UCLA School of Public Health Newsletter - Fall 1998

UCLA

SCHOOL OF

PUBLIC HEALTH

NEWSLETTER

EXTRAMURAL FUNDS AWARDED

PRIVATE FUNDS RAISED

Over a four-year period, the amount of contract and grant funding awarded to the school has risen 58%.

In each of the last four years, the school has established new records in amount of private support from foundations, corporations and ind ividuals, with a 360% increase since 1994-95.

1997-98

1994-95

1994-95

STATE OF THE SCHOOL: SELF-STUDY DOCUMENTS UNPRECEDENTED GROWTH

E

XTRAMURAL RESEARCH FUNDING IS UP SHARPLY. PRIVATE FINANCIAL SUPPORT CONTINUES TO REACH RECORD LEVELS. DEMAND FOR ENTRY

INTO THE SCHOOL'S PROGRAMS HAS NEVER BEEN HIGHER. NEW CEN-

TERS HAVE FORMED. NEW OUTREACH PROGRAMS HAVE ENABLED THE SCHOOL TO EDUCATE PUBLIC HEALTH LEADERS, PROVIDE TECHNICAL ASSISTANCE IN THE COMMUNITY, AND ENSURE VALUABLE FIELD EXPERIENCES FOR ITS STUDENTS.

BY ANY MEASURE, THE UCLA SCHOOL OF PUBLIC HEALTH IS THRMNG. THE SELF-STUDY REPORT, RECENTLY PREPARED FOR THE COUNCIL ON EDUCATION IN PUBLIC HEALTH (CEPH) AS PART OF THE ACCREDITATION PROCESS, SAYS WITH DATA WHAT STUDENTS, STAFF AND FACULTY HAVE WITNESSED WITH THEIR OWN EYES: A DRAMATIC SURGE IN THE SCHOOL'S STANDING AS A LEADER IN PUBLIC HEALTH RESEARCH , EDUCATION, AND SERVICE. continued on page 4

IN THIS ISSUE ...

2 NEWS Leading Foundation Presidents on the Future of Public Health Philanthropy

7 STUDENTS Profiles of Two Community Activists Pursuing Doctoral Degrees

8 FACULTY A Close-up Look at Three Centers

10 FRIENDS Gift Supports Research on Family Planning for Latina Teens ...Katzin To Co-Chair Fund-Raising Effort ...

Campaign UCLA Update

11 ALUMNI Dr. Kenneth Kizer... Angela Oh

SPECIAL REPORT:

W

FouR FouNDATION PRESIDENTS or

hat are the best strategies for improving the health status ofAmerU:ans, and how can philanthropic organizations maximize their grant dollars toward that end?

The presidents offour major health foundations addressed these and other questions last April at the 24th Annual Lester Breslow Distinguished Lecture, sponsored by the UCLA School of Public Health Alumni Association. Fallowing are excerpts from their remarks:

DEAN'S MESSAGE

DR.

Like any biostatistician, I have a special appreciation for numbers.

Perhaps that's why the dramatic growth of our school, as documented in our recent self-study (conducted for the Council on Education in Public Health as part of the accreditation process), has such resonance for me. From my vantage point as dean, none of the resu Its - from the surge in research activity and private fundraising to the high marks for student satisfaction and the growth in community-based education, research and service programs should have come as a surprise.

Still, seeing the data in unison can be quite powerful, whether you're a numbers person or not.

As this issue's cover story illustrates, we have taken big strides since our last self-study in 1991.

We have met - and in most cases, surpassed - virtually every standard by which we measure our success. There is always room for improvement, and in the course of our review we have identified several areas to be addressed. But while we look forward to a better tomorrow for our school and the society whose health we are seeking to promote, we are proud of the remarkable contributions the UCLA School of Public Health familystu dents, faculty, alumni and friends - are making today.

Robert Wood]ohnsonFourukttion

Abdelmonem A. Afifi, Ph.D.

STEVEN

A.

might be the most important way to improve health. But is this where health agencies should venture? I think that health organizations need to forge new partnerships with social service agencies and private organizations.

Health in the next century will depend on the actions of many people in many sectors who are ready to transform what we've learned from pioneers like Lester Breslow into innovative approaches to truly improve the health status of our nation.

SCHROEDER

Certainly the investments in health care and medical research have brought enormous health dividends in this country. But the fact is that an individual's health status is determined not just- and probably not even primarilyby health care. Improving the health of Americans in the next quarter-century will require balancing our infatuation with medical care with an expanded commitment to addressing the other determinants of health: biology and genetics; the environment, both social and physical; and behavioral and lifestyle issues.

We know that the causes of much of the premature mortality that we see in this country are not susceptible to changes in the health care system. We also know that those with higher incomes and more education live longer and healthier. These differences, the source of them, and their implications for policy-makers may be where the real gain in health status lies.

Social interventions that can improve health are still not comfortably within the health infrastructure. Let me speak from my perspective as president of a large health foundation. Our mission is to improve health and health care for all people living in this country. Our mission is not to reduce poverty or to increase employment or to improve the various social ills that so feature life in the United States. And yet we're constantly wrestling with where are the boundaries, because we recognize that expanding education or employment, or reducing income disparities,

Foundation presidents speaking at the school (I. tor.): Schroeder, Smith, Uranga-McKane and Yates.

DR.

MARK SMITH

The California HealthCare Fourukttion

In epidemiology, they taught me to be a lumper.

In business school they taught me to be a splitter.

Most of us in public health have a bad connotation when we hear "marketing." But too often I hear us talk about "what poor people need." Or, "the kind of services that AIDS patients want."

The notion that one will address global public health problems only by the lumping approach is faulty. Those of us in public health tend to make statements like, "Violence is a public health problem," by which we mean, " The police have failed; now let us take over." We ought to be taking a more humble approach, trying to contribute our own disciplines to a unified field theory of violence, tobacco reduction, and the many other problems that we face.

One of the barriers [to adoption of public health principles] is that the behavioral sciences have not nearly as long a history or scientific grounding as the biological sciences, and so we find ourselves in a disadvantaged competitive position in this struggle between the curative and the preventive. In addition, many people in society have experience with the issues with which we 're dealing, and feel entitled to have an opinion, scientific or not. The third barrier, of course, is that there's a lot of money in cure, and little in prevention. So the question is how to harness the motivation of the market to work with us, rather than against us.

Managed care [marks] the first time in the

THE FUTURE OF PUBLIC HEALTH PHILANTHROPY history of the health care industry that someone actually has an economic motivation to do prevention. We've got to figure out how to harness the market mechanisms to test, analyze, report and judge managed care plans, doctors, hospitals, and others on their abilities to do these hard preventive tasks. It at least provides the organizational capacity to do so in a way that the medical care industry never could.

DR. STEVEN URANGA-MCK ANE The California Endowment We must recognize that the current paradigm of health care is too narrow and too exclusive.

It neglects the social and behavioral aspects of health, and focuses almost exclusively on structures of health delivery systems. With a new emphasis on health outcomes, the critical questions are at least these two: What actions beyond medical intervention will result in improved health? And, What added resources are needed to support these actions?

At The California Endowment we've shifted our thinking from a classic philanthropic model of just doing good to a new model focused on achieving meaningful, longlasting change. We believe that our efforts should promote an environment where each person has a sense of self-worth and responsibility for self, family, community and societal well being; where diversity and inclusivity are deemed essential for inuovation and creativity; where communities are recognized for their assets and power to articulate issues and to design and implement solutions; where partnerships and collaboration are considered essential for sustained societal changes.

To make the most of our assets, it's vital that we find new ways to leverage our resources. We must be strategic in our approach. Our progrannning priorities will combine the elements of improving access to care for underserved populations, promoting the health and well being of all Californians, and community building with a commitment to multicultural health.

G ARY Y ATES

The California Wellness Foundation

UCLA

I PLlBLIC HEALT H NEWSLETTER

Our mission is to improve the health of people VOLUME 18, N UM BER 3 in California by making grants for health proFALL 1998 motion, wellness education, and disease preALBERT CARNESALE , Ph.D. vention. We have pursued that mission aggresClwricellor sively. When you begin to move into areas that ABDELMONEMA. AFIFI , Ph.D. address some of the broad social, psychological Dean and physical determinants of health, you open yourself up for criticism. [But] that doesn't SAVE THE DATE: stop us from doing what The 25th Lester Breslow Distinguished Lecwe think is right.

3 ture, to be held Jan. 21, will feature Dr. David When we first anNEWS Satcher, U.S. Surgeon General and Assisnounced [the foundatant Secretary for Health, as the speaker. tion's violence prevention initiative], there were a lot of people who wanted to know what a health foundation was doing in violence prevenEDITORIAL BOARD tion. Violence remains the leading cause of death ABDELMONEMA. AFIFI , Ph .D. of young people in this state. If we identified a Dea 11 bacteria or virus that was killing more kids in JUDITH M. SIEGEL, Ph.D .

California than any other single cause, there 1lsso<:iate D emi for Academic Programs would be a rallying cry to do something about it, MICHAELS. GOLDSTEIN , Ph .D. Associu.te Dean f or Student Affair s and this issue needed that type of rallying cry.

V. GALE WINTING Not only did [the foundation board] take that Associate Dean/or A dministration step, they identified the agent that was killing all JOHN D. MILLER Assistant Dean for Externa l Affairs those young people. They took on the public MARJORIE KAGAWA-SINGER, policy issue of gun control in California, which R.N. , Ph.D. Assistant Professor, we don't often think about in health terms.

Community Health Sciences There was a ballot measure that would have CORINNE PEEK-ASA. Ph.D. Adjw1l Assistant Prof essot; Epidemiology changed tobacco laws dramatically in CaliforJOYCE A. PAGE , M.S .P.I-1. , J .D. nia, would have weakened them tremendously.

Alumni flssociati.on Presiclent We had decided to do a poll about tobacco JONATHAN KEI President , issues in the state and we got feedback that Public Health Stuclents Associcttion people were very confused by the initiative WARREN ROBAK Public lufornmtio11 Representative language and in fact thought it would strengthen the tobacco laws. If that ballot measure passed, the cost to the State of California in increased DAN GORDON Eclito r and Writer health care costs would be at least $100 million MARTHA WIDMANN a year. We decided to do a $4 million public eduA.rt Director cation campaign on that ballot measure. And the measure lost, 70%-30%. Every year, that Photog raphy: ASUCLA (pp. 2-3); Yvette Rommi $4 million is saving the state $100 million in (pp. 4-6; Pitkitt, p. 7; pp. 8-9 ; Upchurch , p . .lO; p. 12). health care costs.

School of Public Health Horne Page: www.ph.ucla.edu E-mail for Application Requests : app-request@admin .ph. ucla .edu

UCLA Public Health is published by the UC LA S c hoo l of Public H ealth for the a lumn i, facult y, students, s taff and fri end s o f tlw sc h oo l.

Copyriglit 1998 hy Th e R egents of th e U ni ve r sity of California. P e rmi ss io n to r e prin t a n y portion of UCLA Public Health mu s t h e o btained from the (-'dito r. Contac t Editor. UC LA Public H ealth , Box 951 772. Los An ge les , C A 90095-1 772. (310)825-6381.

In the 1996-97 academic year, 173 students, or 2 9o/o, · were employed in a research capacity on a project funded through the school.

in strengthening or creating revenue streams to augment the state funds ," Siegel explains. As for the future: "Chancellor Albert Carnesale has an understanding and sensitivity to public health issues and a commitment to preserving an eminent school of public health on the UCLA campus."

4

F

COVER STORY continuedJi"om page 1

THE SELF-STUDY REPORT

"In the years since the last CEPH review, we have gained momentum to the point where we are clearly stronger," says Dr. Judith Siegel, the school's associate dean for academic programs , who headed the self-study. .

Siegel points out that reductions in state funding , along with state and national economic conditions, prompted the school to place greater emphasis on extramural research funding, private support, and generating new funding sources. "We have been very successful

ollowing its last self-study in 1991, the school's administration , headed by Dean Abdelmonem A. Afifi, had resolved to respond better to the needs of the community, and to solidify its relationships with the individuals and organizations in public h ealth practice. Siegel notes that both objectives have been achieved, in ways that have generated revenue for the school in the process.

The Office of Public Health Practice, founded in 1993, has established links between the school and state and local health d epartments, grounding faculty and students alike in the everyday activities performe d b y public

FOURTEEN PERCENT OF THE SCHOOL'S COURSES ARE LISTED IN MULTIPLE DEPARTMENTS; CAMPUS UNITS; AND

16 FACULTY WITH PRIMARY APPOINTMENTS I N

··• 87o/o of

A NOTHER UNIT A LSO H AV E AN APPOINTME

u t· took part r~ in one of the foll wing three aspects ofprofessional service in t e fltsl three years: tion on National Institutes of Health review panels or similar activities (3lo/o overall); expert testimony (20% ); and consulting ( 67%). k

10 SCHOOL F

h e alth professionals. The Technical Assistance Group, a faculty con sultant coalition founded in 1995 , provides assistance to governmental and nongovernmental h ealth and welfare agencies in the areas of program planning, implementation and monitoring, and in information systems a nd evaluation.

Meanwhile, the school 's interdepartm ental International H ealth Committee has b een actively engaged in initiating and expanding partn e r ship s in international settings.

At a time when at least three-fourths of California 's public health professionals do not have a public health d egr ee, the school ha s initia t ed two new executive-style M.P.H. programs for h ealth professionals as well as an M.P.H. in Public Health Nutrition for registered dietitians, and certificate

In 1996, 50o/o of the school's students were non-white, and 64% of the school's students were female. Fifteen percent of the school's students were international. programs administered jointly with UCLA Extension. Moreover, the school has become actively engaged in developing the infrastructure to support distance learning for health and public health professionals in local, state, national, and international settings.

"This will expand the geographic reach of our continuing education efforts," Siegel says.

Mindful of the collaborative nature of the public health field, the school has added to an already extensive reper-

JLTY HAVE JOINT APPOINTMENTS WITH N PUBLIC HEALTH.

toire of interdisciplinary teaching and research programs. The number of research centers based in the school has grown from five at the time of the last self-study to nine today; each includes faculty participants from multiple departments within the school, faculty from other departments and schools on the UCLA and neighboring campuses, elected or appointed community leaders, and service providers. New and continuing interdisciplinary teaching activities include the interdepartmental International Health Committee and Environmental Science and Engineering Program, and nearly a dozen cooperative degree programs with units throughout the campus.

In the previous self-study and subsequent student and alumni surveys, job placement services for graduating

5 COVER STORY

students had been identified as an area needing improvement. That perceived shortcoming has been addressed by the establishment in 1996 of the Health Career Resource Center (HCRC). The HCRC serves as a centralized location for job announcements and for networking efforts, and offers students and alumni assistance in exploring career pos sibilities, developing skills neces sary for a successful job search, and obtaining employment and intern ship leads. "This center has resulted in a significant OTHER increase in student satis faction with available job placement activities," says Siegel. The HCRC also pro. 1al v.ides applicati.on - process_ing as- 1 nericlt/1. ¡!/}~/ [!J: s1stance, retent10n counselrng and / 1 publi( tutorial support, and student mentorl~ ing programs.

1

W

"

hile the self8% more s tud y gives Faculty publ' . - v â&#x20AC;˘ the schoo l articles in j ournals high marks over all, several prob - in than in lem areas were identified. The and published nearly five times student-to -faculty as many books. ratio - approximately 8.5 to 1 is higher than desirable, a shortcoming that is being addressed in part by adding faculty who are partially or fully supported by extramural resources. Both the amount of available space and the quality of the

pe~ieviewed

1996-97

1994-95,

HOW ACCREDITATION WORKS What is the Council on Education in Public Health (C EPH), and how does it hold schools of public health accountable?

The CE PH is a 10-member board made up

Students are significantly more satisfied with 14 of 15 aspec s of the school~ advising ---~;;;;;> and counseling services

_,; . . .

than they were in 1989, ac cording to a comparison of exit surveys .

6 COVER STORY

of public health academics and practitioners, as we ll as represe ntatives of the community at large. The American Public Health Association and the Association of Schools of Public Health, as the CEPH's corporate sponsors , appoint the board members (one of whom is Dr. Abdelmonem A. Afifi, dean of the UCLA School of Public Health).

Schoo ls go in g through the accreditation process undertake a self-evaluation and prepare a report for the CEPH . Once the report

school's laboratory facilities are also causes for concern, according to Siegel.

Although new facilities are expected to be available within the next decade (this is one of the goals of the school's current Campaign UCLA fund-raising effort), short-term solutions are being weighed for the interim. Siegel also notes that the number of applications and proportion of students accepting the school's offers of admissions have remained steady.

The school has given increased attention to its need to emphasize to campus administrators and other faculty the centrality of public health to UCLA's academic mission. Afifi and a number of the school's faculty and staff have given considerable time to campus-wide leadership and service opportunities. As an example, Afifi just completed a three-year term as chair of the Council of Professional School Deans.

Last year, new chancellor Carnesale

MORE THAN

90°/o OF STUDENTS OVER THE

is subm itted, council representatives conduct a site visi t at which they meet with administrat ors, faculty , students, alumni and community representatives . Schools are evaluated based both on universal criteria and on their own stated mission, goals and objectives. Twenty-eight schools are currently accredited. (In addition to accrediting schools of pub lic healt h, the CEPH accredits commu nity-h ealth preventive medicine programs and community-health education programs.)

All accredi ted schools of public health must offer a curriculum that encompasses ttle fi ve core areas of public health knowledge, defined by the CEPH as epidemiology, bios tat istics, social behavioral sciences , health services and environmental health sciences. Th e accreditation criteria are revisited every fi ve years, with all constituents hav-

LAST THREE YEARS EVALUATED THEIR FIELD EXPERIENCES

AS "GOOD" OR "EXCELLENT."

reappointed Afifi to a third five-year term as dean, with a letter indicating a strong commitment to the school and its future well-being.

"Today we enjoy unprecedented support on our campus," Siegel contends. "And our support in the community also continues to grow. Our current and future successes should dispel any doubt about our strength."

ing the opportunity to make suggestions to be considered by the council.

"The accredi tation process ensures that there's a certain level of quality control in graduate public health ed ucation, and that the practitio ners comi ng out of these programs have a certain level of knowledge and expertise," says CEPHaccreditation specialist Laura Rasar.

ASSURING HEALTHY CONDITIONS WITH A RELIGIOUS PASSION

A

t first, Kathryn Pitkin jokingly refers to her role within the Episcopal Church - where the UCLA School of Public Health doctoral student was recently ordained as a deacon - as "another life I have."

Pitkin (M.P.H. '92), a Ph.D. candidate in the school's Department of Health Services, has amassed impressive credentials in her "public health life": more than 10 years experience in community health promotion; six years working with indigenous populations in Ecuador, originally as a Fulbright Scholar in public health; and coordinator of a large study examining the effects of low literacy and language barriers on health care delivery.

Her decision to become a member of the clergy, she says, was in fact not unrelated to these activities.

"A lot of people in public health tend to see the religious community more as an obstacle than an ally in achieving

Doctoral Student Kathryn Pitkin , M.P.H . '92

certain goals," she notes. "My interest is in forming partnerships between these communities in which we can put aside some of the philosophical differences in an effort to achieve our common goal, which is the overall well being of the population."

In that vein , Pitkin is proje c t director of a National Cancer Institutefunded study at RAND designed to test the efficacy of church-based mammography promotion. She has also received financial support, from a communitybased internship fund established

by Robert and Marion Wilson , to help improve the cultural competenc y of chaplaincy services at King-Drew Medical Center.

Pitkin doesn't 7 rule out a return STUDENTS to Latin America, where she first learned that her heart lies in work that combines health education with community organizing and advocacy. At the same time, "I have found that there are many ways that I can apply my language and cultural skills working with underserved populations in this country - especially in a place as diverse as Los Angeles. "

RESEARCH IN - AND FOR - THE COMMUNITY has a master's degree in biology, was a laboratory technician at California State University, Los Angeles when, as she de scribes it, she decided "I want to see people."

She's seen people, all right. So many, in fact, that it's hard to know where to start.

Consider her research in the community Smith is project manager on a study of the acceptability of HIV home test kits for the Los Angeles Doctoral student Lisa Smith (M.P.H. '94) receives campus-wide County Department of award from UCLA Chancellor Albert Carnesale .

Health Services STD t a school that values its rela- Program; and of the Gonorrhea Comtionships with the community, munity Action Project for L.A. County doctoral student Lisa Smith and California State University, Long (M.P.H. '94) is a shining exam- Beach; she is a data analyst for the ple of the importance of public health HIV Mobile Van Testing Program at researchers working closely with the Charles R. Drew University of Medicine and Science; and she works with populations they're studying.

Smith, a Dr. P.H. student in the De- Dr. Linda Bourque at the school in expartment of Epidemiology who also amining the factors that affect people's

A

earthquake preparedness.

But Smith also finds time to serve as one of the school's leading recruiters, speaking about the virtues of a public health career to diverse community audiences and working, from 1995 until this year, as coordinator of the Graduate Record Examination Course for the school's Health Career Resource Center.

Smith's tireless efforts won her campus-wide recognition earlier this year, when she was the only UCLA student selected to receive a Fair and Open Academic Environment Award for 1997-98, given by the Academic Senate's Committee on Diversity and Equal Opportunity for contribution "beyond the call of duty" in furthering a fair, open and diverse academic environment at UCLA. "We're taught at this school to be leaders," says Smith. " That mean s not just looking at data and being glad that we have it, but taking the data back to the community and saying, ' This is what we found. How can we change the situation?' "

CENTER FOR OCCUPATIONAL AND ENVIRONMENTAL HEALTH

8 FACULTY

A n outbreak in the late 1970s of "occupational disease" - specifically, infertility among California workers exposed to the pesticide DBCP provided the spark that led to the establishment of UCLA's Center for Occupational and Environmental Health (COEH). "That alerted legislators and the public to the need for improved research and training on occupational disease prevention," says Dr. John Froines, COEH director.

In 1979, as a result of a legislative mandate, the University of California established occupational health centers in northern and southern California, with the latter center opening at UCLA in 1981 . COEH has evolved over the years, finally adopting its current title in 1990 - a recognition, says Froines, of the connections between occupational and environmental health issues, and the need for broadened research and training activities.

COEH faculty made major headlines recently with a study by Ors. Hal Morgenstern and Beate Ritz that found that workers exposed to radiation at Rocketdyne's nuclear power research facility had an increased risk of dying from two forms of cancer. And Froines, the center's director, is no stranger to policy-makers: He chairs the Scientific Review Panel of the California Air Resources Board, which recently declared diesel soot a cancer-causing pollutant. Froines is currently preparing a major report mandated by the California Legislature on the health effects of the gasoline additive MTBE. The work of other COEH researchers is equally compelling: • Dr. Michael Collins is performing studies to elucidate the mechanism of action of environmental agents that cause birth defects.

• Dr. Victor Liu is developing an automated task-based aerosol sampler to evaluate worker exposure to beryllium.

• Dr. Wendie Robbins is looking at the effects of occupational and environmental exposure on human germline DNA. • Dr. William Hinds is studying the physical and chemical properties of tobacco smoke.

In addition, the UCLA-Fogarty International Training and Research Program focuses on the development of projects related to environmental and occupational health in Mexico. Research currently underway includes an assessment of the effects of pesticides on the reproductive systems of men,·two studies of the health effects of arsenic in drinking water, development of an ergonomics program in Mexican maquiladora industry, and an examination of the health effects of exposure to chromium.

Part of the center's mission consists of working with the community to improve environmental and occupational health. In that regard, the Labor Occupational Safety and Health program, under the direction of Marianne Brown, conducts research and provides education , training, and outreach to workers and labor union members on workplace health and safety in Southern California. Extensive clinical services are available through the Occupational and Environmental Medicine Program , under the direction of Dr. Philip Harber.

These include toxicological evaluations, occupational respiratory disease assessment , agreed medical examinations (AMEs) and screening programs. Finally, continuing education is offered to occupational health professionals by the Southern California Education and Research Center, in collaboration with the UCLA School of Nursing and USC.

SOUTHERN CALIFORNIA INJURY PREVENTION RESEARCH CENTER

F or most people, the term "epidemic" conjures up images of infectious diseases. Similarly, "prevention" in the context of public health is often thought of in terms of staving off illness. A few statistics suggest that we should think otherwise.

Injuries are the leading cause of death from ages 1 to 44 in the United States. They are among the leading causes of morbidity and disability.

And they cost billions of dollars each year in medical expenses. Injuries are the leading contributor to premature years of life lost. And they are among the most preventable of adverse health outcomes.

"Rigorous study of injury patterns is the basis for prevention, clinical treatment, and successful rehabilitation," says Dr. Jess Kraus, director of the Southern California Injury Prevention Research Center. "The center's epidemiologic approach, which involves a methodology of systematically assessing multiple factors at the population level, is ideal to discover the causes of injury and to design evidence-based prevention programs."

The center was established to identify and understand patterns of Each year, approximately 300 natural disasters occur worldwide, ex- injury occurrence in high-risk populations and to control the incidence acting a human toll of approximately 250,000 lives. "Proper planning and consequences of these injuries. A wide range of injury types are for and response to mass-population emergencies requires expertise examined. Approaches include surveillance, risk-factor assessment, from wide-ranging fields," says Dr. Linda Bourque, co-director of the design and evaluation of prevention programs, injury control methodcenter with Dr. Steven Rottman. "Public health, in which bringing disci- ology, and training. plines together to address population-based health issues is a fundaIn its nine years, the center has already had an important impact in armental tenet, is an ideal venue for teaching, research and service de- eas such as evaluation of the California motorcycle helmet law; development of the first population-based traumatic brain injury surveillance signed to improve disaster preparedness and response."

The Center for Public Health and Disaster Relief was established last program; documentation of fatal and severe injuries from the North ridge earthquake; identiyear, and currently offers four courses focusing fication of gender on public health and disasters. "Selected Topics differences in the in Disaster Relief and Humanitarian Assistance" recovery from trauprovides an introduction to disaster public health. matic brain injury; "Program Planning in Community Disaster Preclassification of paredness" covers the planning, implementation homicide as a major and evaluation of disaster preparedness procause of workplace grams in the community. "Cooperative lnterafatality; and identifigency Management in Disasters" looks at how cation of predictors different agencies work together to mitigate the for workplace homihealth effects of disasters. "Post-Disaster Comcide. munity Health" examines the public health role in Ongoing studies a post-disaster community. A fifth course on disinclude a clinicalaster epidemiology will be available later in this based collaborative academic year. Courses are available to graduate SOUTHERN CALIFORNIA INJURY PREVENTION RESEARCH CENTER project with the students at UCLA and to non-enrolled students UCLA Brain Injury through UCLA Extension.

Research efforts are varied. Center faculty have been studying the ef- Research Center examining brain metabolism and long-term outcome fects of and response to California earthquakes for more than a decade. following traumatic brain injury; a community-based evaluation of the Current projects include examination of the impacts of the North ridge causes and effective preventive measures for reducing robbery-related quake on families with minor children in L.A. County, and ongoing re- workplace violence, in collaboration with the LAPD, Cal/OSHA, and search on estimating casualties in earthquakes, both in Northridge and many local community organizations; surveillance programs to enu(as was recently proposed) in Kobe, Japan. The center recently submit- merate injuries in school and special-education programs; a collaborated a report to the L.A. County Department of Health Services (which tive study with the lnstituto Nacional de Salud Publica in Mexico City on provided the center's initial funding) on the impact of the North ridge the prevalence and severity of partner abuse among pregnant women; quake, along with recommendations for planning for future disasters. and a collaborative project that offers interventions in the form of exerWith funding from the county, the center will host the UCLA Confer- cise programs and home safety visits to primarily Spanish-speaking ence on Public Health and Disasters, April 11-14, 1999. An anticipated seniors, aimed at preventing falls. attendance of 300 will come from the policy, practitioner, research and In the last year alone, the center's faculty and staff have collaborated academic communities. The program will include such topics as the with or provided training, prevention information, and/or technical aspublic health response to disasters, community disaster preparedness, sistance to nearly two dozen community-based organizations; local , and disasters and mental health, followed by smaller breakout sessions. national and international government agencies; and academic entities.

For more information, or to register for the conference, call (310) 794More information is available on the center's Web site: 6646 or visit the center's Web site at <http://www.ph.ucla.edu/cphdr>. <http://www.ph.ucla.edu/sciprc/sciprc3.htm>

The Sch Goa1· ool's

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GIFT SUPPORTS RESEARCH IN FAMILY PLANNING FOR LATINA TEENS

$14,ooo.ooo

$12 0

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Dr. Lester Breslow and Carolyn Katzin

10

Dr. Dawn Upchurch

FRIENDS

The Fred H. Bixby Foundation has awarded a major gift to a UCLA School of Public Health faculty member to support her research on family planning and reproductive health issues among Latina teens.

Dr. Dawn M. Upchurch, associate professor in the Department of Community Health Sciences, is using data from a representative sample of Los Angeles County teens to examine the dating, sexual, and fertility behaviors of Latina adolescents and characterize differences by family background, language abilities, ethnic identification and attachment, with an emphasis on immigration status. In addition, within the context of the project, training is provided for a Bixby Research Fellow, Michelle Doty, a doctoral student at the school.

"Latina teens represent an increasing segment of the adolescent population in Los Angeles," says Upchurch. "Better understanding the ways in which cultural factors may influence their reproductive behaviors, as well as their access to reproductive health services, is an important public health concern."

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CAROLYN KATZIN NAMED CO-CHAIR OF SCHOOL OF PUBLIC HEALTH'S FUNDRAISING CAMPAIGN Carolyn Katzin has joined Dr. Lester Breslow as co-chairs of the UCLA School of Public Health's $15 million fund-raising effort, part of Campaign UCLA. Katzin (M.S.P.H. '88, C.N.S.) is a nutritionist and health educator working in private practice in Santa Monica. She received her nutrition training at the University of London in her native Britain and earned her graduate degree in nutritional science from the UCLA School of Public Health.

Katzin, who specializes in nutrition and cancer, has been a consulting nutritionist and member of the professional advisory committee of The Wellness Community for the past 11 years. She is president-elect of the Coastal Cities Unit of the American Cancer Society and was recently appointed to serve on the UCLA Jonsson Cancer Center Foundation Board of Directors.

IN BRIEF

CAMPAIGN UCLA UPDATE

A

iming to raise $1.2 billion by June 30, 2002, Campaign UCLA was launched in May 1997 as the most ambitious private fund-raising effort in the history of public higher educ a t:i on. As part of the campaign, t he School of Public Health has set a goal of raising $15 million. Through August 31, 1998, the school was more than threefifths of the way to achieving that goal.

The official case statement for the UCLA School of Public Health's current fund-raising campaign is now available. Alumni and friends of the school are being [Ji mailed a copy of the publication; anyone who is interested in obtaining additional copies may contact John Miller, assistant dean for external affairs, at (310) 825-6464 or by e-mail: jmiller@support.ucla.edu

Robert J. Drabkin

Carolbeth Korn

Robert J. Drabkin, a member of the school's Dean's Advisory Board, has been elected to the Board of Governors of The UCLA Foundation.

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Dean's Advisory Board member Carol beth Korn has been elected to The UCLA Foundation's Board of Councillors.

VA TRANSFORMED: "IMPOSSIBLE" MISSION ACCOMPLIS HED

I KENNETH W. KIZER, M.D., M.P.H. '76

T

he Department of Veterans Affairs health-care system that Dr. Kenneth W. Kizer (M.D., M.P.H. '76) was appointed to oversee in 1994 was, by Kizer's own description, inefficient, cumbersome, and in danger of withering away as a result.

The VA's under secretary for health inherited a bureaucracy many viewed as deeply entrenched, and a powerful veterans lobby that was seen as a formidable barrier to change.

One publication , skeptical of Kizer's goal of re-engineering the nation's largest health care system , h eadlined its article "Mission Impossible."

But, to the surprise of most observers, the mission has b een largel y accomplished. In the last three years, under Kizer's leadership, the VA has transformed itself to a system focused on outpatient care, reducing the number of acute-care beds by more than 50 percent while earning high marks for quality of care. Once a symbol for bloated bureaucracy, the VA has come to represent a case study in radical organizational change.

"I think we've shown that , while there are certainly obstacles , government can change," Kizer asserts. " One of the things I feel best about is remov-

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ing the barriers that h ave h eld people ba ck. Funda m e ntally, people in the system want t o d o the r ight thing for patients, and a s leader s we n eed to find ways to liberate them so th at they can do their b est job."

Kizer, who we nt thro u gh UCLA's M.P.H. and M.D . program s simultaneously, has b een in the limelight before, having served a s d irect or of t he California Department of H ealth Services for more than six yea rs . By that time, th e form e r e m er ge n c y ph ys i c i a n 11 says h e had b e gun ALUMNI to shift away from a fo c us on treatin g individuals and toward the populationbased approach of public h ealth. " There's a sp ecial feeling of satisfaction from h e lpin g a particular person," Kizer says . " But I began to realiz e I c ould ha ve a m u ch greater impact taking care of a p opulation of several million p eople ."

TAKING THE INITIATIVE ON RACE There's no doubting Angela Oh's credentials as a community leader in Los Angeles - or, for that matter, national ly. Oh (M.P.H. '81 , J.D. ) cu rrently serves as an appointee of Los Angeles Mayor Richard Riordan to the City Human Relations Comm ission. She chairs the board of directo rs for the Korean American Fami ly Service Center in Los Angeles, is an advisory board member to Housing and Urban ANGELA OH , M.P.H. '81, J.D. Development Secretary An drew Cuomo's Community Builder Fellowship Program, and has been a visible speaker and author on a wide range of topics.

Oh, a second-generation Korean American, gained national attention after the 1992 civil unrest in Los Angeles when she emerged as a leading spokesperson expressing the views of first-generati on Korean American inner-city merchants. That year, she served as special counsel to the State Assembly's fact-finding mission on the factors leading to the April 1992 civil disaster. And in June 1997, she was appointed by President Clinton as the only Asian American on the seven-member advisory board to the President's Initiative on Race.

But what does all this have to do with public health? Everything, Oh contends. "We are living in one of the most diverse cities in the world," she says. "If public health is about assuring healthy conditions, that would certainly encompass positive relations among these commu nities, a better understanding of cultural differences, and expanding opportunities for traditionally underserved populations."

Given the career path she pursued, would Oh pursue an M. P.H. if she had the choice to make in hindsight? "Absolutely."

WHY PUBLIC HEALTH AT UCLA? Six newly enrolled students offer their rationale for choosing to enroll atthe school: JENNIFER AYRAN Program: M.P.H., Community Health Sciences I was accepted to four schools of public health, and UCLA was my top choice. The program was ranked nationally, and I also learned about the dual master's degree with the UCLA Asian-American Studies Program. I want eventually to work with underserved Asian and Pacific Islander communities, and Los Angeles has the largest AsianAmerican community in the nation, so I knew that it would be beneficial for me to be here.

SHAHEEN KASSIM¡LAKHA Program: Dr. P.H., Health Services Much has changed in the health care field since I completed my M.P.H. atUCLA in 1984. While I have attempted to stay current, I have reached a point where I would like to do this in a more formal and structured learning environment.

My goal is to contribute to community and social development through health policy research and health systems management. This program will make me better equipped to respond to the tremendous challenges confronting the modern health-service industry.

Program: D.Env., Environmental Health Sciences I worked for a state Department of Public Health for more than two years. The approach was very reactive to environmental problems, and I wanted to be part of a more integrative, proactive approach. The Environmental Science and Engineering Program is one of the only programs in the nation that takes that approach - integrating business, management and science into the study of environmental problems.

mJ

MARISEN RAMIREZ

SARIKA THAKUR Program: M.P.H., Biostatistics I chose UCLA because it's a great school- the name is known across the country, and the biostatistics program is one of the best as well. I just finished my master's in biology. In the process of pursuing that degree I had taken a statistics class and really enjoyed it, so I decided to shift gears. Of course, biostatistics is a field that's employable in many different areas, and this program seemed the most oriented toward using biostatistics in employment situations.

CHAD LEWIS

DAVID SOULELES Program: Dr.P.H., Health Services I entered public health originally because of my desire to be a better HIV/AIDS educator. I have my M.P.H. from UCLA and the education I received has proven valuable in my current position as a manager with the Long Beach Department of Health and Human Services. I decided to continue on to improve my knowledge base so that I will be a more attractive candidate for increasingly responsible and influential positions in public health.

UCLAI PULBLIC HEALTH

NEWSLETTER

Program: Ph.D., Epidemiology I just graduated from the UCLA M.P.H. program in epidemiology, and I 've been working for the Southern California Injury Prevention Research Center. I decided to go forward because of the opportunity to conduct meaningful research. I'm currently conducting a study of how safe the school environment is for disabled kids, and it's helped me realize that working in public health also means working with children in the community and being able to make a difference.

FALL 1998

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