UCLA School of Public Health Newsletter - Spring 1997

UCLA

SCHOOL OF

PUBLIC HEALTH

NEWSLETTER

REVIEWING P.H. SERVICES IN PARTNERSHIP WITH L.A. COUNTY

T

HE NATION'S LARGEST LOCAL HEALTH DEPARTMENT, EMBATTLED BY A BUDGET CRUNCH

WHILE FACING A GROWING UST OF PUBLIC HEALTH CHALLENGES, IS SEEKING GUIDANCE FROM INTERNATIONALLY RENOWNED EXPERTS IN THE DEPARTMENT'S OWN BACKYARD

-

FACULTY FROM THE UCLA ScHOOL OF PuBLlC HEALTH. As PART OF AN UNPRECEDENTED OPPORTUNITY FOR THE SCHOOL TO PLAY A MAJOR

2 NEWS Center for Health Services Man ment...Speakers ... Award Winners...

Save the Date.

ROLE IN THE PUBLIC HEALTH PRACTICE ACTIVITIES OF THE Los ANGELES COUNTY

5

DEPARTMENT OF HEALTH SERVICES, FACULTY ARE CURRENTLY CONDUCTING A COM-

STUDENTS Steven Escoboza ... Randal Henry.

PREHENSIVE REVIEW OF THE COUNTY'S PUBLIC HEALTH PROGRAMS, AND WILL SOON SUBMIT RECOMMENDATIONS FOR IMPROVEMENTS. THE INTENSIVE PROJECT- INVOLVING REVIEW OF NUMEROUS DOCUMENTS, INTER-

6 FACULTY Department of Environmental Health Sciences ... Research Updates.

VIEWS WITH SCORES OF PEOPLE, AND EXAMINATIONS OF OTHER URBAN HEALTH DEPART-

8

MENTS, CULMINATING IN A REPORT SCHEDULED FOR THIS SUMMER -

ALUMNI Billie Weiss ... Class Notes.

IS A PRODUCT OF

THE SHARED VISION OF COUNTY HEALTH DIRECTOR MARK FINUCANE AND UCLA SCHOOL OF PuBLIC HEALTH DEAN ABDELMONEM A. AFIFI, AND IS THE LATEST IN A continu ed on page 4

10 FRIENDS Campaign UCLA Launched.

DEAN 'S MESSAGE Commemorative celebrations often are dominated by nostalgia, but ours has been different.

Since last fall, we have marked the 35-year anniversary of an independent School of Publie Health in various events by recalling the outstand ing achievements of our students , faculty and alumni. At the same time, we have

2

rejoiced over our current position of strength

NEWS

and have looked ahead to a bright future.

Much of the current excitement stems from two of the activities that are featured in this VO LUME

17,

2 1997

NUMB ER

SPRING

CHARLES E. YOUNG

issue of the newsletter. Our cover story high-

Chancellor

lights the partnership we have formed with the

ABDELMONEM A. !\FIFI, Ph.D.

Los Angeles County Department of Health

Veari

Services and the L.A. County Public Health EDITORIAL BOARD ABDELMONEMA. AFIFI, Ph.D .

Dean

JUDITH M. SIEGEL, Ph.D.

Commission , a major step in our continuing

public health in our backyard . The second

i ssociat e Dean for Stmlent Jffairs

V. GALE WINT ING l ssociate Deem/or 1dministration

JOHND . MILLER Dire<'lor of De L·elopmen t

ROGER DETELS, M.D., \1 .S. Prof ess or, Epidemiolog y

especially noteworthy event is our involvement in Campaign UCLA (see p. 10), a major effort to secure the future of UCLA. As part of

JOYCE A. P\GE, M.S.P.Il., J .D. llumni A s.~ o ciation Represeri tatit•e

R\NDA.LIIENRY

this undertaking, our school has set fund-raising

President , Public 1/ealth Students 1i ssociatio11

WARREN ROB\!\.

Public lriformation

goals that, if met, would ensure our ability to

R epre~ e 11lati1 •e

D\l\ GORDO'\/

build on the greatness of our past and present.

Editor mu/ ll rirer

MARTHA WIDM\NN

Finally, I would like to salute Chancellor

lrt Director

Photog raphy: ISL Cl. I (pp . 3-6. 10); h •ette Romcw (pp . 5, 8): Bill Short (p . 3); R o11 Sorenson ( p. 9).

School of Public llealth Tlom<' Pag<': www.ph.ucla.cc! u E-mail for Applicatio11 Requests: app-r equ<'st@admin.ph .uda.Nin l CL.I P ublic fl ea lt /1 is publi sh ed h ) th e l C LA S!'hool of P u b lic II Pa ith fo r tlw a lumni . fae ult y, s tuclt•nh , ... ta ff anti fr iend s of t lw s<' hool. Co p} right 1997 b)' Tlw Re ge nts of tlw l niH"r-;it) of Calllornia. P t•rmi ..,sion to reprint an) po rtion of l -CL,1 Public Health mu st be ob ta ined from tlw edit o r. Contac t Editor. l CL \ Public l/ealth . Bo"X 95 1172 , Lo .., \n gt> lt•s .

CA 90095- 1772. (310) 825-638 l.

To thrive in the rapidly changing healtli care environment, organizations increasingly rely on individuals wit expertise in both health care and management. With that in mind, two renowned UCLA schools have combined forces to create a center that marries their complementary bodies o ' knowledge.

The Center for Health Service s Management, based jointly in th School of Public Health and the Anderson Graduate School of Management brings the schools together for a variet)l of teaching, research and service missions. Explains Dr. Paul Torrens, professor of health services at the School of Public Health and co-director of th center, with the Anderson School's Dr. Victor Tabbush: "The Anderson School has world-class expertise i management, but is not focused specifically on health care . Our school ha world-class expertise in health care and health development, but doesn't neces sarily have the broad expertise in man-

resolve to be a key player in the practice of

Associate Dean for .1cademic Pro{(ram s

LAWRE'\fCE R. \SH , Ph.D.

INTRODUCING: THE CENTER FOR

Charles E. Young for nearly three decades of leadership . As of July 1, Albert Carnesale assumes the role. We look forward to working with Chancellor Carnesale, and wish Chancellor Young well in the future.

Abdelmonem A. Afifi, Ph.D.

MILTON ROEMER RECEIVES DISTINGUISHED AWARD Dr. Milton Roemer, professor emeritus of health services, was named recipient of the Distinguished Investigator Award from the Association for Health Services Research.

The award is given to one person each year based on his or her outstanding contribution to the field of health services research. Last year's recipient was also from the UCLA School of Public Health: Dr. Ronald Andersen.

SAVE THE DATE ...

The UCLA schools of public health, dentistry, medicine and nursing will be the key participants in the first annual Health Professions Career Day, scheduled for Nov. 1 at a site to be determined. The event, sponsored by the UCLA Alumni Association, will feature speakers and workshops aimed at alumni in the health professions who are making or considering career transitions, or who simply want to learn more about their field and other career options. For more information, call Valerie Riggs at (310) 825-7449 or e-mail <riggs@admin.ph.ucla.edu>.

I

ALTH SERVICES MANAGEMENT agement. By bringing the schools together, we're able to draw on the different backgrounds and create a remarkable synergy."

The two schools have had previous ties, including a joint M.B.A/M.P.H. degree program dating hack more than two decades. But with the formal designation of a center, the activities have expanded significantly.

Cooperative faculty efforts are adding health care content to the curriculum of the Anderson students, and management content to the public health students' curriculum, particularly in the Department of Health Services. The center is also helping to develop the School of Public Health's M.P.H. for Health Professionals Program. At job seminars, students are meeting with alumni to discuss possibilities in the health services management field.

For alumni of the two schools, the center is sponsoring two series of seminars with guest speakers and discus-

sions involving community practitioners in general and alumni in particular.

The center also provides non-degree educational and training programs. For example, Cedars-Sinai Medical Center recently requested a management training program for its clinical d epartment heads. Programs have also b een offer ed for visiting hospital dire c tors from Egypt and Indonesia, and another is planned for employees of a pharmaceutical company.

Finally, in the area of research , the center provides support for doctoral students, and is currently developing a research agenda for faculty.

Among the center's highest priorities is to develop strong ties with the local health services management community. "We want to affiliate with large health care organizations on an ongoing basis and have them look to the cen ter as a site for continuing education, research and training, as well as a place where people can meet and discuss issues," Torrens says.

FIRST DEAN'S AWARD GOES TO HARTSHORN Terry 0. Hartshorn is the recipient of the school's first Dean's Award, presented to a distinguished individual who has helped the school fulfill its mission of improving the public's health through its educational, research, and service programs. The award was presented by Dean Abdelmonem A. Afifi at the school's 1997 Commencement.

3 NEWS

Top to bottom: 1997 Commencement speakers included Dr. Molly Joel Coye, former director of the California Department of Health Services, and Dr. Joseph lndenbaum, a member of the Class of '62; as part of Public Health Week at the school, current APHA president Barry Levy (1. ) was joined by former APHA presidents Lester Breslow, Ruth Roemer, and Caswell Evans; and winners of the prestigious Delta Omega Awards were announced at a ceremony that included the Sanville Lecture delivered by Dr. Jonathan Fielding.

4 COVER STORY

continued.from page 1

series of projects in which the school is providing technical assistance. A third entity, the five member L.A . County P ublic H ealth Commission, is also a partner in the review.

"This is one of the most exciting things that has happened at our school since I've been dean," says Afifi. "It is the culmination of the kind of relationship I have been attempting to develop since the beginning of my tenure."

"I believe that public health as it is viewed in urban areas in the United States will be defined by what we do here in Los Angeles," adds Finucane. " I am dedicated to setting a good example for the rest of the nation."

The joint task force conducting the review consists of a dozen fac ulty members from the school, headed by Dr. Lester Breslow, professor emeritus of health services, former dean of the school, and the one-time director of the California Department of Health Services. The task force also includes Dr. Jonathan Fielding, professor of health services at the school, who is currently serving as interim health officer and senior policy advisor to Finucane; other members of the county health department; and three of the five members of the county Public Health Commission. In addition to the members of the task force, many other faculty members at the school may be called upon to bring their special expertise to bear, Breslow notes.

The charge of the task force is to conduct a "zero-based" review of everything under the county health department's p urview except hospital services. "We're not looking just to make improvements, or touch around

the fringes; we're starting from scratch," says Larry Roberts, the former deputy director of the de partment who now chairs the L.A. County Public Health Commission.

Specifically, the review involves: • an examination of hundreds of pertinent documents covering the county health department's mandated functions, operations, budget, personnel, organizational structure and the like; • an inventory of the health problems and public health needs of the county; • interviews with approximately 100 people with insight into the department's work - individuals from both inside and outside the department; and • a survey of exemplary local health departments across the country in an attempt to fi nd elements that could be applied in Los Angeles.

Explains Breslow: "We're going to try to develop an ideal of what the Los Angeles County Department of Health Services might be, and then examine the gap between the current situation and the ideal." The recommendations for moving toward that ideal will be practical, Breslow adds.

Fielding believes the review will be valuable to the department both for the expertise fac ulty can bring to programmatic issues such as controlling HIV and sexually transmitted diseases, and for the school's expertise in the management of public health programs and the establishment of efficient administrative structures.

B

eyond the immediate benefits of the review, Fielding, who embodies the strengthening ties between the school and the county health department, sees the current project as a giant step toward a lasting partnership.

"It can build trust and relationships so that, over time, the partnership can evolve in many beneficial ways," he says.

For example, both sides have expressed the hope that the school will place more students in the department for their practicum and fi eld training. The school can also do more to h elp meet the training needs of county health department personnel. Other possibilities are for the school to play a direct role in implementing the recommendations from the current review. Indeed, Finucane has suggested that one possible outcome of the project would be for the school to create a model public health system in a small part of the county. " I have no doubt that we will forge a strong partnership," concludes Afifi.

n

WHY THE TIME IS RIGHT

"In a little more than ayear, Mark Finucane has brought a new sense of vision in making sure that the department fulfills its public health mission. In addition, an assistant director in charge of public health programs and services is being recruited. So it's a good time to look at the mission of the department and how that translates into the functions of the public health structure."

DR. JONATHAN FIELDING, Prof. of Health Services, UCLA School of Public Health; Interim Health Officer and Senior Policy Advisor to the Director, L.A. County Dept. of Health Services

WHAT THE REVIEW CAN ACCOMPLISH

I

%

"This gives us an opportunity to restructure public health programs and services into the model of public health that we envision for the new millennium."

LARRY ROBERTS, Chair, L.A. County Public Health Commission

"We're concentrating on how we begin to move from here to there, rather than simply making abstract, 'do-good' recommendations. We wantto be practical."

DR. LESTER BRESLOW, Prof. Emeritus of Health Services, UCLA School of Public Health

"I am confident there will be needed changes that will result from this review. Some may be quite visible. Others will be be• hind the scenes and not visible for some time."

MARK FINUCANE, Director, L.A. County Dept. of Health Services

MUTUAL BENEFITS "This gives our school a direct opportunity to work with the heart of public health in our constituency.

Faculty will learn how the largest local health department in the country operates, what are its needs, what is its reality. And in return, the L.A. County Department of Health Services gets a world-class set of minds, each an expert in his or her domain."

DR. ABDELMONEM A. AFIFI, Dean, UCLA School of Public Health

M.P.H. PROGRAM HELPS PREPARE COUNTY'S NEW DIRECTOR OF MANAGED CARE FOR CHALLENGES

Steven Escoboza

S

teven Escoboza believes he enrolled in the UCIA School of Public Health's M.P.H. for Health Professionals Program just in time.

Escoboza , who gr adu a tes from the program this spring, h as just assumed the position of dir ec tor o f th e n ew Office of Manag e d C a r e i n th e Los Angeles County Department of H ealth Services. H e fa ce s th e ch a ll e n ge of attempting to integrate managed care policies and practices into the rap idly changing landscap e of th e c ount y health department.

With the county shifting to an outpatient , clinic-bas ed, public-privat e partnership e mphasizing man a ge d care, Escoboza 's office is taking center stage. As part of his n ew r esponsibilities, Escoboza is president a nd chief executive officer of th e c ommuni t y health plan for the Medi-Cal popula tion served by the county, r epresenting approximately 165,000 enrolled lives .

He is seeking to develop a se amless delivery system that serves Med i-Cal recipients as well as two other pop ulations: individuals on General R elief

fun ds and th ose defined as indigent based on t heir inability to afford h ealth insu ran ce.

The experience Escoboza got from hi s previous position - in which he had served as health director for Santa Barbara County - was helpful , of cou rse . But even so, Escoboza h as been especially impressed with th e ease wi t h which he has been ab l e t o apply the kn owledge h e gained 5 fr om th e M.P.H . for STUDENTS H ealth Professionals Program .

"So m u ch of wha t was presented in the program, material relating not only to managed care but also to management and organization, leadership , st ra t egic planning and finance, has b een relevant to the issues I'm now grappling with in this position ," says E scoboza, who has been a member of the p r ogram's inaugural class.

PHSALEADERRANDALHENRY URGES SOCIAL RESPONSIBILITY

W

ith much to do before his scheduled address at the School of Public Health ' s 1997 Commencement, Randal Henry hadn't decided exactly what he was going to say. "Something about social responsibility," he indicated last April, "to the effect that no one does it alone, that there's always support, and that we are all responsible for society ' s problems - especially as public health professionals, where we' re in a position to help."

For Henry, president of the Public Health Students Association, the past two years have been a transforming experience, taking him from someone who was unsure of his future course to an acclaimed researcher in the field of violence prevention and a leader of the school's student body. Among Henry's highlights was his role in orchestrating the recent Public Health Week activities at the school, which included the appearance of the current president of the American Public Health Association, Dr. Barry Levy.

"Being here has r eally open ed doors for me, " says H enry. While h e h op es to spur public health profe s siona ls t o social action , Henry's own sense of social responsibility begins with his two-and-ahalf year old son, Elias. " H e's my greatest inspiration, the reason I came h er e."

During Public Health Week in April. stu¡ dents answered questions and conducted demonstrations designed to heighten awareness of the public health field among UCLA undergraduates.

PROFILE: DEPARTMENT OF ENVIRONMENTAL HEALTH SCIENCES

T 6 FACULTY

Environmental Health Sciences faculty and staff include , top row: Arthur Winer, Curt Eckhert, William Hinds , Shane Que Hee , John Froines; middle row : L. Donald Duke , Jane Va lentine , Barbara Housel , Richard Am bro se; bottom row : Victor Liu , Lori Maeda (student liaison), Mario Panaqua .

oday's environmental issues are so complex that research into their solutions almost always requires the combined expertise of scholars in fields ranging from policy and law to economics, engineering and epidemiology.

Thus, it's not surprising that faculty in the school's Department of Environmental Health Sciences (EHS) have forged collaborations spanning the UCLA campus.

What EHS faculty bring to each of these joint efforts is a focus on how the environment affects human health, according to Dr. John Froines, professor and chair of the department. But the specific focus of faculty and students in EHS is extremely varied.

One group , including Drs. Climis Davos and L. Donald Duke, is concerned with environmental management and policy - how decisions are reached that affect the environment and human health. Another faculty cluster, including Froines and Drs. William Hinds, Shane Que Hee and Victor Liu, focuses on industrial hygiene and occupational health with approaches that include ergonomics and measurement of indoor air quality.

Drs. Michael Collins, Curt Eckhert and Froines study toxicology, examining environmental hazards and how they affect humans. The department's environmental chemists, including Drs. Mel Suffet, Arthur Winer, Jane Valentine and Que Hee, collect and analyze data on the water, air, and other environmental media for their implications on both the environment in general

/4/1

and human health in particular. And environmental biologists, including Eckhert and Dr. Richard Ambrose, are concerned with the health of ecosystems, which ultimately affect humans.

Faculty typically work in groups, crossing disciplines both within the department and outside the school. "The environment is a multidimensional problem, and it requires a multidisciplinary approach," says Ambrose. "The issues are so intertwined that you generally need a group of experts from different fields." So the department has played a central role in the development of UCLA's new Institute of the Environment, and in the Pollution Prevention Education and Research Center, of which Froines is a cofounder. Faculty are active participants in the Center for Environmental Risk Reduction, based in the School of Engineering and Applied Science. And two interdisciplinary programs are based in the School of Public Health: the Center for Occupational and Environmental Health, and the Environmental Science and Engineering (ESE) Program.

The increasing sophistication of the environmental health field is reflected in the growing percentage of students at the school who pursue a doctoral degree, Froines says. Students are seeking doctorates both to become researchers and, in the .case of the ESE program, to assume leadership roles in the environmental field.

Once, environmental concerns in the field of public health were focused on sanitation issues. That all changed beginning in the early 1970s, when the modern environmental movement blossomed with the passage of such legislation as the Clean Air Act, the Clean Drinking Water Act, and the Occupational Safety and Health Act. "There began to he a recognition that water and air pollution, as well as hazardous waste and workplace issues, were affecting people's lives in a dramatic way,'' says Froines.

Today, environmental health scientists face a new set of issues with the internationalization of the field and the recognition that traditional control technologies are insufficient. "The regulatory approach is giving way to an orientation toward prevention,'' Froines says, "which fits well with the public health paradigm."

RESEARCH UPDATES DR. ABDELMDNEM A. AFIFI, professor of biostatistics and dean of the school, is jointly developing a CD-ROM with Dr. Martin Lee entitled Electronic Companion to Biostatistics, to be produced by Cog~o Learning Media, Inc. Afifi is co-author of a metaanalysis study which concluded that there is insufficient evidence to show a link between exposure to electromagnetic fields and leukemia among electric workers. The article will appear in the Journal of Occupational and Environmental Medicine.

DR. RONALD ANDERSEN, the Fred W. and Pamela K. Wasserman Professor of Health Services, is completing two monographs for an eight-year study coordinated by the World Health Organization on oral health care and outcomes in six countries and three U.S. sites. The study is based on comparable social surveys and clinical examinations. The U.S. portion of the study documents discrepancies in services received and oral health status among African Americans, Hispanics, American Indians and non-Hispanic whites and points to the roles played by financing, beliefs and the presence of a regular source of care.

DR. CAROL ANESHENSEL, professor of community health sciences, is continuing research that links neighborhoods' economic structure and racialethnic segregation to the risk of emotional and behavioral disorder among adolescents, structural effects that are over and above the characteristics of the adolescent and his or her parent. She is also examining exposure to traumatic events among adolescents in Los Angeles, and has found extremely high rates of both exposure and variation according to the social and economic characteristics of the adolescent.

DR. ROSHAN BASTANI, associate professor of health services, is conducting a randomized trial with lowi ncome minority women from Los Angeles County/USC Medical Center and Olive View Medical Center who have been diagnosed with a breast abnormalfy suspicious for cancer. Women randomized to the intervention arm of the study receive a series of telephone counseling calls from a team of ethnically matched professional and lay/peer counselors.

The study seeks to determine whether the intervention is able to increase adherence to all recommended follow-up diagnostic and treatment procedures and reduce psychological distress associated with having the abnormalfy.

DR. LINDA BOURQUE, professor of communfy health sciences, was recently funded by the Los Angeles County Department of Health Services to conduct analyses of data collected following the 1994 Northridge earthquake under the county program "Los Angeles Earthquake Special Outreach: Community Based Outreach Assessment Teams." She recently wrote an analysis of the extent to which surveys and questionnaires could be used following disasters.

DR. LESTER BRESLOW, professor emeritus of health services, is the principal investigator for a project involving several faculty in the UCLA schools of pub1ic health and medicine to develop a system for Health Risk Appraisal of the Elderly (HRA-E). The researchers have developed a system that includes a questionnaire and software for generating computerized, personalized reports and recommendations to participants. The system has tested valid in three populations: at a senior center, with HMO enrollees, and in a national sample of AARP members.

DR. SUSAN COCHRAN, professor of epidemiology, has begun an NIAID-funded study aimed at identifying opportunities for prevention programs directed at high-risk young African American men who have sex with men . Cochran's research gro up will su rvey several hundred gay men ages 18-29 in Los Angeles.

DR. WILLIAM COMANOR, professor of health services, recently completed two research papers: "Strategic Pricing of New Pharmaceuticals," wh ich examines the factors affecting the prices of pharmaceuticals both at introduction and after some years on the market; and "The Impact of Income and Family Structure on Delinquency," which estimates the composite effect of family impact and a parent's presence on the probability that a boy will be stopped, charged, or convicted of a crime between the ages of 14and22.

DR. WILLIAM CUNNINGHAM, assistant professor of medicine and health services, is part of a team of investigators from UCLA, RAND and other institutions who are conducting the first nationally representative study of persons with HIV disease. The research is looking at the costs of, access to, and quality of AIDS medical services. One high-priority analysis for the UCLA researchers who are focused on access to care is determining the characteristics of the population that predict use of the new highly active medication regimens of anti-retroviral drugs, including protease inhibitors.

DR. ROGER DETELS, professor of epidemiology, was in southern China with Dr. Virginia Li, professor of community health sciences, helping to implement a community intervention program to reduce initiation of drug use among young males in the villages.

OR. JONATHAN FIELDING , professor of health services and pediatrics, is principal investigator of a project with the State of Cal~ornia to develop aprivatesector immunization registry for Los Angeles County.

His research group has been developing software for physician offices and for the central reg istry.

Fielding also heads a Centers for Disease Control and Prevention-funded project to determine best practice in community health report cards.

DR. RALPH FRERICHS, professor and chair of epidemiology, is currently focusing on detection policies for HIV, both in California and in Southeast Asia. He is addressing, both in his writings and in computer simulation studies of married couples in Thailand, the implications of notfinding asymptomatic HIV. DR. OSMAN GALAL, professor of community health sciences, has been collaborating with colleagues at Cornell University and in several developing countries on the topic of food systems for improvement of health and nutrition. The nations involved include Egypt, India and Tanzania.

DR. PATRICIA GANZ, professor of health services, received funding as part of a multisite observational study of women 70 and older who are diagnosed with breast cancer. The study will examine patterns of care, looking particularly at whether the drug tamoxifen , which reduces mortality from breast cancer, is being prescribed as oftenas it should.

DR. DEAN JAMISON, professor of community health sciences, recently chaired a World Health Organization committee on health research and development

priorities for developing countries. The committee consisted of scientists from many disciplines, including two Nobel Laureates. Its repo rt, Investing in Health R&D, was recently published and several of its recommendations are being implemented.

DR. MARJORIE KAGAWA-SINGER, assistant professor of community health sciences, is a co-investigator of "Study of Women's Health Across the Nation," which is examining the biology and epidemiology of the transmenopause in a multisite, multicultural, national population-based sample of women 42-52 years of age. She currently chairs the Diverse Populations work group for the national study. She was also recently funded by the Oncology Nursing Society to develop a national database of breast and cervical cancer screening for Asian and Pacific Islander Amer ica n 7 women.

FACULTY

DR. SCOTT LAYNE, associate professor of epidemiology, has begun a new program to develop robotic hardware and Internet software too ls that integrate massive quantities of crossdisciplinary laboratory technologies from biology, laboratory automation and comp ute r science to develop lasting solutions to complicated scientific problems such as the HIV/AIDS epidemic. With such integration, Layne believes it is feasible to increase the productivity of HIV/AIDS research by 100- to 1,000-fold over the next five years.

DR. MARK LITWIN , assistant professor of health services and urology, is continuing work in the area of quality of life assessment in men with early- and late-stage prostate cancer. He has also begun developing methods of measuring patient preferences or utilities for different health states after prostate cancer treatment.

DR . HAL MORGENSTERN, professor of epidemiology, is the principal investigator of "Epidemiologic Study to Determine Possible Adverse Effects to Rockwell/Rocketdyne Wo rkers from Exposure to Toxic Substances and Radiation," funded by the U.S. Department of Energy; and "Chiropractic Versus Medical Care for Low-Back Pa in ," funded by the Agency for Health Care Policy and Research.

DR . CHARLOTTE NEUMANN, professor of community health sciences, received a grant from the Joseph Drown Foundation to determine the extent of hunger and malnutrition among a subsample of inner-city school children in the Los Angeles Unified School District. The research was stimulated by a series of articles in the Los Angeles Times in 1996 about children coming to school hungry and unable to learn.

OR. STEVEN ROTTMAN , professor of community health sciences, is writing an instructor's manual for a course entitled "Citizen, Family and Community Disaster Preparedness Education ." The course is being prepared for the Federal Emergency Management Agency (FEMA) and will be made available to colleges/universities around the country for instructors interested in including it in a curriculum of disaster or emergency management.

OR. STUART SCHWEITZER , professor of health services, is the author of Pharmaceutical Economics and Policy (Oxford University Press: in press), an exploration of the worldwide structure and perfor-

mance of the pharmaceutical industry. Special attention is given to several particularly vexing issues in the bo ok, including price determination, the existence of a "drug lag" that some feel harms U.S. consumers, and measures that would increase supply of medically appropriate pharmaceuticals in developing countries.

DR. JUDITH SIEGEL, professor of community health sciences and associate dean for academic programs, is involved in on going collaborative research on adolescent stress, looking at the contribution of body image to depression. She has found, as have other researchers, that girls are more depressed than boys. But, once body image is taken into account, gender differences in depression disappear, indicating to the researchers that if teenage girls felt better about thei r bodies, they would not experience such severe symptoms of depression.

8 FACULTY

DR. SUSAN B. SORENSON, associate professor of community health sciences, is working on several violence prevention projects. Her newest project expands Sorenson's previous research on immigrants as victims of homicide to include immigrants as perpetrators. The previous research found that, even when controlling for ethnicity, immigrants are at higher risk of homicide than their U.S.-born counterparts.

DR. PAUL TORRENS, professor of health services, is conducting preliminary research on the factors contributing to successful management practice by physician executives. The findings will be used to help redesign teaching and training efforts for physician executives.

DR . DAWN M. UPCHURCH, assistant professor of community health sciences, is focusing on two areas of research : adolescent sexuality and women's life course. Through a grant from the California Wellness Foundati on, she is examining the influences of neighborhood and family on teens' risk of first sex.

And , with a grant from the National Institutes of Health, she is studying the interrelationships among women's decisions regarding fertility, marriage, education and health.

ALUMNI

FIGHTING A DEADLY "DISEASE": "HER ENTHUSIASM IS CONTAGIOUS"

F

or nine years, as an infectious disease epidemiologist with the Los Angeles County Department of Health Services, Billie Weiss (M.P.H. '81) would review causes of death and disability. Invariably, the numbers would tell her that an even greater threat to public health than any virus was the "disease" called violence.

''THE SCHOOL SHOWED ME THAT EPIDEMIOLOGY CAN BE VIEWED IN MANY DIFFERENT WAYS." Violence a disease? To Weiss, it's an epidemic. So in early 1991, at a time when few were looking at violence as a public health issue, Weiss changed jobs, becoming director of the county's Injury and Violence Prevention Program. Four months later, she cofounded (with Drs. Susan Sorenson of the UCLA School of Public Health and Paul Juarez of Drew University) the Violence Prevention Coalition of Greater Los Angeles, for which Weiss currently serves as executive director.

In her county role, Weiss is directing programs that seek to identify groups at high risk for domestic violence, pedestrian injuries, drownings and other preventable causes of injuries and death.

Using various data collection strategies, her staff finds the high-risk groups, identifies risk factors that could be addressed in prevention programs, and evaluates the existing programs.

The Violence Prevention Coalition is a network consisting of communitybased agencies, law enforcement, churches, physicians, mental health providers and university researchers, among others. "We had found that a lot of people were working to prevent violence, but nobody really knew what anyone else was doing," Weiss explains.

"By mobilizing these groups, we 're able to increase awareness that violence is preventable in Los Angeles."

"Billie has an intense commitment to this field," Sorenson observes. "Her enthusiasm is contagious."

As for Weiss's own awakening about the importance of a public health approach to violence, she gives some of the credit to the education she received at the UCLA School of Public Health.

"The school showed me that epidemiology 1;an be viewed in many different ways," Weiss says.

DR. STEVEN P. WALLACE, associate professor of community health sciences , and researchers at UCLA's Center for Health Policy Research have recently com pleted a study of the potential impact of welfare reform on Los Angeles County's private health care system. Wallace and colleagues surveyed local physicians, clinics and hospitals, and analyzed survey data from the general population.

DR. ROBERT WEISS, assistant professor of biostatistics, is collaborating with other researchers on a wide variety of subjects, including: statistical methods for analyzing computerized adaptive tests (CATs); prior specification for model selection in repeated measures random effects models; the effects of surviving childhood leukemia on psychological well-being and on risk-taking behaviors; victim, defendant and crime characteristics that affect prosecutors' charging of homicide defendants; and statistical sensitivity analysis of large comp uter codes that simulate the environment in the Los Angeles Basin.

DR. WENG KEE WONG, assistant professor of biostatistics, received fu nding from the National Institute of Arthritis and Musculoskeletal Skin Diseases for "Efficient Design Strategies In Arthritis Research."

Billie Weiss, M.P.H. '81 , heads the county's Injury and Violence Prevention Program.

CLASS NOTES ARTHURS. SCHNEIDER, B.S. '51, M.D., is professor and chair of the Department of Pathology at Finch University of Health Sciencesffhe Chicago Medical School. He requests updates from environmental sanitation graduates circa 1951 .

INA TILLMAN, M.P.H. '65, worked for the Los Angeles County Department of Health Services in her specialty, community health education, and spent seven years working for the Ministry of Health in Israel. She is now a volunteer in patient education at the Venice Family Clinic.

GARY GORLICK, M.D., M.P.H. '67, has served as peer-reviewer over the last three years for two medical journals: Pediatrics and the American Journal of Family Practice.

CHERYL STIPEK (TRUE), M.P.H. '69, now Cheryl Servais, has moved to Dallas with Tenet Health System Inc., where she is manager of health information services.

OFILIA V. DIRIGE, DR.P.H. '72, is executive vice president of Kalusugan Community Services, and is an adjunct professor in the San Diego State University School of Public Health and lecturer in San Diego State's Department of History.

CORDELL R. WELCOME, M.P.H. '74, most recently served as vice president of health services for the Health Plan of San Joaquin, and is currently director of Medi-Cal marketing for Vista Medical Foundation Inc. ANTHONY RODGERS, M.S.P.H. '75, is chief executive officer of the Local Initiative Health Authority for Los Angeles.

PAULA L. WOODS, M.P.H. '76, is a principal in the strategic planning, marketing and communications firm of Woods/Liddell Group in Los Angeles. Prior to forming Woods/Liddell Group in 1988, she was vice president of National Medical Enterprises for three years, first in the area of business planning/program development and then in product line management.

She is the author/editor of four books published since 1992, including /, Too, Sing America: The African American Book of Days.

Health in Osaka, Japan, participated in the inaugural conference of the International Health Economics Association, presenting "Effects of Insurance Coverage on Cataract Surgery for the Elderly Population."

ELLEN ROSSKAM KRASNOSSEL¡ SKI, M.P.H. '88, has for the past six winters been working for the International Labour Office in Geneva, Switzerland - since 1992, as the training officer in the Occupational Safety and Health Branch. This United Nations specialized agency helps develop , promote and assist member states in implementing international standards on all aspects of work, which are then transformed into policies at the national level. Krasnosselski notes that the school prepared her well for applying public health principles at the international level and for working in cross-cultural environments, an integral part of her position. "It is gratifying to be involved in international policy making and to see how that can end up improving the conditions of work for people at the grass-roots level," she says.

LORRAINE BROWN, M.S.P.H. '89, was appointed manager of HMO contracts and plan operations in the Health Plan Administration Division of CalPERS. She is responsible for performance measurement development for HM Os under contract, and for ensuring contract compliance.

VANESSA GAVIN-HEADEN, M.P.H. '90, M.D., was married on April 20, 1996 to Theodore Headen. She is currently in a family practice residency at Kaiser Sunset Hospital in Los Angeles.

AILSA HOLLOWAY, DR.P.H. '91, has moved to the University of The Western Cape, Cape Town to establish Southern Africa's first university program in disaster mitigation and sustainable livelihoods.

GARY SHETH, M.P.H . '91 , earned his J.D. from Golden Gate University School of Law in May 1996,

9 ALUMNI

where he was recog nized by the faculty as the outstanding student in environmental law. He passed the California Bar in November 1996.

HUI-CHI YANG, M.P.H. '92, is chief of the Department of Medical Records in Provincial Hospital, Hsiu-chu, Taiwan.

ALAN M. HEILPERN , M.D., M.P.H. '93, medical director of emergency services at St. John's Hospital and Health Center in Santa Monica, Calif., was named president of the Los Angeles County Medical Association for the 1997 term . The lecturer and assistant cl inical professor of medicine at UCLA describes his personal philosophy as "to recognize that sound medical practice goes beyond diagnosis and cure."

DIANA E. MAIER, M.P.H. '81, is director of research and epidemiology for Primera Healthcare in Denver.

She founded the Colorado Coalition for Outcomes and Utilization Research in 1993, and founded the Colorado Clinical Guidelines Collaboratives in 1996.

Her daughter Nina was born Jan. 13, 1997.

ROBERTS. RODEN, M.P.H. '84, began a new position last year after five years at LucasArts Entertainment Co. He is now vice president of business affairs and general counsel at Maxis, Inc., publisher of entertainment software, including SimCity.

ATOZ (ETSUJI) OKAMOTO, M.P.H. '88, now with the Kinki University Medical School Department of Public

The school's Health Policy and Management Alumni Association (HPMAA) honored Health Net president and CEO Arthur Southam, M.D ., M.P.H. '84, M.B.A. (right, with last year's honoree Dr. Paul Torrens and HPMAA President Teri Daly Bartholetti) with its annual "Leadership Award " at its successful fund-raising dinner May 29 to benefit the HPMAA student scholarship fund .

$1 .2 BILLION CAMPAIGN UCLA LAUNCHED; SCHOOL SETS GOAL OF $15 MILLION

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iming to rai se $1.2 billion by Jun e 30, 2002, Campaign UCLA was launche,l in May 1997 as the mo st ambitious private fund-raising effort in the history ofpuhlic education. The comprehensive undertaking will engage thousands of members of thP UCLA family- alumni and friends. corporations and foundations, faculty and staff - in partnerships to support academic programs, students, faculty and facilities across the campus.

As an integral part of Campaign UCLA, the School of Public Health has Pstahlished its own fundr aising goal of $15 million. Included among the school's priorities are a renovale1l building in a new location with state-of-the-art space; support for specific programs and research; student feJlowships: endowed fa culty chairs; and unrestricted funds. " The budgetary model familiar to many of our alumni, which is that the state Lakes care of most of the school's costs, is no longer valid," says UCLA School of Public Health Dean Ahdelmonem \. Afifi. " Today, private fund-raising plays a much more integral role in what our school is able to achiev(' in teaching, r esearch and community service.

"Each of u s who is committed to the school's viability and future must realistically assess how much we can give, and then stretch. In addition, we are asking our alumni and friPnds to identify others who share our dream of a healthier society and will help us realize that dream."

MAKING A LIST...

Campaign Kick-off: One of the School of Public Health's highest priorities for Campaign UCLA is to raise at least $6 million in private gifts that would combine with $10 million already in hand in state funds to secure a state-of-the-art space in the partly new and partly rebuilt UCLA Center for the Health Sciences building. The new space would be approximately double the school 's current size. Above, Dean Abdelmonem A. Afifi stands next to a scaled model of the future Center for the Health Sciences facility.

Following are some of the causes for which the school is seeking support.

O Building Complex ...by combining public and private funds, the school intends to double its space and create a state-of-the-art facility. o Departmental Endowments ...to support each of the school's departments: Biostatistics, Community Health Sciences, Environmental Health Sciences, Epidemiology, and Health Services. o Endowed Chairs...to enable the school to recruit and retain outstanding faculty. o Student Fellowships ... to attract the most outstanding and diverse student body and reward excellence. o Laboratory Equipment and Computer Acquisitions ...essential to the teaching, research, and public service mission of the school. o Office of Public Health Practice ... to address the current students, practice requirements and continuing educational needs of health¡ professionals, public health workers and community members. o Health Careers Resource Center...houses both a career development center and a diversity enrichment program. o Distance Learning Program ... advances in communications technology have created extraordinary opportunities.

O International Health Program ... collaborations benefit developing countries as well as the school and its students. o Cancer Prevention and Control ... conducts research and develops community-based interventions for populations at high risk. o Center for Health Policy Research ... conducts research that informs policy makers and community leaders. o Center for Healthier Children, Families and Communities ... research, teaching and service aimed at providing children with the best opportunities for health and well-being. o Center for Occupational and Environmental Health ...public service, research, and interdisciplinary graduate training of occupational and environmental health professionals.

O Environmental Science and Engineering Program ... trains high-level professionals able to tackle complex environmental problems. o Humanitarian Assistance and Disaster Relief Program ... proposed School of Public Health/School of Medicine program would be the first of its kind.

O Automated AIDS Research Laboratory ... combines tools of engineering and basic sciences to increase the pace of HIV/AIDS research by several orders of magnitude.

NAMING OPPORTUNITIES In grateful appreciation of donor support, a variety of naming opportunities are available in recognition of major gifts to the school.

These include:

INSTITUTIONAL Sl'PPORT THE SCHOOL OF PUBLIC HEALTH

$25 million or more unrestricted gift BUILDING COMPLEX

$8 million or more for new facility expansion and renovation

TYPES OF DONATIONS •Cash •Stock • Real Estate • Other Appreciated Assets •Through a Will or Trust •Other Planned Giving Arrangements For more information, please contact John D. Miller, Director of Development, UCLA School of Public Health, Box 951 772, Los Angeles, CA 90095-1772. (310) 825-6464. Fax: (310) 8258440. E-mail: jmiller@support.ucla.edu

INTERDEPARTMENTAL CENTER

$5 million or more unrestricted gift

DISTRIBUTION BY PURPOSE

MAJOR PROGRAM AREA

$2.5 million or more unrestricted gift

Total Goal Amount: $15 million

FACULTY SUPPORT DISTINGUISHED CHAIR

$1.5 million or more to chair endowment CHAIR

- - - Capital: 40% $6 million

$1 million or more to chair endowment TERM CHAIR

$500,000 or more to chair endowment

RESEARCH SUPPORT RESEARCH FUND

$500,000 or more to research endowment LABORATORY

$250,000 or more for equipment and maintenance

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Programs/Research: 25% $3.75 million

- - - Stud.ant Support: 17% $2.5 million ~--Faculty Support: 13% $2 million - - - Unrestricted: 5% $750,000

DEPARTMENTAL LIBRARY

$100,000 or more to library renovation and maintenance

STUDENT SUPPORT DISTINGUISHED FELLOWSHIP

$250,000 or more to fellowship endowment STUDENT FELLOWSHIP

$100,000 or more to fellowship endowment

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DISTRIBUTION BY FUND TYPE

____,____ Non-Capital Current Expense: 22% $3.25 million

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UCLA I PULBLIC HEALTH

NEWSLETTER

Spring 1997

Nonprofit Postage Paid

UCLA School of Public Health Box951772 Los Angeles, California 90095-1772 www.ph.ucla.edu Address Correction Requested