FSPH Magazine Autumn/Winter 2016-17

PUBLIC HEALTH AU T U M N/ W I N T E R 2 0 1 6 –1 7

The UCLA Fielding School of Public Health Magazine

PICTURE OF HEALTH Addressing the Societal Factors That Shape Our Lives

DEAN’S MESSAGE

AT A TIME WHEN ACCESS TO MEDICAL CARE MAY BE THREATENED, can we afford to invest human capital in addressing the social conditions that influence health? The answer is that we can’t afford not to. Just as important as whether people get care when they’re sick is preventing them from becoming sick or injured in the first place. The current rise in discrimination and threats to the environment present profound risks to health, just as any future reductions in access to medical care would. Transforming health in the U.S. and around the world requires not only ensuring the availability of care to all who need it, but also addressing the emerging and longstanding societal factors so important to determining who has a chance to lead a healthy life. That means tackling poverty, ensuring that quality education is universally affordable and accessible, eliminating discrimination, and promoting equal opportunity for all.

While the challenges are formidable, the greatest threats to health are not unsolvable. In the last 25 years, the proportion of people living in extreme poverty around the world has been cut in half, the number of primary school-age children not attending school has decreased by more than 40 million, and the number of children under age 5 who die each year has dropped by nearly 7 million.

At its best, public health works with partners in a wide range of fields to understand the obstacles to improved living conditions and implement solutions that advance the health and well-being of all communities by addressing social and environmental determinants of health.

As the examples featured in this issue attest, our Fielding School faculty, students, and alumni are helping to lead the charge as we turn toward sustainable investments that are transforming health and changing lives. In a tumultuous and too often divisive environment both in the United States and globally, it is more important than ever before that we strengthen our resolve to ensure that everyone has equal rights and an equal opportunity to thrive regardless of gender, race/ethnicity, religion, sexual orientation and gender identity, disability, country of origin, citizenship, or documentation status.

Jody Heymann, MD, PhD Dean

2

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

The UCLA Fielding School of Public Health Magazine

AU T U M N/ W I N T E R 2 0 1 6 –1 7

CONTENTS 22

07

15

20

FEATURES

Q&A

04 Social Determinants of Health Dr. Jonathan Fielding on the importance of factors such as income, education and policy in health

PATH TO THE FIELDING SCHOOL

07 Life Lessons Students on the experiences that brought them to FSPH

ADDRESSING ISLAMOPHOBIA

18 Stressing Discrimination Mental and physical ramifications of subtle and overt bias

HEALTH IMPACT OF RACISM

TRANSPORTATION

IMMIGRATION AND PUBLIC HEALTH

TRANSFORMING JUVENILE JUSTICE

ECONOMIC DISPARITIES

16 Moving Picture A portrait of challenges facing Mexican immigrants

ACCESS TO HIGHER EDUCATION

14 Sick of Their Debt Rising costs taking their toll

19 Restoring Youth Alum advances a public health approach

TRAINING GLOBAL LEADERS

12 A World of Difference Fulfilling an ambitious agenda

15 When Bigotry Threatens Health Alum takes a stand against a growing problem

KEEP IN TOUCH

Visit us online ph.ucla.edu

26 Inequality’s Unhealthy Consequences The peril of visible differences in wealth

MENTORING AT-RISK STUDENTS

20 Composing a Brighter Future Program founded by FSPH alum proves transformative

25 On the Right Track Steering California’s high-speed rail project in a healthy direction

BUILT ENVIRONMENT

22 Space to Move Laying the groundwork for healthier surroundings

DEPARTMENTS

27 School Work 30 Grants & Contracts 32 Transformative Investments

PHOTOGRAPHY & ILLUSTRATION Kailah Ogawa, Rent Control Creative: cover. Betsy Winchell: Dean’s Message. Sebastian Auer Photo (www.sebastianauerphoto.com): TOC: photo for article on p. 22; p. 22. Getty Images: TOC: photo for article on p. 15; p. 15. ©iStockPhoto: pp. 2-3, 18, 24, back cover. Rent Control Creative: charts on p. 5. Lisa Rau: head shots on pp. 8-11; p. 13; p. 16: Pebley; p. 28: Inaugural Employer Showcase; p. 29: Yzquierdo, Garcia-Navarro, Sherrer; p. 32. Margaret Molloy: pp. 16-17; inside back cover. ASSOCIATED PRESS: p. 25. Jane Houle Photography: p. 28: Fielding Fall Fiesta. Mr. Xinglei Pang, Xinhua News Agency: p. 29: Chinese Premier Li Keqiang and Dr. Roger Detels. COURTESY OF: Isabel Guerrero: TOC: photo for article on p. 7; pp. 7, 10: Isabel Guerrero family photos. Harmony Project (www.harmony-project.org): TOC: photo for article on p. 20; p. 20; p. 21: graduation. Dr. Jonathan Fielding: p. 4. Eder Abellaneda: p. 7: Eder Abellaneda family photo. Natalie Dickson: p. 7: Natalie Dickson family photo. Joel Gonzalez: p. 7: Joel Gonzalez family photo. Linghui Jiang: pp. 7-8: Linghui Jiang family photos. Mercede Ramjerdi: pp. 7, 11: Mercede Ramjerdi family photos. Brenda Robles: p. 7: Brenda Robles family photo. Dr. Lauren Gase: p. 19. White House: p. 21: Presidential Medal ceremony. Dr. Karin Michels: p. 27: Michels. Dr. Hilary Godwin: American Public Health Association (APHA) meeting photos, bottom row. Dr. Michael Prelip: APHA meeting photo, top right. Dr. Elizabeth Yzquierdo: p. 27: APHA meeting photo, top left. Lindsay Rice: p. 28: MPH students. Special thanks to CicLAvia.

ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

1

PICTURE OF HEALTH MORE THAN A DECADE AGO, an international team of scientists from around the world completed one of the most ambitious undertakings in biomedicine — the sequencing of the human genome. The Human Genome Project ushered in an era of discovery on the role of genes in health and disease.

But when it comes to living a long and healthy life, genetic code is less important than ZIP code. For children born in New Orleans, life expectancy can vary by as much as 25 years between neighborhoods only a few miles apart. In one Boston Census tract the average life expectancy is 59, similar to what it was for Americans born nearly a century ago. A mere 10 miles separates a South Los Angeles community from a community in West Los Angeles where residents live, on average, a decade longer.

The full picture of health is determined not in the vacuum of individual genetic codes but in the social and physical environments where we live, learn, work, and play. And while the genetic code is determined at birth, the impact of ZIP code is not. The articles that follow illustrate the Fielding School’s commitment to working toward a society in which all people have the opportunity to lead healthy and productive lives.

MAGAZINE STAFF

Carla Denly Executive Editor & Director of Communications

Mikkel Allison Writer & Contributing Editor

Dan Gordon Editor & Writer

Lisa Rau Visuals Coordinator & Contributing Editor

Rent Control Creative Design Direction

Jody Heymann, MD, PhD Dean

2

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

UCLA Fielding School of Public Health Home Page: www.ph.ucla.edu Email for Student Application Requests: app-request@admin.ph.ucla.edu 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 2016 by The Regents of the University of California.

Permission to reprint any portion must be obtained from the school.

Please send requests to communications@ph.ucla.edu.

EDITORIAL BOARD Haroutune K. Armenian, MD, DrPH Professor in Residence, Epidemiology; Thomas R. Belin, PhD Professor, Biostatistics; 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 Emerita, Community Health Sciences; Michael Prelip, DPA Associate Dean for Practice Across the Life Course; Professor in Residence, Community Health Sciences; Beate Ritz, PhD Professor, Epidemiology; May C. Wang, DrPH Professor, Community Health Sciences; Elizabeth Yzquierdo, MPH, EdD Assistant Dean for Student Affairs; Zuo-Feng Zhang, MD, PhD Associate Dean for Research; Professor, Epidemiology; Frederick Zimmerman, PhD Professor, Health Policy and Management; Alvan Cheng and Laureen Masai Co-Presidents, Public Health Student Association; Neil Sehgal, MPH ’05 President, Public Health Alumni Association

ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

3

A

AND

Poverty

SOCIAL DETERMINANTS OF HEALTH FSPH professor in residence and former Los Angeles County Department of Public Health director Jonathan Fielding explains why factors such as income, education, and social policy are public health concerns.

DR. JONATHAN FIELDING’S ORIGINAL PLAN was to become a practicing pediatrician, but during his medical school and pediatric residency training he was struck by the limitations of health care. Societal-level issues such as food insecurity, substandard housing, substance abuse, violence and environmental concerns could not DR. JONATHAN be adequately addressed by a visit to the FIELDING doctor, but were fundamentally affecting the health of his patients.

That epiphany resulted in Fielding’s decision to pursue a career in public health, and ever since — including in his 16 years of service as Los Angeles County’s chief public health official — he has been a leading national voice in advocating for public health strategies that address the social determinants of health. Fielding served as chair of the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, which provided the recommendations to the U.S. Department of Health and Human Services for the development and implementation of Healthy People 2020, the 10-year plan laying out U.S. public health objectives. Under Fielding’s leadership, Healthy People 2020 included social determinants (“create social and physical environments that promote good health for all”) as one of the four overarching goals for this decade. Fielding was recently appointed chair emeritus of the national advisory group for Healthy People 2030.

4

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

Fielding, a faculty member since 1979, spoke with FSPH’s Public Health Magazine about the social determinants that play a powerful role in determining health, and how public health can work across disciplines to make a difference.

Q: What do you mean when you refer to social determinants of health?

A: These are the underlying determinants of health — factors such as income and education, as well as social and environmental policy, that affect the conditions under which people live, work, play and pray. In very fundamental ways, social determinants influence the health choices people make — as well as the choices they have or don’t have — and underlie many of the health inequalities that are so pronounced. If you just look at life expectancy by income, for example, it is very striking. In the United States, the life expectancy of a 40-yearold man in the poorest 1 percent of income distribution is 14.6 years shorter than for a 40-year-old man in the richest 1 percent. For women, the difference is more than 10 years.

Q: Beyond income and education, what are some examples of social determinants and their impact in the United States?

A: Some are obvious and others are much less so. We know that a healthy diet tends to be more expensive than an unhealthy diet, and that people in low-income communities often have limited access to fresh fruits and

“There are many things we can do that can make a difference, both in the short and the long term.”

— both the natural environment and the built environment. On one level, climate change is the result of market forces and population growth that determine greenhouse gas emissions.

Yes, it is a physical issue, but what we do to mitigate these emissions and adapt to changes is determined by politically driven environmental and social policies at multiple levels.

There are many things we can do that can make a difference, both in the short and the long term. Take education as an example. We need universal preschool, after-school remedial programs for math and English that increase graduation rates, vocational training options that are linked with well-paying jobs.

And to start children on the right path, we need to strongly support breastfeeding and the federal Women, Infants,

Q: Since so many of these issues are affected by non-health fields, does public health have an obligation to work more closely across traditional boundaries?

A: Absolutely. We need to work with transportation, with education, with those that determine eligibility for housing. We need to be concerned with labor policies and the criminal justice system.

88.9 Years

87.3 Years

Men

Highest 1%

78.8 Years

72.7 Years

Lowest 1%

Q: How important are social policies in addressing these determinants?

A: Very important. The health gap between African-Americans and whites narrowed in the decades after the civil rights legislation of the 1960s.

Affordable housing, job training programs, and increased access to health insurance have all helped, but not all approaches that improve health at the population level reduce the disparities.

Tobacco is an obvious example — we know policies have been effective in reducing tobacco use, but there are still higher rates among the lower income and less well educated, which disproportionately are represented among minority groups.

But we don’t always win the argument. We have seen the fight that’s gone on with policies around sugar. We know that we could reduce obesity if people reduced their intake of sugar and starches — particularly, but not limited to, sugar-sweetened beverages — and yet we’ve been slow in the uptake. The reality is that private interests greatly outspend those that are interested in the public’s health, and they are often at odds. So the issue of who has a voice in our politics, and how big of a bank account they have to spend to support their position, is a social determinant of health and a public health concern.

Life expectancy of 40-year-old people in the United States, by income:

Highest 1%

and Children program for low-income pregnant and postpartum women. This program, through a focus on prevention and access to healthy foods, has helped reduce obesity among infants.

Lowest 1%

vegetables. What’s less obvious, but of inordinate importance, is the impact of stress in these communities — the concerns people have about whether they are going to have enough money to pay the rent or to eat, and whether they can safely leave their home after dark.

When I say social determinants, I’m including economic and political. How do we get everyone who is eligible for the federal earned income tax credit to use it? How do we change our educational system so that we increase the high school graduation rate? Does our culture celebrate diversity, or do people feel uncomfortable with others who are not like themselves? The physical environment is also a determinant

Women

Source: Journal of the American Medical Association April 10, 2016

Nearly

30% of the poorest children in low-income countries have never been to school.

Source: United Nations Educational, Scientific and Cultural Organization, Global Education Monitoring Report.

Mortality among children under 5, per 1,000 live births:

Low-income countries

High-income countries

Source: World Health Organization

“When we talk about the opportunities people have and how those opportunities affect their health, we’re talking about who we are as a country.”

For example, the pendulum is now swinging back to not incarcerating people for being drug users, but to try to get them help. Those programs need to be expanded, and that involves a knowledgeable judiciary, rapid access to medical care, social support, affordable housing, and efforts to reduce the discrimination these individuals face when their incarceration ends and they seek employment. The bottom line is we cannot be effective if we work alone.

Social Determinants of Health Include: + Educational, economic, and job opportunities + Exposure to crime and violence + Exposure to discrimination + Housing and residential segregation + Opportunities for recreational activities + Poverty + Public safety + Social support + Stress + Transportation options Source: HealthyPeople.gov 2020 Topics and Objectives

6

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

Q: Are these social determinants getting more attention now, or are they still underappreciated?

A: The focus hasn’t always been as strong as it is now. The social determinants have always been a public health issue, going back to the treatises of the mid-19th century that talked about the public health importance of things like housing conditions and access to clean water. However, over time, public health issues enjoyed less attention. Unfortunately, in the United States we are now over-invested in health care and under-invested in social programming and economic support for communities and populations where we know we could reduce the health gradient. Many people still believe health care is the most important determinant of health in populations. It is an important determinant, but not the most important one.

The problem is how do you get people to listen to and embrace public health approaches to remedy the adverse effects of social determinants. We need the thought leaders and our elected politicians to understand the levers for improved health and reduced health inequities — better K-12 educational systems, affordable housing, improving income for those in poverty, and building the right incentives for both the public and private sectors. Unless we in public health are considered experts in how these key factors affect health, our voice will not have resonance with key decision makers.

I do think more people are listening, but there’s still a long way to go. To help strengthen our argument, we need to address these issues in ways that can be demonstrated to be cost-effective and produce a strong health and economic return on investment. We have to try different strategies and carefully evaluate them. We need evidence-based solutions.

And we need to be clear that this is not just about health per se, it’s about economic vitality. When we talk about the opportunities people have and how those opportunities affect their health, we’re talking about who we are as a country.

PATH TO THE FIELDING SCHOOL

Brenda Robles

Isabel Guerrero

Eder Abellaneda

Life Lessons FSPH students recall the experiences that taught them the impact social, economic, and environmental factors can have on health, and led them to the Fielding School.

Joel Gonzalez

Natalie DIckson

Linghui Jiang

Mercede Ramjerdi ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

7

PATH TO THE FIELDING SCHOOL

Brenda Robles AS THE DAUGHTER OF MEXICAN PARENTS

ample open space for recreational activities

from small farm towns in the state of Jalisco,

than my family did.

I grew up living and witnessing the struggles

and inequalities in health that many immi-

For example, although my hometown of

grant families face when they move to a new

Lawndale is only about four miles away from

country with different customs, language,

Manhattan Beach, where my mom continues

and values. It is this background and a

to work as a housekeeper, it has significantly

constellation of other life events that led me

higher childhood obesity rates. This, along

to the field of public health and augmented

with my personal struggles with obesity as a

my commitment to conducting research

child — and painfully observing members of

focused on social determinants of health.

my family share similar struggles — instilled

my passion about obesity prevention

As a child I helped my mother clean

houses in Manhattan Beach, California.

research. My life experiences have fueled

Even before I knew the definition of

my desire to pursue a career that will allow

“health disparities,” it was clear to me that

me to address the upstream factors that

people in this affluent beach city had more

perpetuate a disproportionate burden of

opportunities than others. My mother’s

chronic disease on certain populations —

employers had better access to resources

for the betterment of my family, my

such as healthy food, good schools, and

community, and society.

LINGH UI J I A NG PUBLIC HEALTH WAS NOT MY ORIGINAL

receive a diagnosis and then lose

CAREER CHOICE. My childhood dream was

hope of recovery because they

to become a medical doctor and work in

were diagnosed too late, or did

the health center of my hometown, a rural

not have the financial resources

village in southwest China. Doctors in that

to pay for treatment. What if

health center are my heroes although they

they could have afforded to see a

failed to save my father from hepatitis,

doctor earlier? What if everybody

my grandfather from pneumonia, and my

had been vaccinated against

young neighbor from drowning in a pond.

hepatitis? What if the small pond

Still, I was determined to study hard and

in my hometown had a fence to

become a better doctor so that I could

protect children from falling into it?

cure everybody.

death are caused not just by

During my one-year residency in

I realized that diseases and

hospitals, however, I came across many

germs, but also by fundamental

patients who suffered from illnesses

societal problems such as

that could have been easily prevented

poverty, lack of access to health

or detected at an earlier stage. By the

care, and unsafe environments.

time these patients entered the health

To keep people healthy, we need

care system, it was either too late or too

not only medical doctors but

expensive to treat them. It saddened me to

also public health professionals

see my patients, mostly from places like my

who can make a real difference in

hometown, come to the city hospitals to

communities like my hometown.

8

These disparities persist today.

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

N ATA L I E DIC K S O N I WAS BORN AND RAISED IN SOUTH OKLAHOMA CITY, a part of Oklahoma’s capital known by many for low-income neighborhoods, unsupported public schools, and an abundance of unhealthy food options. But South OKC is home for me, and a place of rich social and cultural traditions bound together by community. In fact, it wasn’t until I left that I realized the egregious inequality that creates neighborhoods like the one I grew up in.

My mom worked long and odd hours in retail, and my dad spent

most of his life working in greenhouses to provide for me. Growing up, I thought all families were forced to decide whether to pay a doctor’s bill or put food on the table. Because I came from such a tight-knit community where most people were struggling to make ends meet,

Joel Gonzalez

I never noticed how people from the affluent parts of town would turn

WHEN I WAS 3, I WAS UNABLE TO TALK.

and resources, and where many were unable to access the health care

Luckily, my public day care program referred

they needed.

me to speech therapy to fully develop my

communication skills. My mother worked

I want people to be empowered with the resources to make healthy

in education; she was a single parent, but

decisions. If that means a 16-year old needs to access safe contraceptive

she knew caring for her children and

options, I am going to fight for that. I am going to advocate for those

providing the best opportunities were vital.

who are unable to navigate our health system. I plan to use my educa-

She advocated on my behalf to take the

tion and training to fight for health for all.

their noses up at the mention of our neighborhood — where it was normal for girls to become pregnant as teens due to the lack of education

I come to public health in the name of social justice, of advocacy.

most advanced courses my high school offered, and as a result I was admitted to UC Berkeley as the first person in my immediate family to attend and graduate from college.

I grew up in a food desert in Oakland,

down the street from three fast-food restaurants and two convenience stores within a three-block radius. We did not have a car, so the grocery store was a 20-25 minute walk or a bus ride that required a 30-minute wait in each direction. This made for a larger food desert than for someone with a car or accessible public transportation. Most of my family struggles with obesity; the concept of the built environment and its impact on the health of the community was part of our lives — we just didn’t have a name for it. I learned about this idea at one of the Environmental Health panels during National Public Health Week in my first year of grad school. The speakers were talking about Los Angeles, but I could relate it to the community where I grew up. After graduating, I plan to address health inequities by working in the community health clinic system and possibly running for public office. ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

9

PATH TO THE FIELDING SCHOOL

ISA BEL GUER R ERO I WAS BORN IN EAST LOS ANGELES TO IMMIGRANT PARENTS who had very few resources and less than a high school education. My father passed away when I was 5 due to complications from AIDS and my mother passed of the same when I was 9. Even before her passing there was not much stability at home, but from her death I experienced more loss. I moved to a different state and was separated from my siblings for six years. When I was 13, someone else close to me died of complications from AIDS.

As a teenager, I participated in educational panels advocating safe sex

and communicating the dangers of sharing needles in high schools throughout Arizona and in New Mexico. It was tough to speak about the loss that I had experienced, but I was empowered by trying to help others. After starting my first year in the MPH program at the Fielding School, I learned about the social determinants of health and the impact of external factors. I was reminded that public health is so important and it reinforced my decision to

Eder Abellaneda

pursue a career in this profession.

Education has been the avenue for my success. My life has taught me

MY INTEREST IN PUBLIC HEALTH CAME

there is much to be learned from helping others. These experiences have

FROM AN AMORPHOUS CHILDHOOD DESIRE

embedded a strong sense of community within me, as well as a yearning to

for a future career helping others. This likely

serve other communities — which is what I plan to do once I graduate.

stemmed from having been raised in a lowincome community where I witnessed the effects of structural inequalities, such as my friends not having enough to eat due to their parents’ lack of employment opportunities, and my classmates having to quit school to work.

My interest in public health became con-

crete during my enrollment in the AmeriCorps national service program. I was placed in an East Los Angeles nonprofit medical organization that served a predominantly Latino population. One of my favorite aspects of being in the organization was that each week brought multiple opportunities for direct service in our neighborhoods during health-related events.

At an outreach activity outside of our clinic at one of these events, I persuaded an elderly woman to come inside to get a free H1N1 vaccination. After receiving the vaccination, she ended up making multiple return trips with different people from her neighborhood so that they could also get vaccinated.

Through this encounter I started to see the

importance of bringing services directly to the community and the utilization of social ties.

I would have numerous such encounters, and they would underscore for me that my career path would involve helping others through public health. I hope to put my Fielding School education toward program implementation, specifically involving LGBTQ youth and mental health.

10

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

but I remained determined to find a way to overcome such institutional barriers.

I entered college in 2010 at the height of the immigrant youth movement, tirelessly

seeking support only to hear responses like, “You can’t access this. There’s nothing for you here.” Absent of support, I founded We B.U.I.L.D. (Bringing Unity to Immigrants, and Life to their Dreams), a campus-based support and advocacy group for undocumented youth and their families, where I began my journey as an advocate for my community.

I also started to notice the deep impact policies had on my life and on my

community. Close friends faced health complications and difficulty accessing health care services because they were undocumented. I knew I needed to learn more about the root causes of their issues and address their needs. That is why I chose UCLA. I am pursuing my graduate education, for my loved ones, as the first undocumented student (to my knowledge) in the three-year, Dual Master’s Program in Public Health and Public Policy at UCLA. For the past three years, I have immersed myself in the diverse

R EGEM COR PUZ

disciplines FSPH has to offer, developing the intersectional and interdisciplinary scope this field requires of me.

Simultaneous to educational pursuit, I have served as a policy analyst/advocate –

contributing to the fruition of the first-ever comprehensive workplace violence prevention DESPITE ENTERING THE UNITED STATES

program for health care workers implemented by the state worker protection and safety

LAWFULLY AND “DOING EVERYTHING

organization Cal/OSHA; working toward the passage of SB 1139 so that undocumented

RIGHT,” I became one of the millions who fell

students in California can access funding to invest in their education as future health care

through the cracks of the immigration system.

providers; and promoting built environment and transportation systems that enhance

“You don’t have papers. You can’t access x, or

safety and health conditions for my communities. I intend to continue breaking barriers in

become y” were formulaic responses I heard,

life, not just for me but for others like me.

Mercede Ramjerdi THE EXPERIENCES THAT LED UP TO MY PLACEMENT IN THE CALIFORNIA FOSTER CARE SYSTEM have driven my sensitivity to and understanding of how social conditions impact health status. These experiences have also led to my desire to take on a leadership role addressing challenging environmental dilemmas that are affecting human health. Navigating the foster care system, you are constantly reminded

I pushed forward and pursued health advocacy internships in socioeconomically

of the way in which adverse socioeconomic conditions

disadvantaged communities, where I found myself staring into the eyes of families

lead to the destruction of families. Children enter a

devastated by pollution-created illnesses. My experiences left me motivated

system where they are supposed to receive support,

to pursue graduate studies where I could learn toxicology, epidemiology,

but the reality is that these children are rarely provided

community health sciences, and risk assessment. Now, I am pursuing my MPH in

with sufficient resources to pursue a college education.

the Department of Environmental Health Sciences at the Fielding School, where

Only 3 percent of foster youth obtain college degrees.

I am learning to evaluate the health risks posed by environmental problems, as

well as how to develop policies and programs that manage these environmental

Instead of letting statistics on the outcomes of

foster youth discourage me, I was left passionate

health risks. Upon graduation, I see myself becoming a leader for environmental

about gaining the education necessary to overcome

risk management and environmental justice campaigns as the U.S. enters a new

my disadvantages and create positive change.

age of modernization and development. ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

11

TR AINING GLOBAL LEADERS

A

W O R L D

O F

The U.N. Sustainable Development Goals tackle poverty, discrimination, and other societal problems that are fundamental to health. Through the Hilton Scholars Program, FSPH’s WORLD Policy Analysis Center is preparing the future leaders needed to achieve the ambitious agenda.

IN SEPTEMBER OF 2015, 193 DISPARATE NATIONS AGREED on a remarkable set of aspirations for the global community. The United Nations Sustainable Development Goals (SDGs) established an ambitious agenda to tackle the world’s most formidable problems — eliminating poverty and hunger, ensuring equal opportunity and protection against discrimination, promoting universal education and health care, and protecting the planet against climate change and other environmental threats.

“Together, these social and environmental factors account for the major reasons people get sick, and the inequalities in who gets sick and dies,” says Dr. Jody Heymann, dean of the Fielding School and director of the FSPH-based WORLD Policy and Analysis Center (WORLD), the largest quantitative center capturing data on the actions governments take to advance social, economic, and environmental well-being for the 193 United Nations member countries. “If we want to truly make a difference in the health of the world’s population, we must address these core issues.”

But as extraordinary as it was for the U.N. member countries to unanimously agree on goals that would alter the life trajectory of the world’s most disadvantaged populations, now comes the hard part.

Over the next 15 years, trillions of dollars and millions of human hours will be invested to achieve the 17 goals, each of which establishes specific targets to be reached by 2030. The impact of these investments will depend on how the funding and effort are expended, but few programs are focused on training the next generation of leaders to address the human development, health, economic, and environmental needs at the heart of the SDGs. With a $5.44 million grant from the Conrad N. Hilton Foundation, UCLA has begun to do just that. The Hilton Scholars Program brings together faculty mentors from across the UCLA campus to equip future lawyers, educators, business leaders, engineers, public policy experts, public health professionals, and others with the expertise and leadership skills that will enable them to contribute to accelerating poverty reduction, advancing equal opportunity and achieving the SDGs.

UCLA Fielding School of Public Health supports the SDGs.

12

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

The initiative includes hands-on training for postdoctoral and doctoral fellows who will develop an evidence base that can be shared with public and private sector leaders on the best ways to effect change, along with a program for master’s and professional students who will be prepared through coursework and international field experiences to implement programs on the ground. Hilton Scholars from across the UCLA campus will be trained at WORLD — a unique resource for researchers, policymakers and the general populations of more than 200 nations and territories for its ability to link more than 1,500 aspects of policies with outcomes, and to shed light on what different countries are doing through comparative data.

Among the first group of Hilton Scholars is Stephanie Ly, a third-year doctoral student in FSPH’s Department of Community Health Sciences who hopes to play an important role in the effort to eradicate global poverty through work with a major intergovernmental organization. Her dissertation research will focus on global childhood malnutrition and

“Instead of heading a study of 100 or 1,000 people, I will have the potential to affect millions in a positive way.”

— Stephanie Ly stunting — a consequence of undernutrition that affects one-fourth of children in the world’s poorest countries, with lifelong health consequences.

Ly has experience in the nonprofit world, having managed an international study spanning nine countries that investigated birth defects in children. But through her training at WORLD, she foresees making an even larger impact by pointing the way toward evidence-based antipoverty measures.

“Instead of heading a study of 100 or 1,000 people, I will have the potential to affect millions in a positive way,” she says.

D I F F E R E N C E

Feliz Quiñones, a fifth-year doctoral student in UCLA’s Graduate School of Education and Information Studies, intends to use her Hilton Scholar training to gain greater insight into educational policies and the quality of education around the world. In her dissertation research, Quiñones studies how neighborhood and school contexts influence middle and high school students’ experiences with racial and ethnic discrimination in Los Angeles.

“It’s been a great experience to begin to think about the issues I care about on an international scale and through a policy lens,” Quiñones says. “In my own research looking at students’ experiences with discrimination at schools and in their neighborhood, it’s important to recognize that these experiences are not isolated. They are greatly affected by the policies that are in place.”

Quiñones was especially attracted to the program by the prospect of collaborating with experts in other fields as a way of seeing educational issues in a new light. As a Hilton Scholar, Quiñones has begun developing WORLD’s workplace discrimination database, looking at the extent to which

social identities are protected under labor codes across countries. In the future, she hopes to take advantage of WORLD’s data to learn more about differences in access to education among low-, middle- and high-income countries.

Worldwide, more than a billion people live in extreme poverty. Approximately 700 million children suffer from at least two forms of deprivation, including lack of adequate food, safe drinking water, decent sanitation facilities, health, shelter, and education. Making substantial progress toward achieving the SDGs would transform the lives of hundreds of millions of the most vulnerable and marginalized people of every nation – although Ly, who teaches an undergraduate course in international health, acknowledges that it won’t be easy.

“When I talk about the SDGs with my students, they often say, ‘Sure, these are great, lofty goals, but are they realistic?

Can we really end poverty and climate change?’ ” Ly says.

“What we are doing at WORLD — measuring the policies of various countries and the impact they are having — allows us to set achievable milestones. It’s a step in the right direction, and I am excited to be part of that.”

ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

13

ACCESS TO HIGHER EDUCATION

Sick of Their Debt FSPH professor Gilbert Gee has found that the rising cost of higher education is taking a toll on more than just graduates’ bank accounts.

FOR GENERATIONS, higher education has given all Americans — regardless of gender, racial/ethnic background or ZIP code — the opportunity to achieve a higher standard of life, and the health-related advantages that go along with it. But as the cost of tuition continues to climb, the health benefits of higher education are not what they once were.

“It’s no longer guaranteed that if you go to college, you will get a good income and in turn become healthier,” says Dr. Gilbert Gee, professor in the Fielding School’s Department of Community Health Sciences. “It’s become more of a gamble. There are people entering retirement who still have student debt to pay.”

Gee notes that the cost of higher education in the United States has increased by 250 percent over the last three decades while wages for the average family have stagnated. This has made borrowing money for college essential for many students. Student loans amounted to a staggering $1 trillion in 2012, behind only home mortgages as a source of debt. Such debt is a reality for Fielding School graduate students. One such student, who wished to be unnamed, mentioned having more than $200,000 in student loans.

In a 2014 study aiming to better understand the impact of this burden on the social and economic well-being

“It’s no longer guaranteed that if you go to college, you will get a good income and in turn become healthier.” of young adults, Gee and his colleagues found that student debt is associated with increased risk of a variety of negative health outcomes, including lack of sleep and poor mental health, likely the result of stress and worry.

14

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

The problem of student debt can potentially affect entire families, Gee adds.

Parents who co-sign for their children may be compromising their own financial well-being.

Gee notes that student loans from both undergraduate and graduate schooling might have “spillover effects” that could also alter or constrain career options upon completion, as well as delaying life events such as marriage and parenthood. In graduate schools of public health, for example, financial strains caused by student debt steer some graduates toward private-sector jobs — a trend made more troubling by the shortage of public health professionals in the United States.

Gee believes local, state and national policy changes could ease the burden of student debt and help ensure that education remains a pillar of public health and individual mobility. As possible solutions, he points to national policies such as income-based repayment plans and monthly limits, as well as local-level policies such as stateallocated funding for public schools and tax measures to support students.

“We need to think about ways to balance the problem of debt and education,” Gee says. “For public health especially, we need to find a way for students to graduate feeling as idealistic and passionate as when they first arrived, so that they are able to go on to make all of our communities healthier without having to sacrifice their own health.”

ADDRESSING ISL AMOPHOBIA

WHEN BIGOTRY THREATENS HEALTH FSPH alum Goleen Samari takes a stand against Islamophobia, arguing that it is making Americans sick.

A UC BERKELEY STUDENT IS REMOVED FROM A COMMERCIAL FLIGHT after he is heard speaking Arabic. A 14-year-old Muslim American boy is suspended from school for bringing a homemade clock suspected of being a bomb. And Goleen Samari (MPH ’10, PhD ’15) receives death threats simply for writing about them. Harassment on college campuses, vandalized mosques, lost jobs…this is the reality of Islamophobia, and the Fielding School alum is speaking out on what she views as a growing public health concern.

“When I was 16,” Samari wrote in an op-ed that appeared in the Sept. 21, 2016 edition of The Dallas Morning News, “a Texas police officer pulled me over and said ‘it’s people like you that are ruining this country. Go back to your country.’ …

I wasn’t sure what he meant. What country was I supposed to go to? I was born and raised in Austin. Then, it dawned on me.

It was a month after 9/11, and he meant Muslims.”

Many people experience this type of discrimination daily, simply based on stereotypes and appearance. Islamophobia — the unfounded hatred of Islam or stigmatization, fear and dislike of Muslims — is widespread in U.S. society. In 2015, only 33 percent of Americans expressed favorable attitudes toward American Muslims, according to the Arab American Institute, down from 48 percent five years earlier. Hate crimes against Muslims in the United States are five times more common than before 9/11.

As a postdoctoral fellow at the University of Texas at Austin’s Population Research Center, Samari is seeking to

“The health of this country requires tackling the hatred that causes real health-related harm to Americans.” better understand Islamophobia’s public health implications.

“Islamophobia is very visible in the media,” Samari says. “Yet, little has been written about it from a public health perspective, despite how damaging discrimination can be to health.”

In an editorial published in the November 2016 issue of the American Journal of Public Health, Samari makes the case that Islamophobia is making Muslim Americans

sick. She argues that discrimination eats away at a person’s mental and physical health over time, leading to stress, social isolation and delays in seeking medical care — all of which can lead to increased risk for heart disease, high blood pressure, obesity, cognitive impairment, and mental health concerns, among others.

Samari notes that her recent review of the research literature on the health effects of Islamophobia returned only 34 studies worldwide. As part of her effort to provide more concrete research findings on the relationship between Islamophobia and health, she plans to focus on the impact of media coverage, political rhetoric and policy on the health and health care utilization of Muslim and Middle Eastern people in the United States — information that could help to inform policies to reduce discrimination in the future.

“This is my country,” Samari says. “And the health of this country requires tackling the hatred that causes real health-related harm to Americans.” ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

15

IMMIGR ATION AND PUBLIC HEALTH

moving picture A decade’s worth of studies by FSPH professor Anne Pebley and her colleagues have painted a more detailed portrait of the health challenges facing Mexican immigrants to the U.S.

DR. ANNE PEBLEY

PUBLIC HEALTH EFFORTS to better understand and promote the health of the Latino population in the United States have focused on the so-called Hispanic paradox and the impact of acculturation. The paradox: On many measures, Latinos are healthier than non-Hispanic whites, despite social and economic disadvantages. Among Latino immigrants and their children, though, this paradox becomes less pronounced over time — an observation that has led many in public health to blame the adoption of unhealthy diet and lifestyle patterns that tends to occur as immigrants become assimilated into American society.

But research over the last decade by Dr. Anne Pebley, professor of community health sciences at the Fielding School, in collaboration with Dr. Noreen Goldman at Princeton University, suggests that the reality is more complex — particularly as it pertains to the health concerns of the nearly 12 million immigrants from Mexico residing in the United States and their children.

Pebley and Goldman were initially motivated to look more closely at these issues by their finding, published in the American Journal of Public Health in 2006, that for Latinos in the U.S.,

“We have to look at other reasons people change their health behaviors as they are in this country longer, including their economic and social environment.”

16

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

higher levels of education and income were not associated with better health to nearly the same extent as for other racial and ethnic groups. To understand why, they began by looking at the impact of social and economic factors on health in Mexico, the country from which Latino immigrants to the U.S. are most likely to come.

They found that in Mexico, unlike in the U.S., people with more education and higher incomes were more likely than low-income, low-educated people to be obese and to smoke.

“In Mexico and other low-income countries, well-to-do people are the most likely to be able to afford high-fat diets and the expense of smoking,” Pebley says. The likelihood that Mexican immigrants to the U.S. bring their health habits with them could explain why better-off Mexican immigrants weren’t necessarily enjoying the health benefits normally associated with income and education, she notes.

But Pebley’s research also documented changing dietary patterns and levels of physical activity that in the ensuing years have led to an epidemic of obesity in Mexico — and consequently among Mexican immigrants to the United States.

Today, Pebley says, Mexican immigrant children in the U.S. are at least as likely to be obese as U.S.born youth of Mexican descent. “Over time, the Latino population in the United States will likely show the expected associations between socioeconomic status and health,” Pebley says.

“So our primary focus should be on how to improve the health of people with lower income and less education.”

The idea that acculturation to American society leads immi-

grants to engage in unhealthy behaviors, such as consuming a poorer diet, has led many public health researchers to conclude that immigrant populations should be urged to hold on to cultural norms, including traditional foods. That thinking has begun to change thanks to the research of Pebley and others. In an analysis of data from the Los Angeles Family and Neighborhood Survey, a RAND-based longitudinal study co-directed by Pebley on Latino health, she found that while duration in the U.S. and generational status are associated with higher obesity rates among Mexican-origin populations, the differences cannot be explained by acculturation.

“We have to look at other reasons people change their health behaviors as they are in this country longer, including their economic and social environment,” Pebley says.

“Consumption of unhealthy ‘American’ foods may be driven by their relatively low cost, availability, and other pragmatic concerns. Many immigrants from Mexico are moving into a much lower economic position when they come to the U.S., as well as experiencing discrimination, and it’s difficult to start moving up the ladder. Their health problems over time may be a function of poverty.”

To delve deeper into the impact of migrating to the United States from Mexico, Pebley and her colleagues analyzed data from a study that tracked the health of immigrants — the majority of them undocumented — through multiple interviews before and for several years after their move. They found that although health status improves for some, for the majority both mental and physical health declines significantly during the immediate post-migration period. The study also found that poor health makes it more likely that Mexican immigrants return to Mexico.

Pebley notes that her research is particularly relevant in Southern California, given the large number of individuals of Mexican origin and the unique health issues associated with the population, both positive and negative. “If we want to understand current and future U.S. health patterns, and specifically social determinants of health, we need to look at this population,” she says. “We should be concerned with their health for humanitarian reasons, and also because the health of one segment of our population affects everyone.”

But more broadly, Pebley believes the lessons learned about the Mexican-origin U.S. population can help to inform strategies for improving the health of other immigrant populations — an issue of growing importance given the likelihood that international migration will continue to increase in the future.

“International migration brings its own set of health issues that need to be addressed,” Pebley says. “But we can’t just look at the issues in isolation. This is about the larger set of social and political conditions that affect health. We need to consider the social and economic context when we think about how to promote the health of immigrant populations.” ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

17

HEALTH IMPACT OF R ACISM

STR E S SING DISCR IMINATION On average, African-Americans fail to reap the same health benefits as whites from higher incomes and education. FSPH faculty member Courtney S. Thomas examines the mental and physical health impact of racial bias.

A LONG HISTORY OF RESEARCH SHOWS THE HEALTH BENEFITS of climbing the socioeconomic ladder: People with higher levels of education, income and job prestige tend to have more knowledge and resources to achieve good health, and this is reflected in better health outcomes among better-educated and more affluent populations than for lower socioeconomic groups. But in recent years, it’s become clear that African-Americans don’t accrue the same health benefits from higher socioeconomic standing as non-Hispanic whites. Moreover, racial health disparities can’t be fully explained by differences in socioeconomic status (SES).

Why might the so-called SES health gradient not be as steep for African-Americans? Dr. Courtney S. Thomas is examining the role of discrimination-related factors.

Thomas, who joined the Fielding School faculty in July, notes that because of broader institutional inequalities, African-Americans on average have lower incomes and less wealth than whites with the same educational attainment. But Thomas is also finding evidence that as they move into higher-SES categories, African-Americans are exposed to more race-based discrimination — and that the stress from these exposures has implications for physical as well as mental health. “When we see higher rates of hypertension, obesity, heart disease, and other chronic conditions,” Thomas explains, “much of that can be linked back to everyday experiences of stress and discrimination that build up over time.”

Thomas notes that race-based stress can often be traced

to micro-aggressions and other nuanced experiences in diverse settings that can leave African-Americans to wonder whether what they encountered was due to racial bias.

“Let’s say an African-American male in upper management is being congratulated for giving a great presentation, and one particular colleague is going on and on about how articulate he was rather than talking about the actual content,” Thomas says.

“That African-American male may think to himself, ‘You’re supposed to speak well in upper management. Is this observation being made because I’m black?’ ” Thomas has coined the term “ambiguous discrimination stress” in her research to describe the types of subtle experiences many African-Americans face on a regular basis, particularly as they move up the socioeconomic ladder. “Surveys often capture only the blatant discrimination,” she says. “Yet, we know that stress from more subtle forms matters, and if we don’t measure it, that makes it hard to intervene effectively to prevent the negative health effects.”

Beyond measuring the problem, Thomas is seeking to understand the roles of coping and resilience among African-Americans who face these race-based stressors. “There is no denying that improving the resources and opportunities for communities of color is important,” she says. “And we are all working hard to improve diversity, inclusion and equality.

But at the same time, our efforts to address health disparities should consider people’s current experiences and harness the resources they already have.”

“Surveys often capture only the blatant discrimination. Yet, we know that stress from more subtle forms matters.”

18

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

TR ANSFORMING JUVENILE JUSTICE

a system that can hamper their ability to become productive, healthy members of society. One challenge is combating the disparities in who gets caught up in the system.

“What really stands out as important is what neighborhood you are from,” Gase says. “If you live in an area where there is less opportunity, you are significantly more likely to be arrested.”

She recently published an analysis of national data demonstrating the important role of racial composition of a youth’s neighborhood in driving disparities in arrest rates, even after accounting for a range of things such as MORE THAN 17,000 delinquent behaviors, educaYOUTH WERE tion level, and parental and ARRESTED in 2014 in Los school factors.

Angeles County, according In Los Angeles County, to the California Depart90 percent of the 17,000 chilment of Justice. Among dren arrested in 2014 were them, approximately 1,000 non-white. To help address were younger than 12. this disparity, Gase is workThis is of great concern to ing with legal, educational Lauren Gase (PhD ’16), and community partners to chief of health and policy promote diversion – linking assessment in the Los Angeyouth to community-based les County Department of services and supports Public Health’s Division of designed to reduce the risk Chronic Disease and Injury for future crime, rather Prevention. than going through formal “We need to think more processing in the justice syscarefully about what’s going tem. “A more rehabilitative on in the juvenile justice sys- and restorative approach tem,” Gase says. “We need is needed for L.A.’s youth, to identify the root causes of the majority of whom enter justice system contact and into the justice system for the best ways to meet the non-violent offenses,” Gase needs of young says. “Diversion Gase is workpromotes holising to better tic well-being by understand the emphasizing both connections accountability between juvenile and relationship justice, education building.” and health while Gase notes identifying ways that another key to keep youth in component of an school and out of LAUREN GASE effective system is

RESTORING YOUTH FSPH alum Lauren Gase aims to transform the juvenile justice system to advance the public health principles of prevention and holistic well-being.

“If you live in an area where there is less opportunity, you are significantly more likely to be arrested.”

ph.ucla.edu

prevention. By implementing health-promoting practices in schools and communities, Gase aims to prevent contact with the justice system altogether. By ensuring that schools are able to address student issues such as transportation, mental health, bullying, access to health services and parental engagement, she aims to reduce the number of youth who go from the classroom to the courtroom. “A more public health-oriented approach within the county’s poorest neighborhoods and school districts can help to give L.A.’s youth an equal opportunity to be healthy regardless of which street they live on,” she says. “There is a real need for this kind of work in Los Angeles, and we have an opportunity to effect change for many young people.”

AU T U M N /W I N T E R 2 0 1 6 –17

19

MENTORING AT-RISK STUDENTS

COMPOSING A BRIGHTER

FUTURE Harmony Project, started by FSPH alum Margaret Martin, has transformed the lives of at-risk youth with its “mentoring through music” program.

MARGARET MARTIN (MPH ’93, DRPH ’98) WAS WALKING THROUGH THE HOLLYWOOD FARMER’S MARKET on a Sunday morning in 1997 when she witnessed a scene that would change her life — and in turn, the lives of thousands of at-risk youth in Los Angeles and well beyond.

Martin watched from a distance as a group of teens who appeared to her to be members of a gang stopped in front of a small boy playing Brahms on a tiny violin. The child was Martin’s 5-year-old son.

Initially apprehensive, Martin quickly realized she was witnessing something remarkable. “They just stood there, as my son moved from one piece to another,” she recalls.

“And after a few minutes, I watched them take out their own money and lay it gently in my son’s case. I was completing a doctorate in public health focused on what it takes to make a healthy community, and here were these young men teaching me that they would rather be doing what my son was doing than what they were doing, but they never had the chance.”

Martin was no stranger to the adversity that prevents many people from pursuing their dreams. A domestic violence survivor, she supported herself from the age of 15, gave birth to her first child when she was 17 and spent 20

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

a year in her 20s homeless with her two children, sleeping on an office floor. At age 33 she enrolled at Los Angeles City College and 10 years later she completed her doctorate at the Fielding School.

In 2001, with a $9,000 initial contribution from the Rotary Club of Hollywood and a small group of founding board members, Martin launched Harmony Project, a program to promote the positive growth and development of at-risk youth through the study, practice, and performance of music. With mentoring from the professional musicians employed by the program, students are engaged in music

“Most of our students are heading toward professional degrees. For them, poverty is over.” classes and ensemble rehearsals 5-12 hours a week, yearround, tuition-free, until they graduate high school.

The program started with 36 participants from disadvantaged homes in Los Angeles. Eight years later, Martin was at

the White House representing Harmony Project as it received the Coming Up Taller Award from First Lady Michelle Obama — considered the nation’s highest honor for an arts-based youth program. Two years after that, Martin returned to accept the Presidential Citizens Medal, the nation’s second-highest civilian honor.

Today, Harmony Project reaches 2,000 youth in lowincome areas of Los Angeles designated as gang reduction zones, with affiliated programs in nine other regions across seven states (including San Francisco, Phoenix, East St. Louis, New Orleans, Miami, and Hudson, NY, among others), bringing the total enrollment to approximately 5,000, and counting. In January, 40 standout string students from Harmony Project Los Angeles performed on stage at the 2016 Super Bowl halftime show with pop stars Beyoncé, Bruno Mars and Chris Martin, along with Los Angeles Philharmonic conductor Gustavo Dudamel.

Martin credits her Fielding School education with informing her approach to starting Harmony Project. “As an academic, I wasn’t going to do anything that wasn’t researchbased,” she says. In developing the blueprint, Martin drew from a RAND study on the elements of arts-based programming that promote pro-social behavior in youth. These elements continue to serve as part of the blueprint for Harmony Project: Allow participants extended participation. Among members of Harmony Project’s 2016 graduating class, the average length of time in the program was seven years.

Provide complementary services beyond the arts programming. Harmony Project counsels students to enroll in academic courses that can help them become college-eligible, provides parenting education and referrals to social services, offers scholarships to graduating seniors who qualify for Harmony Project’s own scholarship program and assists students in applying for additional college scholarship awards.

Provide youth mentorship opportunities. Beyond the mentorship provided by the musicians, advanced students are trained to mentor their less-advanced peers.

Promote accountability through regularly scheduled performances or presentations. Students demonstrate their learning in frequent recitals, as well as other public performances in front of family and peers.

Harmony Project now stands on its own as a successful arts-based program for at-risk youth. Since 2008, 90 percent or more of the program’s high school seniors who participated at least three years in Harmony Project went on to college — this, Martin notes, from neighborhoods where high school dropout rates approach or exceed 50 percent. Graduates include two Fulbright scholars.

In search of a scientific explanation for the striking academic success of Harmony Project participants, Martin contacted Dr. Nina Kraus, director of Northwestern Univer-

TOP: DR. MARGARET MARTIN, HARMONY PROJECT FOUNDER, WITH THE LOS ANGELES CLASS OF 2015. ABOVE: MARGARET MARTIN RECEIVING PRESIDENTIAL CITIZENS MEDAL.

sity’s Auditory Neuroscience Laboratory. Kraus agreed to partner with Harmony Project on a randomized controlled study of the program’s long-term neurologic impact. Publishing a series of journal articles beginning in 2014, Kraus and her colleagues have presented neurological evidence that two years in the program “remodeled” the children’s brains in ways that significantly improve their cognitive function.

“The research from the Kraus lab shows that our kids are changing their own brains,” Martin says. “Music training within Harmony Project enables our students to overcome the negative neurologic impact of poverty and adverse life events on their capacity to learn.”

Martin believes these success stories have powerful implications for public policy and public health. In addition to academic successes, she points to the positive social network maintained by the participants, as well as the confidence, accountability, and agency Harmony Project fosters.

“We are consistently achieving outcomes that everybody wants, and we believe it’s because we have tripped over a Rosetta stone,” Martin says. “Most of our students are heading toward professional degrees. For them, poverty is over.” ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

21

S PAC E TO MOVE The physical environment can promote or discourage outdoor exercise and play.

FSPH researchers help to lay the groundwork for healthier surroundings.

22

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

PHOTO COU RTESY OF SEBASTIAN AU ER PHOTO

BUILT ENVIRONMENT

WHAT ARE THE SOCIETAL FACTORS THAT INFLUENCE HEALTH? When Dr. Richard Jackson asks the question, the response often includes some combination of economics, education, and culture. Rarely does he hear the one he is looking for: the physical environment of one’s neighborhood.

“If it’s not easy to walk to places, you’re surrounded by unhealthy food choices, and you spend hours each day driving to and from your job, that’s a powerful determinant of your health,” says Jackson, professor in FSPH’s Department of Environmental Health Sciences.

A well-known author, lecturer and consultant on how to make urban environments more aligned with public health goals, Jackson has called the built environment “social policy in concrete” given the impact of urban planning and architectural design on health and well-being. Unfortunately, Jackson notes, “communities that don’t have a strong voice are more disenfranchised when these decisions are made.”

At the Fielding School, faculty and students are working with community partners and policymakers in Los Angeles and beyond to ensure that decisions about everything from buildings and green spaces to public transit, bike lanes and streetscapes are made with an eye on their public health implications. Of particular interest is the notion of transportation equity — matching the infrastructure of communities with the needs of their populations.

Dr. Michael Jerrett, professor and chair of FSPH’s Department of Environmental Health Sciences, points out that in Los Angeles and many other cities, inequities persist not just in the ability to get around, but in access to parks and open spaces that are conducive to outdoor activity. In addition to their quality of life value, these facilities are critical at a time when sedentary lifestyles

are associated with high rates of obesity and related chronic conditions such as diabetes, cardiovascular disease and certain cancers.

In a series of studies, Jerrett has found wide-ranging disparities between low-income communities and more affluent areas in both the quantity and quality of park spaces. “People living in low-income communities aren’t getting sufficient access to this health-promoting resource, and when they do have access the area tends to be more polluted, the park facilities are not as well maintained, and there is less park programming and less energy going into the programs offered,” Jerrett says.

Most recently, Jerrett’s group found that for pedestrians and bicyclists in Los Angeles, traveling to and from parks is dangerous — with as much as a 50 percent greater risk of traffic accidents in the area within a quarter-mile of the destination. The study found that the risk is amplified in low-income and predominantly minority communities, in part because of an insufficient safety infrastructure. Jerrett notes that children and young adults are disproportionately at risk for traffic-related injuries and fatalities around parks. “There has been a movement toward instituting safe routes to school and safe routes to transit,” he says. “Given the unequivocal evidence of the benefits of physical activity, we need to also focus on ensuring safe routes to play.” Jerrett is currently providing consultation to the Southern California Association of Governments to integrate his group’s research into ongoing transportation planning.

Efforts to encourage more walking and bicycling face significant obstacles, and not just around parks. Jerrett notes that in Los Angeles, surveys consistently show personal safety concerns as a major barrier to bicycling. “Unless you have an integrated system in which people can have options that

OPPOSITE: PEDESTRIANS AND BICYCLISTS TAKE OVER A BUSY LOS ANGELES STREET AT A CICLAVIA EVENT IN 2016.

ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

23

BUILT ENVIRONMENT

allow them to bike away from dangerous roads and intersections, safety is going to be a deterrent,” he says.

Advocates for more pedestrian-friendly boulevards must also overcome major challenges. “Unlike many European cities that evolved at a time when walking was the predominant mode of

“CicLAvia and other open-streets programs tangibly flip the narrative by saying that pedestrians and bicyclists matter.”

— Christina Batteate, MPH ’12 transportation, much of Los Angeles was developed around a car-dominated culture,” Jerrett says.

Nonetheless, there is growing momentum behind initiatives to reclaim the built environment for walkers and bikers — as illustrated by the recent success of CicLAvia, a Los Angeles nonprofit organization that temporarily closes a section of streets to vehicular traffic for Sunday events that promote walking, biking, local commerce, and community engagement. CicLAvia reports that it has created more than 110 miles of open streets throughout Los Angeles and has drawn more than 1 million people to its events since it began in 2010.

In 2014, a Fielding School group embarked on a series of studies assessing CicLAvia’s impact. The researchers started with basic questions around who was attending the events and what impact CicLAvia had on businesses along the routes, but they quickly realized that something special was occurring — a dramatic shift in the physical and social environment that, though technically only for a day, could have long-term ramifications.

Among the benefits: improved air quality. A 2015 study led by Dr. Yifang Zhu, FSPH associate professor of envi24

ronmental health sciences, measured air pollutants during a CicLAvia event held in and around Downtown Los Angeles and found substantial declines in the presence of ultrafine particles and particulate matter measuring 2.5 micrometers or smaller — both of which are associated with increased risk for respiratory and cardiovascular disease.

“Not only does CicLAvia reduce the concentrations of traffic-emitted air pollutants, but we were also struck that the reduction of particulate pollution extends beyond the CicLAvia route,” Zhu says. Other studies by Fielding School researchers found more good news: significant drops in crime around CicLAvia sites on the event days.

The Fielding School researchers found that more than half of the participants surveyed would have been home or sedentary if not at the event.

And fewer than half of CicLAvia’s participants arrive by car — opting for transit, biking, and walking instead.

Initial evidence also suggests that the

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

more events attended, the less likely the person is to arrive by car. “This could be pointing to alternative transportation behaviors being promoted or reinforced

by CicLAvia attendance, though further study is needed,” says Christina Batteate (MPH ’12), a Fielding School PhD student who helped spearhead the CicLAvia research effort.

The Fielding School team has found that when CicLAvia’s temporary public space is located in park-poor low-income communities, a substantial number of the participants are first-time attendees from the local area. “At each event, thousands of new people are being exposed to this new paradigm of what our city can look like and how fun mobility and social connections can be,” Batteate says.

“CicLAvia and other open-streets programs tangibly flip the narrative by saying that pedestrians and bicyclists matter. Even if for a day, this allows the community to envision that it can be something different.”

TR ANSPORTATION

On the Right Track

An FSPH team is helping to steer California’s high-speed rail project in a healthy direction.

CALIFORNIA HAS BROKEN GROUND on one of the most ambitious

helps to reduce vehicle miles traveled — which is associated with traf-

transportation projects in the state’s history — a $64 billion high-

fic risks, air pollution and greenhouse gas emissions — is likely to have

speed rail system that will link Los Angeles to San Francisco via the

a positive health impact,” says Dr. Michael Jerrett, professor and chair

rural Central Valley, reaching speeds up to 220 miles per hour with

of FSPH’s Department of Environmental Health Sciences and a mem-

connections to the major cities en route. But the implications of

ber of the study team. In particular, the Fielding School researchers

California High-Speed Rail extend well beyond the ability to get from

say, people who live close to highly traveled roads may see a benefit

one place to another.

from reduced roadway emissions. In addition, Cole notes, avoiding the

“Transportation affects health in so many ways,” says Dr. Brian Cole, lead analyst for FSPH’s Health Impact Assessment (HIA) Group, which conducts and provides technical assistance on HIAs

need to endure stressful commutes on congested roadways can bring mental health benefits to high-speed rail commuters.

The population in the San Joaquin Valley region covered by the

for a wide range of public policies and projects. “This project will

Fresno-to-Bakersfield route may also benefit from increased eco-

have significant effects, both direct and indirect, through changes

nomic opportunity, the Fielding School researchers point out. “Many

not only in transportation habits, but also in economic develop-

of these communities are heavily dependent on agriculture and have

ment and how communities are structured. And the decisions and

high seasonal unemployment rates and significant social problems,”

actions by both the state authority and local governments can go

Jerrett says. In the short term, the project is likely to produce a major

a long way toward maximizing potential benefits and minimizing

influx of transportation- and infrastructure-related jobs. And for the

potential harm.”

long term, high-speed rail expands the pool of available employment

With that in mind, in 2014 the California High-Speed Rail

by making it easier for the area’s residents to commute to jobs much

Authority asked a Fielding School team headed by Cole to assess

farther from their homes. Greater economic development in the

the potential health implications of the system as a whole, as well as

region can help to diversify the rural economy; it is also likely to draw

conducting an HIA focusing on the Fresno-to-Bakersfield portion of

more professionals, including those in health fields, which could pro-

the planned project — identified as an area of particular concern by

vide much-needed relief for a medically underserved region.

the California Environmental Protection Agency based on the pop-

The FSPH team is also weighing the potential for negative

ulation’s environmental exposure, health risks, and socioeconomic

effects. “There have been cases in which these types of projects

status. The Fielding School group has been a national leader in the

have connected between places but divided within,” Jerrett says. He

growing HIA movement, which draws on interdisciplinary expertise

points to noise and traffic-safety concerns around the high-speed

to assist decision-makers and communities in weighing potential

rail station, and the tendency of past projects to route the trains

health effects of major projects and policies.

through areas that place a disproportionate share of these burdens

High-speed rail’s health impact stems from providing communi-

on low-income populations and people of color. The Fielding School

ties with an additional transportation option, likely to be less expen-

researchers point out that a major project such as high-speed rail

sive than owning and operating an automobile. Among the benefits,

changes land-use patterns, and “smart growth” policies are critical

using public transit as opposed to a car typically adds walking time

to bringing together housing, retail, and services in a way that pro-

associated with getting to and from the stop. “If you have an other-

motes community cohesion and improves quality of life. The FSPH

wise sedentary population and give them an extra 15 minutes a day

group has partnered with Cultiva La Salud, a community-based pub-

of physical activity, that can be huge,” Cole says. Moreover, high-

lic health organization in the San Joaquin Valley, to provide input for

speed rail development often leads to improvements in local transit

the HIA and use the results in its ongoing work to promote health.

service and in pedestrian and bicycle infrastructure, which can also

“Depending on how they are implemented, transportation projects

increase physical activity.

such as this can either divide communities or bring them together,”

Combating sedentary lifestyles isn’t the only potential health benefit. “It’s very difficult to get people to drive less, so anything that

Cole says. “We are trying to point to ways that this project can be steered in a direction that will maximize the benefits.” ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

25

ECONOMIC DISPARITIES

CAN ECONOMIC INEQUALITY BE HAZARDOUS TO A SOCIETY’S HEALTH? Dr. Akihiro Nishi, assistant professor of epidemiology at the Fielding School, notes that there is substantial evidence showing that wide gaps between rich and poor are associated with higher mortality rates. The reasons are unclear, but scholars have speculated that highly unequal societies may result in increased overall stress levels, leading to higher rates of cardiovascular disease and other stress-related conditions. More inequality can also mean less social support, reflected in reduced access to health care and other health resources among large segments of the population.

In work he started as a postdoctoral researcher at Yale University and is continuing at the Fielding School, Nishi is building on those findings while adding a wrinkle: The visibility of wealth inequality within a society appears to be more harmful than the presence of inequality itself. Publishing in the journal Nature in 2015, Nishi and colleagues concluded that visible inequality — from knowing about the salaries of others to seeing evidence of a neighbor’s wealth in the form of a luxurious home or fancy car — has a negative effect on levels of cooperation, and contributes to even greater inequality.

INEQUALITY’S UNHEALTHY CONSEQUENCES Research by the Fielding School’s Akihiro Nishi suggests that visible disparities in wealth may result in less social support and greater inequality.

26

For the Nature study, Nishi’s group conducted an experiment in the form of an online game, wherein participants were placed into computer-simulated “societies” with varying degrees of inequality. Within each society, some individuals could see how much money their neighbors had while others could not. The game repeatedly asked participants to make choices that tested their interest in cooperating with others — for example, they could invest in their neighbors with the potential of gaining financially in return, or they could keep their money to themselves. In each group, participants could see their neighbors’ choices after every round, potentially affecting their own choices in future rounds.

When participants in the experiment didn’t know about the wealth of others, their level of cooperation wasn’t affected by their society’s economic inequality.

But in unequal societies where wealth was visible, wealthier individuals were less likely to invest in their neighbors, widening the gulf between rich and poor. “We know that when a comparison of salaries is possible within a company, it can lead to lower levels of job satisfaction,” Nishi says. “Our study suggests that visible wealth inequality also leads to lower levels of social cohesion, which is not what we would hope for from the standpoint of public health.”

Nishi notes that although conclusions about the public health effects of visible wealth inequality can’t be drawn from the Nature study, it raises public health questions for future study. Among the questions Nishi intends to pursue: whether policies to make wealth inequality less visible — through pay secrecy or school uniforms, for example — might result in mental health benefits and improved social cohesion within a company or a community.

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

SCHOOL WORK MICHELS JOINS FSPH AS CHAIR OF DEPARTMENT OF EPIDEMIOLOGY DR. KARIN MICHELS JOINED THE FIELDING SCHOOL in July as chair of the Department of Epidemiology. Considered one of the co-founders of epigenetic (non-genetic influences on gene expression) epidemiology, Michels has made seminal contributions to the methods used in this field. Her research, which focuses on women’s health, addresses the role of epigenetics and other factors in the developmental origins of health and disease. In this context, Michels’ research explores the importance of the time period between conception and puberty in the development of breast cancer. Additionally, she has made numerous methodologic contributions to nutritional epidemiology and has explored the importance of a healthy diet for cancer prevention throughout the life course. Prior to joining FSPH, Michels was a member of the faculty at Harvard University.

FSPH AT AMERICAN PUBLIC HEALTH ASSOCIATION MEETING THE AMERICAN PUBLIC HEALTH ASSOCIATION’S 2016 annual meeting in Denver was attended by Fielding School faculty, students, staff, and alumni, many of whom had their work featured. The meeting’s theme was “Creating the Healthiest Nation: Ensuring the Right to Health.”

ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

27

FIELDING FALL FIESTA

INAUGURAL EMPLOYER SHOWCASE

FSPH CAREER SERVICES hosted the school’s first annual Public Health Employer Showcase, designed to introduce students to public health employers in diverse practice areas. The event featured 21 employers and was attended by more than 125 students.

MPH STUDENTS VISIT PARTNER ORGANIZATIONS

STUDENTS, FACULTY, STAFF AND ALUMNI gathered to celebrate accomplishments of the FSPH community and ring in the new academic year at the fourth annual Fielding Fall Fiesta. Dean Jody Heymann shared news of the more than $49.5 million in grant and contract funding earned

by FSPH last year, an increase of nearly 15 percent compared to the previous year. This figure includes funds to support new and continuing training efforts to address cancer; advance leadership and continuing education in nutrition; foster population health advocacy; promote health services research in Los Angeles; mitigate the risks of climate change; strengthen health communication; fight TB, HIV and AIDS; provide training to accelerate poverty reduction and achieve the U.N. Sustainable Development Goals; and improve child and family health. The dean also spoke of more than 140 students receiving fellowship support and funded training opportunities in 2015-16, and of new fellowship and training opportunities for students to come, many of which were made possible by the generosity of both individuals and foundations.

28

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

First-year MPH students in the Department of Community Health Sciences attended a daylong trip organized by the department to introduce new students to partner organizations in Los Angeles. Students visited the Los Angeles County Department of Public Health, L.A. Kitchen, The Wellness Center and The California Endowment, and heard from key individuals at each organization, including FSPH alumni.

PROFESSOR RECEIVES 2016 CHINESE GOVERNMENT FRIENDSHIP AWARD DR. ROGER DETELS, distinguished professor in the Department of Epidemiology, was honored by the Chinese government with a prestigious Chinese Government Friendship Award for training more than 100 students at UCLA and more than 3,300 short-term trainees in China over the last 30 years as part of the Fielding School’s UCLA/Fogarty AIDS International Research and Training Program. The Friendship Award is the highest award bestowed by the Chinese Central Government to honor foreign experts who have made significant contributions to China’s economic and social progress.

PICTURED: DR. ROGER DETELS (RIGHT) WITH CHINESE PREMIER LI KEQIANG

NEW STAFF SUPPORTS STUDENTS AND THEIR PROFESSIONAL GOALS DR. ELIZABETH YZQUIERDO has joined the Fielding School as assistant dean for students. Yzquierdo has shown a passion for cultivating a strong health professional workforce throughout her career. She has led pipeline programs, recruitment efforts, and diversity initiatives, and was instrumental in restructuring career-changing post-baccalaureate and health professional advising programs. Yzquierdo’s previous positions include director of student engagement for the College of Science and Engineering at Loyola Marymount University and director of diversity inclusion and outreach at the UCLA David Geffen School of Medicine.

Ensuring that the Fielding School is accessible and affordable to outstanding students from all communities is one of FSPH’s highest priorities and is fundamental to its excellence. To advance these goals and to continue to expand the financial aid and reach of the school, Michelle Garcia-Navarro has been recruited to fill the newly created position of director of admissions and financial aid. Garcia-Navarro comes to FSPH with extensive experience, including her role as associate director of the Global Access Program at the UCLA Anderson School of

Management and, previously, as admissions director for the University of Hawaii at Manoa’s MBA program.

After more than 10 years of distinguished service as director of career services at FSPH, longtime staff member Arlecia Powell-Halley has assumed a new role as director of academic services. Kristy Sherrer has joined the Fielding School in the role of director of career services to empower students with professional skills and a community of support to confidently make thoughtful career decisions. Sherrer previously worked at the UCLA Career Center, where she was integral in building services for graduate students in the STEM (science, technology, engineering, and mathematics) community. Her numerous accomplishments include the initiation of STEM employer and alumni recruitment opportunities specifically for graduate students, which connected more than 500 alumni and employers with thousands of students. Sherrer worked with STEM master’s and PhD candidates through peer learning workshops and career advising, ultimately contributing to a 20 percent increase in master’s student utilization of career counseling and a 70 percent increase among PhD students. ph.ucla.edu

Dr. Liz Yzquierdo

Michelle Garcia-Navarro

Kristy Sherrer AU T U M N /W I N T E R 2 0 1 6 –17

29

GRANTS & CONTRACTS This section includes new grants and contracts awarded in 2015-16. Due to space limitations, only funds of $50,000 or more are listed, by principal investigator.

YVONNE FLORES Genetic and Environmental Risk of Liver Disease/ Cancer Among Mexicans National Cancer Institute, $804,600 for five years JOHN FROINES

PATRICK ALLARD

BURTON COWGILL

In Vivo Assessment of the Adjuvant Effect of

Application of Novel Approaches Towards

Development of an Afterschool Tobacco Use

Vaporphase Pollutants on Allergic Sensitization

Germline Toxicity Assessment

Prevention Program

South Coast Air Quality Management District,

Burroughs Wellcome Fund, $500,000 for five years

UC Tobacco-Related Disease Research Program,

$172,000

$268,500 for two years RICHARD AMBROSE

E-cigarette Understanding and Use Among a

PATRICIA GANZ

Assessing the Effects of Sediment Augmentation

Diverse Sample of Ethnic Minority Adolescents

A Model Clinical/Translational Research Program

on the Marsh Plain and Tidal Creeks at the Seal

National Cancer Institute, $154,000 for two years

for Breast Cancer Survivors: A Focus on Cognitive

Beach Wetland

Function after Breast Cancer Treatment

California Coastal Conservancy & Southwest Wetlands

SANDRA DE CASTRO BUFFINGTON

The Breast Cancer Research Foundation, $250,000

Interpretive Association, $323,944 for six years

Hollywood Understands Learning and

Biobehavioral Predictors of Fatigue in Newly

Determining Long-Term Changes in Species

Attention Issues

Diagnosed Breast Cancer Patients

Abundances and Community Structure in

The Poses Family Foundation, $100,000

National Cancer Institute, $199,994

Southern California Rocky Intertidal Habitats

Global Media Center for Social Impact Operating

Department of the Interior Bureau of Ocean

Funds Renewal

GILBERT GEE

Energy Management & UC Santa Cruz, $519,966

The Nathan Cummings Foundation, $100,000

Dual-Cohort Prospective Study of Obesity

for five years

National Institute of Child Health and Human ROGER DETELS

Development, $2,680,379 for five years

SUSAN BABEY

Understanding Patterns of Healthy Aging Among

Estimating Pre-diabetes in California

Men Who Have Sex with Men

BETH GLENN

California Center for Public Health Advocacy,

National Institute on Minority Health and Health

Evaluation of “Within Our Reach” Project

$85,000 for one-and-a-half years

Disparities & University of Pittsburgh, $354,982

Centers for Disease Control and Prevention &

Serological Testosterone and Estrogen Levels

California Center for Public Health Advocacy,

SUDIPTO BANERJEE

Increase Risk for Anal Histological High-Grade

$110,000 for two-and-a-half years

Collaborative Research: Hierarchical Sparsity-

Squamous Intraepithelial Lesions (HSIL)

Inducing Gaussian Process Models for Bayesian

Natural History of AIDS in Homosexual Men

PAMINA GORBACH

Inference on Large Spatiotemporal Datasets

(Wiley supplement)

Special Interest Project (SIP): HPV Vaccine Impact

National Science Foundation, $240,000 for three years

National Institute of Allergy and Infectious

Among Men Who Have Sex with Men (MSM)

Diseases, $190,795

Centers for Disease Control and Prevention &

ROSHAN BASTANI

University of Kentucky, $282,117 for four years

UCLA Kaiser Permanente Health Equity Leaders

DAVID EISENMAN

National Network and Training Program

Building Resilient Regions: Workforce Capacity

JULIA HECK

The East Bay Community Foundation, $132,250

for Translation, Implementation and Evaluation

Smoking and Embryonal Tumors Study

of Promising Preparedness and Emergency

UC Tobacco-Related Disease Research Program,

EMMELINE CHUANG

Response Research Centers (PERRC) Products

$436,915 for three years

Qualitative Research, Project, Management, and

Centers for Disease Control and Prevention &

Statistical Analysis

Association of Schools of Public Health, $1,077,392

JODY HEYMANN

Children’s Bureau of Southern California, $489,729

for one-and-a-half years

Leveraging Policies and Laws that Are Pro-women

Mixed Methods Study of Organizational Supports

and Girls to Decrease Inequities in Health and

Used by Private Child and Family Service

JONATHAN FIELDING, BRIAN COLE, AND

Development Outcomes

Agencies to Facilitate Evidence Use

FREDERICK ZIMMERMAN

Bill and Melinda Gates Foundation, $604,786

William T. Grant Foundation, $363,711 for two years

Forecasting the Population Health Burden of

Gender Equality and Economic Empowerment

Mental Health Disorders and Scenarios for

in 2030: A Data-Driven Approach to Advancing

BRIAN COLE

Prevention and Treatment in Los Angeles County

Evidence-Based Steps Critical to Achieving

Bringing a Community Health Lens to Highway-to-

Unihealth Foundation, $429,213 for two years

Sustainable Development Goal (SDG) 5

Main Street Conversions Through the Integration

UCLA Center for Health Advancement

William and Flora Hewlett Foundation, $750,000

of Top-Down Expert Guidance and Bottom-Up

Training and Technical Assistance for California

Training Future Leaders to Accelerate Poverty

Community Engagement

Community Foundations Grant in the

Reduction and Achieve the Sustainable

California Department of Transportation & UC

Centinela Valley

Development Goals (SDGs)

Berkeley, $158,397

California Community Foundation, $150,000

Conrad Hilton Foundation, $5,440,000 for three years

30

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

MOIRA INKELAS

Colorectal Cancer Screening in South Los Angeles

Sciences, $137,580 for two years

Improvement Support to the Magnolia Place

Jonsson Cancer Center Foundation, $50,000

Pesticide Exposure and Cerebral Palsy

Community Initiative Network – Supplement

National Institute of Environmental Health NINEZ PONCE

Sciences, $154,000 for two years

Disaggregation of Health Data Across Asian

Autism Metabolomics and Environment

MICHAEL JERRETT

American, Native Hawaiian and Pacific Islanders

National Institute of Environmental Health

Health and Environment-Wide Associations

(AANHPIs)

Sciences, $436,457 for two years

Based on Large Population Surveys

Robert Wood Johnson Foundation, $100,000

European Union & UC Berkeley, $86,800 for three years

California Health Interview Survey (CHIS)

DAMLA SENTURK

Kaiser Foundation Research Institute [Southern

Modeling Time-Dynamic Multilevel Outcomes in

LEEKA KHEIFETS

California], $1,100,000 for two years;

Patients on Dialysis

Comparative Analyses of Studies of EMF, Radon

CA/Department of Health Care Services, Fiscal

National Institute of Diabetes and Digestive and

and Gamma Radiation

Management and Outcomes Reporting Branch,

Kidney Diseases, $1,354,810 for four years

Electric Power Research Institute, $60,388

$2,400,000 for three years; CA/Department of

Children’s Bureau of Southern California, $50,000

Health Care Services, Information Management

DAMLA SENTURK, DONATELLO TELESCA,

KATHRYN KIETZMAN

Division, $6,000,000 for six years; California

AND CATHERINE SUGAR

Fee-for-Service or Managed Care? An

Children and Families Commission (First

A Unified Longitudinal Functional Data

Investigation of Dual Eligible Consumer

5 California), $1,700,000 for two years; The

Framework for the Analysis of Complex

Preferences for Health Care Delivery

California Endowment, $3,135,008 for two years;

Biomedical Data

Robert Wood Johnson Foundation, $399,129 for

The California Wellness Foundation, $775,000

National Institute of General Medical Sciences,

one-and-a-half years

for two years

$1,355,981 for four years

AskCHIS Neighborhood Edition Application GERALD KOMINSKI

Program Interface

SANGHYUK SHIN

Nutrition Education Obesity Prevention’s

California Healthcare Foundation, $54,896

Partnership for TB Elimination: Preventing

Synthesis of Program Impact Project

Barriers to Breast Cancer Care

Tuberculosis Among Foreign Born Persons Seeking

County of Los Angeles Department of Public

UC/California Breast Cancer Research

Permanent Residency in Los Angeles County

Health, $579,322

Program, $92,416

Los Angeles County Department of Public Health,

Chronic Disease Prevention Strategy In Los

Sub-County CHIS Estimates Through AskCHIS

$175,000 for two years

Angeles (CDPS) Project – Health System

Neighborhood Edition

Strategies Evaluation

Population Health Research Institute &

ANNETTE STANTON

County of Los Angeles Department of Public

CA/Department of Public Health, $59,000

Understanding and Improving the Experience of

Health, $178,439

Breast Cancer

California Health Interview Survey Research Projects

NADEREH POURAT

The California Endowment, $793,000 for two years

Identification of Assessment Measures for

California Health Policy Research Program,

Child and Adolescent Functioning

ONDINE VON EHRENSTEIN AND

Renewal 2016-2017

CA/Department of Health Care Services, $436,970

BEATE RITZ

The California Endowment & UC Berkeley, $68,500

The Breast Cancer Research Foundation, $250,000

Childhood Autism and Air Pollution —

Demographic Analysis and Microsim Model

ANNE RIMOIN

A Statewide Study

Comparison and CHIS — Supplement

Estimating Population Immunity to Poliovirus

National Institute of Environmental Health

California Health Benefit Exchange, $2,500,000 for

in the Democratic Republic of the Congo —

Sciences, $437,220 for two years

two years

Supplement Bill and Melinda Gates Foundation, $597,076

HUA ZHOU

LI LI

Digitization and Support for Development of a

Tensor Regressions and Applications in

UCLA/Vietnam Training Program in Evaluation

Human African Trypanosomiasis Information

Neuroimaging Data Analysis

and Advanced Methodologies

and Decision and Support System in Democratic

National Science Foundation, $85,599 for two years

Fogarty International Center, $1,494,424 for

Republic of the Congo

five years

Bill and Melinda Gates Foundation, $203,375

ANNETTE MAXWELL

BEATE RITZ

Sectors: Technical Assistance in Communication

Building Mixtec Community Capacity for Breast

Air Pollution and Autism in Denmark

and Implementation Using Evidence from an

Health, Phase 2

National Institute of Environmental Health

Economic Model

UC/California Breast Cancer Research Program,

Sciences, $361,578 for two years

De Beaumont Foundation, $919,759 for two years

$193,652 for two years

Psychosocial Stressors, Air Pollution and

FREDERICK ZIMMERMAN Fostering Win-Win Collaboration Across

Childhood Respiratory Health in Los Angeles FOLASADE (FOLA) MAY

Family and Neighborhood Survey (LAFANS)

A Community-Academic Partnership to Improve

National Institute of Environmental Health ph.ucla.edu

AU T U M N /W I N T E R 2 0 1 6 –17

31

TRANSFORMATIVE INVESTMENTS “The Kayne Fellowship meant I could choose a job that best meets my passions and career goals, rather than one that merely meets my financial requirements.”

FELLOWSHIPS FORGE A BRIGHTER FUTURE FOR PUBLIC HEALTH BORN INTO A FAMILY OF TEACHERS, social workers and psychologists, Devin Saragosa-Harris grew up in Southern California believing that a life working for others was the only one worth pursuing.

A recent graduate of the Fielding School’s Department of Community Health Sciences, Saragosa-Harris had the opportunity while still at FSPH to apply her education through work with 9 Dots Community Learning Center, a Hollywood nonprofit that runs after-school projects for disadvantaged Latino students. She worked as a tutor and developed health education materials focused on nutritional topics, such as the sugar content in beverages and the need for balanced meals.

During the second year of her MPH program, Saragosa-Harris was chosen to be among the first cohort of students to receive a fellowship made possible through a generous gift from Ric and Suzanne Kayne. Fellowships like these are designed 32

to eliminate some of the financial barriers that students face while providing them the time and flexibility they need to complete their studies, then find quality jobs that match their passions and will have the greatest potential impact on public health.

The Kayne Fellowship did just that for Saragosa-Harris.

“I was pretty sure I wanted to be working for a nonprofit,” she says, “so having that financial support during a time when I could be depleting all of my financial resources was very helpful.”

At the end of her job search, Saragosa-Harris chose to rejoin 9 Dots, this time as a program manager. She credits the financial support she received with helping her return to work that she finds most meaningful. “Being less burdened by student loans allowed me to pursue a position with a communitybased organization with targeted programs for underserved populations,” she says. Saragosa-Harris now recruits students from 14 schools to participate in 9 Dots programs, trains new tutors, and is designing a new curriculum to include a stronger focus on health through a rigorous and structured fitness program, the creation of a community garden, and an emphasis on food deserts and nutrition. This emphasis meets an acute need in Los Angeles, where more than 38 percent of youth are overweight or obese, and where an estimated one in three young adults now have diabetes or prediabetes, according to a study by the FSPH-based UCLA Center for Health Policy Research.

Saragosa-Harris is one of 12 Kayne Fellows who have devoted their careers to transforming health in communities of high need throughout California and across the country. Other fellows are doing invaluable work on chronic diseases, maternal-child health, cancer prevention, health care delivery, and health communications at organizations such as AltaMed, Project Angel Food, Saban Community Clinic, Weingart East Los Angeles YMCA, the San Francisco Department of Public Health, Brigham and Women’s Hospital, Kaiser Permanente, and the National Cancer Institute.

Receiving a fellowship was instrumental in Saragosa-Harris’ ability to pursue a life working for others. “The Kayne Fellowship meant I could choose a job that best meets my passions and career goals, rather than one that merely meets my financial requirements,” she says. “Without funding, there is very little chance I would have had these experiences that are currently shaping my future.”

U C L A F I E L D I N G S C H O O L O F P U B L I C H E A LT H M AG A Z I N E

PUBLIC HEALTH IS A MARATHON Our team of students, alumni and friends has run enough in the past two years to fund 5,000 hours of work in the community, and together we can do even more in 2017.

HELP US REACH THE FINISH LINE. For more information visit ph.ucla.edu/marathon2017 or call (310) 825-6464.

Nonprofit Org. U.S. Postage PAID UCLA Box 951772 405 Hilgard Avenue Los Angeles, CA 90095-1772 www.ph.ucla.edu Address Service Requested

“Injustice anywhere is a threat to justice everywhere… whatever affects one directly, affects all indirectly.”

— Martin Luther King, Jr.