US Health Status Inferior To Other Comparable High Income Countries Says Expert Committee
In This Issue:
US Health Disadvantage Is Serious And Pervasive Across Age Groups
-3Framing Violence as a Preventable Contagious Disease
“For many years, Americans have been dying at younger ages than people in almost all other highincome countries,” according to a report from the National Research Council and the Institute of Medicine just released in January 2013. The US health disadvantage is reflected in a reduced life expectancy by as much as 3-5 years depending on the comparison population, and in nine health domains.
Tragedy The committee said that the strength of their findings surprised them and stated “this health disadvantage is particularly striking given the wealth and assets of the United States and the country’s enormous level of per capita spending on health care, which far exceeds that of any other
-5Top 20+ Quotes of 2012
-13Jobs
- US Health continues on page 2
Top Ten Stories of 2012 in The Epidemiology Monitor Nominations Invited For A List Of Top Epidemiology Stories of 2012 From Any Source Each new year, we review the top health stories of the previous year in the mass media and select the most interesting stories from an epidemiologist’s perspective. Our selection this year is restricted to articles which have appeared in the newsletter and not in the mass media. They are all of potential or actual relevance for our epidemiology readers.
We welcome your nominations for the top epidemiology stories of 2012 appearing in any publication or outlet. These could be what you consider the most notable research results, methods contributions, public health achievements, books published, conferences held, policies adopted, or other significant - Best Stories continues on pg 4
Find us online: epiMonitor.net also on Facebook January 2013 Volume Thirty Four Number One
-US Health continued from page 1
“no single factor fully explains the US health disadvantage.”
The Epidemiology Monitor ISSN (0744-0898) is published monthly (except August) by Roger Bernier, Ph.D., MPH at 2300 Holcomb Bridge Rd, Ste 103-295, Roswell, GA 30076, USA. All rights reserved. Reproduction, distribution, or translation without written permission of the publisher is strictly prohibited. Advertising Rates Full Page $995 7.5”w x 10” h Half Page $595 7.5”w x 5” h Quarter Page $295 3.75”w x 5” h Typesetting: $50 Ad Discounts: 10% off ads run 2 consecutive months 20% off ads run 3 or more consecutive months. Subscription Rates One year – 11 issues Institutional - $80 Personal - $50 Student - $45 (w/copy of student ID) Foreign subscribers add $20 for air mail All checks must be in U.S.D, drawn on a bank with a U.S. address on the check. Contact Us The EpiMonitor 2300 Holdomb Bridge Rd Ste. 103-295 Roswell, GA 30076 USA 678.361.5170 / Phone call or email for Fax# office@epiMonitor.net
country.” In an online video, the Committee chair, Steven Wolff from Virginia Commonwealth University, called the health disadvantage a “tragedy” because international comparisons show better health exists elsewhere and therefore could be achieved for US residents as well.
Previous Work The Committee undertook its work at the request of NIH after an earlier NRC report in 2011 found a mortality gap among US adults age 50 and older. This second report in 2013 was commissioned to determine if the health disadvantage for adults 50 and older existed at earlier ages as well. It does, and begins at birth, the committee found. It compared the health of US residents to that of persons in 16 other high-income or “peer” countries, including Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom. It documented the ageadjusted death rates per 100,000 population for more than 50 different health outcomes. Problem Areas On the basis of these rate comparisons, the Committee found that the US fares worse in nine health domains including birth outcomes (highest infant mortality, poor ranking for low birth weight), injuries and homicides (motor vehicle crashes, violence), pregnancy
and sexually transmitted diseases among adolescents, HIV and AIDS, alcohol and other drugs, obesity and diabetes, heart disease, chronic lung disease, and arthritis and activity limitations. According to the Committee, deaths that occur before age 50 are responsible for about two-thirds of the difference in life expectancy between males in the US and peer countries, and about one-third of the difference for females. Also, the Committee found that the health disadvantage is more pronounced among lower socioeconomic groups, but the disadvantage exists for persons more well-off when compared to similar groups in the peer countries. Explanations The Committee was also charged with exploring potential explanations for the pervasive health disadvantage and concluded that despite the existence of many differences between the US and peer countries, “no single factor fully explains the US health disadvantage.” However, struck by the pervasive nature of the disadvantage on measures of health, access to care, individual behaviors, child poverty, and social mobility, the Committee “considered” the possibility that there might be a common denominator running through the multiple domains of US health disadvantage.
- US Health continues on pg 6
2
Chicago Epidemiologist Is Framing Violence As A Contagious Disease In Effort To Identify Persons At Risk And Block Shootings It is not uncommon to read or hear about serious problems that affect people on a large scale described as “epidemic”. For example, last year US Transportation Secretary Ray LaHood called cell phone use or distracted driving “an epidemic on America’s roadways.” We normally recognize these statements as metaphors and don’t interpret them literally. However, Gary Slutkin, a Chicago epidemiologist, appears to be getting increasing discussion and traction, for his idea that violence is a contagious disease and that it should be taken more literally in thinking about the causes and treatment of violence. “It has been said for a long time that violence begets violence, but it is just as tuberculosis begets tuberculosis, or flu begets flu, that violence begets violence,” wrote Slutkin in a paper presented to an Institute of Medicine workshop last year entitled “Contagion of Violence”. Workshop Goals The workshop was organized to explore the contagious nature of violence, according to the organizers, and especially “the epidemiology of the contagion, describing possible processes and mechanisms by which violence is transmitted, examining how contextual factors mitigate or exacerbate the issue, and illuminating ways in which the contagion of violence might be interrupted. The report on the workshop pointed out that not all speakers approached the issue of contagion literally.
Slutkin’s paper at this workshop entitled “Violence Is A Contagious Disease” appears to have been instrumental in framing the discussion at the workshop. According to Slutkin, violence is a contagious disease because it meets the definition for a contagious condition, namely it is spread from one person to another.
“To say violence is a sickness that threatens public health isn’t just a figure of speech”
Wired Magazine Article In a Wired magazine article earlier this month, Brandon Keim wrote, “the idea that violence is contagious doesn’t appear in the Obama Administration’s gun control plan, nor in the National Rifle Association’s arguments. But some scientists believe that understanding the literally infectious nature of violence is essential to preventing it.” He goes on to write, “To say violence is a sickness that threatens public health isn’t just a figure of speech they argue. It spreads from person to person, a germ of an idea that causes changes in the brain, thriving in certain social conditions.” Slutkin told Wired “It’s extremely important to understand this differently than the way we’ve been understanding it. We need to understand this as a biological health matter and an epidemiologic process.”
“We need to understand this as a biological health matter and an epidemiologic process.”
-Violence continued on page 9
3
- Top Ten Stories of 2012 in The Epidemiology Monitor continued from page 1 contributions. We will publish your nominations, and, if we receive enough entries, will create a list of the Top Epidemiology-Wide Stories of 2012. Send your nominations to epimon@aol.com Here are our most notable stories from The Epidemiology Monitor. 1. Bill Foege, Epidemiologist and Former CDC Director, Awarded Presidential Medal Of Freedom Bill Foege, an epidemiologist and former CDC Director and global health advisor to the Bill and Melinda Gates Foundation, was awarded the Presidential Medal of Honor in May 2012. President Obama called the medal “the highest civilian honor this country can bestow”. (May 2012) http://tinyurl.com/ajdz7eq
2. The Use Of Epidemiologic Evidence For Public Health Is Doomed To Fail Without Champions According To Tobacco Control Expert It’s a paradox. Smoking and lung cancer are the perfect example of the power of epidemiologic evidence to bring about important social change, and the perfect example of the inadequacy of data to bring about important social change, according to Matthew Myers, President of the Campaign for Tobacco Free Kids. (June 2012) http://tinyurl.com/b4drjwy
3. Epidemiology Consortium Speaks Out On The Well-Established Dangers of Asbestos Obviously, reporting on the dangers of asbestos is not news, nor is it news to document what control or prevention measures should be used. What is eye-opening, however, is that the paper goes further than a typical literature review and points out that unnecessary obstacles to prevention have been raised. “The use of asbestos not only causes a human tragedy, but also an economic disaster,” according to the Committee. (July-August 2012) http://tinyurl.com/bj3dk63
4. Institute Of Medicine Committee Says Need To Address Upstream Causes of Ill-Health “Could Not Be More Pronounced” The status of the United States as an outlier in health could not be presented more dramatically than it is on the graph of health spending and life expectancy prepared by the Organization for Economic Co-operation and Development (OECD) showing the US ranks 28th in life expectancy. Compared to the other OECD countries, the United States at $7960 spends more than two times the average of OECD countries and 3-7 more than some of the rapidly advancing countries such as Poland and Czech Republic. According to the Institute of Medicine Committee on Public Health Strategies, “Debate over America’s place at the top of economic superpowers aside, it is clear that it is not a superpower in health.” (April 2012) http://tinyurl.com/atjy22c
-Best Stories continued on page 7
4
Top 20+ Favorite Quotes Of 2012 Editors of The Epidemiology Monitor are always on the lookout for quotable quotes and these are often featured in the margins of the articles published in the newsletter. The start of a new year is an opportunity to review these quotes and others contained in articles published in the newsletter. Below is our editor’s pick for the best quotes of the year. 1. “No call, no text, no update is worth a human life.” Deborah Hersman, Chairman of the National Transportation Safety Board, speaking about the dangers of distracted driving in our February issue.
2. “Effective policy is the tip of the spear by which evidence becomes practice…we do advocacy because advocacy helps save lives.” Michael Klug, Dean of the Johns Hopkins Bloomberg School of Public Health writing in a letter to school alumni in our March issue
3a. “A good school is good contraception” and 3b. “School retention is pregnancy prevention” Robert Blum, head of the Johns Hopkins Department of Population, Family, and Reproductive Health, speaking as the Alexander Langmuir lecturer at CDC and published in our April issue
4. “Poverty is the slavery of the 21st century” Bill Foege, epidemiologist and former director of the CDC, commenting on the occasion of his receipt of the Presidential Medal of Freedom published in our May issue
5a. “Behind every public health victory is a champion or a group of champions.” 5b. “Political leaders do what they believe the people who are active care about” Matthew Myers, President of The Campaign for Tobacco Free Kids” during his keynote address to a special meeting of the Young Epidemiology Scholars group published in our June issue.
6. “I’m an American, so I don’t have to.” A statement made by Sean Carroll from the University of Wisconsin to describe one of six types of arguments (appeal to personal freedom) made by persons who deny scientific evidence (which works particularly well with Americans), published in our September issue.
7. “Epidemiology was born exactly 350 years ago.” Alfredo Morabia, Columbia University epidemiologist, speaking at an epidemiology meeting in Portugal and seeking to persuade his audience that epidemiology did not begin at the time of John Snow but instead at the appearance of John Graunt’s Political Observations Upon the Bills of Mortality in 1662. He likened the appearance of this book to the conceptual “big bang” that gave birth to the “universe” of epidemiology.
-Quotes continued on page 11
5
--US Health continued from page 2 Common Denominator?
“With so much at stake, especially for America’s youth, the United States cannot afford to ignore its growing epidemiology. health disadvantage.”
What could that common denominator be? The Committee came to no clear conclusion, but stated “because choices about political governance structures, and the social and economic conditions they reflect and shape, matter to overall levels of health, the panel asked whether some of these underlying societal factors could be contributing to greater disease and injury rates and shorter lives in the United States.” Recommendations The Committee made three recommendations pertaining to research and three pertaining to policy.
“I’m appalled that with all the resources we have in this country we should end up at the bottom for many of these critical health indicators.”
6
On the research side, the Committee called for improvements in the quality and consistency of data sources available for cross-national data comparisons, the development of more refined analytic methods and study designs for cross-national health research, and coordinated funding for investigator-initiated research on the potential causes and potential solutions for the US health disadvantage. Policy Side On the policy side, the Committee called for intensifying efforts to meet health objectives using effective strategies directed at specific health disadvantages, informing the general public and stimulating a national conversation, and for an analytic review of the evidence on the role of policies in different domains in
impacting health. If policies are found to be consequential in affecting health, these then could explain some of the cross-national differences. The Committee concluded “With so much at stake, especially for America’s youth, the United States cannot afford to ignore its growing health disadvantage.” Barbara Rimer, the dean of the UNC Gillings School of Public Health commented about this report on her blog. She told readers, “I’m appalled that with all the resources we have in this country we should end up at the bottom for many of these critical health indicators. We know a lot about how to raise ourselves up. And people in public health can help. We’ve got a lot of work to do. We can do better.” A copy of the report entitled “US Health in International Perspective: Shorter Lives, Poorer Health” can be downloaded at: http://tinyurl.com/bgef3qu Interactive Graphs Also, the Committee has made available an interactive set of graphs of mortality rates in all 17 countries for over 50 different health outcomes. Readers can click on a specific condition or a category of conditions such as communicable diseases, injuries, or non-communicable diseases and immediately view a table showing the rates and rankings for all 17 peer countries for that variable. Passing -US Health continued on page 8
- Top Ten Stories of 2012 in The Epidemiology Monitor continued from page 4 5. Science Denialism Is Topic Of University of Wisconsin Science Writers Conference On The Challenges Of Communicating Research Findings Presentation Of The “Playbook” Used By Science Deniers Is Well Received Recently, a conference and workshop were held at the University of Wisconsin to dissect the causes of “science denial” and to apply the insights gleaned to devising more effective communication. The lessons learned and ideas for solutions may be of considerable interest to epidemiologists. The arguments or “playbook” used by science deniers includes: He said that he can now fit any argument made against evolution or scientific topics into one of these six categories. They are: 1. Doubt the science 2. Question the motives or integrity of the scientists. 3. Magnify the disagreements by citing gadflies as authorities. 4. Exaggerate potential harms even if the science is correct. 5. Appeal to personal freedom 6. Acceptance would repudiate a key philosophy or belief (Sept 2012) http://tinyurl.com/b5wylpc 6. Ethics Guidelines Revised By Environmental Epidemiologists To Take Better Account Of Emerging Challenges In The Field “Perhaps more than most other applied sciences, the discipline of environmental epidemiology faces significant ethical challenges because of the involvement of powerful stakeholders whose influence may affect all levels of research and policy formulation.” So write Shira Kramer, Colin Soskolne, B. Adetune Mustapha, and Wael K. Al-Delaimy, in the August issue of Environmental Health Perspectives in introducing new revised ethics guidelines for the International Society for Environmental Epidemiology. The basic principles were judged by the authors to be broadly applicable to the practice of epidemiology. (Sept 2012) http://tinyurl.com/b4rcs3m 7. Paper in Epidemiology Proposes Creation Of A New Knowledge Translation Subspecialty Writing in this month’s issue of Epidemiology, David Dowdy and Madhuhar Pai make a case for creating “Accountable Health Advocates” (AHA’s), a new subspecialty of epidemiologists which would focus more intentionally on the translation or use of epidemiologic findings to improve public health. Support for this work would come from a reallocation of resources or creation of new rewards and incentives for epidemiologists who chose this career path. At present, the authors say there are many disincentives for epidemiologists to advocate for the utilization of established evidence, including “professional fallout” from a perceived lack of objectivity and difficulty of publishing such work in scientific journals. (Oct 2012) http://tinyurl.com/adksace -Best Stories continues on page 8 7
- Top Ten Stories of 2012 in The Epidemiology Monitor continued from page 7 8. National Research Council Issues Report On Using Science As Evidence In Public Policy Despite the much touted evidence-based policy and practice movement of recent years, a new National Research Council report reaches the striking conclusion that “studies of knowledge utilization have not advanced understanding of the use of evidence in the policy process much beyond the decades-old National Research Council (1978) report.” That report, entitled “Knowledge and Policy: The Uncertain Connection” failed to find systematic evidence that social science evidence was being used. The findings from both reports are bleak and apply to all the sciences says the NRC since knowledge from all sciences is potentially relevant to policy choices. (Nov 2012) http://tinyurl.com/bjqnkau 9. Distracted Driving Called “Epidemic On America’s Roadways” Phones May Be A Deadly, Addictive Risk Factor Like Smoking “Every single time you take your eyes off the road or talk on the phone while you’re driving—even for just a few seconds—you put yourself and others in danger,” according to Ray LaHood, US Secretary of Transportation. According to LaHood, nearly 5,500 persons were killed and 450,000 injured in distracted driving crashes in 2009. That translates into nearly 15 people dying and 1,200 being injured each day in the United States from distracted driving. Among those killed or injured in 2009, nearly 1,000 deaths and 24,000 injuries included cell phone use as a major distraction, according to the Centers for Disease Control and Prevention. LaHood calls distracted driving “an epidemic on America’s roadways.” (Feb 2012) http://tinyurl.com/9wevjfj 10. Surprise Decision Ends The Young Epidemiology Scholars (YES) Program “Devastated, dismayed, and surprised” is how Kevin Xu described his reaction and that of fellow alumni upon hearing the news about the termination of the much praised and highly valued Young Epidemiology Scholars (YES) program, a college scholarship competition in epidemiology for high school students. The program was sponsored by the Robert Wood Johnson Foundation (RWJF) and administered by the College Board. The program was established in 2003 and eight competitions were held over the life of the program. During this time, approximately 5,000 students from all 50 states participated in the program. YES awarded $3.7 million in scholarships to 976 students. The top winners received awards ranging from 15K to 50K. (June 2012). http://tinyurl.com/b9eexha ■ -US Health continued from page 6 the mouse over each of the 17 lines on the graph will reveal the actual age adjusted number of deaths. To access the interactive graphs, visit: http://tinyurl.com/aw77tcz Also, to view a video presentation by Dr Wolff on the major findings of the report, readers can visit: http://tinyurl.com/auc472a ■
8
- Violence continued from page 3 Origin of the Idea Slutkin worked on infectious diseases internationally and was struck by the similarity between maps of disease in those populations and maps of violence in the US. This type of spot map is what has triggered his approach in the US. As he told Wired, “the epidemiology of this is very clear when you look at the math. The density maps of shootings in Kansas city or New York or Detroit look like cholera case maps from Bangladesh.” Mechanism of Action What is believed to be the mechanism of action? Keim explains the underlying theory by saying that acts of violence are the germs, which instead of lodging in the intestines or lungs, lodge in the brain. When people, especially the young, repeatedly witness or experience violence their neurological function is altered such that in the future they perceive threats as enhanced and violence as normal. They are more likely to behave violently. According to other experts quoted in the article, the underlying theme to Slutkin’s approach is learned behavior that gets transferred from one person to another. It’s a generalization of the contagion of behavior concept by means of observation and imitation. Limitations Harvard’s David Hemenway, director of the university’s Injury Control Research Center, told Keim that the idea of violence as contagion is more useful as metaphor than literal
description. “It helps you understand things better. What it means is that sometimes, if you get the infection early, you can have a big effect. But if you wait and wait, it’s hard to impose a policy that will have a big effect.” Direct Interventions Interpreting the metaphor more literally has led Slutkin and colleagues to act more directly on the violence problem, not by implementing policies, but by hiring field workers who are familiar with urban violence. This work actually started years ago in a program started by Slutkin in Chicago called Cease Fire which has now been renamed Cure Violence. The Cure Violence approach hires ex-convicts as public health workers to intervene in potentially violent situations and has reportedly reduced gun violence in Chicago and Baltimore where it has been tried and evaluated. As Slutkin told Wired, “You do interruption and detection. You look for potential cases. You hire a new type of worker, a violence interrupter, trained to identify who is thinking a certain way. They have to be like health workers looking for the first cases of bird flu. In a violence epidemic, behavior change is the treatment.”
“What it means is that sometimes, if you get the infection early, you can have a big effect.”
“In a violence epidemic, behavior change is the treatment.”
Gaining Ground According to Slutkin, the idea of violence as a contagious or infectious disease is rapidly catching hold. For -Violence continues on page 10
9
-Violence continued from page 9
“Safe Streets Baltimore cut homicides by more than half in one neighborhood”
“We can now leave the days of a vocabulary of “bad people” and “enemies” and apply a scientific understanding and a scientific approach to this problem.”
10
example, he noted in a recent posting on his Cure Violence website that President Obama called violence a public health issue in his recent talks to the nation and called for expanding the role of the CDC to do more research. Slutkin noted that last year CDC and Johns Hopkins studied an approach called Safe Streets which uses the approach first employed in Chicago of gathering data about the clusters involved and the transmission dynamics to identify those most likely to be involved in a shooting. They combine this analysis with street level outreach to prevent or interrupt problems before they get out of hand. According to Slutkin, the CDC found that Safe Streets Baltimore cut homicides by more than half in one neighborhood where violence had reached epidemic proportions, and positively changed the attitudes of young persons there on the acceptability of using violence to solve a dispute. Concluding Statement Slutkin concluded his paper to the IOM last year with a strong statement about the more epidemiologic or scientific approach he advocates. He stated “The science and the public understanding that follows this science are bringing us into a new era. This new era is an era of discovery—but more importantly of transition. We can now leave the days of a vocabulary of “bad people” and “enemies” and apply a scientific understanding and a scientific approach to this problem.
“Violence is a contagious disease. This is good news as this knowledge offers new strategies for control. There are massive implications for how to better treat urban violence, as well as for international conflicts. As we have done before----for plague, typhus, leprosy, and so many other diseases---we can now apply sciencebased strategies and, as we did for the great infectious diseases, similarly move violence into the past”, he added. ■
Do you have a job, event, academic program, or book targeted at epidemiologists ? Advertise with The Epidemiology Monitor and reach thousands of individuals in epidemiology & related fields monthly ! Ron Aron, Advertising Manager 770.670.1946 ron.aron@epimonitor.net
Top 20+ Favorite Quotes Of 2012 continued from page 5 8a. “If you truly want to make a difference with your life, epidemiology can give you the key.” Jennifer Schindler, student at Columbia University, making an observation about something she learned as a result of participating in the Young Epidemiology Scholars Program
8b. The fact that in public health, our mission is to discover and to translate those discoveries into ways that change the world and alleviate or prevent suffering is a pretty amazing thing.” Michelle Williams, on the occasion of being named the new Epidemiology Chair at Harvard.
9. “One’s ethical and political worldview influences the many phases of the scientific process.” Statement made about “unconscious partiality” in the updated ethics guidelines for environmental epidemiologists released in 2012 by the International Society for Environmental Epidemiology published in September issue.
10. “Sue is to injury prevention what Einstein was to theoretical physics.” A colleague of Susan Baker’s at Johns Hopkins commenting on her role in injury prevention in an article profiling Baker in the Sunday New York Times magazine published in our November issue.
11. “Evidence-influenced politics is potentially a more informative metaphor than evidence-based policy.” The National Research Council commenting on the value of different metaphors used to inform thinking about the interface of evidence and the use of science.
12. “Our faculty have an almost evangelical belief that educating people about public health is a good thing.” Hopkins Dean Michael Klug explaining why his school is offering courses free of charge on line.
13a. “Philosophy of science is about as useful to scientists as ornithology is to birds.” Bart Holland from the New Jersey medical school quoting Richard Feynman, Nobel laureate, in an exchange in the newsletter with Alex Broadbent from the University of Johannesburg about the value of philosophy for epidemiology.
13b. “The birds, or most of them, would agree with Feynman, since most of them are too busy being birds to worry much about the scientists studying them. That is right and proper and just what you would expect. But it does not mean that Feynman was right; only that he had more in common with the birds than the ornithologists.” Alex Broadbent, in response to Holland’s comment published in letters to the editor in our January issue.
14. “The brain is an important gateway by which the social environment impacts on people’s health through the mind. Michael Marmot, UK epidemiologist, in an interview he gave while traveling in Australia published in our May issue.
–Best Quotes continues on page 12
11
Top 20+ Favorite Quotes Of 2012 continued from page 11 15. “…it really takes a lot of changes like Philadelphia has made, so it’s not going to be sugary drinks out of schools, though that’s really important. It’s not going to be shifting to lower fat milk, though that’s important, but each of these small steps is what will add up to the kind of changes we need. And I think it’s very important because you’re almost always asked, well if you had to do one thing, what would it be? And the answer is, you’ve got to do it all.” Robert Wood Johnson’s James Marks commenting in CDC’s Preventing Chronic Diseases publication on a recent 5% decrease in prevalence of obesity in Philadelphia schoolchildren.
16a. What are your allegiances? Do these allegiances have priorities? To the truth? To the social welfare? To employers? What is epidemiology all about? Questions first posed in 1989 at an epidemiology and ethics meeting in Birmingham Alabama just prior to. the meeting of the Society for Epidemiologic Research by a professor of ethics and reprinted as part of our lead story in the October issue on the creation of a new knowledge translation subspecialty.
16b. “All epidemiologists have a fundamental ethical obligation and commitment to enhance population health.” Robert McKeown, in response to a proposal to create a new knowledge translation subspecialty in epidemiology published in the October issue
17. “I believe health is a matter of agency; it is health that provides the conditions that enable humankind to thrive. Kevin Xu, student at Columbia University, commenting after participating in the Young Epidemiology Scholars Program
18a. “This is akin to the world experiencing another Holocaust every year!” Statement by The Epidemiology Monitor reporting that WHO estimates that 6 million people die from tobacco related causes annually.
18b. It’s a paradox. Smoking and lung cancer are the perfect example of the power of epidemiologic evidence to bring about important social change, AND the perfect example of the inadequacy of data to bring about important social change. Matthew Myers, President of The Campaign for Tobacco Free Kids” during his keynote address to a special meeting of the Young Epidemiology Scholars group published in our June issue.
19. “Not every opinion deserves equal ink or bandwidth” Comment included in the conference planning documents introducing the University of Wisconsin meeting on Science Denialism published in our September issue.
20. “Our policies should be based on the best science available and developed with transparency and public participation.”
12
Barack Obama in response to questions on science and public policy posed to both presidential candidates in the 2012 election.■
The Epidemiology Monitor in a Digital Version is now available FREE to subscribers Effective with this issue, The Epidemiology Monitor begins its formal transition to a free access, all digital publication. This change is in response to the opportunities afforded by new technologies and the changing reading habits of people in the digital age. The newsletter will appear online in the same familiar format subscribers are accustomed to, and they will be able to read through the publication on their electronic devices in the same manner they did with the print version. In addition, you’ll be able to download and save copies of The Epidemiology Monitor for easy future access. Over the next year we’ll be exploring ways to make this publication available on additional mobile devices. Do you have a print subscription to The Epidemiology Monitor ? If so, you’ll continue to get your print copy until your subscription expires. Effective immediately, we will not accept or renew any print subscriptions. In addition to the obvious cost and environmental savings afforded by going digital, this new publication format will provide: ► ► ► ► ►
Easier access to information that is more timely Publication alerts via email Embedded hot links in articles Full color advertising Wider circulation for advertisers
One thing that will not change is our commitment to meet the news and information needs of the epidemiology community. We hope that you will join us in this move into a digital future and share this notice about free access with your friends and colleagues in epidemiology and public health. We invite you to send us your comments and suggestions on how we can continue to serve most effectively as “the voice of epidemiology” in the digital age.
SUBSCRIBE FOR FREE TODAY AT: http://epimonitor.net/Subscribe.htm
Epidemiology Job Bank - Recent Additions
14
Note: Jobs with a number in parentheses after the position name indicates multiple openings.
Directions for posting a job with the Epidemiology Monitor In order to create an effective job posting we need the following information from you. Failure to provide this may mean we are unable to post your job. Reqd X X X X X
Opt
X X X X X X
Description Full job title Exact job location (city & state) Job description or web link for online description Job poster’s name, email and phone Full employer name Hiring contact name & phone Hiring email address or web link for online applications Compensation Minimum hiring requirements Duration of listing Type of ad – web or print
Once you have all this information in hand please proceed to: http://tinyurl.com/bt9hcww to begin the process of posting your job opening.
Epi-Monitor Job Bank---A Sampling of our Listings For over 30 years the Epi-Monitor has helped epidemiologists find the best jobs in the field. Our publication helps employers cost effectively reach their target audience. Recently we’ve replenished our job bank to include: ► ► ► ► ►
Opportunities throughout the United States Openings in countries throughout the world Multiple universities looking for 8-10 faculty EACH Jobs in industry Listings for non-traditional epi jobs requiring epi education/experience
In addition to listings found in this print newsletter our website, Facebook page, and e-mail alerts are constantly updated and allow us to help you find the job or employee to meet your needs. See a job listing that interests you or want to see our other listings ? Stop by our website today ! Shouldn’t your next job or employee come from the Epi-Monitor job bank ?
www.epimonitor.net/JobBank.htm
Epidemiology Job Bank - Recent Additions
15
Note: Jobs with a number in parentheses after the position name indicates multiple openings. Location
Position
Employer
Contact
AK
Sr. Epidemiologist
Alaska Native Epidemiology Center
http://epimonitor.net/2012-1412.htm
CA
Asst/Asst Prof – Epi / Pub Hlth
Cal State Northridge
anita.slechta@csun.edu
CO
Asst Prof. Epi / Biostatistics
Univ of Colorado
Stuart.Fine@UCDenver.edu
FL
Duval County Dir DOH
Florida DOH
http://epimonitor.net/2012-1426.htm
IL
Tech Director
Univ of Chicago
http://epimonitor.net/2012-1427.htm
IN
Multiple Faculty Positions
Indiana University
http://epimonitor.net/2012-1400.htm
IN
8 Faculty Positions
Purdue University
http://epimonitor.net/2012-1382.htm
MD
Research Associate
Intl Epidemiology Institute
Mike.Mumma@iei.us
MD
Sr. Study Director
Westat
http://www.westat.com/jobs
MD
Fellowships
National Cancer Institute
http://epimonitor.net/2012-1366.htm
MA
Prof - Pharmacoeidemiology
Harvard Pilgrim Healthcare
Jeff_Brown@harvardpilgrim.org
MA
Genetic Epi –Prof / Instructor
Brigham & Women’s
http://epimonitor.net/2012-1411.htm
MA
Perinatal Epidemiologist
Brigham & Women’s / Harvard Med
LWilkinsHaug@partners.org
MA
Asst Scientist II
Hebrew Seniorlife /
http://epimonitor.net/2012-1402.htm
MI
Epidemiologist
Wayne State University
http://epimonitor.net/2012-1414.htm
NV
Prof – Chronic Disease Epi
Univ of Nevada - Reno
bcoker@unr.edu
NY
Chair Dept of Epi & Community Hlth
NY Medical College
james.obrien@nymc.edu
NY
Asst/Assoc Prof Epi & Biostat
CUNY / Hunter
http://epimonitor.net/2012-1419.htm
NY
Faculty Cardio Disease Epi
Albert Einstein College of Medicine
http://www.epimonitor.net/2012-1416.htm
NC
Food & Nutrition Policy Researcher
UNC Gillings School of Public Health
jscearce@email.unc.edu
NC
Post-Doc Fellows / Cancer Care
UNC Gillings School of Public Health
bryan_weiner@unc.edu
OH
Post-Doc Molecular Epi
Univ of Cincinnati Medical Center
wutg@ucmail.uc.edu
PA
Director. Epi Research
Geisinger Health System
jheid1@geisinger.edu
PA
TT Asst Prof – Public Health (2)
Mercyhurst University
ddausey@mercyhurst.edu
SC
TT Open Rank Faculty - Epi
Univ of South Carolina
http://www.epimonitor.net/2012-1418.htm
SC
Asst/Assoc Prof – Cancer Research
Univ of South Carolina
breager@mailbox.sc.edu
TN
Post-Doc Research Fellow
Vanderbilt University
http://www.epimonitor.net/2012-1425.htm
TX
Post-Doc Adolescent Hlth
UTMB
http://www.epimonitor.net/2012-1421.htm
TX
Program Specialist
Texas Cancer Registry
http://www.epimonitor.net/2012-1406.htm
TX
Director of Biostatistics
UTMB
jsgoodwi@utmb.edu
CA
Medical Epidemiologist - 207875
Henry Jackson Medical Foundation
http://www.hjf.org/careers
CT
Faculty Level Biostatistician
UCONN Health Center
jgrady@uchc.edu
MI
TT Asst Prof – Genetic Epi
UMICH School of Public Health
skardia@umich.edu
For full details on these and other job openings: http://epimonitor.net/JobBank.htm
Epidemiology Job Bank - Recent Additions
16
Note: Jobs with a number in parentheses after the position name indicates multiple openings. Location
Position
Employer
Contact
NE
Epidemiologist
Douglas County Health Dept
http://tinyurl.com/awq9sdl
IL
Post-Doc Cancer Control & Prevent
Univ. of Illinois - Chicago
cecdp@uic.edu
MA
Research Associate
Harvard SPH
agallant@hsph.harvard.edu
UT
Asst Prof. Public health
Westminster College
dstearn@westminstercollege.edu
MD
Research Supervisor / Clinical
Univ. of Maryland
lklein@epi.umaryland.edu
RI
Post-Doc Fellow
Brown University
Yen-Tsung_Huang@brown.edu
MI
TT Faculty – Genetic Epi
Univ. of Michigan
babcockk@umich.edu
NY
Faculty – Open Rank
Queens College
smarkowitz@qc.cuny.edu
WI
Assistant Researcher
Joseph J. Zilber SPH
ETZEL@UWM.EDU
GA
HIV Project Coordinator
Georgia DOH
jdwilliams2@dhr.state,ga.us
GA
HIV Retention Coordinator
Georgia DOH
jdwilliams2@dhr.state,ga.us
TX
Director Environmental
Texas Dept of State Health Svc
http://tinyurl.com/b3dg73m
MA
Post-Doc Fellowship
Harvard School of Public Health
savingbrainspostdoc@gmail.com
France
Scientist
Intl Agency for Research on Cancer
hro@iarc.fr
NC
Asst/Assoc Prof - Epidemiology
East Carolina University
kearneyg@ecu.edu
MD
Dir – Health & Nutri Exam Surveys
Ntl Ctr for Health Statistics / CDC
vcain@cdc.gov
Malawi
Epidemiology Tech Advisor
Intl Training & Edu Ctr for Health
amhb@uw.edu
ME
Research Associate I
Univ. of Southern Maine
mgelinas@usm.maine.edu
MA
Post-Doc Fellow / Cancer Epi
Harvard School of Public Health
signorello@hsph.harvard.edu
FL
TT Open Rank Faculty (1)
Florida International University
http://tinyurl.com/auekoav
CT
Asst. Prof – Biostatistics
UCONN Health Center
jgrady@uchc.edu
Canada
TT Asst Prof - Epidemiology
McGill Dept of Epi & Biostatistics
chairsec.eboh@mcgill.ca
For full details on these and other job openings: http://epimonitor.net/JobBank.htm
School of Public Health ▪ Department of Epidemiology Tenure-track Assistant Professor Faculty Position in Genetic Epidemiology The Department of Epidemiology at the University of Michigan, School of Public Health invites applications for a tenuretrack assistant professor faculty position in Genetic Epidemiology. Successful applicants should have a Ph.D. level training and research background in genetics, epigenetics, statistical genetics, genetic epidemiology methodologies and/or applications. Our Department of Epidemiology is home to over 30 highly interdisciplinary, internationallyrecognized researchers and scholars in a broad range of epidemiologic disciplines. The Department has a large and highly successful training program at both the masters and doctoral level. Genetic epidemiologists from a broad range of disciplines (chronic disease, cancer, cardiovascular, infectious, environmental, nutrition, population dynamics) are encouraged to apply. Inquiries regarding this position can be directed to Dr. Sharon Kardia (skardia@umich.edu). For more information go to: http://www.sph.umich.edu/epid/
Brigham & Women’s Hospital Perinatal Epidemiologist The Department of Obstetrics and Gynecology at Brigham and Women’s Hospital, a major teaching hospital of Harvard Medical School is seeking an Epidemiologist to work in the Maternal Fetal Medicine perinatology area. This position will be a Brigham and Women’s Hospital appointment with full time benefits. Candidates must have a doctorate in epidemiology with experience in perinatal epidemiology. In addition, candidates should have a strong quantitative background with experience in programming and analysis of case control and cohort data. Excellence in writing and teaching must be demonstrated. Strong interpersonal, administrative and collaborative skills are required. A commitment to teaching residents and medical students is essential. Academic rank as Instructor, Assistant Professor and/or Associate Professor at Harvard Medical School will be commensurate with experience, training and achievements. Applicants are invited to submit a letter of interest and their curriculum vitae to: Louise Wilkins-Haug, M.D., Ph.D. Department of Obstetrics and Gynecology Maternal Fetal Medicine Division
Brigham and Women’s Hospital 75 Francis Street Boston Ma 02115 LWilkinsHaug@partners.org
The Brigham and Women’s Hospital and Harvard Medical School are affirmative action equal opportunity employers.
ASSISTANT PROFESSOR OF EPIDEMIOLOGY
The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh invites applications for a full-time faculty position at the level of Assistant Professor. This position is available immediately and requires a doctoral degree in public health, or a related field, as well as experience and training relevant to directing graduate education programs and to conducting research in aging and prevention. The successful candidate will be part of a research group involved in the promotion of healthy aging. The individual will be responsible for staff training and supervision, adherence to protocol requirements, quality control, participant follow-up, administering clinic assessments, overseeing data collection, management, and analyses, and writing reports and manuscripts. The individual will also supervise master’s students and the graduate training program on a part-time basis. This position is outside of the tenure stream and is renewable annually, contingent upon funding. Salary will be commensurate with experience. Applications will be reviewed until position is filled. Send letter of intent, curriculum vitae, and the names of three references to: Position #0127986, c/o D. Bushey, Department of Epidemiology, Graduate School of Public Health, A528 Crabtree Hall, University of Pittsburgh, Pittsburgh, PA 15261. The University of Pittsburgh is an Affirmative Action, Equal Opportunity Employer.
Two Biostatistics Positions Radiation Effects Research Foundation Hiroshima, Japan The National Academy of Sciences seeks scientists to fill two Biostatistics positions a the Radiation Effects Research Foundation (RERF) in Hiroshima, Japan. Primary responsibilities are statistical consulting on the design of radiation research protocols and analysis of research data in consultation with RERF epidemiologists, clinical researchers, and laboratory scientists, with additional independent research on related statistical methodologies and applications. Please visit: http://tinyurl.com/b3z7r6b EOE, M/F/D/V
TT Asst / Assoc Prof Cancer Research 3 openings
NRSA T32 Postdoctoral Fellowship Interdisciplinary Women’s Reproductive Health
The University of South Carolina’s (USC) Arnold School of Public Health (ASPH) in Columbia, SC ( http://www/sph.sc.edu ) seeks applications for three tenure-track faculty positions. USC is the state’s flagship university, which the Carnegie Foundation gave its highest ranking for research activity, as demonstrated by a consistent and steep upward trajectory in the volume and impact of its research and extramural grant funding. USC’s strategic vision incorporates the twin goals of conducting highimpact research and producing socially meaningful outcomes, with a special focus on reducing health disparities. The ASPH leads research activity at USC, with annual extramural grant funding consistently exceeding $25 million. The anticipated hires will contribute to the School’s goal of deepening and broadening its current expertise and research portfolio in cancer-related research.
The University of Texas Medical Branch in Galveston, TX is accepting applications for one postdoctoral fellow interested in pursuing an academic career in women’s health research. This 2-year NIH funded fellowship provides formal and informal training in theory and methods as well as practical experience in conducting clinical research. Program faculty include national experts in statistics, epidemiology, and women’s health who can offer many opportunities to participate in data analysis, manuscript preparation, and grant writing in a collaborative environment.
Prospective applicants should submit their CV, a letter of interest articulating research accomplishments/interests, teaching and mentoring experience, professional goals, and a list of three references to: Cancer Faculty Search, c/o Barbara Reager, Arnold School of Public Health, 800 Sumter Street, HESC 102, Columbia, SC 29208, or email to breager@mailbox.sc.edu .
To apply, send 1) a personal statement including career goals, a brief description of proposed research, and how this training will help achieve your career goals; 2) a current CV; and 3) 3 letters of reference to:
Who may apply: Applicants who have completed a MD, PhD, or equivalent degree in a discipline related to women’s health. Must be US citizen, non-citizen national or permanent resident and able to commit full time effort to the program for 2 years.
Abbey Berenson, MD, MMS, PhD The University of Texas Medical Branch
301 University Blvd. Galveston, Tx 77555-0587 abberens@utmb.edu
For full job info: http://epimonitor.net/2012-1429.htm
Training Courses for Public Health Professionals Co-sponsored by Emory University (RSPH) and The Centers for Disease Control & Prevention (CDC) (Atlanta, GA) Directed by Philip S. Brachman, M.D. Public Health Surveillance May 20-24, 2013 This course is a comprehensive study on public health surveillance and includes discussions of the history and planning considerations, data sources and collection, analysis and interpretation, communication, evaluation, ethical and legal issues, state and local issues , and issues in developing countries as concerns publ health surveillance.
Epidemiology in Action June 3-4, 2013 This basic two-week course in epidemiology is directed at public health professionals and includes discussions of applied epidemiology and biostatistics, public health surveillance, field investigations, selected prevalent diseases and hands-on computer basic training using Epi-Info 7, Epidemiologic case studies are worked on in the classroom
Epi Info 7 *Basic and Intermediate Levels June 13-15 and June 15-17 Each session meets for 2.5 days providing hands-on experience using Epi Info 7, programming Epi Info software at the beginning level and intermediate / advanced level to develop public health data systems. Basic course covers Makeview, Enter, basic Checkcoding, basic Analysis and Epi map modules. Intermediate to Advance level covers Data management, Advanced Analysis, Epi Map and Report Modules.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Contact person: Pia Valeriano, MBA Phone (404)727-3485; Fax 404)727-4590; Email: pvaleri@emory.edu
Website: http://www.sph.emory.edu/EPICOURSES
TT Assistant Professor in Women’s Health The University of Texas Medical Branch (UTMB) Center for Interdisciplinary Research in Women’s Health invites applications for an entry level assistant professor tenure-track position. Supported through the NIH K12 career development program (Building Interdisciplinary Research Careers in Women’s Health), the position provides a minimum of 75% protected time or research, a competitive salary and benefits package, and assistance to establish independent, externally funded research. Applicants must be 1) a U.S. citizen or permanent resident; 2) possess a doctoral-level heath science degree; and 3) have no more than 6 years of post-degree research experience. A strong publication record and experience with grant writing is preferred. Preferred disciplines include epidemiology, statistics, public health, demography, and sociology. Situation on scenic Galveston Island, UTMB has strong research programs in reproductive health, contraception, aging, infectious disease, adolescent health, preventive medicine, vaccine research, and cancer, among others. Campus is located just minutes away from the beach, the historic Strand district (home of the Galveston Mardi Gras), and America’s first indoor/outdoor water park, Schlittlerbahn. You will also enjoy year-round moderate weather, affordable living, rich cultural diversity, and all the amenities island life has to offer. For more information please see: http://tinyurl.com/ambtsng or send electronic curriculum vitae, statement of research interests and goals, and the names of three references to: Abbey Berenson, MD, MMS, PhD The University of Texas Medical Branch
301 University Blvd. Galveston, Tx 77555-0587 abberens@utmb.edu
Opportunities This Month 16 – UMICH / TT Asst Prof Genetic Epi 17 – B&W / Perinatal Epidemiologist 17 – PITT / Asst Professor - Epidemiology 18 – JHSPH / Summer Program 18 – ANTHC / Sr. Epidemiologist 18 – NAS / Biostatisticians (2) 19 – U. SC / TT Asst-Assoc Prof Cancer Epi 19 - UTMB / Post-Doc Fellow Repro Health 19 - Emory / Training Classes – Epi 19 - UTMB / TT Asst Prof Women’s Health 20 – U Chicago/ Tech Director
2300 Holcomb Bridge Rd, Ste 103-295 Roswell, GA 30076
First Class U.S. Postage PAID Permit #1040 Leesburg, FL 34748
Editor & Publisher Roger H. Bernier, Ph.D., MPH Director of Operations Linda P. Bernier, Ph.D.
Find more jobs & enhanced details on listed jobs at www.epiMonitor.net/JobBank.htm
Ron Aron, Advertising Manager 770.670.1946 ron.aron@epiMonitor.net
University of Chicago Medicine
Comprehensive Cancer Center
Technical Director, Epidemiology and Research Recruitment Core (ERRC) In response to the expansion of population research, the UCCCC has established an Epidemiology and Research Recruitment Core (ERRC). The core has a faculty-level Scientific Director and is seeking a senior staff Technical Director who will have day-to-day oversight of the Core and Core staff; strategic planning; staff education; and regulatory management of core-related projects. In addition, this individual will provide research support (project coordination, grant writing, and manuscript preparation) to faculty in the Center for Cancer Epidemiology and Prevention. Specifically, the Technical Director, is responsible for: ► Identifying faculty research needs, developing appropriate services, and providing administrative, financial and technical direction to the Core ► Work closely with UCCCC leadership and population researchers to design and oversee Core staff in designing and planning approaches ► Assume the leadership role in coordinating the implementation of a large population-based multi-ethnic cohort study in the greater Chicago area Qualifications: Advanced degree (PhD, DrPH) in epidemiology, public health or related field required. A minimum of 2 years of relevant research experience. Knowledge of cancer, Chicago’s healthcare community, and diverse community organizations preferred. View online listing for more info. Full job description & requirements: http://www.epimonitor.net/2012-1427.htm or http://tinyurl.com/b8hh4ag Job posting #: 090720 A cover letter and resume are required to be considered for this position.