UCLA Public Health Magazine - Winter 1985-6

In 1960, the 15-year-old UCLA Department of Public Health established a school independent of UC, Berkeley. During the quarter century that followed, faculty and students have built one of the country's leading schools ofpublic health.

UCLA Public Health

On the cover: A collage depicting the early character of the School includes photos of (clockwise): Alumna Or. Suzanne Dandoy as a stude nt, now director of Utah's Departme nt of Health; the Class of 1950; a Los Angeles cityscape circa 1960; and the "3T" Building, first home of the School of Public Health.

Volume 5, Number 2

Winter 1985-86

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Will American Hospices Live to a Ripe Old Age?

Faculty member Paul To rre ns contemplates the history and uncertain future of the mode rn hospice moveme nt.

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Epidemiology Graduates Grapple with Community Health Concerns

Stretching the boundaries of the ir traditio nal roles in the public and private sectors, UCLA epidemio logy graduates help to solve today's diverse public health proble ms.

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Suzanne Dandoy: A Career Spiced with Variety

The director of Utah's Departme nt of Health tackles new issues in a career studded with accomplishment and service to the public.

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A Celebration of Growth: Four Decades of Public Health at UCLA

Those who remembe r "back whe n," reflect on the milesto nes that have brought the School to its 25th Anniversary, and a position of leadership in public health education.

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Strong Support for Dean's Council¡

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News

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Faculty Notes

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Alumni News

UGI.A Public Healtb is pub lished by Health Sciences Comm unications, UCLA Pub lic Communications/ Public Affairs, for the UCLA School of Public Health. It is issued twice a year for the alumni, facu lty, staff and friends o f the School.

Charles E. Young, Cbancellor Roger Detels, Dean Michael T McManus, Assistant Vice Cban-

cello1; Public Commu nications .John Pontarelli, Direct01; Healtb Sciences Comm unications Editor: Judi Goodfriend Writers: Judy Rosenfeld, Fran Tardiff Art Director: Juliet Beynon Design er: Laura Ganter

Pbotograpby: Courtesy of Hospital Home Health Care, pages 5, 6, 7. Courtesy o f Suzanne Dandoy, cover and page 10. Salt Lake Convention and Visitors Bureau, page 10, 11. Office of Instructional Development, Phil Bleicher, page 17. Courtesy of Susan Scr imshaw, page 18. ASUCLA, Norm Schindler, cover, pages 19, 21.

Ed itorial Board: D r. Roger Detels, Dr. Juel Janis, Dr. Snehendu Kar, Evelyn Fassberg, Bruce Shih, Tom Zeko, John Pontarelli Š Copyrigbt 1985 by Tbe Regents of tbe University of California. Permission to reprint any portion of UCLA Public Health must be obtained f rom tbe editor. Contact Healtb Sciences Communications, Weyburn Center, Suite 344, Center for tbe Healtb Sciences, UGI.A, Los Angeles, California 90024. (213) 206-1960.

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UCLA PUBLIC HEALTH WINTER 1985-86

WillA

U:an

Hospices Live to A Ripe Old

by Dr. Paul Torrens

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UCLA PUBLIC HEALTH WINTER 1985-86

Al l hospice programs around the world share the same general purposes and characteristics. Their services are directed toward patients w ith terminal illnesses, usually cancer. Hospices consider both the patient and the family as the unit of treatment. Hospice staff work hard to provide symptomatic rel ief of pain and other d isturbing physical symptoms, and to provide support and counseling for emotional probl ems such as anxiety and depression. Hospices emphasize the importance of excel lent nursing care, as well as maintaining open, frank communication with health care personnel and family members. After a hospice patient dies, d1e staff continues to work w ith fam ily members fo r a year o r more to ease the pain of bereavement.

Not all hospice programs accomp lish their objectives in d1e same way, however, and a wide variety of hospice programs have emerged. St. Christopher 's is located in a new, special ly buil t inpa-

tient unit that was designed to serve o nly terminal ly ii I patients. Most of the early hospice programs in England and Scotland that followed St. Christopher's were also free-standing units, but when the hospice idea was transplanted to North Amer ica, several important changes took place.

The first hospice program in North America began in 1974 at the Royal Victo ria Hospital in Montreal, Canada. Altho ugh it operated as a separate unit, it was located w ithin the confines of a large university teaching hospital. A number of subsequent hospice programs have followed this model and are located w ithin hospi tals of one kind o r another.

The first hospice program in the United States was the Connecticut Hospice in New Haven, Connecticut, organized with the help of facul ty at Yale Un iversity. For the first 10 years of its existence, this hospice was solely an outpatient, home-care program wid1out

inpatient facilities of its own. Indeed, most of the hospice programs that have since developed in the United States have been of the home-care variety and have either borrowed or contracted for inpatient beds when needed.

Approximately half of the hospice programs that have emerged since the Connecticut hospice have been sponsored by community organizations formed solely to provide hospice care; the other half have been sponsored by hospitals, visiting nurse services, home heal th agencies and other organizatio ns that were already offering health care services and wanted to add hospice care to their list of programs. In recent years, many of the wel I-organized comprehensive cancer centers have offered so many hospice-like services to their terminally ill patients that they often resemble hospice programs.

The early hospice programs were unrestrained in their development. There were no guidelines or standards to be

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followed, no licensing laws or accreditation standards. The staffs of these early programs were almost entire ly volunteers, including physicians and nurses, but there was remarkably little hierarchy, since hospice programs were seen as projects in which anyone could make a major contribution regard less of experience or professional status. Finally, hospice workers considered the early hospice "movement" a crusade to improve patient care, revitalize health care consume r advocacy and he lp patients participate in the ir own care.

Hospice programs were usually free.

Those who could make a financial contribution were asked to do so, but an impo rtant philosophical basis fo r the programs was that they should be available to all patients who needed the ir services, regardless of ability to pay.

It soon became apparent to forwa rdlooking hospice leaders that if their programs were to survive, if they were ever to deliver the wide range of services that dying patients needed, a much more solid fina ncial base was needed. The widespread use of volunteers, both professio nals and lay people, had created an important atmosphere of enthusiasm and commitment, but had also caused significant problems in scheduling and availability of services. Although volunteers were important, it became clear that more salaried staff would be necessary for high quality programs. This would require more money than was currently available.

Since a large percentage of patie nts in hospice programs were over 65, an attempt was made to expand Medicare benefits to include hospice care. In 1982, Congressman Leon Panetta of California and Senator Robert Dole of Kansas introduced a law that would require Medicare to pay for care of the terminal ly ill in certified hospice programs. More than 190 members of the House of Represe ntatives joined in cosponsoring Panetta's bill in the House, and more than 28 senators co-sponsored Do le 's proposal in the Senate.

The legislation passed overwhe lmingly and was put into effect in late 1983.

However, the advent of Medicare coverage created significant changes in the atmosphere and the organization of hospice programs all across the country.

For one thing, legislative backers had argued that hospices were a way of saving money, and suggested that hospice coverage under Med icare would reduce hospital costs. Subtly and witho ut many

UCLA PUBLI C HEALTH WINTER 1985-86

people realizing it, the main reason for e ncouraging hospice programs shifted away from improved patient care of the dying to reduced hospital costs. When hospices became a pawn in the economic equatio n o f health care in the United States, its purposes became somewhat blurred in the eyes of public policy makers.

Also, as a result o f inclusio n unde r Medicare, hospice programs began to resemble the more traditional health care programs that they had originally been set up to avoid. Hospices now had to be certified, so fo rmal standards had to be established and accreditation procedures initiated. States began to draft licens ing laws fo r hospice programs where none had existed befo re. More exact and detailed systems of financial accounting and patient care records were established. Gradually, the role of volunteers began to shrink while the role of professio nals, particularly professional managers and administrators, grew. With the advent of more financial support, many new programs opened, bringing the fear that soon there may be too many such programs. (There were 166 hospice programs in California at the e nd of 1984, 58 of them in Southe rn California alone.)

Hospice programs face some interesting challenges for the fu ture. There is stil l a great need fo r mo re hospice programs in city and county hospitals that serve the poor. At present, these p ublic systems of care do not have e nough hospice programs of their own and so cannot offer their dying patie nts the services that private patients receive.

Until recently, 95 percent of patients in hospice programs d iecl of cancer, usually within 30 to 60 clays from the time of referral to the program. Hospice programs are now being encouraged to provide care to patients who are dying from a variety of non-cancer cond itio ns. Patients with severe chronic lung disease or long-term deteriorating neurological disease may be good candidates for new kinds of hospice care.

Probably the most im portant question facing American hospice programs in the future is whether they will continue to be needed as independent services. If trad itio nal hospitals and health care programs can learn from hospices and begin to offe r the kind of specialized services that hospices do, hospices may no longer be needed. If that happens, hospice care could become a fascinating and innovative footnote in the history of American health care.

Dr. Paul Torrens, professor of public health in the Division of Health Services, has been interested in the care of cancer patients since his days of clinical training, some of which were spent at the Memorial Sloan-Kettering Cancer Center in New York City. In I978 , he was a member of a group that started the first hospice program in the Veterans Administration system at the Wadsworth VA Hospital in West Los Angeles. As a result, he was given a World Health Organization traveling fellowship in 1979 to study hospice programs in England, Scotland and Wales.

In December 1984, the American Hospital Association published a monograph edited by Dr. Torrens, entitled " Hospice Programs and Public Policy," which is now widely circulated in American hospitals. Dr. Torrens was recently presented an award by the Wadsworth VA Hospital in recognition of his seven years of continuous involvement with their program . He was also recently invited to give the keynote address at the Third International Hospice Seminar in London sponsored by St. Christopher's Hospice, the first of the modern hospice programs .

UCI.A PUBLIC HEALTH \VINTER 1985- 86

by Judy Rosenfeld

Epidemiology is one of the oldest specialties in the public health field. It has always been considered a central public health science by academic institutions and accrediting public health organizations. Epidemiologists frequently work for county, state and federal agencies controlling outbreaks of infectious diseases, reducing risk factors for non-infectious diseases, researching the causes of diseases and studying ways to improve the quality of health care. Yet today, they are found in increasingly diverse work settings, including the private sector, where, among other things, they help corporations avoid occupational health hazards for employees. s a stude nr, Loren Lieb, M.P.H. '82, was one of the first to organ ize and computerize info rmation on the earliest reported cases of acquired imm une deficiency syndrome (AIDS) cases in Los Angeles County. Today, Lieb is an e pidemiology analyst fo r the county and continues to track the day-to-day incide nce of AIDS, one of the most urgent and baffling health concerns of the day When Lieb began her work for d1e countv in 1982, there were between five and 10 rep orted cases of AIDS a month.

In mid-1985, there were 50 to 70 repo rted cases a month, wid1 no evidence that the curve had peaked.

Ac, part of he r work, Lieb consul ts wim medical and nursing staff to fill info rmational gaps in cases they have repo rted, and answers many calls from concerned members of the pub I ic and from news repo rters. "We try to accurate ly present the facts," she says.

"We want to prevent hysteria among the pub lic."

Loren Lieb is one of many graduates from the Division of Epidemiology who are at ilie forefront of vital public health

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projects.

"Epidemio logists deal with the etio logy of d isease and me iliods of disease control," expla ins Dr. Barbara Visscher, head of the Division of Epidemiology.

"We look at the d istributio n of an illness in d1e population , and decide which populations to target fo r preventive measures."

The D ivision of Epide mio logy in the UCLA School o f Pub! ic Health is the seco nd largest in nu mbers of students and facu ltv, after the Division of Health Services. ¡(The re are about 100 stude nts enrolled in e pidemiology.)

The UCLA School of Public Health h as d1e largest epidemiology program in Califo rnia. Curre ntly, two d irectors of state health departme nts, Suzanne Dandoy in Utah and Kenneth Ki zer in Californ ia are graduates of the program.

Nearly every epidemiology analyst in d1e Los Angeles County Health Department, d1e largest employer of epidemio logists in the region, is a UCLA School of Pub I ic Heal th graduate.

Graduate Perry Brown , Dr. P.H. '82, oversees a staff of 19 who coordinate data e ntry and analyze data in the vene-

real disease control p rogram for the County Health Departme nt. Dr. Brown, an epide mio logy analyst, performs data analysis and surveillance for gonoi-rhea, syphilis and other venereal d iseases.

He is also involved in special projects including a chlamyd ia prevalence survey. Chlamydia is a venereal infection mat is rapid ly spreading in d1e population. According to Dr. Brown, it is often misdiagnosed as a non-specific infectio n and is tho ught to be a major cause o f ocular infections in newborns and pelvic inflammatory disease.

Dr. Brown has worke d for ilie county fo r almost th ree years. "I like the iliinking involved in this work: how to do tbe job more efficie ntly, insuring the integrity of data col lection and analyzing data that can often look very puzzling at first glance," he says.

Dr. Brown and his staff have e l iminated the backlog of cases to be entered into the county's vene real disease data system. The introduction of microcomp uters will allow De Brown to further streamline d1e data collection and analysis processes.

Graduates from the School maintain ties by working wim fac ul ty on epidemio logy research and programs. Ron Frezieres, M.S.P.H. '79, is director of research at Los Angeles Regional Family Planning Council (LARFPC) and coordinates a major study of the effectiveness of the cervical cap. The study has involved a total of about 1,600 women and nine clinics througho ut Califo rnia.

The four-year, $2.3 million study, wbich began in 1983, is sponsored by d1e l a-

UCLA PUBLIC HFALTH WINTER 1985-86

tional Institute of Child Health and Human Development of the National lnsti· tutes of Health. Results of the study will be published this winter and are expected to greatly influence whether the Food and Drug Administration will approve the cervical cap for general use.

Currently, it is still conside red an investigatio nal contraceptive and, therefore, is o nly available through studies sponsored by universities o r family planning cente rs. UCLA facu lty members Anoe Coulson, research epidemiologist and adjunct lecturer~ and Dr: Virginia Clark, professor of biostatistics, have bee n coinvestigato rs on the study.

The study has found that o ne type of cervical cap actually lacerated the cervical wall in some women. That cap is now banned even for investigatio nal use. The other cap used in the study was fo und to have an effectiveness rate comparable to the diaphragm (about 85 pe rcent, accounting fo r all failure factors). Frezie res expects the FDA to approve the cap, and predicts that improved caps with greater comfort and suction will be designed by American researchers. Frezie res was hired by LARFPC to run this project; he is now involved with other fe rtil ity and contraceptive research programs as well.

"Contraception should be both a publ ic health and a medical community concern,'' Coulson explains. "Overpopulation is a major worldwide proble m, and unwanted childre n are far mo re likely to be abused children."

Researchers are expanding the boundaries of epidemio logical concerns to tackle new and o ld health problems. Epidemio logy has been caJled the "mothe r science" of public health, and its practitioners are often thought of as "disease detectives," identifying and tracing the ofte n elusive path of illness and d isease. Their work can be exciting - discovering an out-

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break that th reatens tl1e communitv but it can be ted ious, organ izing die hundreds of puzzle pieces to track the outbreak's source.

Traditional epidemiological concerns, such as acute communicable diseases, are still important, according to Dr. Visscher. But the field is expanding into other specialty areas, such a'> hean disease, neuro logical d iseases and genetic epide mio logy. Collaborative research is a cornerstone of e pidemio logical advancement. Biostatist1cans, nutritio nists and med ical clinicians including cardiologists and cancer specialists are valued me mbe rs of multi· disciplinary research teams.

Facul ty in the Division of Epidemiology often utilize students in their research projects, which include studies o n AIDS; the environmental and nutritional effects on health; healtl1 hazards i n the office environme nt, including exposure to video d isplay terminals (VDTs); tl1e incide nce, causes and effects o f spinal cord injuries; preventive measures in infant and childhood suffocatio n; and a number o f health education and health risk stud ies throughout the commun ity.

While some graduates from the Divisio n of Epidemiology are e mployed by government agencies o r pursue research funded by public institutions, oth ers work in private industry Jim Kore litz, Ph.D. '84, is one of tl1ree graduates working at nocal (formerly Unio n Oil Company of California). Unornl Corporatio n is a high technology earth resources company which eA.1Jlo res for and develops crude o il, natural gas, geothe rma l, o il shale, coal and mine ral resources.

For the pa t year and a half, Dr. Korelitz, senior e pide miologist in the company, has been helping Unocal develop a compute rized health information syste m fo r the general health surveillance

of employees. Dr. Kore! itz learned of tl1e Unocal opportunity through Dr. Gary Spivey, adju nct associate professor in the School who now heads the Divisio n of Epidemiology and Environmental Medicine at Unocal. (Also working for Dr. Spivey are graduates Virginia Banks, M.P.I I., '85 and Mary Ann Black, M.P.H., '82.)

"We want to promote general health in a safe work environme nt," Dr. Korelitz explains. "Our goal is to collect pertinent health info rmation o n our employees in o rder to assure a healthy workplace. Unl ike most research projects, we are not testing any particular hypothesis. Instead, we are setting up a surveillance program designed to help us prevent health problems."

Unocal's program is too new to have documented specific health trends in the company. Currently, Dr. Korelitz and o tl1ers in the company's med ical department are starting health surveillance in many local Unocal plants. The health professionals he works with at Unocal in the design and implementation of the program include a healtl1 educato r, physicians, industrial hygienists and toxicologists.

Dr. Korelitz e njoys the collaboration his work provides. "We not only work with me staff in the medical depart· ment, but other departments as well.

For example, we work with people in payrol I and personnel to review codes for job descriptions and locations of employees and incorporate that information into our system. We don't sit in o ur own corners and work by ourselves. This is a collaborative effort and a very productive atmosphe re."

As they seek the answers to current publ ic health problems, epidemiology graduates from UCLA impact t11e health of the nation whether tl1ev choose a career at the local, state or federal level, or in private industry.

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UCLA PUBLIC HEALTH WINTER 1985-86

rom her office window at the Utah Department of Heald1, Dr. Suzanne Dandoy looks on a garde n with 20 varieties of flowers. The state capitol stands across d1e garden and the Wasatch mountains decorate the background.

However, snow, fog and the 11-degree te mperature greeted her last Februa1y whe n she took over as the departme nt's executive director. But Dr. Dandoy, M.P.H. '63, was by no means starting out cold in her new positio n.

Her 20-year career as physician, public health official, teache r, researcher and public heald1 volunteer in Ethiopia, prepared .her well for the challenges of a major state health agency.

In Utah, protecting the environment, which includes 5 breathtaking natio nal parks, 43 state parks, 7 natio nal monume nts and 16 ski resorts is a priority fo r every public official. And al though she manages 800 employees and a budget

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UClA PUBLIC HEALTH WINTER 1985-86

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o f $240 million, she personally tours wastewater treatment plant5, hazardous waste sites and steel m ills ro gauge the effects of pollution.

Dr. Dandoy's immediate concern is upgrading Utah's local health departments, which she says are behind similar departments in other states in providing basic heal th services like medical clinics and environmental health programs. " But they have not been funded or given d1e aumo rity to really move ahead," she explains. Therefore, she is acting as advocate for me departments with d1e legislature, as wel I as with stare and county agencies. Anod1er priority is a program co control Medicaid costs, her strategy being a gradual two -year process of moving patients into health maintenance organizations and discontinuing the fee-fo r-service policy.

A<>ide from chose demands, Dr. Dandoy has joined the University of Ucah faculty as an adjunct associate professor in the Department of Family and Community Medicine. " Everyw here I go I also teach because it keeps me on my toes. Students constantly question their world, and I learn from them. Each student has different experiences to share, especially those in medicine and publ ic health , and it's very invigo rating."

Academic medicine was the career Dr. Dandm· had in mind when she decided, eari°Y in life, to become a doctor.

But one su.mmer in medical school, working for the Los Angeles City Health Department , diverted her into public health. " I was fascinated with public health because it reaches people - the poor, sufferers of tuberculosis and venereal disease, fo r instance - with services few in the private sector are prepared to offer. " Studying fo r her public healm degree at UCLA in the 60s, she remembers the School being ho used in me H ome Economics Building, "At rhm time no physicians major ed in public heald1, and no one talked about preventive medicine; it was not the 'in' thing. It was a field doctors went into later in life."

After receiving her M.O. and M.P.Jl. from UCLA she returned in 1966 as an assistam professor to teach epidemiology at the schools of medicine and pub lic heal th. Through m e years, she has also taught community medicine and health administrat ion at San Diego State and Arizona State universities, UC San Diego, and the University of Arizona.

Dr. Dandoy's administrative role in public healm began in 1963 as assistant director in the Los Angeles City (now county) Health Department. " Publ ic heald1 work in Los Angeles gave me a breadth of knowledge mat I wouldn't have had elsewhere," she says. She rotated d1ro ugh all the activities of a big city heal th deparunent and concentrated in communicable disease conu·ol. In Los Angeles 20 years ago, she was able to see rare and interesting problems: leprosy, typhoid and a case o f adult chicken pox mat frightened offici als when it wao; mistaken fo r smallpox. As assistant directo r of communicable disease control, she also investigated an o utbreak of botulism in which six people died. J-Jer job was to trace the disease to its source by interviewing fam ily and physicians of the victims. "It's cal led shoeleather epidemiology," she says. And it resulted in tracki ng the botulism to home-canned mushrooms ser ved at a wedding.

Al ways ready for new cha I lenges in new places, Dr. Dandoy and her husband, Jerry, went ro Ethiopia in 1968, taking d1eir three children ( then ages 4, 5 and 8). Her husband was associate directo r of the Peace Co rps in the capital o f Addis Ababa. Ald1ough not a Peace Corps member berself, Dr. Dandoy was asked by the government to teach preventive medicine and public health at Haile Selassie University. She also taught her children at home since no English-speaking schools were available in the area.

While living in a small town far from the capital during their second year in Ethiopia, Dr. Dandoy looked fo r other opportunities to serve the people. She found d1e native wo men feeding both infants and todd lers mod1er 's milk but no sol id food. So she began reaching child care at a local women's center, showing mothers how to bathe their children, and to prepare a variety of foods from the indigenous grains, fruits and legumes. She had no idea how much of me information the women actually understood or practiced. A translator put her words into the native Amharic and Soma! i languages. Says Dr. Dandoy, "It was a strange experience speaking for three sentences and having the interpreter cover it in one sentence."

The fam ily r eturned to the U.S. in 1970, and Dr. Dandoy spent me next 10 years ao; a'>sistanc director, and d1en directo r, of the Arizona D epartment of Health Services. She is most proud of

her efforts mere to close me state tuberculosi s sanitarium and move patients into other hospitals. "The sanitarium took them o ut of me mainstream of m edical care, and was expensive to run.

Closing it was a major project lasting two years," D r. D andoy recalls.

Resear ch in communicable disease has also been an impo rtant pare of Dr. Dandoy's career. Her most recent p rojects concern hepatitis B - me risks, coses and prevention of the d isease in hospitals. Grams totalling $231,000 from Merck Sharp & Dohme pharmaceuticals helped co support her hepatitis research in the late 1970s. The results o f d1at work have been published widely in such journals as d1e Archives ofInternal Medicine, the American journal of Public Health and the

American j ournal of Infection Control.

Her omer professional achievements include election to a two-year post as a Regent of the American College of Preventive Medicine. From 1977-81 she was also a member of the Center for Disease Control's Immunization Practices Advisory Committee which sets nationwide guidelines fo r immunizations.

Nearing her first anniversary with the Utah Department of 1Iealm, she is launching public forums to get citizens mo re involved wid1 the department's rule-making process. What has been m ost satisfying about her job so far? " I appreciate die rapport I 've established with the stare legislature. We"re not adversaries. Altho ugh we may not always agree, a lot of discussion and understanding cakes place that you don't find in some states," she notes.

Or. Dandoy p lans to stay with the Utah Department o f H ealth as long as she is needed. "Then I would eventual h· like to come full circle back to a local · health department, perhaps as a health officer. A local department would give m e mo re direct contact w im the people. The state level is highly visible, full of controversy and politics, so dow n m e road I'll probably welcome a less stressful job," explains Dr. Dandoy.

Fo r now the Utah environment offers her plenty of breaks from m ar pressure.

After the past 15 years in me Arizona heat, she relishes d1e cold and snow that welcomed her back in Febru~' and she hopes to take up skiing cross country, though , nor downhill.

Paraphrasing Erma Bombeck she quips, "Who w anes to take up a sport when you see an am bulance waiting for you at me bottom of me hill?"

UCL\ PUBLIC HEALTH W INTER 1985- 86

by Judy Rosenfeld

lWenty·five years ago, the UCLA School of Public Health was ac· credited as an independent, degree· granting school. However, the School's beginnings stretch back 15 years earlier, when some enterpris· ing public health practitioners de· cided to build an independent school from the fledgling Department of Public Health at UCLA which was still a branch of the Berkeley-based statewide School of Public Health.

The following article reviews the his· torical path of that department and its growth into one of the nation's leading schools of public health.

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he call came late o n a Sunday night in September 1947. When john Chapman answered the phone, he could hardly have guessed that the man calling him, a man he·did not know, was about to change his career forever. That man \.vas A. Harry Bliss, chair of che new Department of Public Health at UOA He asked Dr. Chapman if he wanted to teach a course in health administration in the department.

Dr. Chapman didn't give it a second thought. Yes, he would like to reach.

When did the course begin?

"Tomorrmv morning at 8 a.m.," rep lied Bliss.

The next mo rning, promptly ac 8 a.m.,john Chapman caught his first course in what was co become the UCLA School of Public Healch. I le wa<; pare of a budding department chat began offering an undergraduate curricul um in 1946. The Department of Public Health grew into the School of Public Health when it became accredited in 1961.

This year, the School celebrates it<; 25th anniversary as an independent, accredited School of Public I lealth.

Schools of pub Iic health \vere a relatively new developme nt in academia in post-World War II America, spurred on by unprecedented interest in the field and by equally unprecedented federal support fo r public heal th education and research. (I n 1947, there '"ere onlv a handfu l of schools of public health ir; che United States, including ones at Harvard Universit:y,Johns I !opkins University and the University of Michigan.

Columbia and Yale universities gave public health degrees under the auspices of their medical schools. By 1985, there were 23 schools accred ited by the Council o n Education for Pu b lic · Health.)

Public health concerns in 1947 cente red around what were then often fata l, acute communicable diseases such as tube rculosis, measles and diphtheria.

Since that time, health threats have changed dramatically from acute disease to chronic health proble ms such as cancer and heart disease, although new and unusual infectious diseases like acqui red immune deficiency syndrome (AIDS) still occur.

13 A LTniversitv of Cal ifornia statewide School of Pu1j1 ic I Iealth, based at f3erkeley, was establ ishecl by the Board of Regents in 1944. (Undergraduate and some graduate degrees in public heal th had been granted by the Department of I Iygiene at Berkeley before that date.)

In the next few years, branch depanmenrs sprouted on other UC campuses.

A statewide dean and associate deans located at branch campuses supervised the undergraduate degree programs.

No one expected, much less wanted, another independent school of public heal th to ri\<tl the mother school at Berkeley.

The very idea of establishing an independent school of pub! ic heal th was resisted by many in the University of California system. But the early developers of the UCLA School of Public Heal th won the support of campus leadership, including colleagues in the growing UCLA School of ~ I cd icine.

One such pioneer in the School of Pub I ic I lea! th was A. Harrv Bliss, fo rm er sanitary officer for the Western Flying Training Command and medical inspector for the Santa Ana Armv Ai r Base, who kept the embryon ic j)rogram alive.

Recruited to prepare a special curriculu m for sanitari ans ac UCLA, Dr. Bliss became chair of the department in 19'-17 and remained in that post until 1956. Dr. Bliss had the vision from the o utset to realize that a Department of Public I lealth, as an appendage to f3erkele{s school. was inadequate for the growing educationa l and research needs or the field.

To buttress the department's chances to become an independent school, he recruited public heal th lecturers from a cadre of physicians working at the Los Angeles City I lealth Department. These physicians lent professional and academic credibility to the program. Some of them were among the first facu lty members of the School. Dr. Bliss, who realized that a school would also need administrative leadership, enrol led himself in the USC School of Pub I ic Ad111inistra1 ion and earned his doctorate in pub I ic administration. Dr. Bliss was also a'vardecl the first i\l.P. 11. degree m UCLA in 1950. " Harry Bliss kept the program alive in a remarkable and splend id way," recal Is Dr. Chapman, former head of the Division of Epidemi ology and now pro-

UCLA PUBLIC H EALTH WI NTER 1985-86

fessor emeritus. " I le held the fort and maintained important associations with Berkeley and w ith the leadership at UCLA He had a struggle ahead of him but he did it with good spirits and he didn't give up. " In the first few years, the UCLA program in public heal th enrol led about 25 students, approximately half of whom were Wo rl d War II veterans.

Many of the students were seeking second bachelor's degrees in the growing field. The first fou r students earned their bachelor of science degrees in 1948.

The first home of the Department of Public Health was in building "3T", wartime surplus barracks that housed many UCLA departments in the late 1940s. The first students in the public health program were required to read classical works of the field , including Snow on Cholera and Pammi on Measles, translated from Dutch and pub1ished in 1846. Panum was the first to verify that measles was a communicable disease.

Or: Bliss became a tenured professor of public health in I 953 and continued his efforts in support of the UCLA school. Around this Lime, another man arrived on the scene whose determination to build on the School's foundations laid by Dr. Bliss has become legend.

Dr. Lenor Stephen Goerke was brought to UCLA in 1950 by Dr. Stafford Warren, the founding clean of the UCLA School of Medicine, to head the Department of Preventive Medicine. It was Dr. Goerke's dream, however~ to build a School of Public I Iealth.

D r. Goerke "was the right man in the right place at the right time," according to Dr. Chapman. " He was untiring in his effor ts to work w ith the statewide system and with colleagues in the School of Medicine."

Evelyn Goerke, w idow of Dr. Goerke, recalls her husband's determination to build the School. " I le was a firm bel iever in public health, in seeing that everyone had access to good heal th care," she says. " He wanted the School of Public Heal th to become an integral part of the Center for the I Iealth Sciences, I ike the School of Medicine, the Neuropsychiatric Institute and the School of Nursing. And eventually it did."

Or. Goerke earned his M.D.' degree from the University of Oklahoma

14

UCLA PUBLIC HEALTH WINTER 1985-86

School of Medicine in 1936, and his M.S.P.H. degree from the University of California, Berkeley and San Francisco in 1938. On active duty in the Army for more than five years during World War II, he went overseas with General Patton's 89th Infantry. ln 1946, he became di rector of d1e Medical Bureau at the Los Angeles City Health Department and began teaching at UCLA in 1950.

The School grew rapidly under Dr. Goerke's direction. The "Southern Section" of the University-wide School of Public Health was officially recognized by d1e Acade mic Senate in 1954, and the curriculum for the M.P.H. was approved. Plans for an approved doctoral program began. By 1957, d1e School offe re d its first complete program leading to an advance d degree, wid1 special izatio n in the areas (as they were known d1e n) of biostatistics, epidemiology, health administration, public health education and sanita1y scie nce.

In 1961, the School grew o ur of rhe smal I but homey "3T" barracks and into its own building of mortar, bricks and steel. Not o nly did it inherit the Home Economics building (now Campbell Hall), but it also welcomed distinguished nutritionists and biochemists from the I Iome Economics Department, which had just been dismantled.

These new facu lty members formed the Division of Nutritional Sciences. They included d1e late Dr. Gladys Emerson, Dr. Roslyn Alfin-Slate r, who is now assistant dean for academic affairs, Dr. Marian Swenseid, current division head, Florence McGucken, and Dr. Edward Rada, professor of economics in public health.

Federal support fo r public health education remained strong during the 1960s, allowing the numbe r of faculty to grow as d1e stude nt enrollment demanded. By the e nd of the decade, the School had a larger student body than Berkeley.

Dr. Goerke, who was both clean of d1e School and chair of the Department of Preventive Med icine in the School of Medicine, became ill in 1970 and gave up d1e chair of the Department of Preventive Medicine. Afte r a national search , the School selected Dr. Lester Breslow, who had been professor of public health in the School since 1968, to succeed Dr. Goerke as chair. By 1972, Dr. Goerke's health worsened, and he retired from the deanship. Another na-

I

s ¡'

tional search began, and Dr. Breslow was, subsequently, asked to become dean of the School.

Under Dr. Breslow's direction, the School of Public Health absorbed the School of Medicine's preventive medicine department. Because the School continued tO grow rapidly, Dr. Breslow urged and received approval in the early 1970s for a 50 percent increase in the number of faculty. (From 1972-80, when Dr. Breslow was dean, the number of full-time tenured or te nure-track faculty increased from 25 tO 49. The n under Dr. Roger Detels' deanship from 1980-85, the School continued to increase its full-time tenured faculty from 49 to 67.)

The School's facu lty supported many academic components, which Dr. Breslow soon consolidated into tewer divisions. "This concept of fewer divisions was followed by other schools," observes Dr. Breslow, now professor of public health in the School and co-director of cancer control at the Jonsson Comprehensive Cancer Center at UCLA. "The idea of a school of public health is to bring togethe r the core units in a unified approach to public health proble ms," adds Dr. Breslow. "We wanted our students to have grounding in each e lement; though they would specialize in one, they would know how to work with public health professionals having other areas of expertise."

That unified approach produced stude nts fro m the UCLA School of Pub!ic Health who have tallied an impressive list of accomplishments. Alumni have directed state health departments in California, Arizona and Utah. Two other alumni began and direct Maxicare, one of the largest and highest-quality health mainte nance organizations (HMOs) in the nation. Many have become professors in schools of public health, including at UCLA "Many public health students today have a great degree of maturity and are concerned with broad social issues," observes Dr. Alfred Katz, who joined the facu lty in 1961 and is professor of population and family health. "They are looking for more than a Iivel ihoocl.

Many have been in the Peace Corps.

They are stil I idealistic and that is very gratifying," he says. ln the past 10 years, the School has expanded its programs in population and family health, nutrition and occupatio nal and environmental health sci-

UCLA PUBLIC HEALTH WINTER 1985-86

STRONG SUPPORT FOR DEAN'S COUNCIL embers of the Dean's Council contributed more than $13,000 to the School during the 1984-85 fiscal year.

Dean's Council funds are used as seed money for the development of research projects; to purchase computer hardware and software; to assist in faculty recru itment; to send students and faculty to professional meetings where they present research repo rts; co sponsor d istinguished lecturers for p resentations to professionals and community members, and other activities to support the School. More than 100 alumni, faculty, friends and corporatio ns are members of the Dean's Council.

Membership in the Dean 's Council may be obtained with a tax-deductible contribution of $100 or mo re, made payable to The UCLA Foundation. Contr ibutions shou ld be sent to the School of Public Heal th Dean's Council , P.O. Box 24209, Los Angeles, California 90024. Fo r further informatio n, contact Marie Fox at (2 13) 206-0500.

The School is grateful to the following 1984-85 members of the Dean's Council for d1eir support:

M

SCHOOL OF PUBLIC HEALTH DEAN'S COUNCIL SPONSORS

$300 and up Lester Breslow, M.D., M.P.H. Richard Cohen, M.P.H .

Anne H. Coulson, M.P.H. Roger Detels, M.0., M.S. Joel M. El lenzweig, M.D. , M.P.H. Raymo nd D. Goodman, M.D., M.P.H. Juel Janis, Ph.D. Carolbeth G. Korn, B.S. Elizabeth M. Oster kamp, M.P.H. Barbara R. Visscher, M.D. Fred W. Wasserman, Dr.P.H., M.P.H.

16

INDIVIDUAL

$100-299 Roslyn B. Alfin-Slater, Ph.D. Ellen Alko n, M.D., M.P.H. Ira R Alpert, M.S.P.H .

El ise C. W Anderson, M.S.P. 11.

Lawrence R A<;h , Ph.D. Allan R Barr Beatr iz H. Beliz, M. P.H. Wi lliam A. Benbassat, Dr.P.H ., 1\11.S. P.H. Ann M. Bjor klund, M.P.H. A. Harry Bliss, D. Pub. Adm., M.P. 1-1.

Denn ice Cal ihan, B.S. Carnation Research Laborato1y Alben Chang, M.D. Virg inia A. Clark, Ph.D. Roger A. Clemens, Dr. P.H ., M.P.H .

Anah id T Creceli us, Dr.P.1-1., M.P.H .

William G. Cumberland , Ph.D. l rvin M. Cushner, M.D., M. P.H. Ji ng Ling Dai, M.P.H .

Bruce . Davidson, M.P. H. Rosalyn A. Deigh Hewertson, M.P.H. Br ian P. Do lan , M.D. , M.P.H. O live .Jean Dunn , Ph.D. Sam Elrod , M.P.H. James E. Enstrom, Ph.D. Agnes K. Eubanks, M.P. H. Garold L. f aber, M.D. Jean S. Felto n, M.D. Jonathan E. Fielding, M.D., M. P.H .

Paul M. Fleiss, M.D., M.P.H. l rene M. Fundaun Evelyn M. Goerke Donald ]. Goodwin, Dr.P.H .

Nancy E. Greene, M.P.H. Mr. and Mrs. Murrav Greenwood Yo lande G. Hamwi: M.D. Lawrence Hart, M.D., M.P.H .

Joseph K. l ndenbaum, M.D., M.P. H. Der r ick B. Jelliffe, M.D. Dr. and Mrs. Snehendu B. Kar Dr. and Mrs. Leonard E. Kl einman Joel W Kovner, Dr.P.H., M.P. H. Anna]. Kraus, M.P.l l.

Donald A. Levine, M.D., M.P.H .

Virginia Chung Li, Ph.D., M.P. H. I rvin M. Lourie, M.D., M. P.H., M.S. B1yan R. Luce, Ph.D. Danny Nin Mar, M.P.H. Frank Massey, Ph.D., M.A. Frank P. Matricardi, Dr.P.H., M.P. H. Thurma Mccann-Sanfo rd, M.D. , M.P.H .

Lester A. Meis, M.P. H. Judge and Mrs. Leonard T Mendelsohn Jean L. Mickey, Ph.D .

Ruth Ann Mo hr, M.P.H .

James L. Monahan, D.D.S., M.P.H .

Robert D. Montoya, M.D., M.P. H. Charles N. Moss, M.D., Dr.P.I I Beverlee A. Mvers, M.P.H. Ruby S. Okubo, M.P.H. Edward ]. O 'Neill , M.D., M.P.H. Jean .). Osp ital, Dr.P.H., M. P.H. James .). Palmersheim, Ph.D., M.S. Christos A. Papatheodo rou, M.D., M.P.H. Carl Peirchala, Ph.D. James D. Pinckney, B.S. Edward L. Rada, Ph.D. Shirley W. Rich, M.P.H .

Ruth F Richards, M.P.H., M.A. Milton I. Roemer, M.D., M.P.H .

Stanley N. Ro kaw, M.D. Harold H. Royaltey, M.D., M.P.H .

Ralph R Sachs, M.D. Marvin Salam , M.P.H. . Alan Samuels, M.P.H. Max H . Schoen, Dr.P.H ., D.D.S. Mr. and Mrs. Terry D. Schoessow Stuart 0. Schweitzer, Ph.D. Maria M. Segarra Fran A. Sherwood, M.P.H .

Maryln S. Slawson Marian E. Swendseid, Ph.D .

Forest S. Tennant,Jr., M.D., Dr.P.H., M.P.H. Sue Verity, Dr.P.H., M.P.H .

David H . Wegman, M.D. , M.P.H. Bruce G. Weniger, M.D., M.P.H. Alton E. Wilson, B.S. Mimi C. Yu, Ph .D., M.S. Thomas A Zeko

SUPPORTERS

$1-99 Estella M. Bassett, M.P.H .

D iana M. Boma, M.P.H. John M. Chapman, M.D., M.P.H .

Norman F Hauret, B.S. Pearl W Jue Marlene P. Kamienny Celia Patricia Kaplan Jane T Meier, M. P.H .

Glenn Melnick, Dr.P.H ., M.P.H. Vinette P. Ramsay, Dr.P.H .

Jean E. Scott, Dr.P.H .

News

UCLA PUBLI C I IEALTI I WI TER 1985-86

Aft.ft Appointed Acting Dean r. Abdelmonem A. Afifi has been appointed acting dean of the UCLA School of Public Health. He succeeds Dr. Roger Detels, who served as dean since 1980. Dr. Detels resumed his full-time teach ing and research activities in the Division of Epidemio logy as of ovember 1, 1985.

(1962); and Ph.D., Stat istics, UC Berkeley.

A d istinguished scholar and public health professional, Dr. Afifi received a Fu llbright Grant in 1960, the Mortimer p iegelman Go ld Medal Award from the American Public Heal th Association in 1976 and was a Guest Scho lar at the International Institute of Appl ied Systems Analysis in Laxenburg, Austria from 1976-77.

I le is a fe llow of the Amer ican Statistical A5sociation (A A), and member of the Bio metric Society and the American Public Health Association, among o thers.

Wh ile ser ving as acting dean, Dr. Afifi wil I continue his current research in multivariate statistical analysis, risk factor analysis and the effects of moderate malnutrition.

First H enry Waxman Sch olar Nam ed

Dr: Abcle/monen A. Afifl

Under Dr. Detel 's deanship, the School enjoyed numero us successes and achievements (see article by Dr. Virginia Clark, page 20). The number of students and faculty continued to grow despite dwindling federal support; private support for the School increased significantly; the scope of facul ty-exchange programs with the People's Republic of China was expanded ; the School officiallv absorbed the doctoral program in En~ironmental Sciences and Engineering, and facu lty and students became involved in a number of community service pro jects in Los Angeles County.

Dr. Afifi, professor of biostatistics, w ill serve as acting dean until a new dean is chosen. A seven-member committee, chaired by Or. Arthur chwabe, professor of medicine, is conducting a national search for a permanent dean.

Or. Afifi has been professor of biostatist ics in the School of Public Heal th since 1975, and has twice served as head of the Divisio n o f Biostatistics ( 1975-76 and 1977-80). Dr. Afifi came to UCLA in 1965 fro m the niversi ty of Wisconsin where he was a visiting assistant professor in the Department of Stat ist ics. His educatio nal degrees include a B.Sc. fro m Cairo niversity (1959); M .S., Statist ics, University of Chicago

lex Ross, M.P.11. '86, is the first recipient of a $2,000 scholarship named in ho nor of California Congressman Henry Waxman ( D-L.A. , 24th District).

Chosen by the Division of Health Services for scho lastic achievement and his invo lvement in public heal th projects in the communitv, Ross was recently project leader of che Vol unta1y Heal th Planning Council of Los Angeles and student representative to the divisio n faculty in the School.

"The scholarship is a lifesaver. le rel ieves some of the financial burden and stress o f getting my degree, and l consider it a great personal hono r," says Ross. I le will work coward a Ph.D. in publ ic heal th after complet ing his M.P.11. in health p lanning and policy analysis.

The d r ive to establish the scho larship was led bv the Inland Counties Heal th Systems Agency to honor representac i,¡e Waxman for his strong leadership on issues of public health. A5 a state assemblyman , Waxman authored such major legislation as the Waxman-Duffy Act which sets standards for heal th maintenance organizations ( I IMOs), and the Clean Air Act of 1970. I le has also worked co prevent cuts in Med icare and Medicaid . Waxman chairs the U.S. I louse of Representatives Subcommittee o n Heal th and the Environ ment. Hej received both his undergraduate and law degrees from UCLA.

18

UCLA PUBLIC HEALTH \VINTER 1985-86

Scrimshaw receives Mead award s a freshman in college at Columbia University, Susan Scrimshaw trembled as she entered the office of anthropo logy professor Margaret Mead . Scrimshaw was told by her father, a nutrition researcher who knew Mead, to stop in and say "hello."

Mead was delighted to meet the young aspiring anthropologist, and was do ubly impressed because the student seemed committed to explo ring a topic then considered radical in anthropo logy: reproduction. As Scrimshaw left the office after a brief meeting, Mead said to her, "Tell your father I'm delighted he's producing an anthropologist!"

Scrimshaw took each class offered by Margaret Mead at Columb ia University and Barnard College, and the two kept in contact througho ut the years. Today, Dr. Scrimshaw, associate professor of pub l ic health and associate directo r of the UCLA Latin American Center, is the recipient o f the 1985 Margaret Mead Award for her work in anthropo logy. Dr. Scr imshaw's work includes projects in the areas of medical anthropology, reproductio n, demography, applied anthropology and cultural change.

The Margaret Mead Award, initiated five years ago in memo ry of th e noted anthropologist, is sponsored jo intly by the Society for Applied Anthropo logy and the Ameri can Anthro pological Associatio n. Ir is presented each year to a young scho lar for work " which interprets anthropological data and principles in ways that make them meaningful to a broadly concerned public. " The award is meant to exempl i fy skills in broadening the impact of science, skil Is for which Mead was admired. The award was presented in Washington, D.C. on December 7, 1984 at d1e Annual Meeting of the American Anthropological Association.

Anthropology, according to Dr. Scrimshaw, is an essential compo nent of public health " because a lot of pub I ic heald1 deals with preventive efforts and not curative effo rts," she observes. " People's acceptance of public health measures depends on what they believe about health and illness. A tremendous amo unt is influenced by culture."

Dr. Scrimshaw has taught at the UCLA Memorial Award in School of Public Health since 1975 in Nutritional Sciences the Divisio n of Populatio n, Fam ily and Internatio nal Heal th . A sampl ing of her memorial fund has been esmost recent cross-cul tural field retablished in ho nor of Gladys search includes a survey o f stress and Emerson, Ph.D ., professor other psychosocial med iato rs of comemeritus of nutritional sciences plicatio ns in h igh- and low-risk women and fo rmer head of the division at the thro ughout pregnancy; a survey o f LaUCLA School of Public Health. Dr. tino, Anglo and bl ack patients and fa m- Emerson d ied in 1984.

Dr. Emerson was an internatio nally ilies with epileptic and asthmat ic chilrecognized b iochem ist and nutritionist dren ; and a study of the cultural and who held positio ns on several national med ical contexts of birch in Latino comm ittees includ ing a p residential apwomen. Over d1e years, Dr. Scrimshaw po intment to the 1969 White House has wo r ked in Guatemala, Colombia, Conference o n Food, Nutrition and Ecuador, Barbados and Bo livia o n culHealth. I n collaboration wi th her hustural aspects of contraceptio n and reband , 0 1iver, Dr. Emerson was the fi rst productio n. to isolate tocopherol (vitam in E) in

1936.

The memo rial fund provides that each year, a continuing doctoral student in the Division of Nutritional Sciences wil I be awarded $500 based on scholastic achievement. Patricia Johnston, a candidate for the Dr.P.H. degree, received the first award in June 1985.

Jo hnston's research involves bone metabo l ism.

l D1: Scrimshaw at work in Ecuador in 19 71.

In 1985, Dr. Scrimshaw spoke on at io nal Public Rad io and the CBS Evening News on the social impact of the b irth control pill, and has appeared o n Nat ional Cable News and KABC-l\1 in Los Angeles o n the subject of breastfeeding. She has autho red and co-autho red more than 40 journal articles, book chapters and repo rts. Dr. Scrimshaw's first book, a field guide for the study of health seeking behavior, w ill be published in 1986 with co-aud1or Elena Hurtado, by the UCLA Latin American Center and the United Natio ns University (Tok)'o).

Although Dr. Scrimshaw has many hono rs and awards to her credit, she feels extremely hono red to have received d1e Margaret Mead award. " Margaret Mead taught me d1e importance o f being will ing to speak o ut and to try to translate anthropo logical insights fo r the publ ic," she says. " he was a true role model for my career, and she had a wonderfu l abil ity to relate to people.

I've never stopped being her student."

19

School Task Force Studies ''Healthy Children"

The Task Fo rce released a report entitled "Healthy Children," in ovember. "The pu rpose of the report is to c a cime w hen government provide school officials and decisiondollars for social services are in makers w ith guidelines for w hat should shore supply, how can schools be included in a comprehensive school provide efficient, comprehen- healch program," exp lains Dr.Janis. The sive healch programs for children? And repo rt ouclines some of che majo r jusc whac conscicuces a comprehensive heal ch prob lems of school age children. school health program ?The Los Angeles Accidents, suicide and homicide, for Councy School Healch Task Force was instance, are che leading causes of death formed in che spring of 1984 co examine amo ng junio r and senior high school chese quescions. With Dr. Roger Decels students. Since 1970, birth races among as chairman, the School Health Task girls 15 co 17 years o ld have been higher Force was creaced as (:I collabo rative in Los Angeles chan in California o r d1e efforc including representatives from U.S. Twency-nine percent of high school che UCLA School o f Public Healch, Los senio rs use d rugs. And of special conAngeles Councy school districts, the cern co Los Angeles County w ich its Los Angeles Unified School D istricc large proportion of minoricy and low and the Los Angeles Depar011em income children, d1ere is evidence ch at of Healch ervices. these children are less healthy and sufA 14-member Operatio ns Commicfer more severe illnesses d1an middle cee, chaired by Dr. Juel Janis, assistanc income and non-minori cy child ren. dean, wa5 charged wich comp iling inSchools can help children, and famformation o n the healch stacus of Los ilies, deal w ich chese problems by proAngeles Councy school child ren and on viding a com prehensive school health school hea lch programs througho uc the program. The core elements of such a counuy.

UCLA PUBLIC I I EALTI I WINTER 1985-86

program , says che task force, include: health services, heal ch education, nutrit ion ser vices, a physical educacion program and data col leccion. " Many of these efforts in school heal d1 educacion and services already exisc and are successful in Los Angeles Councy," notes Dr. Janis. According co the reporc, however, nucricion and physical educac ion are two areas in parcicular thac have nm received adequate accentio n in our school syscem.

For the fucure, che task force recommends a number of measures such as; creacing a county-wide School Health Coord inating Council ; developing a data col lection system co gacher up-todate infor mation on che heald1 of school age children in Los Angeles County; passing appropriace laws; idencifying new fundi ng sources; getting parents, pr ivace physicians, communicy g ro ups and industry involved in school heal th programs; and using the resources of local col leges and un iversicies.

In Memoriam r. A. Harry Bliss died October 8, 1985 of hearc failure. He was 76. Dr. Bliss was chairman of che Departmenc of Public Health ac UCLA from 1947- 56.

He guided che chool 's early developmenc and accively suppo n ed che growth of the Deparun ent of Public Healch inco an independenc school. (See article on d1e history of the School.)

,.

El la Whiton Bl iss, Dr. Bl iss' wife of52 years, passed away in April 1985, a vict im of Parkinson's d isease. She was 75.

The couple had one daughter, also deceased. Dr: and Mrs. Bliss resided fo r the last seven years at the Whice Sands Retiremem Center in La Jolla, Cal ifo rnia.

Memorial g ifts can be made to the A. Harry Bliss Scholarship Fund do the Dean's Office, UCLA School of Pub I ic Health, (2 13) 825-6381.

20

UCLA PUBLIC I IEALTH WINTER 1985-86

Faculty Notes he fo llowing is a capsule of some of the activities o f our faculty during the past sbc months.

Dr. Lawrence Ash, professor of epidemiology and fo rmer associate dean, spent fa ll quarter 1985 at the Museum ational d'l !istorie Naturelle in Paris to pursue fi lariasis research with other investigators. After a return to UCL.A during w inter quarte t~ Dr. Ash will collaborate with researchers o n lungworm studies at the Commonweald1 Institute of parasito logy at St. AJbans, England.

Dr.Judith Blake, Fred H. Bixby Professor of Population, gave an invited papet~ "The Effect of umber and Position of Siblings o n Chil d and Adult Outcomes," at the annual meeting of the American Association for the Advancement of Science in Los Angeles, May1985.

Dr. E. Richard Brown, associate professor of behavioral sciences and health educatio n, has been el ected president of the An1erican Cancer Society, Los Angeles Coastal Cities Unit.

Dr. Albert Chang, associate professor of popul ation and family health, has been appointed by the California Department of Social Ser vices as chair of a statewide task force to develop guidelines for d1e management of mild illness in child day-care centers.

Dr. Virginia Clark, professor of biostatistics, ha published with colleagues "General Medical Care and the Education of Internists in University Hospitals," in Annals of In ternal Medicine (1985), and "The Immediate and Subsequent Outcomes of Nursing Ho me Care," in the American journal of Public Health (1985).

Dr.Joe Coyne, assistant professor and acting d irector of the program in Health Services Management, has published two recent articles. One, "Measuring I Iospital Perfo rmance in Multi-Institutional Organizations Using Financial Ratios," appeared in d1e fall issue of f-fealth Care Management. The second, "A Comparative Financial Analysis of Multi-Institutional Organizations: ot-For-Profit vs. Investor Owned ," was published in the ovember/ December issue of Hospital and Health Services

Administration.

Dr. William Cumberland, associate professor and head of d1e Division of Biostatistics, has publ ished w ith a colleague "Conditional Coverage Properties of Finite Population Confidence

Intervals" in d1e journal of the American Statistical Association (1985).

Dr. Roger Detels, clean, served as one of the three co-edito rs of the fourvolume O:>..ford Textbook of Public Health published by the Oxford Universit)' Press. I le also co-authored two chapters in that series.

Dr.John Froines, acting associate professor o f environmental and occupatio nal sciences, was appointed to the Scientific Review Panel o n Toxic Air Contam inants (SRP) which evaluates data o n health effects of chemical substances. He was also appointed by Mayor Bradley to the Advisory Committee o n Hazardous Waste Reduction for the Ci ty of Los Angeles.

Dr. Ralph Frerichs, professor of epidemio logy, has published an article in the November/ December 1985 issue of Public Health Reports, titled "Introduction of a Microcomputer for Health Research in a Developing Cou ntrythe Bang lade h Experience."

Dr. William Glaze, d irecto r of d1e program in Enviro nmental Sciences and Engineer ing, presented an invited paper entitled " Reactio n Products of Ozone" at the Second Internati onal Symposium o n Health Effects of Drinking Water Disinfectants and Disinfectio n Byproducts, in Cincinnati, August 1985.

Dr. William Hinds, associate professor in the Division of Environmental and Occupational Heald1, was one of ll delegates fro m the United States to participate in an occupatio nal health exchange in China in July 1985. The group visited five cities in different regio ns o f China, gave scientific presentatio ns and visited factories and occupatio nal health facilities.

Dr.JuelJanis, assistant dean and associate professor of heald1 services, published an article in the July-August, 1985 Public Healtb Reports entitled " Monito ring Health in Los Angeles County."

Dr. Donald Morisky, assistant professor of behavioral science and heald1 educatio n, was elected to the sectio n council of the American Public Health Association for 1984-86. He is also principal investigator for the Califo rnia state-funded Heald1 Educatio n RiskReduction Program Dr. Mohammad G. Mustafa, associate professor of public health and medicine, has co-written "Murine Lung Carcinogenesis Following Exposure to Ambient Ozone," published in the October 1985 issue of the journal of the

National Can cer Institute.

Beverlee Myers, professor and head of the Divisio n of Heald1 Ser vices, is cod irector of d1e UCWRand Center for Health Policy Studies and has been elected a member of the Institute of Medicine.

In appreciation

by Virginia Clark, Ph.D .

eans come to o ffice in d ifferent stages of their careers.

Some come to d1e deanship in a reflective mood in their mature years after careers in teaching or public health administration. Others, like Dean Roger Detel , take on d1e deanship at fu ll til t early in an active career as an addition to an al ready full schedule. Dr. Detels has now completed a five-year term as dean of public health and is returning full time to research and teaching in epidemiology.

In reviewing the events and changes that have occurred during the five years under Dean Detel's leadership, certain direct io ns become evident.

Fo remost is an increased strengthening of the academic and professional programs begun by Dean Lester Breslow. Under Dean Detels, we went from 48 to 66 full -time, tenured ladder faculty. This increase allowed d1e School to expand its smal l but excellent environmental health program and to start a needed occupational health program using specially designated state money.

Most o f the other d ivisions received add itional faculty that allowed them to further develop their programs. In particular, the heal th education program received several new faculty positions so that this field now has a needed critical mass, and d1e nutrition faculty were formed into their own division to achieve a more cohesive program and greater visibility for their vital area.

What I am even more pleased about is d1e quality of the facu l ty recru ited in the last five years. We have attracted o utstanding facu l ty in each d ivision who can provide the excellence in teaching, research and independent thought expected of first-rate academicians.

As the saying goes, "If you don't know w here you are going, any road w il l get you there. " Dean Detels has provided leadership in setting directions o n the road to academic changes that provide clear goals for our faculty and students. He appointed a LongRange Planning Committee chaired by Dr. Lester Breslow and asked the com-

UCLA PUBLIC HEALTH WlNTER 1985-86

mittee members tO decide upon areas of teaching, research and public service that we should emphasi ze. Two general areas have emerged that have been reviewed and approved by the faculty The first area includes an increased emphasis on the development and teaching o f health indices to enable us to assess whether or not publ ic heal th programs actually improve the health of the target population. Another part of this area is the development of the methodology of heal th information systems and the use of the computer to enable us to set up, access and interpret health data more effectively The second area is health promotion, where there is a need to develop better techniques and to improve assessment methods, and a desire to mor e fu lly integrate teaching health promotion into the program s of all the d ivisions.

One important step in meeting the first area of emphasis is now taking place. The School is currently obtaining a new computer laborarory to be used by all of the divisions. Each division w il l have computer workstations so that sate! lite laboratories wil I be available for faculty and student use throughout the School. The personal computers, PCs and PC/ATs, in the computer laborarory wil I be networked together and wil I be connected to a new central UCLA computer and to a PC/XT in each division.

Service courses in database management are now offered and short noncredit courses are planned for faculty, students and alumni in computer topics of interest to public health professionals. Two new Micro Yax: II computers are also being obtained for National Institutes of Health research computing.

Dean Detels has contributed both planning support and his own considerable expertise in proposal preparation tO the writing of successful grant requests for this equ ipment.

In the last five years, under Dean Detels' leadership, there has been an increased emphasis on the doctoral programs. We have dropped our undergraduate programs and are gradually increasing the ratio of doctoral to mas-

ter 's students. This w ill increase the academic standing of the School of Public Heal th and p rovide the profession w ith high-level professionals, but i t is stil l a troubling change for many facul ty because of the excellence of many of our professional master's programs. In enhan cing academic respectability, we don't want to give up a valuable part of our teaching program.

Clear evidence of the new strength of our academic programs is that the School was able to achieve a seven year accreditation from the Council on Education in Public Health. Accreditation is valuable to the School in obtaining federal fund ing and to our graduates in securing professional positions in government. Dean Detels made the final presentation to the council that allowed us tO receive the maximum accreditation time that is only awarded to the schools the council bel ieves are excellent in meeting public health goals. It should be noted that our faculty, students, staff and alumni also did an outstanding job in presenting our strengths during a site visit by members of the council.

Dean Detels has also promoted ongoing evaluation of our academic programs by appointing an evaluation committee which includes representation from our alumni and other heald1 professionals in our state to see that we keep on the r ight track.

Dean Detels has established a faculty exchange program between the Bejing (China) Medical College of Publ ic Health and the UCLA School of Publ ic Health. Their dean recently spent two years here and is p lanning future teaching and research projects in conjunction with our faculty.

Dean Detels has actively promoted excellence in publ ic heal th at the university, community and national levels.

As dean, he was our representative to the Association of Schools of Public Health (ASPH). While there, he led the movement tO have the five core areas of academic public health defined as behavioral science/heal th education, biostatistics, environmental and occupation health sciences, epidemiology and heal th ser vices. As a result, ASPH reco mmended that to be accredited all schools must offer master's degrees in each of these five core areas and provide doctoral training in at least one area. These criteria have now been approved by the council and represent a change from previous accreditation criteria that were based on each school

setting its own goals within a general framework.

Further, Dean Detels has served as president for two terms of the Western Consortium for d1e I lealth Professions, an organization that promotes cooperative efforts among the West Coast schools of public health. The consortium administers contracts in heald1 services policy, p lanning and management in d1e United tares and in health manpower training overseas. He has been appointed chair of the Health Effects Review Panel of the Environmental Protection Agency. Dean Detels also coed ited the four-volume Oxford Te:xtbook of Public Health.

Dean Detels has increased the interaction between the School of Pub I ic I leal th and the community. This has included assistance to the county in developing health status indicators and encouraging our faculty to have greater involvement in the community. The School has been assigned a liaison officer from the Centers for Disease Control as a result of his efforts.

Dean Detels is returning to the Division of Epidemio logy to teach and pursue research. He had generously passed on d1e administration of his multiple sclerosis project and his chronic respiratory disease project to other faculty in order to devote more time to the deanship. But last year he obtained a major new grant to study the development of AIDS. He is currently writing new proposals for a variety of investigations.

One of these is for studyi ng the effects of nutritional intake on the condition of the gastric mucosa in persons in high and low r isk areas for ga<;tric cancer in Chile. He has been a super star in obtaining research grant support, in many years accounting for half the School's total facu l ty research support in dollars.

These funds have supported numerous other facul ty in their research.

Dean Detels is a qual ity guy who has demonstrated a real comm itment to publ ic health and a sensitivity to d1e needs of the profession and the professionals in it. He is a fast charging professional who will continue to contribute to our School in the future. He is a person I have always enjoyed working with and respected.

Dr. Virginia Clark is professor ofbiostatistics and biomathemalics at the UCLA School ofPublic Health. She received thefirst doctoral degree from the School in 1962 and has been on the f acuity ever since.

Alumni News

UCLA PUBLI C HEALTI-l WINTER 1985-86

Alumni Notes Wadie Elaimy, M.P.H. '65, Or.P.H. '69, H ealth Care Administration, is executive director of the Idaho Cancer Contro l Prog ram.

Jamar Schoessow, B.S.N. '62, M.P.H .

'67, Health Education, a founding member of the Dean's Council, is a school nurse consultant to the South Bay Hospital District Comprehensive School H ealth Ser vices Program. She is also field coordinato r for d1e positive health profile compo nent of the Beverly Hills, Neil Konheim/ UCLA " Know Your Body" Program.

Virginia M. Benander, M.P.H. '70, H ealth Education, has been appo inted field coordinator, school nursing, fo r the Los Angeles Unified School District.

Eva Damski Muchnick, M.P.H. '70, D r. P.H. '82, Health Services Administration, is work ing o n a breastfeeding study spo nsored by Ma,"Xicare. O n April 16, 1985, Eva and Carl Muchnick, M.D., became the parents of a daughter, Taryn Elena.

Marvis Joyce Thompson Oehm, M.S. '71, Com prehensive Health Planning, has accepted a positio n wi th Natio nal Medical Aud it, a private co nsulting fi r m.

Formerl y, she ser ved 10 years as execut ive directo r of Area 24 Professional Standards Review Organizat ion and a year as director of the Los Angeles District o f the Peer Review Organizatio n ( PRO).

Lee A. Richman, Dr.P.H., M.S.P.I-1. '71, Health Educatio n, is Washingto n regio nal d irector of Ebon Research Systems, Washington, O.C. Connie Blair Bertholf, B.S.N. '70, M.P.H. '72, is assistant professor , School of Nursing, at the University of Alaska.

She w ill begin work on her Ph.D. at the University of Colo rado School of Nursing.

Roberta E. Solomon Madison, M.S.P.H. '72, Dr.P.H. '74, Environmental and Occupational H ealth Sciences, is a professor of Health Sciences at California State University, Northridge. She is also a part-time research assistant in epidemio logy at the City of Hope Medical Center.

Elizabeth A. Holston, M.P.H . '76, Population and Family Health, is an independent consultant in health promotion/illness preventio n. She recently produced a videotape, "H ealthy People: A Wo rthwhile Investment," fo r the New England Regio nal Conference o n HP/IP. Fo rmerly, she was director of clinical

services at d1e Institute for Health Maintenance in Bosto n.

Han K. Kang, Dr.P.H . '76, Environmen~al and Nutritional Sciences, is working 111 the Agent O range Projects O ffice of the Veterans Administration, Washington, D.C.

MarkA Robbins, M.P.H . '76, Health Ser vices Administratio n, is Asia program coordinato r for Family Health International, a firm involved in contraceptive clinical trials and other areas of contraceptive/ reproductive research, training and development.

Blair A. Contratto, B.S.P.H. '77, is d irector of corpor ate market ing for Orthopaedic Hospital, Los Angeles.

Richard A. Goren, B.S.P.H. '77, D.D.S. '82, has a dental practice in Santa Monica and is o n the staff of St. Jo hn's Hospital. He is also the team demist for the Los Angeles Lazers indoor soccer team.

Gloria A. Garcia, B.S.N. '73, M.P.H. '80, Health Services Management, is executive director of the Arroyo Vista Family Health Center.

Nancy E. Dye, M.P.H . '83, Behavioral Sciences and Health Educatio n, is assistant d irector of the Los Angeles Basin Area Health Education Center.

Susan Rufsvold, R.N., M.P.H . '83, Population and Family Heal th, and her husband Robert Rufsvold, M.D ., (B.S.P.l l.

'76) own Lyme Family Practice, a rural heald1 education practice in Lyme, New Hampshire.

Margaret Michelle Miller, M.P.H . '84, Population and Family Health, is in her second year of med ical school at the University of Colorado Health Sciences Center. Last sum mer she worked in the Mig rant Health Program of the Colorado Heal th Department's Family Planning Project.

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