Association, first as secretary and now as president.

Barbara Broide

ALUMNI NEWS Aluinllipresidentserves with verve Barbara Broide, M.P.H. '77, the 28year-old president of the School of Public Health Alumni Association has students on her mind. Now halfway through her two-year term as president, Barbara has made great efforts to foster a closer relationship between alumni and students.

Her leadership has resulted in the formation of an Alumni Career and Job Development Committee which is working with the School of Public Health Job Placement Office to provide a link between working alumni and students seeking employment or field experience. For her part, Barbara introduced an internship program to the American Cancer Society, where she is assistant executive directoi; and many of those interns are UCLA public health students.

Barbara works for one of the five Los Angeles County units of the American Cancer Society.

She's been there for the past three years, two of them in her present position . She oversees community volunteer committees that focus on cancer education projects, community service and fund raising. In addition, she coordinates public affairs and personnel activities for her area which spans from Malibu to San Pedro.

Barbara's interests do not stop at one job. She currently serves on the Consumer Advisory Committee to the California Department of Food and Agriculture and has been appointed by Gov. Edmund Brown, Jr. to be a member of the California Board of Food and Agriculture. This follows six years of service as the public member on the California Dry Bean Advisory Board.

Barbara decided to pursue a career in public health while she was a political science undergraduate at UCLA. " I was interested in the policy-making aspects

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IWanted: Your ideas!

·----------------------------------------• Brainstorm with other alumni who are already active in School of Public Health committees, events and the UCLA Public Health magazine by becoming an involved member of the SPH Alumni Association.

I I I

II

Creative members have already spurred us on to provide job placement opportunities for students, to organize a distingushed lectureship series and to have fun!

We've got a good idea for you. Join the SPH Alumni Association and help shape the future of the School.

I

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

DIVISION _ _ __ _ _ _ _ _ _ _ _ DEGREE, CLASS YEAR _ _ _ _ __ ADDRESS _ _ _ _ _ __ _ _ _ _ CITY _ _ _ _ _ _ _ __ _ _ __ STATE Enclosed is my check in support of SPH activities for 1982- 83.

D $15 Active Member

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CSUN health center named for UCLA alumna The health center at California State University, Northridge (CSUN), has been renamed the Addie L. Klotz Student Health Center to honor its former director.

Dr. Klotz, who. died of cancer in 1979, received her M.P.H. degree in health services administration from UCLA in 1967. She served for eleven years as director of CSUN's health services.

"Dr. Klotz was a leader in CSUN's development of a community center for health education and training and was popular with the public, students and academic colleagues," says Dr. Albert Beharry, current director of the center.

Under Dr. Klotz's leadership from 1961 to 1972, the campus health center became the first in the nation to be accredited by the American College Health Assaciation. Also during her administration, a $2 million student medical facility was planned and constructed.

Dr. Klotz received her doctorate in medicine from Case Westem Reserve University in 1958.

She pursued post-graduate studies at UCLA from 1959 to 1967 in internal medicine, psychiatry, preventive medicine and public health.

NOTES Alumni Arthur J. Viseltear, Ph.D., M.P.H. '63, Epidemiology, associate professor of History of Medicine and Public Health, Yale University School of Medicine, presented the twenty-ninth B. Bernard Weinstein Lecture at the Tulane University School of Medicine (May 2, 1981) and the commencement day address "Looking Back at Tomorrow," at the Yale University School of Medicine (May 24, 1981).

Terence Collins, M.D., M.P.H. '73, Epidemiology, is head of the Division of Preventive Medicine at the University of Florida-Gainesville School of Medicine and is also a district health supervisor for Health and Rehabilitation Services.

Ruth A. Mohr, M.P.H. '73, Health Education, is a health education program consultant in private practice in Los Angeles.

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Dwight K. Ogburn, M.P.H. '73, Hospital Administration, is administrator of Ivinson Memorial Hospital, a 100-bed acute facility in Laramie, Wyoming.

Diana Sayler, M.P.H. '74, Hospital Administration, is a senior health educator with the Los Angeles County Department of Health Services Venereal Disease Program.

Sammy Feuerlicht, B.S. '76, Generalist, is a hospital planning consultant for Pacific Health Resources, a subsidiary of the Lutheran Hospital Society. Prior to this job, Sammy spent three years at the regional headquarters of Kaiser-Permanente as a senior health planning analyst.

Diana Kirkpatrick, M.P.H. '79, Population, Family and International Health, has been named project coordinator for the Inland Counties Hypertension Control Coordinating Council, a part of the California State Hypertension Program.

Dina Stolman, M.P.H. '79, Health Policy and Planning, is attending medical school at George Washington University in Washington, D.C., and will graduate in 1984. Dina was married in December to a fellow medical student.

Leora Udkoff, M.S.P.H. '79, Health Policy and Planning, is an administrative analyst for Hyatt Medical Enterprises where she consults for hospitals across the United States in the areas of planning, marketing, finance and quality assurance. She has also collaborated in writing an Aspen Publications book entitled A Practical Handbook on Physician Recruitment.

William Craig, M.P.H. '80, Health Services Management, is living in Crystal River, Florida, where he is assistant administrator at Seven Rivers Community Hospital.

Robert England, M.P.H. '80, Health Education, is director of aerospace medicine at Clark Air Force Base in the Philippines.

Susan Hollander, M.P.H. '80, Health Services Management, is an administrative assistant at the San Antonio Community Hospital in Upland, California.

Gail C. Farmer, Dr. P.H. '81, Health Education, is a professor at California State University, Long Beach, in the Department of Computer Studies where she teaches courses in data analysis, multivariate statistics and survey research methods. Her current research involves social epidemiology of occupational health.

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Send us news about your professional involvements, research activities, honors or personal information for inclusion in UCLA Public Health.

Include your degree, class year and division and mail to: Judith C. Angel Health Sciences Development 12-139 Center for the Health Sciences UCLA Los Angeles, California 90024

Faculty We were pleased to hear from the following faculty who reported their recent activities: Roslyn B. Alfin-Slater, Ph.D., professor, Environmental and Nutritional Sciences, received the 1981 Borden Award in Nutrition for her contributions to understanding the etiology of atherosclerosis, her studies of Vitamin E and its metabolic relationship to polyunsaturated fatty acids and estrogenic hormones and her work on the effects of development and aging on lipid distribution and metabolism. She was recently appointed by the Secretary of Agriculture to the Advisory Committee on Meat and Poultry Inspection, USDA. Climis A. Davos, Ph.D., associate professor, Environmental and Nutritional Sciences, chaired a session and presented a paper at the Third International Conference on Energy Use Management in West Berlin last October.

John R. Froines, Ph.D., has been appointed acting associate professor in the Division of Environmental and Nutritional Sciences.

Dr. Froines, former deputy director of Toxicology at the National Institute for Occupational Safety and Health (NIOSH), will play an important role in the occupational health program.

Raymond Goodman, M.D., M.P.H. '72, adjunct associate professor, Health Services, was interviewed by Mike Wallace on the CBS network's "60 Minutes" about the role of Medicare in controlling hospital costs.

Derrick Jelliffe, professor, and E. F. Patrice Jelliffe, lecturer, Population, Family and International Health, are members of the advisory board of International Nutrition Communication Project, sponsored by USAID. They ha_ve served as consultants to the governments of Burma and Nepal and have helped organize guest speakers for workshops on breast feeding in the Philippines, Indonesia, Costa Rica, Cyprus, Nepal, Burma, Colombia, Spain, Barbados and Fiji.

Robert A. Mah, Ph.D ., head of the Division of Environmental and Nutritional Sciences, presented a paper in November to the Royal Society in London, England at a Symposium on Microbial Systems.

Mohammad G. Mustafa, Ph.D ., associate professor, Environmental and Nutritional Sciences, is chairman of the organizing committee and symposium chairman for "International Symposium on the Biomedical Effects of Ozone and Related Photochemical Oxidants," to be held in March at Pinehurst Hotel and Country Club in Pinehurst, North Carolina.

Milton I. Roemer, M .D., M.P.H., professor, Health Services, was chosen by the New York University Medical School Alumni to receive the Solomon A. Berson Medical Alumni Achievement Award in Health Services.

The School of Public Health Alumni Association presents An International Potluck Dinner Sunday, February 28, 1982 6p.rn.

James E. West Center Call (213) 825-6381

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

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