The Face of Public Health

face

The

of

public

health

We are thousands of scientists and strategists, mentors and leaders, entrepreneurs and policymakers, teachers and innovators. Together and individually, we are shaping the future of public health.

As a nutritionist and registered nurse, Stacy Goldberg recognizes that healthy food can literally change people’s lives.

But how do you change people’s eating habits?

In her capacity as president and CEO of Henry Ford Wyandotte Hospital, Denise Brooks-Williams sees daily proof that a public health perspective can make the difference in the treatment patients receive. Is it possible to excel at this task and also attend to the individual needs of every single patient?

Taesung Park and Seungyeoun Lee wanted to use their talents in statistical analysis to help solve real-life medical questions.

Was there a way to translate data into real-world situations?

Growing up in Battle Creek, Michigan, Ebbin Dotson noticed that the hospital in his African-American neighborhood had such a bad reputation that people actively avoided going there. Is there some way to improve hospitals in low-income neighborhoods without just throwing money at the problem?

In her work with vulnerable communities, America Bracho sees individuals and families affected over and over again by the same preventable medical conditions. She knows the built-in inequity of the system is too big and too difficult to change—or is it?

Justin Cohen and Sharon Greene wanted to design tools to help health providers on the ground prevent or eradicate outbreaks of infectious disease. But how do you use a relatively small amount of money to protect a large population?

As Deputy Assistant Secretary of Health (Science and Medicine) with the U.S. Department of Health and Human Services, Anand Parekh knows we need bold, systems-wide changes in order to lower medical costs and improve patient outcomes.

So how do we get from here to there?

A new era in public health.

T

he 20th century was marked by two transformative advances

in human health: a dramatic increase in longevity, with the majority of those years due to innovations in public health, and a subsequent shift in emphasis from the prevention and cure of life-threatening disease to the management of chronic disorders. Together, these advances have launched a new age in public health.

In the next decade, the School of Public Health will tackle some of the world’s most urgent, complex, and intractable health problems—chief among them widespread childhood obesity, escalating health care costs, unequal access to health resources, emerging infectious diseases, and the need for a new economy in public health. We confront these challenges confident that our expertise is strong and our ability to make an impact is great—as the stories on these pages demonstrate.

As we embark on the campaign for Michigan, we hope you will join us in forging a new and better world for all of us. Our focus is on three key initiatives, each one vital to solving the pressing public health issues of the 21st century:

• Guaranteeing an affordable education • Deepening the student experience • Serving the public good

V i c t o r s

f o r

P u b l i c

H e a l t h

1915

U-M grants its first MS degrees in public health; the first doctor of public health degrees follow in 1916, and the first BS in public health nursing degrees in 1918.

1881

Victor Clarence Vaughan, later known for his work with yellow fever during the building of the Panama Canal, begins teaching sanitary science at the University of Michigan.

1939

U-M’s Nathan Sinai develops a voluntary health insurance plan with the Michigan State Medical Society, which later becomes a prototype for Blue Shield.

The Entrepreneurs.

After getting her MPH in 1999, Stacy Goldberg worked as a nurse and nutrition consultant, but she encountered too many people who did not have access to healthy food—or if they did,

“I saw how

powerful

education is.”

Stacy Goldberg RN, MPH ’99

they didn’t want to eat it. It took Goldberg almost two decades to figure out this conundrum. Now, through her for-profit venture, Savorfull, she is able to introduce thousands of people to the wonders of healthy snacks, nuts, seeds, energy bars, cereals, beverages, and other foods. Launched in 2012, Savorfull consults with businesses and helps them make nutritious food available at the workplace in cafeterias and even vending machines. The secret to her success?

“All our food tastes good,” she says. One of Goldberg’s largest clients is the Quicken Loans

Family of Companies, which has two kitchens in every building and provides free snacks every day, on-site, to its 10,000 team members in Detroit.

According to Corporate Wellness Magazine, every dollar invested in employee wellness programs yields roughly four dollars in savings through reduced sick days, higher productivity, and decreased overall health costs. Goldberg and her business are about to go global. “I’m getting inquiries from around the world, and here in the U.S. there’s still a huge unmet need—people in the Army, charter schools, jails.

I’ve just hired my first director of sales. Everybody deserves healthy food, and everybody deserves to be healthy.”

1941

After 50 years of the teaching of disease prevention and health promotion at the university, U-M regents establish a School of Public Health.

1944

The National Sanitation Foundation is founded at SPH and later becomes NSF International, an independent nonprofit organization that certifies products and develops global standards for food, water, air, and consumer goods.

1945

SPH researchers contribute to groundbreaking water fluoridation studies in Grand Rapids.

The Leaders.

As president and CEO of Henry Ford Wyandotte Hospital, Denise Brooks-Williams knows she is not just running a multimillion-dollar business—she is also shaping a business culture that has a direct impact on how medical care is provided at some of the most critical points in a patient’s life. One of Modern Healthcare’s Top 25 Minority Executives in Healthcare, Brooks-Williams believes it’s critical to incorporate a public health perspective into the relationships between clinicians and their patients.

“We need to understand the whole patient—their cultural background, religion, diet,

thoughts about life and death,” she explains. For example, doctors have for years counseled African-American patients about the risks of certain foods, without acknowledging that some foods are a traditional part of their diet. Doctors and patients must work together to find solutions that fit each patient’s lifestyle, Brooks-Williams says.

As an African American, she has witnessed the heavy toll that health care disparities take on her community, and she says she wants “to narrow that gap

“We need to understand the

whole patient.”

Denise Brooks-Williams MHSA ’91

1955

Professor Thomas Francis Jr. concludes the two-year national field trials of the Salk polio vaccine, and on April 12 announces to the world that the vaccine developed by his former student Jonas Salk is “safe, effective, and potent.”

1956

for low-income people and people of color.” Although she originally wanted to be a doctor, Brooks-Williams learned about the field of public health while taking part in the U-M SPH Summer Enrichment Program. “Leaders with a public health background,” she says, “are more likely than others to think more broadly about how to improve the entire care experience for patients.”

SPH and U-M faculty launch one of the most important public health studies in the world, the landmark Tecumseh (Michigan) Community Health Study, which transforms our understanding of chronic disease and how to prevent it.

1961

Professor S.J. “Sy” Axelrod expands the SPH program in Medical Care Organization, which soon takes on a central role in educating administrators for the Social Security Administration, established by Congress in 1965.

The Scientists.

Taesung Park and Seungyeoun Lee came to U-M SPH to study biostatistics

in 1986. Recently married, they shared a

Taesung Park PhD ’90

desire to help solve real-life medical problems.

Both received their PhDs in 1990. Today

Seungyeoun Lee PhD ’90

“Good statistical

widely considered Korea’s leading scientist

design

can change

the real practice of clinicians.”

in statistical genetics, Park heads up the Creative Research Initiative Laboratory of Bioinformatics and Biostatistics at Seoul National University—the largest laboratory in statistics in Korea. Lee is a full professor at Sejong University who devotes much of her time and energy to recruiting students to enter the field of biostatistics.

Park and Lee are both driven by the knowledge that their work can help save lives—not just one at a time, as in medicine, but by providing data analysis that can improve health outcomes for millions. Park’s research underpins life-saving studies at the Korean Food and Drug Administration and International Vaccine Institute, and he collaborates with SPH Professor Michael Boehnke on research aimed at identifying the genetic foundations of type 2 diabetes—work that has the potential to lead to important new methods of treatment and prevention. As Park puts it, “Good statistical design can change the real practice of clinicians.”

Professionally and personally, both Park and Lee are indebted to U-M SPH. “I know the school is very famous,” Lee says, “but what I will always remember is that the people are very, very kind.”

1972

Professor Marshall H. Becker pioneers the study of how patients’ beliefs affect medical outcomes—work that continues to shape our efforts to prevent HIV/AIDS and other deadly diseases, and to promote healthier, longer lives.

 1985

Congressional testimony by Professor Kenneth Warner helps solidify federal taxation as a smoking disincentive.

1992

With funding from the W.K. Kellogg Foundation, SPH establishes a program in community-based public health (CBPH); SPH becomes a national leader in CBPH, which fosters the creation and principles of equal partnerships between community-based organizations, academic institutions, and health agencies to address community health challenges.

The Mentors.

As an administrator and researcher at Chicago’s Malcolm X College, Ebbin Dotson’s goal is to help African-Americans and others secure jobs in the health care professions through a federally-funded research program called “Health Professions Pathways.” The program provides step-by-step goals that lead to success—something that has eluded many students.

“In this job I see many people like the people I grew up with,” says Dotson, a Battle Creek native. “Maybe they’ve had a few failures, made some bad choices.

For much of our student population, coming to school here seems like their last opportunity. But the minute they walk in our door, we believe in them.”

Graduates of Malcolm X have a high placement rate in the health care sector, which Dotson says is critical if we’re to address the widespread disparities that lead people of color and the poor to experience lower health status in the U.S. “A diverse field like health care needs professionals from diverse

“The minute they walk

in our door,

we believe in them.”

backgrounds,” he explains. “When our students get jobs and start attending classes in their hospital uniforms, the other students realize this isn’t just an exercise. This is real, and it’s going to happen for them, too.”

Ebbin Dotson PhD, MHSA ‘01

1993

Professor Arnold Monto conducts a major study of the effectiveness of influenza vaccine in the elderly, findings from which help convince Medicare policymakers to make flu vaccine a covered benefit.

1995

Professor Victor Strecher founds the U-M Center for Health Communications Research, a multidisciplinary initiative aimed at creating and implementing more effective health interventions by integrating behavioral science, technology, and art. Three years later, Strecher founds HealthMedia, now a Johnson & Johnson company.

2003

In the wake of the Human Genome Project, researchers in the U-M Center for Statistical Genetics develop revolutionary new tools and techniques for identifying and cataloging genetic variants associated with such diseases as diabetes, heart disease, age-related macular degeneration, schizophrenia, and bipolar disorder—work that will underpin the development of personalized medicine.

The Innovators.

After getting her MPH in 1988, America Bracho hoped to return to her native Venezuela, where, as a young physician, she’d been impressed by the impact of community health workers in addressing the medical needs of the rural poor.

But there were no jobs in Venezuela. So Bracho

“Good health comes through

empowerment.”

America Bracho MD, MPH ’88

made her way to Detroit, where she created the first program on AIDS for the Latino community, and eventually moved to California. She is now a U.S. citizen—and the founder and executive director of Latino Health Access, a center for health promotion and disease prevention in Santa Ana, which consistently appears at the top of lists of the nation’s most difficult cities in terms of crime,

unemployment, economic conditions, and quality of life. Santa Ana’s population is roughly 70 percent Latino.

Latino Health Access has a total of 75 employees, and 45 of them are promotores— full-time, trained, paid health workers who live in the community, build trust, and recruit their neighbors into programs to address diabetes, domestic violence, and other threats to health. “We are building a new paradigm where people teach their neighbors how to be well,” Bracho explains. “The local leaders of any city need to understand—they cannot prosper unless everybody is prospering. Good health comes through empowerment, and we give people ways to participate in making their life, their neighborhood, and their world better.”

2003

The U.S. Food and Drug Administration approves FluMist, developed at SPH

by Professor Hunein “John” Maassab. The world’s only nasal-spray flu vaccine, FluMist is shown to be more effective at protecting children than injections.

2004

Research by Professor Robert Wolfe leads to a new and nonbiased system for determining matches between kidney donors and transplant candidates.

2005

SPH launches the U-M Center for Managing Chronic Disease, which helps people and communities around the world control the pain, discomfort, disruption, and costs of chronic conditions like asthma, diabetes, heart disease, and Alzheimer’s.

The Strategists.

“I didn’t want to do just scientific research—I wanted to save lives,” says Sharon Greene. As director of data analysis for the Bureau of Communicable Disease in New York City, Greene helps design automatic screening methods to monitor reports of more than 70 diseases and triages any epidemics-in-the-making. It’s a big job, but happily Greene has an expert with whom she regularly discusses her work—her

save lives.”

“I wanted to

husband, Justin Cohen. The two met during their epidemiology class with SPH Professor Mark Wilson, who later acted as their thesis advisor and officiated at their wedding.

Cohen spent six years as an epidemiologist at the Clinton Health Access Initiative, a foun-

Sharon Greene MPH ’02, PhD ’05

dation started by former President Bill Clinton,

Justin Cohen MPH ’04, PhD ’07

malaria programs. Cohen and his team work

before becoming director of the initiative’s global around the world to help governments make

strategic and objective decisions about how best to use their scarce resources to combat malaria—a disease that kills over a million children annually in subSaharan Africa alone. “This illness is highly interconnected with poverty,” Cohen explains. “We’ve got bed nets that cost pennies and highly effective drugs that cost even less. It won’t be easy, but we can wipe out this disease in a few decades if we keep making the investment.” Both at home and abroad, independently and in partnership with one another, Cohen and Greene are realizing their dreams—and more importantly, helping countless others to realize theirs.

2010

Comprehensive health care reform is enacted, incorporating research from the U-M– based Center for Value-Based Insurance Design (V-BID) that provides the conceptual foundation and data to allow health plans nationwide to remove barriers for high-value preventive diagnostic and therapeutic medical services.

2011

The U.S. Centers for Medicare & Medicaid Services implement a new dialysis-payment system developed by the U-M Kidney Epidemiology and Cost Center (KECC), which leads to a reduction of approximately $225 million per year in Medicare payments for dialysis.

Now

SPH graduates hold leadership positions in governmental public health, health care systems, and private-sector companies in every state in the United States and in 85 countries around the world.

The Policymakers.

Many patients with serious chronic disease don’t have just one medical condition.

Patients with two or more are often shuffled back and forth between specialists, with little—if any—coordination of care. This can be expensive and inefficient, and it raises the risk of mistakes.

In his eight years with the U.S. Department of Health and Human Services, Anand Parekh has sought to address this issue. “We are actively trying to change the paradigm in this country of how chronic diseases are approached—moving from a siloed focus on individual conditions to a multiple chronic conditions approach,” he explains. The result? Improved care coordination, more widespread diffusion of selfmanagement programs, an expansion of provider tools, and greater scientific knowledge in caring for

“We are actively trying to

change the paradigm.”

Anand Parekh MD, MPH ’02

people with multiple chronic conditions.

While at U-M, Parekh studied across an array of disciplines—political science, public health, and medicine. Thanks to this training, he is able to push for and enable the kind of systems-level changes he envisioned as a student. “We need to integrate health care, social services, and public health if we want to improve outcomes and reduce health care costs in this country,” he says. In addition to systematizing the way clinicians treat patients

with multiple chronic illnesses, Parek is committed to tackling the leading causes of chronic diseases and health care costs in this country—obesity and tobacco use.

T

he great challenges before us—the challenges of the 21st century— are to protect health, prevent and manage disease, and deliver effective health care, economically and at scale. Meeting these challenges will require far-reaching change, bold leadership, and fresh approaches to collaboration—hallmarks of the University of Michigan School of Public Health. But we cannot do this alone. It will take all of us to move the world forward. Because, after all, this is our world, and what becomes of it is up to all of us. Be a victor for Michigan.

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