Sen. Amy Klobuchar Praises the Minnesota Model • page 13
Advances SUMMER 2009
from the University of Minnesota School of Public Health
notes from the field SPH Students Report on Their Global Field Experiences
Charred Meat’s Link to Cancer Making Teen Driving Safer The Scourge of the Sea Lamprey SPH Alum Circles the Globe
FROM THE DEAN
Photo: Richard Anderson
This issue of Advances marks the fifth annual installment of our “Notes from Field” feature. It profiles the work of our students who travel the world to take on public health’s greatest challenges. Field experiences are an integral part of our educational programs, as they call for students to put classroom skills to use on real-world projects. The cover photo, taken by Tyler Weber, captures a newly installed water system in the rural community of Mulobere, Uganda. Tyler and fellow SPH student Amber Koskey are there conducting a community health assessment on water and sanitation systems built by the University of Minnesota arm of Engineers Without Borders. Their findings will be used to guide future phases of the water projects. Here in the United States, health discussions are focused on overhauling the health care system, with that debate getting more heated by the day. This fall, our school will kick off a roundtable series on health care reform. The goal is to offer nonpartisan expertise on different aspects of this complex issue. I encourage you to check www.sph.umn.edu as details of these events develop. In other government-related news, I’m proud to say that SPH faculty members will be putting recently awarded stimulus money to good use on projects related to improving treatments for leukemia, alcohol’s connection to violence, and managing nuclear power. University researchers also secured federal stimulus funds to install digital X-ray equipment at the Virginia Regional Medical Center, the site of an occupational cancer study on Minnesota’s Iron Range. For more on this historic project see page 9. Many of the incredible field experiences afforded to our students would not have been possible without the help of our friends who serve as mentors. With the school year upon us, it’s time again for us to encourage you to join our mentor program. You can learn more on the back cover. The connection you make with a student this year could result in the field experiences and careers that you’ll read about in the pages to come. Yours in health,
John R. Finnegan, Jr., Ph.D. Assistant Dean for Public Health Dean and Professor
School of Public Health Leadership John R. Finnegan Jr. Dean
John Connett Head, Division of Biostatistics
Judith Garrard Senior Associate Dean for Research and Academic Affairs
Bernard Harlow Head, Division of Epidemiology and Community Health
Debra Olson Associate Dean for Education
Ira Moscovice Head, Division of Health Policy and Management
William Riley Associate Dean for Strategic Partnerships and Relations Mary Story Associate Dean for Student Life and Leadership Diana Harvey Assistant Dean for External Affairs
William Toscano Head, Division of Environmental Health Sciences Joe Weisenburger Chief Administrative Officer/ Chief Financial Officer
Advances Editor Diana Harvey Managing Editor Kristin Stouffer Contributing Writers Martha Coventry Nicole Endres Art Direction Todd Spichke Riverbrand Design
Contents Table of
Feature: Notes from the Field
SPH students know that more than ever public health is global health. That philosophy is guiding their field experiences in communities around the world this summer.
Hormone replacement therapy brings new benefits; chemical link found between smoking and cancer; making the roads safer for teen drivers; and more.
Couple supports injury prevention research and education; and what you need to know about tax breaks for charitable giving.
Sen. Amy Klobuchar draws on the Minnesota model for new food safety legislation; SPH joins global consortium on doctoral education; faculty take top honors and awards; and more.
Maternal and Child Health program grad circles the globe and volunteers along the way, while another SPH alum reflects on a career that took him from Uganda to Minnesota and back again; and more.
Notes from the
FIELD SPH Students Report on their Global Field Experiences
University of Minnesota School of Public Health
ummer is a time when School of Public Health students head to all corners of the world to embark on international field experiences. This work is often done in partnership with non-governmental organizations (NGOs) and in a variety of settings—from rural schoolhouses to community clinics to massive office complexes to small family farms. Yet despite geographic differences, the goals are the same: prevent disease and improve lives. Students expect to sharpen their skills by applying classroom concepts to the realworld practice of public heath. But the challenges and rewards of working in a culture that is foreign to them bring an education that they may not have anticipated.
Environmental health sciences student Eddie Kasner is in China’s Yunnan province conducting a survey of small-scale farmers to get an idea of their exposure to pesticides. He’s also talking with Chinese colleagues on how pesticide risk assessment is conducted in the United States. One of the organizations Kasner is working with is the Pesticide Eco-Alternatives Center (PEAC), whose mission is to reduce the use of harmful pesticides and promote alternative forms of pest control throughout China. With PEAC staff, Kasner visited two large-scale organic vegetable farms. The farms “give insight into how China is meeting the evolving demands of food consumers,” says Kasner. “Many of the products from these farms are exported to other Asian countries and Europe. With the mass exodus of young people leaving farms for the cities, this balance could be disrupted in the future.”
“I was very impressed by the NGO that I worked with this summer. [It] appears to be setting the curve for environmental NGOs in Yunnan and greater China. I feel very fortunate for having the opportunity to work alongside them.” – Eddie Kasner Tessa Somermeyer is working with Chiba University on the Chemiless Town Project of Japan. The Chemiless Town consists of four experimental housing facilities built on Chiba’s campus. The structures were manufactured with the goal of using as few chemical agents as possible. People who suffer from “sick house syndrome”—a disorder triggered by vapors from building and housing materials—have been invited to live in the facilities. The hope is that their symptoms will improve and researchers can start to assemble a better idea of what causes sick house syndrome. “If they succeed in finding living habitats that decrease these symptoms, the knowledge can then be applied to many different settings such as schools and workplaces,” says Somermeyer. “This is a very ambitious project.”
Above: A Ugandan student uses a mosquito net bag for her school books. At right: Waiting for medical care in Haiti. Far right: Robyn Browning dispenses medication to Haitian children.
health education has trained her to be keenly observant. Outside the classroom, she’s been gaining an understanding of other health issues facing Kenyans—namely those of diet, exercise, and a recent cholera outbreak. “My studies would not be able to tell me specifically what public health issues I would witness in Kenya,” she says. “But they did teach me to reflect on how my daily encounters throughout the community are linked with public health outcomes.”
Contributing to national nutrition policies at the World Health Organization (WHO) is the experience of a lifetime for Eunice Abiemo. But it became even more rewarding when she learned that one of the countries she’d be reviewing is her native Ghana. Working at WHO headquarters in Geneva, Switzerland, the public health nutrition student is reviewing national nutrition policies for high-burdened countries, including Thailand, Fiji, and the Philippines. Abiemo says Before embarking on her field experience to Tanzania, she’s energized to be working in an environment of global Robyn Browning spent a week with three doctors and seven collaboration—she muses that when her bus arrives at the other volunteers at mobile medical clinics around Leogane, WHO, people from all over the world disembark. Abiemo’s Haiti. Weighing clients, measuring work calls for her to children’s arms for malnutrition, and analyze many facets of dispensing medication to fight parapublic health, including sites was immediate and concrete infectious diseases, work. When Browning joined up with agriculture, trade policies, fellow SPH student Katarina Grande and the marketing of in Tanzania just a few weeks later, breast milk substitutes. the work had become less defined “This [work] has all and more broadly based. been very interesting since it shows me a broad and multi-faceted approach to deal with public health nutrition Meghan Mason helps students make public health-themed issues,” she says. videos and joins in the fun at Jambo Jipya: The Future Child School in Kenya.
“Traveling to Kenya solidified my desire to pursue a career in global health. I can confidently say that I am willing and able to participate in public health activities in the developing world.” – Meghan Mason
Mtwapa, Kenya, is the site of Meghan Mason’s field experience. She’s teaching HIV/AIDS awareness to Kenyan teens at Jambo Jipya: The Future Child School and encouraging them to share the facts with their peers through open and mature dialogue. Rather than just stand at the front of the class and lecture, Mason is trying to put herself in the place of her students, literally. She recently decided to get tested for HIV at a center in Mombasa. “Students had been asking about the process,” she says, “How could I encourage youth to do something I myself had never done?” In addition to knowledge regarding HIV/AIDS, Mason says her public 4
University of Minnesota School of Public Health
The two are partnering with engineering students from Michigan Technological University and the University of Dar Es Salam on a National Science Foundation-funded project to use technologies to improve public health. Charged with the planning process of the three-year project, the team met with various NGOs and community leaders to learn about opportunities. “Improving health starts with listening and knowing that you cannot change things overnight,” says Browning. “I was eager to jump in and get my hands dirty right away, but I had to constantly remind myself that I needed to listen and learn first.” The team identified water quality, indoor air pollution, and malaria prevention as areas where engineering interventions could improve public health. Listening, indeed, seems to have helped establish a strong base for future collaboration.
Says Grande, “A great accomplishment has been speaking with my Tanzanian teammates and hearing that they are learning a great deal about their own country from the project. The partnership that emerged between the American and Tanzanian students really brought credibility to our mission and research.”
“My experience has opened my eyes to what life is like in a developing country. Of the many lessons I learned and images I saw, the ones that stick out in my mind are going to influence me in my career in public health.” – Robyn Browning
Eddie Kasner documents life on various farms in China’s Yunnan province.
Improving access to a safe water supply is the focus of Amber Koskey’s and Tyler Weber’s project.The two are working with the University of Minnesota arm of Engineers Without Borders in the rural community of Mulobere, Uganda. While the engineers implement a groundwater supply and sanitation system, the SPH students are conducting a community health assessment to guide future phases of the water project.
Closer to Home
Some 100 SPH students are completing field experiences stateside this summer. For example: Jennifer Case is creating nutrition curriculum for preschool courses at the Tamarack Nature Center in White Bear Lake, Minn. The program teaches children about the nutritional benefits of fruits and vegetables. Patricia Gannon is developing Web-based video training for nurses at 3M locations worldwide. “It’s a global field experience done in Minnesota,” she says.
The lack of clean water has surprised both students. “The information gathered from the assessments so far has been striking,” says Koskey. She notes that families walk an average of one to two miles each day to a water source, which is often a swamp or pond. Water collection keeps many children out of school. “We have all read about how people in areas of the world may spend eight hours a day retrieving water, but words don’t do justice,” says Weber.
Teen leadership is the focus of Linn Agrawal’s work at the Annex Teen Clinic in Robbinsdale, Minn. Agrawal is serving on a team charged with creating a youth advisory council. Adam Hofer is working with the University of California, analyzing proposed health care reform legislation. He is also working on projects related to health disparities in South-Central Los Angeles and expanding the primary care workforce there. 5
“The lack of access to clean water, or water in general, is both appalling and disturbing. Yet I am more surprised by the resilience of the people here.” – Tyler Weber
1 A second focus of the project is to work with a local women’s group to distribute 700 insecticide-treated mosquito nets to people in a dozen communities and to collect their information for program assessment. While Weber says the program has had its ups and downs, a strong system is now in place to distribute incoming nets and to conduct community-based education on malaria prevention. The program is already making an impact. Weber’s most memorable moment in Africa came when an elderly woman walked more than an hour to thank him and his colleagues for her net. “At that point I was able to realize that work and research we had started months before finally made its way to the community,” he says. Uganda is also the site for Sarah Brunsberg and Anna Bartels, who are there working with Minnesota International Health Volunteers on a family planning initiative. The two conducted a survey of 300 women in the rural Sembabule district to determine knowledge and usage of family planning methods. On average, a Ugandan woman gives birth to eight children in her lifetime. Brunsberg says there are a number of reasons for the high number, including a desire for boys, low child survival rates, maintaining tribal populations, and a male distrust of birth control. “My sneaking suspicion is that many women are using birth control without their husband’s knowledge,” says Brunsberg. “Preliminary results from our family planning surveys have confirmed these suspicions.” 6
University of Minnesota School of Public Health
2 The students are also helping to ramp up HIV/AIDS care and prevention in the area. They developed curriculum for a youth prevention effort and for training community-based organizations to provide home-based care for individuals living with the disease. The curriculum included information they had researched on the human and legal rights of children, orphans, and adults living with HIV/AIDS in the Sembabule district. “It was extremely difficult to see the health disparities between women and men, especially in relation to HIV/AIDS and maternal and child health,” says Bartels. “On one hand, I felt incredibly helpless to address gender issues that are so widespread and entrenched in society. But on the other hand, I felt hopeful when I would see women who, against all odds, were fighting for their right to have a healthy family.”
Learn more online!
See videos and photos from abroad and read the latest news from the students themselves in the Notes from the Field blog at www.sph.umn.edu/notes09.
“My three months here have reinforced my dedication to the true spirit of public health.” – Anna Bartels
1 Tyler Weber, Amber Koskey, and others head off to distribute mosquito nets.
2 G loria shows off face paint that a volunteer brought to the
Nazareth orphanage in Masaka, Uganda. A few months ago, the young girl showed up alone on the steps of the orphanage. She’s from Tanzania, but little else is known about her.
3 A new biosand filter is the gathering place for U of M students 7
and women from the Bugonzi community of Uganda. The filter uses gravel and sand to decontaminate water from rain, surface, and ground sources.
4-5 Public health messages in Africa. 6 W aiting for a family-planning film to begin in town of Kikoma,
Uganda. The screening, organized with the help of Sarah Brunsberg and Anna Bartels, attracted more than 200 people.
7 Anna Bartels and Sarah Brunsberg with young friends. 8 K atarina Grande captures a shot of from a point few will ever
see: Uhuru Peak, the highest point in Africa, atop Mount Kilimanjaro. Grande and fellow SPH student Amber Koskey made the trek together.
HRT May Bring Lower Colorectal Cancer Risk Hormone replacement therapy (HRT), once thought of as a magic bullet to relieve menopausal symptoms, turned out to increase a woman’s risk for breast cancer and heart disease. But a recent study by SPH doctoral student Jill Johnson confirmed a positive effect of HRT—a reduction in the risk of colorectal cancer. Although previous studies identified this connection, Johnson’s study pinpointed that the number of years of use and combination of hormones defines the risk. She analyzed data from 56,733 postmenopausal women from the Breast Cancer Detection Demonstration Project. Of these women, 960 were diagnosed with colorectal cancer throughout the 15-year follow-up study. Among Johnson’s findings is that women who stopped taking estrogen and progestin five years ago or more have a 45 percent reduced risk of colorectal cancer compared to women who never used HRT; women who used progestin sequentially, or less than 15 days a month, in combination with estrogen have a 36 percent less risk; and women who have used only estrogen at some point have a 17 percent less risk. Johnson is quick to point out that this study does not encourage HRT use to prevent colorectal cancer. “Our study did find a reduced risk of colorectal cancer with use of menopausal hormone therapy, but this does not suggest that women should be taking these hormones to reduce their risk of colorectal cancer,” she says. “[HRT] should be used to reduce [menopausal] symptoms at the WEB EXTRA WEB EXTRA most effective dose over the shortest duration possible.” WEB EXTRA
To listen to a Public Health Moment on this research, go to www.sph.umn.edu/moment. WEB EXTRA
University of Minnesota School of Public Health
Less Time on the Road Means Fewer Teen Deaths Teenagers have a dismal car accident fatality rate—more than a third of deaths for 13- to 19-year-olds are due to motor vehicle crashes. To lower the fatality rate, almost all states, including Minnesota, have put graduated driver licensing (GDL) in place. Young drivers must move from learner’s permit to intermediate license to full licensure. The policy reduced the number of accidents involving teenage drivers, but no one knew why. SPH assistant professor Pinar Karaca-Mandic decided to look for the answer. “I have been interested in traffic safety as a major public health concern for a while,” says Karaca-Mandic. “One statistic that got my attention was that ‘more than 1,000 16-year-old drivers are involved in a fatal crash each year.’ I wanted to investigate what policy can do to address such a major problem.” Using the relatively new State Data System, Karaca-Mandic and her colleagues found that GDL policies have reduced the number of teenage accidents by limiting teenage driving rather than by improving it. “I was hoping to find that GDL made teens better drivers,” says Karaca-Mandic. “When we found that GDL’s effectiveness primarily operated through limiting the number of teens on the road, especially during the night time, I was surprised.” Now she wants to understand why it’s hard for GDL to improve teen driving. “Maybe [irresponsible teenage driving] is a physiological phenomenon,” Karaca-Mandic says, citing new research that shows that the pre-frontal cortex which governs impulse control, prioritization, and strategy is still “under construction” during teen years. “This makes me want to further investigate how policy can tackle improving actual teen driving behavior given the developmental nature of the brain.”
SPH Seeks Participants for Iron Range Study
Photo: David Hansen
School of Public Health researchers began sending letters last month to current and former taconite workers on Minnesota’s Iron Range to invite them to participate in a respiratory health survey. Members of the research team are trying to find out why so many Iron Range mine workers are dying from mesothelioma, which is commonly associated with exposure to asbestos. The team will randomly select 1,200 current and former mine workers and 800 of their spouses. The survey is part of a larger $4.9 million study funded by the state legislature last year. Researchers are in the midst of the first phase of the five-year project, which also includes an analysis of death certificates of 68,000 miners and an assessment of various cancers associated with asbestos exposure.
Health screenings for the survey will begin this fall at the Virginia Regional Medical Center. Participation involves a health and job history questionnaire, chest X-rays, breathing tests, and blood tests. The researchers will use the data to determine whether dust from taconite operations is causing unusual rates of various lung diseases. This information will be coupled with results of several other University-led studies to form an overall assessment of health in the mining industry. The study presents an historic opportunity for the Iron Range community to better understand the health risks in the mining industry. Researchers are urging participation in the respiratory health survey. “It’s critical that miners and their spouses participate in this survey,” says Jeff Mandel, SPH professor and primary investigator. “To ensure scientifically sound results, we must have a very high rate of participation among those who are invited.”
Taking on the Scourge of Sea Lampreys
Geological Survey (USGS). Carlin was singled out for his expertise in Bayesian analysis, a method that allows researchers to pool a series of datasets and utilize the statistical similarities among them. The biostatisticians are determining the optimal combination of two chemicals that are lethal to lampreys but relatively safe for game fish such as trout and whitefish. “The chemicals are like chemotherapy,” explains Carlin. While the poison kills the cancerous sea lamprey larvae, it is also assumed that it may somehow affect the health of the other water life. So the trick is to determine the least amount of chemicals needed to kill virtually all (99.9 percent) of the sea lampreys while doing as little damage as possible to the native fish. Until now, scientists have been using the same chemical cocktail to destroy lampreys, regardless of environmental factors such as water temperature, pH levels, and alkalinity. “Our hope is that we can help tailor the chemicals to different environments,” says Hatfield. “For instance, if the water is low in pH, you can get by with fewer chemicals.”
For decades now, scientists have struggled with how to control the deadliest parasite of the Great Lakes: the sea lamprey. With its disk-like mouth full of razor-sharp teeth, the sinuous fish attaches to its host and literally sucks the life out it. Left unchecked, sea lampreys would wipe out the game fish population of the Great Lakes. Enter SPH professor Brad Carlin and doctoral student Laura Hatfield. The two have been tapped to create statistical models from five datasets spanning 20 years, collected by the U.S.
Burned Meat May Cause Pancreatic Cancer That yummy charred bit of grilled steak might taste delicious, but, according to Kristin Anderson, it might also cause pancreatic cancer. Anderson, SPH associate professor, and her team surveyed the eating habits of more than 62,000 people taking part in the Prostate, Lung, Colorectal, and Ovarian Multi-Center Screening Trial, noting meat intake, preferred cooking methods, and doneness preferences. They found that eating meat that is burned or charred might increase pancreatic cancer risk by almost 60 percent. Anderson focused her research on pancreatic cancer, because she wants to “identify ways to prevent this cancer because treatments are very limited and the cancer is often rapidly fatal.” In previous research, Anderson found an association between pancreatic cancer and the cancer-causing compounds heterocyclic amines and benzo(a)pyrene that form on the surface of red meat during high-heat cooking. In this new study, disease-free participants reported on their typical diet, and then they were followed to track their health status. Over a nine-year period, Anderson and her colleagues identified 208 cases of pancreatic cancer. “Our findings in this study are further evidence that turning down the heat when grilling, frying, and barbecuing to avoid excess burning or charring of the meat may be a sensible way for some people to lower their risk for getting pancreatic cancer,” says Anderson. She suggests microwaving meat for a few minutes before grilling and pouring off the juices, which contain many of the precursors of the cancercausing compounds. Before eating the grilled meat, it’s best to cut away parts that are burned or charred.
Screening for Lung Cancer
We know smoking contributes to lung cancer, but why do some smokers, heavy and light, get the disease and others don’t? The results from a recent study by researcher Jian-Min Yuan brings us closer to an answer. “We’ve known for a long time that smoking increases a person’s risk for getting lung cancer, but we have not been able to clearly answer why one smoker would eventually develop lung cancer and another one would not,” says Yuan, SPH associate professor and Masonic Cancer Center researcher. “Now we know one definitive link.” That link is how each smoker metabolizes two nicotine by-products: NNAL and cotinine. For the study, Yuan and his colleagues looked at levels of NNAL and cotinine in the urine of 489 smokers from the Shanghai Cohort Study and the Singapore Chinese Health Study. Half had lung cancer and half did not. Compared to smokers with low concentrations of NNAL in their urine, those with high concentrations had double the risk of developing lung cancer. When cotinine was added to the picture, smokers with high levels of both chemicals had more than eight times the risk of getting lung cancer. WEB EXTRA WEB EXTRA “Our goal [at the Masonic Cancer Center] in the next To listen to a Public Health three to five years is to amass information [about the 60 Moment on this research, go to carcinogens in tobacco smoke] so that it can be used as aWEB EXTRA www.sph.umn.edu/moment. screening test to alert smokers of their risks,” says Yuan. WEB EXTRA
University of Minnesota School of Public Health
Leon and Nancy Robertson
Couple’s Gifts Support Injury Prevention Research and Education Having spent most of his career as a transportation injury epidemiologist, Leon Robertson has researched how policy changes such as seat belt laws and lowered legal driving limits for blood-alcohol content can improve safety on the roads. Throughout his career as a researcher on the faculties of Wake Forest, Harvard, and Yale universities, he also has studied how vehicle and road modifications can significantly reduce fatalities. But Robertson argues that there’s still much improvement to be made. “We still have a big problem, but it’s not nearly as big as it was 30 years ago,” he says. That’s why he and his wife, Nancy Robertson, have supported injury prevention education and research at the University of Minnesota School of Public Health. In 1997 the Robertsons set aside $500,000 in their estate plan to eventually create the Leon S. Robertson Professorship in Injury Prevention, which would support the work of SPH professor Susan Goodwin Gerberich, a former colleague of Leon Robertson whom both Robertsons deeply respect. Gerberich has led a major research effort over the last two decades in five Midwestern states examining the magnitude of and risk factors for injuries among agricultural families, with a focus on children. (She and Robertson once collaborated on a study of fatal farm vehicle crashes on public roads.) She also has conducted several studies on work-related violence, most recently violence against nurses and teachers in Minnesota. But this year the Robertsons decided they wanted to start funding Gerberich’s research now. So in March, they contributed $100,000 to the fund through their individual retirement accounts. They plan to make similar contributions in the next few years.
“I decided that we could afford to get it started now because I wanted the program to continue … and if Sue Gerberich ever retires, which I don’t know if she will,” Leon Robertson says with a laugh, “[I want to be assured that the University] would replace her with someone equally qualified.” To further support injury epidemiology at the University, the Robertsons also are funding the Nancy A. Robertson Endowed Fellowship in Injury Prevention to support graduate student training. The SPH’s injury prevention graduate training program, established by Gerberich in the late 1980s, is one of the nation’s first. Robertson knows that Gerberich is teaching her students well—he’s seen her in action. Years ago the two co-taught a graduate summer session in epidemiology through the SPH, although Robertson was never officially a faculty member in the school. Gerberich also received the SPH’s Excellence in Advising Award in 2008. “Sue’s the best,” says Robertson, adding that he refers students to her training program whenever he has the chance. “She’s an excellent teacher and an excellent scholar.”
Did You Know?
Tax breaks still available for gifts from IRAs through end of 2009 It’s not too late—people age 70½ or older can once again make outright charitable gifts using funds transferred directly from their individual retirement accounts (IRAs) without adverse tax consequences through the end of 2009 under the reinstated charitable IRA legislation. Although you cannot claim a charitable deduction for these IRA gifts, you will not pay income tax on the gift amount. Individuals may transfer up to $100,000 directly from their IRAs in 2009. You can make a gift from your IRA even if you aren’t required to take a minimum distribution this year. The donated amount can be made in addition to or to fulfill any previously planned charitable giving. For more information about making a gift through your IRA to benefit the University of Minnesota School of Public Health, contact Adam Buhr at 612-626-2391, 1-800922-1663 (toll free), or email@example.com, or visit www.mmf.umn.edu and click on “Gift Planning.”
SPH Offers Online MHA Programs The School of Public Health’s highly ranked Master of Healthcare Administration (MHA) degree is now available in a flexible online format for health care executives, physicians, and other professionals. “We are responding to a need expressed by health care managers and clinical professionals for education in executive leadership, strategy, and finance, while remaining on the job,” says Daniel Zismer, director of the MHA Executive Studies program and an associate professor at the SPH. “We think it is important to provide two pathways [one classroom based, one Web based] to the highly desired degree.” The Executive MHA can be completed in 25 months and requires students to be on campus for only a few days each semester. The rest of the curriculum is delivered online. U.S. News and World Report ranks the SPH’s Healthcare Administration program second in the nation among similar programs. Launched in 1946, it is one of the first programs of its kind nationally. MHA alumni have gone on to leadership roles in hospitals and health systems throughout the United States. The MHA program is also offering two new Web-based post-baccalaureate certificates in executive healthcare studies. The Management Fundamentals in Healthcare Organizations Certificate provides core courses of the executive MHA for individuals who want to learn the fundamentals of managing health care organizations. The second certificate, Leading Integrated Health Systems: Organizational Design, Strategy, Finance, and Management, focuses on organizations that combine physician practices and hospitals. More information on the Master of Healthcare Administration Executive Studies program can be found at www.sph.umn.edu/execmha.
University of Minnesota School of Public Health
SPH Joins Global Consortium on Doctoral Health Education The School of Public Health has joined an international consortium of schools to ramp up doctoral-level degree programs focused on the global practice of public health. The SPH was one of nine schools invited to the inaugural meeting this summer in London. In order to meet the growing demand for Doctor of Public Health (DrPH) degrees, the group pledged to share expertise to serve a worldwide student base through online curriculum and other technology-enhanced programs. The consortium comes together at a time when the SPH is exploring the feasibility of offering its own DrPH degree program. SPH Associate Dean for Education Debra Olson says the time is right for the practice-based doctoral degree. “Over the past 10 years, there’s been growing recognition that research is not just the discovery of new knowledge,” she says. “It’s also the translation of that knowledge—applying it to have a positive impact on people and communities.” For schools in the global consortium that already offer DrPH degrees, the aim is to maximize program quality. Collaborating on distance technology means that worldclass experts can teach to a worldwide student base. It also fosters the international partnerships needed to address today’s health challenges. The SPH’s charge is to help create a model curriculum for consortium members. Again the timing is right, as the U.S.-based Association of Schools of Public Health recently adopted a set of core competencies for doctoral-level public health practice degrees. “The competencies have been set,” says Olson. “Now we’re looking to see how they translate to training for global leadership.”
This spring, Sen. Amy Klobuchar came to the SPH to introduce a $20 million makeover of the country’s food illness detection and response capability. It’s modeled in part on Minnesota’s stellar system. With her are SPH faculty, left to right, Mike Osterholm and Craig Hedberg, and SPH adjunct faculty and Minnesota Department of Health epidemiologist Carlota Medus.
Bill Recognizes Minnesota Expertise When it comes to food-borne illness outbreaks, Minnesota solves puzzles and saves lives faster than other states through an exceptional collaboration among the SPH and Minnesota’s departments of health and agriculture. And one of the state’s secret weapons is Team Diarrhea (aka “Team D”), a group of Minnesota Department of Health epidemiologists and SPH students who do much of the legwork essential for tracking down foodborne disease patterns. Last year, Team D pinpointed the sources—jalepeño peppers and peanut butter—of two nationwide salmonella outbreaks. In order to replicate what Minnesota does so well, Sen. Amy Klobuchar came to the School of Public Health in June to introduce “The Food Safety Rapid Response Act of 2009,” which she co-authored with Sen. Saxby Chambliss (R-GA). She appeared at a press conference with SPH
professors Craig Hedberg and Michael Osterholm to discuss the issue. The two food safety experts were instrumental in establishing Team D. Two things set Minnesota apart from other states in response to outbreaks: attitude and quick action. According to Carlota Medus, Team D staffer and SPH alum, each case of salmonella and E. coli is considered the first case of a yet unidentified outbreak. A Minnesota state health worker immediately interviews every victim and uses a standardized form to get a detailed history. Hospital or clinics take specimens and send them, as required by Minnesota law, to the state lab in St. Paul for further testing to see if they match other cases nationwide. That lab does its testing fast and sends reports to the state’s epidemiologist every day. If patterns begin to emerge, a health worker interviews victims a second time. Talking about how Minnesota leads the way in finding the source of serious food illnesses, Klobuchar said, “The nation should not have to wait until someone in Minnesota gets sick or dies before there is an effective national response to a large-scale outbreak of food-borne illness.”
Watch a video on Team D at www.sph.umn.edu/teamd.
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SCHOOL NEWS Awards and Appointments Nicole Larson has received the University of Minnesota Outstanding Postdoctoral Scholar Award. Larson is a research associate for Project EAT: Eating Among Teens. She received an M.P.H. and Ph.D. from the University of Minnesota. Her expertise is in studying factors that help adolescents and young adults build healthy eating patterns. Patricia McGovern has been accepted into the Academic Leadership Program offered by the Committee on Institutional Cooperation for all Big Ten Universities. Four to five fellows from the University of Minnesota are selected each year for the program, which develops the leadership skills of faculty who have demonstrated exceptional ability and academic promise from nominations submitted by deans and chancellors. James Neaton has received the Academy for Excellence in Health Research Award from the University of Minnesota’s Academic Health Center (AHC). The award is intended as the highest recognition of research among AHC faculty. Neaton was recognized for his outstanding contributions to HIV research and clinical trials.
University of Minnesota School of Public Health
Debra Olson has received the Academy for Excellence in the Scholarship of Teaching and Learning Award from the University of Minnesota’s Academic Health Center (AHC). The award serves as the highest recognition of excellence in the AHC educational mission. Olson, who is the SPH’s associate dean for education, is an expert on distance learning and using technology to enhance curriculum. Michael Osterholm has been elected to membership of the Council on Foreign Relations. Founded in 1921, the council is an independent, nonpartisan think tank that serves as a resource to government officials and others. The council publishes Foreign Affairs, the preeminent journal on international affairs and U.S. Foreign Policy. Council membership is divided almost evenly among New York, Washington, and other locales around the world. Osterholm also has been appointed chair of the Network Executive Committee for the Centers of Excellence for Influenza Research and Surveillance (CEIRS). The committee is responsible for defining collaboration among the nation’s five CEIRS and for advising on how the CEIRS can be used as a resource in the event of public health emergencies related to pandemics. The CEIRS were established under the National Institutes of Health. Osterholm heads the CEIRS located at the University of Minnesota.
Mary Story has received the Medallion Award from the American Dietetic Association (ADA) in recognition of her outstanding service and leadership to the ADA and the dietetics profession. Story is an internationally renowned expert in child and adolescent obesity prevention. The Medallion Awards, given each year since 1976, honor individuals who have shown dedication to the high standards of the dietetics profession. Deborah Swackhamer has been named president-elect of the National Institutes of Water Resources, based in Washington, D.C. Swackhamer will oversee a network of 54 water resources centers located in land grant institutions across the country, as well as the agency’s efforts to coordinate and promote the training and research activities of water quality professionals and researchers in the United States and around the world.
2 Scenes from the 2009 Public Health Institute Now in it’s eighth year, the University of Minnesota Public Health Institute continues to draw participants from throughout the world. The three-week offering of classes, lectures, and field trips allows professionals to design their own course of study.
1 Students from 10 countries participated in the Global Food Safety Systems Leadership course. Among the course’s 19 students, there were representatives from two intergovernmental agencies: the United Nations Food and Agriculture Organization and the InterAmerican Institute for Cooperation on Agriculture.
2 The Green Institute in Minneapolis, pictured here, is one of the
locations students visited during a “toxic tour” of the Twin Cities. The tour provided an overview of areas where environmental justice issues have been identified and addressed. Other stops included a power plant, park, and mass burn incinerator.
3 Students in the course Vector Field Ecology examine mosquitoes under microscopes at the St. Paul, Minn.-based Metropolitan Mosquito Control District.
4 SPH professor William Toscano talks with Preeti Wasnik, one of
a handful of students who traveled internationally to attend the institute. Wasnik is a medical student at the Tata Institute of Social Sciences in Mumbai, India.
5 Students observe the production floor of Lorenz Meats in Cannon
Falls, Minn., and learn about the importance of protecting the food supply from zoonotic diseases.
5 2009 Institute at a Glance 40 Courses Held 24 States represented by students and faculty 16 Countries represented by students, faculty, and guests: Barbados, Canada, Columbia, Costa Rica, Iceland, India, Italy, the Netherlands, New Zealand, Nigeria, St. Lucia, Somalia, Thailand, the United Kingdom, the United States, Zimbabwe
Faculty and guest speakers represented: 8 University of Minnesota academic units 6 Other universities 19 Community, government, and private sector organizations
Focus Areas Applied Biostatistics and Research Methods Culturally Responsive Public Health Practice Environmental Health Sciences and Global Health Food Protection Infectious Disease Epidemiology Public Health Leadership and Management Public Health Preparedness, Response, and Recovery Woman and Child Health and Nutrition 15
ALUMNI NEWS International Education as a Way to Change the World John Opuda-Asibo grew up in a typical Ugandan rural family in the 1950s, “herding lots of cattle, goats, and sheep and farming cotton, millet, peas, sweet potatoes, and many other crops,” he says. When he went to John Opuda-Asibo school, an interest emerged early: “Naturally, I was a cattle-herding village boy who wanted to study nothing but veterinary medicine.” He stuck to his wishes and earned an undergraduate degree from Uganda’s Makerere University, and then came to Minnesota to earn an M.P.H. (Veterinary Public Health and Epidemiology) and Ph.D. (Microbiology and Public Health) from the SPH. How he got to Minnesota is a story common to many overseas alumni—he had a professor who studied at the U of M. For Opuda-Asibo, that professor was Ibrahim Abdel Aziz. “He introduced me to the U of M which then had the best veterinary public health program in the world,” he says. Opuda-Asibo returned to Uganda and in 1985, joined the faculty at Makerere. He published scores of papers and served as a visiting professor all over the world. Today, he is the first deputy vice chancellor at Uganda’s new Kyambogo University in Kampala and his dedication to public health, and his country, remains. “Uganda needs a strong knowledge base for development,” he says. “My people need better public health education and better methods of food production and preservation.” When he retires, he wants his legacy to be that of “an educator dealing with internationalization of education, linking Uganda and Africa with universities in the U.S.A. and other countries in the world,” says Opuda-Asibo. International education is one way, he believes, to give humanity hope because it brings a diverse perspective to the challenges of those in need.
University of Minnesota School of Public Health
Class Notes Lisa Abicht-Swensen (M.H.A. ’90) has become the chief operating officer of Minnesota Visiting Nurse Agency (MVNA), a nonprofit home nursing and public health care provider. Abicht-Swensen is the founder and former chief executive officer of Hospice of the Twin Cities (HOTC), a subsidiary of MVNA. In her new role, she will continue to oversee HOTC in addition to MVNA’s maternal child health, home care, corporate health, and personal care assistant divisions. Debra Thingstad Boe (M.P.H. ’06) was one of the Dakota County Public Health Department staffers honored with a Local Government Innovation Award from the Hubert H. Humphrey Institute of Public Affairs. The department was recognized for innovations to the Women, Infants, and Children (WIC) program, which Boe supervises. Heather Case (M.P.H. ’06) has been credentialed as a diplomate of the American College of Veterinary Preventive Medicine (ACVPM). Case is assistant director of the Scientific Activities Division at the American Veterinary Medical Association (AVMA), where she coordinates response efforts for emergencies. She recently created a disaster preparedness video to help individuals protect their pets in a disaster. Imee Cambronero (M.P.H. ’09) has begun a one-year fellowship at the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga. In the fall, she will relocate to Tanzania, where she will work on surveillance of HIV/AIDS for at-risk populations. The fellowship is offered through the CDC and Association of Schools of Public Health. Alina Evans (M.P.H. ’08) has received a Fulbright student scholarship to the Norwegian School of Veterinary Science, where she will study infectious diseases in moose, reindeer, and caribou in northern Norway and Alaska. She will also work with Norway’s Hedmark University College to research anesthetic protocols for moose, bears, wolves, and roe deer. Christine Nguyen Hoang (M.P.H. ’08) has become one of the first in the country to earn the newly created certification in public health from the National Board of Public Health Examiners. The credential was introduced in 2008 to set new standards for public health practice. Hoang is the assistant director of public health, zoonoses, and food safety for the American Veterinary Medical Association. Bailus Walker (Ph.D. ’75) is one of the principal authors of the new book Science and Decisions: Advancing Risk Assessment, published by the National Academy of Sciences. Walker is a professor of environmental and occupational medicine at Howard University.
Elizabeth Valitchka volunteers at a clinic in Indonesia.
Around the World with Elizabeth Valitchka In October 2008, SPH alum Elizabeth Valitchka and her husband, family practice physician David Adams, left the United States for an around– the-world trip. When they come full circle this fall, they will have had more adventures than most people can pack into a lifetime. And, through volunteer efforts along the way, they will have Elizabeth Valitchka and David Adams, helped those in at Norway’s Geirangerfjord, about desperate need of halfway through their trip. medical care and disease prevention. Valitchka, who graduated from the Maternal and Child Health program in 2003, and Adams are chronicling their travels in a blog (elizabethanddave.blogspot.com). Their first volunteer experience was in the Indonesian town of Sukadana on the island of Borneo. There they found grueling poverty. “Most houses are small, wooden shacks without any plumbing, refrigeration, and only intermittent electricity. In many cases, houses are built over muddy streams, which serve multiple purposes for the inhabitants: toilet, bath, and drinking water source,” writes Valitchka. The couple worked with Health in Harmony, a foundation that integrates medical care with efforts to save the nearby rainforest preserve, Gunung Palung National Park.
Valitchka’s public health project tackled parasitic worm infections. The clinic had received a large donation of Mebendazole, a de-worming medication. With input from the staff, she created a program called Obat Cacing (“worm medicine” in Indonesian) to distribute the medicine, teach proper hand washing, and raise awareness about the clinic. Because of the low literacy rates in the community, Obat Cacing used storytelling, demonstrations, and teach-back techniques to communicate information. During the first two weeks of the program, 1,200 people in five different villages around Sukadana were de-wormed. By early August 2009, the couple was in Cuzco, Peru, volunteering with Hands Across the Americas. Valitchka worked as a medical Spanish interpreter for two U.S. pediatricians and saw a variety of patients, like a 12-year-old anorexic girl, people infected with parasitic worms, and a 29-year-old mother of two who had been sexually assaulted. Valitchka and Adams are traveling and living modestly, visiting major cities, small villages, and remote areas, and this style has brought them close to the hardships that financial and cultural inequality can bring. “I have felt saddened by the disparity that exists between those who have and those who have not, simply based on where they were born,” writes Valitchka. “So many people don’t have a voice when it comes to the kind of care they need and deserve, especially women and children.” Despite these difficult realities, Valitchka and Adams have encountered authentic open-heartedness everywhere they’ve landed. “I have been inspired by the generosity of people around the world who have so little,” says Valitchka. “We’ve been the recipients of their warmth and hospitality time and time again this past year.”
Join the UMAA Become a member of the University of Minnesota Alumni Association and a portion of your membership dues will go directly toward the SPH alumni society. Membership brings discounts on a variety of goods and services. Join now at www.alumni.umn.edu/society-sph.html.
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Health Care Reform Following Minnesota’s Lead