Public Health - In Brief



	Emory's global hub o become a world leader in public health education and research, the Rollins School of Public Health (RSPH) needs to increase its footprint on the Emory campus, according to the school’s recently released strategic plan. The leading public health schools of the 21st century must provide state-of-the-art physical and virtual education and research facilities. To answer that challenge, the RSPH has just completed a feasibility study to define potential construction adjacent to its current space in the Grace Crum Rollins Building. The proposed building is envisioned as the hub of global health at Emory. The new facility will enhance teaching and collaborative research at Emory among infectious diseases, nutrition, cancer, chronic diseases, and other areas. Additionally, conference capabilities will speed up the development of specialized training, individualized distance-learning modules, and professional exchange programs that will help spread public health solutions around the globe. The school’s goal is to extend its reach well beyond the boundaries of the new physical walls and deliver information and resources to where they are needed—whether locally, nationally, or globally. The new building also will serve as a destination for strengthening and enhancing collaboration with the school’s Atlanta-based public health partners, such as CDC, CARE, The Carter Center, the American Cancer Society, the Georgia Division of Public Health, the DeKalb County Board of Health, and Rotary Club of Atlanta, among others. Within five years, the RSPH estimates the need for an additional 150,000 square feet to accommodate a growing faculty, greatly expanded research programs, and new doctoral students. The new building will allow the consolidation of public health activities now spread out in the School of Nursing building, the 1525 building, the Dental building, the Briarcliff campus, and three additional locations. Plans for the new building call for a mixed-use facility with more laboratory space, classrooms, offices, conference facilities, and an auditorium. Open meetings for faculty, staff, and students will take place throughout the fall to gather a design wish-list from throughout the RSPH community.


	Bookshelf: recent faculty works Urban sprawl and public health: Designing, Planning, and Building for Healthy Communities. By Howard Frumkin, Lawrence Frank, and Richard Jackson. Island Press, 2004. Urban sprawl is taking a toll on Americans’ health, says Howard Frumkin, recently appointed director of CDC’s National Center for Environmental Health (NCEH) and an adjunct professor at the Rollins School of Public Health (RSPH). Frumkin lives what he believes. He has a home near his office so he can bike to work, and his son rides a bicycle to school. When the Frumkins need to travel somewhere a bike can’t take them, they drive a hybrid car. When running errands, they do what they call “trip stacking,” or combining multiple errands in one outing. Frumkin has joined with two of the nation’s leading public health and urban planning experts to present Urban Sprawl and Public Health. The book is a resource for health care professionals, environmentalists, architects, city planners, transportation engineers, developers, and students in these fields as well as members of zoning boards and the general public. “The places we live, work, and play affect our health,” Frumkin says. “We have choices in the way we design our environment, and those choices matter a great deal to those who care about health.” Urban Sprawl and Public Health makes a case for smart growth as a public health strategy. By placing homes, work places, stores, and other land uses near each other, compact communities offer alternatives to the automobile for getting from place to place. These communities encourage physical activity, contribute to clean air, improve personal safety, and promote social interactions, in turn leading to healthier hearts and lungs, a cleaner environment, and even better psychological health. After all, as Frumkin says, “You’ve heard of road rage, but you’ve never heard of sidewalk rage.” Urban Sprawl and Public Health discusses alternate approaches to design, land use, and transportation, and it outlines the complex challenges of developing policies that promote and protect public health. Frumkin’s collaborators are Lawrence Frank, Bombardier Chair in Sustainable Transportation Systems at the University of British Columbia, and Richard Jackson, former director of the NCEH and currently the state public health officer for California. Frumkin himself is a member of the Clean Air Campaign, the Institute of Medicine’s Roundtable on Environmental Health Sciences, and the Board of Physicians for Social Responsibility. From 1995 to 2005, he was professor and chair of RSPH’s Department of Environmental and Occupational Health. Scaling Up Treatment for the Global AIDS Pandemic. Edited by James Curran, Haile Debas, Monisha Arya, Patrick Kelley, Stacey Knobler, and Leslie Pray. National Academies Press, 2005. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected people live in the poorest regions. The largely unchecked pace of infection and its impact on the social, political, and economic dimensions of individuals and communities continue to undermine the development of entire countries and regions. This book is an independent review and assessment of rapid scale-up ART programs by an Institute of Medicine committee, including identification of the components of effective implementation programs. The report recommends that ART scale-up in resource-constrained settings worldwide must proceed immediately to extend the duration of as many lives as possible and to reverse the course of social collapse in many countries heavily afflicted by HIV/AIDS. Chapters cover coordinating and sustaining the global response, developing and managing treatment, building a comprehensive infrastructure for scaling up, and monitoring and evaluating progress. “Recognizing the limited infrastructure, tools, knowledge, and personnel currently available in resource-constrained settings, it is clear that future efforts in the provision of ART will benefit from expanded investments and research,” write the authors. “Given the limited experience with large-scale ART programs in poor countries, the capturing of lessons learned from newly implemented programs will be essential to informing the direction and priorities that will ensure long-term sustainability, quality, and success. Gaps in knowledge still inhibit our efforts to prevent, diagnose, and treat HIV/AIDS more effectively. Such discoveries will ultimately facilitate not only more cost-effective care, but also the saving of millions of lives.” Preventing Childhood Obesity: Health in the Balance. Edited by Jeffrey Koplan, Catharyn Liverman, and Vivica Kraak. National Academies Press, 2004. Reversing the rapid rise in obesity among American children and youth will require a multi-pronged approach by schools, families, communities, industry, and government that would be as comprehensive and ambitious as national anti-smoking efforts, according to this book published by the Institute of Medicine. While no single intervention or group acting alone can stop the epidemic of childhood obesity, the steps recommended by the committee that prepared this report all aim to increase and improve opportunities for children to engage in physical activity and eat a healthy diet. Among specific steps recommended is a call for schools to implement nutritional standards for all foods and beverages served on school grounds, including those from vending machines. The report also recommends that schools expand opportunities for all students to engage in at least 30 minutes of moderate to vigorous physical activity each day. Food, beverage, and entertainment industries must also do their part to voluntarily develop and implement guidelines for advertising and marketing directed at children and youth. The authors recommend that restaurants continue to expand their offerings of nutritious foods and drinks and provide calorie content and other nutritional information as well. The book calls on parents to provide healthy foods in the home and to encourage physical activity by limiting children’s recreational TV, video game, and computer time to less than two hours a day. Emerging Illnesses and Society: Negotiating the Public Health Agenda. Edited by Randall Packard, Peter Brown, Ruth Berkelman, and Howard Frumkin, Johns Hopkins University Press, 2004. From 1998 to 2000, the Center for the Study of Health, Culture, and Society at Emory organized interdisciplinary faculty seminars to explore three themes: emerging illness and communities of suffering; environmental hazards, community activism, and the public health; and emerging illnesses and institutional responses. This volume presents case studies from those seminars, which brought together historians, sociologists, and anthropologists with physicians, public health researchers, practitioners, policy analysts, and community activists. The introductory essay analyzes broad social processes through which emerging illnesses gain or fail to gain a place on public health agendas. “Making Illnesses Visible” examines the efforts of illness support groups and organizations to gain public health recognition for specific health problems such as multiple sclerosis and Tourette syndrome. A second section focuses on how and why the institutions of public health and medicine respond to different types of emerging illnesses. It includes essays on the cultural politics surrounding tuberculosis epidemics in New York City and Lima, Peru; emerging infections and the CDC response; and hepatitis C and the news media, among others.


	National Academy of Sciences medalist IN MAY, the National Academy of Sciences (NAS) awarded Presidential Distinguished Professor of International Health Emeritus William Foege the Public Welfare Medal, the most prestigious award presented by the NAS. Established in 1914, the medal is presented annually to honor extraordinary use of science for the public good. The academy chose Foege for his dedication to eradicating global disease and his leadership in redefining the scope of public health policy in the United States. “In terms of lives saved and freed from disease, Dr. Foege has changed the world as we know it,” says John Brauman, home secretary of the NAS and chair of the selection committee, who presented the award at the academy’s annual meeting.


	Linkage award for SORT THE STUDENT OUTREACH and Response Team (SORT) took second place in the annual 2005 Linkage Awards. Presented annually by the Council on Linkages Between Academia and Public Health Practice, the awards recognize exemplary community-based collaborative activities between public health practice agencies and academic institutions. The Center for Public Health Preparedness and Research at the Rollins School of Public Health and the DeKalb County Board of Health developed SORT to help bridge the gap between classroom theories and the realities of public health practice. It is designed for students to gain a better understanding of how local public health works at a community level and to interest more students in pursuing a career in local public health. “Local and state public health departments have a great need for students trained in public health, and we’re hopeful that the SORT experience in DeKalb will be used as a model for other local public health departments,” says center director Ruth Berkelman. During the past year, SORT students have participated in an outbreak investigation involving a student with active TB at a DeKalb County high school, an investigation of food-borne illnesses, and administration of community-wide influenza vaccination clinics. Since its pilot year in 2002, the program has expanded from 15 students primarily in epidemiology to 30 students from departments across the school.


	Institute of Medicine honorees EPIDEMIOLOGIST Ruth Berkelman was elected to the Institute of Medicine’s recent class of leading national health scientists. Joining Berkelman in achieving this highest honor are Rollins School of Public Health adjunct faculty members Julie Gerberding, director of CDC, and James Marks, senior vice president and director of the Health Group of the Robert Wood Johnson Foundation. RSPH representation in the IOM is strong, including faculty James Curran, Godfrey Oakley, and Reynaldo Martorell; jointly appointed faculty James Hughes, Michael M.E. Johns, Arthur Kellermann, Jeffrey Koplan, Marla Salmon, and Rick Martinez; adjunct faculty Claire Broome, Roger Glass, Jaime Sepulveda, Don Hopkins, and Mark Rosenberg; and emeritus faculty William Foege.



	The sizable costs of supersizing IN A FAST FOOD NATION where supersize is a common verb and the search is on for a carb-free cure-all for the country’s expanding girth, one thing is for sure. As Americans add pounds and inches, the costs are making a dent in both health and the wallet. Rising obesity rates alone account for 27% of the growth in health spending from 1987 to 2001, according to a study by health policy researchers at the Rollins School of Public Health. “The impact of weight on per capita spending is sizable,” says Kenneth Thorpe, professor and chair of the Department of Health Policy and Management who led the study. “Although we attributed the growth in health care spending to three of the major conditions (diabetes, hyperlipidemia, and heart disease), spending is also affected by the rising prevalence of gallstones, some forms of cancer, and other obesity-linked diseases.” Published in Health Affairs (October 20, 2004), the research examined the contribution of obesity-related factors to the growth in spending for three conditions clinically linked to obesity. During the 14-year period, when the prevalence of obesity increased to almost 24% of the population, the obesity trend accounted for more than 38% of diabetes spending growth, 22% of spending growth for hyperlipidemia, and 41% for heart disease. When comparing health care spending between obese and normal weight categories in 1987, the researchers found that the estimated per capita health care spending in 1987 (based on 2001 dollars) was $2,188 overall, with obese people spending 15.2% more per capita than people of normal weight. The year 2001 brought larger differences in health care spending by weight category. Spending among the obese shot to 37% higher than among those with normal weight.



	The spirit of Jefferson RICHARD LEVINSON (right) received Emory’s most prestigious honor at Commencement 2005, the Thomas Jefferson award. Each year at commencement, the award is given to an administrator or faculty member for significant service in the areas of teaching, scholarship, University advancement, community service, and work with students. Levinson is the Charles Howard Candler Professor and executive associate dean of the Rollins School of Public Health (RSPH). He began his Emory career as a sociologist in Emory College in 1972. With a lifelong interest in health issues, he joined a group interested in biomedical ethics. This group led him to join the School of Medicine’s preventive medicine faculty in 1978, a program that grew to offer a master’s in community health. When the RSPH was founded in 1990, Levinson’s broad range of experiences at the University helped him build bridges to the new school. Throughout his career, he has served on dissertation committees for graduate students, taught undergraduate classes abroad in England, and helped create a dual-degree program that combines an MPH with a master’s degree in mathematics. Most recently, he put the finishing touches on two new PhD programs at the RSPH in behavioral sciences and health education and health services research and health policy. Although only 15 years old, the RSPH has four faculty members who have garnered the Thomas Jefferson award: Eugene Gangarosa (1991), Donna Brogan (1993), and John Boring (1996).