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UC's public health schools take the lead


By Alec Rosenberg

The H1N1 flu pandemic and Haiti earthquake highlight the life-saving role public health professionals play when a crisis hits. Whether preparing for an infectious disease outbreak or the next big earthquake, the University of California's two public health schools have been at the forefront of efforts to promote healthy communities, prevent disease and create a safer world.

The UC Berkeley and UCLA public health schools are working on some of California's biggest health issues: obesity, environmental health and disaster preparedness.

UC is also California's primary educator of public health graduate students. But California and the nation face a growing shortage of public health professionals, and the state's budget crisis has halted UC's plans to expand enrollment to meet the growing demand.

"We are turning away some of the most talented students," UCLA School of Public Health Dean Linda Rosenstock told UC Regents at a presentation Jan. 21.

UC's 2007 health work force report recommended more than doubling UC's master's and doctoral public health students to 2,600 by 2020 through expanding existing programs and planning to establish at least one new school. Professionals are needed to work in clinics, health departments, hospitals, universities, governments, non-governmental organizations, corporations and in policymaking and research settings.

"We cannot do it alone," said UC Berkeley School of Public Health Dean Stephen Shortell. "We're going to have to have additional schools in addition to expanding our current schools."

Such expansion is on hold for now, as state funding accounts for 11 percent of the public health school budget at UC Berkeley and 12 percent at UCLA. But the highly ranked schools continue to make an impact. From fighting obesity to making green chemistry breakthroughs to preparing for disasters, here is a look at some ways UC public health is making a difference.


Dr. Antronette Yancey has developed short workout routines to help people increase physical activity.

Obesity is, literally, a huge problem. More than 60 percent of adults and 30 percent of children in California and nationally are overweight or obese. The estimated cost to California for adult overweight, obesity and physical inactivity has nearly doubled in six years to $41 billion a year, according to the California Center for Public Health Advocacy.

UC public health schools are stepping up to the challenge. At UC Berkeley, the Dr. Robert C. and Veronica Atkins Center for Weight and Health conducted research that provided evidence for state policy to remove sodas from schools.

At UCLA, Dr. Antronette Yancey is tackling the obesity problem 10 minutes at a time. Yancey, a professor of health services, board-certified physician in preventive medicine and former college basketball player, has developed 10-minute routines of fun, simple, low-impact movements called Lift Offs! and Instant Recess!

"For somebody who is not very active, you could be doubling or tripling their activity," said Yancey, who co-directs the UCLA Kaiser Permanente Center for Health Equity. "The public health approach is not how to get a few people to do a lot; it's how you get a lot of people to do a little."

Her routines get people marching and moving, whether in the workplace or classroom. She tailors programs to appeal to all ages and ethnicities, using music from big band to gospel and incorporating African, Filipino and Latin dance. She has partnered with pro athletes such as football player Allen Rossum and teams such as the San Diego Padres and Los Angeles Sparks to help spread the message.

"We're interested in prevention," said Yancey, whose "Instant Recess" book will be published this fall by UC Press. "If you start early and you engage the majority of the population, then you can actually prevent heart attacks and strokes."

Yancey would like to see government funding for schools to implement exercise breaks. Also, she supports employer tax incentives for certain wellness programs. "It's not just altruism," she said. "These employees become more productive. Their health care costs go down. Their morale goes up."

Dr. Megan Schwarzman

Environmental health

Chemicals in industrial products and industrial processes pose another set of risks to public health. Despite their ubiquity, the health and environmental impacts of some 80,000 industrial chemicals used in the United States are largely unknown. Where good information exists, there is cause for concern: A recent UC Berkeley study authored by Kim Harley linked reduced fertility to flame-retardant chemicals commonly found in household consumer products such as foam furniture, electronics, carpets and plastics. "The concern is that findings like these may be just the tip of the iceberg," said Dr. Megan Schwarzman, a UC Berkeley research scientist.

In fact, chemical and pollution-related diseases among children and workers in California cost the state an estimated $2.6 billion, according to UC Berkeley and UCLA researchers.

Such concerns have led to action. Informed by the work of UC researchers, in 2007 the California Environmental Protection Agency launched an ambitious Green Chemistry Initiative, designed to spur the innovation of chemicals and products that are safer for human health and the environment.

Michael Wilson

One initiative goal is to prevent the unintended health consequences of chemical substitutions. UC Berkeley research scientist Michael Wilson studied auto mechanics disabled by a neurotoxic blend of hexane and acetone used as a brake cleaner. The product had been substituted for chlorinated solvents phased out for their contribution to dioxin pollution. The next reformulation was no better: Hexane was swapped out for bromopropane, known to cause sterility, Wilson said.

"The current approach to managing chemicals is akin to an emergency response system, which is not enough. You also need to have a prevention system in place," Wilson said.

That's starting. In 2008, following recommendations from California EPA's Green Chemistry Initiative, the Legislature passed two landmark bills to create an online toxic clearinghouse and accelerate the quest for safer products. These efforts were prompted by a 2006 green chemistry report authored by Wilson that the Legislature requested and a second report authored by Schwarzman, Wilson and UCLA colleagues, which outlined the case for transforming chemical management policies.

Chemistry education also is going green. In 2009, UC Berkeley established the Berkeley Center for Green Chemistry, a collaboration of the colleges of chemistry and natural resources and schools of business, law and public health, the first multidisciplinary approach to research, education and engagement in sustainable chemistry practice. The center, which recently received a $500,000 curriculum development award from the state, will train the next generation of synthetic chemists, chemical engineers, business leaders and policymakers to design products and make decisions that are better for the environment and human health.

At UCLA, a multidisciplinary team has established the UCLA Law and Environmental Health Initiative on Sustainable Technology to tackle key environmental sustainability issues from a policy perspective. Additionally, the School of Public Health plays a central role in a federally funded national effort to learn more about the implications of nanotechnology for the environment and human health.

Meanwhile, California's green chemistry laws are bolstering other states' efforts to address the issue and could lead to reform of the federal Toxic Substances Control Act, Wilson said. "There's opportunity for a whole new business approach," he said. "California has the potential to be way out in front on this."

Disaster preparedness

Dr. Arthur Reingold

Dr. Tomas Aragon

From the H1N1 flu pandemic to the Haiti earthquake, it has been a busy year for public health professionals who focus on disaster preparedness and emergency response.

The H1N1 vaccine "is safe as far as we can tell" and its effectiveness is being evaluated, said UC Berkeley Dr. Arthur Reingold, who co-directs the federally funded California Emerging Infections Program, a collaboration of local, state and federal partners. The program, which studies infections from influenza to meningitis, has developed preventive strategies against diseases such as food-borne illnesses and pneumonia. "As things come on the radar screen, we devote more attention to them," Reingold said.

The United States has invested in pandemic flu preparedness for several years. Still, there have been several surprises with H1N1, from its broad spread in our "backyard" before being detected to vaccine manufacturing delays, said Dr. Tomas Aragon, director of UC Berkeley's Center for Infectious Diseases and Emergency Readiness (CIDER), which does public health work force training and collaborates closely with the state Department of Public Health on pandemic flu planning for vaccination prioritization and implementation. "The novel H1N1 influenza A pandemic is testing our preparedness and response systems, which will lead to longer term improvements in our capabilities," Aragon said.

Kimberley Shoaf

CIDER and UCLA's Center for Public Health and Disasters each received federal funding this fall to conduct research to evaluate the structure, capabilities and performance of public health systems for preparedness and emergency response activities. Kimberley Shoaf, an associate professor-in-residence and assistant director of the UCLA center, said the tragedy in Haiti highlights the importance of responding quickly to an emergency with medical care, food and water.

It's also a reminder to prepare for California's next major quake. Shoaf designed the health and medical impacts of the 2008 Great Southern California ShakeOut exercise, which simulated a magnitude 7.8 quake. "I think it raised a whole lot of eyebrows to the length of time it would take us to recover from something of that magnitude," she said. "We need to look at preparedness at all levels — the individual, the family, the community."

And that preparedness needs to extend beyond the "magic 72 hours," she said. "It's not 72 hours. It's a week. We need to be prepared at home and at work." UCLA has a list of preparedness resources available at www.cphd.ucla.edu/resources.html.

Alec Rosenberg is the health communications coordinator in the UC Office of the President's Integrated Communications group. S TO YOUR SOCIAL BOOKMARKS


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