UCLA Fielding School of Public Health Magazine - Spring/Summer 2018

PUBLIC HEALTH SPRING/SUMMER 2018

The UCLA Fielding School of Public Health Magazine

Healthy Direction When barriers to women’s wellness and empowerment are removed, all of society prospers.

DEAN’S MESSAGE

IN THE U.S. AND GLOBALLY, women and girls face unmet needs for preventive services, health care and better living conditions. Around the world, more than 200 million women and youth who don’t want to become pregnant are unable to obtain and use safe and effective means of prevention. In the U.S., free and affordable contraception is threatened for many.

Battles we might have thought were won, such as ensuring access to reproductive health services, still need to be fought.

But the problem goes beyond reproductive health. In the U.S., women are less likely than men to report that they are in excellent or very good health overall, for reasons that can’t be explained by biology. More than 2.6 million fewer American women find themselves in excellent or very good health than would be the case if women had the same health experience as men.

The disparity persists across national borders. The World Health Survey found that women are significantly less likely than men to rate their health as good across eight domains. Importantly, more than half of this disadvantage was attributable to gender differences in work and education.

Extreme economic hardship poses one of the greatest health threats for all people but disproportionately afflicts women, including in the U.S., where 4 million more women than men live in poverty. The pace of progress in this area is unacceptably slow: The World Economic Forum estimates that at current rates, it will take another 217 years to close the economic gender gap.

The challenges women and girls face to their health — and the social conditions that shape it — transcend borders, and so do the efforts of our Fielding School faculty, students, staff and alumni to address these challenges. Locally and around the world, our FSPH community is taking important steps to: • improve the quality of women’s and girls’ lives in ways that will reduce their risk of poor health; • ensure that all health care systems meet the needs equally of women and men, even when they were not originally designed to; • advance the social conditions for women and girls in ways that promote their health; and • increase opportunities for women and girls across communities to lead and have a voice in policymaking and decision-making.

We are developing wide and deep collaborations focused on taking action to address gender-based social and economic inequalities that feed poverty and poor health for many millions of women in the U.S. and internationally. We hope that these efforts and this issue of our magazine can serve as tools for bringing together members of our wider community to work toward our common goals. When women and girls around the world enjoy unlimited opportunities to pursue healthy and fulfilling lives, everyone benefits.

Jody Heymann, MD, PhD Dean

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The UCLA Fielding School of Public Health Magazine

SPRING/SUMMER 2018

CONTENTS 20

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FEATURES

LEADERSHIP AT THE VA

GENDER EQUITY

04 On the Front Lines of Women’s Health Addressing the health needs of the rapidly growing female veterans population 08 Acting Globally Veronica Magar’s WHO team takes aim at inequities

STUDENT ACTIVISM

10 Raising Community Voices Anna-Michelle McSorley works with Latina women advocating for health rights

RESEARCH FOR IMPACT

11 Empowered by Evidence Informing policies for girls and women in low-income countries

12 Giving Cancer Prevention a Boost Major study tests promising strategies to increase uptake of the breakthrough HPV vaccine

COMMUNITY PARTNERSHIP

18 Shedding Light on Intimate Partner Violence How abusive relationships affect women in communities where the issue isn’t typically discussed

DOMESTIC ABUSE

INTERNATIONAL COLLABORATION

WELLNESS PROMOTION

Q&A

TEACHING ADVOCACY

14 Delivering for Women in Rural China Partnership between FSPH and colleagues in Tibet has helped more women give birth in safe settings

LOCAL LEADER

17 Family Focused Mary Hansell heads San Francisco health department’s Maternal, Child and Adolescent Health Section

20 Expanding the View A new paradigm for optimizing women’s health 24 Difference Maker Giving students the tools they need to influence women’s health policy

POWERFUL SURGERY

25 Healing & Hope Helping to transform lives of women with a devastating but treatable condition

CAMPUS ADVOCACY

26 Making Rooms for Campus Mothers FSPH students lead an initiative to make it easier for women at UCLA to breastfeed and pump 27 Promoting Women’s Health Dawn Upchurch on a more holistic approach

DEPARTMENTS 29 School Work 33 Faculty Honors

& Service 34 Student Awards 36 Transformative Investments

PHOTOGRAPHY & ILLUSTRATION Rent Control Creative: cover. Betsy Winchell: Dean’s Message. Reed Hutchinson: TOC: photo for article on p. 20; pp. 20, 23. VA Greater Los Angeles Healthcare System Medical Media: TOC: photo for article on p. 4; pp. 4-7. iStockPhoto/FabVietnam_Photography: TOC: photo for article on p. 11; p. 11. Jane Houle Photography: TOC: photo for article on p. 26; pp. 12-13, 21, 24, 26, 27; p. 29: Ninez Ponce; p. 30; p. 31: LA Marathon; pp. 32, 37. Unsplash/Katherine Hanlon: pp. 2-3. Zvonimir Atletic © 123RF.com: p. 9. California Latinas for Reproductive Justice: p. 10. Nathan Jones: p. 14: Tibetan women and children in health clinic. iStockPhoto/Baona: p. 18. Georgina Goodwin: p. 25. An Chuen Billy Cho: p. 29: group photo. Unsplash/Joshua Rawson-Harris: p. 31: photo of girl behind blinds. iStockPhoto/monkeybusinessimages: back cover. COURTESY OF: Veronica Magar: p. 8. Jessica Gipson: p. 14: photo of woman and child being surveyed; photo of Tibetan woman; pp. 15-16. Mary Hansell: p. 17. Lindsey Pollaczek: p. 25. UCLA-DRC Program/Anne Rimoin: p. 36.

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HEALTHY DIRECTION Several million people in several hundred U.S. cities marched on January 21, 2017 in what has been called the largest single-day protest in the nation’s history.

But the Women’s March wasn’t confined to the U.S. — demonstrators in 81 other countries across all seven continents participated. Nor was this a one-day tour de force to promote women’s rights. By the end of the year, an international movement known in the U.S. as #MeToo was empowering women, girls and their supporters to speak out and take action against mistreatment and for equal rights.

Significant work lies ahead. “Closing the Gender Gap,” a 2015 report by the Fielding School-based WORLD Policy Analysis Center, revealed that more than 170 countries had legal barriers preventing women and girls from experiencing the same rights, protections and liberties as men and boys. More than 150 countries lacked protections critical to ensuring women’s economic participation. The U.S. isn’t immune to these concerns.

The FSPH-based California Health Interview Survey has found that women in the state are significantly more likely to have felt discrimination in accessing health care than men (34 vs. 25 percent), for example.

The Fielding School has long recognized the inextricable link between women’s rights and women’s health. This issue provides a sampling of the powerful efforts of FSPH faculty, students, staff and alumni to improve women’s health through a wide array of approaches, including increasing access to health services, addressing social conditions, and promoting empowerment for women and girls up and down California, across the U.S., and around the world. At this historic moment, there is unprecedented opportunity to close the gender gap, thereby setting all countries and their residents in the direction of a healthy and prosperous future.

Jody Heymann, MD, PhD Dean

Rent Control Creative Design Direction

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MAGAZINE STAFF

Mikkel Allison Writer & Contributing Editor

UCLA Fielding School of Public Health Website: ph.ucla.edu

Stephanie Cajigal Writer & Contributing Editor

Email for Student Application Requests: app-request@admin.ph.ucla.edu

Jurriaan Linsen Visuals Coordinator

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 2018 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.

Carla Denly Executive Editor & Assistant Dean for Communications Dan Gordon Editor & Writer 2

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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; Marjorie Kagawa-Singer, PhD, MN Professor Emerita, Community Health Sciences; Michael Prelip, DPA Professor and Chair, 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; Hajar Ahmed and Rajia Ragab Co-Presidents, Public Health Student Association; Rita Burke, MPH ’03, PhD ’08 President, Public Health Alumni Association

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LEADERSHIP AT THE VA

On the Front Lines of

Women’s Hea lth The number of women in the VA health system is growing rapidly.

FSPH’s Elizabeth Yano has spearheaded a national effort to identify and address their health care needs.

WHEN ELIZABETH (BECKY) YANO, MSPH ’87, PhD ’96, BEGAN HER TRAINING in epidemiology, biostatistics and health policy, the idea that she might use her Fielding School education to spearhead a transformation in how the nation’s largest integrated health system provides care for its female patients was the furthest thing from her mind.

But after Yano arrived at the VA Greater Los Angeles Healthcare System (VAGLAHS) in 1989 for what was intended to be a short stint — to help evaluate the VA’s first primary care demonstration project — she discovered that the Veterans Health Administration, which serves more than 9 million veterans through care provided at more than 1,200 facilities across the country, was an institution with

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TO BETTER MEET THE NEEDS OF ITS WOMEN VETERANS, THE VA HAS MOVED TOWARD GENDER-SENSITIVE CLINIC ENVIRONMENTS AND HAS TRAINED APPROXIMATELY 5,000 PRIMARY CARE PHYSICIANS TO SPECIALIZE IN WOMEN’S HEALTH.

“We now have an evidence base that practitioners can use to transform care for women veterans, and the VA is adopting our research at an unprecedented clip.”

— Dr. Elizabeth Yano

a great interest in using research to implement policy changes. “Once I saw the kind of impact I could have, I never left,” Yano says.

For much of the last two decades, Yano, an adjunct professor in FSPH’s Department of Health Policy and Management, has led a research enterprise that has sought to identify and address gaps in knowledge about women veterans’ health and health care needs in ways that improve the quality of care they receive, as well as their satisfaction with the patient experience in the VA system.

When Yano got started, women represented barely more than 2 percent of the VA user population and their health needs were vastly understudied, she says. But the population of women veterans has grown rapidly: Today women account for nearly 10 percent of the total veteran population, and represent approximately 20 percent of new recruits. For the VA, this has added to the urgency of meeting gender-specific care needs, many of which have been elucidated by the work Yano has led.

Unique health concerns for women veterans include high overall rates of military sexual trauma, Yano notes — both in-service sexual assaults and sexual harassment. “This is a predictor of post-traumatic stress disorder, anxiety, depression and unemployment, and is one of the reasons women veterans have greater mental health burdens than male veterans,” Yano says. Women veterans experience elevated levels of chronic pain, in part as a result of a history of ill-fitting equipment designed for larger men, she adds. With women increasingly entering the VA system at childbearing age, there is a growing demand for repro-

ductive health services. The historic predominance of men in the VA system has also limited the exposure of VA doctors to female patients. In response, the VA has provided clinical retraining to approximately 5,000 primary care physicians so that they can specialize in women’s health.

Yano has helped to address these and other needs of women veterans since as early as 2001, when she secured funding from the Department of Veterans Affairs’ Office of the Under Secretary for Health to pursue the first national survey of how women’s health services were organized at the VA. Three years later she was asked to lead the effort to develop a national VA women’s health research agenda.

“They wanted me to convene a group and come back with something in a couple of weeks,” Yano recalls. “I said this needs to be driven not by what 10 of us personally think is important, but by the epidemiology. So I put together an action plan and asked for funding to analyze the big data and conduct a systematic review of what was already known, as well as to learn what researchers’ needs were so that we could design an agenda to fit those needs. To my surprise, they said yes.”

The resulting agenda included ambitious recommendations for building a research infrastructure for women’s health. Once again, Yano was asked to write a proposal for what was needed; she did, and was again granted approval to move forward.

Today, in addition to her role at VAGLAHS as director of the Center for the Study of Healthcare Innovation, Implementation and Policy, which develops and tests innovative models aiming ph.ucla.edu

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LEADERSHIP AT THE VA

NOT LONG AGO, WOMEN REPRESENTED BARELY MORE THAN 2 PERCENT OF THE VA USER POPULATION. TODAY, APPROXIMATELY 20 PERCENT OF NEW RECRUITS ARE WOMEN.

to improve VA care, Yano is director of the national VA’s Women’s Health Research Network (WHRN), which she co-founded in 2010 to promote studies focusing on the needs of women veterans. The WHRN includes the Women’s Health Research Consortium, consisting of more than 300 clinicians and investigators who receive education and training, technical support in research methods, mentorship, and dissemination support; and a Women’s Health Practice-Based Research Network,

which provides an infrastructure for multisite studies and interventions.

Yano also directs the national Women Veterans Healthcare CREATE Initiative, a $5 million program using research to accelerate implementation of comprehensive care for women veterans in VA settings. She has led or co-led more than a dozen national VA organizational survey studies, has provided a number of federal briefings, and has authored or co-authored 90 articles on women veterans research, many with mentees who are now VA investigators themselves. Among her many honors, Yano is a recipient of the VA Under Secretary for Health Award for Outstanding Achievement in Health Services Research and the FSPH Lifetime Achievement Alumni Hall of Fame Award. “ The VA system was set up to address the needs of male veterans, but women now represent 15 percent of the active duty in the U.S. military and 6

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are in increasingly dangerous occupations,” says Shurhonda Love, assistant legislative director for Disabled American Veterans, which honored Yano this year with a Special Recognition Award for her work on behalf of the nation’s women veterans. “When you consider that women represent a younger cohort, we have many women veterans who will be getting care in the VA for a long period of time, and it’s extremely important to understand their gender-specific needs. Dr. Yano’s research is providing evidence on the issues women veterans have faced for many years, which helps us to advocate more effectively. Her leadership and dedication to her work have made a huge difference for women veterans now, and for those who will serve down the road.”

The Women’s Health Practice-Based Research Network, which involved four sites when it was funded in 2010, has grown to 60 sites across the country with plans to expand even further over the next two years. Yano explains that in addition to increasing the participation of women veterans in multisite studies and quality improvement projects, this infrastructure has been integral to the VA’s ability to test and implement evidence-based quality improvement (EBQI) initiatives, which expedite the incorporation of scientific findings into clinical settings through partnerships involving researchers and clinic administrators and staff.

This rapid adoption of findings is illustrated by the CREATE-funded research to tailor the VA’s patient-centered medical home model — in which patients work in partnership with members of a health care team, each of whom has a defined role, to ensure coordinated, patient-centered care — in ways that promote gender-sensitive care for women veterans. “Before we even finished the trial, the approach we were testing was adopted for use with the VA’s lowest-performing facilities, and we’re now evaluating how well improving and tailoring care to women veterans works in twice the number of VA facilities as we did for the previous trial,” Yano says.

Among the co-investigators on the original study is Dr. Emmeline Chuang, assistant professor in FSPH’s Department of Health Policy and Management. Chuang interviewed providers and staff who see women veterans across eight regions of the U.S. to learn more about their work experience and how that influenced the delivery of care. “Part of what’s exciting about this intervention is that it focuses on building local capacity,” Chuang says.

“The idea is to empower providers and staff to pilot-test and refine changes designed to improve performance so that they can sustain these ongoing quality improvement efforts after the intervention ends.”

In addition to teaching in FSPH’s Executive Masters of Public Health program offered by the Department of Health Policy and Management, Yano has been invited by Chuang to deliver guest lectures to her students on topics that include implementation science and organizational research. Yano also serves on the dissertation committees of several Fielding School PhD candidates. Among them is Julian Brunner, who, while completing his FSPH dissertation on the use of electronic health records in primary care set-

tings, has been working on Yano’s VA team, publishing several peer-reviewed articles on topics related to health care for women veterans. “Traditionally as a researcher you publish papers and hope to capture the attention of people who make decisions,” Brunner says. “What draws me to the work we’re doing at the VA is that the research is designed with input from the policymakers, guaranteeing that it will be relevant and have real-world impact.”

The Women’s Health Research Network headed by Yano remains as robust as ever, with 15 career development awardees around the country and another 15 young investigators soon to be awarded or readying their applications, allowing Yano to continue thinking in ambitious terms about an overarching research agenda for women veterans at the VA. High on her priority list is the ongoing effort to use the evidence-based quality improvement approach to spread promising practices across the more than 1,200 sites where the VA provides care. “We need to ensure that every woman veteran is treated with the same dignity by providers who are proficient and prepared to deliver comprehensive services,” she says. “Within that context, we need to work on improving trauma-sensitive environments and trauma-sensitive care delivery. There are still providers who see a woman veteran and assume she is the spouse of a male veteran.

There are still those who see a woman who is missing a leg and can’t believe that it was from combat. The VA has done a lot of work to bring people along, but we have a lot more work to do.”

Thanks to the foundation laid by Yano and her colleagues, the VA is well positioned to continue moving forward.

Yano notes that the volume of research and published papers on the health and health care of military women and women veterans has grown exponentially since the 2004 VA women’s health research agenda recommendations were made. “We now have an evidence base that practitioners can use to transform care for women veterans,” Yano says, “and the VA is adopting our research at an unprecedented clip.” ph.ucla.edu

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GENDER EQUIT Y

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Alum Veronica Magar leads a WHO team that is taking innovative approaches to reducing inequities in health services worldwide.

FUNDAMENTAL TO THE UNITED NATIONS SUSTAINABLE DEVELOPMENT GOALS (SDGs) — the 15-year agenda for a healthier, safer and fairer world by 2030 — is a commitment to health and well-being for all, gender equality, and the reduction of inequalities within and among countries. These goals are inextricably linked.

“When women and girls are able to stay in school longer, plan or prevent pregnancies, and access health services without discrimination, they can improve their economic opportunities and ultimately transform their futures,” World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus asserted in a statement issued on International Women’s Day 2018.

At the Geneva-based WHO, Dr. Veronica Magar (MPH ’91, MA) is a leader in efforts to meet the ambitious SDG targets. Magar heads WHO’s Gender, Equity and Human 8

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Rights team, which works at the country, regional and global levels to promote universal access to quality health services without barriers or discrimination. Her group has adopted innovative approaches that require stepping out of traditional comfort zones. “At WHO we don’t look at human rights, equity or gender in isolation, but rather through an integrated framework,” Magar says. “That means working across sectors — bringing lawyers together with social epidemiologists and leaders of social movements, for example. It’s challenging, but it’s been effective.”

R aised in Los Angeles, Magar recalls being disturbed as early as high school by the inequalities around her, and determined to devote her life’s work to addressing them. She started her career as a hospital-based nurse, but soon discovered public health and became a public health nurse for Los Angeles County. While in that role, she became active with

her union, serving on the negotiating committee during a time of labor strife. “That was a turning point in my becoming more interested and involved in the intersection between social movements and public health,” Magar says. Among other things, it brought her to the Fielding School, where she earned a joint MPH and MA in Latin American Studies.

At WHO, Magar’s team addresses discrimination and inequities both at the structural level, through policies and laws, and in the field. “Social and cultural norms can have a major health impact,” Magar explains. “If women aren’t being allowed to leave the house, or if someone of a lower caste can’t walk through the village to get to the health center, that’s an access problem. And this isn’t just about women. Social norms and expectations related to masculinity can be harmful to men.”

At least half of the world’s population — a disproportionate number of them women and girls — lack access to essential health services because they are either not available or are financially out of reach, according to the WHO. Nearly 100 million face extreme poverty because they must pay for health services out of their own pockets. Even where health coverage is provided, it often discriminates against women and girls by, for example, not offering contraception, which can lead to unplanned pregnancies that exacerbate gender inequalities. And although women and girls bear higher costs of inequality and disadvantage, Magar’s group also focuses on disparities that negatively affect males, including higher rates of health-risk behaviors such as alcohol and tobacco use. “Masculinity and being male can also negatively influence health outcomes,” she says. “We want to shift the narrative away from viewing gender in a binary way.”

The approaches Magar’s group takes to these and other concerns are both global and granular. The former includes last year’s joint UN/WHO 2017 statement on ending discrimination in health care settings; it also includes WHO’s Women on the Move report on the issue of care workers — largely migrant women in informal home settings who, despite their important public health contributions, are themselves

“At WHO we don’t look at human rights, equity or gender in isolation, but rather through an integrated framework.”

— Dr. Veronica Magar exposed to health risks and access barriers while receiving few labor or social protections.

WHO’s Gender, Equity and Human Rights team has also engaged policymakers to ensure that women’s health is broadly addressed in the United Nations Commission on the Status of Women, the global intergovernmental body dedicated to the promotion of gender equality and female

empowerment. “Veronica has addressed the issue of gender inequality and discrimination, bringing a passion to her work and a focus on social justice for the world’s women,” says Soon-Young Yoon, UN representative of the International Alliance of Women and former chair of the NGO Committee on the Status of Women.

On the ground, Magar’s team is targeting the hardestto-reach populations. The Millennium Development Goals (MDGs), which were the precursors to the SDGs, focused on aggregate-level changes. “We were able to make a lot of difference with the MDGs, but there wasn’t enough attention to those who are left behind — including remote and indigenous populations, and others who face disadvantage and marginalization,” Magar says. “The SDGs mark a shift in that we are looking at inequalities not just across countries, but also within countries.”

The world is in a state of transition that has profound effects on women’s health, Magar notes. The expanding world economy resulting from globalization is generating more jobs for women while creating new opportunities to transform gender roles. But the work is not distributed equally, leading to growing health disparities. At the same time, a seismic epidemiologic shift is afoot. Of the six most common causes of death among women, five are non-communicable diseases (NCDs). “We need to move beyond the myths that women are defined only by their reproductive capacities; that NCDs, especially cardiovascular disease, primarily affect men; and that NCDs in women are an issue only in high-income countries and a result of lifestyle choices,” Magar says. “ The SDGs call us to action to tackle inequalities within and between nations. To do that, we need to go beyond reproductive health to encompass non-communicable diseases, universal health care, aging women, and health workforce gender issues, among others. And instead of a disease and biomedical focus, we must look at inequalities, focus on prevention, and promote policies and programs that not only help women survive, but enable them to live better.” ph.ucla.edu

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STUDENT ACTIVISM

RA I S I N G CO M M U N I T Y VO I C E S As a policy fellow with California Latinas for Reproductive Justice, FSPH student Anna-Michelle McSorley worked with Latina women advocating for health rights.

FSPH STUDENTS (L. TO R.) BERNADETT LEGGIS, JULIE LOC, ELIZABETH ROCHA, MARILYN MERINO, ALEIN HARO AND ANNA-MICHELLE MCSORLEY.

AT A CALIFORNIA LATINAS FOR REPRODUCTIVE legislative visits with their state and federal representatives.

JUSTICE (CLRJ)-hosted screening of No Más Bebés — a During these visits, community members shared their stories documentary detailing the sterilization without consent of and stressed the importance of affordable health coverage, as immigrant women at a Los Angeles County hospital in the well as the need for accessible, comprehensive reproductive 1960s and ’70s — attendees shared their lived experiences health services. McSorley also helped to advance CLRJ’s and discussed the power of advocacy to enact change. As community advocacy by fighting for the passage of protecshown in the documentary, while the women lost a subtions such as the Reproductive Health Non-Discrimination sequent class-action lawsuit, their Act, which sought to protect California efforts succeeded in bringing about employees from workplace discrimsweeping changes to policies around ination based on their reproductive informed consent. health care decisions; and CalWORKs: “No one should have to go through Victims of Abuse, to support survivors what these women experienced,” says of domestic violence.

Anna-Michelle McSorley, a secFor the majority of participants ond-year MPH student in the Fielding in CLRJ’s advocacy week, it was the — Anna-Michelle McSorley School’s Department of Community first time they had engaged with their Health Sciences who conducted her representatives in this way, and many field studies with CLRJ, a Latina-led community-based reported feeling empowered to continue participating in the organization focused on advocacy, research, education and legislative process. That’s a credit to the multitude of “Policy encouraging members of California’s Latina community to 101” and “Know Your Rights” trainings offered by McSorengage in the policy process. ley and CLRJ, and to efforts to keep participants engaged A policy fellow placed with CLRJ as part of FSPH’s UCLA through documentary screenings, community events and Public Health Training Program on Population Health workshops such as zines and cafecitos, which provide welAdvocacy, McSorley spent nine months with the grassroots coming spaces to speak and be heard, helping to make advoorganization helping to advocate for the reproductive rights cacy work more accessible. of Latina women in California through work that included “To be an advocate for change and engage in the policy delivering trainings on the basics of reproductive justice, process is empowering, especially in the context of working California’s policymaking process and effective advocacy within communities that experience disparities and often lack strategies. She co-coordinated ¡California Latinas Presente! access to vital health information,” McSorley says. “As comA Political Week of Action, a 2017 campaign that successmunity health workers we can be allies, helping people navifully recruited approximately 100 Latinas to participate in gate the process and serving as advocates alongside them.”

“As community health workers we can be allies, helping people navigate the process.”

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RESEARCH FOR IMPACT

Empowered by Evidence

Through her research, FSPH’s Corrina Moucheraud sheds light on policies that can help low-income countries promote healthier lives for girls and women.

ADOLESCENCE IS A PIVOTAL MOMENT — a time when quality education, skill development and healthy behaviors can set young people on a favorable life trajectory. But Dr. Corrina Moucheraud, an assistant professor in the Fielding School’s Department of Health Policy and Management, points out that adolescence is also a period when social norms and policies can set girls and boys on divergent paths. “Early marriage and childbearing, as well as education and employment barriers or discrimination, can reduce empowerment for girls starting in adolescence, with implications on their future health and well-being,” Moucheraud says.

In research she conducts in low-income countries, Moucheraud provides evidence for how policies can protect vulnerable adolescent girls and women facing disadvantage or discrimination. She addresses these issues at both the macro level — for example, how global institutions can use health policies to promote equity — and the local level, by examining access to and quality of care for marginalized groups.

As part of a project funded by the World Bank, Moucheraud and her colleagues recently produced a series of policy briefs on four key areas of action that could impact the lives of adolescent girls and women in 15 countries across sub-Saharan Africa where early marriage and childbearing is common: keeping girls in school; equipping out-of-school girls with practical skills; promoting healthy behaviors, including around reproductive health; and addressing

“Women and adolescents are often underrepresented at the policy table.”

— Dr. Corrina Moucheraud

early-childhood development needs, especially for children born to adolescent mothers. The reports summarize global evidence on policies and programs that have achieved impact in each area. The

persisted after the program officially ended, and which factors pro-

researchers also interviewed policymakers and key stakeholders

moted such sustainability. “As external support declines, particularly

to understand their work and develop tailored recommendations.

among countries whose economies have strengthened so they may

Alongside colleagues from the David Geffen School of Medicine at

no longer qualify for certain donor funding, it’s important to under-

UCLA, Moucheraud is also conducting research in Malawi on how to

stand how systems can be set up to ensure that effective programs

best deliver health services for women and adolescents, including

will continue after outside funding ends,” Moucheraud explains.

cervical cancer screening programs and teen-friendly HIV treatment and care.

Elsewhere, Moucheraud is assessing the sustainability of

Through insights into how policies can maximize long-term impact, Moucheraud aims to assist countries in making the best use of limited resources. “Women and adolescents are often underrepre-

programs and policies to improve infant and young-child feeding

sented at the policy table, which means their voices can’t influence

practices in Bangladesh and Vietnam. Alive & Thrive was a five-year,

priority-setting,” Moucheraud says. “I hope my research provides evi-

multi-country initiative that included interventions around interper-

dence to support policies that address the needs of women and girls.

sonal communication, policy change, community mobilization and

This is important not only for reasons of equity, but also because we

mass media messages. Moucheraud is jointly leading an international

know that such investments have far-reaching benefits for families,

group of researchers to evaluate which aspects of the initiative

communities and countries.” ph.ucla.edu

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COMMUNIT Y PARTNERSHIP

R E C N A C G N I V N O GI I T N E V E PR T S O A BO The HPV vaccine represented a breakthrough in the fight against cervical and other cancers, but immunization rates remain disappointingly low. FSPH researchers are teaming up with a major provider of care for low-income patients to test strategies to increase uptake.

THE DISCOVERY IN THE 1980s linking the human papillomavirus (HPV) to nearly all cases of cervical cancer led to the groundbreaking development of a cancer-prevention vaccine, approved for use in females in 2006 and for males in 2009. The U.S. Centers for Disease Control and Prevention (CDC) now recommends that the HPV vaccine — which can prevent cervical, anal, vulvar, vaginal, penile and certain throat cancers, as well as genital warts — be offered routinely to adolescents and young adults ages 11-26. The vaccines are administered in two (ages 11-14 years) or three (age 15 or older) doses over the course of about 6-12 months.

But 12 years after the HPV vaccine was introduced, usage rates among adolescents remain disappointingly low, says Dr. Roshan Bastani, Fielding School professor, director of the UCLA Kaiser Permanente Center for Health Equity and director for disparities and community engagement in the UCLA Jonsson Comprehensive Cancer Center. Nationally, in 2016, just 60 percent of 13-17 year olds had received the first dose of the vaccine, and only 43 percent had completed the series, according to CDC data.

Bastani attributes this in part to missteps in the way the vaccine was introduced. “The fact that it was initially promoted by the pharmaceutical industry and certain legislators raised suspicions among some people,” she 12

says. “In addition, HPV is a sexually transmitted virus and there were early media reports of concern among parents that receipt of the vaccine would encourage their child to engage in sexual activity. Our own research and that of others around the country has shown that most parents do not hold such beliefs. We do know that many providers do not routinely recommend the vaccine to their patients, and that some providers are not comfortable having a discussion about a sexually transmitted virus with parents of young adolescents.”

To learn how health systems can effectively increase HPV vaccination rates, Bastani heads a $6.6 million, five-year study funded by the Patient-Centered Outcomes Research Institute (PCORI). The study is being done through a partnership with the Northeast Valley Health Corporation (NEVHC), a multisite federally qualified health center (FQHC) serving a low-income population in Los Angeles’ San Fernando and Santa Clarita valleys. Bastani’s team — including Drs. Beth Glenn, Alison Herrmann (PhD ’12) and Catherine Crespi from the Fielding School and Debra Rosen and Dr. Gina Johnson from NEVHC — will compare three strategies: › A system-level strategy targeting physicians, staff and clinic-level

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policies, procedures and practices; › Text-messaging or mailing reminders to parents of NEVHC adolescent patients who are due for a dose of the HPV vaccine; and › A combination of the system-level and parent-reminder strategies.

More than 17,000 HPV vaccine eligible adolescents will receive services at participating NEVHC clinics during the five-year study period. The impact of each strategy will be assessed through a review of NEVHC’s electronic medical records.

The team has been laying the groundwork for the current study for nearly a decade, beginning shortly after the vaccine was introduced. In partnership with the Los Angeles County Department of Public Health, NEVHC and other community clinics, the FSPH researchers have conducted multiple studies to learn about parental knowledge and beliefs about the HPV vaccine and ways to improve vaccine uptake, and to pilot-test parent-reminder and system-level strategies.

“We didn’t find major opposition to the vaccine; it was more that many par-

“This isn’t a vaccine to prevent a sexually transmitted disease; it’s a vaccine to prevent cancer.”

— Dr. Roshan Bastani

AT NORTHEAST VALLEY HEALTH CORPORATION, BOTH SYSTEM-LEVEL CHANGES AND TEXT AND MAIL REMINDERS ARE BEING TESTED AS STRATEGIES TO INCREASE HPV VACCINE RATES AMONG ADOLESCENT PATIENTS.

ents didn’t know much about it,” says Glenn, an FSPH associate professor of health policy and management and associate director of the UCLA Kaiser Permanente Center for Health Equity.

“Knowing that, we began to focus on developing interventions within health systems to make sure that parents were consistently offered the vaccine and were reminded when their adolescent was due.”

NEVHC, the community partner in the study, provides care to a primarily uninsured or publicly insured population in which only about one-third of the teens have received the full HPV vaccine series. “This is a great opportunity to better understand what interventions will work with our safety-net population,” says Rosen,

NEVHC’s director of quality and health education. “We are excited to collaborate with the Fielding School and to share what we learn with other organizations.”

Rosen notes that many adolescent patients fail to return to the health center after getting the first dose of the HPV vaccine; to that end, the text and mail reminders will serve both to let parents know that their child is due and to reinforce the importance of completing the series.

But for any organization with limited resources, it is important for strategies to be not just effective, but also efficient. “Convincing individual patients is very inefficient,” Bastani says. “We need to look at systematic changes that will serve patients today, tomorrow and into the future.” Among the system-level changes being emphasized at NEVHC is to view each visit by an adolescent patient, even if it’s for another purpose, as an opportunity to determine whether an HPV vaccine is due, and to offer it when it is. The NEVHC physicians are also being encouraged to make the HPV vaccine a more routine part of practice in the same way that vaccines are routinely ordered for younger-age children, and to de-emphasize that the virus is sexually transmitted. “This isn’t a vaccine to prevent a sexually transmitted disease; it’s a vaccine to prevent cancer,” Bastani says.

The UCLA-NEVHC study is funded through PCORI’s Pragmatic Clinical Studies initiative, which aims to produce results that are broadly applicable to a diverse range of patients and health care settings and can be more quickly adopted in routine clinical practice. “Making an impact on 17,000 patients in this one system is huge,” Bastani says. “But what we learn from this study will also have the potential to improve the prevention of HPVrelated cancers in other low-resource clinical settings across the country.

This is an extremely safe vaccine that prevents a horrible disease from ever developing. It is important that we learn how to ensure that it’s reaching the population.” ph.ucla.edu

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INTERNATIONAL COLL ABOR ATION

Delivering for Women in Rural China

A decade-long partnership between FSPH and colleagues in Tibet has helped more women give birth in safe settings.

NATIONALLY, CHINA’S EFFORT OVER THE LAST SEVERAL DECADES to reduce maternal mortality rates by promoting hospital deliveries has been highly successful.

From 1990 to 2011, maternal mortality rates declined an average of 5.7 percent per year, far greater than the average declines for low- and middle-income countries over the same period.

But maternal mortality rates have remained high in rural, disadvantaged and ethnically diverse parts of the country, particularly in western China, where hospital delivery rates continue to be low. “This suggests that a single approach to lowering maternal mortality might not be sufficient for a country as diverse as China,” says Dr. Jessica Gipson, associate professor 14

in the Fielding School’s Department of Community Health Sciences.

For nearly a decade, Gipson has joined with FSPH colleagues in an ongoing collaboration with colleagues in the Tibetan region of China to implement and study an alternative approach. The collaboration has produced important insights into barriers faced by women giving birth in rural and lower-income communities, and ways in which complex reproductive health problems in such communities can be effectively addressed.

Gipson and other FSPH researchers — including Drs. Anne Pebley, Alina Dorian, Corrina Moucheraud and May Wang from the school’s faculty, along with recent doctoral graduate Tabashir Nobari (PhD ’16) — have

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joined with the Qinghai University Tibetan Medical College (QUTMC), led

by Dean Lhusham Gyal and Kunchok Gyaltsen (PhD ’10), in evaluating the innovative reproductive health programs QUTMC has implemented in recent years. The longtime partnership also involves teaching: Gyaltsen, a Tibetan medical doctor and Buddhist monk, completed his doctorate at FSPH and has since sent 10 Tibetan medical students to train at FSPH for periods ranging from three months to a year.

Funding for the training came from FSPH’s Bixby Center on Population and Reproductive Health and the Tibetan Healing Fund, a nonprofit humanitarian organization Gyaltsen helped establish to improve primary care and education for rural Tibetan women and children.

The collaboration began after the Tibetan researchers had found that more than 90 percent of the rural women in Tibet’s Qinghai Province were delivering at home rather than in a hospital for reasons that included

transportation difficulties, lack of accommodations in the hospitals for accompanying families, the cost of hospital delivery, a shortage of trained community birth attendants, and language and cultural barriers. “This meant that in cases where women needed assistance with delivery, they weren’t getting it in a timely fashion,” Gipson notes.

Based on those findings, Gyaltsen and his Tibetan research colleagues worked with local health authorities to implement a three-level intervention.

At the county level, they launched the Tibetan Birth and Training Center (TBTC), where women who wouldn’t normally deliver in a hospital could easily access highly skilled and culturally relevant care. At the community level, they established a midwife-training program to meet the needs of women who chose to deliver at home. And at the individual level, the birth center prepared midwives, health workers and village residents to serve as peer educators on maternal and child health in their communities.

The TBTC, which opened in 2009, features an all-female staff of Tibetan obstetricians and midwives, modern facilities, and home-like suites for women and their families. “This was a new option for the mostly Tibetan population,” Gipson says. “The women could stay with their families in suites that included cooking facilities, bathrooms, and traditional Tibetan beds heated by stoves, which was what they were used to at home — but in an environment with skilled birth attendants.”

According to Gyaltsen, more than 5,000 babies have been delivered at the center and thousands of women have received health education.

The FSPH and Tibetan research team found the three-level approach to be highly effective in increasing access to and utilization of the formal delivery

services, as well as in changing perceptions about maternal care and delivery options among the target population.

“Tibetan nomadic women face challenging reproductive health problems,” Pebley says. “This research is essential in assessing their needs and evaluating whether programs to meet these needs actually work. In addition, the innovative solutions and experience in improving maternal and reproductive health in rural Tibetan communities provide important models of how to improve health in other poor rural populations worldwide.”

For Gipson, the collaboration is part of a larger body of work on sexual and reproductive health issues in low-income global settings. “I’m particularly interested in identifying how gender, gender norms, and socio-political systems influence decisions about sexual and reproductive health, and how public health programs can best support these decisions and optimize the health of individuals and families,” Gipson explains.

It’s an interest that dates to her time as an undergraduate anthropology student at UCLA, when she conducted an independent study in Mexico with one of her professors, a medical anthropologist; Gipson then took Community Health Sciences 100, a Fielding School course, and ultimately enrolled in a joint MPH program with the Peace Corps, cementing her interest.

Since then, Gipson has spent significant time in disparate settings — in the Philippines, Bangladesh and Malawi, as well as China — examining ways in which culture, politics and gender norms affect the reproductive freedoms of women and men. Among other things, she has studied the role of couple dynamics in contraceptive use and how public health interventions can assist couples in achieving their desired fertility, along with strategies to ensure ph.ucla.edu

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INTERNATIONAL COLL ABOR ATION

KUNCHOK GYALTSEN, PhD ’10 (CENTER), A BUDDHIST MONK AND TIBETAN MEDICAL DOCTOR, HELPED TO ESTABLISH THE TIBETAN BIRTH AND TRAINING CENTER, WHERE RURAL TIBETAN WOMEN WHO WOULDN’T NORMALLY GIVE BIRTH IN A HOSPITAL CAN EASILY ACCESS HIGHLY SKILLED AND CULTURALLY RELEVANT CARE. DR. JESSICA GIPSON (SECOND FROM RIGHT) IS PART OF AN FSPH GROUP THAT HAS SPENT NEARLY A DECADE COLLABORATING WITH GYALTSEN AND HIS TIBETAN COLLEAGUES.

that women and couples can have children if and when they choose to do so. Gipson is also involved in research into how a new male contraceptive gel could expand the range of available contraceptive options and change the way people think about contraception and the politics of reproductive health.

Much of Gipson’s work incorporates interviews and small-group discussions in which members of a community discuss how they are affected by these issues, and how they would like things to change. “It’s important to identify 16

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the different domains in which men and women may have more or less power, and what can influence that,” Gipson says.

“Certainly there needs to be a continued focus on women’s rights: Improving the status of women is one of the best ways of ensuring continued development and economic growth, particularly in lower-resource settings. However, ultimately, progress in addressing many persistent sexual and reproductive health challenges hinges on positively engaging men — both for their health and as supportive partners.”

LOCAL LEADER

FA M I L Y

F O C U S E D

As director of the San Francisco health department’s Maternal, Child and Adolescent Health Section, alum Mary Hansell sets at-risk groups on a healthy course.

AS A HOSPITAL NURSE AT THE OUTSET of her career, Mary Hansell (MPH ’83, DrPH ’89) was quickly drawn to the obstetrics unit. “It was exciting to me to work with people as they prepared to become parents, feeling like I could make a difference in supporting them,” she says. That was when Hansell also began to appreciate the importance of prevention and addressing societal factors to ensure planned pregnancies, appropriate prenatal care, healthy births and positive life trajectories for parents and children. Two years later she applied to UCLA’s Fielding School. “The school was like a magnet for me,” Hansell says.

“I learned so much from my professors.

It was a great fit.”

Today Hansell is protecting and promoting the health of tens of thousands of women of childbearing age, infants, children and adolescents as director of the Maternal, Child and Adolescent Health (MCAH) Section of the San Francisco Department of Public Health. Since taking the position in 2011, Hansell has also made it a point to bring in Fielding School MPH students as interns. “This is my way of giving back to an institution that I appreciate for what it gave me years ago,” she says.

Hansell heads a 190-person team that is involved in community assessment, planning, evaluation, outreach, advocacy, education, training and policy development targeting members of the population who are at increased risk for adverse health outcomes because of financial, language, or cultural barriers, or mental or physical disabilities. Core programs bring direct services, including through home

visits to pregnant women and families with infants and toddlers, with a focus on providing support to low-income populations. In addition to the core programs, Hansell’s group has implemented innovative programs such as a multidisciplinary effort, in partnership with the nonprofit early-childhood advocacy organization First 5 San MARY HANSELL (LEFT) WITH BARBARA GARCIA, SAN FRANCISCO’S DIRECTOR OF Francisco, to fosPUBLIC HEALTH, AT THE 2017 SAN FRANCISCO PRIDE PARADE. ter health-promoting environments at approximately 100 childcare sites. MCAH has also strategically to promote health equity.” increasingly focused on policy developWhile she is quick to point out ment, contributing to changes in San that much work remains, Hansell Francisco that have included expanded has seen positive results from such family and medical leave (becoming efforts. For example, a recent drive to the nation’s first city to require employ- ensure access to family planning and ers to provide six weeks of fully paid reproductive health services for young leave for new parents) and lactation African-American women has signifiaccommodations in the workplace. cantly reduced the rates of preterm Among Hansell’s biggest concerns African-American infants in San are the health disparities that disproFrancisco, the group with the highportionately affect low-income and est rates in the city. “Seeing positive minority populations. “Overall our changes in areas we’ve been focusstatistics for the San Francisco populaing on gives me incredible pleasure,” tion tend to look very good, but we can’t Hansell says. “I came to this position just be content with overall numbers,” to work on things that matter to me, she says. “We always have to look at the and it’s great to know that what you’re subpopulations, and then work very doing is having an impact.” ph.ucla.edu

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DOMESTIC ABUSE

SHEDDING LIGHT ON INTIMATE PARTNER VIOLENCE

FSPH faculty members are studying how abusive relationships may affect women in communities where the issue isn’t typically discussed.

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RECENT DATA ON INTIMATE PARTNER VIOLENCE in the United States indicates that the risk is declining for women, who make up the majority of victims. According to the U.S. Department of Justice, the rate of intimate partner violence dropped by more than two-thirds between 1994 and 2012.

But might some women be less inclined to report intimate partner violence than others? That’s what two FSPH faculty members are investigating. Specifically, they’re uncovering how intimate partner violence affects two groups of women: Asian immigrants and women of all ethnicities who identify as lesbian or bisexual.

Previous research has shown that Asian immigrant women in the U.S. are less likely to report physical or sexual assault by their partners than are other racial and ethnic groups. Dr. Paula Tavrow, associate adjunct professor in the Fielding School’s Department of

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Community Health Sciences and director of the Bixby Program in Population and Reproductive Health, recently led a study to learn how Asian immigrant women would respond after watching a three-minute video in which a woman from the same ethnic group talked about disclosing abuse to a health provider and getting help.

“The idea was that these videos would be equivalent to hearing from a trusted friend,” Tavrow says.

Participants were 60 married women who lived in California and immigrated to the U.S. as adults from four countries: mainland China, Thailand, South Korea and Vietnam.

Fielding School doctoral and MPH students who spoke the languages fluently collected the data, which entailed meeting one on one with the women, showing them the videos and interviewing them in their native tongues. During the interviews, some of the women revealed that they had previously or

were currently experiencing domestic violence, and the team made sure that they knew what services were available to assist them.

Some of the Vietnamese women indicated they would be reluctant to report domestic violence because they felt extremely dependent on their husbands; a few felt reliant on them for their immigration status. Others said they feared that friends and relatives would blame them if they revealed abuse. Some of the Korean women also reported stigma, but more often expressed concern with how reporting the abuse would affect their children.

Several women, for example, said they would be reluctant to report abuse because they wouldn’t want their children to experience the shame of divorce, or of having a father who was labeled a criminal.

Most of the participants said the videos could be useful in encouraging women to divulge abuse. They also shared tips on how the videos could be improved, such as by including specifics on what would happen to a woman or her family if she reported her situation to a health care provider. “Some of the women said unless they knew exactly what would happen next they wouldn’t reveal anything,” Tavrow says.

“One of the saddest things was just how many of these survivors did not believe their own experience was domestic violence.”

— Dr. Chandra Ford

Dr. Chandra Ford, associate professor in the Fielding School’s Department of Community Health Sciences and founding director of FSPH’s Center for the Study of Racism, Social Justice & Health, focuses much of her work on investigating health disparities, specifically how certain populations experience health issues differently from the general population.

In 2009, Ford began working with a Los Angeles City Council committee that had been tasked with looking into intimate partner violence that occurs among members of the LGBT community — who experience similar or higher rates of intimate partner violence than heterosexual women, previous research has shown. She learned that police officers, frontline responders and health care providers want to support LGBT victims of domestic violence but

often don’t know that their needs may be different than those of heterosexual women. Ford and colleagues organized focus groups and interviews with 26 women who identified as lesbian or bisexual. They learned that many of the women, even after experiencing life-threatening situations, didn’t see themselves as victims.

“One of the saddest things my research colleagues and I noticed was just how many of these survivors did not believe their own experience was domestic violence because they can only think of domestic violence as occurring between men and women,” says Ford, who notes that her research team connected the women with information about support services at every interview.

Other women said they hesitated to report the abuse because they didn’t want to tarnish the reputation of a community that has worked hard to establish marriage equality. Several described negative experiences with police officers, who would sometimes arrest both women because they couldn’t identify who the aggressor was.

Ford says resources for lesbian and bisexual women who experience abuse “don’t even come close” to what’s needed. Many of the black and Latino study participants pointed out that centers providing services for LGBT individuals and their families don’t exist in their communities, and that they don’t always feel welcome at centers that cater to the largely white LGBT community or at centers that cater to heterosexual women.

“When you consider the issues documented here, in a city that’s a cultural hotspot for people who want to be supportive of the LGBT community, imagine what it’s like elsewhere,” Ford says.

She adds that a major takeaway from her study was learning how resilient the women were. “Many described having to be the strong force in their own lives, not telling their families because they didn’t want them to think poorly about LGBT people or their own partner,” Ford says. “So there’s a certain resiliency that I think we can tap into and support.” ph.ucla.edu

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WELLNESS PROMOTION

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Through a big-picture perspective on how women can optimize their health, FSPH faculty are contributing to a new paradigm.

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FOR THE TEACHERS IN THE LOS ANGELES UNIFIED SCHOOL DISTRICT elementary school classrooms that participate in Generation Xchange (GenX), the middle-age and older adults who spend at least 10 hours a week providing academic assistance and support to struggling students are a welcome addition, to say the least.

But for Dr. Teresa Seeman (MPH ’78), professor of epidemiology at the Fielding School and medicine at the David Geffen School of Medicine at UCLA, who established GenX in 2014 after collaborating with Johns Hopkins University colleagues on a similar program in Baltimore, there is another side to the equation.

“We were interested in building new socially important roles for middle-age and older adults, given that this population is growing so rapidly,” Seeman explains. “With so many schools losing

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resources and looking for extra help, the idea was that these volunteers could contribute in a way that’s not only fulfilling, but also ends up being health-promoting for them.”

GenX trains adults ages 50 and older to work with teachers in kindergartenthrough-third-grade classrooms on improving students’ skills in reading and math, as well as addressing behavioral issues. The middle-age and older adults, the vast majority of them women, commit to working in the same classroom throughout the academic year.

The program currently has 45 volunteers assigned to four schools located in low-income Los Angeles neighborhoods.

In developing GenX, Seeman and her colleagues foresaw wide-ranging health benefits — social, psychological, cognitive and physical. “These middle-age and older adults are walking around, socially engaged with the

“We were interested in building new socially important roles for middleage and older adults, given that this population is growing so rapidly.”

— Dr. Teresa Seeman

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kids and teachers, and involved in a meaningful activity that is cognitively stimulating,” Seeman notes. A study of the health impact on GenX volunteers produced the hoped-for results. By the end of the academic year, participants showed significant improvements in blood pressure and walking speed while losing an average of five pounds. Seeman’s team found reductions in inflammation — associated with risk for heart disease, cognitive decline and early mortality, among others — along with improvements in immune function.

The volunteers also reported making significant numbers of new friends.

Seeman’s group is now studying the program’s impact on students’ academic performance and behavior; ultimately, she hopes this will lead to its expansion to other elementary schools in the district.

As the ranks of women living decades beyond retirement have increased — the 85-and-older population of women in the U.S. is now approximately 4 million — there is a growing need for meaningful roles that are engaging socially, cognitively and physically, Seeman notes.

“What’s unique about GenX from a public health standpoint is that we attract people for reasons other than their own health promotion,” she says.

“Our participants all say they like that they’re losing weight, but that the main reason they continue to do this is because of the kids.”

GenX is emblematic of a growing movement in public health to expand the paradigm to include strategies that enhance quality of life and overall well-being. “In the past, we’ve often tended to focus on the individual pieces — physical health, mental health, quality of life — but when you back up and start to look at health more holistically, it takes a different hue,” Seeman says.

Although the majority of breast cancer diagnoses occur in women in their 60s and older, as many as 25 percent of new breast cancer cases are in women younger than 50, notes Dr. Patricia Ganz, a Fielding School professor of health policy and management. For

women in their 30s and 40s, she adds, the experience with the disease and its treatments is substantially different from that of older women.

“A woman diagnosed in her 70s has probably had friends who have had breast cancer. She may have already experienced other major health events or gone through them with a spouse,” Ganz says. “It can be very different for a young woman, who might also require more aggressive therapy that can be both disruptive and disfiguring, along with anti-hormonal treatment that can exacerbate symptoms as she enters menopause.”

With improved survival after breast cancer diagnosis, many younger women are living for decades after being treated for the disease. Over the last 30 years, Ganz, a medical oncologist, has been a pioneer in research on the long-term quality of life of breast cancer survivors.

She has found that younger survivors experience the highest levels of symptoms that include depression, stress and fatigue, persisting for as long as a decade after their diagnosis. Yet, little research has been done on strategies to reduce the depression and manage the stress of this younger population.

Based on preliminary research to determine what might be most helpful for young women dealing with cancer’s after-effects, Ganz received funding for a pilot study of a six-week program of mindfulness meditation. The study found that in the short term, the mindfulness-based intervention reduced stress, depressive symptoms and inflammation. Based on those findings, Ganz, in collaboration with Dr. Julienne Bower, a professor of psychology and psychiatry/biobehavioral sciences at UCLA, is now in the second year of a five-year, multisite randomized clinical trial with colleagues at the Dana Farber Cancer Institute and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. The study randomly assigns 360 younger, post-treatment breast cancer survivors to one of two promising group programs, survivorship education or mindful-awareness practices, and compares each to a control group of women who will be offered ph.ucla.edu

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WELLNESS PROMOTION

“Psychosocial strategies that help people feel better are great, but if you can show the biological mechanisms that underpin the change, it’s much more powerful.”

— Dr. Patricia Ganz

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the group program of their choice after the study follow-up period ends.

“We expect that depressive symptoms will improve among women in both intervention groups — whether it’s from information to help them function and cope better with the experience of the cancer or, in the case of mindfulness, learning techniques to address their stress — and that we will learn who might benefit the most from one approach or the other,” Ganz says.

“In addition, although our study isn’t focused on formal psychosocial support, being in a group program with other young breast cancer survivors should be beneficial for these women, who would seldom encounter women their age with a history of breast cancer.”

In the past, many in medicine were skeptical about the efficacy of mind/ body interventions, but a growing body of evidence supports the benefits of mindfulness meditation and other mind/body techniques in reducing the symptoms associated with cancer and other chronic illnesses. Ganz’s group has been a leader in testing these approaches for breast cancer survivors. In previous studies, she has found benefits from yoga and tai chi in addressing symptoms of fatigue and sleep difficulties in survivors.

Importantly, Ganz and colleagues have pinpointed biological underpinnings for these improvements. “Psychosocial strategies that help people feel better are great, but if you can show the biological mechanisms that underpin the change, it’s much more powerful,” she says. “Although our current study is mainly measuring behavioral symptoms, if we also find that the mindfulness intervention results in reduced inflammation — which we think may be associated with the fatigue, sleep disturbance or depression — that would be valuable information.

“Mindfulness isn’t for everyone, but given the rates of depression and anxiety in young adults, it can be a useful tool for those who tend to frequently worry and are easily distracted,” Ganz says.

“We also believe the survivor education group, which teaches about healthy behavior and emotional distress, will

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be effective. The bottom line is that a 40-year-old breast cancer survivor with no other major health problem has many years ahead of her, so it’s particularly important to recommend effective strategies for both promoting wellness and potentially preventing a recurrence.”

As a social epidemiologist, Seeman has long been interested in how social factors influence health. Her early work examined the biological mechanisms by which social connections affect processes associated with aging, such as cognition and cardiovascular risk. Not surprisingly, Seeman learned that social influences affect a wide variety of biological indicators — blood pressure, inflammation, and glucose levels, among others — in significant but small ways.

Seeman’s research trajectory changed when she met Dr. Bruce McEwen, a neuro-endocrinologist at Rockefeller University in New York who conducted a series of studies in the 1990s that introduced the concept of allostatic load. “The idea is that our health risks are more effectively visualized as being the result of multiple biological factors that simultaneously influence health outcomes,” Seeman explains. “I realized that this was probably how social factors affect health — through impact on a slew of biological processes.”

Seeman collaborated with McEwen on some of the earliest studies of allostatic load — a cumulative index of problems across biological systems that was found to be closely associated with aging and predictive of the risk for cognitive decline, physical decline, heart disease and early mortality. Seeman also began studying factors that predict high levels of allostatic load, and discovered that they include low socioeconomic status and weak social networks.

“This points to the importance of promoting strategies that are upstream from the biology,” Seeman says. “Obviously, medication is necessary to bring down high blood pressure, but that’s not solving the problems elsewhere in the body. What’s truly needed are public health interventions such as improving

ABOVE AND ON PAGE 20: IN THE GENERATION XCHANGE PROGRAM ESTABLISHED BY FSPH FACULTY MEMBER DR. TERESA SEEMAN, VOLUNTEERS HELP STUDENTS IN LOW-INCOME ELEMENTARY SCHOOLS WHILE REAPING SIGNIFICANT BENEFITS OF THEIR OWN.

the quality of neighborhoods, offering resources so that people’s lives aren’t as stressful, and providing opportunities for people to integrate socially and engage in ways that make them feel empowered. We know all of these things are associated with lower levels of overall biological risk.”

When she began discussing the concept of allostatic load with Seeman, Dr. Dawn Upchurch, professor of community health sciences at the Fielding School, knew it was an area that she wanted to further explore; soon, she began to collaborate with Seeman.

Upchurch focuses on women’s health, with a particular emphasis on what women can do to promote wellness and well-being. She has recently turned to developing a healthy-behavior index — the combination of lifestyle practices and activities that are optimal for women’s health, especially as they go through midlife and beyond.

In developing the index, Upchurch’s focus is not just on traditional health behavior strategies such as diet and exercise, but also on less traditional behaviors such as stress reduction, social engagement, coping skills, and

activities that give women a sense of purpose and support. “We want to see if there is a combination of factors that might be most helpful for women, and if that combination differs depending on the population of women you’re looking at,” she says.

In addition to its association with accelerated aging and shortened lifespan, allostatic load provides an early indicator of the cumulative physiological wear-and-tear of stressful circumstances, making it an ideal marker for measuring the impact of behaviors designed to reduce that impact, Upchurch notes. Her research has found that allostatic load increases as women age, and that women who face discrimination and high levels of perceived stress experience higher rates of allostatic load increases. “We know allostatic load is one of the ways in which social and environmental stressors get ‘under the skin’ to affect health,” Upchurch explains. “Developing public health programs that assist women in positively coping with life’s stressors can also help to slow down the effects of aging.”

Based on these and other findings, Upchurch is interested in encour-

aging positive coping strategies for women, especially in midlife, which she notes is a particularly significant time marked by changing social roles, increased risk of chronic conditions, and transition through menopause.

She has found that midlife women who engage in greater amounts of physical activity have significantly lower allostatic loads than those who don’t, independent of age or race. Other positive coping strategies might also help to keep stress levels — and allostatic load — in check. These include cognitive strategies, such as reframing the way one experiences negative events or situations. An optimistic attitude is associated with positive coping, as is a strong social network. Mindfulness meditation and other stress-reduction and relaxation techniques can also be effective, Upchurch notes.

“Allostatic load tends to be a subclinical measure — it shows up as a problem before people reach the point where they would be clinically diagnosed as having a chronic condition,” Upchurch says. “As a public health researcher, that’s exciting because it raises the potential for prevention strategies.” ph.ucla.edu

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TEACHING ADVOCACY

DIFFERENCE MAKER A passion for advocacy led Julie Elginer to pursue a Fielding School doctorate. Now, as a faculty member, she gives students the tools they need to influence women’s health policy.

her dissertation on maternal mental health advocacy both in California and throughout the United States.

“I got my doctorate because in order to have a seat at the table, to effect meaningful change, I needed to have credibility,” Elginer says.

Now a lecturer in FSPH’s departments of community health sciences and health policy and management, Elginer is known for her skills-based approach to instruction and has received awards for her teaching. Elginer’s popular course on reproductive health advocacy, currently in its seventh year, teaches students how to create comprehensive advocacy plans including identifying legislation related to women’s health, analyzing the merits of the bills and taking a position on them.

Elginer imparts skills students can immediately put to use, including how to contact a legislator’s office, discuss a bill with legislative staff members and write a letter in support of a bill.

Many students pursue their advocacy work long after the course ends. Chloe Winders-Singer (MPH ’17), now a regional maternal and child health consultant for Kaiser Permanente, has continued to track legislative action related to a bill she analyzed as part of an assignment last year. “It’s one thing to know how to do statistical analysis or a literature

JULIE ELGINER (DrPH ’11) was in the midst of a successful career as a marketing manager for a large biotechnology company when she realized she wanted to take her professional life in a different direction. At the time she was also involved in public policy work with the Junior League of Los Angeles, a women’s volunteer organization. Elginer discovered she had a knack for policy work while leading the organization’s state public affairs committee, through which she helped raise awareness about issues related to health, violence prevention and family support.

To pursue her passion for policy, Elginer came to the Fielding School, where she earned a DrPH in Health Policy and Management. While a student, she continued her advocacy work and fulfilled what she says is her proudest legislative achievement: leading the effort to pass a resolution that established May as Perinatal Depression Awareness Month in California. Elginer was inspired by the experience to focus 24

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“Knowing how to advocate will enable students to ensure that individuals whose voices most need to be heard are represented.”

— Dr. Julie Elginer

review, but speaking about public health issues with people who are creating laws and policies bumps you up to the next level,” she says.

Elginer sees public health students as natural advocates.

“We enter this field committed to serving underserved communities and those experiencing health disparities, inequities and injustice,” she says. “Knowing how to advocate will enable students to elevate an issue, secure resources, and ensure that individuals whose voices most need to be heard are represented.”

POWERFUL SURGERY

Healing & Hope FSPH alum Lindsey Pollaczek is helping to transform the lives of women in sub-Saharan Africa who have a devastating condition that has largely been eradicated elsewhere.

“Many had lived with fistula for years and had no idea it was a preventable or treatable condition.”

— Lindsey Pollaczek

MORE THAN 1 MILLION WOMEN AND GIRLS in low-income countries live with a condition that makes many of them outcasts in their communities and hinders them from earning a living. The condition is not only preventable but also highly treatable through surgery.

The condition is obstetric fistula, a complication resulting from prolonged, obstructed labor. A fistula can develop when the baby’s head pushes against the soft tissues between the bladder and vagina or rectum for such an extended period of time that it cuts off the blood supply to tissues in these areas. As a result, the tissues fall away and leave behind a hole, or fistula, that causes the woman to leak urine or feces continually. In most cases the baby is stillborn.

Thanks to improvements in obstetric care and

LINDSEY POLLACZEK (LEFT) WITH HABIBA CORODHIA MOHAMED, OUTREACH MANAGER FOR THE FISTULA FOUNDATION’S ACTION ON FISTULA PROGRAM IN KENYA.

access to timely caesarian sections, fistulas rarely happen in middle or high-income countries. But

the Bixby Program on Population and Reproduc-

50,000-100,000 new cases occur every year in

tive Health, served as her adviser on her master’s

low-income countries, according to data from the

thesis, which focused on women’s experiences

United Nations.

with fistula in Western Kenya.

Lindsey Pollaczek (MPH ’12) first learned

Pollaczek moved to Kenya in 2014 to launch a

about the devastating effect a fistula can have on

new initiative for the Fistula Foundation that has

a woman’s life during a stint with Direct Relief, a

helped more than 3,000 women access free fistula

nonprofit organization based in Goleta, Califor-

surgery and established a national treatment and

nia. During a 2008 trip to a hospital in Tanzania

outreach network. She recently returned to the

she found herself on the fistula ward, talking to

foundation’s head office in San Jose, California,

women who had undergone fistula repair. “Many

where she works as the senior program director.

of them had lived with fistula for years and had no

The Fistula Foundation raises money for fistula

idea it was a preventable or treatable condition,”

surgeries, invests in the training of local fistula sur-

Pollaczek says. “So many women talked about the

geons, and empowers women who have undergone

shame they experienced, being shunned by their

treatment to spread the word to other women in

families and husbands. One woman told me she

their communities. Last year the foundation funded

would have rather died during childbirth than live

more than 6,600 fistula surgeries worldwide.

with the devastating injury.”

The experience inspired Pollaczek to enroll in

“Imagine a woman who developed fistula during childbirth, suffered deeply with the condi-

the executive-style MPH for Health Professionals

tion, and after surgery is finally dry for the first time

program in the Fielding School’s Department of

in years, sometimes decades,” Pollaczek says. “She

Community Health Sciences to learn skills related

now has a second chance at life for herself and her

to program design, implementation and evaluation

family — that is a powerful thing. Our committed

that she could apply to creating effective interven-

partners on the ground are making huge strides

tions. Dr. Paula Tavrow, associate adjunct profes-

and I am proud to be part of the effort working

sor of community health sciences and director of

toward eradication of obstetric fistula.” ph.ucla.edu

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CAMPUS ADVOCACY

Making Rooms for Campus Mothers FSPH students are leading an initiative to make it easier for women at UCLA to breastfeed and pump.

FSPH STUDENTS LEADING CREATING SPACE, FROM LEFT TO RIGHT: TRISTA BENITEZ, LEAH MCCONNELL, CAREY WALOVICH, EMILY BELL AND CRISTINA HUNTER.

STUDENTS IN THE FIELDING SCHOOLBASED Reproductive Health Interest Group (RHIG) are gaining hands-on experience in research and advocacy while addressing an important public health concern on the UCLA campus: support for students, staff and faculty who are breastfeeding.

Five FSPH students are currently leading Creating Space, which is assessing campus lactation accommodations and documenting the experiences of lactating UCLA mothers in an effort to improve services, spaces 26

and university policies to support breastfeeding — touted by the World Health Organization as “one of the most effective ways to ensure child health and survival.” The project, currently in its third year, is funded by UCLA’s Healthy Campus Initiative.

Creating Space was launched in response to a need identified by the student-led Mothers of Color in Academia de UCLA (MOCA), a campus advocacy group.

“The women were having a hard time finding suitable places to pump on campus and began to raise awareness

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about the need for more lactation spaces. RHIG became aware of their advocacy work and decided to partner with MOCA, ultimately establishing the Creating Space project,” says Cristina Hunter, a second-year MPH student in FSPH’s Department of Community Health Sciences who is the current RHIG co-president and Creating Space co-project manager. “But as the project has developed, we’ve realized that it’s not just spaces, but also services and policies that need attention.”

Through an online survey and focus groups of breastfeeding mothers at UCLA, as well as an assessment of lactation rooms on campus, the FSPH students identified significant barriers faced by breastfeeding and pumping mothers, ranging from a shortage of rooms to inappropriate and unsecured spaces lacking amenities usually provided within lactation rooms. “Some of the women had to walk long distances to get to a room and didn’t have time to do that, or had trouble lugging around their supplies,” says Emily Bell, a second-year MPH student in the Department of Community Health Sciences who serves as co-project manager. “Many reported that the stress of finding comfortable, appropriate spaces became a barrier to pumping, and as a result they experienced a reduction in their milk supply.”

The students are using their grant funds to upgrade existing rooms, and recently issued a report to campus administrators and stakeholders on recommendations for additional lactation rooms and improved policies

pertaining to lactation room access. They have recruited and trained three staff members to become certified lactation educator counselors and have worked with UCLA’s Arthur Ashe Student Health & Wellness Center to better serve lactating students. They are also working with UCLA’s Title IX office to create UCLA’s first student lactation policy.

“This is an important gender equity issue,” Hunter says. “Women should have the same opportunities as their male counterparts, and whether it’s in the workplace or the university setting, that means appropriate maternity leave and accommodations when they return to work.”

In bringing their concerns to campus decision-makers, the students have been met with a positive response. “Most people are surprised to learn that this is an issue, but after hearing about it they are on board,” Bell says. “As a society, we promote breastfeeding because of all of the known health benefits, but we have to also be willing to implement the institutional changes that make it possible.”

A

AND

PROMOTING WOMEN’S HEALTH FSPH professor and vice chair of the Department of Community Health Sciences Dawn Upchurch offers a more holistic view.

AFTER SPENDING THE EARLY PART OF HER CAREER studying factors associated with poor health at midlife, Dr. Dawn Upchurch made a conscious shift to examining the factors associated with good health. She has been especially interested in assessing strategies for stress reduction and positive coping — an interest that led her to years of study on the potential for complementary and alternative medicine as a health-promoting tool. Upchurch, professor and vice chair of the Department of Community Health Sciences at the Fielding School, spoke with FSPH’s Public Health Magazine on the importance of expanding the paradigm for how women’s health is studied and promoted.

ph.ucla.edu

DR. DAWN UPCHURCH (CENTER) SURROUNDED BY FSPH STUDENTS (L. TO R.) PARKER SEXTON, BRIDGET LERMAN, KATHERINE STRONG AND GRACE KIM.

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Q: You have advocated for the need to broaden the way we view women’s health. How so?

A: Historically the model was to look at health problems and risk factors for disease. Now there is more focus on health promotion, but we need to go even further — looking at how we can promote a robust quality of life for women, even in the face of social and environmental constraints. If we’re talking about health promotion and disease prevention rather than just treating illness that’s certainly getting us on the right track, but we have to go beyond that to consider issues around positive coping, resilience, and other things that can lead to healthy aging trajectories that will help women thrive in their senior years.

Q: So it’s expanding the thinking beyond biological factors?

A: That’s right. For a long time, it seemed like all we knew about women at midlife was menopause. That’s important, but there are a lot of other things going on for women around that time as well — economically and socially, with changes in the family, for example. At midlife many women find themselves taking care of their parents, but still having their kids at home. What many of us in public health have contemplated over the last several years is how we can develop a more holistic model of women’s health at midlife, so that we are looking at multiple aspects of women’s lives as well as approaches within these contexts that can contribute to better health.

Q: What are examples of traditionally overlooked factors involved in promoting healthy aging for women?

A: In public health the focus is typically on behaviors like maintaining a healthy weight, consuming a healthy diet, exercising, not smoking, and limiting alcohol consumption. But increasingly we are also interested in strategies around stress management, given that stress is an important contributor to chronic conditions. We also want to be thinking about psychosocial factors, including social support, since we know that women who have higher levels of social support during midlife do better as they age. Social support goes beyond family and friends. It can include meaningful work, meaningful volunteering, and community activities that promote a sense of purpose. We also know that personality characteristics affect healthy aging — including having an optimistic outlook, as opposed to one characterized by cynicism or negativity.

Q: What is the role of public health in this realm?

A: What’s important from our perspective in public health is that all of these factors can be potentially modified through training or teaching. Many people cope with stress in negative ways: They don’t sleep, they eat poorly, they stop exercising. But we can learn positive coping skills in the face of life stressors. We need to ask whether there are programs we can develop as public health researchers and practitioners that would help groups of women to better manage their stress so they don’t take a mental or physiological hit from it, or at least it’s not as severe as it would otherwise be. There’s a lot of research now around mindfulness meditation and its physiological effects, both specific and non-specific. It’s not for everyone, but if we have a number of options, women can make choices based on what is going to work best for them.

Q: How are issues of women’s rights, equality and empowerment important to public health goals?

A: Frankly, these issues are fundamental to women’s health. We have to consider the multiple ways that women are marginalized. In the U.S. we know that men and women have very different salary structures, and that when you look at that over a woman’s life course, it’s going to affect the level of benefits she has available to her when she retires — and if she’s in a heterosexual marriage, she’s likely to live longer than her male spouse. That structural difference in the economics of what it means to be a man and a woman can have a profound impact on women’s wellness as they go through midlife and into their senior years.

Then when you start to think about other factors — a woman’s racial/ethnic background, what kind of education and other economic opportunities she has available, what kind of community she lives in…all of these factors contribute to her ability to maintain and promote her health. Workplace equality is a public health issue as well as a social justice issue, as are educational opportunities and policies such as parental leave.

Fortunately, the last year has seen the growth of a powerful social movement with the potential for important change that will be positive for both men and women in U.S. society.

As structural constraints are removed, women will have opportunities available to them in ways they haven’t historically. We’re in the midst of an exciting, historic moment with implications for improving health and well-being.

“We need to effectively communicate the problems and conditions, but also the solutions to public health professionals, community-based organizations, community members and policymakers.”

— Dr. Dawn Upchurch

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SCHOOL WORK

NATIONAL PUBLIC HEALTH WEEK AT UCLA AS PART OF NATIONAL PUBLIC HEALTH WEEK 2018, April 2-6, the Fielding School’s Students of Color for Public Health organized a week of events around the theme Public Health (Re) Action. Activities included a discussion about immigrant rights, services and ways to empower immigrant communities and allies; a self-care mindfulness workshop; and a session entitled “Using Science to Make a Difference.” The students led activities that engaged community members across the UCLA campus, and ended the week with an FSPH alumni/student volunteer day at L.A. Kitchen, working alongside L.A. Kitchen students, graduates, and chefs to transform rescued California produce into healthy meals that were distributed to local social service agencies.

PONCE NAMED DIRECTOR OF FSPH-BASED UCLA CENTER FOR HEALTH POLICY RESEARCH DR. NINEZ PONCE is the new director of the

cultural survey-based research who helped

Fielding School’s UCLA Center for Health

develop the first California Health Inter-

Policy Research (CHPR), effective July 1.

view Survey (CHIS), for which she has been

An internationally recognized health

principal investigator since 2012. CHIS,

disparities researcher, award-winning

which is based at CHPR and continues to

teacher, and faculty member in FSPH’s

be the U.S.’s largest state health survey, is

Department of Health Policy and Man-

a nationally recognized data tool that pro-

agement since 1999, Ponce examines the

vides a broad and deep look at the health

health effects of national and state policies

and health care needs of California’s diverse

in her research, with a particular focus on

population and informs policy at the local,

impacts in low-income neighborhoods and

state and national levels.

for racial/ethnic/linguistic minority groups in the U.S. Ponce is a pioneering expert in multi-

Separately, Ponce has served as director of the Fielding School’s Center for Global and Immigrant Health since 2014. ph.ucla.edu

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44TH ANNUAL LESTER BRESLOW DISTINGUISHED LECTURE, STUDENT PUBLIC HEALTH CHALLENGE DR. DAVID M. CARLISLE (MPH ’88, PHD ’92), president and CEO of the Charles R. Drew University of Medicine and Science, spoke about his work to eliminate health disparities at the Lester Breslow Distinguished Lecture in April. Carlisle, who has dedicated his career to providing care for people traditionally underserved by the medical community, serves as a member of the Fielding School of Public Health Board of Advisors.

The annual event, held in honor of the late Dr. Lester Breslow, former FSPH dean and renowned public health leader, included presentations by the 2018 FSPH Student Public Health Challenge finalists: Teni Adewumi-Gunn, Hajar Ahmed, Adva Gadoth, Jeffrey Jacobs and Benjamin Rogers. The winner of the competition, Hajar Ahmed, was awarded the $5,000 Lester Breslow Student Fellowship, which was established and is supported by the generosity of faculty, alumni and donors moved

by Breslow’s work. Each of the four runners up received a $1,000 prize, courtesy of Golden Shore Medical Group.

DR. DAVID M. CARLISLE (SECOND FROM LEFT), 2018 LESTER BRESLOW DISTINGUISHED LECTURER, IS FLANKED BY FSPH STUDENT PUBLIC HEALTH CHALLENGE FINALISTS (L. TO R.) TENI ADEWUMI-GUNN, BENJAMIN ROGERS, JEFFREY JACOBS, ADVA GADOTH AND HAJAR AHMED.

2018 RUTH ROEMER SOCIAL JUSTICE SYMPOSIUM AND ALUMNI HALL OF FAME INDUCTION DR. JONATHAN FIELDING (SECOND FROM LEFT) WITH NEWLY

LOS ANGELES COUNTY SUPERVISOR SHEILA KUEHL received the 2018 Ruth

INDUCTED MEMBERS OF THE UCLA FIELDING SCHOOL

Roemer Social Justice Leadership Award from the Fielding School in May. The

ALUMNI HALL OF FAME (L. TO R.) MYAT HTOO RAZAK, EMILY

award is named after the late FSPH professor, who advocated for the importance

FEHER AND MICHAEL PRELIP. VONTHANAK SAPHONN, ALSO

of human rights in public health. Kuehl was recognized for providing funding and

INDUCTED, WAS UNABLE TO TRAVEL FROM CAMBODIA TO ATTEND THE EVENT.

services for people who are homeless and for working to improve the health of citizens in Los Angeles County.

The event included induction of new members into the UCLA Fielding School Alumni Hall of Fame. This year’s honorees are Emily Feher (MPH ’12), interim executive director at Teen Health Mississippi; Michael Prelip (MPH ’85), professor and chair of community health sciences at the Fielding School; Myat Htoo Razak (MPH ’91, PhD ’95), director of the Division of Global Programs within the HIV/AIDS bureau at the Health Resources and Services Administration; and Vonthanak Saphonn (PhD ’03, MS ’04), rector at the University of Health Sciences in Cambodia and adjunct associate professor at the Fielding School.

The evening also featured a presentation of the Ruth Roemer Social Justice Fellowship to three Fielding School students: Onyemaechi Anoruo of the Depart-

LOS ANGELES COUNTY SUPERVISOR SHEILA KUEHL (L.) WITH

ment of Epidemiology, Jeannette Reynaga of the Department of Health Policy and

DR. JODY HEYMANN, FSPH DEAN.

Management and Heidi Tuason of the Department of Community Health Sciences.

KEEP IN TOUCH Visit us online ph.ucla.edu 30

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

BOOKSHELF

HONOR ROLL 2017

Recent books by UCLA Fielding School of Public Health authors:

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/honorroll2017 to view the 2017 Honor Roll.

Behavioral Economics and Healthy Behaviors: Key Concepts and Current Research Edited by Yaniv Hanoch, Andrew J. Barnes (PhD ’11) and Thomas Rice Global Perspectives on Women’s Sexual and Reproductive Health Across the Lifecourse Edited by Shonali Choudhury (PhD ’09), Jennifer Toller Erausquin (MPH ’04, PhD ’08) and Mellissa Withers (PhD ’09)

LA MARATHON 2018

Oxford Textbook of Global Public Health Edited by Roger Detels, Martin Gulliford, Quarraisha Abdool Karim and Chorh Chuan Tan Chapter: Radiation and Public Health,

by Leeka I. Kheifets, Adele Green and Richard Wakeford

Neal Halfon · Christopher B. Forrest Richard M. Lerner · Elaine M. Faustman Editors

Handbook of Life Course Health Development

Handbook of Life Course Health Development Edited by Neal Halfon, Christopher B. Forrest, Richard M. Lerner and Elaine M. Faustman Pharmaceutical Economics and Policy: Perspectives, Promises, and Problems

By Stuart O. Schweitzer and Z. John Lu

A Letter to the Pope: My Journey of Forgiveness, Faith & Love

By Jennifer Wortham

HIV/AIDS in China: Beyond the Numbers Edited by Zunyou Wu

Chapter: Epidemiologic Studies of Extremely Low-Frequency Electromagnetic Fields

By Leeka I. Kheifets, Andrew Park, John Swanson and Ximena Vergara From the Handbook of Biological Effects of Electromagnetic Fields

THANK YOU TO TEAM FSPH for a great #RaceToHealth in this year’s LA Marathon. The team and FSPH community raised $35,000 in support of fellowships for 2018 summer fieldwork. Every $5,000 raised supports 400 student fieldwork hours. To support FSPH student summer fieldwork, visit ucla.in/2L2yuPg.

CHILD MARRIAGE IN THE U.S. UNTIL NOW, there’s been inadequate information about whether child marriage is a substantial problem in the United States. A 2018 Fielding School study by postdoctoral scholar Alissa Koski and her mentor, Dean Jody Heymann, revealed that between 2010 and 2014, approximately 78,400 children living in the U.S. were or had been married, and that child marriage threatens the wellbeing of children and youth in every state.

Although all states in the U.S. set 18 as the legal age minimum for marriage, exceptions to the minimum can be granted in 49 states under varying conditions, including parental consent and official approval. Learn more at ph.ucla.edu/childmarriage. ph.ucla.edu

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R E M E M B E R I N G R AY G O O D M A N

DR. RAYMOND GOODMAN WITH DAUGHTER LAURA OLIVA (RIGHT) AND EMERALD SNOW (MS ’16), A GRADUATE OF FSPH’S DEPARTMENT OF COMMUNITY HEALTH SCIENCES, IN 2016.

DR. RAYMOND D. GOODMAN (MPH ’72), a renowned public health physician dedicated to advancing population health and a Fielding School champion through his philanthropy and leadership, passed away at the age of 97 on February 19.

The FSPH community gathered in April to remember Goodman and honor his achievements in public health as part of the 44th Annual Lester Breslow Distinguished Lecture, an event he and his wife Betty J. Goodman established.

In addition to serving on the faculty of both the Fielding School of Public Health and David Geffen School of Medicine at UCLA, Goodman was founding president of FSPH’s alumni association and founding chair of the dean’s council. He endowed in perpetuity the Raymond D. Goodman Scholarship Fund, which to date has supported more than 100 students across the school’s five departments.

“Experiencing the generous spirit of Dr. Goodman and his

family, and a wonderful education from FSPH, I managed to go on to a successful career as a chief information officer in health care,” says Jean Balgrosky (MPH ’80, PhD ’15), FSPH’s inaugural Goodman Scholar. “More importantly, I internalized the value of providing this type of support to others, so they too can pursue their academic goals and discover themselves in the process. I will always remember and be grateful for the support provided to me and the 100 other students at FSPH who have been helped by Dr. Goodman and his family. May we all emulate his example in our own lives.”

Goodman is survived by his five children and five grandchildren.

His family requests that any donations in his memory support FSPH students through the Raymond D. Goodman Scholarship Fund. For more information or to make a donation, please visit giving.ucla.edu/FSPHGoodmanScholarship.

“I believe in the pursuit of truth by whatever means are available to know the truth. I believe in the dignity of all persons. I believe in social justice. I believe in human rights everywhere and for everyone. I believe in a democratic society.”

— Dr. Raymond Goodman 32

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FACULTY HONORS & SERVICE Kathryn Atchison recently led a team that prepared a 2017 report for the Roundtable on Health Literacy within the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine.

The title of the report is “Integrating Oral Health, Primary Care and Health Literacy: Considerations for Health Professional Practice, Education and Policy.”

Sudipto Banerjee and collaborators received the American Statistical Association’s Outstanding Statistical Application Award for 2017.

Hiram Beltrán-Sánchez has received the 2018 Early Achievement Award from the Population Association of America.

Ron Brookmeyer has been elected to the Johns Hopkins University Society of Scholars.

Catherine M. Crespi has been appointed to the Board of Trustees of the National Institutes of Statistical Sciences.

Roger Detels has received the Albert Nelson Marquis Lifetime Achievement Award and the Humanitarian Award, both from Marquis Who’s Who. David Eisenman has been appointed by the National Academies of Sciences, Engineering, and Medicine as a member of the Forum on Medical and Public Health Preparedness for Disasters and Emergencies. He has also been appointed by the National Academies as a member of the Committee on Evidence-Based

Practices for Public Health Emergency Preparedness and Response.

Susan Ettner has been appointed associate dean of UCLA’s Graduate Division.

Jonathan Fielding has been appointed chair emeritus of the advisory committee for Healthy People 2030, an initiative of the U.S. Office of Disease Prevention and Health Promotion; adviser to UCLA Health’s Sound Body Sound Mind organization; adviser to the Harmony Project; and editor of the Annual Review of Public Health. He has also been appointed to the National Academies of Sciences, Engineering, and Medicine Committee on a National Strategy for Cancer Control in the United States and invited as inaugural speaker to the National Academies Environmental Health Matters Initiative.

Chandra Ford has received the 2018 Research on Diversity, Equity and Inclusion Award from the UCLA Academic Senate Committee on Diversity, Equity and Inclusion.

Patricia Ganz has received the 2018 Ellen L. Stovall Award and Lecture for Advancement of Cancer Survivorship Care from the American Society of Clinical Oncology, and the 2018 Giants of Cancer Care award in the supportive, palliative geriatric care category.

Hilary Godwin has been named dean of the University of Washington’s School of Public Health.

Neal Halfon has received the 2017 C. Anderson Aldrich Award

for outstanding contributions to child development from the American Academy of Pediatrics.

Ronald Hays has been named among the most influential researchers in the social sciences by Clarivate Analytics.

Gerald Kominski served on a National Academies of Sciences, Engineering, and Medicine committee that released the 2018 report, “A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century.”

Carol Mangione was selected as the 2018 recipient of the John M. Eisenberg National Award for Career Achievement in Research by the Society of General Internal Medicine.

Otoniel Martinez-Maza was elected a fellow of the Section of Medical Sciences of the American Association for the Advancement of Science.

For more information ph.ucla.edu

Jack Needleman has been appointed to the National Quality Forum Scientific Methods Panel.

Richard Sinaiko has been appointed chair of the Board of Governors for the Cedars-Sinai Health System.

Kenneth B. Wells has received the 2017 Carl Taube Award for Lifetime Contribution to the Field of Mental Health from the American Public Health Association.

Elizabeth Yano has received a 2018 Disabled American Veterans Special Recognition Award from the organization Disabled American Veterans. ph.ucla.edu

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2017-18 STUDENT AWARDS 3M PSD Occupational Health and Safety Scholarship Charlene Nguyen Environmental Health Sciences Abdelmonem A. Afifi Student Fellowship Ana Ordaz Community Health Sciences Agency for Healthcare Research and Quality Fellowship James Godwin, Kaitlyn McBride, Narissa Nonzee, Mayra Rascon, Sophie Snyder, Deborah Wu Health Policy and Management American Industrial Hygiene Foundation National Award Suzie So Environmental Health Sciences

Ann and Phil Heymann Global Fellowship Molly Brown Health Policy and Management Ann G. Quealy Memorial Fellowship Eesha Jagtap, Cozzette Lyons-Jones Health Policy and Management Anne Sullivan Reher Livio Fund for the Health and Well-Being of the Homeless Elsa Carrasco, Amanda Daigle, Caryssa Lim Community Health Sciences ASA Travel Grant Award Crystal Shaw Biostatistics Atlantic Richfield Company (ARCO) Fellowship Jocelyn Castellanos Environmental Health Sciences Bixby Center on Population and Reproductive Health Doctoral Fellowship Subasri Narasimhan Community Health Sciences Bixby Certificate on Population and Reproductive Health Amy E. Alterman-Paradiso, Joyce Imafidon, Stephanie Ly, Makaela Marie Newsome, Cristina Hunter O’Leary Community Health Sciences Arely Briseno Environmental Health Sciences Cynthia Beard, Brittany Meyer, Graham Toth, Lorena Ulloa Epidemiology Molly Brown Health Policy and Management Bixby International Internships on Population and Reproductive Health Makaela Marie Newsome Community Health Sciences Burroughs Wellcome Fund InterSchool Training Program in Chronic Diseases Cynthia Kusters, Qi Yan Epidemiology California Center for Population Research NICHD Predoctoral Training Program 34

Marta Bornstein, Stephanie Ly Community Health Sciences Calouste Gulbenkian Global Excellence Scholarship for Armenian PhD Students Vahe Khachadourian Epidemiology Carolbeth Korn Scholar Award Maria-Elena Young Community Health Sciences Celia G. and Joseph G. Blann Fellowship Alec Chan-Golston Biostatistics Ryan Cook Epidemiology Child and Family Health Program Fellowship Eryn Block Health Policy and Management Child and Family Health Summer Internship Emily Bell, Aila Hernandez, Ronnie Kuwahara, Rachel Lesser, Julie Loc, Marilyn Merino, Ana Ordaz, Gillian Silver, Elise Wallis Community Health Sciences Adam Rabb Health Policy and Management Clinical Translational Science Institute (CTSI) Training Grant Nathaniel Anderson, Amy Bonilla, Natalie Bradford, Russell Buhr, Timothy Copeland, William Boyd Jackson, Michelle Keller, Sara McCleskey, Helen Ovsepyan, Lina Tieu, Ayae Yamamoto Health Policy and Management Coulson Fund Doctoral Research Travel Grant in Epidemiology Alvan Cheng, Angie Ghanem Epidemiology Dean’s Global Health Fellowships Funded by the Jonathan & Karin Fielding Endowed Fund and the Linda Rosenstock Global Health Innovation Fund Stephanie Ly Community Health Sciences Arely Briseno Environmental Health Sciences Brittany Meyer, Graham Toth, Lorena Ulloa Epidemiology Dean’s Leadership Grant John Soliman, Khoa Tran Biostatistics Jennifer Archuleta, Trista Benitez, Jachael Gardner, Alein Haro, James Huynh, Mehar Maju, Stephanie Prideaux, Noemi Rivera-Olmedo, Armen Ter-Barsegyan, Elise Wallis Community Health Sciences Jasneet Bains, Kali Basman, Arely Briseno, Nadia Ho, Margaret Isied, Joyce Thung Environmental Health Sciences Cindy Agus, Onyemaechi Anoruo, Ryan Assaf, Cynthia Beard, John Donoghue, Mikala Evans, Maxwell Green, Vennis Hong, Chase Israel, Yannan Lin, Brittany Meyer, Cathy Ngo, Katherine Takeshita, Lorena Ulloa, Yang Wang, Liu Yang

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

Epidemiology Ivan Barragan, Veronica Kapoor, Seth Lake, Whitney Li, Alexandra Lizarraga, Sook Jin Min, Nicole Pereira, Sofia Porter-Castro Health Policy and Management Dean’s Outstanding Student Award Daniel Conn Biostatistics Alein Haro Community Health Sciences Tyler Watson Environmental Health Sciences Jee Won Park Epidemiology Andrew Loberg Health Policy and Management Delta Omega Honorary Society Nominees in Public Health, Iota Chapter Daniel Conn, Erica Su, Max Tolkoff Biostatistics Amy E. Alterman-Paradiso, Emily Bell, Alein Haro, Ronnie Kuwahara, Caryssa Lim, Jingfen Lim, Elise Liu, Anna-Michelle McSorley, Monica Pang, Elizabeth Rocha, Elise Wallis Community Health Sciences Savanna Carson, Katherine McNamara, Michelle Romero-Franco, Tyler Watson Environmental Health Sciences Zoe Baker, Rachel Bolanos, Clinton Hall, Yannan Lin, Jee Won Park, Chelsea Shover, Liu Yang Epidemiology Kaylie Alexander, Sean Barry, Gabriel Edwards, Samuel Gonzalez, William Boyd Jackson, Veronica Kapoor, Vanessa Lam, Lucinda Leung, Cozzette Lyons-Jones, Adam Rabb, Joseph Viana, Pamela Vona, Adriane Wynn Health Policy and Management May Bhetraratana, Michael Davoren Molecular Toxicology IDP Department Block Grant Opportunity Award Teresa Bufford, Nan Chen, Ian Frankenburg, Zexuan (Caesar) Li, Crystal Shaw, Khoa Tran, Jay Xu, Ke Zhao Biostatistics Suzette Aguirre, Whitney Akabike, Cinthia De Leon, Shelley Jung, HsienChi (Michelle) Kao, Linghui Jiang, Dana Paycao, Kyle Ryan, Atkia Sadia, Artemisia Valeri, Jade Verdeflor Community Health Sciences Christina Batteate, Yuge Bian, Jocelyn Castellanos Environmental Health Sciences Gabriel Edwards, Bianca Lizarraga, Kimngan Nguyen, Kian Preston-Suni, Sarah Sprague Health Policy and Management Yeonsoo Baik, Cynthia Beard, Paul Brendel, Yan Chai, An-Chi Chen, Alvan Cheng, Kirsty Clark, Ryan Cook, Fang Fang, Adva Gadoth-Goodman, Angie Ghanem, Megan Halbrook, Di He, Kexin Jin, Vahe Khachadourian, Yannan Lin, Gina Nam, Cathy Ngo, Andrew Nguyen, Yusuke Okubo, Jee Won Park, Allison Rosen, Melissa Soohoo, Katherine Takeshita, Qi Yan, Liu Yang, Lara Yoon, Yu Yu, Mingyan Zhang, Yuhui Zhu Epidemiology

Dissertation Year Fellowship Daniel Conn, Qian Li, Max Tolkoff Biostatistics Pornsak (Paul) Chandanabhumma, Chiao-Wen Lan, Maria-Elena Young Community Health Sciences Tyler Watson Environmental Health Sciences Chelsea Shover Epidemiology Julian Brunner, Alina Palimaru, Joseph Viana Health Policy and Management May Bhetraratana Molecular Toxicology IDP Dowdle Mental Health Fellowship Donna Padilla-Frausto Community Health Sciences Christy Clark Epidemiology E. Richard (Rick) Brown Social Justice Fellowship Cosima Lenz Health Policy and Management Eleanor J. De Benedictis Fellowship Suzette Aguirre, Esther Gao, Stephanie Prideaux, Miranda Westfall, David Wiss Community Health Sciences Environmental Health Sciences Student Travel Awards Jasneet Bains, Christina Batteate, Jocelyn Castellanos Environmental Health Sciences Eugene and Sallyann Fama Fellowships in the Fielding School of Public Health Adam Shahar Community Health Sciences Chloe Quinlan Environmental Health Sciences Vennis Hong Epidemiology Harmeet Mann Health Policy and Management Eugene Cota-Robles Fellowship Adrian Bacong Community Health Sciences Timothy Copeland, Lina Tieu Health Policy and Management Jessica Camacho, Gerardo Gutierrez Molecular Toxicology IDP FSPH Dean Hansell Fellowship to Address Gun Violence Danielle Dupuy Community Health Sciences Future Public Health Leaders Fellowship Program Emily Bell, Jennifer Carney, Kar Wai Chan, Saul Garcia, Lorena Gonzalez, Ann Marie Hernandez, Jenny Huynh, Paulette Ima, Rachel Lesser, Julie Loc, Stephanie Ly, Dalia Regos-Stewart, Mariana-Amara Reyes, Gillian Silver, Graham Toth Community Health Sciences Arely Briseno, Haoning Gong Environmental Health Sciences Cynthia Beard, Lorena Ulloa, Liu Yang Epidemiology Molly Brown Health Policy and Management

Graduate Dean’s Scholar Award Jay Xu Biostatistics Nathaniel Anderson Health Policy and Management Graduate Opportunity Fellowship Program Haley Francesca Cameron Community Health Sciences Nathaly Aquino, Raenita Spriggs, Cristina Valadez Environmental Health Sciences Mark Alsay Health Policy and Management Graduate Research Mentorship Award Juhyun Kim, Douglas E. Morrison, Aaron Scheffler Biostatistics Grace Kim, Sarah Roth, Natalia Woolley Community Health Sciences Angie Ghanem, Samuel Wing Epidemiology Petra Rasmussen, Tara Russell Health Policy and Management Graduate Student Researcher Opportunity Award Stephanie Ly Community Health Sciences Graduate Summer Research Mentorship Fellowship Juhyun Kim, John Shamshoian, Yu Shi, Justin Williams, Wenxi Yu, Zizhao Zhang Biostatistics Apurva Barve, Marta Bornstein, Rebekah Cross, Angela Gutierrez, Shelley Jung, Grace Kim, Hannah Malan, Natalia Woolley Community Health Sciences Yeonsoo Baik, Kirsty Clark, Megan Halbrook, Kexin Jin, Samuel Wing, Yuhui Zhu Epidemiology Lucia Beltran, Eryn Block, Dahai Yue Health Policy and Management Health Policy and Management Alumni Association (HPMAA) Award Gabrielle Hands, Corinne Zahlis Health Policy and Management Health Policy and Management and Community Partner Fellowship Endowment Julian Brunner, Madison Gamm Health Policy and Management Hilton Doctoral Training Program Yan Chai, Adva Gadoth-Goodman, Vahe Khachadourian Epidemiology Hilton Global Summer Scholars Joyce Imafidon Community Health Sciences Kristen Leahy Health Policy and Management Jorge Paulo Lemann Fellowship Fund Virginia Sampaio Epidemiology Judith Blake Memorial Fellowship Marta Bornstein Community Health Sciences Juneal Marie Smith Fellowship in International Nutrition Shelley Jung Community Health Sciences

LA Marathon Summer Fieldwork Fellowship Elizabeth Rocha Community Health Sciences Dhannya Vadakkumpadathu Sasi Health Policy and Management Laurie and Bill Benenson Environmental Health Fellowship Emily Marino Environmental Health Sciences Leadership Training in Maternal and Child Nutrition Sakura Takahashi, Miranda Westfall Community Health Sciences Levin-Gordon Health Policy and Management Fellowship Deborah Wu Health Policy and Management Monica Salinas Internship Fund in Latino and Latin American Health Dalia Regos-Stewart, Elizabeth Rocha Community Health Sciences Liu Yang Epidemiology National Institute of Environmental Health Sciences T32 Training Grant in Molecular Toxicology Abigail Bline, Catherine Day, Jenna Harrigan, Hiromi Murata Molecular Toxicology IDP National Institute for Occupational Safety and Health - Southern California Education and Research Center Fellowship Cynthia Blackman, George Brogmus, Teni Adewumi-Gunn, Nadia Ho, Katherine McNamara, Charlene Nguyen, Diana Nguyen, Suzie So, Nu Yu Environmental Health Sciences Matthew Feaster, Clinton Hall Epidemiology National Institutes of Health (NIH) Genomic Analysis and Training Program Cynthia Kusters Epidemiology National Science Foundation (NSF) Graduate Research Fellowship Jessica Camacho, Maureen Sampson Molecular Toxicology IDP National Service Award Taylor Mobley Epidemiology Neumann/Drabkin Global Public Health Field Experience Joyce Imafidon Community Health Sciences New Investigator Scholarship, Conference on Retroviruses and Opportunistic Infections Chelsea Shover Epidemiology PJ Fielding and Friends Child Health Fellowship Cynthia Beard Epidemiology Public Health Advocacy Fellowship Katy Wang Biostatistics Amanda Daigle, Marisol Frausto, Alein Haro, Uyen Hoang, Kyra Huete, Cristina Hunter O’Leary, James Huynh,

Bernadett Leggis, Maliya Lor, AnnaMichelle McSorley Community Health Sciences Joyce Thung Environmental Health Sciences Public Health Challenge Winner – Lester Breslow Student Fellowship Hajar Ahmed Health Policy and Management Finalists – Sponsored by Golden Shore Medical Group Benjamin Rogers Biostatistics Jeffrey Jacobs Community Health Sciences Teniope Adewumi-Gunn Environmental Health Sciences Adva Gadoth-Goodman Epidemiology Ralph Sachs Visiting Scholar Isabel Guerrero Health Policy and Management Raymond D. Goodman Scholarship Thomas Gibson Biostatistics Yan Lin Environmental Health Sciences Ric and Suzanne Kayne Public Health Fellowships Jeannette Reynaga Health Policy and Management Richard and Jean Sanville Fellowship Hongtai Pei Environmental Health Sciences Richard D. and Veda F. Weisman Family Fund Dyna Khuon, Adam Readhead, Kennarey Seang, Phirom Toeng Epidemiology Rose and Sam Gilbert Scholarship Kamila Tan Health Policy and Management Ruth J. Roemer Fellowship in Social Justice Award Heidi T. Tuason Community Health Sciences Onyemaechi Anoruo Epidemiology Jeannette Reynaga Health Policy and Management Samuel J. Tibbitts Fellowship Alexandra Klomhaus Biostatistics Society for Epidemiologic Research Student and Postdoctoral Committee Travel Scholarship Melissa Soohoo Epidemiology Southern California/Orange County American Industrial Hygiene Association Scholarship Xingmei (Sherry) Liu, Charlene Nguyen Environmental Health Sciences Tony Norton Memorial Fellowship Cynthia Blackman, Yu-Tzu Chen Environmental Health Sciences

UCLA/Cambodia HIV/AIDS Training Program in Data Management and Analysis Dyna Khuon, Kennarey Seang, Phirom Toeng Epidemiology UCLA Center for Occupational & Environmental Health (COEH) Student Project Award Gregory Watson Biostatistics Yan Lin, Jonah Lipsitt Environmental Health Sciences Qi Yan Epidemiology UCLA Competitive Edge Crystal Shaw Biostatistics Gerardo Gutierrez Molecular Toxicology IDP UCLA College Freshman Cluster Teaching Fellowship Zoe Baker Epidemiology UCLA/Fogarty AIDS International Training and Research Program Toe Aung, Soe Ohnmar Khin, Diep Nguyen, Natthaprang Nittayasoot, Thet New, Soe Min Oo, Loc Pham, Kaewalee Soontornmon, Lokachet Tanasugarn, Kyu Kyu Thinn Epidemiology UCLA/Fogarty China NCAIDS Program Wei Cao, Jun Chen, Yue Gao, Dai Gu, Sitong Luo, Xiaoyu Xu, Youran Xu Epidemiology UCLA Institute of Transportation Studies Fellowship Jasneet Bains Environmental Health Sciences UCLA Pre- and Post- Doctoral Program in Molecular Genetic Epidemiology of Cancer Rachel Bolanos, Fang Fang, Brian Huang, Solomon Makgoeng Epidemiology UC Smoke and Tobacco Free Student Fellowship Vennis Hong Epidemiology Upsilon Phi Delta National Honorary Society Vivian Beene, Eric Echeverry, Andrew Loberg, Raymond Ople, Arielle Sharfstein, Katherine Sziraczky, Allen Taing, Sarah Ulanicki Health Policy and Management Wilshire Health and Community Services Internship in Geriatric Medicine Alissa Dratch Epidemiology Women’s Transportation Seminar (WTS) Orange County Graduate Scholarship Jasneet Bains Environmental Health Sciences

UC President’s Global Food Initiative Student Fellowship Program Caryssa Lim Community Health Sciences

ph.ucla.edu

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TRANSFORMATIVE INVESTMENTS

Preventing the Next Pandemic Visionary support puts FSPH at the forefront of prevention in the Democratic Republic of the Congo, one of the world’s most complex, important hubs of disease emergence.

WHAT IF WE HAD THE CAPACITY to respond to emerging infectious diseases immediately in one of the most critical disease hotspots in the world? How many pandemics might be prevented? How many millions of lives might be saved?

These are the questions driving the efforts of Dr. Anne Rimoin (MPH ’96), associate professor of epidemiology and director of the FSPH-based UCLADRC Health Research and Training Program in the Democratic Republic of the Congo (DRC). When it comes to the immense task of tracking, mapping and preventing a pandemic, time is of the essence. “Every day countless viruses are mutating, evolving and spilling over into human populations,” Rimoin notes.

“And at any moment, one of them could spark an outbreak that, uncontained, could spread like wildfire.”

The visionary support of Carol and Russell Faucett through the Faucett Catalyst Fund equips Rimoin and the UCLA-DRC team with the ability to act quickly and effectively. Since the program’s inception in 2004, the team has established a permanent presence in the DRC. “The UCLA-DRC program is 36

unlike any other in the world because we had the support of someone ready and able to fund things like infrastructure and the ability to build lasting relationships, and to be prepared for the present while training for the future,” Rimoin says. “Private philanthropy is what allows us to be in the DRC full time, on the ground and ready to respond to the next outbreak in real time.”

With the unwavering commitment made possible by the Faucett Catalyst Fund, the UCLA-DRC team emphasizes the importance of working with local communities and ensuring a sustainable approach to prevention via research and training. Through the Faucett Fellowship, FSPH master’s and doctoral students get hands-on experience in the field: investigating outbreaks, conducting surveys, training health care workers, and establishing vital relationships with the community and local decision makers. The program has also trained the next generation of local public health leaders and epidemiologists in the DRC through a partnership with the Kinshasa School of Public Health, and has employed a number of people who are Congolese as lab technicians and man-

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

agers, biologists and researchers.

In light of the U.S. Centers for Disease Control and Prevention’s announcement in 2018 of an unprecedented 80 percent reduction in its epidemic prevention activities in 39 countries, including the DRC, the support of the Faucett Catalyst Fund is invaluable in preventing the next infectious disease threat. Yet, as governmental sources of funding dwindle and media attention to the region fades, there remains a pressing need for private philanthropy to help expand the UCLADRC program’s reach. To encourage others to make an impact on global health, the Faucett Catalyst Fund is offering to match dollar-for-dollar each gift in support of the UCLA-DRC program through December 31, 2018. To participate, please visit ucla.in/2L0YoCS.

ABOVE: RUSSELL FAUCETT (FOURTH FROM RIGHT), WHO WITH HIS WIFE CAROL HAS PROVIDED CRITICAL SUPPORT FOR THE UCLA-DRC HEALTH RESEARCH AND TRAINING PROGRAM, SHOWN IN 2012 AT AN AIRFIELD IN VANGA, DRC, WITH UCLA-DRC TEAM MEMBERS (L. TO R.) PRIME MULEMBAKANI, CALIXTE SHIDI, JEAN JACQUES MUYEMBE-TAMFUM, NICOLE HOFF (PhD ’14), FSPH ASSOCIATE PROFESSOR ANNE RIMOIN, EMILE OKITOLONDA-WEMAKOY AND JEFF ATIBU.

OUR STUDENTS WILL CHANGE THE WORLD Your gift helps the Fielding School create healthier futures by training the next generation of public health leaders, supporting cutting-edge research and enabling critical work in underserved communities.

SUPPORT STUDENTS OF PUBLIC HEALTH TODAY giveto.ucla.edu/fsph/spring18ss

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

“Do not wait for someone else to come and speak for you. It’s you who can change the world.”

— Malala Yousafzai