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

UCLA

SCHOOL OF

PUBLIC HEALTH NEWSLETTER

DEAN'S MESSAGE

COUNTY OF HEAL TH .; E ~~ 313 NO, TH

Gt.LES I IST STRHT

THE SCHOOL'S ROLE

s the nation's second-largest county health care system teetered o"u the brink of collapse and now faces major restructuring to remain solvent, the UCLA School of Public Health has and continues to play a central role in the ongoing effort to maintain essential health services . Only an 11th-hour prospect of a federal bailout saved Los Angeles County from the closure of all six of its comprehensive health centers and 28 of 39 community clinics (and, potentially, one or more of its hospitals) last Oct. 1. But even after the appearance of federal aid, more than 3 , 000 county health department employees were laid off or demoted, and significant changes - including shifts to more cost-effective outpa-

On countless occasions in a variety of settings since I became dean , I have discussed the == important contributions made by our school's faculty, students, alumni, staff and friends. But at the Jan. 12, 1996 memorial service honoring the life and work of Professor Frank J. Massey, Jr., a former student paid a different kind of tribute that, I believe, captures the essence of what our school is about. Dr. Mei-Miau Wu, whose letter is printed on the back cover of this issue , recounts the difference Dr. Massey made in her life, how he continued to give her advice until his death, and how his lessons live on to this day. In a broader sense, Dr. Wu's words testify to our faculty's neverending commitment to inspiring students and serving the community. INSIDE ... As you will see throughout this issue, our school consists of special people. Whether they're at the table discussing the future of L.A. County 's health system (this page), bolstering the education of public health professionals (page 2), bringing public health to the private sector as alumn i (page 10), or making financial contributions to ensure the school 's continued vitality (pages 7-9), they all have something in common : a remarkable dedication to improving the public's health.

tient and preventive car e, privatization and alternative forms of governance are b ein g weighed as officials seek to avoid a rerun of last summer. All the while, several of the scho ol's faculty have pursued a number of avenues in an effort to en sure that the health outcomes of these decisions are given proper consideration. Las t June, the count y formed a Health Crisis Task Force, which sub sequently appointed former assemblyman Burt Margolin as the so-called h ealth czar. Among those who h ave been in vited to attend task force continued on page 4

Dr. Abdelmonem A. Afifi

2 NEWS

School To Train Leaders Under Grant from CDC

SCHOOL EXPANDS SCOPE WITH FACULTY GROUP,

Two

The school has received a five -year grant from the federal Centers for Disease Contro l and Prevention to conduct the Public Health Leadership Institute, a program that offers intensive instruction to key health officials from state, regional and local agencies. Launched in 1991, the institute seeks to bolster the nation's public health system by improving the skills of the front-line professionals who administer state, regional and local health programs. "Th is grant strengthens our efforts to train and develop the leaders needed to solve our nation's public health challenges," says Dr. Abdelmonem A. Afifi, dean of the UCLA School of Public Health and principal investigator for the grant. "We are delighted to foster this program into the future." Through interactive long-distance seminars, an intensive one-week retreat and a self-study cur riculum , the Public Health Leadership Institute helps officials refine their skills and promote a cooperative network of public health experts. The institute is a cooperative program of the UCLA School of Public Health, the UC Berkeley School of Public Health , the San Diego State University School of Publi c Health and the Western Consortium for Public Health.

Two new academ ic programs and a schoolwide effort to increase faculty involvement in p ublic health p ractice have been initiated as part of a major endeavor by th e UCLA School of Public Health to broaden its scope and enhance its ties to the public health practice community. As part of the overall effort, the state 'S four schools of public health have joined fo rces on a variety of innovative proj ects designed to assist public health professionals.

he UCLA School of Public Health's Technical Assistance Group, administered through the dean's office, offers faculty ser vices for the planning, implementation and evalu ation of public health programs. Typically, proj e cts are undertaken that connect faculty with practitioners. Current activities include: • Collaboration among the four California Schools of Public H ealth

UCLAI PHUBLIC HEALTH I Volume 15, Number l

EDITORIAL BOARD

Winter 1996 Abdel monem A. AJifi , P h. D. Abdelmonem A. Afifi , P h .D . Deon

Oean

J udith M. Siegel , Ph .D . Associ(J.te Denn.for Academic Progra ms

Lawrence ll. As h , Ph .D. Associate Denn.for Student A.flair..

V. Gale Winting Dan Go rdo n E<lit.or a11d IVrit.er

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NEW PRO GRAMS FOR PROFESSIONALS

A ... socia t,e Dean fo r Admi11ist ra t.ion

Jo hn D . Millet· Direc t.or· of Develop men t

Deborah Gbk , P h. D . As ... ociate Professor, Community 1-/ealr.h Scie n ces

Ha l Mo rgenste r n , P h. D . Professor, Epidemiology

Col'inne P eek , M.P.H. ' 91 Alu mni A ssocia tion

T hanh-Nghja Nguyen Pres ident., Public He<1lth St ude nts Associat.ion

Wa n en R obak Public Info rma tion Rep resenta tive

(CSPH) to provide professional and continuing edu cation, distance learning projects, technical assistance, and research services to the public h ealth commu nity statewide (an effort supported by a grant from Blue Cross of California); • Thre e immunization proj ec t s involving media development and distance learning, with funding from the California Department of H e alth Services' Immunization Branch; • A study of the use of earthquakerela ted services following the 1994 Northridge temblor, funded b y the Los Angeles County Department of Health Services; • Development of a Statem ent of Collaboration between the California Conference of Local H ealth Officer s and the CSPH to ensure the integrity of the state's public health infrastructure through training, public h ealth outcomes res e arch and progr a m developme nt. The agree m e nt ha s resulted in an ongoing series of meet-

WHO'S WHO IN HEALTH? If you' r e looking fo r th e mo s t influ e nti a l h e alth car e player s in Los Angeles, you could start b y perusing a list of the people receiving this p ublication. In the Los Ange le s Business ]ournal'S 1995 "Health Care Who ' s Who," we counted 12 UCLA School of Public H ealth alumni , two of the school 's c urr e nt fa c ulty, a nd three others who serve on the Department of Health Services Advisory Committee . That's 17 of the 100 influence-wielders f e atured. Not a bad market share.

Clockwise from upper left: Dr. Dean Jamison was the Lester Breslow Distinguished Lecturer last spring; Corinne Peek, alumni awards coordinator; and Shaista Malik, an award recip ient.

i n gs t o d evel op a nd seek fundi n g for mutually agr eed-upon pro- Dr. Paul Torrens (middle row, left), with charter class of the UCLA School of Public Health's new M.P.H. for Health Professionals Program. jects; and â&#x20AC;˘ Collaboration with the Ventura management tech niqu es ," says Dr. County Health Departme nt in the Paul Torrens, professor of health services and program director . development of projects r elated to the Twenty studen ts are enrolled in the immu nization of children, maternal ch arter class. T h ey inclu de privateand child nutrition and teen pregnancy. For more information, call (310) and p ub lic-sector p h ysicians, health 825-0895 or (310) 825-1352. administrators, a nur se, and a ph armacist , coming from as far n orth as h e M .P .H. fo r Health ProfesSan ta Barbar a a nd as far south as San Diego. The p r ogram is d esign ed sionals Program, offered by the Department of Health Ser vices t o be com p le t ed without givin g up beginning last fall, is a two-year gradprofessional r esp on sibilities - classes uate program in h ealth services manand other instru ctional activities are sch eduled on two weekends a month agement with a cu rriculum that combin es modern m a n agemen t p r actice during th e academic year. with detailed an d topical information For furth er inform ation , call (310) 206-3435. about health care . "This program is a valuable addiA similar program, offered by the D epartme n t of Com mun ity H e alth tion to a rapidl y changing fi el d , b ecause it allows full-time working Sciences , is scheduled to b egin t h is fall . For more inform ation on t h at professionals to r eturn to graduate school and learn the latest in health program, call (310) 825-5156.

In Memorium We regret to report therecent deaths of fivemembers of the UCLA School of Public Health family Dr. A. Ralph Barr, professor emeritus of epidem iology, died on July 2, 1995 after an extended illness. He was well recognized in the professional community of tropical medicine and medical entomology. During his extensive career, Barr published more than 145 articles, abstracts and book chapters on mosquitos and mosquito-related health problems. Dr. Edith Carlisle, an adjunct professor and researcher in the Department of Community Health Sciences, died Dec. 7, 1995. She was an expert in trace elements, the first to show the essentiality of silicon in human nutrition. In recent years, she became interested in the mechanisms by which aluminum and silicon interact with Alzheimer's disease. Dr. John Chapman died Oct. 11 , 1995 after a month-long illness. He first joined the UCLA faculty in 1947, while serving as the 33-yearold medical director and epidemiologist for the Los Angeles City Health Department. From

1955 to 1976, Chapman was professor of epid emiology at the school. He remained active, both with the school and as an infectious disease consultant, until his death. Dr. Frank Massey Jr., professor emeritus of bi ostatisti cs, died Nov. 18, 1995. Massey helped build the Department of Biostatistics at the UCLA School of Public Health an d the Department of Biomathematics at the School of Medicine. He co-authored a top-selling textbook, Introduction to Statistical Analysis, which, 50 years after the original edition, is still published in six languages. (For a student's remembrance, see back cover.) Dr. Ralph Sachs, who died on Oct. 26, 1995, was chief executive officer of the Los Angeles City Health Department from 1955 to 1964, during which he launched community mental health clinics, an alcoholism control program, and an innovative program to provide schooling for pregnant teen-agers. The school has benefited greatly from his endowment of the Ralph R. Sachs Visiting Scholar Program, designed to bring together practicing public health professionals and academics to promote exchanges on UC campuses.

Dr. Jonathan Fielding, professor of health services, has been elected to the Institute of Medicine of the National Academy of Sciences. Fielding, widely known for his work in health promotion, disease prevention and health policy, was one of only 55 members so honored in 1995. Earlier in the year, he became president-elect of the American College of Preventive Medicine and was appointed editor of the Annual Reviews of Public Health through 1999. Dr. Lester Breslow, professor emeritus of health services , has received the Healthtrac Foundation Prize, given annually to recognize a person who has made a major contribution to health improvement. Previous recipients have included international health leader Wi lliam Foege, fitness innovator Kenneth H. Cooper, and former U.S. Surgeon General C. Everett Koop. Dr. Nathaniel Schenker, associate professor and vice chai r of biostatistics, has been named a fellow of the Ameri ca n Statistical Association. The designation from the prestigious group signifies outstanding professional contribution and leadership in the field of statistical science. Dr. Jeremy M.G. Taylor, professor of biostatistics, was selected as the 1996 recipient of the Radiation Research Award, recogn izing a young scientist who has made outstanding contributions to the field of radiation science. Dr. E. Richard Brown, professor of community health sciences an d health services and director of the UCLA Center for Health Policy Research, has assumed the presidency of the American Public Health Association, the nation's largest group of health professionals. Brown, the third member of the UCLA Sch ool of Publ ic Health faculty to serve as APHA president, was elected in 1994.

Two from School Appointed To County PH Commission Dr. Lester Breslow, professor emeritus of health services, has been appointed to the five-member Los Angeles County Public Health Comm ission, which advises the County Board of Supervisors on public health issues. Breslow was appointed by Supervisor Zev Yaroslavsky to represent the third district. Earlier last year, Sophia GuelValenzuela (M.P.H. '94) was appointed to the commission by Sup ervisor Gloria Molina, representing the first district.

4 continued from page 1

L.A. COUNTY'S FUTURE: THE SCHOOL'S ROLE meetings and serve as informal consultants are Drs. Lester Breslow, E. Richard Brown, and Jonathan Fielding from the UCLA School of Public Health faculty. They have also been among the faculty lending expertise to the L.A. County Department of Health Services, foundations, and other groups concerned about the county's future course. In response to a request by members of the task force, Breslow, Brown and Fielding drafted a brief last July assessing the potential public health impact of the proposed closures. "We were concerned that some of these cuts were in programs with a big payoff for the health of people in the county cuts in sexually transmitted disease, tuberculosis, and family planning clinics, for example - and that they would therefore have a substantial impact on health outcomes," says Brown, who also testified before the County Board of Supervisors on the matter. As the county now considers alternative governing structures, Dr. Michael R. Cousineau, associate director of the Center for Health Policy Research (based in the school), has provided technical assistance to the task force in its preparation of a report to the supervisors. "We have

explored various alternatives, including the strengths and weaknesses of what other counties are doing and the types of models that can be applied here given the political climate and the other issues we face," says Cousineau, who issued an October 1994 report on the danger of a county health system collapse. Others connected with the school have continued to have a voice in the discussions as well. In October, Breslow was appointed by Supervisor Zev Yaroslavsky to the Public Health Commission, which provides oversight of the county's public health services. He is joined on the five-member committee by Sophia Guel-Valenzuela (M.P.H. '94), who was appointed last spring by Supervisor Gloria Molina. Indeed, the school's alumni- including Jonathan Freedman (M.S.P.H. '91), deputy director of public health programs for L.A. County, who served as Margolin's chief of staff through Feb. 15; and numerous other high-level County Department of Health Services officials - can be found wherever important discussions concerning the county health system's future occur. In November, the school, along with RAND and the school-based Center for Healthier Children, Families, and Communities (headed by Fielding, Dr. Neal Halfon and Dr. Neal Kaufman) and Center for Health Policy Research (headed by Brown), sponsored a symposium to discuss the development and implementation of a research agenda for monitoring and evaluating the proposed changes. Approximately 135 leading researchers, foundation representatives, policy-makers and their staffers attended. Throughout the process, members of the school ranging from the faculty to the dean have sought to clarify the issues for the public, using the news media and other forums. "The principal message we're trying to deliver is that in these difficult times, there should be a greater-thanever empha sis on the health consequences of what is being proposed," says Breslow. "We recognize the neces-

sity of dealing with the budget stringencies, but within that, we should not concentrate solely on how we're going to save this or that million dollars." Adds Brown, who is also the current president of the American Public Health Association: "I'm not sure the public understands that what happens to the county health system affects all of us, not just indigent patients." As for the school's role in what ultimately happens to the county system? "It depends on what [new county health director] Mark Finucane and the Board of Supervisors are interested in," suggests Fielding. "If they're interested in help in defining what Âˇ might be the most cost-effective systems, and in careful evaluation of the health effects of proposed and actual changes, many of us here - working with the many capable people in the county health department itself would like to assist." Dean Abdelmonem A. Afifi made the school's offer of assistance clear to Finucane in a November letter welcoming the former health director of Contra Costa County to Los Angeles. "I am writing to assure you that the faculty of the UCLA School of Public Health and I will do everything we can to help you make the [Los Angeles County Department of Health Services] a model for all health departments in the country," Afifi wrote. Responded Finucane: "The [UCLA J School of Public Health is sure to play an important role in any efforts to address the health care needs of the people of Los Angeles."

5 STUDENTS

NEW RESOURCE CENTER OFFERS STUDENTS

CENTRALIZED LOCATION FOR MEETING

The following students were among those chosen for special awards in 1994 and 1995. Here is an update on their present activities: IMEE DIEGO

Coordinator of special projects for the dean's office; interim coordinator of the school's new MPH for Health Professionals Program. MARCIA GRAHAM

Director of business development in the Denver office of Pacific Health Dimensions, a health care management company that has five IPA offices managing more than 200,000 enrollees. JACQUELYN KASTER

Manager of business development at St. Jude Hospital (Fullerton , Cal if.). Duties include strategic planning, policy work, and serving as liaison between the hospital and the county for the Medicaid program. BEATRIZ LARES

Organized the Wilmington Vaccination Project, an annual summer program teaching minority medical students about community medicine. Continuing her doctoral studies at the school on breast-feeding and infant nutrition. NGA YEE JACQUELINE LAw Above: The Student Resource Center, which also includes an office for the Public Health Students Association and a conference room. Inset: Terry Hartshorn (M.P.H. '69), who helped to make it possible.

eet me at the vending machines." For School of Public Health students, it was a statem ent requiring no elaboration. They knew which machines. They knew the meeting spot was chosen for reasons having nothing to do with hunger or thirst. They knew the confines, a collection of tables meant for patrons of the UCLA Medical Center cafeteria, were less than ideal for group studying, or just chatting - particularly du ring the lunch hours , when non-diners were often asked to leave. But for students in search of a social setting, there weren' t a lot of other options. Now, thanks to a generous donation by Terry and Sh aron Hartshorn, students h ave space t h ey can call their own . The Studen t R esource Center, located on the fourth floor of the school's wing of the Center for the Health Sciences building, opened in January of this year. "There has never b een a greater need for innovation in the health care field ," explains Terry Hartshorn

(M .P .H. '69) , president a nd chief executive officer of UniHealth. " I am hopeful that many of these students will help meet this challenge, and my wife and I are pleased to s upport their efforts." The Student R es ource Center serves several purposes. Flanking the main room are the new (and larger) office of the Public H ealth Students Association (PHSA), and a conference room, complete with dry erase board and overhead projector, available on a sign-up basis to students preparing for group projects or simply interested in studying together. In the main room, students can relax, study, eat , check bulletin-b oard postings, and, above all, get to know one another. "The time we spend at the school is limited , and it sh ould be special," says Th anh-Nghia Nguyen , who is the current PHSA president. "Students have a ch ance to learn from each other and create lifelong friendships among their classmates . Having this centralized location will make that a lot easier."

Entered the school's Ph.D. program in the Department of Biostatistics last fall. LENE LEVY-STORMS

Completing her Ph.D. dissertation in the school's Department of Community Health Sciences, looking at the social factors that influence breast cancer screening among older Pacific-Islander women. GLORIA MAO

Completing her Ph.D. dissertation ("The Role of Retinoic Acid Receptors in Neural Tube Development") in the school's Department of Environmental Health Sciences. CAROLYN MENDEZ

Scheduled to receive her M.P.H. in the spring, and has applied for the Ph.D. program in community health sciences. ATSUKO SHIBATA

E arned her Ph.D. in epidemiology last spring; now an assistant professor in the Department of Health Research and Policy at the Stanford University School of Medicine. Interested in the molecular events of H. pylori and stomach cancer. JOHN WITTE

A ssistant professor on the Department of Epidemiology and Biostatistics at the Case Western Reserve University School of Medicine; research interests include genetic and nutritional epidemiology.

6 FACULTY

New Faces

PROFILE

Dr. Carol Archie Community Health Sciences

Dr. Nancy Berman

Dr. Stella Grosser

Biostatistics

Dr. Nancy Harada Health Services

Dr. Karim Hirji

Dr. Stephanie Land

Biostatistics

Dr. Beale Ritz Epidemiology

Dr. Hongyu Zhao Biostatistics

Department of Community Health Sciences

f the public health field by definition involves a myriad of disciplines worlcing together for a common agenda, its epitome at the UCLA School of Public Health can be found in the Department of Community Health Sciences (CHS). More than any of the school's departments, CHS comprises faculty and students with widely varying interests and expertise. Of interest, explains Dr. Gail Harrison, professor and department chair, is how health-related behaviors interact with sociological, physical and biological conditions to influence health status, with emphasis on understanding how to enhan ce and improve the health of individuals, families , and communities. The department, the school's largest, includes a mix of social scientists , biomedical scientists, health-care providers and health educators, many of whom r eceived their primary training in fields other than public health. Students in the master's program choose from one of five concentrations: health education/promotion , international family health, public health nutrition, public h ealth policy, and sociocultural aspects of h ealth . And , while there is overlap among fa c ulty, examples of the research conducted within each concentration illustrate the department's diversity: • In health education/promotion, Dr. Deborah Glik sp ecializes in media and communications, with emphasis on adaptations of teaching materials. Dr. Michael Goldstein studies alterna-

tive healing and self-help movements, and Dr. Donald Morisky heads several research programs on the u se of education to slow the spread of infectious disease. • Dr. Osman Galal h eads the school's international family health program, which h as established linkages with overseas institutions, ther eby providing sites for faculty exchanges and field exp erien ces for students. More than a half-dozen faculty focus on international h ealth research, including two health educators , Drs. Virginia Li and Sneh endu Kar, and Dr. D ean Jamison , who came from the World Bank and was editor of the 1993 World Devewpment

Report: Investing in Health. • Sociocultural aspects of h ealth includes a variety of perspectives , from that of Dr. Marjorie KagawaSinger, a m edical anthropologist and nurse inter ested in Asian-American families; to that of Dr. Carol Aneshensel , who has explored levels of stress among the care-givers of people with chronic and terminal illnesses; and Dr. Susan Sorenson , who studies intentional injury and homicide . Drs. Judith Si egel and Emil Berkanovic also contribute to the diver sity of r esear ch in this area. • Health policy research e r s include Dr. E. Richard Brown, director of UCLA's Center for Health Policy R esearch, who h as documented the h ealth ins urance problems

While space limits preclude a complete listing, the following list of research and training grants and contracts of more than $75,000 awarded in 1994-95 is designed to illustrate the variety of grant and contract activity at the school.

affecting Californians, as well as Dr. Steven Wallace, who focuses on health policy as it affects the elderly. â&#x20AC;˘ In public health n u trition, Dr. Charlotte Neumann is currently assessing the prevalence of h u nger among schoolchildren in Los Angeles and the level of iodine deficiency in East Africa. Harrison has just finished a pilot study assisting the government of Egypt on a nation al system for monitoring food consumption. Several programs cut across the department's concentratio n s. The new UCLA Center for Healthier Children, Families, and Communities, under the leadership of Dr. Neal Halfon, augments the department's child-and-family-health focus. A disaster-relief curriculum is being developed by Dr. Steven Rottman, an emergency physician, and Dr. Linda Bourque studies social responses to disasters. Drs. Dawn Upchurch, a demographer, and Joanne Leslie, a nutritionist, conduct research in women's health issues. Two preventive medicine specialists, Drs. Antronette Yancey and Ronald Halbert, round out the mix of faculty backgrounds. A similar diversity of backgroun ds exists among CHS students. T h e M.P.H. program, for instan ce, attracts mid-career health professionals wh o return to broaden their experience, as well as students who come straigh t out of a bachelor's program and t h ose who obtained some field experien ce but remain at the entry level.

Afifi, Abdelmonem A.- "Public Health

Kar, Snehendu B. - ''.4 Partnership tor

Leadership Institute." Centers for Disease Control and Prevention.

Public Health Practice Training." PHS/Health Resources and Services Admin. Kraus, Jess F. - "Injury Prevention Research Center." PHS/Centers tor Disease Control; "Case-Control Study of Older Adult Pedestrian Injury Sites. " University of Washington; "Media and Injury Prevention Program "; ''.4 Study of the Differential Effect of Non-DOT 218 Standard Helmets on Head Injuries. " Calif. BTA Office of Traffic Safety

Andersen, Ronald M. - "Determinants of Oral Health in Older Persons." PHS/Agency tor Health Care Policy & Res.

Aneshensel, Carol S. - "Sources and Mediators of Alzheimer's Caregiver Stress." UCSF Bastani, Roshan - "Adherence to FollowUp of Breast Abnormalities." PHS/Nat'I Cancer Institute

Bourque, Linda B. - "Survey of Los Angeles and Ventura County Residents, Post-Northridge Earthquake." County of L.A.

Breslow, Lester - "Health Risk Appraisal tor Older Persons. " DHHS/Health Care Financing Admin.

Collins, Michael D. - "Literature Search tor Hot Spot Ch.emica/s." Calif. EPA Ott. of Env. Health Hazard Assessment

Detels, Roger - "Cancer Epidemiology Training Program." PHS/Nat'I Cancer Institute; "International Training in Epidemiology Related to AIDS. " PHS! Fogarty Int'/ Center; "The Natural History of AIDS in Homosexual Men "; "Interdisciplinary Training in HIV/AIDS Epidemiology. " PHS!Nat'l Institute of Allergy and Infectious Dis.

Froines, John R. - "Chemical Screening Agreement No. 18-6." Western Consortium tor Public Health; "Non-Carcinogenic Toxico/ogic Endpoints tor Seven Chemicals: A Literature Review." Calif. EPA Office of Env. Health Hazard Assessment Galal, Osman - "Minority Int'/ Research Training Grant. " PHS/Fogarty Int'/ Center

Ganz, Patricia A. - "Sexuality and Intimacy in Breast Cancer Survivors. " PHS/Nat'I Cancer Institute; "Managing Menopausal Symptoms in Breast Cancer Survivors." Army/Medical Res. Acquisition Activity; "Breast Cancer Prevention and Control in Older Women. " PHS/Nat'l Institute on Aging; "Development of a NeutropeniaSpecific Health-Related QOL Questionnaire." Amgen

Halton, Neal - "The Interdisciplinary MCH Training Program." PHS/Health Resources and Services Admin.

Hinds, William C. - "Industrial Hygiene Training Program. " University of Southern California; "Inhalation and Sampling of Large Particles, 10-150 Âľm." PHS/Nat'l Institute tor Occupational Safety & Health

Kaplan, Celia P. - "A Methodological Multi-Ethnic Study of Smoking Initiation." UC Tobacco -R~lated Disease Research Program

Lewis, Charles E. - "The Development of a System tor Use by Physicians Who See Latino/Hispanic Smokers Consistent with the Ecology of Primary Care tor This Population." Assn. of Schools of Public Health Li, Virginia C. - "Cancer Education Program for Chronic Disease Prevention." PHS!Nat'I Cancer Institute

Morgenstern, Hal- "Chiropractic vs. Medical Care tor Low-Back Pain." PHS/Agency tor Health Care Policy & Res.

Morisky, Donald E.- "Behavioral Research in Support of AIDS Prevention." PHS!Nat'l Institute of Allergy and Infectious Dis. ; "Tuberculosis: Prevention and Adherence Interventions." PHS/Nat'I Center for Nursing Research; "Predoctoral Training Grant tor AIDS Research in Social and Behavioral Sciences." UC Universitywide AIDS Research Program

Sanders-Phillips, Kathy - "Evaluating Diet Interventions in Black & Hispanic Women. " PHS/Nat'I Cancer Institute

Schenker, Nathaniel - "Handling Missing Covariates in Analyses of Cancer Data." PHS/Nat'I Cancer Institute

Scrimshaw, Susan C.M. - "Study of Pregnancy and Pregnancy Outcomes by African-American Women in the United States. " PHS!Centers tor Disease Control

Suffet, Irwin H. - "Taste and Odor Investigations at Water Treatment Plants." McNamee, Porter Seeley, Inc.

Taylor, Jeremy M. - "Statistical Methods in AIDS Research"; "Biostatistics Training tor AIDS Research. " PHS/Nat'l Institute of Allergy and Infectious Dis.

Weiss, Robert - "Diagnostics and Graphics for Random Effects Models." PHS!Nat'l Institute of General Medical Science

Winer, Arthur M. - "Critical Evaluation of a Biogenics Emission System tor Photochemical Grid Modeling in California." Calif. RA EPA Air Resources Board

Yancey, Antronette K. - "Enhancing Health Behavior Adherence in the Underserved. " PHS/Nat'I Cancer Institute

8 FRIENDS

Endowment Established by Roemers To Support Doctoral Work in Health Services

He Lays Down the Gauntlet: Challenges Alumni with Offer to Match New Gifts Lester A. Meis (B.S. '47) doesn't mince words. So when the school's development office received a call from the long-time supporter - a call in which Meis expressed concern with the level of private donations going to the school in light of declining state assistance - the conversation was blunt. "He chastised us for not being more aggressive in soliciting alumni support for the school," recalls John D. Miller, who was appointed director of development last year. "Then he decided to put the carrot in front of the horse." Specifically, Meis offered to donate an add itional $5,000 a year for five years on the condition that the funds be used to encourage new gifts to the Dean's Council, which provides resources for such critical needs as student fellowsh ips , academic program support, research and other priority areas as determined by the dean. So last year, alumni who had not donated in the past received a letter updating them on the goings-on at the school and informing them of the critical need for private support. They were also told of the Meis Challenge: that the founder and technical director of National Bugmobiles, Inc., the largest independently owned pest control company in Texas. had offered to match whatever new donations came in, up to a maxi mum of $5,000 annually. The result: a 35-percent increase in the number of donors and a 16-percent increase in the total amount of support. "We're thrilled ," says Miller, "because when a person donates once, there is a high probability that he or she will donate again for years to come." As the Meis Challenge enters its second year, the man beh ind it remains typically understated about his own role . He appreciates the training he received at UCLA, Meis sh rugs , "so it was just a matter of payback."

For more than half a century, they have arguably formed public health's most productive matrimonial duo . Now, Ors . Milton and Ruth Roemer are establishing a legacy that will help others to follow in their footsteps. The Roemers, two giants in the field who, among other honors, were the first hu sband and wife each to win the American Public He al th Associat ion 's coveted Sedg wi ck Me morial Medal for Di stinguished Service , have established Roemer Health Services Adm inist rat io n Fello wships fo r select ed students admitted to the Dr.PH. program in the school's Department of Health Services. The one-year fello wships (they may be renewed for a second year) will be awarded to students who: • have a professional rathe r than acade mic orientation; •have a goal that is broad rather than specialized; and •are engaged in acquiring generalized knowledge encompassing a mastery of basic tools of social analysis, health and disease in populations, promotion of health and prevention of disease, and health systems and their management, through course work in all five of the school's

INTRODUCING

Drs Ruth and Milton Roemer

departments. "We feel that training students for professio nal se rvice is important," explains Milton Roeme r. "We see a need for more doctorally prepared people in the practice of public health and health administration." Milton Roeme r was influential in bringing medical-care organization under the realm of public health , su ccessfu lly arguing that the government's role exte nded to such areas as health insurance, hospital planning and care for the poor. Most recently he has turned his attention to internationa l com parative studi es of health systems. Ruth Roemer is well known for her research and advocacy on health-law issues ranging from women's reproductive rights and tobaccocontrol legislation to health manpower, AIDS, and national health insurance.

The Dean's Advisory Board

Dr. Abdelmonem A. Afifi

Michael Bobrow

Dean of the UCLA School of Public Health since 1981. .. also a renowned statistician, lecturer, and author of seven books and more than 80 published articles .. currently serves on the Council on Education for Public Health, which accredits all US. schools of public health

Chairman of Bobrow/Thomas and Associates, an architectural firm recognized internationally for its health-care design projects the Bobrow/Thomas and Associates Fellowships provide student support in the school's Department of Health Services.

Andrew Allocco, Jr. (M.P.H. '69)

Former dean and professor emeritus of health services at the UCLA School of Public Health ..initiated the prototype chronic disease program at the California State Department of Public Health. .. his landmark studies demonstrated substantially lower mortality and disability could be achieved by practicing seven specific health habits.. .founding editor of the Annual Review of Public Health .. has authored more than 200 publications.

Senior vice president of provider and association relations for Blue Cross of Califomia ... has served in several executive positions at Blue Cross and Blue Shield since 1974.

Ira Alpert (M.S. '66) President and CEO of the Wilshire Foundation, lnc..chairs the UCLA School of Public Health's Dean's Council, for which he has actively solicited ... pro vided the Wilshire Foundation's Endowment in Geriatric Medicine and Long-Term Care at the school.

Dr. Lester Breslow

Robert J. Drabkin Los Angeles businessman with long-standing interests in health care... has provided much-needed funds for students' overseas field-work opportunities

FELLOWSHIPS ESTABLISHED BY ANNETTE BLANN DEMONSTRATE THE VALUE OF ESTATE GIVING

or most of her life, Annette Blann 's connection with the UCLA School of Public Health was minimal. But before she passed away in 1989, she made a decision that will benefit students at the school for years to come. "Annie felt that many of the social problems that the nation faces are being addressed at schools of public health, that people graduating with a degree in public health would have a good deal to give back to the community," explains Marshall Blann, Annette's brother. So when she became ill, Annette Blann - who earned bachelor's and master's degrees from UCLA in Spanish and went on to become a high school teacher in the Wilmington, Del., school district - established two fellowships each at the UCLA School of Public Health and the UC Berkeley School of Public Health. The Celia G. and Joseph G. Blann

Robert Gillespie President/founder of Population Communication, a nonprofit organization dedicated to world-wide population education and planning .. authored the Statement on Population Stabilization by World Leaders, which has been signed by 69 heads of governmenthas innovated numerous family planning programs abroad.

Robert F. Greaves Recently retired chairman, president and CED of Health Net and Health Systems !nternational... under his leadership, Health Net became the state's secondlargest HMO, growing from 100,000 to more than 1.2 million members.

Terry Hartshorn (M.P.H. '69) President and CEO of UniHealth, one of the nation's largest nonprofit health-care systems ... chairman of the board of PacifiCare Health Systems, lnc... .financial support from Mr and Mrs. Hartshorn enabled the school to open the Student Resource Center, providing an office for the Public Health Students Association, a conference room, and a student lounge.

Annette Blann

Fellowship (after Annette's parents) and the Annette Blann Fellowship were established with funds from Annette Blann 's estate - an option that, once the estate is liquidated, will bring more than $500,000 to the UCLA School of Public Health, providing the corpus for the endowment of the two student fellowships. Notes Director of Development John D. Miller: "Through their estates, many people, like Annette Blann, are able to make a contribution in death that they could not have afforded in life."

Donor's Gift Gives Students Overseas Experiences For their summer field internships last year, four M.P.H. students in the Department of Community Health Sciences harbored lofty dreams - they wanted to go overseas. Thanks in part to a gift from Robert Drabkin , a Los Angeles businessman and active supporter of health interests for many years, those dreams became reality. Drabkin provided partial support that made it possible to send Kendel Leet to the Philippines, Anne McMunn to England, Rena Orenstein to Israel, and Beatriz Solis to Brazil, where each completed fellowships doing health-related work. "It was a wonderful experience ," says Orenstein, who spent the summer at Ben Gurion University, where she developed health materials for Israeli immigrants who had been exposed to the Chernobyl plant explosion. The work had special meaning to Orenstein: Her maternal grandmother had come to the United States many years ago from Chernobyl. Also among the appreciative was McMunn, who was already planning to seek a public health position in London after completing her studies, and was able to gain a preview of the British system through her work for a community health authority. She joined the other students at a December reception , where they told of their experiences and thanked Drabkin personally.

Dr. Stephen W. Kahane (M.P.H. '74, D.Env. '78)

Dr. Dennis Strum (M.P.H. '78, Ph.D. '84)

President of !CF Kaiser lnternational's Federal Programs Group, a publicly traded consulting, engineering and construction firm specializing in the environment, infrastructure, and process industries... has been a visiting lecturer at the school and supporter of the endowment campaign for UCLA's Environmental Science and Engineering Program.

Senior vice president of corporate development for UniHealth ... the recipient of a WK. Kellogg Foundation Fellowship in Health Care Administration .. selected as an Emerging Leader in Health Care by the Health Care Forum and Korn/Ferry International.

Carolbeth Korn (B.S. '59) A founding member of the Dean's Advisory Board and one of the first Dean's Council supporters... serves on the board of the Music Center Foundation ..the Korn Convocation Hall recently opened at UCLA's Anderson Graduate School of Management

Audrey Tibbitts Serves on the board of the California Hospital Center Foundation and the Membership Committee for the Huntington Library .. together with her late husband, Samuel Tibbitts, has been among the school's strongest and most generous supporters.

Lester A. Meis (B.S. '47)

Dr. Fred Wasserman (M.P.H. '72, Dr.P.H. '76)

Founder and technical director of National Bugmobiles, Inc., the largest independently owned pest control company in Texas ... has been a consultant to the Food and Drug Administration and is a specialist in toxicology .. helping to build the Dean's Council through a five-year series of challenge grants for new and upgraded donations.

Co-founder and former CEO of Maxicare Health Plan, Inc, one of the nation's first HMOs ... with his wife, Pamela, endowed the Fred and Pamela Wasserman Chair in Health Services ... during his tenure at Maxicare, the company provided student support by endowing the Maxicare Research Fellows in Health Services Administration.

10 ALUMNI

Health Policy and Management Alumni Association Richard Kiel , Jr. (Pres.), M.P.H. '86 Vice President, Administration Huntington Memorial Hospital

Teri Daly Bartholetti (Pres.-Elect), M.P.H. '87 Senior Regional Director/Managed Care UniHealth

Paul R. Wales (Treasurer), M.P.H. '86 Vice President, Business Development St Joseph's Hospital

Michael R. Galper (Secretary) , M.P.H. '94 Partner, Health Care Services Coopers &Lybrand, L.L.P

Ira R. Alpert, M.S. '66 President Wilshire Foundation, Inc.

Daniel Barzman, M.S. '91 Director, Government Relations CareAmerica Health Plans

Christine Moody, M.P.H. '88 Consultant PrimeCare International

Peter G. Fitzpatrick, M.P.H. 77 Vice President Strategic Healthcare Management

Dan Groszkruger, B.S. '68, M.P.H. 70 Principal Risk Management Service

Jay W. Evans, M.P.H. 7l. Administrative Director, Ambulatory Services Simi Valley Hospital &Health Care Services

Lorna Gazas Laparan, M.P.H. 'In Supervisor, Surveys & Evaluation Services Value Behavioral Health

Bruce N. Davidson , M.P.H. '79, Ph.D. '90 Senior Research Scientist Value Health Sciences

Martin B. Ross, M.P.H. 'fil, Dr. P.H. '79 Managing Director Ward Howell International, Inc.

Rosalind Essner, M.P.H. '88 Consultant Rosalind Essner Consultants

Stuart D. Simon (Immediate Past Pres.), M.P.H. '85 Vice President Health Care Partners Ltd.

CONTR ADICTION : PR IVATE-SECTOR P . H .

Public health in the private sector: an oxymoron? Of course not, as illustrated by the important private-sector work of the following three alumni:

s a senior research scientist at the Santa Monica-based consulting company Value Health Sciences, Dr. Bruce Davidson (Ph.D. '90, M.P.H. '79) makes good use of his expertise iu quality of care assessment, health care outcomes evaluation, and health care decision-making. Recently, Value Health Sciences has focused on partnerships with selected pharmaceutical companies iu the development of disease management programs - automated cliuical decision support systems designed to be used iu the primary care settiug of managed care organizations . The company is currently developiug programs for several chronic conditions, and has begun p ilot-testiug programs for depression and prostate disease . "With the growth of managed care, pharmaceutical companies see these programs as the wave of the future a way to help managed care organizations achieve their goals of maiutaiuiug or improviug quality while reduciug costs," Davidson says. Davidson is part of a multidisciplinary team that includes physicians, epidemiologists, and other health services researchers, as well as computer specialists . His tasks iuclude developiug the programs' patient- and physician-education components and evaluatiug the pilot-testiug process. "It remaius to be seen, from a public health perspective , what impact these typ es of systems will have ," Davidson notes , "because in a few years there will b e several competiug programs available for managed care companies to purchase. How will they evaluate them to choose which one to buy and use? What will the reaction be from their physicians and enro llees? These are unanswered questions." On the other hand, "these products have to have clinical credibility

with health care providers iu order to sell ." And, while Davidson is constantly aware of potential conflicts between his obligations to clients and his own iuterest iu the public's h ealth, he points out the groundbreaking nature of the work and its potential to contribute to more cost-effective care. As an aside, he adds: "It's iuteresting that the private sector is investing heavily iu this type of work, while it looks like public funding is being reduced."

n 1992, Douglas H. Stickney (M.S. '79), co-founder, chairman/president and CEO of Quantum H ealth Resources, Inc. , was named INC Magazine's National Entrepreneur of the Year in the category Emerging Growth Company. The next year, Quantum Health appeared on lists of the hottest and best small companies published by INC, Business Week, Fortune and Forbes. Stickney wouldn't turn 40 until this year. A savvy businessman? Undoubtedly. But for Stickney, a graduate of the school's biostatistics program, it's not just the quarterly numbers that matter. "Profit, compensation, stock options ... those are all out there for everyone to see," he says. "But what makes it fun is knowiug that your customers perceive value iu what you do." Indianapolis-based Quantum Health was founded in 1988 on an idea pioneered by Stickney's father nearly 20 years ago: providiug largescale, mail-order distribution of expensive, difficult-to-access drugs for chronic illnesses. In his father's case, the illness was h e mophilia . The younger Stickney saw potential in expa nding the concept to include other rare genetic and chronic conditions. The result was Quantum Health Resources, which proceeded to grow at a breakneck pace. Stickney offers several reasons for his company's success. Patients with chronic conditions often have a long life expectancy, giviug the company an installed customer base each year.

FORUM: WE ASKED SEVERAL ALUMNI. ..

WHAT ASPECTS OF YOUR SCHOOL OF PUBLIC HEALTH EXPERIENCE HAVE HELPED YOU THE MOST? Sophia Guel-Valenzuela, M.P.H. '94 Analyst, Department of Medicare and State Programs, Kaiser Permanente Member, L.A. County Public Health Commission

I'm part of the sales and marketing department, and we're determining products we can develop that will attract more seniors to our health plan. In that capacity, I draw a lot on what I learned about data analysis - what you can infer from data, the ability to question it and view it critically, knowing how to formulate hypotheses and programs. More broadly, the multidisciplinary background I received has helped me in that I'm not constrained to a certain way of thinking. When we approach a problem, I have a broader outlook. Pamela Yates, M.S. '92, is director of health, safety and environmental worldwide for AlliedSignal Turbochargers, a division of high-tech AlliedSignal Inc., which registered $12 billion in sales last year.

Because Quantum Health is a large purchaser of the drugs, it is able to wield national purchasing power and reduce the cost per unit. The company runs an unusually high level of inventory due to the sophisticated mixing and matching required to ensure appropriate closings; that also lowers the costs to the purchaser by reducing the number of units utilized. "Our understanding of the needs of the small hemophiliac population transferred very nicely to a service model for genetic emphysema, genetic immunodeficiencies, cystic fibrosis, and other rare conditions," Stickney says.

amela Yates (M.S. '92) has spent 10 years at AlliedSignal, Inc., the multinational high-tech company whose aerospace, automotive and engineering businesses registered $12 billion in sales in the last fiscal year. Until recently, she was manager of health, safety and environmental audits . As the head of a multidisciplinary team of experts, Yates (who earned a degree in chemical engineering before compl eting the school's program in environmental health sciences) visited more than 20 AlliedSignal plants around the world each year, spending a week looking at everything from waste generation to employee and product safety.

"Th e idea is to identify areas where we are weak and make improve ments, " Yates explains. Even in nations where environmental laws are loose , AlliedSignal facilities a re expected to live up to a single worldwide standard. "This can make things difficult, particularly when you're dealing with countries where r egulatory systems are non-existent ," sh e notes. Earlier this year, Yates moved from the company's Morristown , N.J . , corporate offices to Los Angeles, where she now serves as director of health, safety and environmental worldwide at AlliedSignal Turbochargers, part of the company's automotive division. In h er new capacity, Yates is responsible for all environmental quality, employee safety and health, and product integrity issues at 11 plants in the U.S. and abroad. "In stead of auditing programs, I'm now managing them," she says. "Before, I would identify problems without being able to use my technical background to help solve them." Indeed, it's th e opportunity to "make things happen" that keeps Yates in the private sector. "I find it very exciting to work in an environment where product is being made," she says . "And h ere, I can go into a plant and have a direct, measurable impact on health and safety."

Doris E. Sarni, M.P.H. '84, M.D. Child-Adolescent Psychiatry Fellow Langley Porter Psychiatric Institute UC San Francisco

I tend to look more at the entire person - the biological , psychological , social , and spiritual facets - so that I'm not just treating a symptom, but looking at the person in an integrated way to determine the root causes. Also , I remember a course in health services in which the emerging managed care era was presented . As a result, I have felt prepared for the tremendous changes that have taken place in recent years . My public health background has made me a more sensitive and aware physician, and also more attuned to the global changes in the health care system. Douglas H. Stickney, M.S. '79 Co-Founder, Chairman/President and CED Quantum Health Resources, Inc. (see the accompanying article)

I was a biology major as an undergraduate; I believe I was the only non-math or statistics major admitted to the UCLA biostatistics program. That meant I was at a competitive disadvantage when it came to statistical theory, but when you began talking applications, I was your guy, because I understood the data - and the program focused more on applications than theory. Nearly half of our funding is governmental, so my public health background helps me in that regard. I'm very much involved in rare genetic conditions, for which the epidemiology has really helped . And obviously, the quantitative background didn't hurt either.

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first met Dr. Frank Massey when I began studying biostatistics. 1 was new to California, working in a fast food restaurant while attending school so that I could pay the out-of-state tuition. When Dr. Massey discovered this , he offered me a job as his research assistant. He taught me the fundamentals of understanding statistical ideas, of applying statistics to research, and ofpursuing excellence. When I began my doctorate study, I was so overcome with fear and feelings of inadequacy that I quit school on the first day. It was Dr. Massey who lovingly encouraged me to return. Needless to say, if it had not been for Dr. Massey I would not have successfully completed my education and developed my career in biostatistics. Dr. Massey has remained my mentor long after I left UCLA. I would often seek his counsel and advice. He always patiently listened and helped me to understand the situations and consider the alternatives. His advice motivated me to pursue my ideals without neglecting practical consideration. Dr. Massey had been teaching me for the past lB years. But he was far more than a mentor; he was my friend. The Chinese have a saying, "He who teaches me for one day becomes my fatherfor life." Dr. Massey was like a second fath er to me . Upon hearing of his passing I feel like an orphan. But I am thankful that God has allowed me to be blessed by Dr. Massey's knowledge and love. Thank you, Dr. Massey. -Mei-Miau Wu (Dr.P.H. '87), Marlton, N.J.

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