UCLA School of Public Health Newsletter - Fall 1996 by UCLA Fielding School of Public Health

SCHOOL OF

PUBLIC HEALTH

Remembering When ...

UCLAI pTJsuc HEALTH I 35TH ANNIVERSARY NEWSLETTER

propos of a fledgling school, the UCLA School of Public Health was at its genesis a mixture of greatness and confusion, boasting not only

Volume 16, Num!Jer 3 FaU 1996

leading public health practitioners and r esearchers , but also faculty who, while expert in their field, had little or no previous public health exposure.

It was a small, tight-knit group that would congregate regularly in the

Charles E. Young Clu111cellor

Ahdelmonem A. Mifi, Ph.D. Dean

lunchroom and regale each other with end-of-the-year "talent" shows . (To this day, Dr. Olive J ean Dunn, a charter member of the faculty, chuckles at

the memory of the group of environmental scientists and their students who entertained under the moniker "The Sanitary Singers .") But for all its informality, the school never lacked for influence. Dunn, who taught biostatistics , can vouch for her group. " We felt we could hold

EDITORI AL BOARD Abdelmonem A. Afifi, Ph.D. Dean Judith M. Siegel, Ph.D. Associate Dea11 for Acctdemic Programs

our heads up with anybody," she says. "And we looked down on many."

Lawrence R. Ash , Ph.D. Associate Deunfor Student Affairs

Each of the school's other divisions in 1961 -

V. Gale Winting Associate Dean for Administration

Epidemiology, Health

Administration, Occupational Health, Health Education , Environmental Health, and Public Health Nutrition -

could make a similar claim.

Still, these were different times. Dr. Alfred

John D. Miller Director of Development Steven P. Wallace , Ph.D. Associate Professor, Community Health Sciences Shane Que Het>. Ph.D. Professor, Environmental Health Sciences

Katz recalls b eing one of a handful of faculty anywhere with a background in social work, a

Joyce A. Page,

strong h ealth orientation, and a doctoral degree. He accepted an invitation to join the UCLA

B.S. '69, M.S.P.H. ' 74, J.O. Campbell Hall, the school's first home.

Alumni Association Representative

School of Medicine faculty in 1959. But the man who had recruited Katz , Dr.

Randal Henry Presideut, Public Health Stndents Association

Lenor S. (Steve) Goerke, had other plans, and in 1961 Katz was glad to

Warren Robak Public Information Representative

become a charter member of the n ew school. Goerke, Katz notes , was also unusual for his er a -

an M .D. who understood the b ehavioral aspects of med -

ical care, and on e who envisioned an action-oriented school of public h ealth.

Dan Gonion Editor mul Writer Martha Widmann Art Director

Dr. Milton Roemer, recruited from Cornell University in 1962 to d evelop the nascent school's medical care organization program, was, at least in one sense , more t ypical of his era: a physician who , because h e was oriented toward public h ealth work rather than clinical practice, had to endure the incredulous r eactions of family and friends who wondered why he would settle for a " less prestigious" field . So Roemer shouldn't have b een surprised at the difficulty in recruiting students to the new program. "At first , we had to throw out n et s," h e remember s. "The school was not known ." As this special issue of UCLA Public Health attests, 35 years of leadership in teaching, research and community service would take care of that.

Cover Illustration: Robert Buscher Photography: Carole]. Arnold (p. 10: Dcuuloy); Yvette Roman (pp. 13-14); ASUCLA, UCLA , and School of Public Health Archives School of Public Health Home Page: www.ph.ucla.edu E-muilfor Applica.tion Requests: app-request@admin .ph.ucla .ed u l;i,'l~l l '11blic lle<1/1h ;, pul•li•hr<I h} rl,.· l'(:I. \ s,.f,,..,l .,f Pul.•li•· ll··ahh fur 111'· a lnu1t1i, fon1lt~ . ~hHlrnl•. • loff and fru·nd~ o;f llw ;rh.-,ol. Cu11~ .-ii:l1 l l?'J(• lo) T l1t• li.'~•·111~ •lf 11..- l 'ni•f'r~il ) .,f California . p,.,..,,;. , ;.,., rn rr11r ir11 ' "l" por1;r,., ,,f t Cl.A l'ub/i,· llr<1/1h " "'"' 1·, .. ,,1,1uin•·•I from tlw 1·1hh•r . f;,,,,, ~<'I E•lit .. r , l CIA l 'uh/i,- ll•·u/1/1. ll.,,; 'J::i l ii:!. 1.o• An~··lt•. C \ 'JOO'J:i· 177:!. (:t tO) U2~>-<~ut l .

OF TEACHING, RESEARCH AND SERVICE

T OFFICIALLY BEGAN 35 YEARS AGO, IN A BYGONE ERA WHEN JFK WAS PRESIDENT, DYLAN'S "BLOWIN' JN THE WIND" GRACED THE AIRWAVES, "WEST SIDE STORY" CAPTURED THE ACADEMY AWARD FOR BEST

PICTURE, AND A GALLON OF GAS COST 31 CENTS . IN THE FALL OF 1961, INSIDE THE HOME ECONOMICS BUILDING (SINCE RENAMED CAMPBELL HALL), THE UCLA SCl-IOOL OF P UBLIC HEALTH WAS OFFICIALLY BORN.

FEW HAVE CONTRIBUTED

I N HISTORICAL TERMS, 35 YEARS APPEAR AS A BLIP ON THE RADAR. AND YET, CONSIDER THE CHANGES IN PUBLIC HEALTH SINCE 1961. IT WOULD BE

SO MUCH TO SOCIETY' S HEALTH

THREE YEARS BEFORE THE U.S . SURGEON GENERAL FIRST WARNED THAT CIGARETTES WERE 1-IARMl"UL, FOUR BEFOHE MEDICARE AND MEDICAID WOULD EXPAND ACCESS TO HEALTH CARE FOR THE ELDERLY AND THE POOR , MORE THAL'!

IN SO LITTLE TIME .

A DECADE BEFORE " HEAI:fH" AND "PROMOTION" JOINED TOGETHER AS A CONCEPT, AND A FULL TWO DECADES UNTIL A UCLA PHYSICIAN WOULD FIRST

AND THE BEST

DESCHIBE A DISEASE THAT WOULD BE CALLED AIDS. AND CONSIDER HOW FAR THE UCLA SCHOOL OF PUBLIC HEALTH HAS COME

IS YET TO COME .

FROM ITS EARLY-'60S ORIGINS TO ITS CURRENT STATUS AS ONE OF THE WORLD'S OUTSTANDING SCHOOLS OF PUBLIC HEALTH , WITH FACULTY AND ALUMNI WHO ARE LOCAL, STATE , NATIONAL AND INTERNATIONAL LEADERS IN A FIELD THAT CASTS A FAR WIDER NET THAL'! IT DID TWO GENERATIONS AGO . A SCHOOL THAT

Above (I. to r.): De pt. of Sanitary Science, 1965; promoting fa mily health; UniHealth President/CEO Te rry Hartshorn (M.P.H. '69) discusses the changing health care system.

EMERGED FROM AN ADMINISTRATIVE SCARE I S ARGUABLY HEALTHIER AND STRONGER THAN EVER BEFORE, POISED TO MAKE EVEN GREATER CONTRIBUTIONS IN THE 21ST CENTURY TO A FIELD THAT HAS NEVER BEEN MORE SOC!ETALLY RELEVANT.

AYOUNG SCHOOL MATURES BY LESTER BRESLOW, {Dean, 7972-80)

M.D., M.P.H.

onsider that in the '40s and '50s, when UCLA awarded bachelor's degrees in public health, the emphasis was on sanitation and preventing the spread of communicable diseases. At the time, UCLA's program in public h ealth was a branch within the UC Systemwide School of Public Health. Dr. Wilton Halverson, associate dean in charge of the UCLA branch, and D1Âˇ . Lenor S. (Steve) Goerke, a former deputy health officer with the Los Angeles City Health Department who came to UCLA in 1950 to head the Schoo l of Medicine's Department of Preventive Medicine, constantly l obbied for an independent public health school on the UCLA campus. When Chancellor Franklin Murphy granted their wish in 1961, th e school Goerke inherited was an amalgamation

UCLA joins UC Berkeley and UC San Francisco in offering undergraduate instruction in public health as part of a UC system-wide school. UCLA Department al Public Health housed in Building 3T, a wartime surplus barrack.

fter serving as a professor in the UCLA School of Public Health beginning in 1968 and chair of the Department of Preventive Medicine in the School of Medicine beginning in 1970, I was asked by the founding dean, Dr. Steve Goerke, and Chancellor Franklin Murphy to assume the School of Public Health deanship. In making that move in 1972, I negotiated with Sherman Mellinkoff, dean of the medical school, the transfer of five faculty positions and corresponding space in that department to the School of Public Health; in return, public health faculty would teach epidemiology and preventive medicine to medical students. By 1972, the School of Public Health included 20 faculty members whom Dean Goerke had assembled from both academic and non-academic sources. Some had come from the Department of Home Economics on the campus, which Chancellor Murphy disestablished; others came from the then-existing Los Angeles City Health Department; and a few were recruited from universities elsewhere in the country. Only a very few had any experience in public health. Like professors in general, most of the faculty wanted separate programs that they would personally direct. Thus, in 1972 the school did not have clear-cut elements but functioned rather loosely as a single department. The faculty by that time included several outstanding individuals who were, or became, national leaders in their fields; but not all fell into that category. Executive Vice Chancellor David Saxon challenged me to rapidly improve faculty academic qualifications, in return for which he would allocate additional positions. The faculty size thereby increased 50 percent within a short time. That action gave a tremendous boost to the school, both on the campus and in its national reputation . In a second major development during the 1970s, the school moved toward a more coherent organizational pattern. The first step was to establish divisions in which faculty of similar interest and competence collaborated to plan and conduct effective academic programs . My own thought in that regard was to arrange groups of faculty into divisions, and ultimately five departments, corresponding to public health practice: Epideryiiology, Biostatistics, Health Services, Behaviorial and Community Health Sciences, and Environmental Health . While some progress was made in that direction during my deanship, achieving the organizational goal came only some years later. Meanwhile, the school's faculty grew in quality as well as in numbers, and the student body correspondingly advanced, with emphasis on public health training of young people who reflected the increasingly diversified population of Southern California.

First lour students receive B.S. degrees in public health at UCLA. Future

founding

dean

l.enor S. (Steve) Goerke brought to UCLA by Stafford Warren, founding dean of the School of Medicine, to head the medical school's Department of Preventive Medicine.

Wilton Halverson named associate dean of the UC School of Public Health 's program at UCLA.

AGE - and SEX - STANDARDIZED MOR MOTOR VECHICLE AC

into place. By the time of his death in 1972, the school boasted some of public health's leading researchers and practitioners. It was left to Goerke's successor, Dr. Lester Breslow, to mold the school's diffuse programs into a cohesive and coherent package. Breslow began the process that would ultimately (in 1989 , under the current dean, Dr. Abdelmonem A. Mifi) result in the school having five departments - Biostatistics, Epidemiology, Environmental Health Sciences , Community Health Sciences, and Health Services - reflecting the disciplines of modern public health. These disciplines were all represented in embryonic form in 1961 , but how they have chan ged: 1955 Halverson appoints Drs. John Chapman, Wilfrid Dixon, and Goerke to begin development of UCLA's programs in epidemiology, biostatistics and health administration, respectively.

encompassing~~e~tmlli~~;

• Epidemiologists were still most interested in communicable diseases the emphasis had only begun to sh ift toward chronic illnesses such as heart disease and cancer, and did not yet include intentional and unintentional injuries and deaths. • Environmenta l h ealth scientists focused on sanitation and keeping water free of infectious agents, but have since expanded their attention to chemical toxins , air pollutants, ozone levels and the like. • Health education (which today is a subset of the community health sciences field) was concerned with what to teach

1957 UCLA offers its first complete program leading to an

advanced degree in pub· lie health.

unicating to diverse populations how they can contribute to their own wellness; it was only later , thanks to research such as Breslow's famou s Alameda study, first published in 1972, that the connection between individual behavior and health was made explicit. • Health services emphasized public health and hospital administration; though the UCLA School of Public Health recruited Dr. Milton Roemer in 1962 to head a Division of Medical Care Organization, it wasn't until 1965 , with the enactment of Medicare and Medicaid, that medical care organization and health care financing began to be viewed widely as public health domains. Policy development, now such an integral part of the field, was once seen by many as lying beneath the scholarly pursuits of public h ealth faculty.

1961 UC Regents decentralize School of Public Health, creating independent schools at Berkeley and Los Angeles. Goerke named first dean, overseeing 57 faculty in seven divisions: Biostatistics, Epidemiology, Health Administration, Occupational Health, Health Education , Environmental Health, and Public Health Nutrition.

School of Public Health offers undergraduate instruction leading to a B.S. degree, and graduate programs leading to the degrees of M.S., M.P.H., Ph.D. (in biostatistics), and Dr.P.H. School moves into the former Home Economics Building (now Campbell Hall) .

CHANGE, CHALLENGE AND OPPORTUNITY Bv ROGER DETELS, M.D., M.S. {Dean, 7980-85)

oday, the school's alumni hold some of the most influential positions in the region, the nation and abroad. The school's faculty not only inform policies through their research, but contribute by providing testimony to policy-makers, serving as consultants to the public and private sectors, and disseminating information through the news media. Moreover, the school's ties to the public health practice community have been strengthened dramatically in recent years. Ironically, the stronger link to public health practice is one of several positives to result from what originally seemed nothing more than a nightmare - the UCLA administration's 1993 proposal to

1961

(contd)

Roslyn AlfinSlater, Gladys Emerson,

Professors

Edward Rada, a nd M a ri a n Swendseid move from the former Home Economics Department in the College of Letters and Sc iences into th e new school's Div ision of Pub lic Health Nutrition.

he years 1980-85 were a time of change, challenge and opportunity for the school. Federal support for schools of public health was shrinking rapidly. Although vigorous arguments for the university to replace the federal subsidies were made during my tenure as dean, the issue was not resolved . As federal dollars shrank it was necessary to reduce the number of non-tenure ladder faculty supported by those funds. These decisions were made at great personal loss to the discharged faculty, as well as to myself and the school. Nonetheless, the school survived and actually expanded during this period by using a variety of strategies. We were able to increase the number of students and, thus, the number of faculty, and recruited many outstanding people . The Environmental Science and Engineering Program, now an important component of the Department of Environmental Health Sciences, was formally integrated into the school. A second major challenge was the need to continually convince both the campus and systemwide administrations of the rationale for academic public health as a separate entity within the University of California . The rationale and strength of public health, of course, is that it joins and focuses the social, mathematical , physical and biologic sciences on health problems in the community that cannot be resolved by a single scientific approach . The administrators could easily understand the rationale to support single-discipline schools such as medicine, law and engineering, but found the concept of a school committed to the health of the public - and one that merged many disciplines already existing as other independent departments or schools on campus - difficult to understand and, therefore, to support. I attempted to promote public health in the University of California as a member of the systemwide Committee on the Health Sciences, on the campus through periodic meetings with the chancellor and the executive vice-chancellor, and nationally as secretary treasurer of the Association of Schools of Public Health. During this period the school underwent a major review by the systemwide Committee on the Health Sciences and an accreditation review by the CEPH , the accrediting agency for academic public healih in the United States. The school passed both reviews successfully, receiving the maximum accreditation interval of seven years. On a personal level, I am grateful to the associate dean during much of my tenure, Dr. Lawrence Ash, and to the assistant dean, Dr. Juel Janis, as well as to the faculty for their support and guidance during those years. I personally learned a great deal about public health and its role in academia, and was pleased to participate in the growth of the school in both size and quality.

1963 Virginia Clark becomes the first student to earn a Ph.D. degree in biostatistics at UCLA.

1965 School established as a Center for Training for the Medicare Program for the Southwest States, under the direction of

Dr. Milton Roemer.

1967 Private support to the school first rea ches the six-fi gure level, at $254,000 .

7 I. to r., beginning on p. 6: health promotion in a Los Angeles elementary school; International Epidemiologi· cal Assn. meeting at UCLA in 1990; Ors. Lawrence Ash and Jess Kraus (Epidemi· ology); an AIDS patient with his care-giver; Dr. Derrick B. Jelliffe (Community Health Sciences).

break up th e School of Public H ealth , dividing its programs among the medical school and a n ew School of Public Policy a nd Social R ese ar ch . The struggle to keep the school intact drew national supp or t fr om alumni and other well-placed h ealth leade r s. The UCLA administration's subsequent agreement to maintain the sch ool 's indep endence while phasing in subst antial budget cu ts prompted the sch ool to a d op t a strategy t hat closely parallels that of other p ro minent public health sch ools: movin g away from total relia n ce on sta te r evenu es fo r fac ult y and staff suppor t. R ather than depending on dwindlin g state fun d s, t oda y the sch ool 's gr owth hinges to a g1·eater extent

1968

on extramural r esources , where ther e is no such ceiling. Thus , the school's contract and grant activity has dramatically increased; two departm e nts, Biostatistics and Epidemiology, have substantially expanded the ranks of their non-state funded faculty, while the other three departments are in the process of doing the same; the faculty established th e Techni c al Assistance Group, offering consulting services to the public h ealth community; a new non- s tat e fund e d M . P.H. for H ealth Professionals program was instituted, enabling working profess ionals to enroll in a week end pro gram toward their public health degree; and a r edou-

1972 School moves to the UCLA

Center for the Health Sciences building; Goerke speaks at dedication.

Dr. Lester Breslow named the school's second dean. Alameda study published by Breslow establishes a link between seven behaviors and long-term health and longevity.

bling of private fund-r a i sin g effort s pushed the school over the $2 million level in 1995-96 for the first time in its history, nearly tripling the amount garnered in 1994-95 . In addition to fu eling the school 's financial growth , the se d e velopments illu strate the integral role the school plays in educating current and futur e public health practitioners, serving the community at large and bringing insight to decision-maker s. In just 35 year s, the UCLA School of Public H ealth h as made mon umental contributions to a healthier society. As it embarks on the next 35 years, a school dedicated to the public health has itself never looked more robust.

1974 Public Health Alumni Association founded, with alumnus Raymond Goodman serving as first president. Annual Lester Breslow Distinguished Lectureship established by the Raymond and Betty Goodman Foundation, with Rashi Fein of Harvard University as the first speaker.

1975 Western Consortium for Public Health is jointly established by the schools of public health at UCLA, UC Berkeley, and the University of Hawaii to conduct a range of educational, service, and other scholarly activities performed more effectively through joint institutiona l

action. Private support to the school first exceeds $500,000.

LEADING THE FIELD TOWARD NEW HEIGHTS T HE SCHOOL'S THREE

Bv ABDELMONEM A. AFIFI, PH.D.

AMERICAN P UBLIC HEALTH

(Dean, 1985- )

had several goals upon assuming the position as the school's dean in 1985. Among them was to continue to recruit high-quality faculty, both at the junior and senior levels. In doing so, I sought to find a balance between research- and practiceoriented people. I am certainly proud of the top-notch group we now have, whose prominence has added to our recognition as a world-class school. In 1989, we reorganized academically from a single department with seven divisions to five departments representing the core areas of the public health field . This achievement of our faculty, which was accompanied by a corresponding staff realignment and streamlining, has proved to be a milestone for the school, spurring further academic excellence by adding strength to each individual unit and, as a result, to the school as a whole. Other priorities included solidifying the school-based Environmental Science and Engineering Program. We allocated additional appropriate resources, and by 1991 the program proved worthy of the Graduate Council's unconditional approval, giving it a full eight-year term renewal. We established a gerontology research and education program that became strong and vibrant. In the area of health care financing, our faculty is now recognized as among the strongest in the country. Although budget cuts forced us to eliminate the Division of Nutrition in 1991, we have since rebuilt the program to the level where it is among the nation's finest. Finally, but certainly not of least importance, we have sought to increase the school's ties to the public health practice community, in part by setting up an Office of Public Health Practice. Of course, one of the most significant events affecting the school occurred in June 1993, when the university announced a restructuring proposal calling, among other things, for the disestablishment of the School of Public Health. While this threat to our existence as an independent entity consumed much of our energies and involved a great deal of heartache in the ensuing months, the efforts of our students, faculty, administration, alumni and friends paid off. Today, we remain independent and, despite reductions in state funding, I am convinced we are as strong as ever. Our faculty never have been more cohesive, the campus administration has been highly supportive, and UCLA's leaders have an enhanced appreciation for the importance of public health. We have established new extramural funding mechanisms to replace our loss of state revenues. Given our current position of excellence, I am confident that in the coming years we will be able to achieve a new level of leadership among the world's schools of public health, and establish our school as an indispensable component of the region, the state, and the nation.

ASSOCIATION PRESIDENTS DISCUSS THE PROFESSION DURING THEIR TENURES.

DR. LESTER BRESLOW

DR. Rune ROEMER

DR.

1977

1978 Dean ' s Council established under the leadership of Raymond Goodmon for the purpose of raising unrestricted private donations in support of the school.

UCLA Center for OccupaÂˇ tional and Environmental

Health established under the direction of Dr. Jess Kraus .

Public Health Students Association established.

1980 Dr. Roger Detels named the school's third dean.

RICHARD BROWN

1981 Health Careers Opportun ity Program established , lay ing the foundation for the school to become the leader in training minority students among schools of public health in the continental United States .

RUTH ROEMER, J.D. Adjunct Professo r Emerita APHA President, 1986-87

LESTER BRESLOW, M.D., M.P.H. Dean Emeritus APHA President, 1968-69

y term as president of the American Public Health Association came as the campaign against the Vietnam War was reaching considerable vigor, and members of the APHA were heavily involved. It made my inauguration especially exciting. Upon leaving the presidential platform party dinner en route to the nearby evening meeting room, I was suddenly surrounded and isolated by a group of young people demanding to present an anti-war demonstration at the start of the meeting. In order to proceed with the program expeditiously, I quickly negotiated an agreement for a five-minute demonstration, to be introduced from the platform, after which the demonstrators would sit quietly in the front row through the rest of the evening. That incident typified the '60s in public health and other social endeavors. As APHA president, I was invited to address the founding meeting of NARAL, in those days the National Association for the Repeal of Abortion Laws. It was exhilarating to be involved in such progressive social action that favored health advance. I toured the country with Paul Cornely, the next APHA president, making six visits to highlight the nation's severe community health problems. These were areas where poverty prevailed and minority people congregated. Our report, Health Crisis in America, was intended to stimulate health-oriented action on behalf of people living in such communities. Our profession, as it should be, was caught up in the times but seeking to advance people's health based on scientific understanding of its determinants. â&#x20AC;˘

1983

Professors Wilfrid Dixon and Frank Massey publish fourth edition of Introduction to Statistical Analysis; worldwide sales reach 300,000 , with tran slations available in Spanish , Korean , Thai, and Indonesian.

P rofessor APHA President, 1995-96

he year 1987 was a hard time for health services in America. The Reagan budget cuts in health and welfare programs, begun in 1981, had reached deeply into public health, and health professionals working at state and local levels were struggling to meet public health needs with severely restricted resources. My main thrust as APHA president was to heighten the consciousness of our members about the need for national health insurance (for reasons of both equity and cost containment) and the role of government in assuring health care. I focused on that urgent situation, along with legal-ethical issues in health care, in speeches to the state public health associations all across the United States. The theme of the 115th Annual Meeting of APHA, held in New Orleans in October 1987, was "Health Care for People or for Profit?" The challenge as APHA president is to deal with the many issues facing this vibrant multi-disciplinary professional association. The varied issues commanding our attention that year included the then-emerging AIDS epidemic, legislation for tobacco control, support for public health in Nicaragua, opposition to the nomination of Judge Robert Bork to the U.S. Supreme Court, risk assessment in protecting the environment, prevention of toxic hazards in the work place, establishment of a task force on state health insurance, strategies for health promotion, issues affecting women's health, payment of the U.S. dues to the World Health Organization, education of public health personnel, and many others.

1984 UCLA Environmental Science and Engineering Program moves administratively into the School of Public Health.

E. RICHARD BROWN, PH .D.

Detels begins serving as principal investigator of the UCLA site in the Multi-Center AIDS Cohort Study, the first and largest cohort study examining the natural history of AIDS.

any of the people responsible for delivering public health programs and services are feeling under siege. They've seen their budgets and resources decline, and are, in some cases, threatened by the loss of revenues as a result of managed care organizations absorbing Medicaid patients who were once served by public health departments. Thus, one of my missions as APHA president was to help these professionals develop their capacity to be more effective advocates for public health, whether that involves securing the necessary funding or maintaining appropriate regulations to protect the health of the communities they serve. I encouraged efforts by public health leaders to build coalitions with other constituencies, to get their messages across through the news media, and to explain what it is they do and effectively make their case to community leaders and policy-makers. Beyond the need for adequate resources, today's public health professionals face many technical challenges. There are infectious diseases that we now realize weren't conquered when we became an advanced industrial society. Environmental changes, new transportation technologies and growing income disparities create fertile ground on which these diseases can spread rapidly. The problems of poverty also create social conditions - increased violence and drug abuse representing two examples - that undermine the health of communities and people. To be successful in overcoming these threats to the public's health, public health professionals must win the support of the broad sectors of the community.

1985

1987 Private support reaches $1 million for the first time.

First Ralph R. Sachs lecture held.

Dr. Abdelmonem A. Afifi

Drs. E. Richard Brown , Robert Valdez, Hal Morgenstern and doctoral students Tom Bradley and Chris Hafner publish first studies documenting the number of Californians without health insurance of any kind .

becomes the school 's fourth dean.

+A' '(J

WORDS FROM THE WISE ALUMNI ON WHAT THEY REMEMBER, HOW THEY WERE AFFECTED, AND HOW THEIR FIELDS HAVE CHANGED.

"I probably would have been a physic ian if I hadn't enjoyed the sc hool so mu c h. I thoroughly enjoyed the relatively small classes, sincerity of th e instructors , and uniqueness of the subj ect. Dr. Fred Post was in charge of my major ( environmental health) , and was a wonderful teacher and advisor. Others on the faculty were inte r esting , motivated , and - heaven forbid - fun! We also had great lab e xperien ce s, as well as real-world training." -

HARVEYD. KERN , B.S . ' 64

field, and it changed the entire direction of my career." -

" Most people go to m edical school first and late r bec ome inte r es t ed in public h ealth. I ente red medical school alread y thinking in term s of a publi c h e alth career. So, for example, I chaired th e Inte rnational H ealth Committee of the Ame rican Medical Stude nt Association. I was involv e d with a p ee t· edu cati on and prevention a ctivity to ori e nt m edi c al students toward pre ve ntion. I ' m sure I n e ver would have b ec om e involve d with those sorts of a ctivities had I not akeady had a public h ealth orientation."

TODAY: MOHNING Arn PEll SONALITY AND

NEWS/P UBLI C AFFAlllS DlllECTOll , KNJO -FM, THO USAND OAKS, CALIF.

(after more than 30 years as director of public affairs , L.A. County-USC Medical Center)

MEMORIES "I remember big and chunky Monroe calculators in the statistics class. I recall preparing punch cards in order to run data in the compute r room. I r e membe r a onesemester seminar in the e pidemiology of leuk emia , led by Dr. Rob e rt Day, who h elped me to unde t·stand the applicabilit y of epid e miologic m ethods to a noninfectio us disea se. And I haven ' t forgotten the e pidemiology exercises, which I still have in a big, three-ring binder. My st aff is c urrently using some of th e material from my binder in preparing a mock e pidemic exer cise that we will u se with third- year medical students this fall ." -SUZ ANNE DANDOY, M.D ., M . P . J-1. ' 6 3 T ODAY : DJH ECTOH, VJHGINIA B EAC H HEAU ' H D EPA llTM ENT

1988

"I learned from the giants in the field of infectious disease epidemiology Telford Work , Ralph Barr, Larry Ash, John Schacher. We had field trips where we went out and did raw collection of animals, learned a lot of techniques that are completely missed today. Practically all of our cour se s were lab courses; today, that would be too expensive ." -

HAZEL WALLACE , M.P.H . ' 68, P11 . D . ' 72 TODAY: DlllECTOll OF LABOll ATOHY SEllVI CES,

ROBERT KIM-FA RLEY, M . P . H . '75 , M . D .

TODAY: WHO REPH ES ENTATI VE TO I NDONES IA AND WHO REPll ES ENTATI VE DESIGNATE, ] AKAHTA, I NDONES IA

"Courses with Drs. Shonick , Rada and Goldstein enabled me to see why things are th e way th ey are , emphasizing political, economic and sociological p er sp ectives. This h elped me und e r s tand that more than just a good plan is n eed ed for public health care, and to b e ope n t o alternativ e politi c al per s p ec ti ves t o answer the que stion , 'What should b e done?' " -

LONG B EAC ll C ITY D EPAllTM ENT OF HEALTll

ELIZAB ETH M l L L E H (P INKSTAFF) , M. P . H . '75

TODAY : COO llDI NATO H/NUllSE Tl lE HAP IST, D EA F T ll EATM ENT PllOG llAM, R ES ID ENT IAL CABE A t:l' Ell NATI VE D ETHOIT/W AYNE CO UNTY

IMPACT

COMMUN IT Y M ENTAL H EA LT H B OAllD

"The school set me on a career course that I have follow ed for 35 years . Dr. Lenor S. Goerke, the fir st dean , gave m e an opportunity to work in public h ealth one s ummer whil e I wa s in m e di c al school. That was my introduction to the

1989 Dean's Advisory Board established for the purpose of increasing private support on behalf of the school; alumni Ira Alpert, Carolbeth Korn, Joel Kovner, Samuel Tibbitts, and Fred Wasserman are founding members.

D ANDOY

School is restructured from one department into live: Biostatistics, Community Health Sciences, Environmental Health Sciences, Epidemiology, and Health Services. UCLA Southern California Injury Prevention Research Center established under Kraus' direction.

" I learn ed how to do r esearch , and in doing so , n eve r to give up . The sch ool also increa sed my sensitivity to differ ent grnups of p eople . What I learn ed continues to influen ce the way I teach - wh en I t each nurses, I alwa ys em p h asize th e

1991

1992 UCLA Center for Health Promotion and Disease Prevention established under the direction of Dr. Charles E. Lewis. Dr.P.H. is developed by Dr. Milton Roemer as the standard professional degree in the Department of Health Services.

Office of Public Health Practice established. Dr. Arthur Winer and collaborators publish seminal paper in Science, "Valuing the Health Benefits of Clean Air."

public health aspects of disease , along with the physiological aspects. And I s tr ess the importance of social justice and caring for people, which I learned at the UCLA School of Public Health." -

THEN

& Now

WORLD POPULATION (millions)

PATIUCIA MARTNEH-HEWES , M.S.P.H.

'81, D1cP.H. ' 84

TODAY: ASSOCIATE P11ornsso11 OF BIOLOGY, COLLEGE OF ST. ELIZAHETll, N.J.

U.S.

"For me , learning about the health ca1·e field was a big benefit. I gained a b e tter understanding of all aspects of health, how the health care system works from the federal level to the organizational level, and some of the dynamics of hospital structure and how physicians are organized. The other big piece for me was the relationships with classmates and meeting some people in the field, particularly through some of the internships. Those relationsh ip s have conti nued to be of value. " - HICHARD KIEL, JR., M.P.H. ' 86

POPULATION (millions)

I NTERNS HIP, U .S. AGENCY FOR I NTEHNATIONAL DEVELOPMENT

LIFE EXPECTANCY

INFANT MORTALITY (per thousond)

TODAY: V ICE PHESLDENT FOil

LEADING CAUSES OF DEATH

HOSPITAL

"Two fac ets stand out - mentorship and camarade rie. Working with the dean 's office really h elped me d evelop as a p1·ofessional and provided m e with guidance to get through decision-making times. A nd getting to know my colleagues in the school and what they were doing , particularly in other d epartments , gave me a more c omplete unde rstanding of what public health is all about."

" I had worked in HIV/AIDS education , but was looking for a new area to explore . There was a summer internship off e red b y th e Cent ers for Disease Contt·ol and Prevention that was well-publicized at the school, and it was during that internship that I b ec ame interes ted in occupational health . Fortunately, th e sc hool is very strong in that area , with a unique course on occupational health education and well-known facult y in the Department of Environmental Health Sciences such a s Dr. [John) Froines and Dr. [William) Hinds . Later, I was encouraged to apply to the Preside ntial Management Internship Program , where I am today." -

!MEE DIEGO , M . P.H. ' 9 5

INTEllNSHIP, NAT IONAL I NST ITUTE FOil

TllE CAUff!llNIA ENDOWMENT/PHOGllAM

OCCU PATIONAL SAFETY AND J-lEALTll

DEVELOPMENT DIVl SION

Chancellor Charles E. Young announces Professional Schools Restructuring Initiative, proposing, among other things, to disestablish the School of Public Health.

DOROTHY TAN, M.P. H . ' 95

TODAY: PHESID ENT IAL MANAGE~IENT

To1>AY: P 11oc11AM A ssoc 1Krn,

1993

BESSIE LEE , M.P. H . '95

TODAY: PnESIDENTIAL MANAG EMENT

ADMINISTllAT ION, HUNTINGTON M1•: MOlllAL

"Coming from a humanitie s background, the most positive contl'ibu tion I gained was more of a social science mind-set , a framework with which to really put the lens on problems and analyze them."

1994 Cha ncello r Young and the School of Public Health reach on agreement to maintain the school as on independent entity. To compensate for reduced state revenues, school sh ifts to a strategy emphasizing extramural funding.

Policy Research established under the leadership of Brown .

1995 Faculty establishes Technical Assistance Group under the leadership of Dr. Emil Berkonovic. M .P.H. degree program for health professiona ls is developed by Dr. Snehendu Kor; initial track in the Deportment of Health Services directed by Dr. Poul Torrens.

1996 UCLA Center fo r Healthier C hildren , Families, and Communities established under the leadership of Drs. Jonathon Fielding and Neal Holfon. Private support exceeds $2 million, on all-time high .

CHANGES "One major change has been the access to data and the ease with which we can now enter, process , and analyze data, which can then be used to make decisions and determine policy." -DANDOY

"Advances in scientific research in public health/preventive medicine; the vast number of minorities and women who have become key members of the field; the use of computers and similar tools (I 12 recently cleaned out my garage and with mixed emotions - tossed out my slide rule); the substantial growth of interest in environmental health; and, sadly, deteriorating support for environmental health, and especially occupational health, due to political interference." -

KERN

"The medical system is going a different way, and there's a shortage of specialists in infectious disease control. We have new viruses emerging and old ones re-emerging that we thought we had left behind." -WALLACE

"We have come to have a much broader concept of all of the reasons people choose certain health behaviors. Great work has been done in the areas of tobacco, AIDS and environmental health. But 20 years ago, everyone was saying "prevention is the future." I still think it is the future, but as a society, we have a long way to go before we see true health promotion as an important part of health . " services. -

PEGGY DA SILVA, B.S.

'76, M.P.H.

"Health education and health promotion, my field since 1973, has changed dramatically. In the early '70s it was predominantly focused on individual behavior change. Now, behavior change has a much broader definition. It's influenced by political, environmental and psy chosocial factors, by policy, social marketing, and administ ration." -ROBERT SIMMONS, M.P.H., Dn . P.H. ' 90 TODAY: CHIEF OF HEALTH EDUCATION AND

The school should continue to teach people how to learn, adapt and grow. It should stress practical, applied learning that its graduates can go on to use in a real-world setting."

-KIEL "UCLA, along with so many other schools of public health, is recognizing that the public health professional needs a lot of different skills. In health education, that includes a very good background in sociology, medical anthropology, psychology, communications, administration, evaluation, training, etc."

PHOMOTION, EUGENE DU PONT PREVENTIVE

-SIMMONS

MEDICINE AND REHABILITAT ION INSTITUTE, MEDICAL CENTER OF DELAWARE

"I always tell students, when you're in

"We need people who are able to translate hard science into pub lic health practice. We produce a lot of data in public health that isn't used. We can use it to better effect, for instance, in obtaining funding for our programs."

school, make sure that you look into whatever opportunities are out there and apply to the ones that interest you. Even where it seems extremely competitive, there's a good chance, coming out of UCLA, that you'll get accepted. And take advantage of the exce llent resources among the school's faculty and administration."

-WALLACE

-TAN

THE FUTURE

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TODAY: DIRECTOH OF A NATIONAL THAINING PHOJECT, HEAD STA HT, SAN FHANCISCO

What's happened over the last 10 years is what faculty at the school were saying was going to happen when I was a student - managed care, cost containment and different incentives and relationships with physicians. The pace of change has really accelerated." -KIEL

Please send the comp leted form to: Editor, UCLA Public Health , Box 951772, Los Angeles. CA 90095-1772 (for on-campus mail, Campus Code: 177220) or fax (310) 825-8440. For your convenience, you may a lso e-mai l any information to jmillcr@support.ucla.edu

DR. WILLIAM CUNNINGHAM Assistant Professor of Medicine and Health Services I was always interested in the intersection of health and society. Understanding health from a biomedical point of view was a useful starting point for me, but not sufficient. So while I decided to pursue medicine, simultaneously I wanted to continue to learn about the social dimension. When I joined the UCLA faculty with a joint appointment in medicine and public health, the idea was to serve as a bridge between the two schools. We need to do a better job of using the lessons from public health to improve the health care system; having more people who work in both medicine and public health makes that easier. Ensuring that physicians have a public health orientation is extremely important. We need to change the socialization of medical students , trainees and other doctors so that they understand and respect social science and the populationbased approach.

DR. BE.ATE RJTZ Assistmit Professor of Epidemiology Much more than medical disciplines, public health promises a focus on the prevention of disease. Moreover, public health takes on social iÂˇesponsibility for finding answers to questions of human suffering and pain that go beyond linrited individual coping strategies. The field of occupational and environmental epidemiology allows me to combine my interests in biologic mechanisms and my scientific curiosity with the challenge of finding ways to communicate with communities, companies, and labor unions on the issues of the safety and well-being of their members. I believe that public health can and should play a major role in shaping a healthy environment for people in a physica I, mental and social sense. Public health sometimes seems to me like one of the last bastions guarding the rights of the disadvantaged, people who otherwise would not have a voice.

DR. THOMAS BELIN Assistant Professor of Biostatistics Prior to coming to UCLA, I was at the U.S. Census Bureau focusing on the undercount that disproportionately affects urban minorities. When I heard

about the opportunity to join the UCLA School of Public Health faculty, I saw the chance to make an impact in other policyrelevant areas. Though I had no specific public health training at the time, I was fortunate to becomt> quickly integrated into projects that strike me as being at the heart of what public health is all about seeking to evaluate and improve cancer screening rates in the low-income and ethnically diverse population served by the Los Angeles County Department of Health Services, and to improve the quality of life for breast cancer survivors.

FACING THE FUTURE FIVE OF THE

SCHOOL'S

NEWEST FACULTY MEMBERS ON THEIR ATTRACTION TO THE FIELD AND WHERE IT'S HEADED.

This is what originally attracted me to this field - projects in which someone with an understanding of statistics and the scientific method can contribute to a broader public good.

DR. MARJORIE KAGAWA- SINGER Assistant Professor of Community Health Sciences I have a master's degree in nursing and have been a practicing cancer nurse both in inpatient and outpatient settings and with the School of Nursing. I always felt that inpatient or critical care focuses on only a small segment of a person's life. The emphasis should be on people in their everyday setting and how they can be supported to cope with chronic disease or prevention of illness. So I pursued a Ph.D. in medical anthropology, focusing on ethnic differences in the response to cancer. Health care has often operated in a one-size-fits-all paradigm, under the assumption that if you approach health and health behavior in that way, you'll get the same results. Experience has shown otherwise. We need to be more ethnic-specific, but we also need to understand what are universal needs and what are ethnic-specific ones, and how we, in a cost-effective way, can tailor our efforts for optimal effectiveness.

Faculty (I. tor.): Thomas Belin, Marjorie Kagawa-Singer, William Cunningham, "Mel" Suffet, Beale Ritz.

DR. l.H. "MEL" SUFFET Professor of Environmental Health Sciences After 20 years in a chemistry department, I had the opportunity to apply my knowl. edge in analytical and environmental chemistry to public health problems. I like the idea of being on the front line, tackling critically important problems that come up and need to be solved immediately. When there's a haza1Âˇdous spill or a toxicity problem in the aquatic environment, I have the ability to find out what's causing the problem and to develop solutions as quickly as possible. Increasingly, I see hazard assessment becoming a major focus. We need to be able to evaluate problems that evolve from different uses of chemicals and try to minimize uses of hazardous materials , replacing them with natural materials wherever it's possible. This could be something as simple as making a McDonald's container out of biodegradable materials so it doesn't become an eyesore and a potential health hazard on the beach; in fact, we 're now working with a company in an attempt to develop such a product.

A HEALTHY TOMORROW SEVEN STUDENTS ON THEIR PAST, PRESENT, AND FUTURE. Given the remarkable expansion of public health's scope in the 35 years since the advent of the school, it's not surprising that students in 1996 are far more diverse than those who were here in 1961, whether the subject is their background, their interests or their ambitions. 14 Some aspire to traditional public health leadership positions, others seek the public health grounding that will enhance their work in another field. Dr. Jill Halper, for example, is a clinical physician pursuing an M.P.H. Halper, a pediatrician, has begun her second year in the school's Child and Family Health Training Program. She hopes to build the skills that would one day enable her to run a community clinic; in the meantime, Halper has gained a better understanding of the underlying social problems and public policies that affect her patients. "That helps me to be more compassionate in the clinical setting," she explains. Second-year epidemiology student Avid Reza intends to follow the reverse path she plans to apply to medical school after receiving her M.P.H. in June. Reza had long planned a career in medicine, but, without much previous exposure to public health, was unsure of how to achieve her goal of making an impact in the lives of larger numbers of people than clinical work would allow. Her first year at the school convinced her she could find a way to combine the two fields. "It's amazing how much I've learned in such a short tin1e," says Reza. Among her revelations was a personal one: "In order to be a good epidemiologist, you have to be very analytical and a critical thinker. I've realized that I am strong in that area." Indeed, an informal survey of current students suggests that some knew relatively little about public health before applying to the school. As an undergraduate molecular biology major, Henry Tam had decided on a research career. But after spending some time working in a molecular biology lab, he yearned for something more people-oriented. A professor talked with him about public health. "Before that, I had a narrow view of what it was," Tam says. "I now realize there are many

approaches." Tam, who is interested in HIV/AIDS research, earned an M.S. in epidemiology and entered the school's Ph.D. program in September. Some are set on their course much earlier. Growing up in Southern California's San Gabriel Valley, Raymond Chavira had been disturbed at seeing so many children whose asthma was exacerbated by the region's poor air quality. After college, he worked as a bench chemist for the Air Quality Management District, but eventually concluded that the technical issues he was tackling represented only a small part of the environmental equation. In pursuit of the big-picture background that would enable him to play a future leadership role, Chavira enrolled in the school's Environmental Health Sciences

M.S. program in 1993, and is now pursuing a D.Env. as a second-year student in the school's Environmental Science and Engineering Program. Chavira's graduate education has reinforced that "it's not just the science per se, but the political, social, economic and health-related issues that need to be considered." Mitzi Williams also liked the idea of a field that could make a difference for the people in her community. Williams, who grew up in Compton, Calif., saw health services - through management or policy development - as a way to make a great impact on a large number of people. Her experience has been enhanced by the school's Diversity Enrichment Program, which has offered Williams important information and resources, as well as constant encouragement. "Our dean is cognizant of the need for a program to recruit and retain

talented minority students," she says. Many students have experience as public health professionals, but are hem to receive the academic training they previously lacked. Maxine Weiner had left her career as a schoolteacher to become a health educator. Weiner says the education she is receiving will prove invaluable. "Before, I really didn't know the theory behind what I was doing," she says. "It was news to me that we need not just to count the number of people who get our information, but to determine whether it actually teaches anybody anything." For other students, the school offers an opportunity to find a new path. Randal Henry, who had worked as a qualified mental retardation professional, entered the M.P.H. program uncertain of

tor.: Avid Rezo, Henry Tam, Raymond Chavira, Maxine Weiner, Jill Halper, Mitzi Williams, Randal Henry.

his future course. He became intrigued by the potential impact he could make in the area of violence prevention after meeting with Dr. Susan Sorenson, a leading researcher in the field. Henry applied for and received a California Wellness Foundation fellowship in violence prevention research, and had his first paper, "Ethnicity and Perception of Violence Risk," accepted for a national conference in Boston. "This has been the greatest experience of my life," says Henry, the current Public Health Students Association president. "I've had the opportunity to interact with high-caliber students in an environment that inspires all of us to achieve. I've become aware that I have valuable input to offer. It's been very empowering."

"I value and use my public health education in my daily work. Health care management is more than just a business. I have a business background, but I still drnw on the core disciplines of public health. I think it's helpful to people who are going into the health field to have a background in public health. If it's helpful it needs to be available, and if it's going to be available in this world, we have to support it." -IRA ALPEHT (M.S. '66), president and CEO of t,he Wilshire Foundation, a company involved in various aspects of long-term care. Alpert provided the company's Endowment in Geriatric Medicine and Long-Term Care cit the school. He also chairs the school's Dean's Council; in that role, he has been an active fiind-raiser for the school. "The Department [of Comm unity Health Sciences] has such a broad outreach - the ability of the students and faculty to reach so many people with so few resources amazed me. We all look back upon our own period and wish we had something to motivate us to look forward. I was impressed and wanted to help. When the students reported back to me after they returned, it became clear that they were having an impact on many lives." -ROBEHT J. DHABKIN, a Los Angeles businessman with a long-standing interest in health care, who has provided funds enabling students in the Department of Community Health Sciences to travel abroadfor their.field internships. "What was uppermost in Sam's mind, and I agree, is that we 're so grateful for the education our family has gotten at UCLA. We just feel we owe a tremendous debt for all UCLA has given us." -A.UDBEY TmBJTTS, who, together with her late husband, Samuel Tibbitts (B:S. '49, M.S.), has been cimong the school's strongest sitpporters. She and her husband gave a generous g~ft to the school's Department of Health Services to conunission the recently released book Changing the U.S. Health Care System: Key Issues in Health Senices, Policy, and Management (San Francisco: ]ossey-Bass Inc,, Publishers).

"We'd like to see more cases of doctoral training for people who are going to engage in public health or health administration practice, as opposed to pursuing a career in research. We wanted our earnings to go to a good cause, and we believe these fellowships represent that." -DB. Mtc;roN ROEMEB, professor emeritus of health services. The Roemers, Milton and Ruth, influential members of the school's faculty since .1962, recently established T<oemer Health Services Administration Fellowships for selected students admitted to the Dr. P.H. program in the school's health services department.

PILLARS OF THE

COMMUNITY SEVEN OF THE SCHOOL'S STAUNCHEST SUPPORTERS ON WHY THEY CHOOSE TO ASSIST.

"With my wife, Sharon, I give time and financial support to the UCLA School of Public Health for several reasons. The school helped prepare me for my career, and I want to invest in the school's future. UCLA has grown to become one of the leading schools of public health in the country, and I appreciate the way the school's leadership is always looking for ways to create new programs and develop new relationships relevant to the fastchanging health care environment in which we live and work." - T EHRY HABTSHOHN (M.P.H. '69), president and CEO of UniHealth, one of the nation's largest nonprofit health care systems, and chairman of the board of PacifiCare Health Systems, Inc. The flartshorns made a gift enabling the school to open the Student Resource Center. "The UCLA School of Public Health plays a key role in the continuing growth and improvement of public health practice in California. Opportunities for collaboration, such as the one made possible by our grant, represent the best means to reach larger numbers of people in a more efficient and effective way." -ANN MONHOE, consultant to The California Endowment. As senior vice president of public benefit programs at Blue Cross of California, Monroe was instrwnental in awarding an important grant that enabled the school, in collaboration with other California schools of public health, to provide professional education, technical assistance and research services to the state's public health community.

"I had heard thtÂˇough someone I respect about the great work being done in the ESE program. After looking into it I agreed the program was worthy of our support. I hope this will help to create an awareness about saving the Earth and will foster the research it takes to correct the problems that are plaguing the planet." - NEAL PAHGMAN (CENTEH), president of the Woodland Hills, Calif.-based Save The Earth Foundation, which provided a capstone gift that helped to complete the campaign for a $500,000 Environmental Science and Engineering Program endowment.

35TH ANNIVERSARY

UCLA_?_r1_s L _1c _ HE _A_LT _ H...... NEWSLETTER

UCLA School of Public Health Box 951772 Los Angeles, California 90095-1772 Address Correction Requested