FSPH Magazine Spring/Summer 2015

PUBLIC HEALTH SPRING/SUMMER 2015

The UCLA Fielding School of Public Health Magazine

Clearing the Air

Every day we are exposed to invisible environmental dangers. FSPH is implementing sustainable solutions for a healthier world.

dean’s message WE LIVE IN REMARKABLE TIMES, when technology has broken down barriers and made possible what once seemed unthinkable. And yet, the world we share – our air and water, oceans and soil, forests and cities, along with the climate governing it all – is threatened like never before. We are reminded with growing regularity of the need to be better stewards of our planet, and of the consequences of our actions on our long-term ecosystem, as well as on the health of current and future populations. The World Health Organization estimates that environmental conditions play a significant role in nearly onefourth of all global deaths annually – 13 million each year. Unless we take positive steps, that number seems certain to rise.

Fielding School faculty, staff, and students are leading crucial efforts in the development and implementation of sustainable solutions to our shared challenges in the United States and around the world. We are extraordinarily fortunate to be in a state with a well-earned reputation for taking the lead in addressing environmental hazards, along with uniquely rich data sources to help us better understand the problems and investigate the real and potential effects of policies. A global leader in relevant fields from technology and innovation to agriculture and industry, California serves as a laboratory for testing environmental solutions that can be and are implemented by our national and international colleagues.

Our faculty, students, staff, and alumni work with community and government partners to eliminate dangerous environmental exposures and design healthier cities and countries. I hope you will join us in this vital effort. With your support, the Fielding School will continue to educate and train students who will become tomorrow’s leaders in finding alternatives to unsustainable practices. Yes, these are challenging times for our environment. But together, we can overcome many of the threats to human health.

Jody Heymann, MD, PhD Dean

CLEARING THE AIR T HE UCL A F IE L DING S CHOOL OF P UB L IC HE A LT H M A G A Z INE • S P RING / S UMME R 2 0 15

FEATURES

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ENVIRONMENTAL EXPOSURES

Invisible Dangers We are exposed to countless chemicals, some of which can be toxic.

FSPH researchers identify the risks and develop solutions so we can breathe more easily.

TOXICOLOGY TOOL

Chemistry Test A new approach to examining the safety of chemical compounds.

POLICY EVALUATION

Route of a Problem Studying the impact of an aggressive statewide effort to address the health concerns associated with goods movement corridors.

ACTING ON THE SCIENCE

Potent Combination By identifying dangerous chemical exposures and applying the findings toward policies to protect health, John Froines has pursued his two passions.

SOCIAL DETERMINANTS

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Asthma Disparities: Unraveling the Causes Examining the factors behind increased symptoms for children and adults from low-income communities.

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Making Sense of Asthma-Related Hospitalizations Using geographic information system technology, an FSPH department chair provides an invaluable tool.

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STATISTICAL RESOURCE

INTERNATIONAL PARTNERSHIP

Natural Resources Amid efforts to reduce deforestation, an FSPH team provides a model for considering the health of both the forest and its longtime inhabitants.

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HEALTH IMPACT ASSESSMENT

Saving Wisely Water-conservation strategies are essential in drought-stricken California, but decisions must be made through the lens of public health.

STUDENT PROFILES

Exposed to the Elements Ana Mascareñas and Teni Adewumi saw toxic environments affecting their communities and are determined to make things right.

COMMUNITY ENGAGEMENT

Room to Breathe With smoking increasingly prohibited in public places, a Fielding School-led coalition addresses secondhand tobacco smoke exposure where people live.

CHANGING OUR ENVIRONMENT

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Healthy by Design Amid mounting evidence of the built environment’s impact on health, FSPH experts lead wide-ranging initiatives to change the urban landscape.

DEPARTMENTS 32 School Work 35 Student Awards

PHOTOGRAPHY AND GRAPHICS

Margaret Molloy: p. 7: Zhu; p. 21: Adewumi; p. 22: hands with card; p. 23: Schiller, Gomez; p. 25: basketball; p. 30: Tran; p. 31: farmer’s market; p. 33: Breslow Lecture, Shannon; back cover. Owen Lei: TOC: photos for articles on pp. 9, 20, 26; p. 8: Ritz; p. 9: Allard; p. 12: Froines; p. 20: Mascareñas; p. 28: Jackson; p. 29: Jerrett; p. 32: bikes, water filtration station, cooking class, app graphic (The Apple logo® is a registered trademark of Apple, Inc.); p. 33: map graphic. Nathan Dappen/Day's Edge Productions: TOC: photo for article on p. 16; p. 16 bottom photo. Stevan J. Arnold: p. 16: top photo; p. 18: computer class, Godwin and child. Shweta Saraswat: p. 15: Banerjee; p. 31: herb garden; p. 33: Jerrett. Markku Lahdesmaki: pp.

26-27: LA River. Carla Wohl: p. 32: Race to Health. Alicia Patel: p. 14: graphs. Betsy Winchell: Dean’s Message. © iStockphoto: Cover; pp. 2-5, 10, 13, 19. COURTESY OF: Beate Ritz: p.9: farm aerial; Ana Mascareñas: p. 20: warning tag; Uyen Ngo: p. 30: Ngo. • Special thanks to Thomas Safran & Associates, Renato Ochoa and Skyline Village.

Clearing the Air IN THE FARMING COMMUNITIES of California’s Central Valley, the urban centers of the nation’s most populous state, and in cities, towns, and rural villages all over the world, invisible dangers lurk. They spew from our cars and trucks; from sprays designed to protect our food or improve our products; from industrial processes integral to our economy. Tens of thousands of chemical compounds surround us, most of which we can’t see, many of which we don’t understand, some of which we know can cause us harm.

As is illustrated on the pages that follow, Fielding School faculty, students, staff, and alumni are leading efforts at home and abroad to clear the air and promote safer surroundings. Through rigorous research, they are rooting out potentially perilous environmental exposures. But beyond identifying the problem, they are developing and implementing solutions in the form of new policy regulations, products and tests, and sustainable alternatives.

Unparalleled in its economic, geographic, and ethnic diversity, bustling with both breathtakingly beautiful terrain and formidable ecologic challenges, California is looked upon throughout the world as a leader and testing ground for tackling environmental concerns. At the Fielding School, we are at the forefront of that effort as we bring about sustainable solutions for a healthier planet.

Jody Heymann, MD, PhD Dean

Carla Wohl Assistant Dean of External Affairs

Carla Denly Director of Communications and Executive Editor

Dan Gordon Editor and Writer

Charles Hess Design Director

Owen Lei Sr. Communications Associate and Photography Editor

UCLA Fielding School of Public Health Home Page: www.ph.ucla.edu

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UCLA Public Health Magazine is published by the UCLA Fielding School of Public Health for the alumni, faculty, students, staff and friends of the school. Copyright 2015 by The Regents of the University of California. Permission to reprint any portion must be obtained from the school. Send request to communications@ph.ucla.edu.

EDITORIAL BOARD Haroutune K. Armenian, MD, DrPH Professor in Residence, Epidemiology; Thomas R. Belin, PhD Professor, Biostatistics; David D. Clark Assistant Dean for Student Affairs; Hilary Godwin, PhD Associate Dean for Academic Programs; Professor, Environmental Health Sciences; Pamina Gorbach, DrPH Professor, Epidemiology; Moira Inkelas, PhD Associate Professor, Health Policy and Management; Richard J. Jackson, MD, MPH Professor, Environmental Health Sciences; Marjorie Kagawa-Singer, PhD, MN Professor, Community Health Sciences; Michael Prelip, DPA Associate Dean for Practice Across the Life Course; Professor in Residence, Community Health Sciences; Beate Ritz, PhD Professor and Chair, Epidemiology; May C. Wang, DrPH Professor, Community Health Sciences; Zuo-Feng Zhang, MD, PhD Associate Dean for Research; Professor, Epidemiology; Frederick Zimmerman, PhD Professor, Health Policy and Management; Lauren Harrell and Sean Buono Co-Presidents, Public Health Student Association; Beatriz Solis, MPH ’96, PhD ’07 President, Public Health Alumni Association UCLA FIELDING SCHOOL OF PUBLIC HEALTH SPRING/SUMMER 2015

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Invisible ENVIRONMENTAL EXPOSURES

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Dangers From the pesticides that protect our food supply to the particulate matter that

comes out of our tailpipes, we are exposed to countless chemicals in our daily lives, some of which can be toxic. Fielding School researchers are identifying the risks and developing global solutions so that we can breathe more easily.

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Invisible Dangers DR. YIFANG ZHU believes the on-board

school bus air filtration system she and her Fielding School colleagues have been testing could be the solution to a safer ride for the 25 million children who commute on school buses in the United States nearly every day.

“School buses tend to be very leaky,” explains Zhu, associate professor in the Fielding School’s Department of Environmental Health Sciences. “When they are on freeways and busy streets, the emissions from the surrounding vehicles make their way inside the bus fairly easily, and the children on board can be exposed to significantly greater levels of air pollutants than a typical resident.”

Studies have associated exposure to high levels of vehicle pollution with pulmonary and cardiovascular risks, and children are most susceptible because they breathe more quickly and their immune and cardiovascular systems are developing.

So, with funding from the California Air Resources Board, Zhu’s team studied a prototype high-efficiency cabin air (HECA) filtration system designed specifically to clean the air aboard school buses. The results, published in the journal Environmental Science & Technology, were highly encouraging. Vehicular pollutants inside the buses were reduced by up to 88 percent – with the greatest reductions occurring under freeway-driving conditions. The study found that the air inside buses with the HECA system was as clean as air near the beach in Santa Monica, CA. “A reduction of nearly 90 percent in children’s exposure to pollutant levels on their daily bus commutes would be highly significant,” says Zhu, whose team now hopes to continue with a long-term study measuring exposure levels in buses with children aboard.

“The EPA has said that school buses are by far the safest way to transport children between school and home. Our goal is to make it also the cleanest way.”

Zhu’s solutions to dangerous environmental exposures have global implications. Outside of her school bus work, she has collaborated with researchers at Peking University in China – bringing lessons learned from Los Angeles’ successful air-pollution reduction effort to Beijing as Chinese policy makers grapple with smog levels that have reached 20 times the limit recommended by the World Health Organization. And Zhu isn’t alone. In disparate settings including FSPH laboratories and Central Valley farms, Fielding School researchers are identifying the risks we face through our daily chemical exposures and developing solutions so that we can breathe more easily.

THE RISING PREVALENCE OF AUTISM spectrum disorder in the U.S. can’t be entirely explained by diagnostic changes or genetic factors. That leaves room for the possibility that environmental exposures are playing a role, notes Dr. Ondine von Ehrenstein, assistant professor in the Department of Community Health Sciences.

In a 2014 study published in the journal Epidemiology, von Ehrenstein, who collaborates with Dr. Beate Ritz, professor and chair of the Fielding School’s Department of Epidemiology, examined the potential association between exposure to California Air Resources Board-monitored air toxics during specific periods of 6

pregnancy and increased risk of autism. Von Ehrenstein, Ritz and their collaborators found 30-70 percent risk increases for autism in children exposed in utero to several traffic- and industry-related toxics. Now, the FSPH team is part of the first large-scale systematic investigation of the potential effects of prenatal pesticide exposure on autism risk.

“Exposures involving the developing brain and nervous system may cause substantial public health impacts – as illustrated, for example, by the case of lead,” von Ehrenstein notes. “Identifying adverse environmental factors that are amenable to prevention during early-life development should be a public health policy priority.”

POLLUTION LEVELS in greater Los Angeles have improved in the last several decades, thanks in part to stricter state and local regulations and the use of cleaner fuels. But air pollutants are still a cause for considerable concern – particularly during childhood and earlier.

Aware of the evidence that the developing fetus is particularly vulnerable to environmental influences, Dr. Julia Heck, an assistant professor of epidemiology at the Fielding School, set out to explore a potential link between prenatal exposures to air pollutants and rare childhood cancers. Heck used a sophisticated dispersion model for the State of California, along with data from the California Air Resources Board’s community-based air pollution monitors, to determine levels of exposure to traffic pollution and air toxics during pregnancy. Heck and colleagues then overlaid data from the California Cancer Registry, as well as state birth records, to provide evidence suggesting a potential link between maternal exposure to specific pollutants and the risk of neuroblastoma, retinoblastoma, germ cell tumors, and the two major types of leukemia in children.

“It would have been hard to do this study anywhere else,” Heck says. “California has been at the forefront of environmental monitoring, so we have many years of air pollution data for dozens of air toxics.” Among other resources, Heck has also had access to the geographic information system (GIS) land-use model and exposure assessment methodologies developed by Ritz and her team.

PERFLUORINATED CHEMICALS (PFCs) have been used broadly in industry and commercial products for decades. But in the last decade, concerns have been raised by reports that these ubiquitous compounds persist in the environment, potentially accumulating to exposure levels that can be harmful. PFCs are classified as endocrine-destructing compounds for their ability to disrupt the hormone system of mammals; there are also hints of their ability to cross the placental barrier and expose the fetus during the most vulnerable period of development. “We all have measurable amounts of PFCs in our blood,” says Zeyan Liew (PhD ’14), a postdoctoral scholar in the Fielding School’s Department of Epidemiology who is working with Ritz. “But very little is known about the reproductive and developmental effects, in part because it’s been so hard to study.”

For his doctoral dissertation at the Fielding School, Liew made

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Below: For the 25 million U.S. children who commute on school buses nearly every day, an on-board air filtration system tested

by Dr. Yifang Zhu and her Fielding School team could reduce exposure to vehicular pollutants by up to 88 percent.

watch video ph.ucla.edu

use of a singular resource. The Danish National Birth Cohort recruited 100,000 pregnant women in Denmark from 1996 to 2002, collecting and storing prenatal blood samples and then following their children to learn more about early determinants of health.

Liew received funding to study the impact of prenatal exposure to several types of PFCs on the risk of autism, attention deficit hyperactivity disorder, and cerebral palsy. The funding came via a grant awarded to Dr. Jørn Olsen, former chair of the Department of Epidemiology and founder of the Danish National Birth Cohort, and to Ritz, who was Liew’s PhD mentor.

Liew found prenatal PFC exposure to be associated with increased risk of cerebral palsy (CP) in children. He is continuing to study the Danish cohort to learn whether PFC exposures affect children’s cognitive functions and intellectual development.

PESTICIDE USE has increased dramatically over the last 50 years, to the point that an estimated 5.2 billion pounds of active ingredients were employed in 2007 – or nearly one pound for each person on the globe. But the distribution is far from equal. About 40 percent of the overall use is in agriculture, which is why, when concerns began to grow in the early 2000s about an association

between pesticide exposure and Parkinson’s disease, some neurologists began to refer to the farm towns in California’s Central Valley as “Parkinson’s Alley.”

Much of what is now known about increased susceptibility to the neurodegenerative brain disease among Central Valley farmworkers – as well as others who live or work near fields and come into contact with the agricultural chemicals through dust, air, or well water – comes from the work of Dr. Beate Ritz, professor and chair of the Fielding School’s Department of Epidemiology, and her colleagues at the UCLA Center for Gene-Environment Studies of Parkinson’s Disease, which Ritz co-directs. Their studies over the last 15 years of approximately 1,600 Central Valley residents have built a compelling case for the ways in which genetic and environmental influences conspire to increase the Parkinson’s disease risk through an interplay between neurotoxic pesticides and biologic mechanisms that increase susceptibility of the aging brain.

Ritz was a junior Fielding School faculty member in 1996 when she became intrigued with the idea of investigating the potential Parkinson’s/pesticides link. “We have this large Central Valley

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Through maps of land use and a sophisticated geographic information system approach incorporating state pesticide records, Dr. Beate Ritz and her colleagues have conducted pioneering studies in California’s Central Valley showing the impact of specific pesticides and of the genetic variations that render exposed individuals susceptible to Parkinson’s disease.

with so much agricultural activity and high-intensity chemical use through four growing seasons,” she explains. In the 1980s, a neurologist in the San Francisco Bay Area, William Langston, had linked the compound MPTP, found in synthetic heroin, to early-onset Parkinson’s in a cluster of heroin addicts. Since MPTP’s chemical structure closely resembled paraquat, a widely used herbicide, that reignited the debate over whether something in the environment – specifically pesticides – might trigger Parkinson’s. Ritz also knew she had a rich data source: Since the early 1970s, California law had required detailed reports on pesticide use. “This resource was now electronically available, and had never been systematically used for human studies,” Ritz says.

Exposure to pesticides had long been suspected as a risk factor for Parkinson’s disease, but previous studies had been limited by their reliance on people’s recollection of chemical usage, which made accurate exposure assessment difficult. Ritz and her colleagues overcame that hurdle by using maps of land use and a sophisticated geographic information system approach incorporating the pesticide application records. In doing so, they have been able to provide a high-resolution view of the impact of specific pesticides and of the genetic variations that render exposed individuals susceptible to the disease.

Fifteen years of research have told a powerful story. Among the many findings reported by Ritz’s team: • Central Valley residents living near fields where the pesticides paraquat and maneb were used between 1974 and 1999 were nearly twice as likely to develop Parkinson’s as others living in the region.

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• Further studies have also implicated ziram, benomyl, and other commonly used neurotoxic pesticides such as the insecticides organophosphates and pyrethoids.

• Simply living or working near fields on which pesticides are applied can increase risk in non-farmers.

• Those consuming private well water and living within 500 feet of farms with long-term pesticide use were nearly twice as likely to end up with the disease.

• The level of risk from being exposed to the harmful pesticides depends on an individual’s genetic makeup, which in the most-exposed groups can increase the chances of developing Parkinson’s by up to six-fold.

ALONG THE WAY, Ritz has mentored numerous doctoral students and junior faculty. “The methods she has developed can be used for studying many different diseases, including others that pesticides may be influencing,” says Kimberly Paul, a current PhD student who has worked on the Parkinson’s studies with Ritz since 2012. “Unfortunately, there are many negative health outcomes that can be found in the Central Valley at a much higher rate than one would expect.”

While her studies continue to build a case for the problem, Ritz has also been active in efforts to address it. She has discussed her findings with community-based groups seeking to promote protective measures, and has shared her views with federal legislators seeking to revise the 1976 Toxic Substances Control Act – including accepting an invitation to meet with California Sen. Dianne Feinstein to discuss her work and its implications on the need to strengthen the law.

“We should encourage these Central Valley communities to build a ring of greenery around the neighborhoods to separate them from the agriculture,” Ritz says. “But we also have to think about the workplaces, and promote integrated pest management that avoids pesticide use to the greatest extent possible – especially use of many neurotoxic pesticides.” •

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Chemistry Test A Fielding School faculty member’s new approach to examining the safety of chemical compounds addresses shortcomings in traditional methods.

AN ESTIMATED 80,000 chemical substances currently find their way into our environment through industrial and agricultural waste, as well as through functional uses such as in the case of food additives, pesticides, pharmaceuticals and personal care products. But even as companies continue to produce new chemical compounds at a rapid clip, toxicologists and state and federal regulators agree that conventional approaches to testing chemical safety have significant limitations.

“When we say chemicals in the environment are safe, that’s only within the context of what has been studied,” says Dr. Patrick Allard, assistant professor in the Fielding School’s Department of Environmental Health Sciences. “But what has been studied is only the tip of

the iceberg – there is still a great deal of uncertainty.” For one thing, he explains, in the United States approximately 60,000 chemicals were grandfathered in, exempting them from U.S. Environmental Protection Agency (EPA) testing, by the Toxic Substances Control Act of 1976.

Moreover, Allard notes, while chemical companies are now required to test new compounds before introducing them into the environment, the limits of the old toxicology testing tools leave many unanswered questions about their safety.

“The tests that currently exist can accurately determine whether chemical compounds have the potential to cause genetic damage or cancer,” Allard says. “But when it comes to determining the effects on more complex concerns like reproduction and

aging, this is where the technology lags. The current tests are time-consuming, expensive, and involve the use of many rodents and other vertebrate animals at a time when some are rethinking the current approach to animal testing. What we need are tests that do not require such animals, are inexpensive, and will give us quick and accurate answers about the safety of what we are about to release into the environment.”

By applying state-of-the-art automated technologies from genetics and other biological fields to issues of toxicity, particularly pertaining to reproduction, Allard and his Fielding School laboratory colleagues have developed an approach to chemical toxicology testing that addresses the key shortcomings of Continued on next page

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Applying stateof-the-art automated technologies, Dr. Patrick Allard and his Fielding School laboratory colleagues have developed a method for simultaneously screening hundreds of chemical compounds for their toxicity affecting the reproductive process.

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the conventional methods. Allard’s approach uses C. elegans – tiny worms that have been used as model organisms for research in genetics and developmental biology, both because they share many reproductive processes with humans and because they reproduce rapidly. In a 2013 study with researchers at the EPA, Allard applied his method to the screening of pesticides and showed that using C. elegans for toxicity screens resulted in high rates of accuracy for predicting the reproductive toxicity of chemical compounds in mammals.

“With this approach we can now simultaneously screen hundreds of compounds for their toxicity to the reproductive process, which can help to prioritize the chemicals that need further analysis,” Allard says. “Beyond that, once we find compounds that are repro-toxic, we can look further into the stages of reproduction that are affected, and how they are affected.”

Allard has applied the new approach to the study of bisphenol A (BPA), a compound found in items such as polycarbonate bottles, soda cans and cash register receipts; and bisphenol S (BPS), a very similar compound that is increasingly used as a replacement in “BPA-free” products because of concerns about BPA’s toxicity. Allard and others have previously shown that BPA alters processes important for reproduction, but little is known about the toxicity of BPS. With one of his PhD students, Yichang Chen, Allard has found BPS to be as repro-toxic as BPA in C. elegans – although the toxic effect occurs through different genetic mechanisms.

Allard explains that the tools he has developed are not intended for his lab alone. “Our goal is to create technologies that will assist government and the chemical industry and improve the public’s health,” he says. “With these types of studies, we hope to show that an alternative model such as ours is worth the investment.” • 10

Goods movement corridors represent a major health concern for the populations that live along them.

An FSPH team is studying the impact of an aggressive statewide effort to address the issue.

Each day in Southern California, approximately 40,000 trucks travel the routes to and from the ports of Long Beach and Los Angeles, transporting more than 40 percent of the imports that enter the U.S. in containers.

THE HEAVY-DUTY TRUCKS, trains, ships and equipment involved in the efficient, safe delivery of goods to and from California’s ports are vital to the state’s economic well-being and quality of life.

But the environmental and public health impacts of the goods movement and logistics industry are also a source of considerable concern – particularly in Southern California, where each day approximately 40,000 trucks travel the routes to and from the ports of Long Beach and Los Angeles, transporting more than 40 percent of the imports that enter the U.S. in containers.

The increased levels of air pollution in areas along the transit routes, also known as goods movement corridors, are responsible for thousands of deaths and billions of dollars in health-related costs each year, according to a 2011 report from the South Coast Air Quality Management District, whose executive officer, Fielding School alum Barry

Wallerstein (D.Env. ’88), has called goods-movement-related pollutants the largest source of air pollution in Southern California. Dr. Michael Jerrett, professor and chair of the Fielding School’s Department of Environmental Health Sciences, notes that the problem also raises concerns about environmental inequities. “The populations living close to these truck routes tend to be low-income and communities of color,” he says.

Jerrett is part of an FSPH team that has been evaluating the impact of a major statewide effort, begun nearly a decade ago, to address the problem. In 2006, the California Air Resources Board and local air quality management districts implemented a comprehensive emissions reduction program for the international and domestic goods movement industry. The aggressive plan identified approximately 200 actions – including mandating that nearly all trucks install diesel exhaust filters on their

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rigs by 2014 – to reduce the statewide particulate matter emitted from goods movement by 85 percent.

A team that included Jerrett as well as Drs. Ying-Ying Meng (who led the study) and Beate Ritz from the Fielding School faculty conducted measurements at 71 sites in L.A. County and 49 sites in the San Francisco Bay Area to assess the traffic-related pollution levels in 2012 and 2013, in an effort to determine the impact the goods movement emissions reduction plan has had on air quality. Specifically, they wanted to know whether goods movement corridors (defined as places within 500 meters of truck-permitted freeways or main ports in the state) experienced greater reductions in air pollutants in the post-policy years than non-goods movement corridors (locations within 500 meters of freeways where trucks are prohibited) and residential areas.

The study team found that reductions in traffic-related air pollutants in goods movement corridors were significantly greater than in other areas as a result of the policies.

“These findings show what we would hope – that the regulatory policies are working as intended, to the particular benefit of these vulnerable populations within 500 meters of major truck routes,” says Jerrett.

Now, the group is preparing to follow up with a study examining whether the exposure reductions have resulted in improvements in public health. Past studies have shown that people exposed to elevated levels of traffic-related pollutants have higher rates of asthma symptoms and reduced lung function, as well as greater susceptibility to cardiovascular disease and certain cancers. Using a large data set of California Medicaid recipients, the FSPH group will analyze the impact of the reduced exposures on health indicators such as medication use, emergency department visits and hospitalizations among populations with chronic conditions living in goods movement corridors. •

Potent Combination Dr. John Froines once believed he would have to choose between his two passions, science and policy. But as a national leader in identifying dangerous chemical exposures and then applying the findings toward regulations to protect health, he’s spent a career pursuing both.

IT’S A LONG WAY from the small town of Carpi in Northern Italy to the UCLA campus where Dr. John Froines has made his professional home for the last 34 years. But when Carpi’s mayor presented the Fielding School professor emeritus with the prestigious 2013 Collegium Ramazzini Award for his contributions in occupational and environmental health research and policy, it illustrated the long reach and worldwide recognition of Froines’ body of work.

Over the course of a four-decades-plus career in the field of toxicology and exposure assessment, Froines has played an important role in some of the most seminal evidence-based policies to protect human health – from developing the federal standards for lead and cotton dust exposure in the late 1970s and identifying diesel exhaust as a toxic air contaminant 20 years later, to the 2013 case study he co-authored on California’s process for assessing risk and approving the use of methyl iodide as a fumigant for crops such as strawberries. The latter report, issued by the UCLA Fielding Schoolbased Sustainable Technology and Policy Program, pointed out the failure of the system in approving a chemical that a Froines-chaired committee concluded could not be used safely at any level.

Throughout his career, Froines has gone up against powerful economic interests in his efforts to translate science into policies that protect the health of some of the most vulnerable populations – migrant farmworkers, blue-collar employees, and low-income families residing near freeways, among others. It’s been an ideal marriage of two passions

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for someone who, in the early 1970s, found himself at a crossroads.

FROINES HAD BEEN trained as a scientist at UC Berkeley and Yale before going on to postdoctoral work at the Royal Institution of Great Britain under a Nobel Laureate, Sir George Porter. But he also maintained a strong interest in social issues, and was active in politics and the anti-Vietnam War movement. “I had to figure out whether I was going to become a person focused on policy and politics, or whether I was going to do science,” he recalls.

The question was resolved, and Froines’ career path set, when he was hired to serve as director of Vermont’s Office of Occupational and Radiological Health in 1974. “Getting involved in environmental and occupational issues in that way made me realize I could combine my scientific interest with social policy,” Froines says.

During the Carter administration, Froines was tapped to serve as director of the Office of Toxic Substances for the Occupational Safety and Health Administration (OSHA). There, he authored landmark standards for cotton dust and lead – the only two standards, he notes, that OSHA has ever adopted for non-carcinogen toxicity. The cotton dust standard helped to eliminate byssinosis, a respiratory disorder that affected workers in the textile industry. The lead standard, designed to protect workers from the neurologic effects associated with the occupational use of lead, was promulgated despite strong industry opposition.

After serving as deputy director of the National Institute for OccuContinued on next page

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pational Safety and Health, Froines decided to move into academia, joining the Fielding School faculty in 1981. Throughout the 1980s and 1990s he continued to focus on occupational health with a research emphasis on arsenic, chromium, lead, and the development and application of hazard surveillance methods. For the last 15 years he has turned much of his research attention toward studying the toxicity of air pollutants – his work on the mechanistic features of the roadmap leading to health outcomes has been widely cited in policy-setting arenas.

And Froines has himself been a central figure in shaping policy, serving on California’s Scientific Review Panel on Toxic Air Contaminants. It was under his leadership as director in 1998 that the panel identified diesel exhaust as a carcinogenic air contaminant, setting the stage for California to become a world leader in regulating and reducing the health risks associated with exposure to diesel particulate.

Today, Froines says, there is much greater recognition of the problem of toxic environmental exposures, but also more opposition to addressing it.

“An extraordinary amount of science

has now gone into identifying chemicals as being toxic or worse,” Froines notes. “But when you consider the fact that the Environmental Protection Agency says there are between 60,000 and 80,000 chemicals used in the environment and that OSHA has, since 1970, adopted only 26 standards, you realize we’re nowhere near addressing the problem.”

AS A FACULTY director emeritus of the UCLA Sustainable Technology and Policy Program (STPP), Froines is in the vanguard of a new paradigm for tackling these issues. STPP is an interdisciplinary initiative of the Fielding School and UCLA’s law, engineering and business schools. Dr. Peter Sinsheimer of FSPH’s Department of Environmental Health Sciences serves as executive director.

The program is developing testing methods in the emerging field known as predictive toxicology that would enable thousands of chemicals to be assessed in the laboratory for their potential health effects. STPP is also spearheading an approach called alternatives analysis – the process of scientifically identifying and then promoting the use of safer substitutes once a chemical is identified as hazardous. In addition, STPP has

a strong law and policy component led by Timothy Malloy, a professor in the UCLA School of Law with a secondary appointment in the Fielding School who also serves as STPP faculty director. “In the past, scientists have come up with methods that weren’t closely linked with legal frameworks or regulations,” says Malloy. “We’re taking a pragmatic approach by developing the frameworks and methods in concert.”

When it comes to combining policy and science, Malloy couldn’t ask for a better partner. “John brings both a depth of knowledge and a perspective, going back to the early days of occupational and environmental health regulation, that you can’t get anywhere else,” Malloy says, “and he has a remarkable ability to translate complex scientific issues into understandable language.”

Hailed by the committee for the Ramazzini Award as a “public health hero,” Froines reflected on a career that has enabled him to pursue his dual passions. “I was honored to receive the award and will cherish it always,” he says. “It proves the value of integrity in science and demonstrates that one is able to combine solid science with policy.” •

As a faculty director emeritus of the Fielding School-based UCLA Sustainable Technology and Policy Program, Dr. John Froines is in the vanguard of a new paradigm for tackling issues of toxic chemical exposures.

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SOCIAL DETERMINANTS

ASTHMA DISPARITIES: UNRAVELING THE CAUSES

Higher exposure to air pollutants, reduced access to quality health care and psychological distress are among factors contributing to increased symptoms for children and adults from low-income communities.

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HE MORE THAN 5 MILLION CALIFORNIANS who have been diagnosed with asthma represent a cross-section of the state: men, women and children of all ages, ethnicities, household incomes and geographic regions. But when it comes to how people experience this chronic lung disease, asthma tends to be much more discriminating.

Researchers at the Fielding School’s UCLA Center for Health Policy Research have found that Californians with asthma who are from low-income families have more frequent symptoms, end up in the emergency department or hospital more often, and miss more days of work and school than those in higher-income brackets. Analyzing data from the center’s California Health Interview Survey (CHIS), the researchers reported that of the more than 600,000 Californians experiencing frequent (daily or weekly) symptoms, 32 percent of adults were from families earning less than 200 percent of the federal government’s poverty standard – amounting to $41,300 for a family of four at the time of the study.

Low-income children missed twice as many days of school due to asthma as children from higher-income families. The research team was headed by Dr. Ying-Ying Meng, senior research scientist at FSPH’s UCLA Center for Health Policy Research and co-director of the center’s Chronic Disease Program.

Other research has similarly shown that racial and ethnic minorities as well as low-income Californians suffer disproportionately from asthma attacks and asthma-like symptoms. What accounts for the differences? In a 2013 study funded by the California Air Resources Board, Meng and her FSPH colleagues sought to determine whether the disparity in the asthma experience has to do with low-income populations’ greater vulnerability (including such factors as lack of access to quality health care and the existence of other chronic conditions), or to exposure to higher

levels of air pollutants. The answer was both.

Linking CHIS data to existing air pollutant and traffic data, the Fielding School team found that low-income populations and racial and ethnic minorities (including Latinos, African-Americans, and Asian/Pacific Islanders) were exposed to greater levels of certain air pollutants, including nitrogen dioxide and particulate matter; in turn, they suffered increases in asthma-related difficulties. “These populations are more likely to live near heavy-traffic freeways and in areas where there are industrial pollutants,” says Meng.

But Meng’s group also found that even when low-income and minority populations experienced the same exposure levels as higher-income populations, they had higher rates of asthma-related symptoms, emergency department visits and hospitalizations. “Many factors

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are involved,” Meng says. In addition to issues of access to quality care, she notes that low-income populations may be more likely to experience other environmental triggers such as exposure to secondhand smoke and substandard housing conditions, including the presence of mold and lack of insulation.

Gretchen Bandoli, an FSPH doctoral student in the Department of Epidemiology, has similarly found that even when taking into account air pollution exposures, adolescents in stressful environments are more likely to suffer from reduced lung function, a predictor of asthma. While previous studies have associated both air pollution and psychosocial stressors with reduced lung function in children and adolescents, Bandoli’s was among the first to account for both factors in the same model – enabling her to assess the impact of each on its own. She has found that higher exposure to certain air pollutants is associated with reduced lung function, but

so are psychosocial stressors such as the absence of a father in the house and the perception of family conflict, particularly in older male adolescents. “Studies are increasingly showing that psychosocial stressors to children and adolescents can be detrimental to many of their health outcomes, including something as objective as a lung-function measure,” Bandoli says.

For Meng, the understanding that both environmental and psychosocial factors are contributing to disparities in asthma-related problems begs the question of what can be done to improve outcomes for the most vulnerable populations. “We need to do more at the policy level, from not building low-income housing near freeways and improving housing conditions to reducing traffic-related emission exposures,” she says. “Asthma has the potential to be debilitating, but it can be effectively controlled through appropriate medical care and avoidance of triggers.” •

Banerjee and his colleagues used their models to demonstrate that ozone’s effects are seasonal – while levels may be higher in the summer, the impact on asthma hospitalizations is more pronounced in the winter.

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MAKING SENSE OF ASTHMA-RELATED HOSPITALIZATIONS Using geographic information system technology to show patterns by place and time in California, the Fielding School’s biostatistics chair provides an invaluable tool for hospital administrators and epidemiologists.

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HE DATABASE OFFERED FOR ANALYSIS by a California state health official to Dr. Sudipto Banerjee, then a professor at the University of Minnesota, represented a potential treasure trove of information for hospital administrators and epidemiologists: the records of asthma-related hospitalizations from each of California’s 58 counties, collected daily from 1991 to 2008.

But as with many of the complex data sets tackled by biostatisticians, this one was “messy.” Daily records from multiple hospitals are considered too unwieldy and error prone for rigorous statistical analysis. So Banerjee, now professor and chair of the Department of Biostatistics at the Fielding School, proposed to work with his colleagues to create something new in the era of geographic information systems (GIS) – a method to aggregate the hospitalization data by month, per county, over the 18-year period, then convert to rates per 100,000 residents, as a way to better understand spatial and temporal patterns up and down the state.

The result is a series of models created by Banerjee and his colleagues – Dr. Harrison Quick, now at the Centers for Disease Control and Prevention; and Dr. Bradley P. Carlin, professor and head of the Division of Biostatistics at the University of Minnesota School of Public Health – that can be used to predict hospitalization rates in any county for any day of the year. The models incorporate socio-demographic variables (taking into account that children and African-Americans, for example, have disproportionately high rates of asthma attacks), environmental factors (including ozone data from the California Air Resources Board), and seasonal patterns.

The spatial and temporal trends can be visualized using GIS maps of the state, with rates color-coded by county.

By showing when spikes in hospitalization tend to occur within each county, Banerjee’s work enables hospital administrators to better prepare for the influxes by adjusting staffing levels accordingly. While the vast majority of counties’ hospitalizations are fewer than 20 per 100,000 residents per month, the range extends from zero to as high as 90.

Equally important, the models can be used by epidemiologists and other public health professionals to learn more about the environmental and seasonal factors associated with asthma exacerbations, potentially pointing the way toward preventive measures. “For hospital planners the key question is ‘when,’ ” says Banerjee. “For epidemiologists, it’s more about ‘why.’ These models provide epidemiologists with tools to map spatial patterns that are more reliable than mapping raw data, so that they can see how these patterns evolve over time.”

Showing asthma hospitalizations by time and place at a much higher resolution than was previously possible, Banerjee’s group has provided a tool for revealing previously inaccessible details. For example, although efforts to associate asthma incidence and ozone levels may not produce statistically significant results, Banerjee and his colleagues used their models to demonstrate that ozone’s effects are seasonal – while levels may be higher in the summer, the impact on asthma hospitalizations is more pronounced in the winter. At the Fielding School, Banerjee plans to continue monitoring asthma hospitalization rates to see whether the trends his group has observed persist. He also intends to apply the models to other diseases, such as certain types of cancers.

Advances in GIS technology have led to a burgeoning of spatial-temporal databases and the need for statisticians and data analysts with expertise in modeling and analysis to assist professionals in making sense of them.

For Banerjee, the work is particularly meaningful. Growing up in Calcutta, India, he suffered from asthma, as did both his paternal grandmother and paternal grandfather. “I have a young son, and would certainly not want him to experience what I did with this condition,” Banerjee says. “It’s rewarding to be able to contribute something that may help to prevent some of these problems in the future.” •

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watch video ph.ucla.edu

Below and left: The model Dr. Sudipto Banerjee created with his colleagues reveals when spikes in asthma hospitalization tend to occur within each California county.

INTERNATIONAL PARTNERSHIP

16 Photo by Nathan Dappen / Day's Edge Productions

SPRING/SUMMER 2015 UCLA FIELDING SCHOOL OF PUBLIC HEALTH

Natural Resources As international organizations seek to reduce deforestation in the face of climate change, an FSPH team is providing a model for considering the health of both the forest and its longtime inhabitants.

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PPROXIMATELY A BILLION PEOPLE

around the world are dependent on forests for their livelihood and daily sustenance, including countless indigenous and highly vulnerable populations. But in the face of development, climate change and deforestation, many of the world’s forests and the populations that depend on them are being threatened. While forest conservation is a worldwide priority, these programs have the potential to make matters worse for the local populations that rely on them – leading to a phenomenon known as “conservation refugees,” in which indigenous populations that have lived in the forest for centuries are forced to leave their homes, livelihoods and cultures behind in the name of forest conservation.

“Many indigenous populations have been negatively affected by the historical perspective that people and ‘pristine’ forests are independent of one another,” says Savanna Carson, a Fielding School PhD student in the Department of Environmental Health Sciences. “In fact, the opposite is true – these populations often have sustainable livelihoods and a deep expertise in forest dynamics. They are part of the ecosystem and should be widely incorporated, not excluded or alienated, in conservation management.”

Carson entered the Fielding School doctoral program with an interest in exploring what constitutes effective and sustainable international assistance in the face of climate change. Dr. Hilary Godwin, her faculty adviser, told her about a proposed United Nations Reducing Emissions from Deforestation and Forest Degradation (UN-REDD+) program to be situated in southern Cameroon, which would focus on conserving critical forests in the Congo Basin.

Godwin’s concern was that these forests are also home to the Baka, the largest indigenous population in Cameroon.

The Baka (or “forest people”) have traditionally lived as hunter-gatherers, maintaining their own language and living sustainably in the forests of the Congo Basin. The question for potential study: How can public health professionals work together with conservationists to ensure that the needs of people and the environment are both considered when new conservation programs are implemented?

Together with Godwin and Brian Cole (DrPH ’03), adjunct assistant professor in Environmental Health Sciences and program manager and lead analyst for the Fielding School’s Health Impact Assessment Group, Carson has embarked on a project that aims to use the health

impact assessment (HIA) as a tool to both quantify the health impacts of the proposed REDD+ project in Cameroon and engage the Baka and other local stakeholders in critical decisions about how the program will be implemented. Using health as a metric shifts the conversation from one that focuses on economic outcomes to one that focuses on the well-being of local populations. And by engaging local stakeholders in the process early on, the program is more likely to achieve its conservation goals and be sustainable in the long run.

“In the past, we’ve seen a disconnect between concerns about protecting the environment and efforts to ensure that the rights of indigenous populations are also protected,” says Godwin, professor of environmental health sciences and associate dean for academic programs at the Fielding School. “HIA provides a methodology that allows for a more systematic approach to balancing conservation concerns with people’s health concerns.”

HIAs have been used increasingly within public health to inform decision-makers about the health implications of potential policies or programs. But Cole, who has conducted HIAs and provided technical assistance on their use in policies and projects that include living-wage ordinances, urban redevelopments, school programs, and transportation initiatives, notes that this is among the first uses of the HIA in an international setting. “With this project, we’re saying that health is a valuable lens to look at how the local people will see the potential benefits of the policy options and how certain policies might harm them,” he says.

Last summer, Carson, Godwin and Cole partnered with FSPH adjunct assistant professor Kevin Njabo and a local Cameroonian student and spent several weeks interviewing an indigenous population in four villages, as well as staff at health clinics, in and around the northern region of the Dja Reserve, a proposed UN-REDD+ conservation site in Cameroon. The pilot study conducted by the Fielding School team was designed to obtain baseline information on the current health conditions and challenges facing local populations; how they are affected by deforestation and resource exploitation (e.g., logging and mining activities); and how a REDD+ program could protect both the forest and their health.

“With this approach, we are taking a broad perspective on health,” says Cole. “It means the totality of physical, mental and social well-being; it includes their ability to

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Opposite page: Indigenous Baka villagers of the Dja Reserve, a rainforest in Cameroon. The Baka have lived sustainably in the forests of the Congo Basin for thousands of years.

“In the past, we’ve seen a disconnect between concerns about protecting the environment and efforts to ensure that the rights of indigenous populations are also protected.”

—Hilary Godwin

make a living so that they can feed their children, house their family and have access to education; and it includes access to clean drinking water, good food sources, and health and social services.”

Above Left: UCLA and Cameroon students working together at a training workshop focusing on biodiversity and data management. Right: Dr. Hilary Godwin with Benjamin Mboundji, a Baka villager.

The Intergovernmental Panel on Climate Change has estimated that deforestation and forest degradation (through activities such as agricultural expansion, infrastructure development, fires, and logging) contribute close to 20 percent of the overall greenhouse gases entering the atmosphere. UN-REDD was established in 2008 to offer financial incentives for low-income countries to help maintain their forests as carbon sinks.

In recognition of the impact such actions could have on the local populations – potentially relocating indigenous populations into urban areas to the detriment of their health, culture, and way of life – the REDD+ program is aimed at promoting sustainable management of forests in ways that benefit the forest-dependent populations at the same time that they are contributing to reductions in greenhouse gas emissions.

The FSPH team is committed to making sure forest-dwelling indigenous populations are recognized and included in future forest policies and programs. “There’s a growing awareness that local and indigenous populations should be at the table in formulating these policies, but recent projects that tried to benefit these populations have solely focused on economic development, such as paying them for ecological services,” says Carson. “This is in opposition to what these populations need, want, and encompass in their traditional lifestyles. If you talk to people in the population, they will tell you they don’t care about money; their way of thinking is in the forest.”

The HIA is designed to be an inclusive process, and 18

it provides UN-REDD+ programs with a methodology for ensuring the social safeguards they are intended to provide. As part of its pilot study, the Fielding School-led group spelled out the potential positive health impacts of policies that ensure forest resource rights for local populations, investment in maternal and child health programs, improving access to clean water, and developing sustainable job creation programs. Most importantly, the team noted, the indigenous population should be at the forefront when decisions are made that affect their future and livelihood.

“We’re very concerned about the Baka, a vulnerable population,” says Godwin. “And, more broadly, we are hoping to demonstrate a way to introduce public health concerns into the dialogue about how to create conservation programs that have multiple benefits, including co-benefits for local people.”

In her interviews with Baka families, Carson heard firsthand about the needs of a population devastated by easily preventable health problems. Like many indigenous populations, Carson says, the Baka stand to benefit from an investment in their health and well-being – and from a new comprehensive approach to forest conservation policy – but they deserve to have a say in how those policies and programs are developed and implemented.

“Indigenous populations are especially vulnerable because of cultural differences and language barriers that leave them misunderstood,” Carson says. “Yet, they know better than anyone about which traditional medicines come from which trees, or which animals have disappeared recently. Working with them to develop these policies is the right thing to do from both a human rights and a conservation perspective.” •

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HEALTH IMPACT ASSESSMENT

SAVING WISELY Water-conservation strategies are essential in drought-stricken California, but decisions must be made through the lens of public health.

As California adopts increasingly aggressive water-conservation measures in the face of a severe drought, a Fielding School faculty member warns that such policies can have unintended and potentially harmful consequences on the health of the state’s residents.

Brian Cole (DrPH ’03), adjunct assistant professor in the Department of Environmental Health Sciences and program manager/lead analyst for FSPH’s Health Impact Assessment Group, says draconian water rationing and escalating water prices in response to the crisis could have severe implications for lower-income Californians, especially those who already have cut back on all but the most essential water uses.

Last year, a Fielding School team headed by Cole issued a health impact assessment (HIA) offering short- and long-term recommendations for urban water conservation strategies to protect and promote public health. The HIA concluded that any plan should be based on a “quadruple bottom line” – assessing the amount of water it saves, the amount of greenhouse gas emissions it creates, cost, and impact on local health. Among the potential health impacts: Physical Inactivity: Cole notes that if cities stop watering public parks, valuable green space – already in short supply in many low-income communities – could be lost. By making outdoor exercise less appealing, this could have an unintended health consequence.

Hotter Temperatures: In some areas, the urban heat island effect (in which a city is hotter than surrounding areas as a result of human activity) could be worsened if

vegetation isn’t sufficiently watered and trees are lost.

Poorer Air Quality: Switching to water sources that generate more energy to pump or treat water, such as desalination plants and long-distance aqueducts, could increase emissions, adversely affecting air quality.

Economic Hardships: Sharp increases in the cost of water to the consumer as a result of the scarcity could also disproportionately affect low-income communities. “For a household that’s barely making ends meet, a sudden rise in the price of water can be significant, and financial difficulties can lead to health problems,” Cole says.

Given that low-income families are already more likely to have low water use, he explains, these households would benefit from a tiered pricing structure that charges significantly more for high-volume use while keeping rates for low-volume use in check.

Pursuing the right mix of water conservation measures can actually bring health benefits, Cole points out. He is currently working with an FSPH doctoral student, Sharona Sokolow, to study the long-term effects of water recycling. In addition to being more sustainable, the strategy could reduce the state’s carbon footprint and improve air quality by cutting back on the energy currently required to import water.

The bottom line, Cole argues, is that given long-term climate projections, expected population growth and the projected depletion of water reserves, California needs to prepare for the long haul. “The longer we delay meaningful action, the more severe the consequences will be when we are faced with no other choice,” Cole says. “We can’t lose sight of the fact that if we run out of this valuable resource it’s really going to harm people’s health.

Looking at it through that lens will help us to make wiser decisions.” •

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The Fielding School’s health impact assessment concluded that any plan should be based on a “quadruple bottom line” – assessing the amount of water it saves, the amount of greenhouse gas emissions it creates, cost, and impact on local health.

STUDENT PROFILES

Exposed to the Elements They were born thousands of miles apart and raised in different cultures, but Ana Mascareñas and Teni Adewumi both saw toxic environments affecting their communities and are now determined to make things right.

ANA MASCAREÑAS:

R AISED IN NEW MEXICO by a family that included three generations of California farmworkers, Ana Mascareñas grew up with a clear understanding of the harsh conditions farmworkers faced – be it from labor exploitation, heat stress, or exposure to potentially dangerous pesticides. “My mom instilled in me the belief that we all deserve a healthy environment, including people who work hard every day to make sure we have the services and food we need,” Mascareñas says. “She set me on my career path, although I didn’t know I would end up working on these issues so directly.”

From 2008 to 2013, Mascareñas worked for Physicians for Social Responsibility-Los Angeles, ultimately as policy and communications director. As one of only five staff members for the nonprofit environmental health organization, she was charged with informing the medical community and policy makers about toxic

threats, promoting safer practices, and assisting community-based organizations in their efforts to engage in public health and environmental advocacy.

“Being part of conversations with experts on toxic exposures was eye-opening,” Mascareñas says. “These exposures affect everyone, but there is a lot of evidence that low-income and communities of color bear the highest burden because of where they tend to live and work.

People who are exposed to toxic chemicals in the workplace and in their communities understand that this is a major concern, but even in the face of compelling evidence, translating those concerns into health-protective policies is a challenging task that takes a lot of focused people committed to staying up on the science and communicating with the media and decision-makers.”

Mascareñas did her part, with considerable success.

Most notably, she helped to coordinate a statewide coaContinued on page 22

After delivering a guest lecture on environmental health advocacy to FSPH students, Ana Mascareñas decided to pursue a master’s degree at the school.

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TENI ADEWUMI:

WHEN TENI ADEWUMI landed an occupational health and safety internship at the Santa Ana, CA, medical manufacturing plant of the Fortune 500 company Medtronic, she thought it would be for three months.

Adewumi stayed on for a year and a half, falling in love with the task of ensuring a safe working environment.

Born in Lagos, Nigeria and heavily influenced by her mother, a registered nurse, Adewumi says that her return visits to her native country only reinforce her current interest. “There is an important intersection between our environment, our work, and our health,” she says.

“That is what drew me to this field.”

With the encouragement of her mentor at Medtronic, Lisa E. Hong (MPH ’01), Adewumi decided to pursue her MS in industrial hygiene at the Fielding School where, through the nationwide Occupational Health Internship Program and the UCLA Labor Occupational Safety and Health (UCLA-LOSH) program, she began working last summer with the South Los Angeles-based nonprofit organization Black Women for Wellness on its Healthy Hair Initiative project. The project aims to raise awareness of the potential adverse health effects associated with certain products used at beauty salons in the African-American community, and to empower professionals and patrons to advocate for a healthier workplace.

“This is an industry that isn’t regulated, and many of the products include ingredients that are known to be possible carcinogens, endocrine destructors, or allergens,” Adewumi says. “These professionals are exposed both from using the products on themselves and from using them on their clients.”

Adewumi and another UCLA-LOSH intern, Esmeralda Ponce, have visited beauty salons in Inglewood and South Los Angeles, surveying workers to learn more about their occupational exposures and health concerns while compiling a list of some of the most frequently used products to determine what potentially harmful ingredients are being used. In focus groups involving the beauty care workers and consumers, they have gauged the interest in moving toward healthier hair salons with greener products.

The surveys have revealed the need for more education about health risks and the use of proper protective equipment. Adewumi found high rates of poor reproductive health outcomes among the workers, including miscarriages and uterine fibroids – outcomes that have been linked in research with the use of hair relaxer products. She heard horror stories of stylists who no longer

Teni Adewumi developed a passion for ensuring a safe working environment during her internship at a medical manufacturing plant. With the encouragement of her mentor, an FSPH alum, she enrolled at the Fielding School for her MS in industrial hygiene.

Continued on page 22

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ANA MASCAREÑAS:

lition of more than 20 public health, firefighter, environmental, and consumer advocacy groups in a successful fight to revise California’s flammability standard to eliminate the use of toxic flame-retardant chemicals in furniture products. A 1975 California law requiring that manufacturers load furniture foam with large amounts of flame-retardant chemicals had become the de facto national standard, but the chemicals had been shown to cause cancer and reproductive problems. Mascareñas was featured in interviews and coalition-work activities for the 2013 HBO documentary “Toxic Hot Seat,” which depicted the long and successful struggle against wellfunded industry opposition.

“I really enjoyed collaborating with Ana,” says Dr. Arlene Blum, an environmental health scientist and executive director of the Berkeley, CA-based Green Science Policy Institute, who worked closely with Mascareñas to engage communities, scientists, media, and others on the issue. “Ana is a very caring and talented young woman with the leadership skills and character to contribute to large and positive changes for public health and environmental justice.”

Among the many environmental health scientists Mascareñas regularly consulted with in her work at Physicians for Social Responsibility-Los Angeles were two Fielding School faculty members, Drs. Richard Jackson and Hilary Godwin. In 2012, Godwin invited Mascareñas to deliver a guest lecture on environmental health advocacy for one of her courses. Interacting with Fielding School students and talking with Godwin convinced Mascareñas that she wanted to pursue a master’s degree at the school.

By the time Mascareñas returned a year later to speak to a new group of Godwin’s students, she had applied to be a student at the school. The same day she gave her lecture, Mascareñas learned that she had been admitted as part of the fall 2013 class. This spring, Mascareñas was appointed by Gov. Edmund G. Brown Jr. to serve as assistant director for environmental justice at the California Department of Toxic Substances Control. •

TENI ADEWUMI:

Adewumi is working with Black Women for Wellness to raise awareness of the potential adverse health effects associated with certain products used at beauty salons in the African-American community.

Mascareñas helped to coordinate a statewide coalition in a successful fight to revise California’s flammability standard to eliminate the use of toxic flame-retardant chemicals in furniture products.

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had fingerprints after working with certain chemicals, as well as stylists coming down with respiratory disorders from inhaling the product fumes.

Adewumi is now participating in an effort to train interested stylists in the use of proper protective equipment, ensuring proper ventilation, and moving toward the creation of greener salons. She is also part of a push to pilot a Healthy Hair Salon program, starting in the City of Inglewood. Working with the California Healthy Nail Salon Collaborative, which is led by three Fielding School alumni and has established a Healthy Nail Salon program (see the autumn/winter 2014-15 issue of this magazine), Adewumi and her Black Women for Wellness colleagues are surveying consumers; they hope to build partnerships with members of the Inglewood City Council, and plan to approach salon owners to seek enrollment.

Black Women for Wellness executive director and founder Janette Robinson Flint explains that beauty salon workers are being targeted for education both because they are vulnerable to toxic exposures and because they can be powerful community ambassadors.

“Everyone knows these beauticians and hair stylists inside of African-American communities,” she says. “If this group of professionals is empowered to share health knowledge, it has the potential to disseminate widely inside of our community.”

Of Adewumi’s contribution to the project, Robinson Flint adds: “Teni is ‘the ground troops.’ She is the one going from salon to salon asking questions, providing information, analyzing and acting on the data. Without her, this is all just theory.”

As she continues to pursue her MS at the Fielding School, Adewumi has stayed on as a staff member at Black Women for Wellness to see the work through.

“Growing up I spent countless times in salons without ever thinking about the fact that the chemicals being used could cause health problems, and so did my family and friends,” she says. “It’s been a great experience to be able to work with some incredible women to try to improve their conditions.” •

SPRING/SUMMER 2015 UCLA FIELDING SCHOOL OF PUBLIC HEALTH

COMMUNITY ENGAGEMENT

ROOM TO BREATHE With smoking increasingly prohibited in public places, a Fielding School-led coalition is bringing together Los Angeles apartment owners and their tenants in an effort to address the harmful effects of secondhand tobacco smoke exposure where people live.

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UBLIC HEALTH EFFORTS in California over the last two decades have succeeded in clearing the air of tobacco smoke in the workplace, in restaurants and bars, and in most other public places. But for those who reside in multi-unit apartment complexes, the home is not always a smoke-free zone – even if they want it to be, and even if their health suffers as a result.

With a $3 million federal grant from the U.S. Centers for Disease Control and Prevention (CDC), the Fielding School’s UCLA Center for Health Policy Research is leading an initiative to change that reality for low-income Latino and African-American families living in the City of Los Angeles. The Fielding School team, in partnership with the grassroots group Smokefree Air for Everyone (S.A.F.E.) and a host of other public- and private-sector organizations, is spearheading a comprehensive community action plan to reduce exposure to smoking in Los Angeles apartment buildings where there is a high density of low-income Latino and African-American families – two groups at particularly high risk of suffering the effects of secondhand smoke exposure.

The effort, which works with landlords and tenants to facilitate voluntary non-smoking policies while increasing the opportunities for smokers to access smoking-cessation services, is part of the federal Racial and Ethnic Approaches to Community Health (REACH) initiative in support of public health efforts to reduce chronic diseases, promote healthier lifestyles, reduce health disparities, and control health care spending.

“You shouldn’t be exposed to a known health risk just by virtue of where you live,” says Dr. Steven P. Wallace, professor and chair of the Fielding School’s Department of Community Health Sciences, associate director of the UCLA Center for Health Policy Research and principal investigator on the REACH grant. “This project is designed to make the home a safe and healthy place for some of the most vulnerable populations in Los Angeles.”

The Fielding School-led initiative is focused on parts of the city with the greatest need. “These are areas with high rates of chronic diseases and respiratory conditions, and where options for housing are limited,” says Peggy Toy, director of the UCLA Center for Health

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Policy Research’s Health DATA (Data, Advocacy, Training, Assistance) program and director of the REACH project. Toy notes that in Los Angeles, 56 percent of Latino households and 54 percent of African-Americans reside in multi-unit buildings.

The CDC estimates that 2.5 million nonsmokers have died from health problems caused by exposure to secondhand smoke since 1964, the year of the U.S. Surgeon General’s landmark report on smoking and health. For adults who have never smoked, secondhand smoke can cause heart disease, lung cancer and stroke. For children, exposure has been linked with ear infections; more frequent and severe asthma attacks; and respiratory symptoms such as coughing and sneezing, shortness of breath, bronchitis, and pneumonia. Secondhand smoke exposure has decreased over time in the U.S. population amid declining smoking rates, more states and communities enacting laws banning smoking in public places, and changing social norms around the acceptability of lighting up around nonsmokers. But tenants of apartment complexes and other multi-unit housing remain vulnerable to tobacco smoke traveling through walls, windows and electrical fixtures.

IN HER WORK as associate director of S.A.F.E. from 2004 to 2013 and now as REACH project manager, Marlene Gomez (MPH ’11) has encountered the frustration of tenants who are bothered by the smoke drifting into their unit but feel powerless to do anything about it. “Often, they don’t know how best to address the issue with their landlords or they are concerned about whether they have a right to complain,” she says. In other instances, Gomez notes, tenants find they cannot obtain protection from drifting secondhand smoke because they live in properties that are under rent control in the City of Los Angeles. The rent control law prohibits landlords from making changes to existing leases, so if the non-smoking provision isn’t already included in the lease, the landlord may be unable to protect the tenant from the secondhand smoke infiltrating the unit. “It can become Previous page: a nightmare for those who can’t afford to live in a At Skyline Vilsingle-family home and find that it’s not feasible lage, a smoketo just get up and move,” Gomez says. free affordIn addition to engaging tenants, the REACH able housing project makes the case to apartment owncomplex in ers about the economic advantages of going Downtown smoke free – including potential discounts Los Angeles: on insurance and reduced maintenance costs.

Esther Schiller While many are aware of these benefits, they (left), founder are concerned with protecting tenants who do of Smokefree smoke and uncertain about how to implement Air for Everysmoke-free policies without violating existing one, who is lease agreements, Gomez says. lead strategic Rather than promoting a combative enviconsultant on ronment, the REACH project seeks to bring the Fielding together tenants and landlords. “Our aim is to School-led educate and facilitate the adoption of smokeeffort; and free housing practices and policies in a way Marlene Gomez that preserves tenancy and enables people (MPH ’11), who who do smoke to access the services they need serves as projto quit,” Toy explains. ect manager.

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Following the approach of the UCLA Center for Health Policy Research’s Health DATA program, the Fielding School team provides the resources, expertise and training to build the capacity of partner organizations to successfully carry out the initiative.

For example, CD Tech Community Development Corporation, a nonprofit organization based in South Los Angeles, is assisting with tenant education. The Los Angeles Unified School District’s Student Health and Human Services division is conducting home visits to families of students vulnerable to secondhand smoke because of asthma and other conditions. The Apartment Association of Greater Los Angeles offers technical assistance and outreach to landlords who want to go smoke free, while the Oakland-based law and policy group ChangeLab Solutions is tailoring educational seminars for apartment owners on implementing smoke-free practices within the law. Other partners working with FSPH include the Los Angeles County Department of Public Health, David Geffen School of Medicine at UCLA, USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, and American Lung Association in California.

ESTHER SCHILLER was a middle school teacher in the Los Angeles Unified School District in the late 1980s when she began to realize that the asthma attacks she was experiencing on the job were related to the tobacco smoke she was inhaling. At the time, the district had no policy against teachers smoking; some smoked in their classrooms, others used a bathroom on the first floor, sending smoke wafting up the stairs and into Schiller’s classroom directly above. “I was breathing tobacco smoke, and at first I didn’t know it,” Schiller says. By the time she did, Schiller was on her way to being diagnosed with chronic obstructive pulmonary disease.

After receiving a settlement from the Los Angeles Unified School District in 1992 in a well-publicized workers’ compensation case stemming from her exposure to secondhand tobacco smoke as a middle school teacher, Schiller founded S.A.F.E. as a community-based effort to ban smoking from California workplaces. But following the passage of laws that made the state’s restaurants and bars, as well as all workplaces, smoke free, S.A.F.E. began getting calls from people who lived in apartment and condominium complexes. “They were now breathing clean air at work and in restaurants, then returning to their own homes and having to breathe their neighbor’s tobacco smoke,” Schiller says.

When S.A.F.E. began to focus on promoting smoke-free environments for people living in multi-unit buildings more than a decade ago, the effort was met with skepticism. “We were told you couldn’t tell people they couldn’t smoke in their homes,” Schiller recalls.

“But we were hearing from residents whose health was affected by the smoke drifts, and we knew this needed to be addressed.”

Now Schiller is serving as lead strategic consultant to the Fielding School’s REACH project, an effort that’s larger than anything she could have imagined when she first took up the cause. Marlene Gomez, the FSPH alum who once worked with Schiller at S.A.F.E., and has reunited with her as project manager for the REACH initiative, believes the time is right. “Communities across the nation are taking this on,” she says. “The momentum is on the side of protecting the health of people where they live.” •

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In children, secondhand tobacco smoke exposure has been linked with ear infections; more frequent and severe asthma attacks; and respiratory symptoms such as coughing and sneezing, shortness of breath, bronchitis, and pneumonia.

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CHANGING OUR ENVIRONMENT

HEALTHY BY DESIGN As evidence of the built environment’s impact on physical activity and quality of life continues to mount, Fielding School experts are leading wide-ranging initiatives to change the urban landscape.

WHEN DR. RICHARD JACKSON speaks to groups of developers, landscape architects, city planners and others making decisions about land use in cities across the United States, he explains that whether they realize it or not, their actions are vital to the public’s health.

“Many of them have more impact on people’s health than doctors,” says Jackson, a pediatrician and professor in the Fielding School’s Department of Environmental Health Sciences. “As physicians, we’re often at the end of the disease pipeline trying to undo the results of years of physical inactivity and unhealthy eating, much of which is influenced by the living environment.”

During his nine-year tenure as director of the National Center for Environmental Health of the U.S. Centers for Disease Control and Prevention, Jackson became a pioneering voice for the notion that the design of cities is a key determinant of the health of their inhabitants. Much was known about the important role of social determinants of health (including factors such as income and education), but Jackson noted that in many parts of the world people who were poor and had limited schooling tended to be healthier than those living in more affluent, better-educated U.S. communities with environments not conducive to an active lifestyle.

“Beginning in the 1950s, we emptied our cities, sprawled everyone across the landscape and became dependent on automobiles,” Jackson says. “Sitting in our cars rather than living

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in walkable cities has led to two of our biggest public health problems, obesity and stress. When I give talks in Los Angeles, people say their commute is the hardest part of their day. Not their job – their commute.”

Today, in addition to his FSPH teaching and research activities, Jackson frequently lectures, writes and consults on ways to make urban environments more aligned with public health goals – some of which he spelled out as the host/narrator of “Designing Healthy Communities,” a four-hour PBS series that first aired in 2011. But amid growing recognition that a well-designed built environment may hold the key to addressing some of the nation’s major public health concerns – from cardiovascular disease, diabetes, and other obesity-related conditions to asthma and depression – Jackson is far from alone.

At the Fielding School, across the UCLA campus, throughout Los Angeles and beyond, momentum is on the side of shaping the built environment in ways that promote active living, social engagement and economic growth.

“We’re in an exciting transition, where Los Angeles is moving away from the idea that we have to be a car-centric city and toward building communities that are healthy and sustainable,” says Tyler Watson, a doctoral student in the Fielding School’s Department of Environmental Health Sciences who worked with Jackson on “Urban River Parkways: An Essential Tool for Public Health,” a report for the Sacramento-based non-

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“Sitting in our cars rather than living in walkable cities has led to two of our biggest public health problems, obesity and stress.”

— Richard Jackson

profit Resources Legacy Fund on the public health benefits of connecting parks and other recreational spaces with residential and commercial centers in populated areas along rivers and other bodies of water.

“Public health education and interventions are definitely needed,” adds Watson, “but if you can influence the actual spaces where people live, work and play so that it becomes safe and appealing for them to be more active and not depend on their cars for every trip they make, that can have a huge impact.”

In the process of developing their report on the public health impacts of urban river parkways, Jackson and Watson became involved with the L.A. River Revitalization Corp., a nonprofit group working to catalyze sustainable land-use projects along a restored Los Angeles River. The group’s ultimate vision is of a 51-mile greenway corridor that would support many of the goals laid out in the Fielding School team’s report – vibrant communities along the river with ample green spaces, bike paths, trails, public art and thriving businesses. The City of Los Angeles has developed an L.A. River Revitalization Master Plan, and under an agreement between the city and the federal government, an initial 11-mile section of the river, stretching roughly from Griffith Park to Downtown Los Angeles, is now slated for a $1 billion restoration effort.

“There’s a lot of talk about the environmental and economic benefits of restoring urban rivers that have been concrete channels for decades, and we are helping to bring the public health argument into the discussions,” says Watson. “The L.A. River goes through parts of the city that lack convenient and accessible open spaces for physical activity and have some of the city’s highest rates of obesity and chronic disease. This is a natural resource that can be used not only for flood control, but also to 28

provide irresistible opportunities for active living, to the benefit of city dwellers.”

FUNCTIONAL SEPARATION is a term that describes

the conventional landscape of the U.S., particularly in suburban areas: large swaths of communities that are only residential, resulting in increased traffic as people are forced to use their cars to access commercial areas and get to work. It’s no coincidence, says Dr. Michael Jerrett, professor and chair of the Fielding School’s Department of Environmental Health Sciences, that this pattern of development starting in the second half of the 20th century has been accompanied by reduced physical activity and increased rates of obesity.

“Smart-growth communities are a response to the shortcomings of these conventionally designed communities,” says Jerrett. “They’re an effort not only to make the landscape denser and more walkable, but also to ensure that residents have easy access to attractive green spaces and recreational opportunities.”

More than a decade ago, as he saw the concept beginning to pick up steam, Jerrett applied for and received funding from the National Cancer Institute to test the hypothesis that a smart-growth community would promote more active lifestyles, leading to reduced obesity rates. For the study, children and their parents in a smart-growth community in the Southern California city of Chino and those in eight conventionally designed communities in the surrounding area were tracked for four years through geographic position and accelerometry technologies to determine physical activity and location information.

Publishing in the American Journal of Preventive Medicine in 2013, Jerrett’s group reported that children in the study’s smart-growth community participated in

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“Smart-growth communities are an effort to make the landscape denser and more walkable, [and] to ensure that residents have easy access to attractive green spaces and recreational opportunities.”

— Michael Jerrett

46 percent more moderate-to-vigorous physical activity within their neighborhood than children in the conventionally designed communities. Jerrett is also part of a large consortium that has conducted a number of studies in Europe and North America showing that improved access to well-maintained parks and recreational spaces adjacent to water is associated with increased physical activity and reduced body mass index levels in children.

The elements of a “healthy community” vary, but generally feature an infrastructure that supports active transportation – attractive sidewalks, safe-to-use bike lanes, reliable public transit; well-maintained and well-lit park spaces that promote multigenerational recreation; and a mix of land uses, including a vibrant combination of commerce and the arts to encourage foot traffic.

The most obvious benefit of such communities from a public health standpoint is the promotion of physical activity. An estimated 80 percent of U.S. adults fail to put in the minimum recommended amount of exercise (either 2.5 hours per week of moderate-intensity aerobic exercise, an hour and 15 minutes per week of vigorous-intensity activity, or a combination), according to the Centers for Disease Control and Prevention. But built environment experts at the Fielding School and beyond point to other important benefits. Creating an appealing shared space that brings people out for shopping, dining and strolling rather than keeping them confined in their cars not only helps local businesses to flourish, but also potentially increases civic engagement and social interaction. Walking, biking and public transportation reduce both noise and emissions from motor vehicle traffic, improving air quality. And improved quality of life, increased physical activity and more appealing surroundings all add up to reductions in stress, among other mental health benefits.

“EVEN MODERATE AMOUNTS of physical activity such as climbing the stairs at work or walking to the grocery store can make a huge difference in people’s health, and a well-designed city makes these active lifestyle options convenient and possible,” says Uyen Ngo (MPH ’13), who earned degrees from the Fielding School and UCLA’s Luskin School of Public Affairs Department of Urban Planning and now serves as a policy analyst for the Los Angeles County Department of Public Health’s Policies for Livable Active Communities and Environments (PLACE) program.

A recognition that the design of cities can play an important role in reducing chronic conditions and improving quality of life led the county public health department to establish PLACE in 2006. Featuring both a competitive grant-awarding process and direct technical assistance in low-resourced areas, PLACE works with cities to develop plans and/or policies that promote active lifestyles through engineering, programming and outreach. “If the streets are lively with attractive landscaping, lots of shops, wide sidewalks and good lighting, you get people away from a sedentary lifestyle and build a better sense of community,” Ngo says.

Ngo co-managed a direct technical assistance project with the City of Cudahy, located in southeastern Los Angeles County, on a “safe routes to school” plan to increase walking and biking among children through safety changes to the streets and sidewalks, collaborations with law enforcement to address concerns about crime and motor vehicle driver behavior, and training parents on developing programs such as supervised walking clubs for children. In a separate partnership with the City of Los Angeles and the Los Angeles County Bicycle Coalition, Ngo oversaw the development of the “Active Streets LA” toolkit, which educated

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This page, left to right: Uyen Ngo (MPH ’13) and MPH student Jimmy Tran at CicLAvia open-streets events. Opposite page, left to right: Farmer’s markets are a key feature of “healthy cities”; FSPH students install an herb garden in the courtyard of the UCLA Center for Health Sciences building.

community members on urban design options to create safer streets for pedestrians and bicyclists. PLACE has also provided funding for the nonprofit organization CicLAvia to hold open-streets events promoting physical activity in low-income cities in southeast Los Angeles where there are high rates of obesity and obesity-related chronic diseases.

Launched in 2008, CicLAvia has become a nationally recognized leader in “open streets” programs, in which a section of city streets is temporarily closed to vehicular traffic for events that promote walking and biking, local commerce, and community engagement. Inspired by a tradition that started 40 years ago in Bogotá, Colombia, CicLAvia has drawn hundreds of thousands of people to free events that are now held several times a year in various parts of Los Angeles. “The open streets movement is growing, and because it has been so popular here, many cities are looking to Los Angeles for lessons on how to emulate this model,” says Christina Batteate (MPH ’12), project manager in the Sustainable Technology and Policy Program (STPP), a joint venture of the Fielding School and UCLA School of Law that brings together multidisciplinary teams from the two schools and other parts of the UCLA campus to tackle environmental health problems through research and policy development.

Batteate has helped to spearhead STPP’s built environment efforts, working with Jackson, Jerrett, and Drs. John Froines and Brian Cole from the Fielding School as well as faculty members from the UCLA Luskin School of Public Affairs. The group, with Cole as the principal investigator, has been studying CicLAvia events to learn more about the types of people who are drawn to them, 30

the effect on physical activity and their level of interest in having such programs in their neighborhoods. “Our goal is to use this evidence to make recommendations for how to improve this process, while keeping in mind that this will serve as a case study to inform the open streets efforts of other cities,” Batteate explains.

The STPP built environment group is working with a variety of partners outside of UCLA, including CicLAvia and other community-based organizations as well as the L.A. Mayor’s Office and L.A. Department of Transportation. A project funded by the California Department of Transportation (Caltrans), also headed by Cole, is seeking to identify the best practices for plans to convert Caltrans-owned highways in urban areas into more livable streets. Batteate has also led an STPP effort to create a mobile phone application measuring walkability in cities. “We all share a vision of communities in which the environment supports healthy living – particularly in urban areas, since we live in one of the nation’s great mega-cities,” Batteate says. “As researchers at UCLA, we can provide evidence-based recommendations that might facilitate change in our local environment while serving as a model for large cities everywhere.”

JIMMY TRAN was drawn to the Fielding School in part

by Jackson’s leadership in promoting the public health benefits of well-designed communities. “It just made a lot of sense to me that with the problems we face involving obesity and chronic diseases, we need to look more closely at how the physical environment, including the transportation infrastructure, affects people’s health,” says Tran, who is working toward both his MPH in FSPH’s Department of Environmental Health Sciences

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and an MA in Urban Planning. Reflecting the growing recognition of the public health importance of urban planning decisions, the FSPH and UCLA Department of Urban Planning now offer a formal curriculum for students interested in pursuing the dual degree.

Tran serves as co-chair of the UCLA Built Environment and Public Health Council (BEPHC), a new student group that promotes research and education on the relationships between the built environment and public health. The group has hosted speakers and screened documentaries on issues related to healthy communities, as well as participating in National Public Health Week events. “This is serving to foster conversation and raise awareness,” Tran says. “A lot of students are very interested in how they can get involved academically and professionally in this field.”

Tran and other Fielding School students are finding many outlets to get involved close to home, not only through the BEPHC but also as part of the UCLA Healthy Campus Initiative, a campus-wide effort (under the leadership of Associate Vice Provost Wendy Slusser, a member of the Fielding School faculty) to promote healthy lifestyle choices and develop best practices that can be applied in other communities. The initiative includes a section on the built environment and health – both on campus and in the surrounding community – headed by Jackson, with active participation by many FSPH students.

Much of the focus has been on partnering with groups such as UCLA Transportation, UCLA Bike Shop, the campus architect and others to make walking and biking around campus safer and more appealing. The group has worked with local businesses and public officials on a

push to build protected bike lanes in Westwood Village and to promote a bike-sharing program for the campus and the village. Watson and other Fielding School students have also promoted an initiative, underway, to make the FSPH stairwells more visible and inviting as a strategy to encourage more physical activity among people who would otherwise opt for the elevators.

Any effort to fundamentally change the way communities are designed is bound to encounter some resistance. Jerrett notes that some developers hesitate to move away from profitable business models, and bylaws and planning regulations in many communities foster suburban sprawl as opposed to smart-growth concepts. But, he adds, governments can induce the types of changes that promote these concepts, and many are doing just that. In California, the Sustainable Communities and Climate Protection Act, signed into law in 2008, aims to reduce greenhouse gas emissions through coordinated transportation and land-use planning. As part of the law, municipalities are mandated to develop smart-growth plans that promote public transit and “complete streets” that serve the needs of pedestrians and bicyclists as well as cars.

Jackson, who has seen a dramatic increase in the popularity of ideas he began advancing 15 years ago, believes there is no turning back. “This wasn’t mainstream when we first started talking about it, but it has gained tremendous traction,” he says. “When people see the kind of lifestyle you can have in communities that take these common-sense measures to improve the physical environment, they are voting with their feet.” •

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more photos ph.ucla.edu

school work National Public Health Week 2015 at UCLA The Fielding School’s Students of Color for Public Health addressed the roots of health inequities in conjunction with National Public Health Week in April. The FSPH student group held activities and discussions across campus that examined the link between labor and health, explored efforts to mobilize communities for increased health care access, and, during the 2nd Annual Tour de UCLA, educated on the bikeability of the university and local neighborhoods. ✺

APPLE MOBILE APP TRACKS BREAST CANCER SURVIVOR EXPERIENCES

Water Filtration System

Dr. Patricia Ganz, FSPH professor of health policy and management and a pioneer in research on the quality of life for cancer survivors, helped launch Share the Journey: Mind, Body, and Wellness after Breast Cancer, a patient-centered mobile app that empowers women to be partners in the research process by tracking their symptoms and successes. Launched in partnership with Apple and Sage Bionetworks and developed by UCLA’s Jonsson Comprehensive Cancer Center, Penn Medicine, and the Dana-Farber Cancer Institute, the app aims to understand why some breast cancer survivors recover faster than others, why their symptoms vary over time, and what can be done to improve symptoms.

FSPH students spearheaded a campaign to have an environmentally conscious water filtration system installed in the UCLA Center for Health Sciences building, where the school is housed. The water station, in place since January, tracks the number of plastic bottles saved from landfills —more than 10,000 in the first four months.

Cooking Healthy

TEAM FSPH RACES TO HEALTH

In a series of cooking demonstrations in South Los Angeles, Fielding School student Jennifer Taylor (right), assisted here by FSPH student Lauren Wemple, shared plant-based, healthier alternatives to fatty foods with community members. The classes, held in partnership with L.A.-based nonprofit Esperanza Community Housing Corporation, were part of an FSPH initiative to support student-led projects in the community.

More than 30 Fielding School students, faculty members, alumni, staff and friends took part in the 2015 ASICS LA Marathon March 15 to raise money for summer fieldwork fellowships for public health students. ✺

✺ photos & video ph.ucla.edu

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SPRING/SUMMER 2015 UCLA FIELDING SCHOOL OF PUBLIC HEALTH

CLOSING THE GENDER GAP A WORLD Policy Analysis Center report in March revealed that more than 170 countries have legal barriers preventing women and girls from experiencing the same rights, protections, and liberties as men and boys.

WORLD’s data, which seeks to heighten global accountability and transparency, was featured in hundreds of media outlets around the world, including The Guardian, Newsweek, Washington Post, National Geographic, Forbes, and CNN.

Breslow Distinguished Lecture, Student Writing Competition, and Alumni Hall of Fame

2015 Ruth Roemer Symposium The Fielding School of Public Health Alumni Association presented Sarah Shannon with the 2015 Ruth Roemer Social Justice Leadership award, which recognizes community leaders advancing and protecting health in vulnerable populations. The award is named after the late Ruth Roemer, who contributed extensively to the fields of reproductive health services, environmental health, tobacco control, and more. As executive director of Hesperian Health Guides, Shannon has led work focusing on women’s health, disability, child development, primary care, and environmental health, creating resources now translated into more than 80 languages and distributed worldwide. ✺

Dr. Marjorie Kagawa-Singer, whose research focuses on the cause and elimination of disparities in physical and mental health care outcomes for communities of color, delivered the Fielding School’s 41st Annual Lester Breslow Distinguished Lecture in April. The annual event, held in honor of the former FSPH dean and renowned public health leader, included the induction of this year’s FSPH Alumni Hall of Fame members: Doris Browne (MD, MPH ’68), who has dedicated her life to prevention and education programs related to cancer, women’s health, HIV/AIDS and chronic diseases, and to enhancing participation of minority and underserved populations in clinical trials; Mario Ricardo Calderón (MD, MPH ’84), who has spent more than 25 years mentoring leaders in public health and international development in dozens of countries; and Fred Wasserman (DrPH ’76, MBA, MPH ’72), who co-founded one of the first federally qualified HMOs in the U.S., for which he served as CEO. The evening event also included presentations by the 2015 Breslow Student Writing Competition finalists: Lauren Harrell, Jacob Beckerman, Jennifer Taylor, Clint Hall, and Boback Ziaeian. Each finalist received $1,000 from the competition co-sponsor, Molina Healthcare, for their presentations on the most critical ways public health affects lives. A panel of judges selected Harrell and Beckerman as co-winners of the competition; each received a $5,000 prize courtesy of the Breslow Student Fellowship Fund and the Elias family. ✺

Jerrett Named Chair of Department of Environmental Health Sciences Dr. Michael Jerrett joined the Fielding School in January as chair of the Department of Environmental Health Sciences. Internationally recognized for his academic work, Jerrett was named to Thomson Reuters’ 2014 Highly Cited Researchers list, ranking him in the top one percent of cited scholars in the fields of the environment and ecology. His research includes exploring the long-term effects of air pollution on cardiorespiratory diseases and the contributions of built and natural environments to activity, behavior, and obesity. Prior to joining FSPH, Jerrett was a professor at UC Berkeley.

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faculty honors HONOR ROLL 2014 The UCLA Fielding School of Public Health is pleased to honor our alumni, friends, students, staff, and foundation and corporate partners whose generosity strengthens our school and keeps us at the forefront of public health education. Please visit ph.ucla.edu/ honorroll2014 to view the 2014 Honor Roll.

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For more information ph.ucla.edu

Patrick Allard was awarded the 2015 International ToxScholar Grant, the second time he has received this honor from the Society of Toxicology.

Sudipto Banerjee was elected as a Fellow of the Institute of Mathematical Statistics; awarded a Distinguished Achievement Medal for 2015 by the Section on Statistics and the Environment of the American Statistical Association; and will be the Presidential Invited Speaker at the 2015 Western North American Region of the International Biometric Society annual meeting.

Diana Bontá received a 2015 Hispanics in Philanthropy Giver Award and the 2014 Bronx Community College Alumni Leadership Award.

Ron Brookmeyer received the 2015 Nathan Mantel Lifetime Achievement Award from the American Statistical Association.

Richard Jackson received the 2015 Henry Hope Reed Award from the University of Notre Dame School of Architecture.

Marjorie Kagawa-Singer was selected as the 2015 Fielding School of Public Health Dean’s Distinguished Scholar and Lester Breslow Distinguished Lecturer; she also convened and led the Culture Research and Health Outcomes Panel for the National Institutes of Health’s Office of Behavioral and Social Sciences Research.

Snehendu Kar was invited to be a keynote speaker at the International Conference on Evidence Based Management 2015 by the Birla Institute of Technology and Science in Pilani, India.

Leeka Kheifets was elected to serve on the National Academy of Sciences Committees on Airport Passenger Screening: Backscatter Millimeter Wave Machines.

Paul Chung was elected chair of the Pediatric Policy Council, a national child health policy consortium of academic pediatric organizations.

Susan Kirby served as co-chair of the Society of Public Health Education’s Health Communications/Social Marketing Community of Practice, and also as guest editor for Social Marketing Quarterly.

Linda Delp received the American Public Health Association Occupational Health and Safety Section’s Alice Hamilton Award.

Gerald Kominski was appointed to the National Advisory Board of the Robert Wood Johnson Foundation Health Policy Center at Meharry Medical College.

Alina Dorian was named Educator of the Month by the Los Angeles Lakers organization for April 2015.

Vickie Mays was reappointed by the U.S. House of Representatives to serve a second term on the National Committee on Vital and Health Statistics.

Jack Needleman served on the Institute of Medicine Standing Committee on Nurse Credentialing Research and the IOM Committee for the Evaluation of the Impact of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health.

Beate Ritz was appointed to the National Academy of Sciences Committee on Incorporating 21st Century Science into Risk-Based Evaluations.

Linda Rosenstock was honored as a 2014 International Scholar by the Open Society Foundations.

Robert Schiestl was named 2015 Professional of the Year by America’s Registry of Outstanding Professionals.

Brennan Spiegel was selected to become co-editor-in-chief of the American Journal of Gastroenterology.

Catherine Sugar was elected as a 2015 Fellow of the American Statistical Association and is currently serving as president of the ASA Southern California chapter.

Nathan Wong received a 2014 Distinguished Fellowship Award from the International Academy of Cardiology and an Honorary Membership by the Academy of Nutrition and Dietetics.

bookshelf Recent books by UCLA Fielding School of Public Health authors: ASPC Manual of Preventive Cardiology

By Nathan D. Wong, Ezra Amsterdam and Roger Blumenthal Coming and Going: Poems and Songs of Rabindranath Tagore Translation and Images by Snehendu B. Kar

Diabetes and Cardiovascular Disease: Evaluation, Prevention & Management

By Nathan D. Wong and Shaista Malik Epidemiology of Electromagnetic Fields Edited by Martin Roosli, with contribution by Leeka Kheifets Essentials of Health Information Systems and Technology

By Jean A. Balgrosky

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Hierarchical Modeling and Analysis for Spatial Data, Second Edition

By Sudipto Banerjee, Bradley P. Carlin and Alan E. Gelfand Linear Algebra and Matrix Analysis for Statistics

By Sudipto Banerjee and Anindya Roy Oxford Textbook of Global Public Health, Sixth Edition Edited by Roger Detels, Martin Gulliford, Quarraisha Abdool

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Karim and Chorh Chuan Tan, with contributions by Sander Greenland, Richard J. Jackson, Leeka Kheifets, Robert J. Kim-Farley, Shira Shafir, Frank Sorvillo, Nathan D. Wong and Zuo-Feng Zhang Pharmaceutical Economics and Policy, 2nd Edition (Chinese translation)

By Stuart O. Schweitzer

2014-15 student awards Abdelmonem A. Afifi Student Fellowship Joanna Mimi Choi Health Policy and Management Agency for Healthcare Research and Quality Fellowship Karleen Giannitrapani, Andrea Morris, Deborah Sophie Snyder, Andrea Sorensen, Claire Than, Caroline Yoo Health Policy and Management American College of Toxicology (ACT) North American Graduate Fellowship Julie Castañeda Molecular Toxicology IDP American College of Toxicology (ACT) Student Travel Award Julie Castañeda Molecular Toxicology IDP American Industrial Hygiene Foundation 2015 Lawrence R. Birkner and Ruth K. McIntyreBirkner Memorial Scholarship Charlene Nguyen Environmental Health Sciences American Industrial Hygiene Foundation General Scholarship Katherine McNamara Environmental Health Sciences American Society of Safety Engineers James P. Kohn Memorial Scholarship Katherine McNamara Environmental Health Sciences Ann G. Quealy Memorial Fellowship Jennifer Paaske, Christine Tran Health Policy and Management Arco Fellowship Kevin Ng Mayra Rascon Health Policy and Management Breslow Student Writing Competition Grand Prize Lauren Harrell Biostatistics Jacob Beckerman Community Health Sciences Burroughs Wellcome Fund Inter-School Training Program in Chronic Diseases Yu-Hsuan Chuang, Kimberly Paul Epidemiology California Wellness Foundation Fellowship Jackie Leon, Vanessa Rodriguez, Elia Salazar, Devin Saragosa-Harris, Katelyn Tran, Claudia Vargas Community Health Sciences Ana Bonilla, Ana Mascareñas, Stephania Olamendi Environmental Health Sciences Joel Gonzalez, Jason Williamson Health Policy and Management

Carolbeth Korn Scholar Award Alice Villatoro Health Policy and Management Celia G. and Joseph G. Blann Fellowship Anne Fehrenbacher Community Health Sciences Geoffrey Hoffman Health Policy and Management Child and Family Health Program Fellowship Melissa Patao Community Health Sciences Rosana Chan, Allison Maxwell, Aleksandra Van Loggerenberg Health Policy and Management Clinical Translational Science Institute (CTSI) Training Grant Amy Bonilla, Natalie Bradford, Julian Brunner, Anna Davis, Sarah Friedman, Lauren Gase, Geoffrey Hoffman, Charleen Hsuan, William Boyd Jackson, Michelle Keller, Selene Mak, Narissa Nonzee, Andrew Siroka, Diane Tan, Linda Diem Tran, Joseph Viana Health Policy and Management David Satcher Opportunity Award Sonja Perryman Community Health Sciences Dean’s Continuing Student Opportunity Award Gabriel Pimentel Health Policy and Management Dean’s Continuing Student Recognition Award Ejiro Ntekume, Elia Salazar, Claudia Vargas Community Health Sciences Natalie Sanchez Health Policy and Management Dean’s Global Health Fellowships Emily Epsten, Jenese Girgis, Carla Hegwood, Angelica Jimenez, Ian MacKenzie, Amy Zaycek Community Health Sciences Allyn Auslander, Justin Chien Epidemiology Dean’s Leadership Grant Sophia Hur Biostatistics Laura Baetscher, Nadia Borchardt, Jesse Damon, Nancy GuerreroLlamas, Erin Manalo, Margot Markman, Melissa Medich, Taylor Schooley, Jacqueline Sun, Natalia Woolley Community Health Sciences Morgan Caswell, Noelle Watanabe Environmental Health Sciences Zuelma Esquivel, Chelsea Shover Epidemiology Danielle Andrews, Maria del Sol Rodriguez Avila, Ping Tseng Michelle Chen, Lucy Pagel, Nahal Sabrkhani, Stephanie Tepper, Diane Webber Health Policy and Management

Dean’s Outstanding Student Award Lauren Harrell Biostatistics Patience Afulani Community Health Sciences Sean Banaee Environmental Health Sciences Nicole Hoff Epidemiology Folasade May Health Policy and Management

Eugene Cota Robles Fellowships Brenda Robles Community Health Sciences Maureen McGuirk Sampson Molecular Toxicology IDP Courtney Coles Health Policy and Management

Delta Omega Honorary Society in Public Health, Iota Chapter Heidi Fischer, Jacob Konikoff, Shemra Rizzo Biostatistics Patience Afulani, Ana Blanco-Cortes, Rachel Brady, Jesse Damon, Anne Fehrenbacher, Ann Le, Erin Manalo, Margot Markman, Sonja Perryman, Goleen Samari, Jacqueline Sun Community Health Sciences Sean Banaee, Chitrada Kaweeteerawat, Jennifer Taylor, Noelle Watanabe Environmental Health Sciences Gretchen Bandoli, Angela Chow, Reena Doshi, Nicole Hoff, Jennie McKenney, Stephanie Reading Epidemiology Danielle Andrews, Catherine Chanfreau, Monica Gross, Ann Kelly, Allison Maxwell, Esmeralda Pulido, Diane Webber Health Policy and Management

Fielding School of Public Health Nonresident Scholarship Qian Li, Priscilla Yen Biostatistics

Delta Omega National Poster Competition Award Matt Beymer Community Health Sciences

Foster G. McGaw Scholarship Michelle Chen Health Policy and Management Fred H. Bixby Certificate on Population and Reproductive Health Melissa Medich, Melissa Papp-Green Community Health Sciences Fred H. Bixby Doctoral Fellowship in Population and Reproductive Health Gretchen Bandoli Epidemiology Fred H. Bixby International Internships on Population and Reproductive Health Irish Del Rosario, Amy Westermann Community Health Sciences Cathi Lee Epidemiology FSPH Global Health Certificate Amy Zaycek Community Health Sciences Allyn Auslander Epidemiology

Dissertation Year Fellowship Lauren Harrell, Shemra Rizzo Biostatistics Patience Afulani, Julia Caldwell, Anne Fehrenbacher, Goleen Samari Community Health Sciences Aolin Wang Epidemiology Geoffrey Hoffman Health Policy and Management

Future Public Health Leaders Award Jacob Beckerman, Jesse Damon, Nancy Guerrero-Llamas, Margot Markman, Melissa Medich, Alexandra Prince Community Health Sciences Carlos Barragan, Shijuan Bian, Larry Lai, Noelle Watanabe Environmental Health Sciences Rishi Das, Zuelma Esquivel, Evan Shannon, Chelsea Shover Epidemiology Danielle Andrews, Maria del Sol Rodriguez Avila, Nahal Sabrkhani, Diane Webber Health Policy and Management

Dr. Ursula Mandel Scholarship Hector Alcala Community Health Sciences Drabkin/Neumann Global Public Health Field Experience Ya-Wen Cheng, Zuelma Esquivel Epidemiology Ronald Del Castillo Health Policy and Management E. Richard (Rick) Brown Social Justice Award Marina Acosta, Anne Lattime Health Policy and Management

Graduate Opportunities Fellowship Natalie Dickson, Ashley Lewis, Tanya Moreno, Shayla Spilker, Maria Torres Reyes Community Health Sciences Carlos Barragan Environmental Health Sciences Marisol Arguelles Epidemiology

Eleanor J. De Benedictis Fellowship in Nutrition Natasha Adams-Young Community Health Sciences

UCLA FIELDING SCHOOL OF PUBLIC HEALTH SPRING/SUMMER 2015

Faucett Catalyst Fellowship Farah Abdi Epidemiology

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2014-15 student awards Albert Funes Health Policy and Management Graduate Research Mentorship Award Maria-Elena Young Community Health Sciences Bryan Moy, Tyler Watson Environmental Health Sciences Megan Claire Dillavou, Solomon Makgoeng Epidemiology Adriane Wynn Health Policy and Management Graduate Summer Research Mentorship Fellowship Evan Krueger, Subasri Narasimhan, Maria-Elena Young Community Health Sciences Bryan Moy, Tamanna Rahman, Tyler Watson Environmental Health Sciences Vivian Alfonso, Claire Bristow, Drew Westmoreland Epidemiology Tina Phan Molecular Toxicology IDP Adriane Wynn Health Policy and Management Health Policy and Management Alumni Association (HPMAA) Award Kevin Blansit, Claire Crawley Health Policy and Management Incoming Student Opportunity Award Tara Hitzeman Biostatistics Natalie Dickson, Amelia FayBerquist, Nicole Garcia, Elida Ledesma, Jackie Leon, Ashley Lewis, Andrea Lopez, Chelsea Santos, Sarah Smith, Maria Torres Reyes Community Health Sciences Syeda Azeemuddin, Rica Dela Cruz Epidemiology Joel Gonzalez, Amarachi Okoro, Nicole Porter, Janani Srikantharajah, Jason Williamson Health Policy and Management Joint Statistical Meeting 2015 Section on Bayesian Statistical Science Student Travel Award Heidi Fischer Biostatistics Judith Blake Memorial Fellowship Gretchen Bandoli Epidemiology Juneal Marie Smith Fellowship in International Nutrition Tabashir Sadegh-Nobari Community Health Sciences Los Angeles Sustainability Collaborative Research Fellowship Sharona Sokolow Environmental Health Sciences

Interdisciplinary Maternal and Child Health Training Program Joanna Mimi Choi, Kimberly Narain, Joseph Viana Health Policy and Management Max Factor Family Foundation Summer Internship Fund Tamara Marzouk Community Health Sciences Molina Healthcare Student Writing Competition Award Lauren Harrell Biostatistics Jacob Beckerman Community Health Sciences Jennifer Beth Taylor Environmental Health Sciences Clinton Hall Epidemiology Boback Ziaeian Health Policy and Management Monica Salinas Fellowship Stephania Olamendi Environmental Health Sciences Monica Salinas Internship in Latino and Latin American Health Logan Hitchcock, Stephania Olamendi Environmental Health Sciences Olivia Aparicio Ramos Health Policy and Management Monica Salinas Opportunity Award Stephania Olamendi Environmental Health Sciences National Institute of Child Health and Human Development Predoctoral Training Program (California Center for Population Research) Subasri Narasimhan Community Health Sciences National Institute on Aging Predoctoral Training Program (California Center for Population Research) Danielle Dupuy, Evan Krueger, Mienah Sharif Community Health Sciences National Institute for Occupational Safety and Health - Southern California Education and Research Center Fellowship Teniope Adewumi, Sean Banaee, George Brogmus, Nu Yu, Chanbopha (Amy) Sen, Calvin Wong Environmental Health Sciences National Institutes of Health Ruth L. Kirschstein National Research Service Award Julie CastaĂąeda Molecular Toxicology IDP

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Philip & Aida Siff Educational Foundation Scholarship Zuelma Esquivel Epidemiology

UCLA Epidemiology Student Poster Session Zoe Baker, Victoria Tseng Epidemiology

Raymond D. Goodman Scholarship Gregory Watson Biostatistics Jennifer Taylor Environmental Health Sciences

UCLA Epidemiology Summer Research Fellowship Ya-wen Cheng, Dvora Davey Epidemiology

Roemer Health Services Fellowship Robin Flint, Sara Lin, Ashley Parks Health Policy and Management Samuel J. Tibbitts Fellowship Olivia Ellis Environmental Health Sciences Singapore Clinician Investigator Bronze Award, Singapore Health & Biomedical Congress 2014 Angela Chow Epidemiology Toni Yancey Opportunity Award Jaime Lopez Community Health Sciences Tony Norton Memorial Fellowship Teniope Adewumi Environmental Health Sciences

UCLA Faculty Women’s Club Tyler Watson Environmental Health Sciences UCLA/Fogarty AIDS International Training and Research Program Aritra Das, San Hone, Vannda Kab, Sitong Luo, Sonyuan Tang, Xiaoyu Xu Epidemiology Upsilon Phi Delta National Honorary Society Tina Cheng, Aninda Das, Ashley Lopez, Olivia Aparicio Ramos, Maria del Sol Rodriguez Avila, Stephanie Tepper, Jeffrey Tran Health Policy and Management Virginia Li Opportunity Award Marcie Lee Community Health Sciences

Turpanjian Family Educational Scholarship Vahe Khachadourian Epidemiology

Wilshire Foundation Internship Fund Jade Aquino, Brittany Madigan Community Health Sciences Elizabeth Lien-ha Vu Health Policy and Management

UCLA Affiliates Award Bryan Moy Environmental Health Sciences

WNAR Student Paper Competition Jacob Konikoff Biostatistics

UCLA Blum Center Summer Scholars Erik Pena, Jennifer Zelaya Community Health Sciences UCLA Epidemiology Department Fellowship Vivian Alfonso, Aileen Baecker, Zoe Baker, Gretchen Bandoli, Priya Bhagwat, Claire Bristow, Yan Chai, Chun-Pin Esther Chang, Yu-Hsuan Chuang, Xin Cui, Dvora Davey, Rica Dela Cruz, Reena Doshi, Aline Duarte Folle, Zuelma Esquivel, Matthew Feaster, Adva Gadoth-Goodman, Clinton Hall, Nicole Hoff, Hilary Hsu, Somee Jeong, Daniel Keebler, Diana Khuu, Cynthia Kusters, Chenxiao Ling, Caleb Lyu, Solomon Makgoeng, Kaila McDonald, Jennie McKenney, Travis Meyers, Roch Nianogo, Negar Omidakhsh, Andrew Park, Joshua Quint, Stephanie Reading, I-Fan Shih, Chelsea Shover, Drew Westmoreland, Xiaoqing Xu Epidemiology

SPRING/SUMMER 2015 UCLA FIELDING SCHOOL OF PUBLIC HEALTH

KEEP IN TOUCH Visit us online

ph.ucla.edu

A VISIONARY GIFT

While producing their award-winning documentary Dirt! The Movie, Bill and Laurie Benenson learned that a teaspoon of soil can hold more than a billion organisms. “So much is occurring that we don’t see,” Laurie says. “But the more aware people are of what we’re doing to the earth, the more everyone will become environmentalists.”

Laurie, a former print journalist, recently collaborated with her husband, who has been making environmental documentaries for more than 40 years. Bill and his team have traveled to the Honduran jungle in search of hidden cities, to the plains of Tanzania to document the last remaining hunter-gatherer Hadza tribe, and to numerous places in between, crafting films on humans’ interaction with their environment – and the need to promote sustainable practices.

Now, the Benensons are promoting sustainability in a new way. Their $1 million endowment to establish The Laurie and Bill Benenson Environmental Health Fellowship will fund the tuition, room and board of one student in the Fielding School’s Department of Environmental Health Sciences each year in perpetuity.

“We are grateful to the Benensons for their visionary gift, which is critical to launching our fellowship initiative,” says Dean Jody Heymann. “Freed of the burden of debt upon graduation, Benenson Fellows will become powerful agents for protecting our planet – just like their benefactors.”

Nonprofit Org. U.S. Postage PAID UCLA

Box 951772 405 Hilgard Avenue Los Angeles, CA 90095-1772 www.ph.ucla.edu Address service requested

“You cannot get through a single day without having an impact on the world around you.

What you do makes a difference, and you have to decide what kind of difference you want to make.”

— Jane Goodall