UCLA School of Public Health Newsletter - Winter 2001 - Portrait of a New Dean (Special Issue)

WEBCAST SHOWS TECHNOLOGY'S POTENTIAL TO EDUCATE PUBLIC HEALTH PROFESSIONALS

CONTENTS

Left: Jessica Nunez (M.D., M.P.H. '00) helped organize the School's international Webcast. Right: Ors. Paul Torrens and E. Richard Brown were among the faculty participants in a panel discussion.

2 NEWS • Webcast • New Assistant Dean • Campaign UCLA Update • Doctoral Student Remembered 4 COVER STORY • Portrait of a New Dean: Dr. Linda Rosenstock

8 FACULTY • Dr. Milton Roemer Remembered • Perspectives on the New Leadership in Washington • Grants and Contracts • New Molecular Toxicology Program

12 STUDENTS • Attending the APHA Annual Meeting • PHSA Goals • 2000 Student Awards 14 ALUMNI • Making Connections in E-Health • E-Health at the School of Public Health

P

ublic Health Live/ School to work with the "The foundation is Online," an intercampus to implement the now laid for the national Webcast Webcasting of public School to work with presented by the health information on a the campus to impleSchool Oct. 4, provided regular basis. " ment the Webcasting both a summary of current The discussion featured ofpublic heahh public health issues and four prominent professors from the School: Drs. challenges and a glimpse at information on a how technology may be Lester Breslow, E. Richard regular basis. " used in the future to reach Brown, Jonathan Fielding, v. GALE WINTING a broader audience of puband Paul Torrens. In addiAssociate Dean lic health practitioners. tion to a live audience at for Administration The Webcast, produced the site, public health proin collaboration with UCLA Academic fessionals throughout the state, country Technology Services, the California and world tuned in to the online WebDepartment of Health Services and the cast or (locally) the TV broadcast.

Los Angeles County Department of The technology offers opportunities to Health Services, could be viewed live reach vast new audiences efficiently and from a link at www.ph.ucla.edu, as well inexpensively, says Jessica Nunez, M.D., as on cable public access Channel 36 in · M.P.H. '00, who worked with Winting Los Angeles. It was also archived and is and the School's collaborators in orgacurrently available for viewing on the nizing the program. "We hope this is goSchool's Web site. ing to be a model that will help to guide "It was an unqualified success," says future public health work force training V. Gale Winting, the School's Associate certificate programs," Nunez says. " The Dean for Administration. "As the last School's experts can help disseminate beta test after several previous Web- important information to people in the casts, the foundation is now laid for the trenches who can't get to UCLA."

DOCTORAL STUDENT REMEMBERED Marty Roseman, a doctoral student and teaching assistant in the Department of Health Services, died following a heart attack on January 23. He is remembered by those who knew him for the enthusiasm, intelligence, energy and good humor he brought to every activity.

FOR THE RECORD-Our Fall 2000 issue contained errors regarding a donor to the School, Monica Salinas.

Ms. Salinas has a Ph.D. in clinical psychology and a License in Marriage and Family Therapy; she is not a clinical psychologist, as the article stated.

Also, Ms. Salinas has been a frequent speaker in the Santa Monica/Malibu School District on acculturation and cultural differences; she is not a consultant to the district, as the article stated. We regret these errors.

UCLA

ASST. DEAN FOR COMMUNICATIONS JOINS NEW ADMINISTRATION

SCHOOL OF

PUBLIC HEALTH

Along with Dean Linda Rosenstock, the School now has two other new faces in its administrative offices.

Julie Tisdale Pardi, Rosenstock's Deputy Director for Health

NEWSLETTER

VOLUME WINTER

ALBERT CARNESALE. Ph.D. Chancellor

$12,390.593 through 6/30/00

Communications at Julie Tisdale Pardi the National Institute for Occupational Safety and Health (NIOSH), has come to the School as its first Assistant Dean for Communications. Rosenstock created the position to help increase the School's visibility.

Tisdale Pardi was at NIOSH for more than seven years. She worked on a variety of communication campaigns, covering subjects such as hearing loss prevention and farm safety for children. She coordinated national media efforts and promoted the strategic reinvention of NIOSH. Born and raised in Michigan, she received a B.A. in communications from the University of Michigan and an M.A. in communications from American University in Washington , D.C. "The more I learn about the work going on at the School , the more excited I get about my job," says Tisdale Pardi. After communicating worker health and safety issues for the last seven years at NIOSH, she looks forward to dealing with the School's broader topic base. "The depth of the School's research and service activities offers many communication opportunities," she says. "The real challenge is determining where to begin ."

Brandy Robin has also joined the School's administrative team, serving as Executive Assistant to Dean Linda Rosenstock. A graduate of UCLA, Robin returned to her alma mater when she Brandy Robin joined the School of Public Health in November. Previously, Robin had spent 10 years working at Universal Studios in various capacities in the Recreation, Corporate Partnerships, and Corporate Online departments.

"I'm delighted to be back at UCLA and working at the School of Public Health," says Robin . "I look forward to working with the School's faculty, staff, and students."

21, NUMBER 1 2001

LINDA ROSENSTOCK. M.D .. \1.P.H. Deari

$10. 007' 687 through 6/30/99

3 NEWS

$8,086,551 through 6/30/98 EDITORIAL BOARD LINDA ROSENSTOCK, '\1.D .. M.P.H. Dean

JUDITH M. SIEGEL. Ph.D .• M.S.Ilyg.

4ssoci"te Dean/or Academic Programs

MICHAELS. GOLDSTEI"I. Ph.D. :issociate Dean for Student \ffoirs

$4,226,596 through 6/30/97

V. GALE WINTING Associate Dean for i<lmini.stration

JULIE TISDALE PARDI :1-ssistant Dean for Communications

LAUREL WRUBLE Director of Developtnent

JEFFREY LUCK. Ph.D. As.~i.010tant

$1,982,123 through 6/30/96

Professor, lleolth Serekes

THOMAS R. BELi:\, Ph.D. Associate Professor. Riostatistics

JO) CE A. PAGE, M.S.P.H .. J.D . .4lumni 1ssocUition President

MARA BAER Presidem, Public flealth Students As.~ociation

DAN PAGE Public Information Representatfre

CAMPAIGN UCLA UPDATE

L

aunched in May 1997 as the most ambitious private fund -raising effort in the history of public higher education, Campaign UCLA reached its initial goal of $1.2 billion two years ahead of schedule.

Chancellor Albert Carnesale cele brated this achievement with UCLA donors and fund -raising volunteers, and announced an increased Campaign UCLA goal of $1.6 billion, to be raised by June 30, 2002. The School of Public Health's goal within Campaign UCLA remains at $15 million. As of Dec. 31, 2000, the School was 95 percent toward its goal.

DAN GORDON Eclitor and lf'riter

MARTHA WIDMANN Art Director

Photography: ISUCL..I (pp. 6-7, p. 8: Roemers); l'n>lte Roman ( coi·er, pp. 3-1.

p.10: Ponce, p. 11: Collins, p. 12: Perpich, /J. 1.3: Baer); E. Brooke Whitaker, Ill (p. 2: llebcast); Alan Br<ms (p. 9: ,4ndersen, Brou·n); Craig F'erre (p. 9: Kominski); courtesy of Dr. Linda Rosenstock (p. 5); .~ Pl\T'ide lrorld Photos (p. 9: White House)

School ofPublic Health Home Page: www.ph.ucla.edu E-mail for Application Requests: app-reqtu•st@admin.ph.ucla.edu The UCLA School of Public Health 'eU"sletter is published by the UCLA Sd1ool of Pub lie Health for the alumni, faC'ulty. students, staff and friends of the SC'hool. Cop)Tight 2001 by The Rt>gents of the UniYersity of California. Permission to reprint any portion must bf' ohtaint'd from the editor. Contact Editor, CCLI School of Public Health r\eit·sletter, Box 951 i72. l ..o"' \ngrle~, CA 90095-l 7i2. Phom•: (310) 825-6381.

FROM WASHINGTON TO WESTWOOD: NEW DEAN BRINGS HER PUBLIC HEALTH VISION TO

4 COVER STORY

UCLA

THE l CIA SCHOOL OF PlBLIC llE\LTJI \\ \SYTTJIE O~L\ Pl BLIC HE \LTJI institution to stare down the threat of elimination in the mid-1990s. And like the School, the National Institute for Occupational Safety and Health did more than just survive the threat; it emerged stronger than ever.

When Dr. Linda Rosenstock was appointed Director of NIOSH in 1994, the agency was under fire from critics. "A lot of people from outside felt that the lnstitute 's science was strong, but that it was an ivory tower institution, not connected to the real world of what was going on at work," Rosenstock recalls. The low point came in 1995, when the 104th Congress threatened to eliminate the federal Institute, which is part of the Centers for Disease Control and Prevention.

There is no such discussion today.

During her six-and-a-half years at NIOSH, Rosenstock expanded the scope of responsibility and size of the Institute, increased partnerships, emphasized practical recommendations, and spearheaded an internationally recognized priority-setting process.

By the time Rosenstock announced she was leaving NIOSH to become Dean of the UCLA School of Public Health effective Nov. 1, 2000, she had presided over a doubling of the lnstitute's annual appropriations and more t.han a fivefold increase in the number of research grants funded by NIOSH.

W

hether it's in the government or in academia, working as a clinician, a researcher , a teacher or an administrator, Linda Rosenstock has always looked for opportunities to serve as a force for positive social change.

Born and raised in New York City, she earned her undergraduate degree in psychology from Brandeis University in 1971, then enrolled in medical school at Johns Hopkins University.

There, she made the then-uncommon decision to concurrently pursue an M.D. and an M.P.H. (She was one of only two students in a class of 120 to do so.)

That road less traveled has worked in Rosenstock's favor over the years, as the medical and public health paths have converged and the demand for professionals to work at the interface between medicine and public health has grown.

"The U.S. health care system is in chaos," Rosenstock says. "The working poor in larger and larger numbers are either unable to get health care or are receiving inadequate care. This, along with a lot of other problems, translates to in-

dividuals and what happens to them in the health system. A lot of the analysis, understanding and potential solutions to these problems come from the practitioners and researchers in public health. As such, medicine and public health need to tackle these problems together."

Rosenstock became interested in occupational health through serendipity. At Johns Hopkins, she had focused on health services. After graduating with her M.D. and M.P.H., she did a three-year internal medicine residency at the University of Washington, eventually becoming Chief Resident in Primary Care Internal Medicine. Rosenstock was accepted into the two-year Robert Wood Johnson Clinical Scholars Program, which is designed to develop researchers interested in the non-biological aspects of health care. There , she found herself in search of a new study focus when it became clear that federal budget cuts proposed by the Reagan administration would overwhelm any effects that might be found in her planned study of the impact of Washington State's cuts on health insurance and health access among disadvantaged populations.

She found it at the annual meeting of the American Public Health Association, where colleagues who had gone into occupational health urged her to attend their session and learn more. "I realized that this population fit a lot of my concerns," Rosenstock says. Workers' health problems covered the waterfront of adult health concerns. And from a public health standpoint, this was a population that was underserved in both prevention and treatment for work-related issues.

Having decided on a study of occupational health clinic patients, she faced only one problem: The University of Washington had no such clinic. So, working with Harborview Medical Center, one of the two university hospitals and others in the community, Rosenstock helped found a university hospital-based occupational medicine program, part of the first wave of such clinics. Over the next 13 years, in addition to continuing her work in general internal medicine, she split her time between clinical practice, teaching and research in occupational health, serving on the faculty at the University of Washington's schools of public health and medicine. Among her scientific contributions were scores of journal articles on occupational diseases, and three books, including Clinical Occupational and Environmental Medicine, arguably the world's most respected textbook on that subject. She also became active internationally in teaching and research.

A

imlii•id11als often respond that they are 11·orried about the political pressures that might be force</ upon them at the expense of indiridual

belief~

and integrity.

I hare used Dr. Linda Rosenstocl.· as w1 example of a professional 1dw used lier bacl.·gro1md, her understanding, and her personal code of ethics as the principal tools for the creation of her leadership policies."

RH 11\IWL. L\\\<.;O\ l'n·,id .. nt and ( ,hiPf l .'l.P1'11liw ( )ffin·r 0

t NIOSH, Rosenstock guided the only federal agency that undertakes research and prevention activities in occupational safety and health. "It was exciting to be able to work with the extraordinarily talented staff at NIOSH," she says. The Institute employs the world's largest body of occupational safety and health professionals - a total of 1,500. continued on next page

Above right: As Director of the National Institute for Occupational Safety and Health, Dr. Linda Rosenstock is greeted by thenPresident Clinton at the White House signing of the Needlestick Safety and Prevention Act. Right: At a reception celebrating Rosenstock's Presidential Distinguished Executive Rank Award, clockwise from left: HHS Deputy Secretary Kevin Thurm, Rosenstock, HHS Secretary Donna Shalala, Rosenstock's husband Lee Bailey and the couple's children, Matthew and Adam.

"When asked abo11t their a mi/ability for p11blic office ...

\atwnal \linin~ \ ... sn.

6 COVER STORY

Dean Rosenstock introduces herself to the School's faculty and staff upon arriving in November.

The initiative that was key to transforming NIOSH into a more outwardlooking agency was the National Occupational Research Agenda (NORA). The agenda, developed in collaboration with 500 external partners, aimed to produce a framework for guiding occupational safety and health research. "We set up a very transparent process in which anyone could get to us," Rosenstock explains.

"And it quickly became clear that people's input was making a difference. At the end of the day, in a very controversial arena, we were able to get all of the parties together on what should be the next step."

Working with opposing interests that rarely conversed, let alone agreed with each other, NIOSH was able to find remarkable consensus. Industry leaders who were once opposed to the Institute became ardent supporters. With bipartisan backing, Congress began putting new money into the effort.

NORA's 21 priority research areas were announced in 1996, and the effort has gained momentum ever since, with governmental and non-governmental agencies and organizations working together to implement the agenda. Thanks to Congressional support, the NIOSH investment in NORA increased from $15.4 million in 1996 to $72.3 million in 1999.

While NORA proved to be an extremely useful tool for guiding future research, Rosenstock was a strong advocate for using the knowledge already gained to inform policy. "The science base is always incomplete," Rosenstock notes, "but we can still ask ourselves, 'Given what we know, how can we best protect workers?'" For example, when it became apparent that health care workers were at risk of developing a potentially careerending and sometimes even fatal allergy to the latex found in virtually all medical gloves produced at the time, NIOSH quickly alerted the public to the hazard and provided information on how to minimize exposure. While NIOSH research on the topic wasn't complete, the data available were strong enough to justify alerting the public. Following NIOSH's warning, the FDA began requiring labeling of products containing latex, and many hospitals moved to reduce latex exposure. The results of latex research conducted by NIOSH and others further strengthens the original data on the risks oflatex allergy.

Leadership on issues such as latex earned Rosenstock the Presidential Distinguished Executive Rank Award (the highest executive service award in the federal government) in 2000-five years after her lnstitute's future appeared tenuous.

A

s someone who loves universities and the ideals they represent, Rosen stock always figured she would end up returning to. campus life if the right situation arose for her and her family. (Rosenstock and her husband, Lee Bailey, have two children: Adam Lee Bailey, 7, and Matthew Lynn Bailey, 5.) The UCLA School of Public Health position was ideal, Rosenstock says, for several reasons. One is the elite stature of the University as a whole, and the School as an integral part of the campus. But she was also attracted by the prospect of being in Los Angeles, at the forefront of many of the nation's most critical public health concerns. "It's a great setting," Rosenstock says, "and I hope that the School of Public Health, working with other parts of the campus, can play an important role in forming partnerships with the community to improve health status, including access to high-quality health care."

Coming from the federal government, she has a particular appreciation for the public health work force needs and the importance of keeping the pipeline of talented new public health practitioners , teach ers and r esearch ers flowing. At the same time , Rosen stock says, universities must continue to be bastions for the

independent, scholarly voice asking tough questions and getting answers. "As proud as I am of all we were able to accomplish in government," she notes, "there are certain constraints."

These three facets - teaching, research and service - form the core of the School's mission, and Rosenstock hopes to enhance all three. She is quick to point out that the School is already on the right path. "As I get to know all of the people and components of the School, I'm gaining a deeper appreciation for the wealth of talent and energy that's here," she says. One of her goals is to convey to the campus and the community at large a better understanding of the School's contributions. Toward that end, Rosenstock recruited NIOSH's Deputy Director for Health Communications, Julie Tisdale Pardi, to be the School's first Assistant Dean for Communications (see page 3).

At NIOSH, Rosenstock concluded that before making the case that the Institute was doing important work, it was necessary to first demonstrate why research and prevention initiatives in occupational safety and health are beneficial. Similarly, she believes that for the School to gain more recognition for its own contributions, it must first focus on promoting a better understanding of public health's contributions toward making populations healthier.

"A lot of people don't understand what public health is," she says. "Some still think of it as providing health care to the disadvantaged. Of course we know it's broader, more complicated, and different than that. We need to put a more understandable face on what we're doing, and also to be very responsive to the community and make ourselves even more useful to them. We can do that by forming partnerships with the health department, community-based organizations, health professionals, foundations and the like."

In addition to increasing the School's visibility, Rosenstock plans to concentrate on increasing partnerships and outreach, while also enhancing the infrastructure to support the School's mission of education, research and service.

T

he UCLA School of Public Health's fifth dean begins her tenure at a time of great promise not only for the School, but also for the field itself. Rosenstock points out that the recent boon in federal funding for medical research is benefiting public health investigators as much as anyone else - a sizable chunk is going to researchers in health services and epidemiology, to name two . Public health is also playing a critical role in newly emerging fields: at the interface between molecular genetics and the health of populations; in informatics and the use of information technologies; and in the increasingly global community, as economics and technology break down boundaries between countries, so that one nation's public health problems become problems for all.

Then there are the problems at home that won't go away. "I still think that the primary issue for public health is the disparities in health outcomes and access to care," says Rosenstock. "No one's going to solve that problem alone , but universities certainly have a role to play. Figuring out the right role and making the right contribution given the enormity of the problem is no small task. " But Rosenstock is convinced that all of the elements are in place - growing societal support for public health's mission , more public and private resources, talented public health academics and practitioners - to make a go at tackling the important issues of today and tomorrow.

"This is the era of public health ," Rosenstock says. " We're in for some wonderful times , and we can work together - everyone at the School as well as our alumni, friends and community partners - to lead the way. "

At a January reception sponsored by the Public Health Students Association, Rosenstock met with students.

"Dr. Linda Rosenstocl.· s steadfast derotion and

l'i.~ionary

lemlershiJ>

hare contributed sip1ifica11tl)· in establishin{{ :VIOSH as the model a{{ency for occ11patio11al safety and health research." f)\\llJ R. OBI) (D-\\ 1:-i.) ( .onµ;n•:-.:-.ional Ht•f·onL

l

.'°'. llowwofHt•prt"•"f'ntati\t'~ (kt.:;,~()()()

DR. MILTON ROEMER.

I

1916 - 2001

" ... ONE OF THE FEW CURRENT-DAY LEGENDS IN PUBLIC HEALTH"

f you build it, they will come" was a line made famous in the 1989 film Field of Dreams. But that was already old news to public health leaders. More than three decades earlier, Dr. Milton I. Roemer had concluded much the same in a published study that continues to influence health planners. Under a system of health insurance, Roemer found, the ultimate determinant of the volume of hospital days is the 8 supply of beds FACULTY available; simply put, a hospital bed built is a bed filled.

This landmark finding, which led to legislation requiring hospitals to prove a need before they could expand facilities and buy equipment, continues to be known as Roemer's Law. Roemer, whose pioneering and farreaching career as a health services researcher, teacher, and public health professional included 38 years on the UCLA School of Public Health faculty, died Jan. 3 of cardiac failure after a brief illness. He was 84.

"Dr. Roemer was a world-renowned scholar in many areas of public health, including international health, primary care, rural health and health care organization," says Dr. Ronald Andersen, a colleague in the School's Department of Health Services. "He and his wife, Professor Ruth Roemer, have been bastions in the UCLA School of Public Health, advocates and committed teachers of our students, and gracious hosts not only to the UCLA community but literally to the entire world of public health."

For more than six decades, Roemer's work benefited the lives of millions of people around the world. He was beloved by generations of students and admired by colleagues as a luminary. A lifelong fighter for human rights, Roemer worked in 71 countries and published 32 books and 430 articles on the social aspects of health services.

He proved prescient time and time again over the course of his distinguished career. Among other things, Roemer's research at UCLA encouraged the development of HM Os, promoted the use of ambulatory care, and documented the need for national

Top: Milton and Ruth Roemer, married 61 years, both received the APHA's prestigious Sedgwick award. Bottom: Roemer with Cuba's Fidel Castro. health insurance covering the entire U.S. population. He advocated development of doctoral training in health administration to prepare students for leadership in public health practice, and established an endowed fellowship to support students in the program.

In a 1992 interview, Roemer told UCLA Public Health that the inclusion of medical-care organization in public health was his proudest achievement.

"When I entered the field in 1942, any discussion of the organization or financing of medical care was considered inappropriate and disruptive to the preventive objectives of public health,"

he said. Roemer was one of several at the time who argued that the government's role extended to such areas as health insurance, hospital planning, and care for the poor.

Roemer had many proud achievements from which to choose. "Professor Roemer is one of the very few currentday legends in public health," stated Dr. George Pickett, then-Health Commissioner of Nassau County, N.Y., in 1992.

"There have been many in the history of the United States ... but, regretfully, few who are still active and few [who] are still so relevant."

Roemer earned his M.D. from New York University in 1940, along with a master's in sociology from Cornell University in 1939, and a bachelor's in public health from the University of Michigan in 1943.

As a Medical Officer of the New J ersey State Health Department, he supervised 92 venereal disease clinics, as they were called in 1943. During World War II, as a member of the commissioned corps of the U.S. Public Health Service, he served as Assistant to the Chief Medical Officer of the War Food Administration and Associate in Medical Care Administration to the Chief of the State Relations Division. His 1948 book Rural Health and Medical Care, writâ&#x20AC;˘ten with F.D. Mott, was the first to analyze systematically rural health care needs and services in the United States.

As County Health Officer of Monongalia County, W.Va., he introduced public health innovations, including pioneering a cancer detection clinic for the mining community - against the objections of organized medicine. Roemer explained to the doctors that the screening clinic would provide more patients for them to treat. This experience led him later to establish a prize for a creative local public health leader who had overcome opposition to advances in public health. Roemer was among the first to advocate integration of public health and medical care, and launched the Medical Care Section of the American Public Health Association.

His international work began in 1951, when he served as Chief of the Social and Occupational Health Section of the newly formed World Health Organiza-

PERSPECTIVES ON THE NEW LEADERSHIP IN WASHINGTON

tion in Geneva, Switzerland. In 1953, in the midst of the McCarthy hysteria, he was forced to leave Switzerland and his work as an international civil servant when the U.S. government withdrew approval of his appointment at WHO. In 1953, the province of Saskatchewan, Canada had just introduced hospital insurance and was on the verge of extending it to include insurance for doctors' care. Roemer was appointed Director of Medical and Hospital Services of the Saskatchewan Department of Public Health, North America's first social insurance program for hospital care.

After teaching at Yale and Cornell, Roemer came to the UCLA School of Public Health in 1962, where he taught health administration, conducted research and continued to publish for 38 years. He also chaired the Department of Health Services for eight years.

The capstone of Roemer's many publications was his two-volume work,

National Health Systems of the WorUl, a monumental comparative analysis of national health systems of countries of the world.

The American Public Health Association awarded Roemer its International Award for Excellence in Promoting and Protecting the Health of People in 1977.

In 1983, APHA awarded him its highest honor, the Sedgwick Memorial Medal for Distinguished Service in Public Health - an honor bestowed on his wife, Ruth, in 1991. In 1992, the Centers for Disease Control gave Roemer its Joseph W. Mountain Award. In 1997, he received the Lifetime Achievement Award of the APHA International Health Section and the Distinguished Career Award of the Association for Health Services Research.

Roemer is survived by his wife of 61 years, Ruth Roemer; his son, John E. Roemer, of New York City; his daughter, Beth Roemer Lewis, of Berkeley, Calif.; and six grandchildren.

A memorial service will be held at UCLA in the spring. Contributions in Milton Roemer's memory can be made to the American Public Health Association; the Department of Health Services, UCLA School of Public Health; or Physicians for Social Responsibility.

9 What do the Bush administration and 107th Congress portend for the future of key public health issues? Members of the School's faculty were asked to discuss their hopes and concerns.

Dr. Ronald Andersen The United States is the only developed country that does not ensure access to health care through guaranteed coverage.

Given the new administration and Congress, the goal of improving access will continue to be addressed through private market initiatives or piecemeal legislation.

Three recent Institute of Medicine committees highlight the challenges for providing effective access in this environment. The committee studying America's "health care safety net," including public hospitals, community health centers and local health departments, noted that in the absence of universal comprehensive coverage, the safety net will continue to be the default system for caring for many of the nation's uninsured and vulnerable populations .

However, the growth of mandated Medicaid managed care, the elimination of subsidies that helped finance charity care, and growth in the numbers of uninsured place unprecedented strain on the safety net. A second committee found that 44,000-98,000 people die in a given year as a result of medical errors. It concludes that "it would be irresponsible to expect anything less than a 50% reduction in errors over five years." A third IOM committee is just beginning its work on the "Consequences of Uninsurance." The committee will assess and document the health, social, and economic effects of having 43 million uninsured persons in the country.

Dr. Marion Taylor Baer We have an obesity epidemic in this country that is accelerating. Most alarming is the prevalence of overweight and obesity among children. Al-

FACULTY

though there are some public and private programs trying to combat this epidemic, the resources being devoted to the efforts are minimal. For example, the CDC has approximately $1 million to fund the "5-a-Day" campaign to increase consumption of fruits and vegetables. Compare this to McDonalds' advertising budget of more than $500 million . We need a national initiative with enough money behind it to effect some changes. It is possible that President Bush's education priority, which emphasizes "leaving no child behind, " might be expanded to include children's health as well as their education. However, I fear that this administration will take a pro-business stance and the food industry, a contributor to the pr-oblem, is very large and powerful.

Dr. Thomas Belin The decennial census has become the focus of intense political disputes due to its roles in allocating political power and tens of billions of dollars in public funds. In the past half century, the Census Bureau has carried out post-census surveys and matched the results to the decennial census, each time finding that disproportionately many minorities and inner-city residents were omitted from the attempted headcount.

This has led to calls for statistical adjustments using sample-based evidence, but critics argue that there is no unique way to adjust, and that any procedure would be based on an unverifiable model. The issue is ripe for partisanship since the groups that would benefit most tend to support Democrats. The U.S. Supreme Court ruled against using adjusted counts for apportioning the U.S. Congress but left open the possibility of using them for funding pur-

poses and redistricting within states. I expect the issue to flare up this spring when a decision is made on whether to anoint adjusted numbers as the "official" counts.

Dr. E. Richard Brown

Dr. Gerald F. Kominski

The high cost of prescription drugs emerged as an important policy issue during last year's presidential campaign. Prior to the election, there appeared to be strong bipartisan support in Congress to enact a prescription drug benefit for Medicare beneficiaries, who are hardest hit by the rapid increase in drug costs. The presidential candidates proposed fundamentally different approaches to adding such a benefit to Medicare, however. President Bush supports a market-based approach to encourage seniors to purchase prescription drug policies, with government assistance for low-income individuals. Congressional Democrats will need to decide whether to support this more limited approach or fight for a more comprehensive and uniform benefit.

government helps to fund family planning programs in many poor countries. Under the Mexico City doctrine, family planning programs providing abortion services, counseling or referrals - even with non-U.S. funding will no longer receive U.S. funds for family planning. In an action that would have a more direct impact on Americans, the Bush administration may also decide to reconsider the recent FDA approval of mifepristone (the "abortion pill") or restrict physician access to this medication. Less clear is the new administration's policy on continued funding for other domestic or international reproductive health services, including contracept ive services , maternal health programs, and STD programs.

President Bush has made very conservative appointments to lead a number of key departments related to public health.

However, his choice to head the Department of Health and Human Services, Tommy Thompson, does have a good record on health insurance expansion. Thompson is known for being strongly anti-abortion, which is a reproductive rights position at odds with dominant public health values and policy. But as Governor of Wisconsin, his efforts to expand health insurance to children exceeded in generosity California's own programs. It's not clear how much that signals an intention of the Bush administration to push expansion proposals in this area, but it would not be inconsistent with things that President Bush talked about during the campaign, in terms of giving states more flexibility. The question is whether states will be given more money and flexibility, as well as clear minimum performance standards. Flexibility without strong federal standards and increased funding will provide little benefit to the 43 million uninsured Americans.

Changes in reproductive health policy between the Clinton and Bush administrations are clearest in the area of abortion.

Among President Bush's first acts was reinstating the "Mexico City Doctrine" instituted by the Reagan and Bush (Sr.) administrations, but overturned by the Clinton administration. As part of its foreign aid, the U.S.

I hope the Bush administration will preserve the Department of Health and Human Services' "Initiative to Eliminate Racial and Ethnic Disparities in Health, " which started during the Clinton administration. I am also hopeful that the new administration will continue to promote the Cultural Linguistic Access Standards recently promulgated by the federal Office of Civil Rights. Providers are grappling with how to meet these standards by offering services that are culturally and linguistically sensitive. If it's

GRANTS AND CONTRACTS

BERKANOVIC EMIL -

"Mission of the State Building Trades Council of California"

Beryllium," "UCLA-Mexico Collaborative Training and Research Program"

While space limits preclude a complete listing, the following list of research and training grants and contracts of $100,000 or more awarded in 2000 illustrates the variety of grant and contract activity at the School.

"Policy Information and Analysis Program," "California Health Interview Survey (CHIS)," "Core Support Renewal Application," "The Decline of Employment-Based Health Insurance and the Changing Social Contract in California's Labor Market" COCHRAN SUSAN D - "Risk for Psychopathology Among Lesbians and Gay Men" CUMBERLAND, WILLIAM G - "Biostatistics Training for AIDS Research" CUNNI~ GHA ~ WILLIAM E. - "The Effect on Health Outcomes of Access to Medical Care for Persons with HIV Disease in the United States"

GANZ PATRICIA A - "Breas t CancerPreparing for Survivorship," "Improving Colorectal Cancer Screening Rates" GLIK DEBORAH C. - "Evaluation of Gestational Diabetes Educational Software for Low Income Hispanic Women "

M D BORAH L. - "Assessment Scale for End-of-Life Care for End-Stage Dementia" AB O A - "Pacific Public Health Training Center (PPHTC)," "Pediatric Indicators Project," "Public Health Leadership Institute," "Public Health Traineeship " DERSEN RONALD M - "UCLA/RAND Health Services Research Training Program" SH C RO S - "Neighborhood, Socioeconomic Status & Adolescent Distress"

"Leadership Training in Maternal and Child Nutrition" AR O T -

O H - "Asian American Network for Cancer Awareness, Research & Training," "Colorectal Cancer Screening in High Risk Individuals," "UCLA Cancer Education and Career Development Program" I

Dr. Anne Pebley

BROWN E RICHARD -

"International Training Grant in Epidemiology Related to AIDS," "Natural History of AIDS in Homosexual Men" DUKE, L DONALD - "Effectiveness Assessment of NPDES Regulations for Storm Water Discharges" DETELS ROGER -

Dr. Ninez Ponce

HALFON NEAL - "Vivian Weinstein Child Advocacy Program," "The Interdisciplinary Maternal and Child Health Training Program" HARRISON, GAIL G. - "Calibration of California Dietary Instruments" HINDS, WILLIAM C -

"Breast Health Education Project for Hmong Women and Men"

KAGAWA-SINGER MARJORIE -

KO INSKI GERALD F. -

"AMI Outcome

Study - Cycle 5 Contract" KRAUS JESS F -

"Injury Prevention Re-

search Centers" "Topics in Semiparametric Analysis of Survival Data"

ENSTROM JA

~ESE. - "Environmental Tobacco Smoke and Mortality"

LI, GANG -

"An Automated System for Task-Based Evaluation of Size Distributions of Beryllium Aerosol at the Los Alamos

MAXWELL, ANNETTE E -

FROINES, JOHN R -

"Education and Re-

search Center"

"Breast and Cervical Cancer Screening Among Filipino Women"

important to the new administration, it has to make sure providers have adequate resources to follow through . I would also like to see the new administration promote the continued expansion of the Children's Health Insurance Program to cover entire families. Only a couple of states have done this. Part of the problem, especially in states such as California with large immigrant populations, is that the federal matching funds for these new beneficiaries wouldn 't cover new, legal immigrants .

..,_

Dr. Thomas Rice

During his campaign, President Bush advocated turning Medicare into a "Premium Support" program. Under this proposal , Medicare beneficiaries would essentially receive a voucher to purchase their health insurance. They could use it to buy coverage from a managed care plan, or alternatively, purchase "traditional" Medicare fee-forservice coverage from the government. Those who purchased more expensive plans would have to pay the difference out-of-pocket; this is designed to encourage beneficiaries to choose the most efficient plan available. The down side is that traditional Medicare might cost much more, not necessarily because it is less efficient but because sicker people are likely to choose continued on page 16

MORGENSTERN HAL - "Marijuana Use and the Risks of Lung and Other Cancers" PEEK-ASA CORINNE L - "Work-Site Intervention to Reduce Work-Related Assault Injury" QUE HEE SHANE S - "Permeation of Irritant Mixtures Through Protective Materials" RITZ BEATE R - "Extended Follow-Up of the Rocketdyne Worker Cohort," "Parkinson's Diseases Susceptibility Genes and Pesticides" ROTTMAN STEVEN - ''Training and Education for Disasters in Public Health" SCH US ER ~ARK A - "UCLA Center for Adolescent Health Promotion" SOR NSO SUSAN B - "Academic Fellows Program," "Adolescent Gun Survey" UPCH RCH DAW - "Contextual Effects of Adolescent Risk Taking and STD/HIV"

o G w NG E- "Efficient Design Strategies in Arthritis Research" A CEY A TRONETTE K - "Community Steps to Minority Fitness" ZHA G zuo F NG Training Program"

"Cancer Epidemiology

In the past, toxicologists have focused mostly on death. "Classically, you give a chemical substance to a rat and see when it dies," says Dr. Michael Collins, Associate Professor of Environmental Health Sciences at the School of Public Health. "If it doesn't die with 2 mg of the substance, give 4, and so on."

Death continues to be an important parameter, but in the era of molecular biology, toxicologists can closely examine the processes by which chemicals alter biological systems to produce a host of aberrant outcomes short of death - from chemicals that cause birth defects and neurobehavioral changes in children to carcinogenic interactions. The growing sophistication of the field, and the increasing importance of toxicology in public health, are reflected in UCLA's new ¡ Molecular Toxicology Interdepartmental Ph.D. Program, based in the School of Public Health.

The new doctoral program, which will enroll its first students in the fall, focuses on the molecular mechanisms of toxicological injury. It draws on the expertise of 19 faculty from eight departments and four schools across the campus. In addition to Collins, who is one of the program 's associate directors, other faculty who were already doing work in toxicology within the School of Public Health include Ors. Curtis Eckhert, John Froines , Wendie Robbins, and ZuoFeng Zhang . Among others, they are joined by faculty from the School of Medicine's Department of Molecular and Medical Pharmacology, including Associate Director Jon Fukuto and Nobel Laureate Louis lgnarro; as well as faculty from the Department of Chemistry and Biochemistry in the College of Letters and Science.

"We've put together an excellent group of faculty covering a wide range of what toxicologists study," says Collins. "We're very excited. We think

we're going to be rated as one of the top toxicology programs in the country in the very near future."

The program's Director, Dr. Oliver Hankinson of the medical school's Department of Pathology and Laboratory Medicine, studies cancer-causing substances. Other faculty members look at oxygen or nitrogen species that can react with lipids or proteins and cause damage. Still others study neurodegenerative diseases, the interaction of nutritional substances with chemicals, sperm abnormalities resulting from chemicals, and other concerns.

Collins, whose own research focuses on genetic susceptibility to birth defects resulting from environmental chemicals (including arsenic and cadmium) and the interaction of nutritional factors (namely vitamin A and folic acid), notes that the tools of molecular biology are having a major impact on his field.

"With the sequencing of the human genome, we can start determining how people's genes make them susceptible to various toxic substances," he explains. "We've known for a long time, from epidemiological studies, that some people are more susceptible than others to toxic effects, and now we hope to be able to sort that out."

Not surprisingly, Collins notes, job prospects in the field are excellent, with a rapidly expanding need for molecular toxicologists in academia, government, and the pharmaceutical and biotechnology industries. "Whereas some areas of basic science have been experiencing a relatively tight job market, there are a lot of opportunities for the toxicologists we will train, " Collins says.

"We're hoping to make a real impact."

For more information, visit the program's Web site at www.ph.ucla.edu/moltox

ictured above: r.

1cnae1 Gottrns

Approximately 30 of the School's students attended the annual meeting of the American Public Health Association in Boston last November. Many of them, including Denise Perpich (lower right, with her poster) and Julliet Park (opposite page, left, with Billie Weiss, M.P.H. '81, Executive Director of the Violence Prevention Coalition), were there as presenters.

12 STUDENTS

STUDENTS ATTENDING APHA MEETING LEARN, TEACH ABOUT PUBLIC HEALTH

M

ara Baer was one of many students who, upon getting her first glimpse of an American Public Health Associa tion annual meeting, was struck by its enormity.

Included among the 14,000 attendees at the APHA conference in Boston last November was a strong contingent of UCLA School of Public Health faculty, alumni, and approximately 30 stu dents. For the School's students like Baer, most of whom were attending APHA for the first time, the experience was both informative and exhilarating.

"There were so many opportunities that one of the challenges was deciding what to go to," says Baer, a secondyear M.P.H. student in the Department of Community Health Sciences.

In between attending presentations and break-out sessions, she made sure to allow ample time to roam through the exhibition hall, talking to repre sentatives of the myriad organizations that had booths.

"It was such a diverse group of professionals," says Baer. "I met clinicians, academics, epidemiologists, attorneys, policy people, people from all

types of agencies, people in international health ... " Baer, who was planning to apply for a fellowship with the Presidential Management Intern program, also benefited from meeting some of the program's current fellows.

Rhea Durr, another first-time APHA attendee, was also rewarded in her efforts to learn more about job opportunities and make contacts in her field of interest. A second-year M.P.H. student interested in violence prevention, Durr met Dr. Arthur Kellerman, a leading researcher in the field, and discussed a potential position that would enable Durr to work with Kellerman on some of his projects.

Denise Perpich, a second-year student in the Department of Health Services, relished the chance to peruse the hundreds of exhibitor booths, which covered everything from community program development and health care consulting to environmental assessments, international health, and inform a tics. "Any student would have a great opportunity to make contacts for internships or jobs after graduation," she says. Perpich was one of more than a dozen UCLA School of Public Health students who gave either verbal or poster presentations at APHA. Another student presenter, the Department of Epidemiology's Julliet Park, enjoyed both answering ques -

PHSA FOCUSES ON EDUCATING

r.oM

11 ITV

P I I Ir.

E

TH

In an effort to enlighten high school students about the career opportunities available in the field of public health, representatives of the School's Public Health Students Association (PHSA), in conjunction with the Student Services Office, are presenting at health fairs at selected magnet schools in the Los Angeles community. "A lot of students at these schools are interested in pursuing health careers, but they know little about public health," explains Mara Baer, PHSA President. "Our goal is to educate them about the diverse opportunities available in this field."

Among its other activities, PHSA is working on programs in which students will discuss their internship experiences in order to help other students with decisions on what to pursue this summer. In addition, for the first time, the Association now has two doctoral student representatives in an effort to better meet the needs of that student pop-

tions about her own poster and posing inquiries of her own at an epidemiology roundtable discussion. "There were epidemiologists from every sector, and you could go around and ask them questions and see what's out there after graduation," Park recalls.

"It helped me get a clearer understanding of my options."

Park was impressed not only with the opportunities in her own field, but with the wide-ranging possibilities on display in the public health field as a whole. She wasn't alone. "When you're in school attending classes, it's easy to lose sight of the fact that you're part of this larger family," says Baer.

"It was exciting to be around so many people who care about the same things I care about, people who have strong beliefs and goals for how to promote public health."

13 Left to right: Beverlee Myers Scholarship recipient Kathryn Derose, Professor Emily Abel, Dean Linda Rosenstock, Professor Thomas Rice.

2000 STUDENT AWARDS Ann G. Quealy Memorial Fellowship in Health Services Paul Albert Sharon Ashley Chiquita Flowers Beverlee A. Myers Memorial Scholarship Kathryn Derose-Health Services Bixby Fellowship Michelle Doty-Community Health Sciences Vilma Enriquez-Haass-Community Health Sciences Celia Blann Fellowship Kathryn Derose-Health Services Chancellor's Fellowship Yan Cui-Epidemiology Yu Guo-Biostatistics Jun Wu-Environmental Health Sciences Charles F. Scott Fellowship Dara Amboy-Health Services Jonathan Won-Health Services Dissertation Year Fellowship Judith Katzburg-Health Services Carolyn Mendez-Community Health Sciences Zhishen Ye-Biostatistics Jingyang Zhang-Environmental Health Sciences Dr. Ursula Mandel Scholarship Meghna Karnath-Biostatistics Catherine Taylor-Community Health Sciences

PHSA President Mara Baer ulation. The School's students are also gearing up to play an active role during national Public Health Week in April , when they will spread important public health messages across the UCLA campus.

STUDENTS

Eleanor J. DeBenedictis Fellowship in Nutrition Mable Everette-Community Health Sciences Maria del Cielo Fernandez-Ortega -Community Health Sciences Nicole Harbert-Community Health Sciences Susan Higginbotham -Community Health Sciences Eugene Cota Robles Fellowship Taigy Thomas-Community Health Sciences Fishbaugh/Pollak Scholarship Ming-Yu Cheng-Health Services Catherine Taylor-Community Health Sciences

Foley & Lardner Fellowship in Health Services Marcus Fong Felix Nunez Gordon Hein Memorial Scholarship Christian Shinaberger- Epidemiology Graduate Opportunity Fellowship Paula Amezola de Herrera- Epidemiology Elvira Jimenez- Health Services L.S. Goerke Memorial Award Nina T. Harawa- Epidemiology Milton and Ruth Roemer Fellowship for Dr. P.H. in Health Services Shaheen Kassim ¡Lakha Martin Roseman Raymond Goodman Scholarship Wenli Tu - Biostatistics Jianming Wang- Biostatistics Research Mentorship Program Susan M. Higginbotham- Epidemiology Stephanie Teleki - Health Services Rose and Sam Gilbert Fellowship Ramogi Huma- Health Services Ruth Richards Outstanding Student Award Paul Albert- Health Services Antonio Machado-Environmental Health Sciences Al ice West- Community Health Sciences Meiko I. Winton- Epidemiology Fei Yu - Biostatistics Samuel J. Tibbitts Fellowship Chaofeng Liu- Biostatistics Tony Norton Fellowship in Environmental Health Sciences Phillip Lowenthal Vavra Fellowship Gretchen Coffman- Environmental Health Sciences Wayne SooHoo Fellowship Jonathan Won- Health Services

SPH ALUMNI ARE MAKING CONNECTIONS AS E-HEALTH ALTERS THE HEALTH L~NDSCAPE

I

f you wer e just diagnosed with type 2 diabetes mellitus and wanted to learn more about the condition, you certainly wouldn ' t be at a loss for material online. Punch in the word " diabetes" on the Lycos search engine and you are offered 1,438 ,813 choices (at this writing, anyway).

A recent report in the Los Angeles Times suggests that there are approximately 20,000 health Web sites; others put the number at 14 closer to 30 , 000 or ALUMNI more. As with every other category of content on the Internet, many of these sites are either redundant, contain inaccurate information, or are on financially unstable ground. But this much seems certain: E-health - using the Internet to deliver health-related information, or facilitate health carerelated transactions - is transforming the public health landscape.

"There is a digital revolution in health care, which , like other aspects of e-commer ce, is changing a lot of business models," says Bruce Kobritz, M. S., a health c are consultant with a merchant banking company who chairs the H ealthcare Collaborative at UCLA (see the sidebar on n ext page). "When you put the digital r evolution alongside the medical technology revolution, the consumer empowerment revolution and the r ed uction-in-governmen t -regulations revolution, it creat es a rich culture for a lot of new inter action that will change the way p eople get health care."

"In the future, every h ealth-related organization will have some kind of an e-h ealth strategy," adds Daniel Rubin , M.D. , M.B.A. , M.P.H. '97, whose n ew e-health company, Health Services Exchange, is d escribed on the n ext page.

"Wh ether it's providers communicating with patients , h ealth plans reaching their beneficiaries and performing administra tive functions, or providers and third-party payers communicating with each other, there will be opportunities along all avenues. " While it's early to gauge the full impact of e-h ealth, it is clearly casting a wide net, affecting virtually every aspect of health and health care.

The first , and perhaps still most impressive , impact of the new medium has been in the tremendous increase in the availability of consumer information about health, disease and treatments. " Patients are taking more initiative , and because they can go online and ge t all this information, they ' re much smarter when they talk to their do c tor ," says Karinn Sammann , M.P.H. ' 96, M.B.A, co-founder of the e-health company DrugVoice (de scribed below). "The Internet isn't necessarily causing patients to take a more active role in their health care, but it's d efinitely enabling it."

"Patients are taking more initiative, and because they can go online and get all this information, they're much smarter when they talk to their doctor. " Kamm Sammann, M.P.H. '96, M.B.A.

One alumnus who has seen the Intern et 's empowering effect on patients from the other side is J effrey Siegel , M.D., M.P.H. '98. Siegel , part of a new ehealth company that is using the Internet to make medical records more accessible, also sees up to 100 patients a week in his internal medicine practice in N ew York City. "Patients are much better informed than they u sed to b e," h e says.

They're u sing all of this information to feel a sen se of control. Often , they're trying to compen sate for their frustra-

tion with the health care system." The down side, Siegel says, is that information on the Internet can be either inaccurate or taken out of context, and patients often lack the ability to properly assess what they read.

Although the explosion of consumer information probably represents ehealth's biggest impact to date, popularity hasn' t translated into profitability for companies that are purely informational, as illustrated by popular but financially ailing sites like DrKoop.com that have relied on advertising for revenue . "Information alone doesn't necessarily result in success in this business, no matter how good your information is," says Natalie L. Sanders, M.D., M.P.H. ' 95, M.B.A., a physician at Kaiser Permanente in West Los Angeles and Harbor City who previously served as medical director of eBioCare.com, a specialty pharmacy (injectable biotechnology-based products) that uses the Internet for e-commerce and information dissemination. "You need a product and a customer who will purchase that product."

That realization, combined with the downturn in funding for dotcoms, has led to the current period of consolidation and sorting the healthy business models from the unhealthy, according to Kobritz. He and others believe the trend will continue to move toward more "bricks and clicks" integration of established organizations with ehealth strategies - either bricks-and.mortar companies that find ways to en hance efficiency and better r each their target audience online, or online companies that can offer a valuable service to the bricks-and-mortars.

"E-health is searching for a definition right now," observes Ruben. "A lot of brilliant technologists got into it when Wall Street was treating the industry so nicely, but many of these p eopl e haven ' t understood their clients. There isn' t enough expertise coming in from the consumer and health care side."

For all of the fits and starts , though , the digital revolution is already u sher in g in major c han ges in the public h ealth arena. Some of these promising innovations are b eing spearh eaded by UCLA School of Public H ealth alumni:

S

ammann's company, DrugVoic e ( www. drugvoice . com ), d evelop s con sumer insights for pharmaceutical and health care companies through in-

depth surveys of large panels of patients. "Pharmaceutical companies have a tremendous amount of information about physician practices, but a real lack of understanding on the pa tient side," Sammann explains. "Especially at a time when patients are playing a much more influential role in their health care, we saw the need to gather feedback from these patients on their response to medicines and their satisfaction with medical care in general."

Working mostly through patient advocacy groups and Web advertising, Drug Voice recruits large panels of patients divided by therapeutic area so far, the panels cover migraine, diabetes, depression, high cholesterol, asthma, allergy, irritable bowel syndrome, and gastroesophageal reflux disease. Patients fill out surveys online, sharing perspectives on their experiences with the conditions and the medicines they're taking. DrugVoice has had a relatively easy time recruiting patients for its panels, Sammann reports. "Patients have opinions about these things, and they often feel like they don't get heard by the health care community," she says. In addition, participants receive top-line survey findings, and thus can benefit by learning about the experiences, positive and negative, of others with their condition.

D

avid Krasnow, O.D., M.P.H. '98, M.B.A., is an international consultant in the field of telemedicine, which uses computer networks, telecommuni-

E-HEALTH AT THE

teleophthalmology program in Cuba.

"This field is going to expand geometrically," he says. "It provides access to care to isolated populations that would not otherwise have such access. In some parts of Peru, for example, it can take 2-3 days to get to a major clinic. This way, patients can obtain second opinions or speciality consultations and start dealing with the problem locally."

S

"Everyone~

struggling to simplify

the means by which people

will have access to [medical recordsJ information when they need it, and to be able to enter that information in a simple fashwn."

Jeff Siegel, M.D., M.P.H. '98

cations and imaging technologies to deliver health care across social, cultural and geographic boundaries. Krasnow, who heads a foundation that has designed, developed and implemented eye care programs in 14 countries, helps to put in place telemedicine programs that Ministries of Health have determined are priorities - from networks on child abuse and violence against women in Peru to a national

UCLA

SCHOOL OF PUBLIC HEALTH he School will be offering its first course one-health this spring. Designed as a survey course for UCLA health sciences students on how the Internet is being used in the health field, it is coordinated by Dr. Paul Torrens, Professor of Health Services at the School and Co-Director of the UCLA Center for Health Services Management. It will feature speakers many of them graduates of the School - involved in thee-health field.

For the second consecutive year, the Healthcare Collaborative at UCLA (www.healthcollab.org) will present a one-day seminar in the spring, designed to bring health care professionals up to date on e-health and discuss the issues it raises. The Healthcare Collaborative at UCLA, based in the Center for Health Services Management, is a group of UCLA faculty, students, alumni and staff, along with Southern California health care executives, that promotes professional development.

iegel hopes that his company - still in the early stage - will contribute in the medical records area. "Everyone's struggling to simplify the means by which people will 15 have access to the ALUMNI information when they need it, and to be able to enter that information in a simple fashion," he says. "As someone practicing medicine, I have to deal with so much paperwork that is repetitive and wasteful. A unifying source would help, but any streamlining of the process has to also allow for variation in the realm of how people practice. No one has been able to do that yet."

R

uben recently received funding for a company, Health Services Exchange, that uses Web-based tools to automate contracting functions for providers and purchasers. "The price for high-end services isn't dictated by how much it costs to provide those services," he explains. "It's dictated by the leverage of the purchaser vs. the p¡rovider/seller in a given marketplace." For example, the centers that perform a high volume of heart surgeries can take on additional cases at a much lower cost than facilities that perform the procedure only a handful of times each year. Moreover, Ruben notes, the high -volume centers produce the best results. "We want to make the health service transaction transparent to all parties involved consumers, payers, and providers," he says. "We can do that by providing information on quality and then letting the parties compete on price."

Ruben cautions that students interested in pursuing e-health careers focus first and foremost on an aspect of health care or public health. "The part that's most important in e-health," he notes, "is the 'health,' not the 'e.' "

Perspectives continued from page 11 this option. As a result, many will be unable to afford it and will be forced to join HM Os. This would be quite a shock to many, since currently fewer than 20% have chosen to join Medicare HMOs - although the percentage is higher in California.

Dr. Paul Torrens Along with the number of people without health insurance, tobacco use is the single greatest threat to health in the United States today. Half a million deaths a year are attributed to the effects of smoking. It seems very clear that the future is in stronger regulatory and legislative control on the use of cigarettes by children. The results of advertising campaigns here in California have been very impressive. What it takes, though, is the political will to enforce that effort. The tobacco industry is very resilient. It's on the run, and feeling anxious about wanting to prevent any further regulation and control.

But if the new administration really wants to impact health, this is an area where it can make a big difference.

r---------------------------------------------------------------, ST

0

1

Please let us know if vou have a new atldress. Also, please jot clown an~' updates ,·ou· cl likr to sec included in a future issue. Commentsl:iHquiries aud photos are welcome.

Please indicate:

0 Chano·e of Address Add to Mailing List Alumni lnfon11atiou Update

0 0

Nau1e _ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Year of Craduation. _ _ _ _ _ _ _ _Degree(s) _ _ _ _ _ _ _ _ _ __ Address. _ _ _ _ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ __

Home Phouc (_ _ )_ __ _ _ _ _ Business Phone (_ _ )_ _ _ _ __ 1:;:-mail Address._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Co1rnnents/Updates: _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Pleasr se11d il1e completed fonn to: Editor, UCLA School of P1tblic Health Newsletter. Box 9.51772.

Los Angeles, CA 90095-1772; fax to (.310) 82.5-8-:140; ore-mai l to frodic@suppon.ucla.cdn

---------------------------------------------------------------~

UCLAI F>irsL1c HEALTH

NEWSLETTER

WINTER 2001

Nonprofit Org. U.S. Postage Paid UCLA

UCLA School of Public Health Box 951772 Los Angeles, California 90095-1772 www.ph.ucla.edu Address Correction Requested