FSPH Magazine Spring/Summer 2017

PUBLIC HEALTH SPRING/SUMMER 2017

The UCLA Fielding School of Public Health Magazine

Food and Fitness for a Better Tomorrow

DEAN’S MESSAGE

THE WORLD PRODUCES ENOUGH NUTRITIOUS FOOD FOR EVERYONE, but many of the most profound public health challenges are food-related.

Despite substantial progress over the last 25 years, the United Nations Food and Agriculture Organization estimates that globally nearly 800 million people suffer from chronic undernourishment. Even in the United States and other middle- and high-income countries, large numbers of people are food-insecure.

At the same time, countries around the world increasingly face a different kind of nutrition problem: the overconsumption of unhealthy foods — a long-term development that, combined with the trend toward more sedentary societies, has produced an epidemic of obesity and conditions associated with these changes in diet and exercise, including diabetes, cardiovascular disease and some cancers.

Thanks to public health efforts, most of us have at least a general understanding of which foods are good for us and which ones aren’t. We know that a well-balanced diet and regular exercise are critical to our health. But information is not enough when wages are low and healthy foods for a family are unaffordable, in communities where fresh produce is rare and large servings of unhealthy foods are both ubiquitous and inexpensive; where safe spaces for exercise are lacking; and where impossibly long work hours (paid and unpaid) make the barriers to exercise and other care needed for health nearly insurmountable. Social, political and economic forces powerfully shape access to quality food and health-promoting physical activity through issues such as affordability, safety, time, and availability of information and goods, among other factors.

Fielding School students, faculty and alumni understand this, and as the examples in this issue attest, many are leaders in the ongoing effort to transform nutrition and physical activity through programs and policies designed to reduce obstacles to healthy eating and exercise.

Social conditions exert tremendous influence over people’s ability to lead nutritious and active lives. Our school and its graduates are addressing these conditions to ensure that everyone, regardless of where they live and work, has access to affordable, nutritious foods as well as safe and fulfilling opportunities for physical activity.

Jody Heymann, MD, PhD Dean

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The UCLA Fielding School of Public Health Magazine

SPRING/SUMMER 2017

CONTENTS 14

28

22

30

FEATURES

HEALTHY EATING

04 Separating Food Facts from Fiction Epidemiology department chair challenges common nutrition myths

COMMUNITY ENGAGEMENT

06 Weighing the Options Computer simulations assess ways to combat early childhood obesity

MPH FOR RDs

09 Bringing Public Health to the Table FSPH/VA partnership broadens the training of dietitians

POLICY ADVOCACY

10 Food Fight Alum successfully takes on junk food and soda

12 Empty Calories Dana Hunnes on sugary drinks’ nutritional value 13 Sugar Overload Soda’s hold over consumers is a “marvel of advertising”

ENHANCING PHYSICAL EDUCATION

14 Student Bodies in Motion Program helps PE teachers keep their classes engaged 17 Fun Facts Projecting long-term health benefits in reimagined PE

FACULTY PROFILE

18 Hungry for Something New William McCarthy’s passion for healthy foods is hard to miss

26 Screen Grabbers Videos to bring healthy messages to schoolchildren

FIGHTING HUNGER

AGRICULTURAL SHIFT

OUTREACH TO STUDENTS

28 Nutrition & Public Health Marion Taylor Baer on strategies and policies for healthy eating

26 Students Helping Students FSPH Nutrition Club

DEPARTMENTS

20 Poverty Policies Evaluating efforts to assist society’s poorest members 22 Cultivating Change Crop substitution in China addresses food security and increases farmers’ profits 24 Food for Thought Seeking sustainable solutions on campus

KEEP IN TOUCH

Visit us online ph.ucla.edu

PATH TO PUBLIC HEALTH

27 Family Fueled What began as a personal mission brought Jocelyn Harrison to FSPH

Q&A

30 School Work 33 Faculty Honors

& Service 34 Student Awards 36 Transformative Investments

PHOTOGRAPHY & ILLUSTRATION Kailah Ogawa, Rent Control Creative: cover. Betsy Winchell: Dean’s Message. Jane Houle Photography: TOC: photos for articles on pp. 14, 28, 30; p. 14: PE class; pp. 15-16, 24; 26: carrots; pp. 27, 29; p. 30: FSPH Run Club, top left, and LA Marathon photos: bottom left and top right. COURTESY OF Dr. Virginia Li: TOC: photo for article on p. 22; p. 23. Unsplash: pp. 2-3; p. 4: wheat field; back cover. COURTESY OF Dr. Karin Michels: p. 4: Michels. ©iStockPhoto: p. 4: red meat; pp. 5, 7, 17, 19. Margaret Molloy: p. 8. Lisa Rau: p. 9; p. 14: Prelip; p. 18; p. 23: Li; p. 31: Godwin; National Public Health Week, bottom three photos; pp. 32, 36. Rent Control Creative: p. 10. California State Senate Media Archive: p. 11. Leonard Zhukovsky / Shutterstock.com: p. 13: billboard. COURTESY OF Dr. Neal Baer: p. 13: Baer. [Law Alan] © 123RF.COM: p. 20. [Stephen Bures] © 123RF.COM: p. 21. Ning Xia, Deputy Director of Yunxi Agriculture Bureau: p. 22. PCI Media Impact: p. 26: video still. Renee Cantrell: p. 30: FSPH water station, bottom right. Estelle Robinson: p. 31: National Public Health Week, top. Photography by Reed Hutchinson: p. 31: Liew receiving award.

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APPETITE FOR HEALTH Food sustains life. It brings comfort and joy. It plays a role in defining cultures. Home-cooked and commercially prepared meals bring families together and unite friends, old and new.

But food — or more precisely, certain types of foods and the extent to which they are consumed — can also promote chronic disease and early death. More than two-thirds of U.S. adults are considered overweight or obese, putting them at risk for diabetes, cardiovascular disease and certain cancers. At the same time, more than 42 million U.S. residents live in households that lack reliable access to sufficient amounts of affordable and nutritious food. Paradoxically, many of the same people who are food-insecure are also prone to obesity, in part because the cheapest meal options tend to be unhealthy, and low-income communities are often characterized by an abundance of fast food and a scarcity of fresh produce. The problem is exacerbated by a sedentary population — 80 percent of U.S. adults fail to meet recommended physical activity levels.

The Fielding School has a long history of promoting improved nutrition and physical activity, from the pioneering work of early faculty members in identifying essential nutrients and the benefits of a healthy lifestyle, to more recent efforts that have contributed to a dramatic shift in food policies for a federal program benefiting low-income families and major improvements in the food and fitness environments of schools, workplaces and communities. As the stories on the pages that follow illustrate, FSPH faculty, students and alumni continue to identify and implement solutions that are making it possible for more people to lead nutritious and active lives.

MAGAZINE STAFF

Carla Denly Executive Editor & Assistant Dean for 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

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UCLA Fielding School of Public Health Website: 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 2017 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

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HEALTHY EATING

SEPARATING FOOD FACTS FROM FICTION When it comes to what constitutes healthy eating, misconceptions abound.

FSPH’s Dr. Karin Michels takes on some of the most common ones.

AS A NUTRITIONAL EPIDEMIOLOGIST DEVOTED TO PREVENTION, DR. KARIN MICHELS has spent much of her career studying how health can be optimized through a proper diet. “People think it all comes down to their genes, but there is so much we can control by not smoking or being overweight, eating right, and exercising at least moderately,” says Michels, professor and chair of the Fielding School’s Department of Epidemiology.

C

ER

TIFIE

D

LOW FAT PA

Myth: Cut the Carbs

LEO

On the low-carbohydrate diet,

Myth: A Low-Fat Diet Is Optimal

Myth: We Should Eat Like Our Ancestors

Myth: Red Meat Is a Good Source of Iron

which has gained popularity in

Many believe limiting fat

The Paleo diet goes in another

Michels often hears the argu-

recent years, Michels’ advice:

consumption is good for the

direction — advocating that we

ment that red meat is important

Don’t change the proportion of

heart. In fact, Michels says, the

follow the path of our hunter-

to avoid an iron deficiency.

carbs you consume, but instead

average American diet includes

gatherer ancestors in eating

What many don’t realize, she

lower the refined carbohydrates

about a third of calories from

lots of energy-dense red meats,

says, is that the iron from red

and sugars while upping the

fat, and it should stay that way.

while excluding grains. “We

meat is very different from the

intake of whole grain (not to be

“What we do want to modify

are nothing like our ancestors

iron that comes from vegetable

confused with multigrain, which

is the type of fat we consume,”

— instead of running around all

sources, legumes and whole

usually means more than one

she explains. That means steer-

day, most of us sit in front of

grains. “The red-meat iron

type of refined flour). Quinoa,

ing toward unsaturated fats and

our computers,” Michels says.

actually promotes cardiovascu-

oats, rice and pasta are good

away from saturated and trans

Rather than following any of

lar disease,” Michels explains.

sources of carbs as long as

fats. It’s the unsaturated fats —

the aforementioned dietary

“The plant iron found in beans

they’re made of whole grains,

including those found in olive

trends, she adds, the best

and green leafy vegetables is

she says. And there is no good

and canola oils, and in foods

approach is a balanced diet

much healthier. Unfortunately,

reason to avoid gluten unless

such as fish, nuts and avoca-

that limits or avoids red and

it is more difficult to absorb, so

you’re intolerant — by doing so,

dos — that raise the body’s HDL

processed meats, which were

we need to consume more of it

you’re missing out on important

(“good”) cholesterol, while the

classified as carcinogens in 2015

or help absorption by consum-

nutrients and fiber that come

saturated fats from animal and

by the World Health Organiza-

ing vitamin C-rich foods at the

from the grain.

dairy products and the artificial

tion’s International Agency for

same time.”

trans fats found in margarines,

Research on Cancer.

cookies and many things crispy will bump up the LDL (“bad”) cholesterol. (A word of caution: Coconut oil, which many assume to be healthy, is laden with saturated fat.)

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What constitutes healthy eating? Michels, who frequently gives public talks on the topic, has found there are many widely held misconceptions that lead to misguided dietary decisions. Below are some of the most common myths she seeks to dispel.

Based on the feedback she receives from her public talks, Michels believes many physicians fail to adequately counsel their patients on proper nutrition. “Public health has an opportunity and an obligation to educate people about how to optimize their diet,” she says. “Many of the risk factors for disease people can’t control, but the diet is something we can change. We all eat, and what we eat involves choices. We need to make sure people understand which choices are best for their health.”

Ca Myth: A Well-Balanced Diet Provides All Essential Nutrients

Myth: Alcohol Should Be Avoided

Myth: It’s Advisable to Load up on Calcium

Myth: Milk Does the Body Good

Some assume that alcohol is

Calcium is often promoted

Milk is widely assumed to be

Michels is frequently asked

unhealthy, but the verdict is

to strengthen the bones, but

healthy, but Michels says it’s

about the value of supple-

actually mixed. “Alcohol cleans

Michels says most people

not — at least not the type

ments. The only one she

out your coronary arteries, so if

get plenty in a balanced diet,

that comes from cows (plant

strongly recommends is

you have a strong family history

and vitamin D warrants more

alternatives such as almond

vitamin D. “Two-thirds of the

of coronary artery disease it

focus for bone health. The two

and soy milk are better). “Cow’s

U.S. population — especially

may help you,” Michels says.

subgroups with an increased

milk is not designed for humans

those living in colder climates

“On the other hand, you have

calcium need are children and

— its composition is com-

— is vitamin D deficient, and

to balance that against the

postmenopausal women, the

pletely different from that of

many don’t realize it,” she says.

fact that alcohol increases the

latter as a protection against

human mother’s milk,” Michels

While certain foods contain the

risk of many cancers. For most

osteoporosis. But even for that

says. Part of the problem, she

nutrient, it’s nearly impossible

people, we recommend limiting

population, Michels says, the

explains, is that in the interest

to get enough from the diet —

alcohol consumption to one

increase can come from a dietary

of efficiency, cows are artifi-

and when we use sunscreen to

beverage a day.”

uptick in calcium-containing

cially inseminated to remain in a

protect ourselves against skin

foods or small doses of supple-

constant state of simultaneous

cancer, we’re also blocking the

ments; too much may raise the

pregnancy and lactation. That

best source of vitamin D pro-

risk of coronary artery disease.

means significant doses of the

duction in the body. The easiest

pregnancy hormones estrogen

way out of the dilemma is to

and progesterone make their

take vitamin D supplements.

way into milk products sold to

Myth: Coffee Is Unhealthy

consumers, which raises the risk for several cancers.

Coffee, too, gets a bad rap, but Michels says it lowers the risk of many common diseases, including diabetes, colorectal cancer and aggressive prostate cancer subtypes.

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COMMUNIT Y ENGAGEMENT

WEIGHING the Options An ambitious FSPH-led study uses computer simulations to determine the most effective strategies for combating early childhood obesity in community settings.

CHILDHOOD OBESITY HAS BEEN VIEWED AS A PUBLIC HEALTH CRISIS since at least the early 2000s in the U.S., with the percentage of obese children having more than tripled since the 1970s. In response, public health departments, private foundations, schools, community-based organizations and others have implemented wide-ranging strategies — particularly in low-income communities, where access to healthy foods and places to exercise tends to be limited. In Los Angeles County, efforts have been undertaken to improve the food environment by introducing farmers markets and working with corner stores to increase healthy options; improving physical activity resources through investments in safer parks; and providing nutrition education and breastfeeding promotion for families, to name a few.

Taken as a whole, these interventions appear to be making some headway. For example, among L.A. County children ages 3-4 who are participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) — an important subgroup given that WIC serves a low-income population, and because of

“We want to understand which strategies are most effective within the context of a specific neighborhood.”

— Dr. May Wang

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the strong connection between obesity early in life and obesity in adulthood — obesity rates increased from 2003 to 2009, then began to decline.

But knowing exactly which interventions brought about the positive change — and as a result, where to continue investing finite resources — is another question. Moreover, strategies that succeed in one neighborhood might be less successful in another because of a host of environmental, demographic and cultural factors. “In looking at our data it became very clear that we have families in census tracts right next to each other with very different obesity rates — one community where the trajectory was going up right next to another where it was going down, for reasons that weren’t clear,” says Dr. Shannon Whaley, director of research and evaluation at Public Health Foundation Enterprises WIC (PHFE-WIC), which provides services in Los Angeles, Orange and San Bernardino counties as the nation’s largest local WIC agency. “Up to now, no study that I’m aware of has looked at the interplay between community-level environmental issues and early childhood obesity rates.”

In that sense, a Fielding School-led research group — in partnership with PHFEWIC, the Los Angeles County Department of Public Health and other institutions — is breaking new ground through an ambitious

five-year project funded in 2013 by the National Institutes of Health. Taking advantage of the extensive administrative database maintained by PHFE-WIC and the high quality of data as reported by co-investigator Dr. Kate Crespi of FSPH’s Department of Biostatistics, the Early Childhood Obesity Systems Science Study (ECOSyS) is examining the impact of major obesity-related programs and policies in L.A. County since 2003 on preschool-aged WIC participants.

“We want to understand which strategies are most effective within the context of a specific neighborhood,” says Dr. May Wang, professor in FSPH’s Department of Community Health Sciences and one of the study’s two principal investigators. “Ultimately, our goal is to create a tool that will allow agencies to identify the most effective strategy for addressing childhood obesity in the communities they serve.”

Wang notes that ECOSyS is among the first studies to evaluate community-based public health interventions employing methodology from the field of systems science, which uses computer modeling to assess the impact of interventions in a way that considers the complex interactions that occur rather than analyzing individual strategies without

consideration of the myriad factors that influence the effectiveness of an intervention.

“ECOSyS is providing us the opportunity to rethink how we evaluate public health programs and policies,” explains the study’s other principal investigator, Dr. Michael Prelip, professor in FSPH’s Department of Community Health Sciences and the school’s associate dean for practice across the life course. “Rather than examine one program or policy at a time to see its impact, with systems science we can examine a collection of programs and policies all at once to determine their impact on obesity among the 2-5 year old population.”

Fifty-five percent of L.A. County children under 5 are enrolled in the WIC program, which serves pregnant and postpartum women, infants and children up to age 5 who are low income (at or below 185 percent of the federal poverty level) and at nutritional risk.

WIC provides vouchers for nutritious foods, nutrition education, breastfeeding support, and referrals to health care and other services.

PHFE-WIC has maintained a sophisticated database for L.A. County since 2003 thanks to partnerships with the California Department of Public Health WIC Program and the six other local agency WIC programs providing services in Los Angeles County.

This work has been supported by the nonprofit child advocacy organization First 5 LA. Along with demographic information and records tracking each child’s height, weight and body mass index over time, PHFE-WIC’s database includes responses to the triennial L.A. County WIC Survey of participants on topics such as food and sugar-sweetened beverage intake, breastfeeding practices, and household food security. Information on each WIC family is also geo-coded by census tract, allowing the FSPH-led team to look at trends at the neighborhood level. “This is a unique resource — most WIC programs don’t collect or maintain data in a way that can be analyzed by researchers, but PHFE-WIC had the forethought to do that,” says Wang, who has worked closely with the agency since joining the Fielding School faculty in 2008.

To determine which intervention strategies are most effective in a given community, the FSPH researchers are applying a form of systems science known as agent-based modeling. “Agent-based modeling creates a virtual laboratory using computer models that incorporate the best available evidence about ph.ucla.edu

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what governs individual behaviors and how these behaviors are influenced by our past behaviors, people around us and where we live,” explains Roch Nianogo (PhD ’17), who has contributed to the modeling as a graduate student researcher. “This allows researchers and policymakers to run simulated experiments to evaluate the impact of potential interventions through ‘what-if’ scenarios so that we can avoid wasteful spending on interventions that will not prove successful.”

Wang notes that because systems science is relatively new and not typically taught in schools of public health, the study has led to unlikely working partnerships between computer programmers and public health researchers. The FSPH research team brought in Dr. Nathaniel Osgood of the University of Saskatchewan in Canada, a faculty member in both computer science and community health, to help bridge the divide as a consultant. “We paired our students with his computer science PhD students,” Wang says. “It took a lot of teaching on both sides to understand each other’s work, but it has been very successful.”

“It is very rare that a complex issue like childhood obesity is going to be amenable to just one discipline,” says Dr. Onyebuchi Arah, FSPH professor of epidemiology, who has contributed to the statistical modeling as a study co-investigator. “By drawing on the tools of computer science, biostatistics, epidemiology and community health sciences, we can accomplish so much more.”

Traditionally, public health strategies to combat obesity relied largely on education, but beginning in the early 2000s, the focus shifted to the neighborhood environment, notes Wang, who led one of the earliest major studies on the impact of neighborhood food environments on obesity in California. Since

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that time, a number of interventions have been implemented in Los Angeles, and the FSPH-led study has cast a wide net in the strategies being evaluated. These include investments by The California Endowment and Kaiser Permanente in changing the neighborhood and school food environments of low-income communities; community transformation grants funded by the U.S. Centers for Disease Control and Prevention; and First 5 LA’s programs promoting breastfeeding and healthy eating among preschool-aged children.

Fielding School research in the early 2000s by the late Dr. Gail Harrison and one of her students, Dena Herman (MPH ’95, PhD ’02), now an adjunct associate professor in the Fielding School’s Department of Community Health Sciences, inspired another major change in the food environment for children under 5. Harrison and Herman found that providing WIC recipients with vouchers for fruits and vegetables resulted in sustainable increases in consumption, leading to a revamping of the WIC food package in 2009 to include fruits and vegetables. The L.A. County Department of Public Health, meanwhile, has introduced farmers markets to improve the food environment of low-income areas, worked with corner stores and faith-based organizations to emphasize healthy food offerings, and encouraged the development of purchasing cooperatives to enable small store owners to negotiate lower prices for healthy items, among other strategies.

The stakes for these strategies are high.

Obesity early in life tracks into adulthood, Wang notes, with overweight preschool-aged children at much greater risk of becoming obese adults than non-overweight children.

Being able to better predict the impact of proposed strategies on early childhood obesity in given communities would allow public and private dollars to be invested with more precision.

“We know that the older people get, the more their habits become ingrained,” says Dr. Tony Kuo, adjunct associate professor of epidemiology at the Fielding School and acting director of the Division of Chronic Disease and Injury Prevention for the L.A. County Department of Public Health. “By understanding the best ways to steer parents toward instilling healthy habits in their young children, we have a chance to set those families on a healthy course for the rest of their lives.”

MPH FOR RDs

BRINGING PUBLIC HEALTH TO THE TABLE

Through a partnership with the VA, students earn an MPH at the Fielding School while completing their training as a dietitian.

KAITLIN REID (MPH ’16) BRINGS HER PUBLIC HEALTH PERSPECTIVE TO HER ROLE AS A HEALTH EDUCATOR AND REGISTERED DIETITIAN NUTRITIONIST AT UCLA.

KAITLIN REID (MPH ’16) ALWAYS PLANNED TO BECOME A DIETITIAN. But as much as she admired dietitians who worked with patients in hospitals and other clinical settings, she had a less traditional path in mind.

“I wanted to work on the prevention side,” Reid explains.

“I am interested in giving people, from a young age, the tools to build a healthy lifestyle.”

While many dietitians pursue graduate degrees in nutritional sciences, Reid found the ideal fit for her interests at UCLA, where a partnership between the Fielding School and the VA (Veterans Affairs) Greater Los Angeles Healthcare System, established in 1969, provides students with an opportunity to earn an MPH while completing a dietetic internship at the VA. After completing their first year of studies in FSPH’s Department of Community Health Sciences, dual-track students spend the summer in supervised practice experiences at the VA. In autumn, they complete their accelerated MPH education, then return for the remainder of the academic year to their VA rotations, which include clinical, community and administrative settings.

“The MPH gives these students a broader skill set beyond the clinical nutrition physiology-based work they’ve previously done,” says Colleen Ross, the internship program’s director.

“In one-on-one interactions with patients, these graduates are more likely to look at social and food-access issues that might be contributing to nutrition-related problems. And with the public health focus, they are well equipped to go on to nonclinical positions, including involvement in policy, program development and advocacy — roles that allow them to affect the larger population as opposed to individual patients.”

During her dietetic internship, Reid began working for UCLA’s Healthy Campus Initiative, a university-wide wellness movement aiming to make UCLA the nation’s healthiest university campus. “I fell in love with the work UCLA is doing, on this campus and as a national influencer of the health

of young people in collegiate settings,” Reid says, “and I let everyone know I wanted to stay.” She is now a health educator and registered dietitian nutritionist for the UCLA Arthur Ashe Student Health & Wellness Center’s Office of Student Health Education and Promotion, involved in broad-ranging activities to promote wellness and healthy eating patterns on campus, including the development of a curriculum for a new teaching-kitchen collaborative and a peer-to-peer body image/ eating-disorder prevention program.

“As a dietitian with a public health degree, I’m able to promote healthy eating and healthy lifestyles in a way that can make a difference in the lives of many.”

— Kaitlin Reid Reid has nothing but praise for the dietetic internship program, including the support she received from Ross and her FSPH faculty mentors, Drs. Michael Prelip and May Wang, as well as from Janet Leader, associate director of field studies in FSPH’s Department of Community Health Sciences. “There is so much more recognition now of the importance of food and a healthy diet for longevity, disease prevention and quality of life,” Reid says. “As a dietitian with a public health degree, I’m able to promote healthy eating and healthy lifestyles in a way that can make a difference in the lives of many. This program put me in a position to get paid to do what I love.” ph.ucla.edu

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POLICY ADVOCACY

F

D FIGHT

More than a decade after successfully pushing for the nation’s first soda-and-junk-food ban from public schools, FSPH alum Harold Goldstein continues to make the policy case for healthier eating environments.

WHEN THE FIELDING SCHOOL-based UCLA Center for Health Policy Research released a study last year finding that nearly half of California adults have either prediabetes or undiagnosed diabetes, many were surprised by the magnitude of the problem. Harold Goldstein (MSPH ’89, DrPH ’97), executive director of Public Health Advocates, the Davis, CA-based organization that commissioned the study, wasn’t among them.

As far back as 1999, the year he founded Public Health Advocates (then called the California Center for Public Health Advocacy), Goldstein was publicly warning that without major changes, the state would soon see people in their 30s and 40s with heart disease and diabetes. Pointing to factors such as the preponderance of fast food, oversized meal portions and the free flow of sugary drinks, he continues to argue: “We have created a world where diabetes is the natural consequence.”

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IN 2015 TESTIMONY SUPPORTING A CALIFORNIA STATE SENATE BILL TO INCLUDE SAFETY WARNINGS ON SUGAR-SWEETENED BEVERAGES, GOLDSTEIN STATED: “ONE 20-OUNCE SODA HAS 16 TEASPOONS OF SUGAR. IMAGINE EATING 16 TEASPOONS OF SUGAR.”

From the beginning, Public Health Advocates took aim at the childhood obesity epidemic, promoting state and local policies that would foster environments more conducive to healthy eating and physical activity — particularly for children and in low-income communities, where access to both healthy foods and exercise opportunities is often limited. “People might think they make their food and activity choices based only on their personal preferences, but that ignores the fact that those preferences and decisions are embedded in the world in which they live,” Goldstein says. “If I’m at a meeting, sitting at a table with a bunch of gourmet cookies, I don’t have the option of eating a banana. My choice is whether to eat a cookie or not, and of course I will — that delicious sugar and fat are as likely to seduce me as anyone. That’s pretty well programmed into our biology.”

More than merely making that case to the public, Goldstein’s intention for Public Health Advocates is to promote healthier environments as an advocacy organization “that plays hardball” at the state and local levels of government. That positioning has been essential to the organization’s leading role in taking on powerful and well-funded interests in an

“We have created a world where diabetes is the natural consequence.”

— Dr. Harold Goldstein

attempt to curtail the consumption of soda and so-called junk food. The effort began with a six-year struggle that culminated in 2005 with the signing by then-California governor Arnold Schwarzenegger of first-inthe-nation laws banning the sale of soda and junk food in public K-12 schools.

Public Health Advocates and others pushing for the soda and junk food bans believed they had a strong case based on both the health dangers and the premise that minors shouldn’t be held responsible for making important health decisions on their own — especially considering the influence of advertising and peer pressure, and given that they are often captive audiences to what is served in the school cafeteria and vending machines.

“Schools had become a common place for the food and beverage industry to market their products because they knew that kids establish their eating habits early,” Goldstein says.

“So the industry fought like heck to keep us from getting these laws passed.”

Goldstein’s early work in pushing for the legislation included collaborations with leaders from six low-income Los Angeles communities in raising awareness among local elected officials on issues of children’s nutrition and physical activity, along with concerns about the quality of food offered in the schools. In his role as executive director of Public Health Advocates, Goldstein also brought together a panel of experts to develop the nation’s first nutritional standards for school-age children. Meanwhile, Public Health Advocates worked with partners to marshal support for the legislation. Goldstein estimates that 200 organizations signed on as backers.

Then there were the hardball tactics.

Goldstein notes that the California School Boards Association (CSBA) originally opposed the legislation on the grounds that schools relied on money raised from selling soda and candy bars and that the policy was an issue of “local control.” CSBA eventually changed its stance and wound up cosponsoring the legislation — in part, Goldstein says, because “we were battering them in the media year after year.” The same pressure was applied to legislators. A week before the final vote on the bills, Public Health Advocates released a study showing obesity rates by legislative district. The result: Reporters covering the study turned up the heat on the elected officials by pointing out the troubling ph.ucla.edu

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11

findings affecting their constituents and asking how they planned to vote.

In the end, Goldstein says, “the combination of solid data, great media coverage, strong partnerships and champions in the Legislature we had nurtured for six years allowed us to beat the deep-pocketed corporate interests that were fighting us tooth and nail.”

California’s actions proved influential.

After a number of states passed similar laws, sugary soda and junk food are now banned from all U.S. public K-12 schools as a result of the federal Healthy Hunger-Free Kids Act, enacted in 2010. Meanwhile, Public Health Advocates followed up on the school ban to successfully push for the nation’s first statewide menu-labeling law, requiring calorie counts to be displayed on menus in chain restaurants; similar provisions were later included in the Affordable Care Act. Goldstein’s organization has also played a pivotal role in starting the movement to institute soda taxes. Although efforts to pass a statewide tax have stalled, four cities in California and others around the world have done so, and the World Health Organization recently endorsed taxing sugary drinks to lower consumption and reduce obesity. Among its other advocacy efforts, Public Health Advocates is pushing for legislation to require that warning labels be placed on sugary beverages.

One of Public Health Advocates’ allies in the California State Legislature on the soda issue, Senate Majority Leader Bill Monning (D-Carmel), calls Goldstein a dedicated public health advocate who doesn’t shy away from a challenge. “Given the powerful and multi-factored forces that adversely impact health,” Monning says, “we are lucky to have Harold Goldstein and Public Health Advocates working every day to bring science-based analysis and advocacy to the public commons.”

Goldstein credits the mentorship he received at the Fielding School — particularly from the late Ruth Roemer, a member of the FSPH faculty for more than four decades and founder of UCLA’s health law program — with preparing him for his career as a public health advocate. “I was enormously fortunate during my time at UCLA to have people who believed in me,” he says. “I couldn’t be doing this work if it weren’t for the education, mentoring and genuine love and caring I got from my professors at UCLA.” 12

y t p s m e i E a l or C

Dana Hunnes (MPH ’07, PhD ’13), adjunct assistant professor in the Fielding School’s Department of Community Health Sciences and senior dietitian at Ronald Reagan UCLA Medical Center, says of soda and other sugary beverages: “There is nothing beneficial in these drinks. They’re pure sugar and chemicals.”

sugar and carbohydrates. If you think about how we evolved, our ancestors were more likely to survive if they could get a high dose of sugar all in one fell swoop to finance their physically taxing hunting/gathering expeditions, as opposed to scrounging around and eating vegetables all day. There are also food scientists testing different flavors and mixing to just the right level of sweetness. And

What is unique about soda’s

when we utilize carbohydrates

role in the obesity epidemic?

and our blood sugar gets low we

If you were to chew, say, a

feel hungry and want something

candy bar that’s full of sugar,

that’s going to boost it again.

the chewing sensation and the

Soda is a quick way of doing

cascade of digestive processes

that. Not a healthy way, but a

would at some point make you

quick way.

feel some satiety. Beverages don’t have that effect, so you

How can public health more

can drink 400 calories of soda

effectively address this problem?

and not feel satiated in the

For the most part, education

way you would if you had 400

hasn’t succeeded in get-

calories of food. In fact, the

ting people to change their

insulin response might make

behaviors when it comes to

you hungrier afterward. So if

sugar-sweetened beverages —

you drink 400 calories of soda,

people’s daily habits are hard to

you’re not going to compen-

break. Taxing soda and putting

sate by having 400 fewer

those tax revenues toward

calories of food; it just adds

public health programs has

calories to the diet.

demonstrated a larger impact.

In Mexico, a 10 percent tax on

Why are so many people drawn

sugar-sweetened beverages led

to these drinks?

to a 12 percent reduction in sales

Our bodies are meant to seek

in the first year.

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“We are bombarded with messages to drink products that we know are not nutritional.”

— Dr. Neal Baer

day to help close the sale. “You don’t see smiling obese people; you don’t see people with rotten teeth,” Baer says. “The message is that consuming this product will make you a happier person.

SUGAR OVERLOAD

We see Beyoncé drinking Pepsi and she’s in great shape, so it must be OK.” Baer, a pediatrician who has written and produced for such television series as ER, Law & Order: Special Victims Unit and Under the Dome, adds that because of the ubiquitous nature of soda — readily available, often at less cost than water, everywhere from small villages in low-income countries to big-city movie theaters, conve-

Soda’s hold over consumers is a “marvel of advertising,” says Dr. Neal Baer, FSPH professor and media expert.

SODA AND OTHER SUGARY DRINKS are major

nience stores, sporting events and even hospitals

contributors to diabetes and obesity among chil-

— it’s all too easy to overlook its harmful effects.

dren and adults. “These drinks have no nutritional

Moreover, soda companies cultivate an image

value whatsoever,” says Dr. Neal Baer, adjunct

of social responsibility by giving handsomely to

professor in the Fielding School’s Department of

important philanthropic causes, thus distracting

Community Health Sciences and a co-founder of

from the public health consequences of their

FSPH’s Global Media Center for Social Impact. Yet

products through a practice Baer and other critics

we continue to pour. In the United States in 2015,

call healthwashing. “They show concern for the

the average person consumed 650 eight-ounce

community, but their bottom line is to their share-

servings of carbonated soft drinks.

holders, which means selling products that are not

That a multi-billion dollar industry can be built on a product made for pennies from water,

DR. NEAL BAER

good for people,” Baer says.

For all of these reasons, Baer doesn’t accept

high-fructose corn syrup and flavoring is “a marvel

the argument that soda companies are simply

of advertising,” Baer observed in his Afterword to

meeting a demand for their product, and that

Marion Nestle’s 2015 book Soda Politics: Taking on

it’s up to individuals to make their own dietary

Big Soda (and Winning). “There’s no place one can

choices. “These companies talk about giving

travel in the United States, or even in the world,

consumers what they want, but it’s not a level

and not see soda advertised,” Baer says. “We are

playing field,” Baer says. He believes public health

bombarded with these messages to drink prod-

efforts to reduce soda consumption should follow

ucts that we know are not nutritional.” The market-

the model of successful anti-tobacco strategies by

ing campaigns focus on joy and refreshment while

focusing on policies that discourage users, includ-

enlisting some of the biggest celebrities of the

ing soda taxes. ph.ucla.edu

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ENHANCING PHYSICAL EDUCATION

Student Bodies in Motion An FSPH team is working with middle school physical education teachers on ways to ensure their classes stay active and engaged.

DR. MICHAEL PRELIP

14

IN THE NATIONAL EFFORT TO PREVENT CHILDHOOD OBESITY, much attention has been paid to promoting healthier eating. While that is undeniably important, a Fielding School professor believes another vital part of the equation is underemphasized.

Most children and adolescents are falling well short of the recommended hour of daily physical activity, notes Dr. Michael Prelip, professor in FSPH’s Department of Community Health Sciences and the school’s associate dean for practice across the life course. And physical education (PE) remains undervalued in many school districts, he says — a missed opportunity to engage students in what is often the only physical activity they experience each day.

“In many cases the funding for physical education has been reduced, and whenever there is a field trip, assembly

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or standardized testing, it’s the first subject considered expendable,” Prelip says. He notes that this is a particular problem in under-resourced communities, where parent groups may not be able to raise funds to offset any budget cuts and, outside of school, children tend to have fewer opportunities to participate in organized sports as well as less access to parks and other informal spaces for play.

Through a partnership with the Los Angeles Unified School District (LAUSD), a Fielding School team headed by Prelip is currently studying the impact of a program aiming to improve the quality of PE in middle schools. Project Shape, funded by the National Institutes of Health and developed with input from district officials, school administrators, community members, PE teachers and their students, involves 16 low-income middle

schools spread throughout LAUSD, and approximately 5,000 students.

The study intends to identify opportunities for PE teachers to increase the amount of moderate-to-vigorous physical activity in their classes while improving students’ attitudes toward PE by making it more fun, less competitive and more inclusive.

M iddle school is a key group to target for these goals. “There tends to be a big drop in physical activity as kids move into their teenage years,” Prelip says. “And so this is a key moment to try to prevent that from occurring and help them build a foundation of healthy behaviors that can be carried on into adulthood.”

Through the professional development offered as part of the study, Project Shape has sought to work with middle school PE teachers to overcome some of the challenges they face in resource-strapped urban settings.

“They are expected to teach a standards-based curriculum, but because of budget cuts at the elementary school level, many of their students have never previously had a formal PE class, and so they may be learning to play an organized sport or to do push-ups and sit-ups for the first time,” says Lindsay Rice, the FSPH study’s project manager. Although the teachers are trained in PE, she adds, many of those assigned to middle schools have little or no experience with students that age, and PE class sizes in the district are typically as high as 55.

In the face of these challenges, the FSPH research team found that at the onset of the study only 15 percent of students’ PE classroom time was spent in moderate-to-vigorous physical activity, well short of the national recommendation of 50 percent. Much of the idle moments were being spent in class-management activities such as calling roll and receiving verbal instruction, or waiting while other students participated. In addition, the students most likely to engage in higher levels of physical activity tend to be the ones who need it least. “For the kids who are sedentary and overweight or obese, it’s uncomfortable and not fun,”

Prelip says. “We want to shift the focus more toward these students in a way that’s non-competitive and inclusive.”

For the study, the FSPH group partnered with SPARK (Sports, Play & Active Recreation for Kids), a program of San Diego State University Research Foundation that provides professional development and curricula designed to make PE more fun and engaging. The participating middle school teachers were offered 12 hours of SPARK certification training in skills such as classroom management, instructional techniques and motivation, all designed to increase physical activity levels. The teachers were given SPARK educational materials as well as vouchers to purchase new sports equipment.

Christine Berni-Ramos, a national board-certified PE teacher at Elizabeth Learning Center in Cudahy, southeast of downtown Los Angeles, says the training helped her to rethink her practices. “When we teach, we aren’t always aware of how much time students spend sedentary as opposed to being physically active,” she says. “So this really served as an ‘aha’ moment and got me thinking about innovative ways to keep my students engaged and moving.”

One of the changes Berni-Ramos has instituted is “active roll call” — rather than sitting passively for several minutes at the beginning of the class period while Berni-Ramos takes roll, her students go straight to their assigned station and place a popsicle stick with their name on it on the “present” side of the station’s cone before proceeding with the activity.

To reduce the time spent transitioning from one activity to the next, BerniRamos now issues verbal cues and plays music designed to motivate the students to move quickly. Through a strategy known as “disguising fitness,” she introduces exercise as part of a fun activity — for example, students who would normally remain frozen in a game of freeze tag are able to return to active participation by performing calisthenics.

“A lot of kids aren’t initially motivated, but they just need the tools to learn how to be physically active in

“There tends to be a big drop in physical activity as kids move into their teenage years. And so this is a key moment to try to prevent that from occurring.”

— Dr. Michael Prelip

ph.ucla.edu

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SHOWN ABOVE AND ON PREVIOUS PAGES, CHRISTINE BERNI-RAMOS, A NATIONAL BOARD-CERTIFIED PE TEACHER AT ELIZABETH LEARNING CENTER IN THE LOS ANGELES COMMUNITY OF CUDAHY, LEADS HER MIDDLE-SCHOOL CLASS.

ways they enjoy,” Berni-Ramos says.

“And by making this something they like to do, you’re setting them up for a lifetime of physical activity.”

Project Shape has provided venues for Berni-Ramos and other PE teachers to make their voices heard within the district. The Fielding School team partnered with LAUSD’s director of physical education to revitalize an existing PE task force, providing a forum for the teachers to meet with administrators and others to discuss physical activity programming. The study has also sought to empower PE teachers to take on leadership roles in their schools and communities. After learning from one of the study’s volunteers, Lorena Gonzalez, about a local run/walk event she was involved in to combat childhood obesity, Berni-Ramos joined in the planning process and brought in students from her school to assist. Gonzalez has since entered the Fielding School as an MPH student.

More than a dozen students from FSPH and other parts of the campus, 16

including undergraduates, have participated in Project Shape as student researchers. “Through my work on the project, I have had the opportunity to see the benefits of effective collaboration — not only with the schools and teachers involved in the study, but also with the members of our research team,” says Monique Gill, a doctoral student in FSPH’s Department of Community Health Sciences who has assisted in tasks that include collecting and analyzing data, as well as interviewing teachers in an effort to capture how health fits into their daily school programming.

Alec Chan-Golston, a doctoral student in the Department of Biostatistics who has spent time at the schools collecting, validating and analyzing survey data, says the hands-on experience of seeing how the information is obtained will make him a better biostatistician. “Fieldwork gives a perspective as to how much goes into data collection and leads to better data analysis and interpretation,” he says.

“For instance, instead of being discouraged that a few students didn’t fill out

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their surveys, I was impressed with how many did.”

Beyond serving as a learning experience for the students, Project Shape has helped to draw attention to the work of the teachers. “The importance of PE isn’t fully appreciated as part of a well-rounded education and its contribution to students’ wellbeing,” says Dr. Kate Crespi, an associate professor in FSPH’s Department of Biostatistics and member of the study team. “These teachers don’t always get the credit they deserve or the support they need, so I was excited to have them be the focus of this research.”

“One of our goals has been simply to acknowledge that PE teachers work hard at an important job, and deserve opportunities for further development,” adds Prelip, who explains that the study intervention was designed so that it could be easily scaled up and more widely adopted in LAUSD. “These teachers want their students to be more engaged, and they have been eager to work with us in identifying the best ways to get there.”

ENHANCING PHYSICAL EDUCATION

Fun Facts

Sophisticated modeling techniques project long-term health benefits and improved classroom performance made possible by reimagining a traditional PE program.

AT THE NORTHSIDE INDEPENDENT SCHOOL DISTRICT IN SAN ANTONIO, TEXAS, an obesity prevention program has increased physical activity and improved nutrition among elementary school students through an innovative physical education (PE) curriculum, special equipment, after-school programs and family involvement. As the program’s centerpiece the district adopted SPARK, a research-based curriculum that aims to make recess and PE less competitive and more fun. Traditional gym-class sports are replaced by the likes of yoga, Zumba, Frisbee golf, scarf juggling, and rock climbing on a portable climbing wall. Teachers receive guidance on ways to minimize idle time so that students remain actively engaged — another departure from traditional PE.

“Across the country, PE has borne more than its share of budget cuts. Our results make the case that this is shortsighted.”

— Dr. Frederick Zimmerman

SPARK and similar programs have been implemented in varying forms all over the country.

But even as these programs earn praise, proponents often find it hard to secure funding for

in math. The $8 million, three-year investment

enhanced physical education amid the realities of

would amount to $61 per child, but the FSPH

constrained budgets. So a team from the FSPH-

research team estimates that 31 percent of that

based UCLA Center for Health Advancement

spending would be returned through lower future

has adopted a new approach designed to bridge

health costs for local and state governments.

academic studies of such programs with concrete

The modeling effort, which has since been

results that can assist policymakers. Using data

expanded to include Los Angeles, Philadelphia

modeling techniques that start with the known

and the state of Arkansas, is headed by Dr.

effects of the program employed at Northside

Frederick Zimmerman, co-director of the UCLA

and factor in research on the impact of obesity in

Center for Health Advancement, and includes

later life, the center’s researchers can estimate in

three other Fielding School faculty members:

concrete and realistic terms the long-term return

Drs. Jonathan Fielding, the center’s founding

another city or state can expect from its own

co-director; Steven Teutsch, formerly the chief

investment in the program.

science officer for the Los Angeles County

Framed that way, the results are eye opening.

Department of Public Health; and Brian Cole.

For the 130,000 elementary school children (30

Nathaniel Anderson, who will enter the FSPH

percent of whom are obese) in 15 school districts

Department of Health Policy and Management

in San Antonio and the surrounding area, invest-

PhD program in the fall, serves as chief modeler,

ing in the Northside program would prevent 560

and Natalie Rhoads is the project manager.

cases of diabetes and 800 cases of hypertension

“Across the country, PE has borne more than

during adulthood. Moreover, enhanced physical

its share of budget cuts,” Zimmerman says. “Our

education would lead to better academic perfor-

results make the case that this is short-sighted. For

mance — an additional 12 percent of third-, fourth-

an intervention that doesn’t cost a huge amount,

and fifth-grade children testing at proficient levels

there is a significant impact on test scores, to say

for reading and an additional 11 percent proficient

nothing of the health benefits.” ph.ucla.edu

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FACULT Y PROFILE

HUNGRY FOR SOMETHING NEW Dr. William McCarthy’s passion for creating environments that promote healthy eating is hard to miss.

WALK INTO DR. WILLIAM MCCARTHY’S OFFICE and you’re surrounded by posters, magnet messages and hand-painted mobiles featuring fresh fruits and vegetables. The four fruits and vegetable soup McCarthy brings to the office each day occupy a prominent spot on his desk.

And if that’s not enough, the adjunct professor in FSPH’s Department of Health Policy and Management makes a daily sartorial statement, with fruits and vegetables adorning most of his ties.

“Dr. McCarthy’s devotion to promoting the consumption of fresh fruits and vegetables is difficult to miss,” says Dr. Lillian Gelberg, a close colleague who serves as professor in the Fielding School and David Geffen School of Medicine at UCLA. “He is passionate about improving the health of vulnerable populations, and his career has focused on developing interventions to support making the 18

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‘right choice the easy choice’ by creating healthier households, schools, workplaces and neighborhoods.”

Over the course of dozens of studies and program evaluations designed to shed light on how to effectively encourage healthy eating among at-risk populations, McCarthy has adhered to a simple premise. “Human nutrition is optimized when our environments make it easy for us to eat the quantity of minimally processed plant foods that our forebears consumed 1,000 years ago,” he says. “And environments lacking in physical-activity opportunities and convenient access to minimally processed fruits and vegetables make it difficult to sustain a healthy appetite for water-rich, fiber-rich plant foods.”

McCarthy’s zeal for creating surroundings conducive to healthier eating emanates from two professional epiphanies. The first came when, as a graduate student studying

social psychology in the late 1970s, he learned that two of his siblings had taken up smoking. “I was shocked,” he recalls. “We had solemnly agreed as preteens never to smoke, so their reversal of attitude toward smoking when they became adolescents piqued my intellectual curiosity.”

His pursuit of possible reasons for youth smoking onset prompted McCarthy to apply his interest in environmental influences on behavior to the burgeoning field of health psychology. He conducted wide-ranging studies to identify effective strategies for persuading members of targeted populations not to smoke. McCarthy also served as chief evaluator of California’s tobacco-use education efforts in the state’s public middle and high schools for 11 years.

In the late 1980s, he found himself again challenged by unexpected behavior change. In 1989, the first year after California voters passed Proposition 99’s 25-cents-per-pack tax on cigarettes, researchers reported a decline of more than 10 percent in smoking statewide. Because Proposition 99 tax revenues had not yet accumulated and were unavailable to fund any tobacco control education in 1989, the first-year decline was attributable mostly to the increased expense of the habit. “I should have become an economist if I really wanted to reduce tobacco use,” McCarthy quips.

“Despite all of the anti-tobacco education in previous years, we had been getting only 1 percent reductions per year.”

For McCarthy, the lesson was that health education goes only so far if people are surrounded by unhealthy options. “We have communities that are ‘food swamps’ — everything is calorie-rich, nutrient-poor and processed,” he says. “In my professional lifetime the percentage of adult Americans who are overweight or obese has more than doubled. That’s obviously not because of any change in genetics; it’s our environment.”

Through his work, McCarthy is increasingly convinced that the best way to fight obesity is to promote healthier food choices rather than simply urging people to reduce the calories consumed from their usual food choices. His recent projects include a six-session program offering instruction in

“One way or another, I am going to get this message across.

Mother Nature intended for us to eat Mother Nature’s produce.”

— Dr. William McCarthy urban agriculture to East Los Angeles residents, as a practical strategy to offset a less-than-optimal food environment.

He also worked with the Los Angeles Unified School District (LAUSD) in its efforts to provide healthier foods to its students. In 2011, LAUSD began offering more wholesome items, especially fruits, vegetables, whole grains, and a range of healthy ethnic foods. “Given that children con-

sume up to half of their daily nutrients in school, school food service departments can powerfully influence students’ liking for healthier foods,” McCarthy said, adding that it can take 8-12 tastings for children to overcome their initial dislike of a new vegetable. McCarthy has become a proponent of providing garden-fresh produce to schoolchildren. “Every elementary school should have a garden,” he says. “Gardening should be part of the curriculum for both educational and health reasons.”

McCarthy has found his beliefs about the weight control benefits of healthier food choices strengthened by the emerging research on the gut microbiota — the trillions of microorganisms that inhabit the intestine and exert considerable influence on health and disease. “These studies are explaining some of the conundrums in our field, such as why low-income populations, which suffer food insecurity, are at greater risk of obesity than populations with everyday access to food,” McCarthy says. “The gut microbiome research suggests that the quality of what one eats is an important influence on satiety. People who need to economize when it comes to food choices buy low-cost foods that are fiber-poor and calorie-rich, and because the lack of fiber reaching the gut microbiota depresses satiety signaling, it also means they need more calories to feel satisfied than people with diets high in fruits and vegetables.”

From a societal perspective, McCarthy argues, the short-term costs associated with fostering environments that promote physical activity and fresh fruit and vegetable consumption are more than offset by the longer-term benefits of improved health and quality of life. “Unfortunately, short-term horizons are leading to policies that contribute to avoidable disease and premature deaths,” he says. “Academic researchers have a responsibility to point out the long-term avoidable costs associated with these decisions.”

McCarthy doesn’t shy away from making that case. “One way or another, either from my mouth or visually through my ties, I am going to get this message across,” he says. “Mother Nature intended for us to eat Mother Nature’s produce.” ph.ucla.edu

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FIGHTING HUNGER

POVERTY POLICIES How can legislative strategies such as increasing the minimum wage improve the nutritional status of a society’s poorest members? FSPH researchers are investigating.

WHILE THE IMPACT OF POVERTY on nutrition has been widely recognized, there has been far less research on what can be done to address the problem. Seemingly straightforward approaches like raising the minimum wage have been political footballs, with some contending a higher minimum wage lowers the income of poor families through job loss while others say this risk is overstated.

Whether raising the minimum wage can serve as a powerful tool for improving nutritional outcomes is among the questions being pursued by several Fielding School research groups.

Using data from the FSPH-based WORLD Policy Analysis Center, a team headed by Dr. Ninez Ponce has found that in low- and middle-income countries, an increase in the inflationadjusted minimum wage of 20 percent over an average of more than five years led to statistically significant declines, 20

even among the poorest fifth of families, in the probability of two consequences of malnutrition in children under age 5: stunting (impeded growth as measured by height for age) and anthropometric failure, a composite measure that includes stunting, wasting (weight for height) and underweight (weight for age).

“Macroeconomic policies can have major consequences on the wellbeing of families,” says Ponce, professor in FSPH’s Department of Health Policy and Management. “The minimum wage is one policy lever that can help to protect children in the poorest families against malnutrition, which is a factor in approximately 45 percent of child deaths worldwide.”

Focusing on 23 low- and middleincome countries (mostly in South Asia and Africa, which have the highest malnutrition rates), Ponce’s team linked data from the WORLD center on national minimum wages with

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individual-level data from the U.S. Agency for International Development’s Demographic Health Surveys.

The study compares the impact on malnutrition in countries that raised the minimum wage during the period from 2003 to 2012 with the impact over the same period in countries where the minimum wage remained constant.

Arguments for and against increasing the minimum wage typically focus on market consequences, including the potential impact on employment. But Ponce argues that the health effects should also be considered. “Beyond the moral argument, addressing food insecurity by improving the financial status of low-income families could be seen as an investment in a healthier, more productive workforce,” she says.

Minimum wage increases also appear to have beneficial health effects on adults in low-income countries, according to a separate study led by Dr. Annalijn Conklin while she was a postdoctoral fellow at the Fielding School last year. Conklin was joined on the study by Ponce, as well as FSPH Dean Jody Heymann, who also serves as WORLD’s founding director; Dr. Kate Crespi, associate professor in FSPH’s Department of Biostatistics; Dr. Arijit Nandi of McGill University; and Dr. John Frank of the University of Edinburgh, UK. Taking advantage of the WORLD center’s unique data set, which enables the comparative effects of countries’ minimum-wage policies to be analyzed, Conklin’s group found that a $10-per-

month increase was associated with a reduction in underweight among the more than 150,000 women in the 24 low-income countries studied — a benefit that became more pronounced over time. “Our findings suggest that a social protection policy such as higher minimum wage has some impact on health over and above the more standard economic influences that are usually the focus, such as an individual’s income and education,” says Conklin, who has since joined the faculty at the University of British Columbia. “Yes, income and education are strong influences, but what governments do also matters.”

In the U.S., raising the minimum wage has emerged as a major issue in recent years, with many states and cities enacting significant increases.

Dr. Frederick Zimmerman, a professor in FSPH’s Department of Health Policy and Management, notes that the

issue elicits strong reactions on both sides. “There has been fairly extensive research on the impact of minimumwage increases on labor markets, which has found that the effects on employment are small enough that it should not be a major concern,” Zimmerman says. “However, most of the increases in the minimum wage that have been studied have been relatively small. In Los Angeles, by contrast, the minimum wage is set to go up by 50 percent over seven years. I am not aware of any study that tests the effects of such a large increase.”

Moreover, Zimmerman says, wages and employment are only part of the puzzle. More important for the plight of low-income households is how the policy affects their overall resources and quality of life. “It could be that the effects of a minimum-wage increase on a household budget are different from

“Addressing food insecurity by improving the financial status of low-income families could be seen as an investment in a healthier, more productive workforce.”

— Dr. Ninez Ponce

what has been studied so far,” Zimmerman explains. “It’s important to test the impact on health behaviors like physical activity and healthy eating, health outcomes, and access to health care.”

Zimmerman is now doing just that, in a national study using data from the annual Behavioral Risk Factor Surveillance System survey.

Apart from the effects of wages on nutritional status, Tabashir Nobari (PhD ’16), a research scientist at the Fielding School and a research analyst at the Public Health Foundation Enterprises (PHFE) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), has found evidence that unaffordable housing exacerbates the problem of childhood obesity — particularly in a city such as Los Angeles, where housing costs are high. Nobari examined data from the 2011 and 2014 Los Angeles County WIC Survey run by PHFE WIC. She found that in families reporting having a “very difficult” time paying for housing, the children had 33 percent greater odds of obesity than children in non-burdened families.

Nobari points to several factors that likely contribute to the increased risk. “Reduced resources left over after paying for housing mean less money for spending on healthy foods and a greater likelihood of relying on processed and energy-dense foods,” she says. “These families are also more likely to be food insecure, and to have stressful home environments for children.” The stress on parents who are worried about being able to pay rent and have a place to live may also affect their interactions with their children, Nobari notes, making them less likely to cook or limit their children’s screen time, both of which can contribute to obesity risk.

“At a minimum, we need to look at interventions that would buffer these effects, such as programs to reduce stress or to increase the amount of supplemental foods WIC provides to families,” Nobari says. “But ultimately, this shows that as part of the fight against childhood obesity, we need more affordable housing for lowincome populations.” ph.ucla.edu

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AGRICULTUR AL SHIFT

CULTIVATING CHANGE

In China’s tobacco heartland, FSPH professor emerita Virginia Li showed how a crop substitution program could address food security concerns while increasing farmers’ profits.

TOBACCO IS A MAJOR PROBLEM IN CHINA, where an estimated 316 million people smoke and 1 million smokers die of lung cancer each year. But efforts to tackle this public health scourge in the world’s most populous nation are complicated by economics. Some 20 million Chinese farmers are dependent on tobacco cultivation, manufacturing and sales for their livelihood. The Chinese government controls production and regulates the tobacco industry. Tobacco revenues account for 7 percent of the gross national product.

So rather than push the health argument, Dr. Virginia Li, professor emerita in the Fielding School’s Department of Community Health Sciences, approached government officials in China’s tobacco-growing capital nearly a decade ago with a new idea: lower the supply of tobacco by showing farmers how to increase their profits through substitute crops.

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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

“In China, anti-smoking campaigns aren’t enough,” Li explains. “To really make a difference, farm families that plant tobacco need to be shown they can generate a greater income by substituting vegetables and other crops.”

Li was born in China, the oldest of five children to accomplished parents: Her mother directed an operation during the Sino-Japanese War that rescued more than 20,000 newly orphaned and refugee children from occupied territory; Li’s father was a military general and later governor of Guangdong Province who, Li has said, “had the heart of a poet and believed in the nonviolent teachings of Buddhism.” The family moved to New York City in 1947 when Li was 13; she wouldn’t return to China until 1974, a quarter-century after the Communist Revolution.

As an FSPH faculty member in the 1980s, Li began to focus on the issue of smoking in her native country. While visiting in 1987, she advocated moving China toward being a

“Farm families that plant tobacco need to be shown they can generate a greater income by substituting vegetables and other crops.”

—Dr. Virginia Li smoke-free nation in an article published by the People’s Daily, the official newspaper of the Chinese Communist Party. “It was met with silence,” Li recalls.

But by 2008, she sensed the timing was right to try again. Five years earlier, China was among the 192 World Health Organization member nations to sign on to the landmark Framework Convention on Tobacco Control, a declaration of its commitment.

With modernization and economic development, the government was less dependent than before on tobacco revenue. And in the face of food security concerns, there was a need to grow more edible crops. “China is a mountainous country with about one-third of the arable land that the United States has, but 1 billion more people,” Li says.

Li had also worked in southwest China’s Yunnan Province uninterrupted for 20 years, organizing grassroots programs to address women’s reproductive health and other issues. In addition to the relationships forged there through these programs and her education of local students, she had trained approximately 30 students who had come to UCLA as visiting scholars and gone on to serve in key positions throughout China. Li consulted with a colleague and long-time friend, Yunnan Province’s former director of public health, who helped her get the go-ahead from the government to work with the Bureau of Agriculture in Yuxi Municipality. With modest funding from a private donor, Li and her local partners launched a three-year tobacco cropsubstitution pilot project in 2009.

Yuxi was China’s tobacco capital, with more than 96 million acres of tobaccoproducing farmland and a

tobacco-driven economy that ranked first in the province. But Li knew the farmers could do better. “With tobacco you have only one crop a year, and it’s labor-intensive,” she says.

“Planting food you have four seasons. Also, the average farm size per capita was onesixth of a U.S. acre. Farmers could never get rich with such a small piece of land, but my thinking was that with the right training, farmer cooperatives could be turned into business enterprises.”

The Yuxi Bureau of Agriculture worked with village heads to recruit more than 450 farm families to a for-profit cooperative that would enable them to take advantage of economies of scale. Instead of growing tobacco, the farmers grew crops such as vegetables, arrowhead and grapes. Most importantly, the bureau’s agricultural specialists trained the farmers in skills such as market research, seed selection, maximizing crop yields, storing and selling the produce, and accounting.

The farmers elected their own officers, and each cooperative’s responsibilities included supplying members with seeds, pesticides and other needed materials.

Over a period of three years, farmers earned 20-115 percent more than they had from tobacco crops. Every crop at every site yielded a higher income. “Many of these farmers do not read or write,” Li says, “but the Yuxi pilot showed that they can gain the knowledge and skills they need to run a business that brings them more income than they would receive from tobacco farming.”

Seeing the success in Yuxi, farmers all over the province have followed suit. In Tonghai County, previously China’s largest tobacco producer, vegetables have replaced tobacco as the leading crop. The effort is now buoyed by the “redline” policy initiated

by China in 2013 to ensure adequate food production through a minimum threshold of 120 million hectares of cultivated land.

According to data released by the State Tobacco Monopoly Administration, the policy reduced China’s tobacco planting acreage by about 20 percent over three years.

In Li’s most recent visits to Yunnan Province, she has seen the impact of what she started. “In the countryside there are new houses being built, and farmers are sending their children to college,” she says. “This has put more money in their pockets while improving health. It’s a win-win.” ph.ucla.edu

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OUTREACH TO STUDENTS

FOOD FOR THOUGHT

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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

FSPH students Tyler Watson and Hannah Malan are leading an effort to understand barriers to healthy eating among college students, and to promote sustainable solutions.

NATIONWIDE, MORE THAN 42 MILLION PEOPLE live in households that are food-insecure — defined by the U.S. Department of Agriculture as “a household-level economic and social condition of limited or uncertain access to adequate food.” Recent studies indicate that the prevalence of food insecurity is higher among college students compared to the general population, including at the University of California (UC) — illustrating the need to ensure that a UC education is affordable to all students through efforts to keep the amount of tuition paid by students down and increase financial aid, both of which are top priorities for UCLA and the Fielding School.

In addition to those efforts, two FSPH students are looking inward as leaders in a UCLA and UC-wide effort to examine obstacles many college students face to eating well. Tyler Watson (MPH ’13), a doctoral candidate in FSPH’s environmental health sciences department, is working alongside Hannah Malan (MS ’16), a first-year doctoral student in community health sciences, to better understand why many students struggle with food. “We have this societal norm of the starving college student that’s widely accepted, but college should be a time of learning, personal growth, and skills development,” Watson says. “We want to make it a time when students can learn life skills, such as cooking and budgeting, that can protect and promote lifelong health.”

Watson and Malan conducted a series of 11 focus groups with undergraduate and graduate students living in on- and off-campus housing at UCLA, the findings of which they presented to the UC Board of Regents to help guide solutions for food security UC-wide, and were also accepted for publication in California Agriculture. The FSPH students emphasize the need for programs and curricula on UC campuses to improve food access and literacy, as well as pointing to a variety of barriers to students eating healthy, including affordability and food skills. Many students in the study reported choosing cheap, nutrient-poor foods and some students experienced stress around accessing healthy food due to resource limitations. “Students consistently said they wanted more support from the university with learning to manage their resources and prepare healthy, inexpensive food,” says Malan, whose research focuses on understanding how students learn about food and identifying approaches that empower them to plan, select, prepare and eat food in a healthful and enjoyable way. “It’s more than just nutrition education; it’s giving students the skills they need to put their knowledge into practice.”

As graduate student researchers with UCLA’s Healthy Campus Initiative (HCI) — envisioned and supported by philanthropists Jane and Terry Semel — Watson and Malan are helping to lead the effort to make UCLA the nation’s

healthiest campus. Through HCI’s EatWell working group, they have used the results of their research to inform how best to allocate resources and create programs to improve students’ wellbeing. One example is a partnership forged with Food Forward, a local nonprofit that recovers fresh fruits and vegetables that would otherwise be discarded.

Watson and a team of student volunteers, including undergraduate student Savannah Gardner, have delivered more than 20,000 pounds of farmers market produce to students on a weekly basis since the partnership began in November 2016. Cooking demonstrations held by student groups such as FSPH’s Public Health Nutrition Club ensure that students know how to prepare the food they’ve received. It is one of the many ways Watson is helping to combat both hunger and food waste — work that earned him recognition in 2016 as one of three students honored with the UC President’s Award for Outstanding Student Leadership.

“Tyler and Hannah’s research has helped paint a picture of the student experience,” says Dr. Wendelin M. Slusser, associate vice-provost of HCI and an adjunct professor in FSPH’s Department of Community Health Sciences and clinical professor in UCLA’s David Geffen School of Medicine.

“Based on the evolution of work we’ve done at UCLA through the Healthy Campus Initiative, we are now getting all of UC’s campuses to focus on food efforts through the University of California Global Food Initiative.”

Launched in 2014, the UC Global Food Initiative (GFI) is addressing how to sustainably and nutritiously feed a growing world population by starting with UC’s 10 campuses.

Watson and Malan were among 10 UCLA students selected as GFI fellows for the 2016-17 academic year. At UCLA, Watson helps facilitate a campus food-security working group to identify best practices and strategies that will be shared across the UC system, and ultimately with schools and communities nationwide. With funding from the UC Office of the President, the group has expanded the existing UCLA-based Community Programs Office Food Closet, promoted CalFresh enrollment, and supported a meal voucher program that converts unused meal plan “swipes” collected by the nonprofit student group Swipe Out Hunger. In addition, Malan is working with the HCI to launch and evaluate a Teaching Kitchen Collaborative pilot program at UCLA. The program will provide hands-on cooking classes and nutrition information for graduate students in public health, dentistry, nursing and medicine.

“Our goal is that one day teaching kitchens and food literacy will become a part of the health sciences curriculum,” says Janet Leader, a registered dietitian nutritionist, lecturer and associate director of field studies in FSPH’s Department of Community Health Sciences who was appointed to lead the program’s launch in April 2017. “We hope this pilot will show how effective it can be not only to change students’ knowledge about food so they can be more healthy themselves, but also to increase future health professionals’ confidence and food literacy so that they can talk about healthy nutrition and choices to their patients or clients in the community.” ph.ucla.edu

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OUTREACH TO STUDENTS

Students Helping Students FSPH’s Nutrition Club improves food literacy and students’ access to quality food.

COLLEGE IS A PIVOTAL TIME OF INTELLECTUAL

ond-year MPH student who serves as vice president

GROWTH, but for too many students, it’s also a

of the Public Health Nutrition Club and plans to

time when healthy eating becomes secondary.

pursue a career in sustainable food systems.

“Many college students are away from home and

In addition to advocating for nutrition issues

managing food purchasing and meal preparation

and raising awareness through a monthly semi-

independently for the first time,” says Dr. Dena

nar series addressing public health nutrition and

Herman, an adjunct associate professor in FSPH’s

policy topics, the club has begun offering students

Department of Community Health Sciences who

Community Supported Agriculture (CSA) boxes

serves as faculty advisor to the Public Health

filled with fresh, locally grown organic fruits

Nutrition Club and director of the FSPH-based

and vegetables at an affordable price. The club

Maternal and Child Health (MCH) Nutrition Lead-

also emphasizes improving student food liter-

ership Training Program, funded since 1993 by

acy through quarterly cooking demonstrations

the Maternal and Child Health Bureau of the U.S.

at various campus locations in partnership with

Department of Health and Human Services. “These

local farmers markets and other student organi-

students may lack the knowledge and skills to

zations, supported in part by funding from the

prepare healthy, inexpensive meals.”

UCLA Healthy Campus Initiative. Through the

Believing that food and nutrition literacy needed

demonstrations, the Public Health Nutrition Club

to be a greater part of campus life, the student-led

teaches easy-to-prepare, healthy recipes utilizing

Public Health Nutrition Club was founded in 2012

accessible and inexpensive seasonal ingredients.

by a cohort of MCH nutrition trainees as a way for

“By making shopping and cooking simpler and

its members to help their fellow students eat better.

less expensive for students,” O’Connell says, “we

“One of the goals of the club is to provide students

are not only aiding students in eating healthier,

with tools to prepare healthy food for themselves,

but building links between the campus commu-

even if they’re extremely busy with school or on

nity and local farmers that will help build a more

a tight budget,” says Meghan O’Connell, a sec-

sustainable food system at UCLA.”

SCREEN GRABBERS As part of the effort to prevent childhood obesity, FSPH is partnering to create tools to help elementary school teachers bring key messages to young children.

Now FSPH’s Office of Practice Across the Life Course, working with PCI Media Impact, has created compelling videos to reach some of the youngest students (ages 7-9) with important messages about healthy eating and physical activity, thanks to the vision and generous support of philanthropists Renee and Meyer Luskin.

Six short videos, each approximately 60-90 seconds in length and recorded in English and Spanish, present stories about family members supporting each other on their way to becoming healthier. FSPH students have been involved in reviewing scripts for the videos, as well as assisting in providing translations. The videos aim to engage the young children using fun and relatable characters, which then creates an opportunity for teacher-led classroom activities to augment and reinforce the messages. Faculty and students are working together to develop teaching materials to accompany the animated short films.

“Given the significant problem of childhood obesity, it’s critical that we reach young children with these messages,” says Dr. Michael Prelip, FSPH professor of community health sciences and associate dean for practice across the life course. “Humorous and engaging video content is a great way to get their attention so that teachers can take the next step to show them the value of healthy eating and

ONE OF EVERY FIVE SCHOOL-AGED CHILDREN in the United

physical activity. We are grateful to the Luskins for their vision in

States is obese, according to the U.S. Centers for Disease Control

focusing on this critical age group and are excited about the poten-

and Prevention. The percentage of obese U.S. children has more

tial impact of this collaboration among faculty, students, media

than tripled since the 1970s.

professionals and the community.”

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PATH TO PUBLIC HEALTH

Family Fueled What began as a personal mission to save her family from chronic disease led to Jocelyn Harrison enrolling at the Fielding School. Now she’s made it her mission to help improve nutrition for all.

“We need policies promoting environments that support and encourage healthy behavior across the lifespan.”

— Jocelyn Harrison

“I WAS STANDING IN THE CEMETERY WITH ONE OF MY BROTHERS,” Jocelyn Harrison (MPH ’17) recalls. “We had just lost two family members that week — our mother at the end of a long, full life and our brother Steve from a heart attack five days before her.

My brother turned to me.

‘I was just diagnosed with diabetes,’ he said. ‘What?’ I almost shouted at him. ‘How could you let this happen?’

I’ll never forget the look on his face.”

At the time, Harrison was well into a successful career as a media advertising and marketing expert with 25 years of experience influencing consumer behavior. But the interaction in the cemetery prompted her to rethink her vocation. Motivated to make a difference for people like her own siblings as a registered dietitian (RD) and public health professional, Harrison completed a BS in Nutrition Science, then enrolled in the combined MPH-VA Dietetic Internship Program offered through the Fielding School’s Department of Community Health Sciences and the VA (Veterans Affairs) Greater Los Angeles Healthcare System.

The internship has given Harrison the opportunity to work with a highly vulnerable population of chronicdisease patients.

Through the yearlong dietetic internship at the VA Greater Los Angeles Health-

care System, Harrison has delivered medical nutrition therapy to hospitalized veterans with acute dietary needs. She has provided local veterans with individual and group nutrition counseling services and education to assist in making better health choices and addressing chronic diseases such as diabetes. She has also helped plan and implement a community nutrition education outreach program.

In addition, Harrison has contributed to developing and testing new plans for the 2,500 meals the VA West Los Angeles Medical Center prepares and delivers to patients each day.

Harrison’s ultimate goal is to contribute to food policies and communication strategies that make an impact well beyond the individuals she currently counsels. “We need policies promoting environments that support and encourage healthy behavior across the lifespan — where fresh pro-

ph.ucla.edu

duce is accessible, affordable, abundant and convenient, and where everyday life includes plenty of physical activity,” she says.

After going through the RD/MPH program, Harrison says she has a new understanding of the physiological factors and social determinants that play a powerful role in nutrition and health. She also has a different perspective on the interaction she had with her brother at the cemetery.

“When I said, ‘How could you let this happen?’ that came from a lack of awareness that there are so many factors that come into play with chronic disease,” she says. “It starts early in life and includes everything from the sleep you get and stressful life events to the food available in your community and your access to health care. I wouldn’t have that depth of understanding without the education I’ve received from the Fielding School and VA.”

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Nutrition & Public Health

FSPH adjunct associate professor Marion Taylor Baer reflects on strategies to encourage healthier eating, and on the role of policies, for better or worse, in nutrition outcomes.

DR. MARION TAYLOR BAER’S professional focus has evolved in the nearly 50 years since she graduated from the Fielding School with an MS in nutrition science. An adjunct associate professor in FSPH’s Department of Community Health Sciences, Taylor Baer has long been interested in issues of maternal and child health, especially regarding the nutritional status of children with developmental disabilities and access to preventive care for children with special needs. This interest soon broadened to include U.S. food and nutrition policies and their impact on public health.

Not long after being recognized at the 2016 American Public Health Association annual meeting with the Catherine Cowell Award for her achievements in leadership, planning, administration and mentoring in public health nutrition, Taylor Baer spoke with FSPH’s Public Health Magazine.

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What should public health’s message be when it comes to a healthy diet?

A: [Author] Michael Pollan sums it up in seven words: “Eat food, not too much, mostly plants.”

That’s really what it boils down to even though it’s not very “sexy,” and the food industry does its best to take advantage of the fact that we don’t have any regulatory definition of what is “natural,” although “organic” and “nonGMO” labels are USDA approved.

And so, nutritionists tell people to stay out of the central aisles in the supermarket as much as possible, and to read the labels.

Despite what we know, the majority of adults in the U.S. are overweight or obese, with the highest rates among low-income populations. From a public health standpoint, where are we falling short?

A: There are many contributing factors, but the problem has a

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

lot do with our food policies. If you are hungry and poor you tend to eat junk food, because it’s cheap. Why is it cheap? Through the Agricultural Act passed in Congress every few years, better known as the Farm Bill, our government subsidizes corn and soybean crops — which are used to produce cheap sweeteners and oil — but fruits and vegetables, which could otherwise be less expensive, get very little support in spite of the fact that we tell people to eat more of them.

Clearly, our agricultural policies don’t sync with our health policies, in part because nutrition policies and funding for food and nutrition programs are determined by the USDA and not the U.S. Department of Health and Human Services, and in part because we have very powerful people in Congress from the farm states.

When did you become interested in nutrition policy?

A: My master’s program was very bench-science oriented.

Then I worked for a long time in an interdisciplinary training program funded by the federal Maternal and Child Health Bureau, focusing on kids with special needs and their families, where it was clear that nutrition was extremely important. But my early clinical focus began to change as I saw families in the context of their communities and became aware of health and nutrition policies that could make a difference in their lives. Surely nutrition education is important, but most people have a pretty good idea of what food is good and what isn’t. On the other hand, we could change our policies so that junk food becomes expensive and healthier food is cheaper. Look at smoking — education went only so far, then we started taxing tobacco and banning smoking

in public places, and that’s had a bigger impact. Social norms also played a major role, and it’s encouraging to see the growing public interest in “whole foods.”

Where have our policies improved, and what would your priorities be?

A: The WIC [Special Supplemental Nutrition Program for Women, Infants, and Children] food package was changed in 2009 to be more healthful, which is very positive since WIC covers many of our most vulnerable people, nearly 49 million per month in 2015. The change not only emphasized fruits and vegetables, but also included sources of protein such as tofu and other culturally appropriate healthy foods.

The school food programs have made strides in the meals that are being provided. In terms of where we need to go, with the Supplemental Nutrition Assistance Program, which used to be known as food stamps, there is still a debate about whether recipients should be allowed to use that benefit to buy junk food. Taxing foods with high amounts of sugar and/or unhealthy fat could have a positive impact. But we also have to think more broadly.

How can you buy healthy food if you’re poor? We have to tackle the problem of poverty, as well as making healthy food affordable and accessible by reprioritizing the Farm Bill expenditures. And we need a health care system in which the incentive is to keep people healthy through preventive measures, which include emphasizing nutrition.

“on and off,” which has amazing future implications. The emerging research on the microbiota — the trillions of microbial cells in the gut of every person — and its relationship to food and metabolism is another important area.

We’re discovering that not only do these gut bugs influence the brain, but they can also produce certain nutrients, such as vitamin B12, which can be important to vegans. What comes from these research directions is likely to influence the thinking about what makes an optimal diet at different points during one’s life. Ultimately, in addition to the growing knowledge we have about nutrition science, in the near future more personalized diets may be prescribed to prevent disease and promote optimal health.

“We could change our policies so that junk food becomes expensive and healthier food is cheaper.”

— Dr. Marion Taylor Baer (below)

Where do you see the field of nutrition headed?

A: There are two exciting emerging areas of research. First, in the field of epigenetics, animal studies have shown that diet can alter phenotypes by providing nutrients that can turn genes ph.ucla.edu

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SCHOOL WORK

POSITIVE STEPS

FIELDING SCHOOL STUDENTS ARE WELL AWARE of the importance of regular exercise — in fact, many have participated in initiatives designed to encourage people to become more active. But given the pressures and demands that come with graduate school and adult life, implementing exercise into their own routines can be challenging.

The FSPH Run Club has emerged as an increasingly popular tool to help students stay well. “Many are initially hesitant to come out because they’re worried about grades and tests,” says Alvan Cheng, a PhD student and Run Club co-founder along with fellow master’s students Michele Wong, Alison Ryan and Amanda Landrian.

“But it’s a good break from studying, and a place where people from different depart30

ments can get together and be active.”

Since its creation in the spring of 2016, Run Club has grown from its four initial founding members to nearly 30, with about 20 students regularly participating in the group’s weekly workout. “We get people of all different levels,” Cheng says. “It’s been really cool to see how much participants have improved.”

One such student is Saanchi Shah, who says the extent of her physical activity since she joined the club went from just walking to and from class to now participating in the 2017 LA Marathon and Charity Relay.

Shah ran 13.1 miles as part of the Fielding School’s Race to Health, which raised more than $20,000 for the third year in a row in support of student fieldwork.

“I had never imagined that I would be

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

able to do something like run in the LA Marathon and Charity Relay,” Shah says.

“The first day I went to Run Club I was really embarrassed. I could barely jog. I would get tired really quickly, but I just kept going.”

Over the past year, Run Club has grown from a social gathering into a support system that has helped to spark sustainable lifestyle changes for a number of Fielding School students while maintaining the sense of fun and community that inspired its creation.

“Without the support of Run Club, I wouldn’t have been motivated enough to run in the relay,” Shah says. “I used to think I didn’t have time, but after Run Club I feel so much more energetic and charged to study, like I can get more done in less time.”

FSPH’S FRUIT & VEGGIE STAND

NATIONAL PUBLIC HEALTH WEEK AT UCLA

AS PART OF NATIONAL PUBLIC HEALTH WEEK 2017, April 3-7, the Fielding School’s Students of Color for Public Health organized a week of events around the theme Public Health Awakened. With a series of vibrant and engaging lectures and activities throughout the week, students leading the effort sought to illustrate the effects of the current political climate on “the health of communities we are from, study and work with.”

DR. HILARY GODWIN (pictured above), professor of environmental health sciences and associate dean for academic programs at the Fielding School, recently led an initiative to introduce the FSPH Community Fruit and Veggie Stand, located in the Office of the Dean. To promote healthy eating and sustainable practices, community members who have extra fruit or vegetables from their home gardens bring them in to share with others.

People looking for a healthy snack are free to stop by during business hours and help themselves to any of the items in the bin.

FSPH SCHOLAR RECEIVES A 2017 CHANCELLOR’S AWARD DR. ZEYAN LIEW, a postdoctoral scholar in the Department of Epidemiology at the Fielding School, was named a winner of the 2017 Chancellor’s Award for Postdoctoral Research. The award “recognizes individual research accomplishments that show clear potential to have meaningful and enduring implications in their field.” Liew was one of four winners among 18 finalists selected from the 1,314 postdoctoral scholars across UCLA’s campus.

PICTURED: LIEW (RIGHT), WITH INTERIM VICE CHANCELLOR FOR RESEARCH ANN KARAGOZIAN

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NEW LEADERSHIP IN DEVELOPMENT AND ALUMNI AFFAIRS

HONOR ROLL 2016

DAILY BURST OF WORKPLACE EXERCISE NEARLY EVERY DAY at approximately 2:30 p.m. in the office common area shared by the Center for Cancer Prevention and Control Research and the Kaiser Permanente Center for Health Equity, which are part of the Fielding School and the Jonsson Comprehensive Cancer Center at UCLA, FSPH staff, faculty and visitors gather to engage in a 10-minute aerobic exercise activity set to music.

The daily tradition is a tribute to work pioneered by the late Dr. Antronette (Toni) Yancey, FSPH professor of health policy and management, founding co-director of the Kaiser Permanente Center for Health Equity, and a renowned advocate for the health benefits of incorporating brief sessions of physical activity into daily routines. Yancey introduced the mid-day activity to the centers in 2007, and since her passing in 2013 center staff have continued the daily tradition.

“As long as I’m here, we’re going to do this every day,” says Maria Trejo, project assistant for the centers, who has led the activity since 2015. “We’re going to continue in her honor, because she really wanted to spread the word and get people moving. It’s the least we can do — exercise for our own benefit.”

All members of the Fielding School community are welcome to join any day the center is open, at approximately 2:30 p.m. in CHS A2-125.

TAL GOZANI has joined the Fielding School as assistant dean for development and alumni affairs. Previously, Gozani served as senior vice president of the Jewish Federation of Greater Los Angeles.

In that role, she advised the federation’s Board of Trustees, led several high-profile volunteer committees, and cultivated relationships with major individual and foundation donors. Gozani has also served as curator at the Skirball Cultural Center, and as philanthropic advisor at the Righteous Persons Foundation. A proud Bruin, Gozani pursued her doctoral studies at UCLA, earning Candidate of Philosophy and Master of Arts degrees in history. She earned her Bachelor of Arts in Philosophy from UC Santa Cruz.

The UCLA Fielding School of Public Health is pleased to honor our alumni, friends, students, staff, and foundation and corporate partners whose generosity strengthens our school and keeps us at the forefront of public health education.

Please visit ph.ucla.edu/ honorroll2016 to view the 2016 Honor Roll.

KEEP IN TOUCH Visit us online ph.ucla.edu

BOOKSHELF Recent books by UCLA Fielding School of Public Health authors: Living in Death’s Shadow: Family Experiences of Terminal Care and Irreplaceable Loss

By Emily Abel

CONTRIBUTING AUTHORS Gregory A. Aarons Kim Anderson Onyebuchi A. Arah David Atkins David M. Balshaw Sanjay Basu Anne Lise Brantsæter C. Hendricks Brown Ross C. Brownson Germaine M. Buck Louis David L. Buckeridge Pierre R. Bushel David A. Chambers Ken Cheung Linda M. Collins Peter Craig Lisa Croen Gracelyn Cruden Yuxia Cui Geoffrey Curran Alan D. Dangour Julie Daniels Smita Das Evelyne de Leeuw Tim Doran Lori Dorfman Isobel Drewett Naihua Duan Lori Ducharme Genevieve Dunton Paul Campbell Erwin

M. Daniele Fallin Nicole D. Ford Nicholas Freudenberg Sarah Garza Christopher D. Golden Samuel L. Groseclose Sarah Guth Molly Hall Margaretha Haugen Deanna M. Hoelscher Xuezhi Hong Jane A. Hoppin Peter Huybers Michael Jerrett Loretta Jones Spyros Karakitsios Srinivasa Vittal Katikireddi Amy M. Kilbourne Gerald F. Kominski Petros Koutrakis Richard K. Kwok Christine Ladd-Acosta John Landsverk Brian K. Lee Laura C. Leviton Barry S. Levy Alastair Leyland Gordon G. Liu Rene Loewenson Kristen Lyall Arjun K. Manrai

Carolyn J. Mattingly Kristin A. Maurer Ankita Meghani Helle Margrete Meltzer Brian S. Mittman Charles Mock Nathaniel D. Mueller Eleni Murphy Samuel S. Myers Shoji F. Nakayama K.M. Venkat Narayan Gila Neta Craig Newschaffer Mark Nieuwenhuijsen Narissa J. Nonzee Lawrence A. Palinkas P. Christopher Palmedo Bo Y. Park Chirag J. Patel Shivani A. Patel Jonathan A. Patz Adriana Pérez Stephanie R. Pitts Frank Popham Judith J. Prochaska Nalini Ranjit Teri A. Reynolds Marylyn Ritchie Andrew M. Ryan Stacy Salerno Denis A. Sarigiannis

Annual Review of Public Health Volume 38, 2017 Fielding, Brownson, Green Editors

Hendry R. Sawe Diana Schendel Charles Schmitt David Shulkin Arjumand Siddiqi Victor W. Sidel Sarah Simpson Matthew R. Smith Nathaniel W. Snyder Andrea Sorensen Barclay Stewart Jeanette A. Stingone Rachel G. Tabak Susan L. Teitelbaum Duncan C. Thomas Tamitza Toroyan Michelle C. Turner Bapu Vaitla Thomas W. Valente Roel C.H. Vermeulen Heather Volk

Samantha A. Vortherms Andrea Wallace Kenneth B. Wells Tisha Wiley Gayle C. Windham David Wishart Trond A. Ydersbond Kelly C. Young-Wolff

Annual Review of Public Health, Vol. 37 Edited by Lawrence W. Green, Ross C. Brownson and Jonathan E. Fielding

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Care of Adults with Chronic Childhood Conditions Edited by Mariecel Pilapil, David E. DeLaet, Alice A. Kuo, Cynthia Peacock and Niraj Sharma

FACULTY HONORS & SERVICE Onyebuchi Arah was named an editor of the International Journal of Epidemiology.

Pablo Cicero-Fernandez and Tao Huai received the Professional Achievement Award for 2016 from the Professional Engineers in California Government for their contributions to the project, “VW Diesel Cheating Detection Team.”

Anne Coleman was elected to the National Academy of Medicine; received the 2016 Suzanne VéronneauTroutman Award from Women in Ophthalmology; and was appointed to the National Academies of Sciences, Engineering, and Medicine: Committee on Public Health Approaches to Reduce Vision Impairment and Promote Eye Health, which prepared the publication, “Making Eye Health a Population Health Imperative: Vision for Tomorrow.”

Roger Detels received the 2016 Chinese Government Friendship Award from the Chinese Central Government.

Chandra Ford was invited to serve as a member of the AntiRacism Collaborative (ARC) Advisory Board to the President of the American Public Health Association; and as co-chair of the ARC’s Council on Science.

Pamina Gorbach received the “Royal Order of Sahametrie Commander” from the Royal Government of Cambodia for her contribution to public health and capacity building in Cambodia.

Nina Harawa received the Champion of Women Award from the Los Angeles Women’s Collaborative on HIV/AIDS. Ron Hays was identified by Thomson Reuters as one of the World’s Most Highly Cited Researchers for 2016.

Felicia Schanche Hodge was appointed to serve as a member of the U.S. National Library of Medicine’s Literature Selection Technical Review Committee for 2016-2020.

Steve Horvath received the Best Paper Prize for 2015 from the editors in chief of Aging Cell.

Michael Jerrett was appointed to the National Academies of Sciences, Engineering, and Medicine: 2017 Standing Committee on Geographical Sciences; and was identified

by Thomson Reuters as one of the World’s Most Highly Cited Researchers for 2016.

Emmett Keeler served on a committee for the National Academies of Sciences, Engineering, and Medicine that published a report with findings and recommendations on the status and utilization of molybdenum-99 for medical use.

Gerald Kominski was appointed by UC President Janet Napolitano to serve as the UC Academic Senate representative and voting member of the newly established Executive Steering Committee on Health Benefits for UC faculty and staff.

Randall Kuhn was appointed to a five-year term as member of the Population Sciences Subcommittee for the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Mark S. Litwin received the Faculty Community Service and Praxis Diversity, Equity and Inclusion (DEI) Award from the UCLA Academic Senate.

Corrina Moucheraud was elected to serve as member of the AcademyHealth Education Council.

Ninez Ponce was appointed to the Centers for Disease Control and Prevention Board of Scientific Counselors, National Center for Health Statistics 2017.

Beate Ritz was named president-elect of the International Society for Environmental Epidemiology; and was appointed to the National Academies of Sciences, Engineering, and Medicine committee: Review of the Health Effects in Vietnam Veterans of Exposure to Herbicides– Eleventh Biennial Update.

Linda Rosenstock was inducted as Honorary Fellow to the New York Academy of Medicine for receiving the 2016 Stephen Smith Award for Distinguished Contributions in Public Health.

Janet Sinsheimer was selected to receive the 2017 L. Adrienne Cupples Award for Excellence in Teaching, Research, and Service in Biostatistics from Boston University.

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Marc Suchard was selected as a 2016 Institute of Mathematical Statistics Fellow.

Irwin (Mel) Suffet was recognized in an April 2017 symposium named in his honor, “Chemistry of Water Treatment from Sorption to Taste and Odor: A symposium honoring the contributions of Mel Suffet,” sponsored by the American Chemical Society’s Division of Environmental Chemistry.

Catherine Sugar was selected to serve as co-chair of the End Stage Renal Disease (ESRD) Dialysis Facility Compare (DFC) Star Ratings Technical Expert Panel (TEP).

Marion Taylor Baer received the 2016 Catherine Cowell Award sponsored by the Food and Nutrition Section of the American Public Health Association.

Paula Tavrow received the faculty/practitioner award for the 2017 Reflection in Global Health essay contest from the Consortium of Universities for Global Health.

Leah Vriesman was named chair-elect of the 20162017 Global Healthcare Management Faculty Forum for the Association of University Programs in Health Administration.

Jennifer Wortham was elected to serve as a director of Desert Healthcare District.

Elizabeth Yano was elected to serve as board member and committee member on the 2017 AcademyHealth Board of Directors.

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2016-17 STUDENT AWARDS Abdelmonem A. Afifi Student Fellowship Sean Barry Health Policy and Management

Beverlee A. Myers Memorial Fellowship Mayra Rascon Health Policy and Management

Sara McCleskey, Narissa Nonzee, Helen Ovsepyan, Andrea Sorensen, Linda Tran, Ayae Yamamoto Health Policy and Management

Agency for Healthcare Research and Quality Fellowship James Godwin, Tanya Olmos, Petra Rasmussen, Sophie Snyder, Claire Than Health Policy and Management

Burroughs Wellcome Fund Inter-School Training Program in Chronic Diseases Cynthia Kusters Epidemiology

Dean Hansell Fellowship to Address Gun Violence Danielle Dupuy Community Health Sciences

Air & Waste Management Association Air Quality Research and Study Award Mercede Ramjerdi Environmental Health Sciences

California Certified Unified Program Agency (CUPA) Forum Student Research Award Katherine McNamara Environmental Health Sciences

American College of Toxicology (ACT) Student Furst Award Julie Castañeda Molecular Toxicology IDP

California Certified Unified Program Agency (CUPA) Student Project Scholarship Award Ivan Torres Environmental Health Sciences

American College of Toxicology (ACT) Student Travel Award Julie Castañeda Molecular Toxicology IDP

California Immigration Research Initiative Fellowship Maria-Elena Young Community Health Sciences

American Society of Safety Engineers’ Foundation (ASSEF), Rixio Medina & Associates Hispanics in Safety Scholarship Ivan Torres Environmental Health Sciences

Ann and Phil Heymann Global Fellowship Amanda Landrian Epidemiology

Calouste Gulbenkian Global Excellence Scholarship for Armenian PhD Students Vahe Khachadourian Epidemiology

Ann G. Quealy Memorial Fellowship Haleigh Mager-Mardeusz, Alicia Popoff Health Policy and Management Anne Sullivan Reher Livio Fund for the Health and Well-Being of the Homeless Kymberly Aoki, Estelle Robinson Community Health Sciences Annie’s Sustainable Agriculture Scholarship Mercede Ramjerdi Environmental Health Sciences Association of Rheumatology Health Professionals (ARHP) Outstanding Student in Rheumatology Award Priti Prasad Molecular Toxicology IDP Atlantic Richfield Company (ARCO) Fellowship Emily Marino Environmental Health Sciences

Bette and Hans Lorenz Fellowship Alein Haro Community Health Sciences Regem Corpuz, Joel Gonzalez Health Policy and Management

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Carolbeth Korn Scholar Award Hilary Aralis Biostatistics Celia G. and Joseph G. Blann Fellowship Yan Lin Environmental Health Sciences Charleen Hsuan Health Policy and Management Charles F. Scott Fellowship Tyler Watson Environmental Health Sciences Alma Jusufagic Health Policy and Management

Child and Family Health Program Fellowship Subasri Narasimhan Community Health Sciences Eryn Block, Joseph Viana Health Policy and Management Child and Family Health Summer Internship Eder Abellaneda, Emily Ferro, Caitlin O’Connor, Sabrina Owens, Vanessa Perez, Lauren Schenker, Sarah Jane Smith, Katherine Strong, Chloe Winders-Singer Community Health Sciences Therese Chen Environmental Health Sciences Connie Lu Epidemiology Clinical Translational Science Institute (CTSI) Training Grant Amy Bonilla, Natalie Bradford, Julian Brunner, William Boyd Jackson, Michelle Keller, Selene Mak,

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Dean’s Global Health Fellowships Natalie Dickson, Makaela Newsome, Jasmine Uysal Community Health Sciences Briana Yeh Environmental Health Sciences Ushma Dharod, Rachael Jackson, D’Andre Spencer, Melissa Wiles Epidemiology Dean’s Leadership Grant David Phak, John Soliman Biostatistics Anika Akhter, Meron Begashaw, Trista Benitez, Jessica Coates, Katie Cobian, Alein Haro, James Huynh, Nandini Inmula, Tania Perez, Vanessa Perez, Estelle Robinson, Jaime Ruiz, Jose Velasquez, Elise Wallis Community Health Sciences Arely Briseno, Therese Chen Nadia Ho, Elbert Hsiung Jimmy Phong Environmental Health Sciences Cindy Agus, Victoria Autelli, Cynthia Beard, Jesse Bendetson, George Dewey, Rachael Jackson, Amanda Landrian, Brittany Meyer, Adriel Neely, Cathy Ngo, D’Andre Spencer, Lorena Ulloa, Kartavya Vyas Epidemiology Kristin Calsada, Landon Gibson, Veronica Kapoor, Whitney Li, Xiang Li, Rathi Ramasamy Health Policy and Management Dean’s Outstanding Student Award Anna Antonio Biostatistics Brittany Morey Community Health Sciences Amanda Wagner Environmental Health Sciences Roch Nianogo Epidemiology Boback Ziaeian Health Policy and Management Delta Omega Honorary Society Nominees in Public Health, Iota Chapter Hilary Aralis, Thomas Gibson, Yihao Li, Di Xiong Biostatistics Anika Akhter, Stephanie Albert, Meron Begashaw, Natalie Dickson, Erica Mahgerefteh, Brittany Morey, John Peipert, Lauren Schenker, Jenna van Draanen, Daisy Walker Community Health Sciences Bryan Moy, Yubin Zhou Environmental Health Sciences Aileen Baecker, Zuelma Contreras, San Hone, Roch Nianogo, Travis Meyers, Alison Ryan Epidemiology

Anna Davis, Alma Jusufagic, Cosima Lenz, Haleigh Mager-Mardeusz, Sarah Schulte-Waters, Boback Ziaeian Health Policy and Management Julie Castañeda, Priti Prasad Molecular Toxicology IDP Department Block Grant Opportunity Award Christopher German, Cameron Goldbeck, Joseph Kyeong, Jane Pan, Heather Stemen, Katy Wang Biostatistics Marta Bornstein, Elsa Carrasco, Marisol Frausto, Aila Hernandez, Cristina Hunter O’Leary, Linghui Jiang, Elise Liu, Julie Loc, Anthony Paul Mendoza, Ana Ordaz, Elise Wallis Community Health Sciences Christina Batteate, Olivia Ellis, Katherine Gibbs, Nan Jiao, Larry Lai, Emily Marino, Mercede Ramjerdi, Robert Reny, Joyce Thung Environmental Health Sciences Richard Dumbrique, Sarah Elliott, Jin Sol Lee, William Sheppard Health Policy and Management Dissertation Year Fellowship Brittany Morey Community Health Sciences Roch Nianogo Epidemiology Anna Davis, Sarah Friedman, Di Liang, Diane Tan Health Policy and Management Dowdle Mental Health Summer Fellowship Amber Brink, Jaime Ruiz Community Health Sciences Haleigh Mager-Mardeusz, Victor Shiau Epidemiology Bryce Henderson Health Policy and Management Dr. Ursula Mandel Scholarship Subasri Narasimhan, Natalia Woolley Community Health Sciences Alina Palimaru, Lee Sook Hee Squitieri Health Policy and Management Drabkin/Neumann Global Public Health Field Experience Alexis Balina, Stephanie Kiesow Community Health Sciences

E. Richard (Rick) Brown Social Justice Fellowship William Boyd Jackson Health Policy and Management Epidemiology Congress of the Americas, Russell Kirby Travel Scholarship Roch Nianogo Epidemiology Epidemiology Congress of the Americas, Student Prize Award, Poster Session 1 Roch Nianogo Epidemiology

Eugene and Sallyann Fama Fellowships in Public Health Eder Abellaneda, Lorena Gonzalez, Bernadett Leggis, Anna-Michelle McSorley Community Health Sciences Mercede Ramjerdi Environmental Health Sciences Cristina Hunter O’Leary, Dianna Soto Health Policy and Management Eugene Cota-Robles Fellowship Eryn Block Health Policy and Management Fred H. Bixby Certificate on Population and Reproductive Health Natalie Dickson, Caitlin O’Connor Community Health Sciences Fred H. Bixby International Internships on Population and Reproductive Health Aiyu Chen Biostatistics Ryan Raypon Epidemiology FSPH Marathon Student Fellowship Amanda Barbanica, Leila Kamareddine, Erica Mahgerefteh Community Health Sciences Jimmy Phong Environmental Health Sciences Rachael Jackson, Alison Ryan, Hubert Sung Epidemiology Future Public Health Leaders Fellowship David Phak Biostatistics Anika Akhter, Meron Begashaw, Jessica Coates Community Health Sciences Elbert Hsiung Environmental Health Sciences Jesse Bendetson, Kartavya Vyas Epidemiology Regem Corpuz, Adriel Neely, Rathi Ramasamy Health Policy and Management Graduate Dean’s Scholar Award James Godwin Health Policy and Management Graduate Opportunity Fellowship Program Anna-Michelle McSorley, Mariana Reyes Community Health Sciences Arely Briseno, Karla Vasquez Environmental Health Sciences Hajar Ahmed, Dianna Soto, Allen Taing, Vernonica Vicenas, Marwin Yeung Health Policy and Management Graduate Research Mentorship Award Amy Bonilla, Natalie Bradford, Lucinda Leung Health Policy and Management Graduate Student Researcher Opportunity Award Stephanie Ly Community Health Sciences Dahai Yue Health Policy and Management

Graduate Summer Research Mentorship Fellowship Aaron Scheffler Biostatistics Angela Gutierrez, Anna Hing, Stephanie Ly, Helene Riess, Sarah Roth, Jenna van Draanen Community Health Sciences Aline Duarte Folle Epidemiology Lucinda Leung Health Policy and Management Health Policy and Management Alumni Association (HPMAA) Award Whitney Li, Katherine Sziraczky Health Policy and Management Health Policy and Management and Community Partner Fellowship Endowment Courtney Porter Health Policy and Management Judith Blake Memorial Fellowship Alec Chan-Golston Biostatistics Juneal Marie Smith Fellowship in International Nutrition Shelley Jung Community Health Sciences Laurie and Bill Benenson Environmental Health Fellowship Emily Marino Environmental Health Sciences Leadership Training in Maternal and Child Nutrition Jocelyn Harrison, Jasmine Mercado, Rebecca Oh, Monica Pang Community Health Sciences The Lemann Fellowship Talent Program Aline Duarte Folle Epidemiology Mary G. and Joseph Natrella Scholarship Yan Wang Biostatistics Molina Healthcare Student Writing Competition Award Sangeeta Mondal Biostatistics Chloe Winders-Singer Community Health Sciences Amanda Wagner Environmental Health Sciences Negar Omidakhsh Epidemiology Veronica Kapoor Health Policy and Management Monica Salinas Internship Fund in Latino and Latin American Health Frances Huynh Community Health Sciences Hubert Sung Epidemiology National Institute of Environmental Health Sciences T32 Training Grant in Molecular Toxicology Lisa Barnhill, May Bhetraratana, Yichang Chen, Jenna Harrigan Molecular Toxicology IDP

National Institute for Occupational Safety and Health Southern California Education and Research Center Fellowship Teni Adewumi-Gunn, Jack Arouchian, George Brogmus, Katherine McNamara, Charlene Nguyen, Diana Nguyen, Jimmy Phong, Ivan Torres, Nu Yu Environmental Health Sciences National Institutes of Health (NIH) Genomic Analysis and Training Program Cynthia Kusters Epidemiology National Science Foundation (NSF) Graduate Research Fellowship Maureen Sampson Molecular Toxicology IDP National Swimming Pool Foundation (NSPF) Board Fellowship Jennie Wung Environmental Health Sciences Public Health Advocacy Fellowship Anna Ferrarie, Natalia Garcia, Gayle Palma Community Health Sciences Mercede Ramjerdi Environmental Health Sciences Laureen Masai Epidemiology Randall Lewis Health Policy Fellowship Katherine McNamara Environmental Health Sciences Raymond D. Goodman Scholarship Cynthia Kusters Epidemiology Maureen Sampson Molecular Toxicology IDP Ric and Suzanne Kayne Public Health Fellowships Natalie Dickson, Natalia Garcia, Khalela Hatchett, Nga Le, Esmeralda Melgoza, Makaela Newsome, Gayle Palma, Lauren Schenker, Sarah Jane Smith, Matthew Wright Community Health Sciences Jimmy Phong Environmental Health Sciences Katrina Blust Epidemiology Isabel Guerrero, Jazmine Gutierrez, Allen Taing Health Policy and Management

Southern California/Orange County American Industrial Hygiene Association Scholarship Ivan Torres Environmental Health Sciences Tony Norton Memorial Fellowship Ivan Torres Environmental Health Sciences UC Global Health Institute Migration and Health Fellow Brittany Morey Community Health Sciences UC President’s Global Food Initiative Student Fellowship Program Hannah Malan, Meghan O’Connell, Carly Randolph Community Health Sciences Tyler Watson Environmental Health Sciences UCLA Affiliates Fellowship Tyler Watson Environmental Health Sciences UCLA Faculty Women’s Club Scholarship Mercede Ramjerdi Environmental Health Sciences UCLA Institute of Transportation Studies Fellowship Jasneet Bains Environmental Health Sciences UCLA Sustainable LA Grand Challenge Powell Policy Fellowship Tyler Watson Environmental Health Sciences Upsilon Phi Delta National Honorary Society Elena Delvac, Sarah Elliott, Katherine Gilmer, Nikhil-Raj Kulkarni, Jennifer Liang, Rachel Mashburn, Alicia Popoff, Brett Thompson Health Policy and Management Wilshire Health and Community Services Internship in Geriatric Medicine Janett Guzman Escobar, Esmeralda Melgoza, Carly Randolph, Matthew Wright Community Health Sciences Qingqing Wen Epidemiology Homaira Toukhi Health Policy and Management

Samuel J. Tibbitts Fellowship Maria-Elena Young Community Health Sciences Southern California American Industrial Hygiene Association Student Project Scholarship Award Ivan Torres Environmental Health Sciences Southern California Society of Toxicology (SCCSOT) Graduate Student Travel Award Priti Prasad Molecular Toxicology IDP

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For more information ph.ucla.edu

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TRANSFORMATIVE INVESTMENTS

ENABLING FUTURE PUBLIC HEALTH LEADERS TO FOLLOW THEIR DREAMS AS AN UNDOCUMENTED STUDENT set to graduate from UCLA’s three-year dual master’s program in public health and public policy, Regem Corpuz (above, second from right) has been motivated by his experience immigrating to the United States as a child, when a clerical error rendered him undocumented.

“Despite entering the U.S. lawfully and doing everything right, I became one of the millions who fell through the cracks,” Corpuz says. “Like the experiences of many other undocumented immigrants, mine demonstrates that the lives and wellbeing of communities are very much subject to policy.”

Corpuz’s concern about the impact of institutional barriers on the health of undocumented immigrants led him to the Fielding School. “As an immigrant student, paying for college out of pocket was stressful for me,” he says. “Realizing I had limited access to financial aid was even more stressful.”

Receiving the Future Public Health Leaders Fellowship proved transformative to Corpuz, as it has for all 40 students awarded the scholarship provided by the Dream Fund at UCLA. The fund was born out of the vision and unwavering generosity of the late businessman and humanitarian Kirk Kerkorian. These scholarships, launched by a generous gift from the Dream Fund, have succeeded at their goal of bridging students’ dreams with the means to make them possible. As one of the first endowed fellowships of the Fielding School’s Centennial Campaign, the Future Public Health Leaders Fellowship helped to inspire an additional $6.19 million raised to provide 116 students with fellowship and fieldwork support 36

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that is critical to educating and training the public health workforce needed to keep communities healthy.

Students like Corpuz and the full cohort of Future Public Health Leaders are poised to play a pivotal role in the health of populations in the U.S. and overseas, but for so many of these potential leaders, a public health education is difficult if not impossible without financial assistance. The Future Public Health Leaders Fellowship provides full tuition support, ensuring that cost is no longer a barrier for students from, or committed to working in, high-need communities. Students supported by the fellowship have gone on to positions in such organizations as Children’s Hospital of Los Angeles; UCLA Health, Women’s and Children’s Services; and the U.S. Environmental Protection Agency, as well as to further their academic pursuits at leading institutions such as the University of Michigan Medical School and Harvard T.H. Chan School of Public Health.

With the fellowship support, Corpuz completed his field studies as a policy advocate for California’s Occupational Safety and Health Administration (Cal/OSHA), where he participated in a campaign to implement a statewide workplace violence prevention program for health care workers. Today, Corpuz says his focus is on advocating for minimum-wage workers who struggle to provide for their families despite holding multiple jobs, and who are subject to poor working conditions. “In advocacy and policymaking,” Corpuz says, “I try to listen to workers and see how I can be their megaphone — amplifying their voices as they speak their truth to power.”

WE NEED PUBLIC HEALTH CHANGEMAKERS. NOW MORE THAN EVER. At the Fielding School, we are preparing the next generation of public health leaders.

Your support will ensure that bright, talented and committed students pursue careers in a profession that benefits all of us.

TO LEARN HOW YOU CAN HELP MAKE A DIFFERENCE, PLEASE VISIT GIVETO.UCLA.EDU/FSPH/SPR17 OR CALL (310) 825-6464.

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“Think the tree that bears nutrition: Though the fruits are picked, the plant maintains fruition. So give all the love you have. Do not hold any in reserve.

What is given is not lost; it shall return.”

— Kamand Kojouri