Fall 2005 - For the Health of California - Public Health

FALL

2005

Public HealthUniversity of California, Berkeley

p.15 Informing Consumers and Policy Makers

p. 24 The School Responds to Hurricane Katrina

For the Health of California

International Hero: Jeffrey Sachs, Ph.D., director of the Earth Instituteat Columbia University, for his work on the UnitedNations Millennium Project, a multinational plan tohalve global poverty and hunger by the year 2015.

Save the Date10th Annual Public Health Heroes Awards Ceremony

Friday, March 17, 2006The Exploratorium, San Francisco

The annual tradition of

honoring public health

heroes was initiated in

1995 by the School of

Public Health’s Policy

Advisory Council. This

honor acknowledges

individuals and organiza-

tions for their significant

contributions and excep-

tional commitment to

promoting and protecting

the health of the human

population, and through

this public recognition,

broadens awareness and

understanding of the

public health field.

For more information:

http://www.publichealthheroes.org

(510) 643-6382

Regional Hero: Robert Scott, M.D., for his service and deliveryof care to communities of color in the East Bay,especially his work in HIV/AIDS treatment and advocacy.

Organizational Hero: The San Francisco Free Clinic, for its work providing health care services to uninsured patientswho do not qualify for federal or state aid.

2006 Honorees

National Hero: Norman McSwain, M.D., chief of trauma surgeryat Charity Hospital in New Orleans and professorat Tulane Medical School, on behalf of all theunsung heroes of the Hurricane Katrina disaster.

1Public Health

FeaturesBuilding the Public Health Workforce 4by Michael S. Broder

With California facing a critical shortage of public health workers now and in the future,the School of Public Health is cultivating the next generation of health professionals.

Improving Life for Children 7by Kelly Mills

Asthma, obesity, violence, and child-unfriendly physical environments are among the threats to children’s health that the School is working to overcome.

Meeting the Needs of Older Californians 10by Michael S. Broder

A statewide network of senior leaders works to enhance the quality of life for California’s elders,while medical students learn how to provide quality care for older patients.

Serving California’s Diverse Population 12by Kelly Mills

Researchers and students at the School develop strategies to convey health messages to different cultural groups and look for the causes of vast disparities in health status among California’s many racial and ethnic populations.

Informing Consumers and Policy Makers 15by Vivian Auslander

Faculty at the School of Public Health offer practical advice for consumers and reasoned analysis for policy makers on a range of health issues that impact the future of Californians.

Preparing for Disaster 19by Kelly Mills

The UC Berkeley Center for Disease Preparedness prepares students and public health practitioners to respond to natural disasters, major disease epidemics, and acts of bioterrorism.

DepartmentsDean’s Message 2

Past, Present, Future 22

Faculty News 27

Partners in Public Health 34

Alumni News 37In Memoriam 43

Public HealthUniversity of California, Berkeley

DeanStephen M. Shortell, Ph.D., M.P.H.

Assistant Dean, External Relations and DevelopmentPatricia W. Hosel, M.P.A.

EditorMichael S. Broder

Associate EditorKelly Mills

DesignArcher Design, Inc.

ContributorsVivian Auslander, Michael S. Broder, Kelly Mills,and Sarah Yang.

PhotographyIstockphoto, cover & p. 24; Getty Images, cover & p. 4; Peg Skorpinski, pp. 2, 13, 22–23, 25–26,27–33 (head shots), 35, & 37; Kelly Mills, p. 6;Jupiter Images, p.7; courtesy of Oakland Kicks Asthma, p. 8; Patricia W. Hosel, p. 10; Pam Riby,

p. 12; Ellen Davidson, p. 15; Corbis, p. 17; Dale A.Ogar, p. 18; Michael S. Broder, p. 34; and AnitaSmiley, back cover.

Communications Advisory BoardW. Thomas Boyce, Patricia A. Buffler, MargaretCary, Helen A. Halpin, Meredith Minkler, LindaNeuhauser, Lee Riley, Stephen M. Shortell, RobertSpear, and S. Leonard Syme.

UC Berkeley Public Health is published semi-annually in the spring and fall by the University

of California, Berkeley, School of Public Health,for alumni and friends of the School.

UC Berkeley School of Public HealthOffice of External Relations and Development140 Earl Warren Hall #7360Berkeley, CA 94720-7360(510) 642-9572

© 2005, Regents of the University of California. Reproduction in whole or part requires written permission.

p. 10

p. 17

p. 25

2 University of California, Berkeley

All the leaves are brown

And the sky is gray

I’ve been for a walk

On a winter’s day

If I didn’t tell her

I could leave today

California dreamin’

On such a winter’s day*

These lyrics from the popular 1960s folk song “California Dreamin’” by the Mamas and the Papas evokethe aspirations of many Americans who moved to California over the past century. From the gold rushdays of the 1850s to the growth of the entertainment industry in the 1950s to the Silicon Valley biotechand infotech innovations of the 1990s, California has been the both the beacon and the icon for “dream-ers.” These people have not just wanted a better life for themselves but have been driven to createsomething new, different, and better for others as well. They represent the spirit of California.

Our ability to realize our dreams depends in large part on our health. Our health is determined not onlyour individual biology and behavior, but also by our collective interactions with each other and with ourenvironment. Public health is the only field that embraces this broad understanding of the determinantsof health. “Root cause” public health addresses and promotes the conditions “….in which people canbe healthy” (Institute of Medicine, 1988).

Leadership in the Face of ChallengeAs described in the pages that follow, the UC Berkeley School of Public Health continues to provide inno-vative leadership in addressing issues facing all Californians, from our preparedness for natural disasters,infectious disease, and bioterrorism, to the growing epidemic of obesity among children and adults, toworking to eliminate the disparities in health that exist by race, ethnicity, and socioeconomic status.

But the challenges we face are quite daunting.While on many health indicators California does reasonablywell, we lag far behind in others. For example, we are twenty-fifth among all states in heart disease deathsper 100,000 population and thirty-first in limited activity days reported within the last 30 days. A high per-centage of our population is without health insurance coverage. For example, 36 percent of Californiansunder the age of 65 were uninsured for at least part of the past two years, representing 11 million people.Reflecting disparities, more than half of California’s Hispanic population and 39 percent of CalifornianAfrican Americans were without health insurance coverage for at least part of the past two years.

On a scale of 1 to 10 in which 1 represents the least degree of preparedness and 10 the highest degreeof preparedness for infectious disease or natural disaster, California had a score of 5 out of 10; actually a drop from 7 out of 10 in 2003 (Trust for America’s Health, 2005).

On the obesity front, 22 percent of California adults are obese and 59 percent are overweight orobese—similar to the national average. Further, nearly 18 out of 100 low-income children ages 2 to5 are overweight—the second worst rate in the country. We are not even able to produce the datafor high school students.

From the Dean

Dean Stephen M. Shortell

Fulfilling the California Dream

“Forty-five percent of the state’spublic health workforce is eligibleto retire within the next five years—among the highest percent in thenation.”

*By John Philips/Michelle Gilliam ©1965 Trousdale Music Publishers, Inc. (ASCAP)

3Public Health

We could meet these problems with confidence if we had adequate numbers of trained public healthprofessionals, up-to-date facilities, and modern communication and disease surveillance systems. Butthis is largely not the case. A recent report on the health professions developed by the UC Office ofthe President documented a serious shortage of trained public health professionals in California withonly about 20 percent of currently practicing public health professionals having received any formaltraining—similar to national estimates. Further, 45 percent of the state’s public health workforce iseligible to retire within the next five years—among the highest percent in the nation. We do noteven have enough scientists to test for anthrax or plague (Trust for America’s Health, 2005). Toaddress these issues, the Office of the President report called for a minimal 25 percent increase in the training of public health graduates between 2005 and 2010 and an additional 25 percentincrease between 2010 and 2015 with associated increases in faculty and facilities. The report alsonotes the woefully outmoded and inadequate facilities at both Berkeley and UCLA.

Speaking about the University at large, UC President Robert C. Dynes recently made the statementthat “if the University of California becomes just another university, then California becomes justanother state.” As the data above indicate, in many respects, California has already become justanother state. Without concerted remedial attention, the threats to our health will slowly underminethe long term economic growth, productivity, and quality of life of all Californians, effectively killingthe “California dream.”

To remedy the situation we must invest in our state’s schools of public health and other healthprofessions; we must invest in the public health infrastructure throughout the state; we must findcreative ways of insuring that all Californians have financial access to at least a basic set of healthservices; we must find ways of working with our schools and communities to promote healthy eatingand physical activity; and, perhaps, most importantly of all, we must work to eliminate the growingdisparities that exist in access to health services, the quality of health services received, and healthstatus by ethnicity, race, and socioeconomic status.

There are many encouraging signs. State government has recently taken the lead by sponsoring theGovernor’s Summit on Obesity and signing legislation to set nutrition standards for foods served andsold in schools.

We have also enjoyed tremendous success in lowering the rate of smokers. Building on these suc-cesses, our state government leaders can work with the private sector to address other serioushealth issues facing the state. Creative public-private partnerships stimulated by the state’s innova-tive health foundations are also beginning to demonstrate positive effects. As the School of PublicHealth at the world’s leading public university, we look forward to working with all partners so thateveryone in California can continue to enjoy the good health needed to pursue their dreams.

Stephen M. Shortell, Ph.D., M.P.H.Dean, School of Public HealthBlue Cross of California Distinguished Professor of Health Policy & ManagementProfessor of Organization Behavior

A History of “Firsts”

Over the past 63 years our School of PublicHealth at Berkeley—the first school of public health west of the Mississippi—hasworked to create the conditions under whichall Californians can live healthy, productivelives. Among many other contributions, theSchool:

• Developed the first vaccine for coccidioidomycosis;

• Completed the first sequencing of the chlamydia trachomatis genome;

• Established the first longitudinal cohort study of low-income Latino families to track the relationship between the envi-ronment in an agricultural community (the Salinas Valley) and children’s health;

• Identified the genetic factors that predis-pose people to multiple sclerosis, as well as lupus and rheumatoid arthritis; and

• Pioneered the field of social epidemiology,identifying social and environmental factors associated with heart disease.

4 University of California, Berkeley4

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The state’s public health workforce isalready insufficient to meet currentneeds, and, based on demographictrends, the demands are certain toincrease. California’s population is grow-ing faster than that of any other state inthe nation, and the proportion of olderadults is also increasing. According tothe California Department of Aging,California comprised 12 percent of thenation’s population in 1990 and isexpected to have 14 percent of thenation’s population by 2020 (an increaseof 15.7 million people). The state’s eld-erly population is expected to grow morethan twice as fast as the total population.

Building the Public Health WorkforceBy Michael S Broder

California depends on public health professionals working

in a broad spectrum of occupations that protect and pro-

mote human health—from safeguarding our air, food, and

water, to managing the delivery of our health care, to

preparing for disasters. The public health workforce

comprises clinicians, environmental health specialists,

nutritionists, health economists, hospital administrators,

epidemiologists, biostatisticians, health educators, policy

experts, and many others, working in both the public and

private sectors.

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“We have an aging population that’sgoing to demand more public healthservices going forward, and we have anaging public health workforce,” saysJeffrey Oxendine, M.B.A., M.P.H., asso-ciate dean for public health practice. “Ifwe’re going to have leaders and profes-sionals in the future who are going to beable to take care of us, we’re going toneed to really focus on building the nextgeneration of health care professionals.”

At the same time, the population isbecoming more culturally diverse; projections indicate that by 2025,Hispanic Americans will constitute thelargest ethnic group in the state. Morethan ever, the public health workforcewill require the skills of professionalsfrom diverse backgrounds who are cul-turally competent. In addition, newpublic health challenges, such as theemergence of new diseases and disasters,and the persistence of existing chal-lenges, such as chronic illnesses, will taxthe public health infrastructure even fur-ther. To meet these challenges head-on,the School is cultivating future publichealth leaders who come to the work-force with practical experience.

Master’s Students Gain Hands-onExperienceThe School’s Center for Public HealthPractice prepares master of public health(M.P.H.) students for the workforce bymatching them with practical opportu-nities that make a difference in the com-munity. The center places more than100 students in internships each year, inhealth departments, community-basedorganizations, health care systems, andother public health organizations. SaysOxendine, “Our School has producedmany of the leaders in public health inCalifornia, and we’re working on mak-ing sure that in addition to theirstrong, world-class academic training,they’re getting the best possible practi-cal experience.”

The center also facilitates students’ entryinto the public health workforce throughprofessional development activities suchas the popular “What Can You Do witha Public Health Degree?” series, a 15-ses-sion program which brings in leaders toaddress key issues and discuss howpublic health graduates can becomeinvolved. Individual sessions havefocused on obesity, HIV/AIDS, sub-stance abuse, and, in the fall of 2005,Hurricane Katrina. Another professionalworkshop series, PH291, presents mod-ules on management, communicationsand advocacy; planning and strategy;and personal and project management.

A Diverse Workforce for a MulticulturalPopulation“Our population is becoming more mul-ticultural in California, as we know,” saysOxendine, “so it’s natural that we wantand need more people from populationsof color to meet our workforce needs, justlooking at sheer numbers. At the sametime, they will be more knowledgeableabout how to design and deliver servicesto the populations they represent.”

Through a series of collaborative pro-grams, the center is exposing youngpeople from underrepresented back-grounds to the professional opportunitiesafforded by public health professions. TheHealth Professions Partnership Initiative,led by the School’s Health Research forAction Center (formerly Center forCommunity Wellness), enhances oppor-tunities for middle and high school stu-dents, while the FACES for the Futureprogram at Children’s Hospital and

Research Center of Oakland provides acomprehensive high school program.Another initiative, Health CareerConnection, provides exposure, experience, and mentoring to collegestudents, including Berkeley publichealth undergraduates. All three pro-grams share the goal of inspiring andattracting a diverse group of studentsinto the health professions.

Oxendine also estimates that at least onequarter of the center’s internship place-ments are in organizations or communi-ties where the students focus on address-ing health inequities. “We have a particu-lar focus on finding internship opportuni-ties that contribute to health inequityreduction—for example, working withcultural or linguistic competency issues tohelp organizations deliver quality pro-grams and services that are sensitive to thecultural dynamics of their population.”

Doctoral Program Develops Leaders The School’s Dr.P.H. (doctor of publichealth) Leadership Program aims to cre-ate public health leaders by providingacademic research skills and practicalleadership training and experiences inthe public health community. Studentsworking toward their Dr.P.H. focus onthe development of knowledge and skillsin the areas of research, professionalleadership, administration, and theapplication of state-of-the-art approachesto public health problems. Graduates areprepared to occupy positions in whichthey will have major influence on thepolicies, programs, and institutions ofpublic health.

“We have a particular focus on finding internship opportunities thatcontribute to health inequity—for example, working with cultural orlinguistic competency issues to help organizations deliver quality pro-grams and services that are sensitive to the cultural dynamics of theirpopulation.”


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“UC Berkeley students have made profound contributionsto the programs and services that the public health depart-ment offers to Alameda County residents. The students’ diverseskill sets, interests, and personal backgrounds serve as invalu-able tools as they address a wide range of critical health issuesaffecting the entire Bay Area.”

—Arnold Perkins

Director, Alameda County Department of Public Health

Collaboration with Communities Is Key“The Dr.P.H. program in the School isunique in being a true interdisciplinaryprogram and one that puts a heavy accenton collaboration with communities,” saysMeredith Minkler, Dr.P.H., professor ofhealth and social behavior and director ofthe Dr.P.H. program. Grants from theWK Kellogg Foundation and TheCalifornia Endowment were instrumentalin transforming the program and facilitat-ing its emphasis on community partner-ships and diversity.

Both the School and the participatingorganizations benefit from the Dr.P.H.program’s community-academic partner-ships. For example, all Dr.P.H. studentsundertake a summer residency in whichthey make tangible contributions to thelocal organization or community, and atthe same time learn about community-based public health leadership. A net-work of Dr.P.H. alumni and profession-als who serve as community mentorshelps foster this exchange.

In addition to working on individualresearch dissertations, the students ineach class participate in a year-long“Dr.P.H. in Action” seminar—now in itsthird year—in which they choose a proj-ect of major concern to a local heathdepartment or a community-based

organization or other entity to tacklecollectively with their research and pro-fessional problem-solving skills.

The first year, the class chose as itsproject an impending syphilis epidemicin Berkeley. “They met with healthdepartment people, community mem-bers, and other stakeholders, and cameup with a white paper, from whichsome recommendations have subse-quently been put into practice by thehealth department,” says Minkler.

The second year, students worked withPromotoras, a network of lay health

workers in California, and created a com-pilation of resources and a web site tosupport health promotion programs inCalifornia. This year’s class, inspired bythe lessons of Hurricane Katrina, is work-ing on community readiness and disasterpreparedness in Alameda County.

Solid Academic ProgramPractical experience is one part of a stu-dent’s training at the School of PublicHealth; the School also offers a strongacademic program. In addition to its pro-fessional degree programs—the M.P.H.and Dr.P.H. programs—the School offersacademic degree programs leading to themaster of arts (M.A.), master of science(M.S.), or doctor of philosophy (Ph.D.)degrees in several different areas of study.The School also offers joint degreeoptions with other Berkeley departmentsand other institutions.

“The intellectual resources of Berkeleyenable us to pursue a truly interdiscipli-nary approach to public health,” saysDean Stephen Shortell, Ph.D., M.P.H.“The School’s broad curriculum providesstudents with an understanding of epi-demiology, biostatistics, environmentalhealth, health behavior, health policy andmanagement, and the means with whichthis knowledge can address pressinghealth problems locally, nationally, andinternationally.”

Building the Public Health Workforce, continued

In fall 2003, the School’s “Dr.P.H. in Action” classundertook a collective semester-long project toassist the City of Berkeley Public Health Division.Students worked with community partners todevelop recommendations to address an impend-ing syphilis outbreak.

Healthy LifestylesIn the modern urban neighborhood, mostchildren do not walk or bicycle to school.Many areas are bereft of parks or safe placesfor children to engage in physical activities.This contributes to a sedentary lifestyle and arise in obesity. “We have engineered activityout of children’s lives,” explains Jackson, who

has devoted much of his career to identifyingand addressing environmental factors thatendanger the health of children. (See newfaculty profile, page 32.)

Jackson’s research focuses on the built envi-ronment, and how urban planning can affectthe health of children. He notes that many

children live in environments that lack ade-quate sidewalks, bike paths, and police pro-tection, which contributes to a lack of physi-cal activity. Modern schools are built on lessexpensive land far from the neighborhoodsthey serve, which discourages children fromwalking to school. As part of his research andadvocacy, Jackson works with city planners

7Public Health

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Improving Life for Children

“Some people say children are our most important resource. Children are not this nation’sresource; they are not iron ore or agricultural land,” says Richard Jackson, M.D., M.P.H. ’79,adjunct professor in the School of Public Health. “Children have value intrinsic to the gift thatthey are, and not because they are our resource.” Jackson is one of many researchers at theSchool using innovative and proactive approaches towards protecting children’s health.Children are especially vulnerable to health threats, and the alarming rise in asthma, obesity,and other health problems makes it clear that California must take strong steps towardsimproving the health of our children.

By Kelly Mills


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and transportation authorities to developneighborhood designs that enable children towalk, bicycle, and play outdoors.

Agricultural Toxins and ChildrenResearchers for the Center for HealthAssessment of Mothers and Children ofSalinas (CHAMACOS) are also investigatingthe effects of environment on children’shealth, specifically the impact of pesticides,toxins, and allergens on child developmentand respiratory disease, including asthma.The multifaceted project is the only longitudi-nal birth cohort study to focus on children inan agricultural area. The studies, which beganin 1999 with 600 pregnant women in theSalinas area, have resulted in a number ofadvances for children’s health, includingmore efficient methods for measuring pesti-cide exposure and effects. The project hasserved as a model for the upcoming NationalChildren’s Study, which aims to study100,000 U.S. children from birth to age 20, toproduce comprehensive data on the influenceof the environment on children’s health.

CHAMACOS has combined research on expo-sure and risk with pragmatic measuresdesigned to reduce children’s contacts withharmful pesticides by working with their par-ents. For one study, investigators providedstrawberry workers with coveralls and gloves,and gave them warm water to wash theirhands. “We wanted to try and intervene atthe field, to prevent farmworkers from takingpesticides into the home on their clothingand hands,” states Asa Bradman, Ph.D.’97, associate director of CHAMACOS.

Combating AsthmaOakland Kicks Asthma takes a similarly aggres-sive approach towards combating asthmaaggravation and complications in children. Theprogram, led by principal investigator IraTager, M.D., M.P.H., professor of epidemi-ology, identifies children in Oakland middle andhigh schools with asthma, and then provideseducation and resources to school personnel,health care providers, families of the children

with asthma, and the children themselves.Oakland has the highest rate of hospitaliza-tions due to asthma in the state, and one ofthe highest in the country. Screening children inschools enables researchers to identify studentswho have not received diagnosis or adequatetreatment for the condition, or are otherwisenot well-managed. Researchers also hired anasthma nurse for the Oakland schools, whopassed one of the most comprehensive schoolasthma policies in the country, designed toinstitutionalize some aspects of the programand ensure continued treatment and resourcesfor affected children.

Many of the children in the program are fromlow-income and single-parent families, wherethe parent may not have the time to attendan asthma management education class atthe local hospital. “This is a very proactiveprogram,” says Adam Davis, M.P.H. ’99,M.A. ’01, of the American Lung Associationof the East Bay, and director of the program.“Rather than waiting for children to come infor diagnosis and treatment, we go out tothe schools and bring them services.”

Asthma educators make a series of visits tothe homes of families of children with thecondition, and offer services ranging fromadvocacy within the health care system andassistance obtaining health insurance toadvice on how to make the home environ-ment asthma-friendly.

High School Students Participate inTheir Own HealthEmily Ozer, Ph.D., assistant professor ofcommunity health and human development,works with adolescents in high schools toconduct research to identify the health prob-lems that are the greatest concerns for thekids themselves, and then to develop actionplans to address these issues. Last fall, teenswho were enrolled in a peer resources classin a San Francisco school learned to designsurveys and collect data on the health con-cerns of their peers. Students identified mari-juana use as a major health concern, andprogram participants developed an actionplan that included a Health Day Teach-In.“The event was quite inspiring for students andstaff at the school because it was student-

Improving Life for Children, continued

“Rather than waiting for children to come in for diagnosis andtreatment, we go out to the schools and bring them services.”

A participant in the Oakland Kicks Asthma program takes emergency asthma medication through a nebulizer, which converts the medication into a mist for more effective transmission to the lungs.

9Public Health

“California is facing an obesity epidemic—over the last

decade Californians have gained 360 million pounds and

one in every three of our children is overweight. This dan-

gerous trend is unacceptable. I challenge leaders in gov-

ernment, business, education, medicine and parenting to

continue the work we have begun today to make California

the nation's model for health, nutrition and fitness.”

—Governor Arnold Schwarzenegger

driven,” says Ozer.The principal of the schoolcited the teach-in as “the best day the schoolhas ever had.”This academic year, Ozer is work-ing with four additional high schools to furtherdevelop the model. The peer resources classoffered the students experience in researchmethodology, data collection, and interventiondesign. “The students came and presented toone of my graduate classes, and many of thehigh school students said it was a very mean-ingful experience for them,” Ozer notes.

Ozer is now working with the Center for theStudy of Social Change in the establishmentof the Center on Culture, Immigration, andYouth Violence Prevention, funded by a grantfrom the Centers for Disease Control. As leadinvestigator on a grant within the center, Ozerwill expand the research to Oakland, whereshe will focus on using youth research andplanning to strengthen violence prevention.“In early education, the process is more par-ticipatory,” says Ozer. “Even in preschool, chil-dren help determine the rules of conduct. Butas children get older, the system becomesmore rigid. We wanted to create a genuineprocess of participation—to have teenagersbe contributors, rather than passive recipi-ents.” As part of the interactive process, thelocal stakeholders—students, parents, teach-ers, and administrators—evaluate the effectiveness of health intervention and vio-lence prevention programs.

Targeting ObesityThe Center for Weight and Health has beentargeting another issue in California’sschools: nutrition. The center recently con-cluded a study on the effects of removingsodas and other highly sweetened beveragesfrom the vending machines at local highschools. One early finding of the Sodas Outof Schools project, or SOS, was that the students were fairly comfortable with thechange in beverages. “People told us that ifwe took away the sodas, we’d have large-scale student protests,” says PatriciaCrawford, Dr. P.H. ’94, R.D., adjunct professor in the School of Public Health,codirector of the Center for Weight andHealth, cooperative extension specialist,nutritional sciences and toxicology. “Wefound that was not the case at all.” In fact,students at the control schools not participat-ing in the intervention expressed interest inhealthier food and beverage choices. Withobesity on the rise among California teens,the center is exploring the ways that changesin the environment—such as soda-freeschool grounds—impact the eating habits ofchildren and adolescents. In another ongoingstudy, the center is examining the effects ofschools offering lunches with a higher nutri-tional value.

On September 15, 2005, the Center for Weightand Health participated in the “Governor’s

Summit on Health, Nutrition, and Obesity.“Researchers from the center compiled materialson obesity for participants, including promisingapproaches towards improving nutrition, com-munity priorities around weight and health, andan extensive list of resources and contacts.Awide range of leaders from various sectors ofsociety participated in the summit.Among themwere notable figures from the food industry,including Safeway, Kraft, Subway, El Pollo Loco,Dole, McDonald’s, Ruiz Foods, and 7-Eleven, allof whom pledged to offer and promote morenutritious food choices. Members of theCalifornia Association of Health Plans—specifi-cally Kaiser Permanente, Blue Cross ofCalifornia, Health Net, PacifiCare, and L.A.Care—made extenisve commitments to fightobesity. Governor Schwarzennegger signedgroundbreaking legislation that extends theban on the sale of sodas in vending machinesat elementary and middle schools to includehigh schools, and sets nutrition standards forfoods served and sold in schools, and providesfunding for more fruits and vegetables forschool meal offerings.

“In order to make substantial changes weneed community research, active communitypartners, and bold policy makers,” saysCrawford. She is heartened by the positiveresponse to the summit and the momentum ofthe new movement to combat obesity. “We areseeing the beginning of a cultural shift.”

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Meeting the Needs of Older Californians

Training Tomorrow’s Physicians toCare for Older PatientsThe UC Berkeley-UC San Francisco JointMedical Program (JMP) is preparing tomorrow’sphysicians to treat older patients through aninnovative geriatric curriculum that matchesmedical students with elderly residents.Thenew curriculum, instituted by the JMP in 2003,brings students into continuing care retirementfacilities to meet face-to-face with the residentsand follow them over the course of three years.

Led by John Swartzberg, M.D., the JMP isa partnership between UC Berkeley and UCSF;the five-year program of study leads to a mas-ter of science degree and a medical degree.Unlike most medical degree programs, which

usually introduce geriatrics late in a student'smedical education, and often as an elective,the JMP requires the geriatric curriculum andstarts it in the student’s first year. Studentslearn how to work as a member of a patient’scare team; how to focus on living with chronicdiseases; how to assess what will help an eld-erly patient live as independently as possible;and how to care for people over time.

“It is clear that we need more doctors whohave an understanding of what it’s like tobe an elder in our society and who havesome training in their care,” says GuyMicco, M.D., clinical professor in the JMPand director of UC Berkeley’s ResourceCenter on Aging. “The standard medical

interview often leaves out questions con-cerning various activities of daily living. Animportant contribution of geriatrics is to putfront and center these matters of how wellsomeone is able to function in their world.We can teach students to ask such thingsas, ‘Can you use the bathroom on yourown?’ ‘Can you shop and prepare your ownmeals?’ ‘Are you able to manage your finan-cial affairs?’ Thinking about how people livewith the problems that come as they age—some of which are considered diseases,some of which are not—and how to pre-vent these problems or help make them better—this is the stuff of geriatrics.”

By Michael S Broder

The trend is clear: There are more

older Californians than ever before,

and the number is increasing.

According to the state’s Department on

Aging, there will be a 112 percent

increase in the number of Californians

age 60 and over during the period

from 1990 to 2020. The 85-and-over

age group will grow at even a faster

rate, with an increase of 143 percent

during the same period. With this in

mind, the School of Public Health is

taking action on a number of fronts to

ensure that the needs of older

Californians will be met—from training

medical students in geriatrics, to trans-

lating research on aging into action, to

building a network of seniors who are

actively making a difference in their

communities.

Essie Reed (left) and Beverly Taylor are among 60 “Senior Leader” awardees who are enhancing the health and quality of life for elders in California.

Helping Seniors Stay ActiveIn Sonoma, California, researchers in theStudy of Physical Performance and Age-Related Changes in Sonomans (SPPARCS)have been following 2,092 people ages 55and older for approximately 10 years, look-ing at different aspects of age-relatedchanges in physical activity and functioning.The study is supported with funding fromthe National Institute on Aging.

Physical activity declines with age, despitethe fact that it is associated with myriadhealth benefits, from lowering blood pres-sure to reducing risk of falls. “People wholive with a spouse and maintain social net-works are more likely than others to engagein healthy behaviors,” says WilliamSatariano, Ph.D., M.P.H., professor ofepidemiology and community health. Aspart of SPPARCS, he has been looking at thephysical activity of older married couples,examining how the physical activity of onespouse affects the other. Over an eight-yearperiod, he compared levels of physical activ-ity among married couples with levels ofactivity among randomly assigned pairs.“There is a concordance in physical activityamong older spouses, evident both at base-line and over time,” says Satariano. Thefindings from this study may be used todevelop interventions to encourage seniorsto stay active.

Building a Network of Senior LeadersIn a mutually beneficial partnership, theSchool of Public Health is building a networkof “Senior Leaders”—individuals age 60 andover who are making outstanding contribu-tions in healthy aging or community building.

“Typically, they are active on more than onelevel. They may be working on the neighbor-hood level and also on the policy level inSacramento; or on the regional level and thenational level,” says Meredith Minkler,Dr.P.H., professor of health and social

behavior. Minkler serves as principal investi-gator for the California Senior Leaders andHealthy Aging program, which is supportedby The California Wellness Foundation.“Some of the seniors are working on issuesaffecting a particular group—such as AfricanAmerican elders in California—and aredoing work to enhance and improve theirhealth and quality of life.”

The 60 leaders, who come from throughoutCalifornia and range in age from 60 to 96,have been selected from a larger group nom-inated by health departments, foundations,academia, community-based organizations,and local and state government. The firstclass of senior leaders began in 2002, andthe second in 2005. Awardees participate ina two-day recognition and training event,which includes interactive sessions on mediaadvocacy, healthy aging, influencing policy,fundraising, and related topics.

In addition, the seniors are linked with grad-uate students in the School of Public Health.Student project director Marty Martinson,M.P.H. ’05, and six other students—eachfocusing on a different issue area—check inwith the seniors regularly over 12 months,learning about their progress and arrangingtechnical assistance if needed.

“We provide them with training in areas likehow to more effectively utilize the mass mediato bring attention to the issues that they’reworking on, how to raise money for theirorganizations, and projects, offer tips on howto make an impact at the policy level, and wehook them up with classes of students thatmight be helpful to them,” Minkler explains.

"Student participants learn at least as muchas the seniors, and they learn from the mas-ters,” says Martinson.

Minkler agrees. “We’re seeing a lot of benefitsand the building of a web of connectionbetween senior leaders up and downCalifornia, senior leaders and university stu-dents, and other intergenerational collaborations,” she says. For example, twosenior leaders who recently returned fromthree weeks in Louisiana working on reliefefforts for Hurricane Katrina will be serving asadvisers to the School’s “Dr.P.H. in Action”seminar, in which students are working on aKatrina-inspired class project on disaster pre-paredness for Alameda County.

The sharing of information among the seniorsis a key element of the program. The partici-pants hold reunions in different regions wherethey share ideas with one another and oftenapply what they’ve learned to their own com-munities. Some of the seniors from the firstgroup also serve as mentors to the secondgroup. Says Martinson. “We’re trying to build anetwork of California senior leaders who willbe in touch, and we hope to ignite a more for-mal senior leadership alliance.”

11Public Health

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The School’s Health Research for Action Center(formerly Center for Community Wellness) haspublished a comprehensive 68-page resource to help seniors navigate HMOs, advocate for themselves, and take full advantage of theirhealth care coverage.

12 University of California, Berkeley12

Feature

California is one of the most

ethnically diverse states in

the nation, with a population

that represents a wide range

of cultures, languages, and

backgrounds. However, there

are vast disparities in health

outcomes among residents,

and rates of morbidity and

chronic illness are signifi-

cantly higher for African

Americans, Latino Americans,

and Asian Americans than for

white populations, according

to the Department of Health

Services. Many researchers at

the School of Public Health

are examining why such

inequities exist, and looking

for ways to address these

issues in communities and in

the health care system.

Examining Pregnancy Outcomes forAfrican Americans and LatinasOne of the most glaring areas of healthdisparity for African Americans is inbirth outcomes. The National Centerfor Health Statistics reports that nation-ally, African American women have thehighest rates of preterm births and low-birth-weight babies, two factors whichare also linked to infant mortality.Amani Nuru-Jeter, Ph.D., M.P.H.,assistant professor in the divisions ofCommunity Health & HumanDevelopment and Epidemiology, islooking at the connections betweenracism as a chronic social stressor andbirth outcomes among African

American women. She is working withresearchers at the UCSF Center onSocial Disparities to develop a validatedassessment tool of chronic exposure toracism for African American women ofchildbearing age in order to examinewhether the experience of racism playsa part in pregnancy outcomes. Nuru-Jeter and colleagues are in the processof analyzing data from a series of focusgroups conducted with AfricanAmerican women, designed to measureperceptions of racism. “We are workingto identify and measure the experienceof racism across the life course,” shesays. Nuru-Jeter is also examining datafrom a longitudinal survey project tofurther understand the effects of racismas a chronic stressor on birth outcomesand cardiovascular risk. (See “Meet theNew Faculty,” page 33.)

Sylvia Guendelman Ph.D., M.S.W.,professor of health and human develop-ment, has researched an interesting para-dox: Mexican-born women in the U.S.have better pregnancy outcomes in termsof birth weight and infant health than

Caucasian women, despite the fact thatMexican-born women have more healthrisk factors such as higher levels of pover-ty. Studies indicate that this may in partbe attributable to better nutrition, andlower rates of smoking and illegal druguse among Mexican-born women thanamong Caucasian women. Guendelmanexamined hospital records and birth cer-tificates and found that while Mexican-born women in California had betterbirth outcomes, they also had higher ratesof postpartum complications resultingfrom poor or suboptimal obstetric care,such as hemorrhaging and fever. Shecompared pregnancy outcomes for theU.S. born children of Mexican immi-grants with women born in Mexico anddiscovered that pregnancy outcomes wereworse for U.S. born Latinas. “We foundthat maternal health deteriorates with theprocess of acculturation,” says Guend-elman. Understanding how acculturationdisadvantages Latinas will help researchersdesign interventions to prevent thedecline in positive birth outcomes.

Serving California’s Diverse PopulationBy Kelly Mills

Oakland middle and high school students participating in the Health Professions Partnership Initiativecreated a mural titled, “What Is Health?” The program encourages minority youth to pursue careers inpublic health and health care.

Developing Strategies to Bring HealthMessages to Underserved CommunitiesAt the Center for Family andCommunity Health, Joel Moskowitz,Ph.D., has collaborated with AsianHealth Services and the KoreanCommunity Advisory Board since 1993to improve health in the KoreanAmerican community, a populationthat historically has been underservedand understudied in the state ofCalifornia and in the nation. The cen-ter designed and implemented educa-tional strategies to improve breast andcervical cancer screening rates amongKorean American women.

One offshoot of the effort was the cre-ation of the Virtual Village Project with

the Korean Community Center of theEast Bay. The project provides internetaccess and training at important com-munity sites, such as churches and sen-ior centers. Moskowitz believes that theinternet can be an effective tool fordelivering health information to mem-bers of the community. Currently, he isconducting a Korean-language internet-based smoking cessation study thatcontrasts two self-help strategies forquitting smoking. “Our data show veryhigh rates of smoking among KoreanAmerican males, and good internetaccess,” states Moskowitz. “The inter-net offers a very promising technologyfor studying health promotion and dis-ease prevention.”

Looking at Environmental Factors in Breast CancerBreast cancer affects women and men ofall backgrounds and ethnicities, butwomen of color are more likely to bediagnosed with breast cancer than anyother cancer. African American womenare less likely than white women to sur-vive five years after diagnosis, according tothe American Cancer Society. PatriciaBuffler, Ph.D., Kenneth Howard Kaiserand Marjorie Witherspoon KaiserEndowed Chair, professor of epidemiolo-gy, and dean emerita, has been a leadingresearcher and advocate for greater under-standing of the causes of breast cancer—and how factors such as socioeconomicinequality contribute to the diseasethrough environmental exposure risks.

13Public Health

Feature

continued on page 14

Abby Rincón, M.P.H. ’86, had only beenworking at the School of Public Health for aweek when Hurricane Katrina devastatedparts of the southern United States. Rincón,the newly hired director of diversity for theSchool, was approached by members of theMulticultural Students Organization aboutcreating an event for students and facultyto discuss the questions and emotions thatarose around public health issues for vulner-able populations.

Rincón and the group organized an open forum, held on September 27, 2005. The eventopened with moving speeches by a studentwho transferred to Berkeley from Tulane fol-lowing the disaster and a physician who wasone of the first responders to the rescue efforts.The forum was then opened up for students toshare their thoughts and concerns. “The stu-dents found it very beneficial to discuss theseissues,” says Rincón. “It was definitely a com-munity-building event.”

The School of Public Health created the direc-tor of diversity position to help recruit andmaintain a student body that reflects thecommunity. The School also hopes to foster aculture that values and promotes diversity.“Much of what I do is putting a human faceto the School,” says Rincón. “I’m buildingrelationships with diversity coordinatorsacross campus and on other campuses, andworking on the best practices for recruitment.

I’m reaching students who may not have everconsidered Berkeley, who didn’t believe theycould come to Berkeley. I also follow up withcurrent students, to make sure they are ableto stay in school.”

As a graduate of the School and a long-timepublic health professional, Rincón is excitedabout the opportunity to preserve and promotediversity. “I can’t think of a better way todevote my life’s work than to be part of mak-ing a difference in the next generation of pub-lic health leaders,” she says.

Rincón, who earned her master’s degree fromthe School in 1986, has worked at the GeneticDisease Branch of the State Department ofHealth Services; as a lecturer for UC Berkeleyand for City College of San Francisco; andmost recently as director of health promotionfor the Berkeley campus’s Tang HealthServices Center.

New Position Helps Promote Diversity


Feature

Students Work with Communities toCombat Heath InequitiesThe Center for Public Health Practice(CPHP) gives students at the School ofPublic Health frontline experience inthe struggle to reduce health dispari-ties. The center connects over a hun-dred students a year with internships incommunity organizations, professionalhealth agencies, and governmentdepartments, many of whom servepopulations with disadvantaged healthstatus. “The students have the oppor-tunity to work on real, pragmatic solu-tions to health inequities,” says JeffOxendine, M.B.A., M.P.H., associatedean for public health practice. Theinternships allow students to worktowards health disparity reduction on a number of fronts: through the devel-opment of intervention methods and disparity assessments; by helpingorganizations deliver culturally and linguistically appropriate services; andby reseraching the causes of health disparities and understanding the barri-ers to health care access for particularcommunities.

In 2002, the Center for MulticulturalHealth was formed within CPHP tohelp students and partner organizationsdesign, implement, and evaluate practicalstrategies for reducing health inequity.One of the goals of the Center forMulticultural Health is to identify andsupport students from underrepresentedbackgrounds who are interested in acareer in public health. The center con-ducts outreach with intermediate, highschool, and undergraduate students. “Weare creating a pipeline of support pro-grams and exposure programs for stu-dents, so that someone can be inspired atan early age, supported at each step of theway, and actually make it into graduateschool and into the field,” says Oxendine.

Faculty and students from the Centerfor Multicultural Health often collab-orate with local public health agenciesin an effort to improve access to care. For one project, students and facultyfrom the center worked with theAlameda County Association forLanguage Access and Health CareCoalition to identify methods for pro-viding non-English speaking patients

with linguistically appropriate treatmentand information. Language often pres-ents a formidable barrier to people seek-ing care, both in interactions with physi-cians, and in reading printed materialsranging from prescription instructions tobasic preventative care measures.

Health Information in Many LanguagesThe Health Research for Action Center(formerly the Center for CommunityWellness) has been providing importanthealth information to California residents for over 18 years through the acclaimedWellness Guide. The Guide has demonstra-ble results in improving access to healthcare knowledge and resources, notably forSpanish-speaking users. In 2004, thecenter built on the success of previouspublications and released a Chinese/English edition of the Wellness Guide.The Chinese/English Wellness Guide wasdeveloped in collaboration with an advi-sory board of community leaders andhealth care professionals, and aims tomeet the needs of the diverse communityof Chinese speakers, which includes peo-ple from mainland China, Hong Kong,Taiwan, Macao, and Vietnam, who speakEnglish, Mandarin, Cantonese, and avariety of other dialects.

Serving California’s Diverse Population, continued

Korean American ministers and their spouses attend an orientation for a breast and cervical cancerscreening project through the School’s Center for Family and Community Health.

Infomacíon de salud en variosidiomas

Por más de 18 años el Centro deInvestigación de Salud en Acción(conocido anteriormente comoCentro para el Bienestar de laComunidad) ha proporcionadoinformación de salud importante alos residentes de California a travésde su aclamada Guía del Bienestar.La Guía ha demostrado resultadosen cuanto al mejoramiento delacceso a información y recursos decuidados de la salud, en especialpara los usuarios de habla hispana.

Measuring Medical GroupPerformanceAs health care delivery has come undergreater scrutiny for quality as well as cost,researchers and reformers alike have beenfocusing on how well medical groups are performing, particularly in caring for patientswith chronic diseases.

“Diabetes, congestive heart failure, asthma anddepression are the high-cost conditions thataffect all Americans,” says Dean StephenM. Shortell, Ph.D., M.P.H., Blue Cross ofCalifornia Distinguished Professor of HealthPolicy and Management. “It’s estimated thatthose four conditions account for 75 percent

of all health care costs in the United States.So the big question for this country is howwe’re going to manage chronic illness.”

Shortell and colleagues at UC Berkeley, UCSan Francisco, and the University of Chicagoare addressing this question by studyinglarge medical groups throughout the nationthat treat patients for those four chronic diseases. The work includes an in-depth lookat some 200 groups of 20 or more physiciansin California.

Measuring quality of care, organizationalcapacity for learning, and financial perform-ance, the researchers have found three key

characteristics that set high performancemedical groups dramatically apart from othergroups: the responsibility to report resultsexternally, use of information technology (e.g.,electronic health records), and a culture ofcommitment to quality improvement.

The study has received widespread attention,especially from California legislators who areinterested in encouraging the use of informationtechnology in medical practice. It has also beenthe source of some of the measures being usedin California’s demonstration Pay for Perform-ance program, which is rewarding medicalgroups for providing better quality care.

15Public Health

Feature

Informing Consumers and Policy Makers

With research showing thathealth care in the U.S. fallsfar short of recommendedstandards, the School’s fac-ulty has a major role to playin creating new knowledge,educating consumers andinforming policy makers. Onthe following pages, wehighlight some of the facul-ty’s recent contributions tohealth care research andevaluation, and discuss thenewsletter that put theword “wellness” into every-day use.


By Vivian Auslander

In the five years during which Shortell and hisresearch colleagues have been assessingmedical group performance and identifyingfactors that contribute to high-quality care,many of those factors have come to occupy alarger place in the health care landscape:incentive programs like Pay for Performancehave been launched; external reportingrequirements have increased; more informa-tion technology has become available fortracking patients; and the government,through the Center for Medicare/MedicaidServices, has sponsored projects using finan-cial incentives to improve treatment for thechronically ill.

Have changes like these actually improvedmedical group performance? Shortell and colleagues are conducting a two-year updateof their research to find out.

“Because of all this attention, we wouldexpect medical groups to be doing better atmanaging patients with chronic illness,” hesays. “We’re going to see what areas haveimproved the most, what has improved theleast, what the differences are across thecountry and why that might be.”

Rewarding High Quality Care California is a national leader in efforts toimprove the quality of health care by offeringfinancial incentives to medical groups andreporting on their performance-based on uniform measurable objectives.

The Pay for Performance program (P4P) seeksto improve preventive services, like cancerscreening, and treatment for chronic condi-tions, like asthma and diabetes. Developed bythe Integrated Health Association (IHA), P4Pis the largest undertaking of its kind in thenation, affecting the care of over 6.5 millionCalifornians.

IHA is a statewide organization in which lead-ers from across the health care spectrum—health plans, providers, academia, purchasers,policy makers, pharmaceutical firms, and

consumer groups—come together, put asidetheir differences and “find areas for collabora-tion and innovation to improve health care andhealth care delivery to Californians,” as IHAexecutive director Tom Williams explains.

Dean Shortell and James Robinson,Ph.D., professor of health economics andchair of the Division of Health Policy andManagement, serve on the IHA board.Shortell oversaw development of the analyti-cal underpinnings for P4P: uniform perform-ance measures, standards for data collectionand other technical components.

“This program is new, and it’s evolving,”Williams says. “That’s why it took somebodylike Steve Shortell to help us figure out whatwe should measure.”

Based on measurements of clinical quality,patient experience, and information technolo-gy to support patient care, the health plansparticipating in P4P reward medical groupsfor their performance. The California Office ofPatient Advocate posts the results of thequality assessment on a public web site(http://www.opa.ca.gove/report_card/).“Being able to compare the results is greatfor consumers,” Williams says, “but, morefundamentally, the medical groups now havean incentive to improve their care, whichhelps consumers get the care they need. Forexample, more women are now gettingmammograms.”

Williams, a former health plan executive whois working on his doctorate at the School ofPublic Health, is pleased that P4P has suc-cessfully engaged the private sector to workon public health initiatives. “There is a huge

need to connect the public health side of theworld with the private sector health care sideof the world,” he says. “Dean Shortell andJamie Robinson are folks who can connectthose two worlds.”

Informing Health Care PolicyWhen California legislators need to under-stand the potential impact of new bills thatseek to mandate health insurance benefits,they turn to a trio of UC experts: EdwardYelin, Ph.D., M.C.P., adjunct professor of medicine and health policy at UC SanFrancisco, Gerald Kominski, Ph.D.,professor of health services at UCLA andassociate director, UCLA Center for HealthPolicy Research, and Helen Halpin,Ph.D., professor of health policy and direc-tor of the UC Berkeley Center for Health andPublic Policy Studies.

At the request of the legislature, in the 60days following the introduction of a mandatebill, the trio revs into action: Yelin and hiscolleagues review the scientific literature forevidence that the proposed new benefit ismedically effective, Kominski and his col-leagues estimate its impact on state expen-ditures, and Halpin and her research teamanalyze its potential impact on public health.

UC performs this service as part of theCalifornia Health Benefits Review Program(CHBRP), established by the Office of thePresident in 2002 in response to the legisla-ture’s passage of AB 1996, which requiresthe University to provide comprehensive,objective, evidence-based information onwhich to base policy decisions. The billscover the gamut of health care concerns—from drugs to length of hospital stays toprofessional services.


Feature

Informing Consumers and Policy Makers, continued

“There is a huge need to connect the public health side of theworld with the private sector health care side of the world.”

When California legislators need to understand the potentialimpact of new bills that seek to mandate health insurancebenefits, they turn to a trio of UC experts.

17Public Health

“To date we have analyzed 22 bills,” Halpinsays. “It’s an unbelievable effort. I have anamazing staff in my research center, and whenthe bills come in, we drop everything to workon them.” Halpin calls her team’s role “revolu-tionary,” explaining, “California is one of thefew states in the country that actually consid-ers the impact of health insurance policy onthe health of the population.”

The reports that UC provides play a significantrole in decision-making. “In many cases, afterour report comes out, we’ve seen bills pulled orgutted and something new introduced,” Halpinsays. “Bills about mandates that we’ve foundwould be very effective and cost relatively little—for example, management of pediatric asthma—pass the legislature.” What happens after that point, she adds, is in thegovernor’s hands.

In the course of their work, the researchershave developed new methodologies, whichthey will publish early next year in a specialissue of Health Services Research, along witha paper detailing the process they used toanalyze management of pediatric asthma.

CHBRP—the only program of its kind in thenation based in a university system—has

distinct advantages. It is independent andremoved from the political process. And it canmarshal expertise in many fields. Halpin, Yelin,and Kominski call upon colleagues at UCDavis and UC San Diego whenever they needtheir special experience.

“I’ve been in many multi-university endeavorsbefore, but this one has worked the best,”Halpin says. “Everyone has different expertise,and the reports are much better than any of uscould do alone. We’re really proud of the prod-ucts, and we feel like we’re introducing somerationality into the public policy process.”

Understanding the Impact of ChangeThe Nicholas C. Petris Center on Health CareMarkets & Consumer Welfare, located at theSchool of Public Health, plays a critical role inexamining how changes in health care andhealth care policy affect health care markets,consumer protection and access to care,especially for low- and moderate-incomeCalifornians. For example, the center is cur-rently undertaking four studies that will havea major impact on health care decision-mak-ing and programs.

In the first study, Petris Center researchers areevaluating the impact of Proposition 63, the

Mental Health Services Act, which taxes mil-lionaires to fund mental health programs inCalifornia. Led by center director Richard Scheffler, Ph.D., Distinguished Professor ofHealth Economics and Public Policy, theresearchers are tracking the fiscal impact ofthe law, examining how it is changing mentalhealth services and studying its effect onmental health outcomes. Their findings will inform policy makers about how the funds affect the availability and design of mentalhealth services.

“The interest in this study goes well beyondCalifornia,” says Timothy Brown, Ph.D.’99, Petris Center associate director. “Manypeople recognize that Prop. 63 is very innova-tive in what it is attempting to do. They arevery interested in what programs are workingand whether or not people are getting moreaccess to mental health care.”

In another study, Petris Center researchers arefocusing on Attention Deficit HyperactivityDisorder (ADHD)—the most common behav-ioral disorder in children—which is beingdiagnosed and treated at an accelerating ratethroughout the world. The use of the manypsychostimulant drugs that treat ADHD,including Ritalin, varies tremendously, and thePetris Center is partnering with the UCBerkeley Psychology Department and a majorCalifornia health system to learn why.

“The use of psychostimulants for ADHD is oneof the most important public policy issuesnow for parents,” Scheffler says. “We are try-ing to document and understand the factorsinfluencing the supply and demand for thesedrugs and the variations in their use. Ourstudy will help policy makers and health pro-fessionals decide if the current treatment dis-parities are acceptable, and, if not, how theymight be changed.”

A third Petris Center study deals with pre-scription drugs. Although they are importantfor treating disease and improving health,

Feature



many people lack access to these drugs because of their cost. To inform decisionsabout proposed legislation addressing lackof access to prescription drugs for the unin-sured—including Propositions 78 and 79,the competing measures on the Novemberballot—Petris Center researchers analyzedvarious methods for defining the number of uninsured Californians and examined the programs available to help those who cannotafford prescription drugs. Based on theseanalyses, they estimated that nearly 5 millionto 6.5 million Californians are uninsured andthat private programs to provide free or low-cost drugs to people in need reach only aboutfive percent of the uninsured population. Thestate has yet to determine the number ofuninsured Californians who require help topay for prescription drugs.

A fourth Petris Center study addresses thedearth of African American and Hispanicphysicians in underserved minority communi-ties, a problem that can contribute to dispari-ties in the health of the people in those com-munities and the care that they receive relative to other populations. Centerresearchers have just completed a studyexamining the factors that influence AfricanAmerican and Hispanic doctors to movewithin California and leave the state. The

study will help UC and policy makers designprograms to improve medical care for under-served minority communities.

Offering Practical Advice toConsumersEvery month, the UC Berkeley Wellness Letterbrings practical advice about healthy living,good nutrition and disease prevention to morethan 350,000 subscribers here and abroad.Established in 1984, the popular newsletter hasgiven meaning to the term “wellness,”and has built a reputation as one of the mostcredible resources in the world for plain-spokenanalysis of health-related issues.

“We see ourselves as a filter,” says DaleOgar, managing editor. “We read and hearwhat the issues of the day are. Then we digbehind the reporting to look in-depth at the literature, review the data ourselves, and thenstand back to offer sensible advice.”

The 13-member editorial board, chaired byJohn Swartzberg, M.D., F.A.C.P., clinicalprofessor of health and medical science at UCBerkeley and UC San Francisco, includesexperts in preventive medicine, epidemiology,gerontology, cancer, risk assessment, occupa-tional and environmental health, and nutrition.The board “goes over every word,” Ogar says,

and nothing gets published without theirapproval. Through the years the newsletter hashad wide-ranging impact, influencing the kindsof questions that consumers ask their doctors,providing early warnings about the safety ofdietary supplements, and inspiring efforts topromote the health and welfare ofCalifornians.

“Fairly early in our history, some people fromHealth Net came to us and said they wantedto start a foundation whose funding effortswould reflect the principles we were espous-ing in the newsletter,” Ogar recalls. “Thatbecame The California Wellness Foundation.”The newsletter’s contribution to the School ofPublic Health has been profound. Under theleadership of the late Sheldon Margen,M.D., world-renowned nutritionist andcofounder of the newsletter, the newslettercreated an endowment and devoted all earn-ings above those needed for operations tostudent support. Generations of public healthgraduate students have been the beneficiariesof this support and have moved on to servethe public as health professionals.

Planning for a Healthy FutureLooking to the future, the School of PublicHealth, in conjunction with the Public HealthInstitute and The California Endowment, isplanning a health summit that will present a health report to the state and explorestrategies for improving the health of allCalifornians.

A steering committee drawn from the privateand public sectors, consumer groups and aca-demia has been established. Work groups willfocus on infectious disease preparedness andchronic illness.

Planners are seeking funding in the hope ofoffering the health summit next September asthe first of an annual series that will raise visi-bility about health issues, develop actionplans to improve health, and chart the state’sprogress over time.

Feature

Informing Consumers and Policy Makers, continued

Dr. John Swartzberg, chair of the UC Berkeley Wellness Letter’s editorial board, reviews an issue.

“When dealing with a public health disaster, you need a well-trained workforce, andyou may also need a rapid and massive response,” says Tomás Aragón, M.D.,Dr.P.H., principal investigator and executive director, Center for Infectious DiseasePreparedness (CIDP), and assistant adjunct professor, Division of Epidemiology. “Adisaster is not the time to determine how you are going to respond. You need to knowin advance how you are going to communicate, move water, and move antibiotics.”

CIDP was founded in response to growing concerns about bioterrorism and theability of the public health system to respond to microbial threats. “We started offlooking at intentional threats like anthrax. If you don’t know how to identify casesor deliver antibiotics, you are going to end up with hundreds of thousands of peo-ple in hospital beds, and hundreds of thousands more dying,” Aragón states.

Training Workers for the Front LineCIDP offers a number of programs designed to address needs in the public healthinfrastructure. The Core Infectious Disease Emergency Readiness (CIDER) programis designed to train students and professionals in a number of areas, including emer-gency operations planning, field epidemiology, and infection control. The programfocuses on effectiveness in core areas during an emergency. The Readiness

19Public Health

Feature

Preparing for Disaster

Graduate student researchers Andy Anglemeyer and James Bullard compare notes at the Core Infectious DiseaseEmergency Readiness two-day intensive exercise.


By Kelly Mills

Recent calamities like

Hurricane Katrina have left

many people in California

wondering if our public

health system would be able

to effectively respond to a

similar emergency. The ques-

tion seems to be not whether

a large-scale disaster will

strike the state, but when. A

capable and efficient public

health infrastructure is

essential to the safety of the

people of California, in order

to meet the crises posed by

natural disasters, major

disease epidemics, or acts

of terrorism. The Center

for Infectious Disease

Preparedness is working to

address these challenges,

providing training and

resources in infectious dis-

ease control, bioterrorism

response, and other health

emergencies to public health

practitioners and students

across California.


Operations Planning and Exercise pro-gram helps health departments developemergency operations plans and testthem in exercises designed to simulatemicrobial threats and other disasters.CIDP also offers the EpidemiologicalPreparedness and Informatics programfor in-depth training in infectious dis-ease epidemiologic detection, investiga-tion, and information management.

Overall CIDP focuses on the core princi-ples of detection, investigation, response,and recovery. While CIDP deals primarilywith microbial threats, Aragón says that“many of the concepts are applicable toother disasters.” CIDP plans to offercourses in the spring 2006 semester thatintegrate the lessons learned from theGulf Coast hurricanes.

“You need the ability for collaborationand communication between states andthe federal government, between thepublic and private sector,” says Aragón.

Participants Learn from SimulatedOutbreakStudents completing the CIDER sum-mer intensive program face a specialkind of test anxiety. The exam doesn’tinvolve number two pencils or essayquestions. What it does require, howev-er, is a combination of professionalskill, adaptability, and teamwork. Theculmination of the CIDER summerintensive program is a two-day simulat-

ed disease outbreak, during which theparticipants must work in teams todetect, investigate, and contain a poten-tially devastating epidemic. Of course,these aren’t ordinary students either—many have been working on the frontlines of public health for years.

Cindy Lambdin, R.N., M.S., one of theorganizers of the two-day intensivetraining, cites two major weaknesses inthe current public health system. “Mostprofessionals in public health do not seethemselves as ‘first responders’ in anemergency, the way fire, police andEMTs do. And the Incident CommandSystem is not fully integrated into thepublic health system.”

The Incident Command System, orICS, is an organizational tool thatallows responders from different areasto communicate with each other effec-tively in an emergency. The system wascreated by fire personnel in response toproblems that arose when firefightersfrom different areas needed to workcooperatively to combat multi-jurisdic-tional fires. It is already used by emer-gency personnel such as police and firedepartments, and is slowly being imple-mented in public health.

The ability to communicate across sec-tors and regions becomes critical in alarge-scale emergency, when efforts mustbe coordinated in order to succeed. ICS

also helps establish responsibilities andchain of command, a factor that takeson fundamental importance when peo-ple are forced to take on unfamiliar rolesto meet the demands of a situation. “Forthe second day of our exercise, weswitched people’s roles. That createdconsiderable stress,” says Lambdin.However, public health professionalsshould be prepared to fill any position ina disaster. “I always tell people, ‘Duringa crisis, you may be the most knowl-edgeable person in the room.’”

The summer program offered by CIDERis aimed at familiarizing public healthworkers with ICS, and ensuring that par-ticipants have the necessary experience tomeet the problems posed by a major dis-aster. The intensive exercise simulatedpandemic influenza, and response roleswere assigned to each of the students. Theexercise created a realistic and highlystressful situation, and forced participantsto quickly develop plans for containingthe outbreak, communicating with themedia and the public, and managingresources effectively.

The summer intensive course is justone of the ways CIDP enables publichealth professionals to develop the skillsnecessary for meeting the next healthcrisis. “We occupy the space betweenpublic health practitioners and the aca-demic community.” says Aragon.“There are really few opportunities for

“If we are to continue to protect our homeland from terrorism,then a well trained and sound public health infrastructure is a must. The University of California, Berkeley, School of PublicHealth plays a vital role building the nation’s capacity todetect, respond to, recover from, and mitigate consequences of terrorism and other health emergencies.”

—Julie L. Gerberding, M.D., M.P.H. ’90Director, Centers for Disease Control and Prevention

Feature

Preparing for Disaster, continued

21Public Health

Public Health Nurse Puts EmergencyTraining to Good Use

Tamara Cohn didn’t have to wait long to use the training she received at the Core InfectiousDisease Emergency Readiness (CIDER) summer intensive program offered by the School’s Centerfor Infectious Disease Prevention. A week after she returned to Inyo County, where she is the clinical services director for the Public Health Department, Cohn received reports of multiple casesof encephalitis in the area.

“When we first heard of the cases, we immediately took out the tools from the summer intensivesession.” Cohn said. “We work with epidemiologists from the state department of HealthServices, and the tools from CIDER helped us anticipate what kinds of questions the epidemiolo-gists would ask us. It not only made us feel more prepared, but it also enabled us to move muchfaster than we could before. The CIDER course gave me the leg up to be able to anticipate whatwe would need to know and do.”

As a public health nurse in rural Inyo County for 25 years, Cohn has had plenty of practical expe-rience dealing with infectious disease cases. She credits the CIDER training with giving her moreconfidence and consistency in identifying possible outbreaks and taking the necessary steps tocontain them.

“CIDER helped us develop a standardized approach to dealing with outbreaks, such as with therecent cases of pertussis in our area. The course gave us a language and a map.”

Cohn passed on the information she learned at CIDER to the public health staff in her area. Shedeveloped a worksheet based on the principles of the CIDER course for an annual disaster drill.“The worksheet gave the staff parameters and a structure to use in the investigation. I think mostof them had the same experience that I had at CIDER—it was really an ‘aha’ moment.”

The course also helped Cohn develop a bioterrorism response plan that recruited emergency fieldinvestigators from outside public health. “Because we are a rural county, we only have six publichealth nurses.” Says Cohn. “We just don’t have the resources to respond. So we brought in environmental health investigators, child protective services workers, social workers...We haveexpanded our plan to embrace people with interview skills. I conducted a training using the foundation I got at CIDER, and we have been able to include these people from these other disciplines to use as field investigators if we were to have a biological event.”

professional development for people already working in the field of publichealth. We meet that need.”

At CIDP, there is a strong focus onmaking courses accessible and practicalfor people working in the field. In addi-tion to the two-week summer intensiveprogram, CIDP offers free, half- to full-semester classes all day on Tuesdays toallow long-distance commuters to makethe most of their time. CIDP webcastsmost of the courses for distance learn-ing, and provides regional field training.

Developing LeadersCIDP plans to expand the CIDER sum-mer intensive program to include courseson designing drills and exercises so thatprofessionals can evaluate emergencyplans and ensure that emergency measureswill be effective in the event of a catastro-phe. CIDER will also offer a one-weekleadership training course, ending withanother two-day emergency exercise inwhich participants will use ICS.

“The leadership training is a uniquecourse because people have to work inteams—they have to coordinate, dele-gate, recognize when their colleaguesare stressed, and basically use real-worldproblem solving,” says Aragón.

Aragón states that one of the strengthsof the CIDER program is the valueplaced on the teaching skills of the fac-ulty, many of whom are professionalsworking in the field of public health.Aragón himself served as a deputyhealth officer for San Francisco, whichhe believes gives him credibility withpublic health practitioners.

“The field is changing so rapidly. It isdifficult for academicians to keep up.New systems are being implementedconstantly. My challenge is to bring infront-line responders as teachers, and torecognize that the courses will need tochange all the time.”

Would you talk a bit about changesyou’ve seen in your 37 years at theSchool?I suppose the most striking difference in theSchool during the years I’ve been here hasbeen the change from a faculty that was verylargely made up of former practitioners ofpublic health to a more academic researchoriented faculty. That’s not to say that therewasn’t a lot of research 30 years ago—therewas—but I think it was perhaps more prac-tice oriented than it is today. So today wehave a faculty almost exclusively made up ofPh.D. research academicians, and I think theyare making important and substantial contri-butions to knowledge, but I think there’s lessemphasis now on application than there wasin the past.

Also the student body has changed, particu-larly with respect to gender. When I camehere, two-thirds of the students were male.Today, at least two-thirds of the student pop-ulation are female—which makes some dif-ference in terms of orientation of interestsand also on substantive issues.

Of course one thing has remained quite con-stant, and that is the major problem created

by an inadequate physical facility and thesplitting up of activities into different venues. Public health is by its very naturemultidisciplinary, and I think our Schoolwould benefit, both in terms of its researchorientation and in its ability to provide students with meaningful instruction, byaddressing this Balkanization, if you will, ofthe locations. So we could use a new buildingthat would centralize the various activities.

What would you say has been your mostinfluential work?Well, probably the most influential work I didwas my early work on air pollution in ErieCounty, New York, [which was the basis forsetting up air quality standards for the UnitedStates] and the work that my colleagues and Idid on HIV/AIDS in the 1980s and ‘90s.[Winkelstein directed the landmark SanFrancisco Men’s Health Study, a large cohortstudy of HIV infection and AIDS which helpeddetermine the link between sexual activity—especially types of behavior—and HIV infec-tion. Ed.] I also was involved in vaccine evalu-ation research. I worked on the polio vaccinefield trial, but of course I was just a tiny partof a giant mobilization, if you will. And then Iworked on other vaccine evaluation activities.


Past, Present, Future

Influential Epidemiologist and Esteemed Professor:Warren Winkelstein, Jr., M.D., M.P.H.

UC Berkeley Public Healthrecently interviewed ProfessorEmeritus Warren Winkelstein, whojoined the School’s faculty as pro-fessor of epidemiology in 1968,served as the School’s dean from1972 to 1981, and has been aprofessor emeritus since 1991.Born in Syracuse, New York, in1922, Winkelstein earned hisbachelor’s degree from theUniversity of North Carolina in1943, his medical degree fromSyracuse University in 1947, andhis master’s degree in public healthfrom Columbia University in1950. He has received numeroushonors, including membership inthe Institute of Medicine; fellow-ship in the American Associationfor the Advancement of Science;and the prestigious BerkeleyCitation.

23Public Health

I think, perhaps, from a scientific point ofview, the most important thing I did was myearly study on risk factors for coronary heartdisease in women. I believe it may have beenthe first case control study of risk factors inwomen for myocardial infarction.

One of your research interests is the lifeand work of Janet Elizabeth Lane-Claypon.Would you explain your interest in her?In our epidemiology program, all of the stu-dents in their first semester here read classicsof epidemiology and discuss them and relatethose classics to current research. And someyears ago—eight years ago or so—I becameconcerned that we had no examples of classicwork by women epidemiologists. When I wasa student of epidemiology or of public health,the 1926 paper on breast cancer authored byJanet Elizabeth Lane-Claypon was always ref-erenced when the issue of breast cancer epi-demiology came up or when case controlmethodology was discussed. So I knew about

this classic paper and this classic study—500cases and 500 controls—and I introducedthat into our seminar. At the same time, Iintroduced Florence Nightingale’s work—she’s remembered more as an expediter ofthe nursing profession, or an advocate orinnovator of nursing, but she also did pioneer-ing work in hospital epidemiology. So weintroduced readings from Lane-Claypon andNightingale into our program.

Subsequently, my wife wanted to spend sometime in England…and I felt that I needed tohave something more to do than just go toart galleries, museums, and the theater andmusic, which I, of course, love to do as well. Idecided I would like to know something more

about Lane-Claypon, so I contacted friends Ihave at the library at the London School ofHygiene and Tropical Medicine and theywrote me that they knew nothing about herand could find out nothing.

So I went to the London School to visit myfriends and talk about my project. The LondonSchool of Hygiene and Tropical Medicine hap-pens to be located right across the street fromthe administration building for UniversityCollege London. Well, the British, as you mayknow, keep every little scrap of paper. Theyarchive everything. After chatting with myfriends in the library, I went across the streetto see whether I could find out anythingabout Lane-Claypon, because on the facepage of her classic paper, it gives her degrees,which were Sc.D.—doctor of science—andthen there’s a parenthesis that says“London.” I assumed what that meant wasthat she got her doctor of science fromUniversity College London, and indeed when I

went across the street, I found a filing cabinetwith 3x5 cards in it, with all the people whohad ever received a graduate degree fromUniversity College London. There was Lane-Claypon’s card. But someone had written atthe bottom of the card, “married Forber.”Well, that information was obviously an opendoor, and in fact I was so excited, I literallyran back to the library at the London Schoolof Hygiene, and within a half hour we had herobituary. Janet Elizabeth Forber, née Lane-Claypon. So with the obituary, I could easilyconstruct her bibliography and then from thatI went on to find out more about her. That ledto several summers’ research work, and itrevealed an amazing scientist.

In your view, what are the key issuesconfronting epidemiologists in 2005?Well that’s a tricky question. You would think itwould be easy to answer that. I think there areareas that are, let’s say, underserved, or under-addressed. Population explosion, the world-wide increase in population is, I think, atremendous challenge to public health. I thinkyou can relate many of our problems to popu-lation pressure. Problems like energy and vio-lence… I think that civil unrest is a majorunaddressed issue. It’s a field that I think epi-demiology can well address. I think epidemolo-gists have a role to play in better understand-ing natural disasters, what happens as a conse-quence of them. And then of course, as theindustrial societies evolve, new problems inoccupational health are going to continuouslyemerge. They’re going to have to be studiedand understood and controlled—a function ofepidemiology. I guess that’s at least a partiallist. I’m sure there are many other things thatcould be identified as major challenges.


“Public health is by its very nature multidisciplinary, and I think our School would benefit, both in terms of its research orientation and in its ability to provide students withmeaningful instruction, by addressing this Balkanization, if you will, of the locations.”

In the wake of the devastation and destruc-tion caused by Hurricane Katrina, the UCBerkeley School of Public Health opened itsdoors to 14 public health students displacedfrom Tulane University’s School of PublicHealth. Dean Stephen Shortell, Ph.D.,M.P.H., along with faculty, program man-agers, and student representatives, wel-comed the Tulane students to the School ata lunch on September 16.

Later that month, students organized anopen community forum on HurricaneKatrina as a way of building community andexpressing concern for the visiting students.A powerful part of the event was the Tulanestudents’ sharing of their experiences withthe hurricane and its aftermath. Items dis-cussed at the forum included racism andclassism as they impact health and vulnera-ble populations; lessons learned from this

disaster and how to better prepare for dis-asters as a School community; and thebuilding of community capacity to makesure such devastation and human toll nevertakes place again.

In addition, the School’s Center for PublicHealth Practice held a two-part panel ses-sion on Hurricane Katrina and disaster pre-paredness (part of its “What Can You Dowith a Public Health Degree?” series), whilethe School’s Center for Infectious DiseasePreparedness participated directly inresponse operations through activation anddeployment of Cindy Lambdin, R.N.,M.S., emergency operations specialist, tothe impacted area.

The School will continue to take on theissues raised by the Katrina disaster. Thisyear, for example, the “Dr.P.H. in Action”

project, conducted by first-year Dr.P.H. stu-dents, will be studying “Applying LessonsLearned from Hurricanes Katrina and Rita toImproving Local Disaster Preparedness forVulnerable Populations.”

In spring 2006, the Center for InfectiousDisease Preparedness will offer several train-ings related to Hurricane Katrina. A newcourse on disaster epidemiology will includepreparation for deployment in the event offuture disasters, and the center’s regularspring course, “Core Infectious DiseaseEmergency Readiness,” will address publichealth issues and challenges faced during theGulf Coast hurricanes. The center will alsoconduct regional conferences throughoutCalifornia on “Designing Exercises to TestPublic Health Emergency Operations Plans.”


The School Responds to Hurricane Katrina with Action,Training, and Caring


In a major new joint effort to bring public healthstudents into the Berkeley community, BerkeleyMayor Tom Bates and Dean StephenShortell launched the first annual VolunteerMobilization Day for incoming public health grad-uate students on August 26. After a brief kick-offevent, 70 participating students were deployed tochildcare, homeless, and public health sitesthroughout Berkeley for a day of service.

“This is an exciting opportunity for our students to be directly engaged with theBerkeley community. Public health embraces allaspects of the community, and we expect thatthis initial contact will lead to ongoing relation-ships that benefit everyone,” said Dean Shortell.

“I am thrilled to welcome these public healthstudents to Berkeley and put them right to

work in our community,” said Mayor Bates.“This is exactly the type of cooperation that weenvisioned as part of the new UC-city partner-ship. I believe it will be a model for otherdepartments to follow.”

Following the kick-off event, organized teamsof volunteers proceeded to preapproved sitesto perform community service until 3:00 p.m.Volunteer sites included Berkeley Food andHousing Project, Options Recovery Services,Bahia School-Age Program, City of BerkeleyEnvironmental Health, Center for the Educationof the Infant Deaf, Lifelong Medical Care, Inc.,Women’s Daytime Drop-in Center, Peoples Park,Fred Finch Youth Center's Homeless YouthCollaborative, and Berkeley Youth Alternatives.

25Public Health

Students Mobilize for Day of Volunteerism

Students in action on Volunteer Mobilization Day: Sprucing up People’s Park; getting their handsdirty at the Malcolm X School garden; fixing lunch at the Women’s Daytime Drop-In Center; and

preparing for a graduation celebration at the Bay Area Hispano Institute for Advancement. BerkeleyMayor Tom Bates (left) addresses students at the kick-off ceremony.

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How do you help students integratetheir theoretical, often specializedacademic knowledge with the realitiesand uncertainties of contemporarypublic health practice?

This was the challenge that professor emeritusWarren Winkelstein, Jr., Ph.D., M.D.,M.P.H., and lecturer Jeffrey Braff, Dr.P.H.’01, M.B.A., of the Division of Epidemiologytook on four years ago when they set aboutdesigning a course that would add a practical,real-world dimension to students’ experience.

The course, PH 200D, “Applied Public Health:Putting Theory into Practice,” gives students a pre-view of what it will be like to work in the publichealth trenches and provides opportunities tomeet with practitioners who are grappling with abroad spectrum of public health issues.

All master’s degree students take PH 200D intheir last semester. The core of the course is agroup of 30 public health problems—everythingfrom aging populations and public health toarresting the spread of West Nile Virus—that thestudents tackle in five- or six-person teams.Aswould occur in the real world, students cannotchoose the topic they will address. Braff assignsthe groups, but is careful that the members havea mix of skills, “so everybody has a different giftto bring to the team.”

Thirty faculty members serve as consultants forthe teams, each in his or her area of specializa-tion. So, for example, a team looking into stemcell research can draw upon the expertise of JodiHalpern, M.D., Ph.D., associate professor ofbioethics and medical humanities.Another teaminvestigating environmental lead can seek guid-ance from S. Katharine Hammond,Ph.D., C.I.H., professor of environmentalhealth. The team studying health care in LosAngeles can discuss its work with ThomasRundall, Ph. D., Henry J. Kaiser Professor ofOrganized Health Systems, who will also be co-teaching the course in 2006.

In the course of the semester, each team exploresits topic; researches precedents; defines the issuesto be addressed and why they are important;looks at the options, costs, politics and other fac-tors involved in solving the problem; decides upona plan of action; and explains why the team haschosen that approach.

This work culminates in a report and a posterpresentation in the lobby of Warren Hall to whichthe entire School of Public Health is invited. Braffsends exceptional reports to appropriate govern-ment agencies, where they are invariably wel-comed and appreciated.

Developing Work Skills“We are interested in the technical aspects ofwhat folks produce, but we are very much moreinterested in assuring that students develop goodworking group habits, good interpersonal skills,and good planning, writing and presentationskills so that they can successfully continue to doprojects like this,” Braff explains.

To encourage meaningful group participation, acomponent of each student’s grade in the courseis based on peer assessment.

Outside Experts Discuss Real-LifeProblemsIn addition to work on a public health issue, PH200D exposes students to the reality of publichealth decision-making and practice through lec-tures, field trips and panel discussions in whichthey hear from outside experts.

“When we talk about what it’s like to run a pub-lic health department, we don’t rely on an aca-demic discourse about what is important toknow,” Braff says. “We get in one of the publichealth directors in the Bay Area to talk aboutdealing with a budget shortfall in one depart-ment when you have money for bioterrorism inanother department that you can’t use—that’s areal-life problem.”

The field trips take students to a multitude oflocal industries and services. Classes have visiteda dairy processing plant to hear about pasteur-ization and product purity; San Quentin, to learnhow prisoners are treated from a public healthpoint of view; oil refineries, to learn about envi-ronmental protection and occupational health;the East Bay Municipal Utility District, to discusswater and sewage processing; and the bloodbank of Northern California to learn about thepublic health implications of its work.

The site visits provide for a lively exchange ofviews and information about public health prac-tice in action. Braff recalls with a chuckle the firsttime he called the Hayward-based milk processorBerkeley Farms to arrange for a tour: “They nor-mally deal with kindergarteners and first graders,so someone misunderstood and said, ‘You realizethese students are all going to need permissionslips from their parents.’ When I explained thatthese are all master’s and doctoral students atUC Berkeley, they successfully ratcheted up theirpresentation, assigning a microbiologist to meetthe level of sophistication of the students. We seethat response everywhere we go. People areproud of what they do and are thrilled to be ableto discuss with peers the kind of work that goeson that has direct public health implications. Theyare pleased, and so are our students.”

—Vivian Auslander


Putting Theory into Practice

Dr.P.H. student Eddy Jara—who is collaboratingwith Professor Emily Ozer on a project to pro-mote child nutrition through school garden pro-grams—puts theory into practice by working inthe garden at Berkeley’s Malcolm X ElementarySchool on Volunteer Mobilization Day.

27Public Health

Faculty News

Robin Baker, M.P.H., director of UCBerkeley’s Labor Occupational HealthProgram, received support from the Stateof California Department of IndustrialRelations to provide outreach and educa-tional information to California’s youngworkers regarding injury prevention aspart of the statewide California ResourceNetwork on Young Worker Health andSafety.

Joan R. Bloom, Ph.D., professor ofhealth policy and management, is princi-pal investigator for a study to determinewhether weight-bearing exercises can helpreduce bone loss among women who havegone through chemotherapy for breastcancer. With support from a new $2.1million grant from the National CancerInstitute, researchers at UC Berkeley andUC San Francisco are teaming up with theYMCA of San Francisco and the NorthernCalifornia Cancer Center. Women whoparticipate in the intervention trial—allunder age 50—will be randomly assignedto either an exercise intervention programat one of the 12 YMCA of San Franciscobranches selected for the study, or a con-trol group. Women in the interventionprogram will receive a one-year YMCAmembership, be assigned a personal trainerand get a tailored exercise regimen basedupon an assessment of their physical fit-ness. Bone density will be determinedthrough X-ray tests and biochemical mark-ers of bone turnover. The researchers willalso monitor changes in lean body massand reports of overall mental and physicalhealth. In addition to studying bonehealth, the researchers will monitor eachparticipant's fitness throughout the study.

Ralph A. Catalano, Ph.D., professor ofpublic health, is lead author of a studyexamining the impact of capitation on hos-pital emergency visits to address whethercapitation has an impact on the effective-ness of the mental health system as a whole.The study was published in the June 2005issue of Psychiatric Services. Joan R.Bloom, Ph.D., professor of health policyand management, is a coauthor.

Sylvia Guendelman, Ph.D., M.S.W.,professor of community health and humandevelopment, and Brenda Eskenazi,Ph.D., professor of epidemiology andmaternal and child health, received sup-port from the Health Resources andServices Administration for a multidiscipli-nary program dedicated to developing andtraining maternal and child health leadersto conduct research and provide maternaland child health services at regional, state,and national levels.

Jodi Halpern, M.D., Ph.D., associateprofessor of bioethics in the UC Berkeley-UCSF Joint Medical Program, has beenselected as one of three Greenwall FacultyScholars Program recipients in Bioethics.The Greenwall Faculty Scholars Programin Bioethics is a career development awardthat allows faculty members to conductoriginal research that will help resolveimportant policy and clinical dilemmas atthe intersection of ethics and life sciences.The award includes three years of researchsupport.

S. Katharine Hammond, Ph.D.,C.I.H., professor of environmental healthsciences, is principal investigator of“Evaluation of the Effect of Changes Madein Response to the Respiratory HealthStudy in the New NUMMI AssemblyPlant,” supported by New United MotorManufacturing, Inc. (NUMMI). The proj-ect is a follow-up to an earlier study con-ducted in 2000–2001 by the University ofCalifornia Northern Center for Occupat-ional and Environmental Health, whichfound increased respiratory symptomsamong NUMMI team members whoworked in the body shop. As a result ofthe earlier study, the ventilation wasincreased in the body shop, and this newgrant will evaluate the effectiveness of thechanges through a survey of the ventilationsystem and administration of a follow-uprespiratory symptom questionnaire.

Eva Harris, Ph.D., associate professor inthe Division of Infectious Diseases, hasreceived support from the InternationalVaccine Institute for “A Murine Model forDengue Virus Infection and Disease.” Theproject’s major goals are to develop amodel for secondary dengue virus infec-tion, and evaluate changes in the in vivocellular tropism, viral load, kinetics of viralinfection, and immune response upon sec-ondary infection.

Susan Ivey,M.D., associateadjunct professorin the Division ofCommunityHealth & HumanDevelopment, ispresident-elect of

the American Medical Women’s Associ-ation, an organization of 10,000 womenphysicians and medical students dedicatedto serving as the unique voice for women’shealth and the advancement of women inmedicine.

William J.Jagust, M.D.,professor of publichealth and neuro-science, has beenawarded theUniversityEndowed Chair in

Geriatrics for the Berkeley campus. Thenew chair is part of the UC AcademicGeriatric Resource Program, authorized bythe California Legislature in 1984 as amechanism for developing new initiativesin geriatrics, gerontology and other disci-plines related to aging.

Thomas McKone, Ph.D., adjunct pro-fessor of environmental health sciences,received support from the State ofCalifornia Air Resources Board for“Quantifying Pollutant Emissions fromOffice Equipment,” a study of the cham-ber concentrations of air pollutants emit-ted by major categories of distributedoffice equipment.

Faculty News and Notes


Faculty News and Notes, continued

Faculty News

SPH researchers have found that a newblood-based tuberculosis (TB) test is asuseful as the traditional tuberculin skin testin a head-to-head match-up between thetwo methods of detecting latent infection.The results of the study mean that switch-ing to the more expensive blood test maynot be necessary for people in India.Madhukar Pai, Ph.D. ’04, is the study’slead author; other School of Public Healthcoauthors include John Colford, Jr.,M.D., Ph.D., M.P.H., associate professorof epidemiology, Lee Riley, M.D., pro-fessor of infectious diseases, and ArthurReingold, M.D., professor of epidemiol-ogy. The results of the study were pub-lished in a special June 8, 2005, themeissue on tuberculosis in the Journal of theAmerican Medical Association.

Mark Nicas, Ph.D., C.I.H., adjunctassociate professor of environmental healthsciences, and Michael P. Wilson, Ph.D.’03, M.P.H. ’98, assistant research scien-tist, received support from the BodycoteGroup for “Preventing Worker Fatalities inConfined Spaces: Evaluating the OSHAConfined Space Entry Standard.” Thestudy examines the root causes of occupa-tional confined space fatalities inCalifornia and the rest of the U.S. in thepost-federal OSHA standard era (1993 tothe present). Nicas is principal investigatorand Wilson is project manager.

The Nicholas C. Petris Center onHealth Care Markets andConsumer Welfare recently released areport, Uninsured Californians and Accessto Prescription Drugs. California is current-ly considering a number of bills andpropositions, including competing propo-sitions on the November special electionballot, Propositions 78 and 79, as well asSenate Bill 19 and Assembly Bill 75,which address the lack of access to pre-scription drugs for the uninsured. To helpinform the discussion of the proposed leg-islation, this report examines variousmethods for defining the number of unin-sured Californians and the programs, both

public and private, that are available toprovide assistance to those who are unableto afford prescription drugs. The reportexamines data from the California HealthInterview Survey, the Current PopulationSurvey, the Behavioral Risk FactorSurveillance Survey, and the NationalSurvey of America's Families to estimatethe number of uninsured in the state. Italso looks at the uninsured population byage, federal poverty level, gender, county,and race.

The NationalWomen’s HealthNetwork(NWHN) hashonored CheriPies, Dr.P.H.,M.S.W., lecturerin the Division

of Community Health & HumanDevelopment, for her achievements in the field of women’s health. As part of theorganization’s “30 for the 30th” projecthonoring its 30th anniversary, it recognized30 activists who best represented the vari-ety of people and issues addressed by thewomen’s health movement. “Cheri Pies hasnever shied away from addressing contro-versial topics. She has written about issuesrelated to lesbian parenting, bioethics, andreproductive health.…Cheri makes it a priority to apply her vision of social justiceto her work in women’s health,” statesNWHN’s web site. Pies currently directsthe Family, Maternal, and Child Healthprograms of Contra Costa County,California.

Traffic Safety Center director DavidRagland, Ph.D., M.P.H., and colleaguesrecently published two reports. The first,Pedestrian and Bicycle Safety Evaluation forthe City of Emeryville at Four Intersections:Powell and Frontage, Powell and Route I-80,Powell and Christie, and Christie andShellmound, was commissioned by theCity of Emeryville. The project includedfield observations, intercept surveys andcommunity forums. The second was the

final report of Phase I of the center’sLatino Traffic Safety Project, funded by theCalifornia Office of Traffic Safety. Thisproject consisted of an extensive literatureand best practices review, focus groups inurban and rural regions of the State, andconvening of stakeholders on this issue oftraffic safety in Latino communities inCalifornia. The Traffic Safety Center alsoreceived support from Caltrans to researchand analyze twenty years of workplaceinjuries among Caltrans employees, withthe goal of assisting Caltrans with promis-ing approaches to reducing employee acci-dents and injuries.

Thomas Rundall,Ph.D., Henry J.Kaiser Professor ofOrganized HealthSystems, receivedthe Filerman Prizefor Innovation inHealth Care

Management Education from theAssociation of University Programs inHealth Administration (AUPHA). Theaward was presented this past June at theAUPHA annual meeting in Boston. Theprize recognizes individuals from AUPHAmember programs who have made out-standing contributions to the field ofhealth care management education, exhib-ited leadership in the field, and enrichedtheir institutions, their students, and theirfield through their work.

WilliamSatariano,Ph.D., M.P.H.,professor of epi-demiology andcommunityhealth, hasauthoredEpidemiology ofAging: AnEcological

Approach, a book published by Jones andBartlett Publishers. It provides a compre-hensive overview of the leading topics in

the epidemiology of aging, such as physicalfunctioning, depression, and survival withthe ecological model. Using this ecologicalmodel, Satariano highlights the causes andconsequences of the aging population andillustrates that all of the topics are interre-lated. The model is being used increasinglyby national and international health bodiesto characterize the multidisciplinary natureof research and practice in public health.

Richard M.Scheffler,Ph.D.,DistinguishedProfessor ofHealthEconomics andPublic Policy,

and director of the Nicholas C. PetrisCenter on Health Care Markets &Consumer Welfare, has received fundingfrom the National Institute of MentalHealth for a new postdoctoral MentalHealth Economics Training Program.

He has also received funding from theUniversity of California Tobacco-RelatedDisease Research Program for “Effects ofSocial Capital on Smoking: Elasticities andPathways,” a two-year study on how com-munity social capital (CSC) influencesindividual smoking behavior. CSC is aconcept originally developed from sociolo-gy and political science, and represents thelevel of participation in civic, social, or reli-gious organizations within a community.In this study, CSC is hypothesized to affecthealth through three possible pathways:political processes that bring health-pro-moting resources to the community; likeli-hood of access to social and psychologicalsupport; and diffusion of information andattitudes about smoking.

In addition, Scheffler coauthored“Millionaires and Mental Health:Proposition 63 in California,” with NealAdams, special projects director at theCalifornia Institute of Mental Health.Published in the May, 2005, isssue ofMental Health, the article analyzed the

election results for Proposition 63, a land-mark California law funding mental healthwith a tax on those making more than $1million a year. They found that countiesthat voted in support of the ballot measurewere more likely to have a higher percent-age of registered Democrats, a higher num-ber of registered social workers per capita,and a higher rate of homelessness thanthose that did not vote in favor of theproposition, and that the measure hadmore support in urban and coastal areas.The Petris Center has received fundingfrom The California HealthCareFoundation to undertake a three-year studyto monitor and report on the implementa-tion of Proposition 63.

Kirk R. Smith, Ph.D., M.P.H., Brianand Jennifer Maxwell Endowed Chair inMaternal and Child Health and professorof environmental health sciences, receivedsupport from the Shell Foundation for“Promotion of Technology Innovation andDissemination for High-Efficient, Low-Emissions Biomass Household Stoves inChina and Abroad,” a joint project withthe China Association of Rural EnergyIndustry and the School of Public Health’sCenter for Entrepreneurship in Inter-national Health and Development, withthe primary objective of identifying themost promising high-efficiency, low-emis-sions biomass stove technologies and thebest enterprises innovating in this field.The project will also identify subsequentexport opportunities for these products indeveloping countries outside of China.

S. LeonardSyme, Ph.D.,professor emeri-tus, published anarticle in the April19, 2005, issue ofEpidemiologicPerspectives and

Innovations discussing his experiences in the early days of research on social determi-nants of disease. The article is based on a lecture he delivered at ColumbiaUniversity's Mailman School of Public

29Public Health

Faculty News

Robert C. Spear, Ph.D., professor and chair ofthe Environmental Health Sciences Division,was honored by the People’s Republic ofChina with the state-level Friendship Award, inrecognition of his work to understand, moni-tor, and control the spread of the water-borneparasitic disease schistosomiasis in rural com-munities in China.

Inaugurated in 1981, the Friendship Award isthe highest recognition given by China to for-eign experts for their contributions and dedica-tion to the training of Chinese personnel, aswell as China’s social development and eco-nomic, scientific, technological, educational,and cultural construction. The award lettercommends Spear for his hard work and thankshim for promoting cooperation and friendshipbetween the United States and China.

Spear is one of 50 international recipients ofthe 2005 award, which was presented byChinese Vice Premier Wu Yi at a ceremony inBeijing on September 29. After the event inBeijing, Spear traveled to Sichuan Province,where his nomination for the national awardoriginated, for a provincial reception.

Spear Receives China’sFriendship Award


publication. Two of his former students,Sir Michael Marmot, Ph.D. ’75,M.P.H. ‘72 and Irene Yen, Ph.D.’97, M.P.H ’90, published comments in subsequent issues.

At the 2005Joint StatisticalMeeting inMinneapolis thispast August,Mark van derLaan, Ph.D.,who holds the

Jiann-Ping Hsu and Karl E. PeaceEndowed Chair in Biostatistics, receivedthe 2005 Presidents’ Award, given annu-ally by the Committee of Presidents ofStatistical Societies to a young member

of the statistics community in recogni-tion of extraordinary merit. The com-mittee recognized van der Laan’s work inseveral areas of theoretical and appliedstatistics, including causal inference inlongitudinal studies and computationalbiology. Van der Laan and NicholasJewell, Ph.D., professor of biostatisticsand statistics, received the prestigious2005 George W. Snedecor Award for anoutstanding publication in biometry.The award recognizes an individual whohas been instrumental in the develop-ment of statistical theory in biometry.Jewell and van der Laan were honoredfor their paper, “Case-control currentstatus data,” which appeared in a 2004issue of the journal Biometrika.

In addition, van der Laan was named2005 Myrto Lefkopoulou DistinguishedLecturer by the Department ofBiostatistics at the Harvard School ofPublic Health. Each year the lectureshipis awarded to a promising statisticianwho has made contributions to eithercollaborative or methodologic research inthe applications of statistical methods tobiology or medicine and/or has shownexcellence in the teaching of biostatistics.In September 2005, van der Laan pre-sented a lecture at the Harvard School ofPublic Health, titled, “History AdjustedMarginal Structural Models: Applicationsin AIDS Research.”

Faculty News

William H.Dow, Ph.D.,associate pro-fessor of healtheconomics,began a one-year stint inWashington,

D.C., serving as a senior health econo-mist advising members of PresidentBush’s Council of Economic Advisors(CEA). Dow is one of nine senior staffeconomists advising the three-membercouncil on specific sectors of the econ-omy. The CEA was established by theEmployment Act of 1946 to providethe president with objective economicanalysis and advice on the develop-ment and implementation of a widerange of domestic and internationaleconomic policy issues.

“Serving at the CEA is a tremendousopportunity to observe and participate inthe policy-making process,” says Dow.“The CEA plays a unique role in theinternal White House policy processgiven that it is staffed by academics and,as such, its role has historically been toprovide objective economic analysis.That advice is not always welcomed,particularly when it conflicts with politi-cal interests. Working on health care willbe particularly exciting in light of themagnitude of the challenges this nationfaces, such as soaring health care costsand high rates of uninsured.”

Dow’s background is in health policy,both domestic and international, par-ticularly as it relates to health insur-ance. He received the 2001 John D.Thompson Prize for Young Investigators,

awarded by the Association ofUniversity Programs in HealthAdministration. He also won the 8thAnnual Kenneth J. Arrow Award, givenby the International Health EconomicsAssociation for the best health econom-ics paper published worldwide in 1999.

He earned his Ph.D. in economics fromYale University. Before coming to UCBerkeley, Dow was an assistant profes-sor of health policy and administrationat the University of North Carolina atChapel Hill, and a National Institutes ofHealth postdoctoral fellow at RAND. Heis also a faculty research fellow at theNational Bureau of Economic Research.

Dow Starts Term as Senior Adviser on Presidential Council

Faculty News and Notes, continued

31Public Health

Faculty News

Meet the New Faculty

Lia Fernald, Ph.D.Assistant Professor, Public Health Nutrition, CommunityHealth & Human Development

When she was an undergraduate atSwarthmore College, Lia Fernaldspent a semester in Kenya studyingwildlife behavior and ecology. “At thattime, I thought I wanted to go intoanimal behavior,” says Fernald. “ But

when I saw what extreme poverty people lived in, that was aturning point for me. I said, ‘I can’t let this happen. I can’t live ina world where people are living in such extreme poverty that theydon’t have any food to give their children.’”

After receiving her bachelor’s degree, Fernald won a Fulbrightaward to study public health in Jamaica, where she looked atmalnutrition and its link with child development. “I workedwith Sally McGregor, who is really a pioneer in this area oflinking nutritional deficiencies with cognitive outcome,” shesays. When McGregor went to the University of London,Fernald went with her, supported by a predoctoral fellowshipfrom the National Institutes of Health (NIH), and earned herPh.D. there.

But research for its own sake didn’t satisfy her. “I felt it was allgoing into journals and it wasn’t turning into action,” she says. “I was alarmed by the fact that Coke can get anywhere in theworld—you go to a rural village in Kenya and there’s Coke—sohow come we can’t get micronutrients to those villages? I startedthinking, how can we use the power of economics and business?”

Fernald then began pursuing her M.B.A., which she earned atUC Berkeley’s Haas School of Business. There she worked withPaul Gertler, professor of economics at the Haas School and pro-fessor of health services finance at the School of Public Health,who was engaged in a project in Mexico that looked at childdevelopment. Fernald designed the child development outcomemeasures for the study; then, with funding from the NIH’sFogarty International Center, she added components examiningmental health and stress. She continues to work on this andother projects in Mexico.

Fernald’s research focuses on inequalities in health and how varia-tions in socioeconomic status contribute to adverse nutritionaloutcomes in children and adults. “I’ve been working for the pastfour years on a very innovative welfare program in Mexico thatties economic incentives with behavioral change, so families aregiven unconstrained cash transfers and then are required to go tothe doctor and keep their kids in school,” she says. “We’re talking

about people who live on less than two dollars a day, so a thirtypercent increase in their income is really quite substantial. Givingpeople health benefits may or may not result in behavioralchange. Giving people cash with which they can do whateverthey want—it’s a huge motivator.” She also has been consultingwith the governments of Ecuador, Chile, and Colombia, all ofwhom have replicated parts of the program.

Fernald joined the faculty in fall 2005 and will begin teaching inspring 2006. “The main draw for me was the integrated thinkingat the School of Public Health,” she says. “I really resonate withthe ecological model. My work has always been multidiscipli-nary…and I think that’s the only way to find solutions—through looking at the intersections.”

EducationPostdoctoral Fellow in HealthEconomics, National Institute ofPublic Health, Mexico and UCBerkeley, 2001–2003

M.B.A., Haas School of Business,UC Berkeley, 2000

Ph.D., Clinical Medicine, withfocus on International Nutrition,University of London, 1999

B.A., Swarthmore College,Biological Anthropology and FoodPolicy, 1994

Selected ExperienceAssistant Professor, School ofPublic Health, UC Berkeley,2005–present

Assistant Adjunct Professor,Department of Medicine, UCSF,2004–05

Consultant to World BankObesity Task Force and ChildDevelopment Group,2004–present

Consultant to Governments ofMexico, Colombia, Ecuador andChile, 2003–present

Network Associate, MacArthurResearch Network onSocioeconomic Status andHealth, 2002–present

Selected HonorsNIH International ResearchScientist Development Award,2002–2006

Young Scholars Award, AmericanPsychosomatic Society, 2004

NIH Pediatric Research LoanRepayment Award 2002–2004

NIH Pre-doctoral Fellowship,1995–1998

Fulbright Fellowship 1994–1995

“I was alarmed by the fact that Coke can get any-where in the world—you go to a rural village inKenya and there’s Coke—so how come we can’t getmicronutrients to those villages?”


Faculty News

Meet the New Faculty

Richard Jackson, M.D., M.P.H. ’79Adjunct Professor, EnvironmentalHealth Sciences and Health Policy& Management

“In public health, the patient is thepopulation, and our patient has asystemic disease, one aggravated bythe environment we live in,” saysDr. Richard Jackson, new adjunctfaculty at the School of Public

Health. “The illnesses we face are not random events. Whena patient has a systemic disease, we need to find and treat theroot causes, not just the blister or the fever.”

Jackson attributes some of his passion for public health to hisfather’s death from polio when Jackson was young. Afterworking as a pediatrician and an epidemiologist, he earned amaster’s degree in public health from Berkeley in 1979. Heserved as the director of the National Center for Environ-mental Health, and then as senior adviser to the director atthe Centers for Disease Control and Prevention. In 2004, hewas appointed state public health officier and chief deputydirector of the California Department of Health Services.Throughout his career, Jackson has worked on a broad rangeof environmental health issues, from pesticides in food tobioterrorism investigation.

In the past several years, Jackson has received substantialacclaim for his work on the built environment and health.His research examines many aspects of urban planning, fromthe amount of parkland in a neighborhood, to whether chil-dren are able to walk or ride a bicycle to the local school. Heplans to continue this research at Berkeley and further inves-tigate how neighborhoods and transportation systems can bedesigned to encourage physical activity and other healthypractices. “Environmental changes can have major impact onbehavior,” he says. He argues that designing communitiesthat allow for physical activity benefits everyone, from chil-dren, to the elderly and people with disabilities.

“What is so special about public health is that you are alsoexpected to analyze the chain of causes leading to disease inorder to put in place prevention efforts. Yes, the obesity epi-demic is partly because we human beings don’t always havethe self-discipline and willpower that we need, but largely theepidemic originates from an unhealthy environment—a dan-gerous nutritional, advertising, and built environment. Anutritional environment where school children are encour-aged to consume abundant amounts of junk food in the veryplace where they need to learn and prepare for their future; a

built environment that makes it hard to walk, run or play.”Jackson is enthusiastic about working with students at theSchool. “We need to develop the next generation of publichealth workers. The challenges we face in the twenty-first century are so profound and overwhelming… People whothink of public health in a narrow, textbook way are not goingto be prepared for these challenges. The most important thingwe can do now is to prepare leaders that can step up.”

EducationM.P.H., Epidemiology, School ofPublic Health, UC Berkeley, 1979

M.D., School of Medicine, UCSF,1973

M.M.S., Rutgers Medical School,1971

B.A., Biology, St. Peter’s College,1969

Selected ExperienceAdjunct Professor, School ofPublic Health, UC Berkeley,2005–present

State Public Health Officer andChief Deputy Director, CaliforniaDepartment of Health Services,2004–2005

Senior Adviser to the Director,Centers for Disease Control andPrevention, 2003–2004

Director, National Center forEnvironmental Health,1994–2003

Selected HonorsAlumnus of the Year, School ofPublic Health, UC Berkeley, 2005

Presidential Distinguished RankAward, 2005

Presidential Citation, AmericanInstitute of Architects, 2004

Commendation from theGovernor, State of Hawaii, 2004

Champion of EnvironmentalPublic Health, Centers for DiseaseControl and Prevention, 2003

Health and Human ServicesSecretary’s Award forDistinguished Service

The World Trade Center AnthraxInvestigation and Response Team,2002

Calver Award, American PublicHealth Association, 2001

Presidential Citation, NationalEnvironmental Health Association,2001

“Yes, the obesity epedemic is partly because we human beings don’t always have the self-discipline and willpower that we need, butlargely the epidemic originates from anunhealthy environment.”

33Public Health

Faculty News

Amani Nuru-Jeter, Ph.D., M.P.H.Assistant Professor, CommunityHealth & Human Development and Epidemiology

“For so long, we have focused onidentifying the determinants ofhealth,” says Amani Nuru-Jeter, assistant professor in the divisions of Community Health & HumanDevelopment and Epidemiology.

“Now we need to know where to intervene. We know that racematters and that class matters. As we think about the complexi-ties of how race and class interact, we need to better understandthe pathways through which these determinants affect healthdifferently for different social groups and how we can interveneat both the community and policy levels to affect change.”

Nuru-Jeter’s research examines the links between social inequal-ity and racial disparities in health. Previously, as a Robert WoodJohnson Health and Society Scholar at the UCSF Center forHealth and Community and the UC Berkeley School of PublicHealth, her research examined social contexts and health, andhow factors such as racial segregation of neighborhoods andconcentrations of poverty influence the health of populations.Now she has combined this work with a more individual-cen-tered approach, and is looking at the ways in which the socialand structural aspects of environments interact with biologicalprocesses to effectively alter states of health and influence racialhealth inequalities.

“I’m interested in the process by which social factors such asracism ‘get under the skin,’ and in understanding the psycho-physiologic mechanisms involved in the production of healthboth across and within social groups,” says Nuru-Jeter. “I’mlooking at how repeated and prolonged exposure to social stres-sors such as racism can keep people cycling through the stressresponse process, and how that influences health.”

“It is easy for us to go into a community and say, ‘You need tolower your blood pressure,’” says Nuru-Jeter, “but we also needto be mindful of the challenges people face, and how social fac-tors, such as the availability of healthy food options and safespace for outdoor activity, influence health outcomes.”

Nuru-Jeter is addressing these questions in a number of ways.For one project, she conducted focus groups with AfricanAmerican women, in order to develop a comprehensive diag-nostic tool for measuring the perception and experience ofracism. The long-term goal of the project, developed in collabo-ration with researchers at the UCSF Center on Social

Disparities in Health, the Centers for Disease Control, theDivisions of Public Health in Berkeley and Sacramento, andthe San Francisco Department of Public Health, is to examinethe possible link between racism as a chronic psycho-socialstressor and pregnancy outcomes.

In another project, Nuru-Jeter is working with researchers atUCSF and the Kaiser Division of Research to analyze the rela-tionship between perceived discrimination, racial differences inallostatic load, and low birth weights. Allostatic load is thephysiologic marker for stress, and is tied to health risk factorssuch as diabetes, atherosclerosis, a suppressed immune system,and decreased memory function. The study uses data from theCoronary Artery Risk Development Study in Young Adults, alongitudinal community-based sample with participantsrecruited from Oakland; Minneapolis; Chicago; andBirmingham, Alabama.

An interdisciplinary approach is the foundation of much ofNuru-Jeter’s research. She works with epidemiologists, psychol-ogists, sociologists, and cultural anthropologists for much of herresearch, and more broadly, believes in the importance of col-laboration between academia, community, and public healthagencies to develop pragmatic and sustainable interventions forimproving public health.

Education

Ph.D., Health Policy andManagement, Johns HopkinsUniversity, 2003

M.P.H., Maternal and ChildHealth, George WashingtonUniversity, 1998

B.S., Biology,University of Maryland, 1995

Selected Experience

Assistant Professor, School ofPublic Health, UC Berkeley,2005–present

Robert Wood JohnsonPostdoctoral Fellow,University of California, Berkeleyand San Francisco, 2003–2005

Selected Honors

University of Pittsburgh Center forMinority Health (Project EXPORT),Summer Research CareerDevelopment Institute, June 2005

Student Investigator Award, BlackYoung Professionals Public HealthNetwork, November 2003

Minority Health Award, The JohnsHopkins University, BloombergSchool of Public Health, 2002

Victor P. Raymond Award inHealth and Public Policy, JohnsHopkins Bloomberg School ofPublic Health, 2001

Washington Institute of IsraelHealth Policy Research Internship& Scholarship, Ministry of Health,Jerusalem, Israel, 1998

Margaret Cary, M.D., M.B.A., M.P.H. (Chair)Deputy Chief Business Officer for VA+Choice, Veterans Health Administration

Raymond J. Baxter, Ph.D.National Senior Vice President, Community Benefit,Kaiser Foundation Health Plan and Hospitals

Larry Brilliant, M.D., M.P.H.Founder and Chair, Seva Foundation

Terri Carlson, M.P.H. ’84UC Berkeley Parents Fund

Peter F. Carpenter, M.B.A.Founder, Mission and Values Institute

Alfred W. Childs, M.D., M.P.H. ‘64Physician

Linda Hawes Clever, M.D., M.A.C.P.Chief, Occupational Health,California Pacific Medical CenterFounder, RENEW

Abla A. Creasey, Ph.D. ’78Vice President, Biological Sciences,ALZA Corporation

Lauren LeRoy, Ph.D.President and CEO, Grantmakers in Health

Leslie Louie, Ph.D. ’90, M.P.H. ’85President, Public Health Alumni AssociationDirector, School-Based Health Clinics and PracticeAdministrator, Children’s Hospital and Research Center at Oakland

Nancy K. LuskChairman of the Board, The Lusk Company

Martin Paley, M.P.H. ’58Management Consultant

Arnold X. C. PerkinsDirector, Alameda County Public HealthDepartment

J. Leighton Read, M.D.General Partner, Alloy Ventures

L. James Strand, M.D., M.B.A.General Partner, Institutional Venture Partners

Kenneth S. Taymor, Esq.Attorney-at-Law, MBV Law LLP

Barbara S. Terrazas, M.P.H. ’76Director, Planning , Development, and PolicyTiburcio Vasquez Health Center, Inc.


Policy Advisory Council WelcomesTerri Carlson

Terri Carlson, M.P.H. ’84, is the newest member of the School of Public Health PolicyAdvisory Council. An alumna of the School, Carlson earned her M.P.H. fromBerkeley in 1984 and her bachelor’s degree in nursing from the University of OregonHealth Sciences Center in1978. She is married to John R. Carlson, M.D., a gastroen-terologist and Berkeley alumnus. Their two sons both attend UC Berkeley.

The Carlsons enjoy participating in the advisory board for the Cal Parents Fund,which provides the chancellor with flexible funding to invest in student programs andresources to support students. Terri’s work on behalf of Cal has included coordinationof a “Discover Cal” event and a Cal Aquatics event, both in Southern California. Shehas also has also contributed her time and expertise as a volunteer for many othernon-profit fundraising projects in northern and southern California, including educa-tional institutions and health care institutions.

Before raising her family, she worked in critical care nursing at UCLA and CedarsSinai Medical Centers in Los Angeles and in London, England, among the NationalHeart Hospitals, particularly Brompton Hospital. She also worked as an independentmanagement consultant on various West Coast hospital strategic planning projects, aswell as serving as a functional and space programming consultant to Anshen + AllenArchitects on a variety of hospital projects.

Carlson is enthusiastic about the School’s collaborations with other departments andcampuses, such as the combined master’s in public health and M.D. program withUCSF, and their potential for raising funds and capability and heightening publicawareness. “My passion is public health,” she says. “That’s something my husband andI are dedicated to—so it's an honor for me to serve.”

“My passion is public health. That’ssomething my husband and I arededicated to—so it’s an honor forme to serve.”

School of Public Health Policy Advisory Council

Partners in Public Health

35Public Health

Your tax-deductible contribution to the School of Public Healthensures the viability of valuable School of Public Health programs,such as scholarships and recruitment efforts. Support the future ofpublic health.

Give online at http://sph.berkeley.edu/giving/how.htm or mail your gift (payable to the “School of Public Health Fund”) to:

University of California, BerkeleySchool of Public HealthExternal Relations & Development140 Earl Warren Hall #7360Berkeley, CA 94720-7360

For additional information about makinga gift to the School, call Pat Hosel, AssistantDean, External Relations and Development,at (510) 642-9654.

Our Graduates are Trained to Tackle Complex Health Challenges

“In my work with Cal/OSHA, enforcing occupationalsafety and health regulations, I am continually remindedthat there is much yet to be done to improve the workingconditions for men and women in California. Despitethe many technological advancements of our age,workers are still exposed to a variety of hazards in theworkplace that can leave them sickened, poisoned,crippled or dead.

“The multidisciplinary training I received at the Schoolof Public Health still forms the cornerstone of my abilityto recognize and evaluate these hazards, whether theyare chemical, physical or biological. Likewise, the broadeducation that today’s students receive at the Schoolenables them to go out into the world and tackle some ofthe most difficult and complex public health challenges.

“When I hear about the amazing work being done bystudents, alumni and faculty of the School, in Berkeleyand around the globe, I feel proud to be a part of thatwork. I give to the Annual Fund out of my gratitudeto the School, and to enable this work to continue.”

—Susan Eckhardt, M.P.H. ‘85Industrial Hygienist

Cal/OSHA Enforcement

Support the Annual Fund


A Time For Giving and ReceivingConsider A Life Income Gift

Are you interested in supporting the Schoolof Public Health whilealso supporting yourself?

Two-Life Charitable Gift Annuity Rates

Spouse 1 Spouse 2 Payment Rate

60 60 5.465 65 5.670 70 5.975 75 6.380 80 6.985 85 7.990 90 9.395 and over 95 and over 11.1

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Age Payment Rate

60 5.765 6.070 6.575 7.180 8.085 9.590 and over 11.3

Consider making a “life income gift” to Cal. These life income gifts, which begin at

$10,000, provide the following benefits:

• Income payments to you for your lifetime;

• Avoidance of capital gains tax at the time of the gift if appreciated assets are donated;

• A current income tax charitable deduction; and

• The knowledge that your gift will ultimately benefit the School of Public Health.

For more information, and a proposal prepared for your own situation, pleasecontact the Office of Gift Planning at: (800) 200-0575 or (510) 642-6300.

UC Berkeley Sample Charitable Gift Annuity Rates:

37Public Health

Leslie Louie

Greetings Fellow Alumni,

I’m honored to be serving you as president of the Public Health Alumni Association board ofdirectors. Lots of changes are happening in the School of Public Health that make this anexciting place to be. The School is addressing health disparities by building more support forincreasing diversity among students and faculty. The Center for Public Health Practice isdeveloping a career center, which will benefit both students and alumni. Plans are underway tobuild a new home for the School—a huge project that presents many challenges. And so I’mexcited to be working with an energetic board, which has already set high expectations forwhat we want to accomplish.

During our summer planning retreat, we set an ambitious agenda for ourselves in which weoutlined four major goals. One of these is to increase alumni engagement in School and boardactivities. I have personally found many opportunities for networking, professional develop-ment, socializing, and mentoring students—all of which have been rewarding—and I inviteyou to join me. With all of the changes and activities happening in the School, you can keepupdated by signing up on the @cal web site (sphalum.berkeley.edu).

We want to create and monitor the policies and procedures necessary for the board to conductits business. In this time of change, our mission and bylaws need to be revisited. How shouldwe focus our energies? Whom are we serving? How well are we doing it? Once we revisit theseissues, we will need to have our membership (you!) give us feedback and vote on any changes.So we decided to bring back our Spring Brunch to hold our annual business meeting whereyou will get to voice your opinion—stay tuned for more details. Of course, you can give usfeedback during the process if you want to join this committee. At the Spring Brunch you willalso get to meet the student recipients of our PHAA scholarships, which this year includes sev-eral Reshetko Family Endowed Scholarships of $10,000 each, through the generous gift ofLola Reshetko, cousin of recent board member, George McKray.

To further support both students and alumni, we want to collaborate with the Center forPublic Health Practice to provide a link between teaching, research, and the practice of publichealth. This includes active participation in increasing diversity in the School as well as inother health professions, and supporting activities such as the career center, conferences forprofessional development, and the UC Berkeley Wellness Letter.

Finally, we want to support the School and Dean Shortell by helping to develop a financial basethat supports board business, student scholarships, and other priorities. While we have limitedcapacity for fundraising, we can increase efforts to enhance alumni membership and activity,increase awareness of the issues that the School faces, and give our feedback on School priorities.

You can see that we have several areas that are key to the future of our alma mater and I inviteyou to join us in supporting these efforts. Board membership not required!

Yours truly,

Leslie Louie, Ph.D., ’90, M.P.H. ‘85President, Public Health Alumni Association

President’s Message

Alumni News

Leslie Louie, Ph.D. ’90, M.P.H. ’85(President)

Carol A. Clazie, B.S. ’62(Vice President)

James H. Devitt, M.P.H. ’77(Secretary-Treasurer)

John W. Eastman, Ph.D., M.P.H. ’80(Immediate Past President)

Philippa Barron, M.B.A., M.P.H. ’94Lucinda Brannon Bazile, M.P.H. ’94Julie M. Brown, M.B.A, M.P.H. ’85Brandon DeFrancisci, M.P.H. ’96David Harrington, M.P.H. ’88Paul R. Mico, M.P.H. ’58Lisa Tremont Ota, M.A., M.P.H. ’90Beth Roemer, M.P.H. ’76Jan Schilling, M.P.H. ’91Alan R. Stein, M.P.H. ’78, M.S., M.F.T.Sarah Stone-Francisco, M.P.H. ’03John Troidl, Ph.D. ’01, M.B.A.

Public Health Alumni Association Board of Directors 2005–2006


Alumni News

Appointed secretary of theBusiness, Transportation andHousing Agency by GovernorArnold Schwarzenegger inNovember 2003, McPeakdirects California’s largestgovernment agency.

Alumna Spotlight: Sunne Wright McPeak, M.P.H. ‘71

As a master’s student in health educationat the School of Public Health, SunneWright McPeak learned how to collectinformation by going directly into com-munities. She credits this education—the knowledge of how to survey herconstituency—with helping her winelection to the Contra Costa Countyboard of supervisors, where she servedfor from 1978 to 1993, including severalterms as chairman.

“I was always interested in health,” saysMcPeak, who grew up on a dairy farm inrural Livingston in the San JoaquinValley and received her bachelor’s degreein international medicine at UC SantaBarbara. “It seemed to me it would betough to make the world well onepatient at a time. I had studied publicpolicy in college; I thought an M.P.H.degree would bring it all together.”

As a Contra Costa County supervisor,she became known as a leader on statewater policy and was one of the earliestadvocates for promoting regional solu-tions to Bay Area policy challenges. “In1979 I created the first HMO with licen-sure from the state,” she says. “That wasa direct result of my training at UCBerkeley.” Under her leadership, thecounty was also ahead of its time in itsefforts to curb tobacco use. “In 1985, theTobacco Institute called Contra CostaCounty and me the ‘lunatic fringe’ forpushing tobacco-free efforts,” she recalls.

Appointed secretary of the Business,Transportation and Housing Agency byGovernor Arnold Schwarzenegger inNovember 2003, McPeak directsCalifornia’s largest government agency.Her 16 departments include such com-plex organizations as Caltrans, theCalifornia Highway Patrol, Departmentof Motor Vehicles, and the Departmentof Corporations.

McPeak notes that her education at theSchool, which taught her to look at

inputs and outcomes and to considerenvironmental quality and economic sta-tus, has shaped her approach to her work.Also, she says, she is able to use healthdata to enlighten policy discussions.

“I am fully integrating and mobilizing tosave lives,” says McPeak about her cur-rent post, citing such successes as seat-belt compliance. “Last holiday season,there was a 26 percent reduction indeaths on the highways. In 2005 to date,there has been a reduction of 14 per-cent—35 percent in incorporated areasof cities.”

Prior to leading the Business, Transpor-tation and Housing Agency, McPeakwas president and CEO of the Bay AreaCouncil, where she established and ledmajor regional initiatives that addressedpolicy challenges involving transporta-tion, housing, sustainable economicdevelopment, water policy, telecommu-nications infrastructure, and educationand workforce preparation. Before join-ing the Bay Area Council in Novemberof 1996, she served for three years aspresident and CEO of the Bay AreaEconomic Forum, a partnership formedin 1988 by the Bay Area Council andthe Association of Bay Area Governmentsto facilitate public-private collaborationfor promoting the regional economy.

McPeak has been honored by more than30 organizations and was named a"Women Who Could be President" hon-oree in 1997 by the League of WomenVoters of San Francisco. The SanFrancisco Business Times has named herone of the 100 Most Influential Womenin Business in 1998, 1999, 2000, 2001,2002, and 2003. She is the recipient ofthe 2000 California Water Policy H2OLeadership Award. Recently, CaliforniaState University, Hayward, and the boardof trustees of California State Universityawarded her an honorary doctorate inhumane letters.

—Michael S. Broder

Sandra Shewry was a student at theSchool of Social Work at UC Berkeleywhen she took a class taught byProfessor Emeritus Henrik Blum of theSchool of Public Health. “It was a classin health planning,” remembers Shewry.“It changed my life—Dr. Blum’s warmthand passion, and the sense of empower-ment I gained through understandingthe determinants of health (biology,behavior, and the environment) and theimportant but modest contribution ofhealth care services to improved healthoutcomes.” Blum’s course helped Shewrysee public health as a field for enactingsocial change. She went on to earn herM.P.H. at the School.

Shewry has worked on many aspects ofpolicy in public health. She began hercareer with the state as a health planninganalyst more than 20 years ago. She wasthe director of health at the NationalGovernor’s Association’s Center for BestPractices. She also served as executivedirector of the California Managed RiskMedical Insurance Board, where sheworked on developing and implement-ing California’s high risk pool, a subsi-dized pregnancy coverage program, asmall employer purchasing cooperative,and the state’s Healthy Families. In2004, Governor Schwarzeneggerappointed Shewry director of California’sState Department of Health. In thisposition, she leads a staff of 6,000 and isresponsible for the expenditure of over$37 billion in public funds.

As a policy maker, Shewry looks forways to advance the department’s mis-sion of protecting and improving thehealth status of Californians. This year’stop priorities range from improving thestate’s ability to detect and respond topublic health emergencies—be theymanmade or naturally occurring—toadvancing policy that addresses the obe-sity epidemic, to expanding enrollment

of Medi-Cal members into organizeddelivery systems. “The way we haveapproached obesity is a good example ofour approach to prevention,” saysShewry. “We support healthy eating,regular physical activity, and responsiblepersonal choices. That being said, weknow that people make choices within acontext. We are looking at policy leversthat create the kind of environment inwhich it is easy, natural and accepted foreach of us to live a healthier life. Wehave moved away from looking at obesi-ty and inactivity as simply a matter ofpersonal choice, and look at environ-mental influences. People make personalchoices within a context. The governor’ssignature on the laws that will removejunk food and soda from school cam-puses and put more fruits and vegeta-bles into school meals are examples ofenvironmental changes that reinforcehealthy living.”

Shewry cites the importance of usingmultiple strategies for dealing withhealth issues, and assessing and evaluat-ing those strategies. “The state has donea fabulous job on the challenge of teenpregnancy,” she says. “We have builtmany community partnerships and col-laboratives. With a public health issue ascomplex as teen pregnancy, you needmany ways of addressing the problem:strategies to influence communitynorms, community programming, andclinical services. The results are impres-sive: Teen pregnancy rates in this statehave dropped significantly. We believe itis due to the comprehensive and sus-tained approach we have adopted.”

Along with emergency preparedness,Shewry sees workforce recruitment asone of the primary challenges facing thepublic health system. “We have a genera-tion of fabulously talented baby boomerswho are now retiring. We need to findways to bring people into the field.”

“I would advise more public health stu-dents to try public service,” she says.“The Department of Health Services isinvolved with the policy-related issuesimpacting the health of our state. Weserve at the intersection of big picturepolicy decisions and daily implementa-tion of programs and policies. I encour-age students to consider a career in pub-lic service—it is a chance to make a con-tribution to improving the health statusof Californians.”

—Kelly Mills

39Public Health

Alumni NewsAlumni News

In 2004, GovernorSchwarzenegger appointedShewry director of California’sState Department of Health.

Alumna Spotlight: Sandra Shewry, M.S.W., M.P.H. ’81


Alumni Notes

Alumni News

1940s

Flora Everding Maclise, B.S. ’43 “I’vedigressed from public health a bit to teachingand helping run nature education projects forchildren and adults during the last 30-plusyears. UC public health education has beeninvaluable in this field!”

1950s

Norman L. Roberts, Jr., M.P.H. ’55 “After 37years at Baptist Health and three years visitingSouthern Baptist Hospital and churches in India,Indonesia, and Germany, we nested back inNorth Little Rock for nine years. Recently wemoved to Parkway Village, a Baptist HealthRetirement Community. We are attempting tobe the youngest people here and are havingsome success.”

Laverne “Gerry” Borg, M.P.H., B.S. ’52, andJane Wood Borg B.S. ’53, are retired and live inWatsonville, California. Both received bachelor’sdegrees in public health from UC Berkeley. Gerryreceived his M.P.H. from the University ofMichigan in 1957; his M.H.A. from BaylorUniversity in 1966, and became an APHA Fellow(Community Health) in 1967.

1960s

Anne Waybur, Dr.PH., M.P.H. ’60 “Retired, trav-eling to far and distant places, ‘agitating’ for anational health services system, so urgentlyneeded!”

Doris E. Hawks, B.S. ’63, has helped hundreds ofCalifornia residents as an elder law attorney. Hercontributions in the areas of unbefriended eldersand non-beneficial treatment in institutions arebeing recognized by Santa Clara County’sMedical Association.

Elaine B. Base, M.P.H. ’64 “Active member ofAlaska State Defense Force—Medical Unitattached to aviation and costal command—inhomeland security mission.”

Mildred F. Patterson, M.P.H. ’65 “I still enjoydriving, quilting, keeping up with family andfriends, selected activities in the retirementhome.”

1970s

Tommie J. Haywood Pippins, M.P.H. ’71 “After31 years, retired as nurse practitioner fromAlameda County Health Care Services.”

Margaret H. Jordan, M.P.H. ’72, executive vicepresident for corporate affairs at Texas HealthResources, was recently elected to serve on theAmerican Hospital Association (AHA) board oftrustees. The AHA, which includes nearly 5,000hospitals, health care systems, networks, andother providers of care, is a nonprofit associationof health care provider organizations that arecommitted to health improvement in their com-munities.

Harrison Spencer, M.D.,M.P.H. ’72, was electedto the Institute ofMedicine in 2003.Spencer is president andCEO of the Associationof Schools of Public

Health. Before that, he was dean of the LondonSchool of Hygiene and Tropical Medicine. He hasalso served as dean of the Tulane School of PublicHealth and chief of the parasitic disease branch atthe CDC.

Ruth Grogan, M.S.W., M.P.H. ’73 “Retired asdirector of early childhood mental health pro-grams, Richmond, California.”

Michael E. Williams, C.I.H., M.S. ’75, M.P.H. ’74,recently became a reserve firefighter for theHealdsburg Fire Department in the SonomaCounty wine country.

Winnie Chu, M.P.H. ’76, is an independentconsultant for nonprofit organizations andfoundations.

Brent Green, Ph.D., M.P.H. ’76, with E.F.Schmerl, M.D., invented Med Log™ (a medica-tion adherence record tool for elderly outpa-tients and their caregivers). Green is a formerFDA representative, a UN World Assembly onAging delegate to Vienna, and former editor ofthe Journal of Social Issues. He is a consultantto Sutter Health. His recent publications focuson executive leadership development.

Daniel S. Janik, M.D., Ph.D., M.P.H. ’77, hasauthored a new book, Unlock the Genius Within:Neurobiological Trauma, Teaching andTransformational Learning, recently published byRowman & Littlefield Education. In this secondbook in a series on neurobiological and transfor-mational learning, Janik discusses his theoryabout the traumatic roots of traditional teach-ing—how it results in loss of interest and creativ-ity—and describes the neurobiological founda-tions of a new form of nontraumatic learning.

1980s

Pamela J. Armstrong, M.B.A., M.P.H. ’80, isauthor of the book Surviving Healthcare, whichwon two awards conferred at the annual BookExpo America Convention in New York City onJune 3, 2005. Surviving Healthcare was namedHealth Book of the Year by ForeWord magazineand won the Publishers Marketing Association’sBenjamin Franklin Award as best health book.

Jean Marie Naples, M.D., Ph.D., M.P.H. ’81“Family medicine physician—certification, 1993;Ph.D., Johns Hopkins SPH, 1990; M.D., Universityof Maryland Medical Center, 1989; general sur-gery residency and certification, 2003; researchfellow at JHSPH—association of schistosomiasisand bladder cancer—early disease detection andprevention of infection with the parasite (researchproject in Ghana, West Africa).”

Linda Rudolph, M.D., M.P.H. ’81, was appointedhealth officer for the city of Berkeley in October2005. She has more than 20 years’ professionalexperience in public health administration, pro-gram and policy development, and clinical practice.

Sang-Ick Chang, M.D., M.P.H. ’85 “After attend-ing the Interdiscplinary Program in 1985, I com-pleted medical school at UCSF and a family prac-tice residency at San Francisco General Hospital.Since then I have devoted my professional lifeto working with underserved populations inCalifornia, in both direct care and administrativecapacities. After stints in rural health and the SanFrancisco Health Department, I am now vice pres-ident and medical director for San MateoMedical Center, the county-run safety net healthsystem for San Mateo County, just south of SanFrancisco. I still practice two half-days weekly atone of our community clinics.”

41Public Health

Alumni News

Jacob Eapen, M.D., M.P.H. ’85, was electedtrustee-director on the board of directors ofthe Association of California HealthcareDistricts, the industry association for healthcare districts providing hospital care, skillednursing care, or diverse health and wellnessservices in their communities.

Richard Hirsh, C.I.H., M.P.H. ’86 “Recentlygiven Distinguished Scientist Award by Rohmand Haas Company. Recently elected as presi-dent-elect of the Northern California Sectionof the American Industrial HygieneAssociation.”

Michael G. Lyon, M.P.H. ’87, is a clinical assistantprofessor of medicine at Stanford UniversitySchool of Medicine. His current research activitiesare in the use and effectiveness of group medicalvisits for arthritis patients.

James E.T. Jackson,M.P.H. ’88, was namedchief operating officerof San Francisco’s SaintFrancis MemorialHospital in June 2005.He has approximately

15 years’ experience in health care adminis-tration and most recently served as vice presi-dent of ancillary and support services at theChildren’s Hospital and Research Center inOakland.

Denise Koo, M.D., M.P.H. ’88, is now directorof the Career Development Division at theCDC. This division houses public health resi-dencies such as the Epidemic IntelligenceService, Preventive Medicine Residency, thePublic Health Prevention Service, the PublicHealth Informatics Fellowship, and thePrevention Effectiveness Fellowship.

1990s

Terry Winter, R.N., M.P.H. ’90, continues tofocus on developing interdisciplinary team ofcare for chronic disease.

Luis Ramon Mireles, M.P.H. ’92 “As districtmanager of the Cal/OSHA Compliance Unitfor San Diego and Imperial Counties, I amcontinually stimulated by the diversity ofindustries and sectors that we regulate. I getto use most of my public health graduatetraining. My next big life experience will befatherhood, as my wife, Genoveva Avalos-Mireles, is expecting a baby boy due in 2006.”

Renee (Cronk) Drellishak, M.P.H. ’94“Currently a doctoral student in educationalleadership and policy studies at the Universityof Washington.”

Jacqueline Brooks Hanel, Dr.P.H. ’94, M.P.H.’80, began a new job as site administrator forthe Brentwood Medical Center of the JohnMuir/Mount Diablo Health System.

Paul B. Hofmann, Dr.P.H. ’94, M.P.H. ’65, recipi-ent of last year’s Distinguished LeadershipAward from the UC Graduate Program inHealth Management Alumni Association,coedited Management Mistakes inHealthcare: Identification, Correction, andPrevention, published by 2005 by CambridgeUniversity Press.

Bjørn-Inge Larsen, M.B.A., M.P.H. ’94“Since 2001 I have been the director generalof Norwegian Directorate for Health andSocial Affairs.”

Robert S. Brown, Jr., M.D., M.P.H. ’96, wasappointed to the scientific advisory board ofArbios Systems, Inc., a biomedical device com-pany developing proprietary liver assistdevices for the treatment of liver failure.Brown is associate professor of medicine andsurgery and chief, Division of Hepatobiliaryand Abdominal Transplant Surgery at theColumbia University College of Physicians andSurgeons. In addition, he is medical director,Center for Liver Disease and Transplantationat New York Presbyterian Hospital, a positionhe has held since 1998.

Maureen Sinclair, M.P.H. ’98 “I moved toAlmaty, Kazakhstan, last year to work as thedeputy director of CDC’s Central Asia regionaloffice. It is a beautiful part of the world and anexciting time to be here.”

Stacy Sterling, M.S.W., M.P.H. ’98 “While ingrad school I worked as an interviewer on NIDAand NIAAA-sponsored studies of drug and alco-hol treatment services. The skills and the knowl-edge that I gained from the School of PublicHealth (biostatistics, epidemiology, program plan-ning and evaluation, community organizing)enabled me to move from interviewing to a lead-ership role on the research team. I am currently asenior research project manager with theDrug and Alcohol Research Team at KaiserPermanente’s Division of Research, overseeingmany aspects of several large NIH-fundedhealth services studies. Our research groupaddresses issues of access, treatment out-come, and cost and utilization of alcohol anddrug treatment in public and private settings,including managed care.”


Anne Bakar,presidentand CEO ofTelecareCorporation,served onthe School ofPublicHealth’s

Policy Advisory Council from 2001 to 2004.She spent seven years in the investmentbanking field before taking over leadership ofTelecare in 1987, following the unexpecteddeath of her father, Telecare founder MortonBakar. The company’s clinical and financialsuccess has been attributed to her initiativesto forge active partnerships with her work-force as well as other constituencies involvedin client care, consumers’ families, communityproviders, and county agencies. Bakarreceived her bachelor’s degree from UCBerkeley in 1980.

SusanDesmond-Hellmann,M.D., M.P.H.’88, presi-dent, prod-uct develop-ment,Genentech,

joined the company in 1995 as a clinical sci-entist, was named executive vice president,development and product operations in 1999,and later chief medical officer. Prior to joiningGenentech, Desmond-Hellmann was associatedirector of clinical cancer research at Bristol-Myers Squibb’s Pharmaceutical ResearchInstitute. While at Bristol-Meyers Squibb, shewas the project team leader for Taxol.

Mary AnnThode,M.P.H. ’78,was namedpresident ofKaiserFoundationHealth Planand

Hospital’s Northern California region in 2002.She previously served as the organization’s chiefoperating officer, Northern California, and priorto that, senior vice president and area managerfor the Golden Gate Service Area (San Francisco,San Rafael, Santa Rosa, and South SanFrancisco). Thode started her health care careeras a staff nurse at the Kaiser PermanenteOakland Medical Center. She also served as asenior vice president of operations of CatholicHealthcare West, and president and CEO of St.Mary’s Medical Center in San Francisco.


NEWSMAKER SPOTLIGHT

Bay Area’s Most Influential Businesswomen

Alumni News

The San Francisco Business Times has named three women associated with the UC Berkeley School of Public Healthas being among the Bay Area’s 100 most influential women in business. “These women were chosen because theyare in high-ranking positions in their companies, and because they are outstanding leaders and role models with awide range of influence,” reports the San Francisco Business Times.

Blue Walcer, M.P.H. ’98 “I am the founderand director of San Francisco GeneralHospital’s CARE (Cancer Awareness,Resources, and Education) program—an inno-vative program that provides medically under-served cancer patients with education andpsychosocial support.” Walcer was the 2004National Grand Winner of the California PacificAward for Excellence in Patient Education.

2000s

Geoffrey Lomax, Dr.P.H. ’02, M.P.H. ’97, wasrecently hired as senior officer for theStandards Working Group at the CaliforniaInstitute of Regenerative Medicine. He is theformer research director for the CaliforniaEnvironmental Health Investigations Branch,where he supported the professional andresearch needs of the legislatively mandatedExpert Working Group that developed astrategic plan for the Environmental HealthSurveillance System in California.

Sayan Tudupdorjiev, M.D., M.P.H. ’03 “I cordiallyextend my greetings to good old Berkeley, to thestaff and faculty of my School. Upon returningback home I applied for a director position in myhospital [Zabailisk Regional Hospital, Chitaregion, Russia] and later was given it. Am nowbusy managing things, trying to make it betterand sensible.”

Jennie Walcek, M.P.H. ’05 “I will be gettingmarried July 23, 2005, to Dr. Wil McClay, an elec-trical engineer at LLNL.”

Alumni Notes, continued

43Public Health

In Memoriam

Glenn Elwin Austin, M.D., B.S. ’43, died April11, 2005, at his home in Beaverton, Oregon,at age 83. Born July 5, 1921, in Berkeley, heserved in the U.S. Army during World War II,then put himself through medical school atStanford University. He practiced pediatrics inLos Altos, California, for 48 years. Austin wasinstrumental in establishing guidelines fortesting and treating children with ADHD. Hewas active in medical politics, pushing theestablishment to make changes in health carethat were more sensible and affordable to theaverage person. His hard work and dedicationto medicine led to a term as president of theAmerican Academy of Pediatrics from 1981 to1982. He is survived by his wife, Olive E.Austin, three daughters, one son, and sevengrandchildren.

Sir RichardDoll, M.D.,D.Sc., D.M.,one of theworld’s fore-most epi-demiologistsand a widelyrespected

cancer researcher, died at the John RadcliffeHospital in Oxford, England, at age 92. Dolland his colleague, Sir Austin Bradford-Hill,proved the link between cigarette smokingand lung cancer while working at the BritishMedical Research Council's StatisticalResearch Unit. Their report, published in1950, was based on a survey of lung cancerpatients in 20 London hospitals. The followingyear they questioned 40,000 British doctorsabout their smoking habits. As a result theywere able to confirm the link between smok-ing and lung cancer, as well as other diseasessuch as coronary thrombosis. Doll’s 1994report on 40 years of follow-up of a group ofBritish doctors is considered the definitivepaper on the health consequences of smok-ing. Follow-up studies proved that long-timesmokers suffered three times the mortalityrate of non-smokers. In addition to his studiesinto cancer and heart disease, he investigatedthe effects of alcohol on unborn babies, andthe side effects of the birth control pill. For his

pioneering work, Doll was awarded $10,000from the World Health Organization andreceived a knighthood in 1972. He receivedthe UC Berkeley International Public HealthHero Award in 2000. Doll was born inHampton, England, and attended St. Thomas’sHospital Medical School. During World War II,he served in the Royal Army Medical Corps.His wife died in 2001; he is survived by hisson and daughter.

Reed E. Grier, Ph.D. '04, M.P.H. '82, M.C.P.,died August 12, 2005, at age 51. Born inSeattle, Washington, he moved to the BayArea in 1975 to attend UC Berkeley, where heearned his bachelor’s and graduate degrees.During his years in the Bay Area, he workedwith a wide range of public and private sectorresearch and service organizations addressingissues of health and welfare. Grier’s workincluded planning for services for the elderlyincluding Alzheimer’s services and home sup-port for frail elders. He was involved in com-munity-based planning for the San FranciscoDepartment of Public Health in the 1980s.Recently, he completed a research project forthe Health Research and Educational Trust,which included several case studies fromaround the country documenting the hospital-public health linkages for disaster prepared-ness. Other recent projects were with the U.S.Public Health Services HIV/AIDS Bureau, theMather Institute on Aging in Evanston, Illinois,the Public Health Institute in Berkeley, NancyFrank & Associates in Oakland, and theNational Assembly for Voluntary Health &Social Welfare Organizations in Washington,D.C. He is survived by his life partner, GlenStroud, and his family in the Portland area.Donations to the “Reed Grier Memorial LoanFund” may be sent to Patricia Hosel, Office ofExternal Relations, School of Public Health, UCBerkeley, 140 Earl Warren Hall, Berkeley, CA94720-7360.

Emery A. Johnson, M.D., M.P.H. ’64, formerU.S. assistant surgeon general and the longestserving director of the Indian Health Service,died June 26 at his home in Rockville,Maryland, at age 76. From 1969 to 1981 heran the Indian Health Service, the principalhealth care provider and health advocate for

1.6 million American Indians and Alaskanatives. He was a major contributor to thedevelopment of legislation such as the IndianSelf-Determination and Education AssistanceAct of 1975 and the Indian Health CareImprovement Act of 1976, both of which stillgovern federal policy. During his tenure, con-struction of major hospitals and clinicsincreased dramatically. Johnson was born inSioux Falls, South Dakota. He graduated fromHamline University in St. Paul, Minnesota, andreceived his medical degree from theUniversity of Minnesota in 1954. He receiveda master’s degree in public health from theUniversity of California, Berkeley, in1964. Hejoined the Public Health Service after medicalschool, just as the Bureau of Indian Affairswas turning over the Indian Health Service tothe Public Health Service. Johnson stayed withthe agency throughout his career. He was areservation staff physician in Winnebago,Nebraska, and White Earth, Minnesota, andan administrator in Billings, Montana,Phoenix, Arizona, and Silver Spring, Maryland.He helped develop the John F. KennedyNational Medical Center in Monvoria, Liberia,and was a consultant to the Peace Corps andWorld Health Organization in Africa. He is sur-vived by his wife, Nancy Mourning Johnson,four children, and a grandson.

Catherine T. Kennedy, B.S. ’37, died May 15,2005, at age 91. She was a registered nursefor 45 years including 37 years as a nurse inthe Long Beach Unified School District in LongBeach, California. She also served as a publichealth nurse during World War II. She was anactive supporter of women’s rights andAlzheimer’s research and was involved withchildcare and seniors’ issues. Born inBrooklyn, New York, she moved to LongBeach with her family as a child. She is sur-vived by her son, Patrick Kennedy, threegrandchildren, and four great-grandchildren.She was preceded in death by her husbandand another son. Memorial donations may bemade payable to the “School of Public HealthFund” and sent to the attention of PatriciaHosel, Office of External Relations, School ofPublic Health, UC Berkeley, 140 Earl WarrenHall, Berkeley, CA 94720-7360.

In Memoriam


Marc AlanLappé, Ph.D.,died May 14,2005, at hishome inGualala,California,at age 62.Lappé was a

leading figure in the movement to integrateethics and public policy, especially as it relatedto toxics and genetics. He also served as anexpert witness and consultant for plaintiffattorneys suing chemical companies, includinglawsuits against silicone gel breast implantmakers, the producers of the herbicide Agent

Orange, and the high-profile case againstW.R. Grace & Co. The Newark, New Jersey,native earned his Ph.D. in experimentalpathology from the University of Pennsylvania.He authored or edited fourteen books, manyof which predicted public health and environ-mental problems long before their appear-ance. In 1978, he was named by CaliforniaGovernor Jerry Brown as chief of the state’sOffice of Health, Law, and Values, and then ashead of the state’s Hazard Evaluation System.He resigned in 1980 after opposing thestate’s spraying of the insecticide Malathionto halt the Medfly outbreak plaguingCalifornia’s citrus crops. He held teachingposts at Sarah Lawrence College; University of

Illinois at Chicago School of Medicine; theCollege of Marin; and the University ofCalifornia, Berkeley, where he was an associ-ate adjunct professor at the School of PublicHealth from 1983 to 1985. He was the direc-tor of the Gualala, California-based nonprofitCenter for Ethics and Toxics, an environmentalpublic policy organization that works directlywith California municipalities concerned aboutcontaminants in their water supplies. Lappéwas also an award-winning poet. He is sur-vived by his wife, Jacqueline Durbin, as wellas his father, his brother, two sons, threedaughters, and two step-children.

In Memoriam

Seiko Baba Brodbeck, B.S. ’48, who served for 17years as associate executive director of theAmerican Public Health Association (APHA), diedAugust 13, 2005, at the age of 77.

Brodbeck received her bachelor of science degreein public health microbiology in 1948 from theUniversity of California, Berkeley. Upon graduating,Brodbeck became a public health microbiologist forthe Oakland City and Los Angeles County HealthDepartments. Shortly thereafter, she became thelaboratory director for the Oakland City HealthDepartment.When the Oakland City Health andAlameda County Health Departments merged, shewas asked to direct their public health laboratoryservices, which she did for 12 years. In 1971 sheassumed the directorship of the Western RegionalOffice of the American Public Health Associationand became its executive director. In 1976 shebegan her 17-year tenure as APHA’s associateexecutive director at its national headquarters inWashington, D.C. In 1993 she returned to herCalifornia roots first as deputy director, audits and

investigations, and subsequently as assistantdeputy director of public health practice for theCalifornia Department of Health Services.

Brodbeck was involved with a variety of publichealth projects over her long and distinguishedcareer, including “National Health and SafetyPerformance Standards: Guideline for Out-of-Home

Childcare Programs” and “Model Standards—Health Communities 2000.” In 1996 shereceived the Distinguished Member Award fromthe California Public Health Association–North; in1970 she received the John J. Sippy Award fromthe Western Branch of APHA and in 1995 wasnamed Outstanding Public Health Laboratorianby APHA.

She was actively involved with the UC BerkeleySchool of Public Health as an alumna, serving onthe Public Health Alumni Association board ofdirectors from 1999 to 2002. In 1998, she receivedthe School’s Alumna of the Year Award.

She is survived by her daugher and son-in-law,Stacey Baba and James Vokac.

Gifts in memory of Seiko Baba Brodbeck may bemade payable to the “School of Public HealthFund” and sent to the attention of Patricia Hosel,Office of External Relations, School of PublicHealth, UC Berkeley, 140 Earl Warren Hall,Berkeley, CA 94720-7360.

In Memoriam, continued

Seiko Baba Brodbeck, Former Associate Executive Director of the American PublicHealth Association

Ruth Lois Huenemann, D.Sc., professor emeritaand founder of the public health nutrition pro-gram at the University of California, Berkeley,died August 19, 2005, at the Lake ParkRetirement Residence in Oakland at the age of95. Huenemann was one of the first researchersto recognize the importance of systematicallystudying the longitudinal development of obesityin children, conducting seminal studies that tothis day inform the understanding of the currentepidemic of childhood obesity.

“She was a legend in her time,” says PatriciaCrawford, Dr.P.H. ’94, R.D., codirector of UCBerkeley’s Center for Weight and Health and oneof Huenemann’s former students and colleagues.“Students sought out nutrition programs thatshe created.”

Huenemann’s research and teaching combinedrigorous scientific methods with a pragmaticapproach to improving nutrition in a variety ofcultural settings. She traveled widely in LatinAmerica, Asia, and Europe as a consultant andlecturer for the World Health Organization, theU.S. State Department’s food aid program, andnumerous international health and nutritionorganizations. She was particularly noted forseveral longitudinal studies of nutrition andphysical activity among adolescents and chil-dren. In the Berkeley Teenage Study, she studiednearly 1,000 students from the Berkeley UnifiedSchool District from 1961 to 1965 to determinethe onset and prevalence of factors related tothe development of adult obesity.

She also led the initial four years, from 1969 to1973, of what would become the BerkeleyLongitudinal Nutrition Study, which workedwith children from the age of six monthsthrough age 16 years. That study was subse-quently led by a colleague in the School ofPublic Health, Leona R. Shapiro, M.S.

“Research in which such a large group of chil-dren was studied for so long was unusual at thattime,” says Shapiro. “Huenemann looked at thewide-ranging factors that could have influencedthe development of obesity.”

Her studies provided a wealth of detailed dataon teenagers’ eating habits, physical activity andbody composition. The research revealed a link

between low income and an increased risk forobesity, something researchers are still trying tofully understand today.

“That was one of the first studies to show thecomplex relationship between socioeconomicstatus and obesity,” says Crawford. Theresearchers also found that teenagers weregetting much less exercise than previouslythought, signaling the influence of televisionand cars. Says Crawford, “The issue of child-hood obesity seems so current now, but imag-ine what it was like in the 1960s when shesought funding for such studies. She had fore-sight into a growing problem.”

Huenemann was born to a farming family inWaukon, Iowa, on February 5, 1910, the second-oldest of 14 children. In 1913, her father movedthe family to Wisconsin. In 1928, Huenemanngraduated from Menno High School in SouthDakota, where her family had moved the prioryear. She spent five years teaching in a one-roomschool, and saving money to attend college.

She received a B.S. in nutrition from theUniversity of Wisconsin in 1938, and earned anM.S. in nutrition from the University of Chicagoin 1941 while working as a staff dietitian at theuniversity's clinics. Over the next decade, sheworked as an associate professor at theUniversity of Tennessee, where she establishedthe university's public health nutrition programas well as a community nutrition program in

Knoxville. During her years at Tennessee, she wasoffered a scholarship to study at HarvardUniversity and proceeded to earn her doctor ofscience degree in public health nutrition in 1954.

She joined UC Berkeley’s School of Public Healthin 1953, where she founded the school's publichealth nutrition program, establishing its curricu-lum, research program, staff and funding.

“In her first class at UC Berkeley, there were onlytwo students who majored in public health nutri-tion,” says Shapiro. “By the time she retired, theschool had awarded more than 250 publichealth degrees in nutrition. The program shedeveloped at the UC Berkeley School of PublicHealth had become the preeminent center fortraining of applied nutritionists in the country. Bythe time she retired in 1977, she had created anenviable record in teaching and research.”

Her 24-year tenure at UC Berkeley includedterms as chair of the Department of NutritionalSciences at UC Berkeley’s College of NaturalResources, and chair of the Department of Socialand Administrative Health Sciences in the Schoolof Public Health.

While at UC Berkeley, she created the first pro-gram to enable students earning a bachelor’sdegree in public health nutrition to also becomeeligible as registered dietitians. This model hassince been emulated in other public health nutri-tion programs around the country.

Huenemann sat on many notable committeesthroughout her career, including the NationalAdvisory Council on Child Nutrition and theNational Research Council. She was also a mem-ber of the editorial board of the Journal of theAmerican Dietetic Association, served as presi-dent of the Society for Nutrition Education andreceived the Dolores Nyhus Memorial Award in1979, the highest honor given by the CaliforniaDietetic Association.

Huenemann is survived by her brother anddozens of nieces and nephews.

Donations in her memory may be made to theRuth L. Huenemann Scholarship Fund, Office ofExternal Relations, School of Public Health, UCBerkeley, 140 Earl Warren Hall, Berkeley, CA94720-7360.

—Sarah Yang

Ruth Lois Huenemann, Professor Emerita and Public HealthNutrition Pioneer

In Memoriam

University of California, BerkeleySchool of Public Health140 Warren Hall #7360Berkeley, CA 94720-7360

Non-Profit OrgUS Postage

PAIDUniversity of California

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This fall 206 new graduate students entered the School of Public Health, representing a wide rangeof backgrounds and academic interests. The new class comprises 162 women and 44 men, rangingin age from 21 to 58 years old. There are 151 students working on M.P.H. degrees (19 of whomare in concurrent or joint degree programs); 10 working towards an M.A. or M.S.; 10 students inthe Dr. P.H. program; and 35 Ph.D. students.

The students hail from 19 states (California, Colorado, Connecticut, Florida, Georgia, Indiana, Massachusetts, Michigan, Minnesota, New Jersey, NewMexico, New York, Oregon, Pennsylvania, Tennessee, Texas, Virginia, Washington, and Wisconsin) plus the District of Columbia, and 16 countries (Canada,China, Denmark, Ethiopia, Great Britain, India, Iran, Israel, Mexico, New Zealand, Nigeria, Singapore, Switzerland, Uganda, Vietnam, and Zimbabwe).

In addition, the School’s undergraduate program, which was reinstated in 2003–2004 after a break of more than 30 years, continues to grow in populari-ty: 80 upper division undergraduate students declared a major in public health this year, for a total of 200 undergraduate public health majors.

WELCOME, ENTERING CLASS OF FALL 2005

Fall 2005 - For the Health of California - Public Health

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Transcript of Fall 2005 - For the Health of California - Public Health