Advances – Spring 2014

Advances

SPRING 2014

FROM THE UNIVERSITY OF MINNESOTA SCHOOL OF PUBLIC HEALTH

Sharing a Common Vision Public health and primary care tackle chronic disease in a new way

Military readiness and thoughts on obesity Transforming a ruin into a food oasis Partnering with the Somali community Layers of harassment compound harm

School of Public Health Leadership

Beth Virnig Senior Associate Dean for Academic Affairs & Research Kristin Anderson Associate Dean for Learning Systems & Student Affairs Debra Olson Associate Dean for Global Health Mary Ellen Nerney Assistant Dean for Education Operations Bruce Alexander Interim Head, Division of Environmental Health Sciences

Bradley Carlin Head, Division of Biostatistics Bernard Harlow Head, Division of Epidemiology and Community Health

Dear Friends, Another spring is upon us, and it is most welcome this year! When the snow and ice has finally left our boulevards and the glacier in my backyard has receded, we’ll celebrate a new and wonderful bunch of SPH alumni. On May 19, those students will be the first SPH graduating class to walk across the stage of the beautifully renovated Northrop Auditorium.

Ira Moscovice Head, Division of Health Policy and Management Joe Weisenburger Chief Administrative Officer/Chief Financial Officer John Merritt Senior Director, Advancement and External Affairs

Advances Editor Martha Coventry Contributing Writers Karen Carmody-McIntosh Nicole Endres John Merritt Rick Moore Charlie Plain Art Direction Cate Hubbard Design cat7hubb@gmail.com Advances is published by the University of Minnesota School of Public Health. To submit comments, update your address, or request alternative formats email sphnews@umn.edu.

Printed on recycled and recyclable paper made in Minnesota with at least 10 percent postconsumer material.

© Regents of the University of Minnesota.

All rights reserved. The University of Minnesota is an equal opportunity educator and employer.

FROM THE DEAN Those newly minted alumni will find a welcoming community waiting for them, one that will link them to the broader public health community and work to support and enhance their careers. Tara Anderson, our alumni relations director, has worked hard over the past year to formalize the life-long connection to SPH that students inherit when they come to our school. You can read more about that connection on page 15.

Our cover depicts the intersecting vision of public health and primary care, a vitally needed viewpoint to tackle the rise of chronic disease. No longer can we stay in our own silos and believe we can make enough of a difference to turn the advancing tide of diabetes, obesity, heart disease, and cancer. If you don’t think the situation is dire, take a look at the statistics in the cover story.

A sidebar to that story introduces some of you to what will be a new concept: Health in All Policies, a principle that keeps health impacts front and center when making decisions from local library boards to city hall to the Senate.

In our Findings section on pages 10–11, you’ll discover some of the SPH research that leads to changes in policy and treatments. We’ve found that we need to look at the damage from strokes in a new way; that the birth process can be made so much better; that postpartum depression can be ameliorated with more maternal leave; and that there is a way to help nursing home residents be happier.

SPH continues to rank among the top 10 schools of public health in the nation and scattered throughout the magazine are examples of where we shine and where we’ve made history. We have an enduring legacy and a solid foundation for the future.

Yours in health,

John R. Finnegan, Jr., PhD Assistant Vice President for Public Health Dean and Professor

PHOTO BY RICHARD ANDERSON

John Finnegan Dean

Contents

SPRING 2014

Features FEATURES 2 Have we come a long way, baby?

Since SPH faculty member Len Schuman helped craft the milestone 1964 Surgeon General’s report, smoking has gone down for some sections of the population. But teens still increasingly smoke, and now we have e-cigarettes.

4 Embracing a wider view How to stem the tide of chronic disease—responsible for 7 out of 10 deaths in America—is a question of bringing public health and primary care together. A shared vision may lead to a common understanding of what makes us sick and what keeps us well.

10 Forging stronger ties, together The Confederation of Somali Community in Minnesota was the recipient of the 2013 Community Partners Agency Award. It is one of two groups partnering with Prof. Donna McAlpine on research into autism within Minnesota’s Somali, Hmong, and Latino communities.

11 Mind-changing messages Prof. Sarah Gollust found the message that weight problems among potential recruits can hurt military readiness may sway conservatives’ views of gov­ern­ment intervention in the obesity epidemic.

COVER ILLUSTRATION BY KEITH NEGLEY

12 ‘Urban Oasis’ idea wins big

Departments DEPARTMENTS 8 Findings

SPH alum Tracy Sides, MPH, PhD, had the winning answer to the Forever St. Paul Challenge: What would you do with $1 million to make St. Paul great? Her idea will create a food hub out of an abandoned, graffiti-littered building.

Decline in function may occur pre-stroke; commuter students tend toward unhealthy on-campus foods; three factors lead to a better birth experience; more hours per day with staff make nursing home residents happier; opioid risks increase with multiple prescribers; longer maternal leaves may lower postpartum depression.

13 Compounding pain According to a study by SPH researcher Michaela Bucchianeri, the odds of an adolescent suffering depressive symptoms or engaging in self-harm increase with each additional type of harassment or bullying he or she experiences.

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School news How to build an “alumni-centric” culture; SPH pairs with Arizona State to offer degrees; Vernon E. Weckwerth Professorship in Healthcare Administration Leadership funded; in memoriam.

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WITH E-CIGARETTES, BELIEFS SHAPE BEHAVIOR E-cigarettes are all the rage, with sales revenue of $1.5 billion in 2013.

RECENT GRANT: MAKING THE WORKPLACE SAFER

Hierarchical Statistical Modeling and Bayesian Melding for Occupational Exposure Assessment National Institute of Occupational Safety and Hygiene (NIOSH) 9/1/13—8/31/16 $1,015,771 Faculty in the divisions of Biostatistics and Environmental Health Sciences (EnHS) are collaborating in this NIOSH-funded study to find the optimal way to calculate worker safety and risk in the face of hazardous elements.

Assessing worker exposure levels is a major challenge because it’s cost prohibitive to get sufficiently large numbers of actual measurements.

However, mathematical models created to predict exposures can be important tools for occupational hygienists, but they need to be empirically validated.

In this study, Biostatistics principal investigator Professor Sudipto Banerjee and PhD student Xiayoue Zhao are developing deterministic mathematical models. EnHS coinvestigator Professor Gurumurthy Ramachandran and PhD student Susan Arnold are testing them in an experimental chamber as well as in real occupational settings.

Banerjee and Zhao will use the large database resulting from the EnHS work to corroborate their models, which may then be used to help reduce occupational risks.

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Although we don’t yet know what these electronic devices do to our health when they deliver a dose of nicotine-infused vapor, suspicion of harm runs high enough that businesses and schools, including the University of Minnesota, have included them in smoking and tobacco-use bans.

Among many young people, however, there is a pervasive belief that they’re harmless, and, what’s more, can help people stop smoking tobacco. Do those positive beliefs have an impact on e-cigarette use? Jean Forster from the Division of Epidemiology and Community Health and Kelvin Choi, now an investigator with the National Institute on Minority Health and Health Disparities, wanted to explore the question.

Forster and Choi looked at 1,379 young adults with the mean age of 24.1 years.

At the beginning of the research, none had used e-cigarettes. At a one-year follow-up, this is what they found: Participants who agreed e-cigarettes can help people quit smoking and those who agreed that e-cigarettes are less harmful than cigarettes were more likely than those who did not agree to subsequently report experimenting with e-cigarettes.

With tobacco use prevalent among adolescents and young adults, the fear is that e-cigarette use may lead to more experimentation with tobacco.

Read the study in the American Journal of Preventative Medicine at z.umn.edu/ecigarettes.

UNDENIABLE DANGER Liquid nicotine in e-cigarette refill fluids poses serious risks In stores selling e-cigarettes, little bottles of flavored liquid are lined up on the shelves. There’s grape flavor, mint, bubble gum, and fruit punch, among a host of others. The bottles contain liquid nicotine, the essential component of e-cigarettes. And a known neurotoxin.

“This easy and widespread access to e-cigarette fluids creates opportunities for unintentional exposures to toxic doses of nicotine and is truly frustrating” says SPH assistant professor Irina Stepanov, an expert in the chemistry of tobacco products. “Nicotine is a toxic chemical, a powerful poison, and when people buy it, they don’t think about the fact that they’re bringing poison into their homes.”

A heat source in the e-cigarette turns the liquid nicotine into inhalable vapor.

The liquid is held in a cartridge that users need to refill several times a day, depending on use.

One of the small bottles of liquid used to refill the cartridges can contain up to 18 mg/ml nicotine or more. 1mg per kilogram of body weight can be a lethal pediatric dose, says Stepanov. Liquid nicotine can be ingested or absorbed through the skin, and the kind used to refill e-cigarettes, with its candy-flavored smell, may be especially attractive to children.

A recent New York Times article, “Selling a Poison by the Barrel,” reports that “accidental poisonings, notably among children, are soaring…of the 74 e-cigarette and nicotine poisoning cases called into Minnesota poison control in 2013, 29 involved children age 2 and under.”

Stepanov believes government oversight of e-cigarette products is critical.

“E-cigarette design should be restricted to versions that use manufactured replacement cartridges that cannot be opened and refilled,” she says. “In addition, education of retailers and consumers about the toxicity of e-cigarette liquids is necessary.”

Cancer Sticks: The SPH connection to the 1964 Surgeon General’s report

Every road-weary traveler yearns for the comfortable routines of home. Returning from Washington, D.C., on an evening flight in January 1964, Len Schuman was no doubt looking forward to smoking a few of the cigarettes that he kept in the breezeway between his garage and house.

But when he got home, they weren’t there. He went into the house and called to his wife, “Marie, what happened to my cigarettes?”

“I heard what they said on the radio,” she replied. “You’re going to quit.”

‘What they said on the radio’ was part of the landmark 1964 report, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service, that outlined a clear connection between smoking and disease.

In the first half of the twentieth century, a growing body of research documented the relationship between smoking and a wide range of health issues, including a strong suspicion that it was the chief culprit in lung cancer.

The impetus for an official report on

smoking and health came when a number of health organizations wrote to President John F. Kennedy in June 1961 and called for a national commission on smoking.

Schuman, a physician by training and longtime director of SPH’s division of epidemiology, played a key role in drafting the report. “It hit the country like a bombshell,” Surgeon General Luther Terry later recalled. “It was frontpage news and a lead story on every radio and television station in the United States, and many abroad.”

As a longtime smoker, Schuman recalled that part of the reason he agreed to serve on the committee was that he didn’t want to believe there was a relationship between smoking and disease. But scientific method prevailed, and Schuman reportedly wrote a large portion of the final report.

You can watch clips of the 1964 “CBS Reports” on the Surgeon General’s report at z.umn.edu/smoking. More about Prof.

Shuman and his enduring legacy can be found at z.umn.edu/shuman.

Above: 1964 press conference to release the Surgeon General’s report on smoking and health

50 YEARS OF PROGRESS

1964

First Surgeon General’s Report on Smoking and Health.

1973

Arizona is the first state to restrict smoking in some public spaces.

1988

2009

Surgeon General’s Report concludes nicotine is addictive.

Congress authorizes the biggest federal tobacco excise tax in U.S. history.

1990

Congress makes domestic airline flights smokefree.

JOINING THE GOOD FIGHT The University recently passed its latest effort to decrease tobacco use. Building on increasingly restrictive policies issued since 1993, the U’s Smoke and Tobacco Free Campus: Crookston, Duluth, Rochester, and Twin Cities policy goes into effect July 1, 2014 —50 years after the Surgeon General’s report.

The four campuses named in the policy will join more than 800 campuses, universities, and colleges across the country that are smoke-free and tobacco-free.

The latest policy includes electronic cigarettes and prohibits their use, along with any tobacco product, in all facilities and on all University property.

Exceptions are in the following areas and use in the first three must be approved in advance by the Director of Environmental Health and Safety: 1) Peer-reviewed, scientific studies.

2) Traditional Native American spiritual or cultural ceremonies.

3) Theatrical productions.

4) Enclosed, privately owned vehicles, while driving on campus or parked in surface parking lots as defined by Parking and Transportation Services, provided users make a reasonable effort to contain smoke and tobacco materials inside the vehicle.

According to the ASPPH (Association of Schools & Programs of Public Health) and its Tobacco-Free College Campus Initiative, 99 percent of smokers start before age 26. What’s equally disturbing is the ASPPH’s statistic that “Based on current rates, it is predicted that more than 1 million current college students will die prematurely from tobacco use.”

You can learn more about the University’s new tobacco-free policy at z.umn.edu/tobacco. You can read about the ASPPH initiative at z.umn.edu/ initiative.

2014

50 years after the first Surgeon General’s Report on smoking, 18% of American adults smoke, compared to 42% in 1964.

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Sharing a common vision

Public health and primary care tackle chronic disease in a new way

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ILLUSTRATION BY KEITH NEGLEY

n the 1940s, South African physicians Sidney and Emily Kark worked together in a Zulu tribal reserve.

They had to do everything, from stitching up wounds to investigating disease outbreaks. They were responsible for the health—in the broadest sense—of the people they served. It was the convergence of primary care and public health on the ground and in practice.

Later in the decade, they trained people from around the globe in what they called community-oriented primary care (COPC), a view of care that considered all contributions to individual and community health.

The United States never fully embraced COPC, or social medicine as it is sometimes called, though there were pockets of successful efforts around the country. Clinical-oriented, individual-focused care became and remains the standard.

But today, America—out of dire necessity and great concern—is embracing a wider view of what influences health and how to care for people and populations. That view necessitates a new alliance between public health and primary care.

understanding that health care alone cannot solve America’s woes is bringing public health fully into the picture.

“We’re looking at epidemics of obesity, diabetes, hypertension…and in primary care, we realize that there’s more that needs to be done for people than just giving them medicine,” says Paul Erickson, a family medicine physician and Medical Director of NorthPoint Health and Wellness Center in Minneapolis. “Public health is being recognized as having some of the solutions to these problems and the field is coming into its own as we face up to America’s health burden.”

In tandem with a Fellowship in Adolescent Medicine, Erickson got an MPH at the School of Public Health.

Today, he hears other family medicine physicians question their ability to make significant inroads into people’s health without considering the social and environmental determinants.

SPH Dean John Finnegan also hears this need for larger systems thinking from physicians who come to the school for an MPH. “Some of what these physicians say drove them to seek an MPH was seeing their 1,000th case of type 2 diabetes, and wondering if they’re condemned

MEETING THE CHALLENGE Our country devotes 20 percent of its GDP to health care, about $9,000 per person—more than any other country except Switzerland—yet we rank 17th in life expectancy among high-income nations.

Chronic diseases, exacerbated by obesity, grind away at our entire population and are responsible for 7 out of 10 deaths. These diseases show no sign of a significant turnaround, and, in a striking example, current estimates are that 1 out of 3 babies born today will develop diabetes in their lifetime. According to the Centers for Disease Control and Prevention, more than three-fourths of U.S. medical costs are attributed to illnesses that are for the most part preventable.

No matter how much money the United States spends on health care, research shows it will not make much of a difference. As it stands now, health care is only a 10 percent determinant when it comes to influencing the health of U.S. citizens. Genetics, environment, and behavior are responsible for the rest. The growing

to treat the next person to keep his or her disease from getting worse, or if they can look upstream and prevent it altogether,” says Finnegan.

FINDING NEW MODELS Bringing public health and primary care closer together has been explored

‘‘

Some of what these physicians say drove them to seek an MPH was seeing their 1,000th case of type 2 diabetes, and wondering if they’re condemned to treat the next person to keep his or her disease from getting worse, or if they can look upstream and prevent it altogether.

’’

in an exceptional number of papers, special issues, and reports in the past five years, like Primary Care and Public Health: Exploring Integration to Improve Population Health from the Institute of Medicine (IOM). Public health and its relation to primary care received long-awaited federal attention in the Affordable Care Act and vitally needed monetary support from the ACA’s Prevention and Public Health Fund.

Just how these two fields can work more closely together is evolving and communities are already designing new and varying relationships. The IOM report cited a community-based approach, with public health and primary care working hand in hand, in Durham, N.C., to tackle high rates of asthma and emergency room visits.

Public health had the tools to assess the environment for irritants, find pockets of concern, reach out to the neighborhoods, and create community education programs. It brought together primary care physicians and asthma experts to help devise one protocol, instead of the previous 50, for treating patients in Durham County.

In Minnesota, the county initiative Hennepin Health, of which Erickson’s clinic is a part, has brought medical sph.umn.edu 5

care, behavioral and environmental care, and social services into a coordinated system of care, resulting in a 20 percent drop in emergency room visits among its patients.

COMBINING STRENGTHS “For a variety of political, cultural, and historical reasons in the United States, we’ve developed these two silos—public health and primary care—when it comes to tending to the health of the nation,” says Finnegan.

What Finnegan envisions for a new working relationship is the two silos sharing a common foundation, while each maintains its particular talents and skills. Public health, he believes, can contribute three central areas of expertise to that shared foundation: analyzing big data, building relationships, and planning ahead.

As more health-related data comes pouring in with the increase in electronic medical records, Finnegan believes that public health and primary care will have an unprecedented opportunity to discern patterns of chronic disease almost in real time and work together to create better health outcomes.

Building capacity, relationships, and collaboration among stakeholders to better the health of the community has never been a specific goal of primary care, but it has always been one of public health’s principal functions and strengths.

“SPH has a long history of building relationships and the question is how can we bring this ‘technology’ to this new collaboration between primary care and public health,” says Finnegan.

“We need to explore how we can help

primary care and health care delivery organizations build the partnerships they’re going to need to maximize their effectiveness.”

When it comes to planning ahead, Finnegan believes that only in the last generation have people begun to realize that this is what public health does so very well. In fact, he says, public health has done it so well that it has gone unrecognized in the past.

“A major part of what we do in public health is look ahead and put steps in place to reduce the impact of disease outbreaks or the blowback of environmental hazards before they occur,” he says.

“By lending public health’s strength to planning for future health issues,

Keeping people in the picture Health in All Policies widens the decision-making lens We have been considering the impact of social systems on human health “from Aristotle on down,” according to SPH associate professor Michael Oakes. When we plan a sewer system, we think about how to protect people from harmful bacteria. If we want to build more ships and planes, we debate how that money might be better spent on health care. Historically, political economists have framed the issue as a tradeoff between ‘guns and butter.’

But until about 10 years ago, this consideration of human health outside of simple health policies had not been formalized or given a name. Now we have Health in All Policies, a principle to apply to decision making that, as Oakes says, “is intended to extend the reach of thinking about health.”

From local library boards to city hall to the Senate, people can choose to adopt this principle to guide their deliberations and enrich their views on issues seemingly unrelated to health. Oakes offers student loan legislation as an example of where health could be left out of the picture and the topic seen as strictly about economics and education. “As students take on more loans, their debt rises and that slows their individual economic development, and we know that economic disadvantages impact health,” says Oakes.

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For health practitioners, educators, researchers, and policymakers—and certainly for people in public health— considering the health impact of all policies can only be a good thing. But Oakes, who will address the Minnesota Public Health Association annual conference in June on this topic, says we shouldn’t be naïve about what Health in All Policies can accomplish given our political culture, if not human nature.

Research shows that minorities who live in areas segregated by race tend to have worse health outcomes, so bringing health into decisions on affordable housing makes perfect sense.

“Integrating first- and second-ring suburbs is a win for minority health, but people on the ground still fight back,” says Oakes. “The fear is that residential integration will lower housing prices and school ratings. As we apply this principle, we will be faced forever with the tension of individual freedom vs. the good of the group.”

But Health in All Policies is worth the effort as we struggle as a country to put people’s health and well-being on a par with the things we think are more important.

By lending public health’s strength to planning for future health issues, perhaps we can get one step ahead of them so they don’t create such a burden for the primary care system.

’’

perhaps we can get one step ahead of them so they don’t create such a burden for the primary care system.”

STARTING AT THE BEGINNING For Barbara Brandt, a University of Minnesota College of Pharmacy professor and associate vice president of education for the Academic Health Center, bringing primary care and public health closer together is one step toward realizing the “triple aim” of health care reform—improve population health, improve the patient experience of care, and reduce per capita cost—as laid out in the now classic 2008 Health Affairs paper by Donald Berwick, Tom Nolan, and John Whittington.

For Brandt, realizing that aim must start with education and with encouraging an early spirit of collaboration among budding health professionals. As director of the first National Coordinating Center for Interprofessional Education and Collaborative Practice, a publicprivate partnership, she’s putting the concept into practice. The center recently received grants totaling $12 million over the next five years and is exploring how to use interprofessional education to transform health care in America.

Through interprofessional education at the University, students in

medicine, nursing, pharmacy, public health, dentistry, veterinary medicine, and allied health are coming together to concentrate on three core competency domains: professionalism and ethics, communication, and teamwork.

Solving a real-world problem together and following a common curriculum will help them develop a shared approach to health care and understanding of all the factors at work.

These students know they will be entering a new landscape where traditional care methods must be paired with a larger view of the surrounding forces that influence individual and community health.

Medical students at the University and across the country, for example, are becoming more of a force in curriculum change than ever before.

Knowing the challenges of chronic disease, they want to learn more about epidemiology and biostatistics, community health promotion and nutrition.

“We are at an historic intersection of public health and primary care, and there is no question that public health skills are needed by the clinical professions,” says Brandt.

STANDING TOGETHER Due to insurance plans available through state exchanges and the expansion of Medicaid, some reports estimate that up to 35 million more people will seek medical care in 2014.

A great proportion of them will have chronic diseases and further stress an overextended medical system.

The happiness of people in our country depends in large part on a thriving “ecology of health,” the myriad critical factors that influence our individual and community well being. To tackle the health future we face, it’s essential that public health and primary care come together to recognize, tend to, and maintain positive and sustainable health ecosystems.

Public health and primary care are less firmly rooted upstream and downstream when it comes to tackling disease: the entire watershed is quickly becoming their collective concern.

By holding a common and broader understanding of what makes us sick and what keeps us well, they can work together, integrating their own expertise, to help forge a healthier America.

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FINDINGS

Losing ground pre-stroke

What makes a good birth?

Strokes can occur at any age and having one carries with it the fear of losing independence. Stroke severity is partially measured by the extent of loss in physical functioning and in the ability to complete daily tasks. However, those losses may not be entirely new, according to research by SPH assistant professor Ben Capistrant.

In a new long-term study, he uncovered an unexpected fact: “People who had strokes were declining in function before the stroke,” says Capistrant.

Capistrant’s study also found a trend showing blacks who would eventually have a stroke scored 10 percentage points lower in their ability to complete daily living activities than whites who would suffer strokes. What’s more, the difference persisted in the years after the stroke.

More on the study can be found online in The Journals of Gerontology, Series A: Medical Sciences.

SPH doctoral student Laura Attanasio is the lead author of a recent study in the journal Maternal Child Health that examined how to create a more positive birth experience.

Overall, Attanasio found the strongest predictor of being confident during birth was feeling comfortable with labor before it begins.

The study also revealed three more key factors that led women to consider birth a positive experience: • Being included in decisions about medical care • Benefiting from strong partner support • Having communication with care providers that is open and respectful “Feeling like the nursing staff was attentive and really cared about them and treated them like a whole person rather than just another woman in labor was something that came up quite a lot,” explains Attanasio.

Overall, she found that 42 percent of first-time and experienced mothers reported feeling confident while giving birth.

And within that statistic was a demographic surprise.

“Among first-time mothers, black and Hispanic women were more likely to report feeling confident while giving birth than white women, and that was something we didn’t previously see in the literature,” says Attanasio.

Among first time mothers, black and Hispanic women were more likely to report feeling confident while giving birth than white women, and that was something we didn’t previously see in the literature.”

Connecting to happiness When it comes to learning what makes nursing home residents happy, SPH assistant professor Tetyana Shippee really likes to hear it from the source.

Using self-reported data from nursing home residents, she explored elements that had an impact on their quality of life. Her study appeared in The Gerontologist.

The results showed residents who are in worse functional health generally tend to report lower quality of life.

“That’s to be expected in many ways,” says Shippee. However, when it comes to boosting quality of life, the most important factor was socializing with staff.

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According to Shippee, previous research showed staffing levels are important for residents‘ quality of life. But this study revealed for the first time that it’s actually the number of hours per day that activity and social work staff spend with residents that most dramatically raises their happiness quotient across multiple domains like social engagement and mood.

Now that she has found the link between time spent with activity and social work staff and a sense of well-being, Shippee says her ultimate goal is to design an intervention to build on that crucial connection.

And, as always, she’ll want to hear how it’s working by letting residents tell her about it.

Multiple prescribers add danger to opioid use From 1991 to 2009, the NIH reported an almost threefold increase in the United States for prescriptions for opioid analgesics—also called narcotic painkillers—and physicians have argued that obtaining prescriptions from more than one provider can increase the risks associated with these medications.

SPH assistant professor Pinar Karaca-Mandic, Harvard’s Anupam Jena, and USC’s Dana Goldman, with the assistance of SPH graduate student Lesley Weaver, explored the issue in the first comprehensive study of the multiple-provider danger. The results were recently published in BMJ. The researchers looked at 1.8 million Medicare beneficiaries who had filled at least one opioid prescription in 2010.

This is what they found: • 30 percent had received opioid prescriptions from more than one doctor.

• Nearly 25 percent with more than 1 opioid prescription received prescriptions from 3 or more providers.

• Among these 25 percent, nearly 64 percent received concurrent opioid prescriptions from different providers.

• Patients who received their prescriptions from more than one doctor were at a significantly greater risk of hospitalization from complications of narcotic use than patients with a single provider and risk went up with the number of prescribers.

• Patients with four or more prescribers were twice as likely to be hospitalized for narcotics-related complications than patients receiving the same number of prescriptions from a single caregiver.

Commuter students eat like fast food diners Plenty of recent attention has been paid to making dormitory dining hall food healthier, but according to a new SPH study by PhD student Jennifer Pelletier, schools should consider what’s available to commuter students as well.

Pelletier wanted to know more about the eating habits of commuter students because nearly half of U.S. high school graduates younger than 25 are enrolled in a post-secondary school and living off-campus.

“The transition from adolescence to young adulthood is a time of increasing autonomy and responsibility, and establishing healthy eating habits during this period can set the stage for healthier behaviors later in life,” says Pelletier.

In her study, published in the American Journal of Health Promotion, Pelletier found that approximately 45 percent of students purchased food and beverages from at least one campus-area venue three or more times per week. Such students typically skipped breakfast more often and overall had higher fat and added sugar intake, similar to frequent fast food diners.

By comparison, students who brought food from home fared much better nutritionally. This group displayed lower fat and added sugar intake, skipped meals less often, and ate more fruits, vegetables, fiber, dairy, and calcium.

Decreasing the risk for postpartum depression A study of Minnesota women showed that taking less than six months of leave (about 26 weeks) after birth may increase the risk of postpartum depression for some women.

Taking time off work after childbirth is an important strategy for all new mothers, but for women with risk factors for post­ partum depression, longer leaves up to six months may be an important protective factor for their health and the well-being of their families.

Approximately 13 percent of new mothers will experience postpartum depression and there is mounting evidence that maternal depression has adverse outcomes on women and their children, affecting child development, maternal-child attachment, and cognitive performance.

Yet, the federal FMLA only provides 12 weeks of unpaid leave for eligible women at covered employers, raising questions about the adequacy of leave for women at risk for depression during pregnancy or the postpartum period.

The study by Rada Dagher, SPH alum and assistant professor at the University of Maryland, and SPH professors Pat McGovern and Bryan Dowd appeared in the Journal of Health Politics, Policy and Law.

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Forging stronger ties together SPH Community Partners Celebration

Left to right: Donna McAlpine, Farhiya Farah, Mohamud Noor, Mariam Egal, Kathleen Call

L

ast year marked the 10th anniversary of the School of Public Health Community Partners Celebration. The event honors the school’s local and global collaborators and recognizes that, by working together, they can forge stronger ties between them while advancing their own missions.

Partnership for mutual benefit is evident in the school’s ongoing connection with the Confeder­ation of Somali Community in Minnesota, recipient of the 2013 Commu­n­ity Partners Agency Award.

The confederation connects individuals in the Somali community to resources they need, including health services, and it was chosen this year for its exemplary commitment in working with SPH to improve community health.

The confederation is one of

two groups partnering with associate professor Donna McAlpine on research into autism within Minnesota’s Somali, Hmong, and Latino communities. The other is the Somali, Latino and Hmong Partnership for Health and Wellness (SoLaHmo).

Mohamud Noor, confederation executive director, points out key advantages that his agency brings to a University project, including a shared cultural and linguistic background with research participants. “Being a trusted source for the Somali community gives us access to that community,” he says. “We can do the focus groups and the interviews and be a good source of information, unlike someone who [study participants] cannot relate to.”

McAlpine emphasizes shared decision-making with

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her community partners at all stages of the project, from methodology to plans for dissemination of findings, and the benefits that relationship brings. “I couldn’t by myself understand what autism means for the Somali community,” she says. “Groups most affected by disparities or barriers to care need to be involved in setting the research agenda to address those disparities.”

At the same time, Noor’s organization gains from the resources and the research capacity that the University brings to the table. Guided by reports from McAlpine’s partnership studies, the

Groups most affected by disparities or barriers to care need to be involved in setting the research agenda to address those disparities.

confed­­eration has become better able to advocate at the Capitol around issues important to the Somali community and to bridge the gap between the need for culturally appropriate health services and their availability in Minnesota.

According to McAlpine, the benefits of working with community partners gives SPH students a major leg up when it comes to research “[Community partners] allow us to do research that would be impossible otherwise,” she says. “From a teaching point of view, there’s only so much we can do in the classroom. Our students need to get in the field. Without community partners they wouldn’t get the experience of applying their skills in real world settings.

They critically need that opportunity to be well trained as public health professionals.”

The University sits right next door to the largest East African community in Minnesota. Noor points out that beyond the mutual benefits derived from McAlpine’s research, the experience has given the University and its neighbors the opportunity to become better acquainted.

Each year at the Community Partners Celebration the school honors that spirit of local and global neighborliness, of working together in partnership to build a stronger, healthier society.

Mind-changing messages If obesity is shown to threaten troop readiness, will conservatives support government intervention policies?

The surprising shift came when conservatives, who the study revealed normally believe obesity is the responsibility of children and their families, encountered the following message: Young people are increasingly rejected from the military for being obese, threatening the military’s ability to protect the nation. Research indicates that 12 percent of men and 35 percent of women of military age are ineligible for duty because of weight problems.

The military message boosted conservatives’ views that obesity could be more of a responsibility of the government.

“If the goal is to actually move people’s opinions, a military readiness message sparks a new connection between a public health topic and an issue you wouldn’t normally think of as being a public health topic,” says Gollust.

But a warning emerged from the study’s data.

The researchers found that certain persuasive messages led some participants to feel even more that children are responsible for their obesity, further stigmatizing them.

“There’s a lot of evidence that says the stigma of obesity has huge health consequences,” says Gollust. “[With persuasive messaging] you not only have to worry about whether you’re actually achieving what you’re trying to achieve, which, in this case, is increased awareness of obesity or increased support for policies, but also about any unintended outcomes.”

Taking such warnings into account, the results of the study give policymakers a new angle to pursue in persuading a key sector of society to support more government involvement in obesity prevention.

PRIZING POTENTIAL SPH faculty members receive McKnight Land-Grant Professorships

PHOTO BY JOSEPH FINNEGAN

M

ilitary readiness could be an important factor in rallying governmental support in the fight against childhood obesity, says a study by the School of Public Health.

Lead author SPH assistant professor Sarah Gollust (see sidebar) and her colleagues wanted to examine how the public understands the various social, economic, and health-related consequences of obesity. Their goal was to uncover opportunities that might help foster broader public support for obesity prevention policy.

The first phase of the study gave participants different messages about obesity’s consequences to discern which ones people believe are most credible.

Participants taking the survey were also asked about their political ideologies to determine if their responses fell along political lines.

“It’s well known that there are political divisions among the public over what type of role the government should have in obesity prevention,” says Gollust.

The study found that 60 percent of people in the sample believed that linking childhood obesity to health consequences is a strong reason for the government to address childhood obesity. The next top three reasons rated by political liberals, moderates, and conservatives concerned health care costs, weight-based bullying, and military readiness, respectively.

Gollust and her team then pitted messages concerning these four consequences head-to-head to see if they could actually change opinions. The testing showed that, for the most part, the messages didn’t change the minds of liberals and moderates because they already likely favor government intervention.

Two of SPH’s most promising assistant professors have received the University’s 2014–16 McKnight Land-Grant Professorships.

The recipients of the coveted award are Sarah Gollust (right in photo), an assistant professor in the Division of Health Policy and Management, and Assistant Professor Pam Lutsey from the Division of Epidemiology and Community Health.

Gollust and Lutsey were named to the McKnight Land-Grant program because they’ve been identified as exceptional junior faculty who are early in their careers and show the potential to make significant contributions to their departments and fields. During their two-year professorships, they’ll receive $25,000 each year for research and scholarly work.

Lutsey specializes in researching cardio­ vascular disease epidemiology, particularly in the areas of venous thromboembolism—the disease process producing blood clots in the veins—and the effects of low vitamin D and sleep apnea on heart health. She plans to spend her professorship identifying novel biomarkers, which predict cardiovascular disease risk— America’s biggest health threat.

Gollust devotes her research to under­ standing the consequences of the politicization of health issues, like the Affordable Care Act and soda taxes aimed at preventing obesity, in the United States. (See story this page.)

Gollust is excited to join Lutsey as a McKnight Professor. “I’m thrilled about receiving the professorship, and doubly excited to share the honor with Pam!” she says. “It’s a wonderful testament to the importance of public health in society that two public health faculty members received the award.”

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‘Urban Oasis’ idea wins big SPH alum takes her vision into action ABOVE: An architectural rendering of the Urban Oasis. INSET: St. Paul’s former Lowertown Depot building isn’t much to look at right now, but down the road it’s expected to house the food hub, a cultural center, and other tenants. It’s located in the Bruce Vento Nature Sanctuary just east of Lowertown and beneath Dayton’s Bluff. LEFT: Tracy Sides

in natural and cultural history and on land that nourished Native Americans long before Europeans arrived.

PARTNERS FROM THE U AND THE COMMUNITY As she built her plan, Sides found other people and partners who shared her vision.

There’s Jenny Breen, for example, another School of Public Health alum and a colleague who is a professional chef and works with the U’s Healthy Foods, Healthy Lives Institute.

Then there were people in the community who read about the Urban Oasis idea online and “cold called” Sides, wanting to help.

So Sides formed a council and asked all the participants what they thought they could contribute to the food hub idea. “As serendipity happens, everyone had a complementary piece to bring,” she says.

Other partners include Community Table, a farmers’ cooperative; the Association for the Advancement of Hmong Women; Twin Fin, a local aquaponics company; and the Lower Phalen Creek Project.

PICTURE THIS FROM EPIDEMIOLOGIST TO ENTREPRENEUR Sides has already had what she describes as a traditional public health career. After her time as an SPH student, she worked at the Center for Infectious Disease Research and Policy (CIDRAP) until 2012.

Then she left to become “a public health entrepreneur,” she says, and founded the social enterprise Bravely Be, which fosters healthy connections with people, the natural world, and one’s self.

There’s a magic inherent in food, she says: food can create jobs, improve our health, and build a sense of community and place.

She feels the Urban Oasis can do all those things. She’s also thrilled with the food hub’s location in the nature sanctuary, a place rich 12 University of Minnesota School of Public Health

Sides has lofty dreams for the food hub and for the four-story building, once known as the Lowertown Depot, that will house it.

She imagines people walking or biking over to it on the trail from Lowertown, stepping through the doors, and taking in the delicious smells from a cooking class in the classroom attached to a commercial kitchen. Or seeing workers processing food from local farmers that will become healthy snacks for kids in schools and fresh ingredients in restaurants and hospitals.

“I’m very interested in staying intimately involved with this project,” she says. “I very much feel like a midwife…helping to bring it into the world.”

RENDERING BY RAFFERTY RAFFERTY TOLLEFSON & LINDEKE, DEPOT PHOTO BY RICK MOORE, SIDES”S PHOTO BY GEORGE PFAFF

T

racy Sides believes in healthy connections, the power of community, and the “magic” of food. Those three things have already played a role in her career path, and now they’ve come together in a vision that has netted her a grand and … well, healthy prize.

Sides, who received an MPH and PhD from the School of Public Health, learned in early September 2013 that her idea for an “Urban Oasis” was the winner of the $1 million Forever St. Paul Challenge.

The Saint Paul Foundation had issued a community challenge: What would you do with $1 million to make St. Paul great? Sides had an idea—and a plan—for an urban food hub that would be the focal point for local produce, fish, and meat, and would combine a food processing operation with a kitchen, a classroom, a café, and an events center. What’s more, it would help transform an abandoned, graffiti-littered building in the Bruce Vento Nature Sanctuary east of the burgeoning Lowertown area.

Her idea emerged from a pool of 946 ideas to be one of three finalists, and then garnered over half of the more than 16,000 votes cast by the public to pick a winner. In February 2014, the foundation chose Twin Cities Local Initiatives Support Corporation as the nonprofit partner to lead implementation of Sides’ Urban Oasis.

Compounding pain Experiencing more than one form of bullying is associated with greater damage

I

n schools and communities across America, bullying is a problem of grave concern.

The peer-on-peer form of harass­ment contributes to substance abuse, self-destructive behavior, violence, and suicide.

The key to stopping bullying is to first characterize its nature, severity, and impact on kids.

A new SPH study has done just that and among the many details, found an even more sobering result.

“Not only are four specific types of harassment associated with a wide variety of negative behaviors and conditions, but boys and girls who experience multiple types of harassment fare even worse than those who experience a single type,” says lead author and SPH researcher Michaela Bucchianeri.

The report is a follow-up to an earlier SPH study that found harassment on the basis of race, weight, socioeconomic status, and sex was highly prevalent among a large sample of middleand high-schoolers in the Minneapolis/St. Paul metro area.

“We were concerned by the high rate of harassment and we wanted to better understand how it might be related to adolescents’ emotional and physical health,” says Bucchianeri.

To find out more, the team examined data from 2,800 local teenagers regarding teasing or harassment. The topics of teasing or harassment again involved race, weight, their family’s financial situation, and any experience of being teased or harassed in a

sexual way, such as grabbing/ pinching, sexual comments, or unwanted touching.

The results show a majority of kids have been harassed in at least one way and there is an alarmingly strong association between students who reported being harassed and suffering from poor emotional and physical health.

“We found that adolescents who reported some form of harassment—a single instance of being teased about weight, for example—had lower selfesteem, lower body satisfaction, greater symptoms of depression, and greater odds of self-harm behaviors and substance use compared to those who had not experienced any harassment,” says Bucchianeri.

SEXUAL HARASSMENT MOST PERNICIOUS Sexual harassment stood out as particularly strongly associated with all types of substance abuse and self-harm in victims. Girls who reported sexual harassment were 2.98 times more likely to use alcohol than those girls who were not sexually harassed.

Boys who were sexual harassed engaged in self-harm behavior 2.71 times more than boys who were not.

CUMULATIVE HARASSMENT

negative health and well-being variables measured.

“Every additional type of harassment was associated with even greater depressive symptoms, greater chances of self-harming, using substances, and so on,” says Bucchianeri.

“The picture is not as simple as an adolescent being harassed vs. not harassed; rather, there seems to be a cumulative effect, with each additional type of harassment further elevating his or her odds of experiencing harm.”

Bucchianeri says the multiplicative effect of harass­­ment underscores the critical need for adults to take this issue

seriously by continuing to study it and to look for everyday opportunities to intervene and prevent harm. To help, the study advises parents, pediatricians, and other providers to be on the lookout for signs of mood or behavior changes in youth, as well as for unhealthy coping mechanisms. In addition, they should be vigilant for signs of even seemingly normal teasing experiences, and take steps to provide support and additional resources as appropriate.

To learn more information about how to help prevent, identify, and respond to harassment, visit stopbullying.gov

The picture is not as simple as an adolescent being harassed vs. not harassed; rather, there seems to be a cumulative effect, with each additional type of harassment further elevating his or her odds of experiencing harm.

Even more concerning, the researchers found that one in three kids experienced multiple types of harassment, and that compounded harassment raised the risk for all of the

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Events for spring/summer 2014

MAY Weckwerth Professorship Celebration Reception honoring the establishment of the Vernon E. Weckwerth Professorship in Healthcare Administration.

Monday, May 12 | 5:30 p.m.

Northrop Memorial Auditorium sphalumni.umn.edu/weckwerth Delta Omega Pi Chapter Reception & Induction Ceremony All members of the Pi Chapter are invited to the reception and induction of the 2014 class.

Thursday, May 15 | 5:30 p.m.

Reception; 6 p.m. Program Coffman Memorial Union, Mississippi Room sphalumni.umn.edu/pi 2014 School of Public Health Commencement Monday, May 19 | 5 p.m.

Northrop Memorial Auditorium sph.umn.edu/2014commencement

14 University of Minnesota School of Public Health

Public Health Institute May 27–June 13 sph.umn.edu/2014phi The institute offers a course for everyone practicing in or studying public health, or fields related to public health. Participants can build or expand their professional expertise, learn best practices, broaden career options, network with other professionals, or explore a new area of interest.

Courses are intensive, highly interactive and applications-based with opportunities for field trips, case studies, hands-on labs, and simulations.

Examples of courses offered this summer include: • Data Driven Decision Making •F arm to Table Study Program: Minnesota •L anguage and Culture: A Spanish Immersion Course for Students & Practitioners in Health Sciences • Introduction to GIS •A pplied Critical Thinking in the Workforce •R efugee Health: Trauma, Stress and Coping •T opic in Infectious Diseases: Rabies

JUNE Industrial Hygiene Alumni Gathering @ AIHCE Monday, June 2 | 5:30–7:30 p.m. sphalumni.umn.edu/ih14 Alumni Gathering in Seattle Wednesday, June 25 | 6 – 8 p.m. sphalumni.umn.edu/2014seattle

Your SPH community

2014

marks the 70th year since the University of Minnesota established the School of Public Health. In these past seven decades, SPH has produced first-rate research and influenced life-changing policies. It has also fostered a rich and diverse community of alumni who are changing the world.

Each year, more of our students graduate to join the nearly 9,500 living SPH alumni around the world. How can SPH better support this global resource? How can alumni help each other?

And how can alumni enhance the SPH experience for current students? The answers may come from adopting an “alumnicentric culture” that revolves around SPH helping alumni, alumni helping alumni, and alumni helping students.

AN ALUMNI-CENTRIC CULTURE: WHAT IT COULD LOOK LIKE SPH helping alumni: When you chose to attend the School of Public Health, you signed up for a life-long connection and SPH took on the responsibility to add value to your career as it progresses. Take advantage of the school’s career services and continuing education resources.

Think of SPH as your link to the broader public health community. This year, we are also launching three new alumni awards to implement a focus on recognizing the talent and accomplishments of SPH graduates. For more info, visit z.umn.edu/sphalumniaward.

Alumni helping alumni: The SPH connection is a strong one. We want to make it easier for you to interact with fellow alumni and to know you have colleagues in your court. Other alumni and the Alumni Society Board of Directors can be your sounding boards and they can help implement activities that benefit the entire alumni community.

Alumni helping students: Today’s students will be your colleagues tomorrow and we want students to build relationships with alumni before graduation.

If we can complement the student experience with activities, knowledge, and connections that can’t be taught in a classroom, we enhance the value of an SPH degree and build a stronger community.

GET CONNECTED | GET INVOLVED | GET INFORMED To help forge this new culture, we need to hear from you and we need your involvement! Browse the new SPH Alumni Community online so you can: •G et Connected: Attend events, network by searching the Alumni Directory, and utilize resources such as the SPH Career Services and the school’s job board; • Get Involved: Volunteer for numerous activities such as the SPH Mentor Program, agree to serve as a virtual online career advisor, or join the international alumni network; •G et Informed: Read the latest school and alumni news and learn about the school’s continuing education offerings.

Be sure to log in to the SPH Alumni Community to keep your information up to date and check back often.

Over the next few months, the SPH Alumni Society Board of Directors will be seeking your input. We want to know what you think about the school, how you connect with it, and what it can do for you. Watch your mail or your email (please send us your current email address at sph-alum@umn.edu), or visit the SPH Alumni Community online to share your thoughts. This information will help us better plan and communicate with you.

We look forward to meeting and interacting with you on our way to building a stronger SPH community. Please don’t hesitate to contact Tara Anderson, director of alumni relations, at tlanders@umn.edu with any thoughts, ideas, or feedback!

SPHALUMNI.UMN.EDU

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CLASS NOTES

North by Southwest SPH offers MPH degrees via ASU Last year, Arizona State University officials identified a need in their region for access to a public health curriculum, but they didn’t want to create a school of public health. So they approached SPH because of its reputation for high-quality education and experience with hybrid and online education. The two schools proposed a partnership and the University of Minnesota Board of Regents approved it.

In fall 2014, ASU will offer pro­ gram­­ming that will allow students to earn MPH degrees in Public Health Nutrition and in Public Health Administration and Policy from SPH. The programs will address the educational need for public health professionals in southern Arizona and California, and SPH will be enriched by the diversity of students recruited from those areas.

In some instances, courses that are currently taught face-to-face in Minnesota may be converted to a hybrid or online format, and some will also be taught in the classroom

by ASU faculty who will have adjunct faculty status at SPH. “This partnership provides the opportunity for ASU’s excellent faculty in public health to work with Minnesota faculty on teaching and research, and gives the University of Minnesota access to new populations, as well,” says Elizabeth D. Phillips, ASU executive vice president and provost.

Sherie Apungu, MS ’11 (health services research, policy & administration), recently relocated to Boston, where she is senior analyst, global marketing strategy, research and analysis at Boston Scientific.

Javon Bea, MHA ’78, serves as president and chief executive officer of Mercy Health System, which was named to AARP’s 2013 list of Best Employers for Workers over 50.

Meredith “Meg” Bruening, MPH ’08 (nutrition), is among the 2013 recipients of the National Institutes of Health’s Early Independence Award. The award provides an opportunity for exceptional junior scientists who recently received a doctoral degree or finished medical residency to skip traditional postdoctoral training and move immediately into independent research positions. Bruening is an assistant professor at Arizona State University.

Claude Betene á Dooko, MPH ’13 (epidemiology), recently joined UCare as a health care analyst.

Matthew Doyle, DVM, MPH ’09; Honorata (Kuki) Hansen, DVM, MPH ’12; and Kristen Voehl, DVM, MPH ’12, graduates of the veterinary public health program, passed the American College of Veterinary Preventive Medicine (ACVPM) exam.

Judith Gundersen, DDS, MPH ’13, was promoted to Director of Dental Policy at the Minnesota Department of Human Services.

16 University of Minnesota School of Public Health

Lindsey Fabian, MPH ’00 (epidemiology), was presented the Award for Excellence from the American Public Health Association Council of Affiliates for her significant leadership, support for innovative initiatives, and effect­iveness in her efforts within the Minnesota Affiliate and Great Lakes Region. The Great Lakes Region also recognized her with a certificate of appreciation. Fabian is senior project coordinator in SPH’s Division of Epidemiology and Community Health.

Lauren Hills, MHA ’14, and Mary Ellen Wells, MHA ’84, established an alumni organization for women in healthcare administration. The Women’s Organization is a Twin Cities-based group for female students and alumni of the MHA program created to build relationships and network in non-professional settings. The group held its inaugural event in May 2013 and has held two since then.

If you are interested in getting involved, contact Hills at l.hills89@gmail.com.

Meghan Krause, MPH ’13 (community health promotion), was named director of wellness at Gustavus Adolphus College.

Prior to graduating in fall 2013, Meghan served as a research assistant in the University of Minnesota’s Center for Integrative Leadership.

William McCulloch, DVM, MPH ’60 (veterinary public health), received the 2013 Karl F. Meyer-James H. Steele Gold Headed Cane Award from the American Veterinary Medical Association (AVMA).

The award is given annually to recognize an individual concerned with animal health who has significantly advanced human health through the practice of veterinary epidemiology and public health.

Megin Nichols, DVM, MPH ’08 (veterinary public health), was recently awarded the James Steele 2013 Veterinary Public Health Award given to a current or former CDC Epidemic Intelligence Service officer who has made outstanding contributions in the field of veterinary public health.

Sylvester Onyeneho, PhD, MPH ’11 (executive public health practice) and SPH faculty advisor and professor Craig Hedberg, PhD ’93, published “An Assessment of Food Safety Needs of Restaurants in Owerri, Imo State, Nigeria” in the International Journal of Environment Research and Public Health.

Jennifer Schultz, PhD ’01 (health services research policy and administration), is running for the Minnesota House of Representatives in Duluth, Minn., district 7A. She is a professor of economics and director of the health care management program in the Labovitz School of Business and Economics at the University of Minnesota-Duluth.

Brian Sinotte, MHA/MBA ’04, was recently named CEO of MetroSouth Medical Center located in Blue Island, Ill. He previously served as chief operating officer of Porter Health Care System in Valparaiso, Ind. Alicen Spaulding, PhD ’13 (epidemiology), recently began a position at the National Institutes of Health as a Presidential Management Fellow designated to the National Institute of infectious Diseases. Spaulding’s epidemiology PhD thesis was titled: “Quality of Life Among People Living with HIV: An Evaluation of Methodological Issues and Independent Effects of Age and Gender on Changes Over Time.”

Jesse Tischer, MHA ’03, was promoted to chief operating officer of Sanford Health Network in Sioux Falls, SD, from vicepresident of Sanford Health Network (ND) Region.

Tricia Todd, MPH ’94 (public health administration), is the 2013 recipient of the American Public Health Association’s W. C. Woodward Award, given to a health administration member who has advanced the practice of health administration through outstanding leadership and contributions in a management or educational setting and who has provided significant service in that area. Todd currently serves as assistant director at the University’s Health Careers Center.

Fundraising for Weckwerth endowed professorship reaches a milestone ALUMNI IN MEMORIAM: 2013 Ellamae Branstetter, MPH ’57 (public health nursing) Timothy Bray, DDS, MPH ’85 (dental public health) Peggy Brewer, BS ’71, MPH ’88 ( public health administration) Keith Burau, MS ’75, PhD ’80 (biometry) Joann Chapman, MPH ’85 (public health nursing) Margaret Christianson, MPH ’77 (public health nutrition) Elizabeth Emery, BS ’43, MPH ’73 (public health nursing) Marie Giese, MPH ’52 (public health nursing) Luther Goehring, MHA ’60

Mavis Nymon, MPH ’60 (health education), PhD ’63 (public health nutrition) Thomas Oas, MPH ’70 (public health administration) Joseph Powell, MHA ’55 John Pratt, MHA ’50 Sharon Quast, MPH ’76 (public health nursing) Hamilton Reid, MHA ’54 Otto Ravenholt, MD ’58, MPH ’62 (epidemiology) James Riley, MPH ’76 (environmental health) Robert Robinson, MPH ’71 (veterinary public health) David Rosen, MPH ’90 (maternal & child health) Shelley Ryan, MPH ’83 (maternal & child health)

Steven Gunson, MPH ’74 Ira Shimp, MHA ’71 (environmental health) Donald Shumrick, MS ’52 Vernon Harris, MHA ’52 (physiological hygiene), Peter Haviland, MHA ’57 MD ’57 Arvid Houglum, MD ’50, Mary Jo Siebenaler, MPH ’66 (public health MPH ’91 administration) (environmental health) Iver Iverson, BS ’54, MPH ’58 (biometry)

Stanley Silberg, MPH ’59, PhD ’65 (epidemiology)

Gordon Johnsen, MHA ’55

Phyllis Skogen, BS ’56 (public health nursing)

Jack Johnson, PhD ’71 (environmental health)

Kenneth Torbert, MHA ’72

Chantelle Kurtz, MPH ’13 John Van Susteren, (public health nutrition) MD, MPH ’55 (public James Lauer, MPH ’76 health administration) (environmental health) Maurine Verplank, Barbara LaVigne, BS ’74 MPH ’52 (veterinary (public health nursing) public health) Ruth Loewenson, PhD ’68 (biometry) Lois Mallory, BS ’71, MPH ’73 (public health nutrition) John New, Jr., MPH ’77 (veterinary public health)

Joel Watson, MHA ’58 Allan Welch, MPH ’60 (environmental health) Donald E. Wood, MHA ’52

The teaching career of Vernon Weckwerth, PhD, spans 50 years, five continents, and an untold number of students. Now Weckwerth’s former students, colleagues, and friends are adding two more figures: 1 million and 220, the total number dollars raised and donors, respectively, to the Vernon E. Weckwerth Professorship in Healthcare Administration Leadership at the University of Minnesota School of Public Health.

“His commitment to students is unrivaled and deserves to be honored,” says former student Richard Norling, MHA ’75, past president and CEO of both Premier, Inc., and Fairview Health Services, who made a lead gift of $250,000 help fund the endowed position. “Creating [this chair] is a fitting tribute to the impact he has had on our careers and health care as we know it.”

Weckwerth started the first-of-its-kind Interdisciplinary Studies Program in 1968 through the School of Public Health’s Master of Healthcare Administration (MHA) program. The ISP was created to offer an executive education program for hospital administrators. When the program closed in 2008, it boasted 3,117 alumni from 45 countries, more than 1,000 of whom went on to become top-level executives.

Now that $1 million has been raised for the Weckwerth endowed faculty position, the annual funds it generates can be used at the discretion of one deserving SPH faculty member (to be named later). An endowed professorship is one of the most time-honored and treasured means of paying tribute to the contributions of prominent faculty leaders.

A celebration will be held Monday, May 12, to commemorate the Weckwerth Professorship. Visit z.umn.edu/weckwerth for details.

Honor a dedicated educator and help the University’s MHA program maintain its standing as a leader in educating the best and brightest health care administrators for years to come. Make a gift to the Vernon E. Weckwerth Professorship in Healthcare Administration Leadership by contacting Adam Buhr, director of development for the School of Public Health, at 612-626-2391 or adambuhr@umn.edu

sph.umn.edu 17

420 Delaware Street SE Minneapolis, MN 55455 www.sph.umn.edu

Nonprofit U.S. Postage PAID Twin Cities, MN Permit No. 90155

Many things go into whether a woman feels depressed or happy and confident during pregnancy, childbirth and early motherhood.

BRIGHTER BEGINNINGS FOR BABIES AND MOTHERS U of M researchers are finding new ways to help mothers and babies have a safe and healthy start.

Discover more at sph.umn.edu.