Public Health, Spring 1998

School Sampler Lessons from cows
New chair for Behav. Sciences & Health Educ.
Asthma and ozone
Project MARTIN
Controlling injuries
Campus food labeling program

Lessons from cows

In the Great Teacher Lecture, Bill Foege focused on the interrelationships in today's world and gave a wake-up call for action.

When Presidential Distinguished Professor of International Health William Foege took the podium in Cannon Chapel to address the Emory University community in the Great Teacher Lecture Series, who would have t hought that his subject would be cows? But Foege, an internationally known public health leader, is also well known for his humor and for finding analogies in unusual places--even the barn.

"When I was 10, and I showed visitors around my family's farm," Foege told the audience. He proudly showed them the Jersey cows, claiming they were better than Holsteins because they produced the highest quality milk. "That set the stage for my profess ional life," Foege said. "I was dead wrong because of course I was associating quality with a high fat content."

Foege's remarks, however, are misleading. He hasn't often been wrong. Rather, he's usually been found on the edge of a different approach that has taken some of public health's biggest assumptions and turned them on their ear--for example, his search a nd containment strategy that helped turn around the smallpox eradication effort and make it the first successful infectious disease to ever be completely wiped from the earth, and under budget and ahead of schedule.

On this night, Foege shared the observations gleaned from two decades at the forefront of his field. His first lesson focused on interdependence. "In the past, things happened in isolation," Foege said, "but now everything influences everything."

To demonstrate his point, Foege again turned to cows. He shared the discovery of Edward Jenner, a man who knew nothing about germs or immunity, but who had noticed in reading poetry that the complexions of milkmaids were often praised. The maids' skin lacked the pox scars that marred much of the population. Jenner extrapolated that the cowpox entered the milkmaids' bodies through sores on their hands, making them somehow immune to smallpox. He was right, and the cow even provided the vaccine itself, gi ving "public health its first tool," Foege said.

Foege also explored the recent interrelationship of three recent articles in the New York Times, which at first glance seemed unrelated. One reported an obscure environmental problem, that television sets, even when turned off, continue to draw five to ten watts of electricity, using in the United States alone some $1 billion of electricity a year. The second article Foege cited had to do with the continuing problem of global warming, and the third examined rift valley fever in Kenya, caus ed by a virus in the eggs of the mosquito, in turn caused by superfluous rains, in turn due to global warming. "So as you sit here tonight, even with your TV off, you are influencing death and disease in Kenya," Foege said.

The speaker acknowledged that ours is a complicated world, holding potential as well as pitfalls. "Your life expectancy has increased seven hours a day since the day you were born," Foege said, "and in those years, you have been able to do more."

However, oftentimes, "we gobble up resources," he said. "We provide the tools of violence and then are surprised when young people use them. Today, one-quarter of all mammals are threatened with extinction, one-third of all fish. More children die in w ar than soldiers, some 2 million since 1988."

What can be done? "We must promote action, not just words," said Foege. "The U.S. should have more answers than other countries because we have more resources." Foege advocated making views known to political representatives, "who can't change the futu re without us."

New chair for Behavioral Sciences and Health Education

DiClemente is well known for his research in HIV prevention.

Internationally known health psychologist Ralph J. DiClemente will join the school's faculty as Charles Howard Candler Professor and chair of the Department of Behavioral Sciences and Health Education in June .

Prior to coming to Emory, DiClemente was professor in the Department of Health Behavior at the University of Alabama School of Public Health, with joint appointments in the School of Medicine. While at Alabama, he also served as a professor in the Depa rtment of Psychology and Sociology, as co-director of Prevention Sciences in the Center for AIDS Research, and as a senior scientist in cancer control and prevention.

DiClemente believes the Department of Behavioral Sciences and Health Education is "poised on the brink of greatness. My role is to catalyze its vast resources and galvanize its energy to take it from a regional center of excellence to national prominen ce," he says.

"Emory represents an opportunity," DiClemente says, "to develop and create an environment which can produce health promotion interventions that make a significant impact on the public health of residents in Georgia, the Southeast, and the nation."

Well known for his research in the field of HIV prevention and health promotion, DiClemente's current focus is the development of interventions to prevent sexually transmitted diseases and HIV in adolescents and young women. "It is estimated that about half of new HIV infections will occur in persons younger than 25," he says. "We need to focus on this population and develop innovative prevention programs."

DiClemente received his PhD in health psychology from the University of California, San Francisco, and an MSPH from Harvard University. He has written more than 70 articles, eight books, some 40 book chapters, and serves on the editorial board of three journals.

Asthma and ozone

Epidemiologist Paige Tolbert has recently completed a study on the quantitative relationship between pollution and pediatric asthma.

A number of studies have suggested that air pollution exacerbates the symptoms of asthma, but epidemiologist Paige Tolbert wanted to know more about the quantitative relationship between pollution and pediatr ic asthma. As the principal investigator of a recently completed collaborative study, she's found some intriguing evidence.

Funded by the Electric Power Research Institute and the Southern Company, the study compared the relationship between the number of pediatric emergency room visits for asthma in eight major hospitals in Atlanta and ambient air quality during the summer s from 1993 to 1995. The study drew together many collaborators, including more than a dozen faculty and staff members from the Rollins School of Public Health, the Georgia Institute of Technology, and the Centers for Disease Control and Prevention (CDC).

Researchers from several of the School of Public Health's departments, including environmental and occupational health and biostatistics, were responsible for evaluating data on almost 129,000 pediatric emergency visits in the metropolitan Atlanta area during these three summers. Of these visits, approximately 5% were related to asthma. The eight hospitals participating in the study cover approximately 80% of the pediatric emergency care visits seen in Atlanta.

Researchers at Georgia Tech were responsible for evaluating the environmental components of the study. They collected air pollutant data, drawing the initial information from stations across Atlanta that monitor ozone. Using a variety of tools and stat istical models, researchers then came up with an estimate for exposure level that was based on zip codes and dates.

When the researchers assessed the relationship of the emergency visits for asthma to air quality variables (including ozone, particulate matter, nitrogen oxide, pollen, mold, and temperature), they found a positive association between asthma symptoms a nd air pollution. "We found clear evidence of exposure-response between air pollution indices and children's emergency visits for asthma," Tolbert says.

The research, soon to be published in several peer-reviewed journals, has a more "immediate public health use," according to Tolbert. The study findings contributed to the scientific basis for the EPA's recent revision of the national ambient air quali ty standards.

Legions of smiling, frowning, winking, and blinking masks bobbed above the Atlanta Arts Festival parade last fall, carried atop streamer-bedecked poles by young artists. These middle school children are pa rticipants of Project MARTIN (Mentoring Adolescents through Risk Reduction, Training, Insulation, and Nurturing), a substance use prevention initiative run by researchers at the Rollins School of Public Health. Project MARTIN students painted their masks under the expert direction of puppet masters working in conjunction with the Center for Puppetry Arts in Atlanta. This project is one of several ongoing collaborations between Project MARTIN and the puppetry center.

Controlling Injuries

The Center for Injury Control has been designated a Pan American Health Organization/World Health Organization Collaborating Center for Injury Epidemiology and Control. The center also received support from the Internationalization Fund of Emory University to provide consultation on injury prevention and control projects in Latin America.

All over the Emory campus, nutrition labels are popping up on foods from bagels to beans to roast beef sandwiches. That's due, in part, to the efforts of Susan Butler (far left), director of programs in th e school's Office of Health Promotion. The food labeling program, which Butler has been promoting in conjunction with Dobbs University Center, exemplifies just the type of collaboration she intends to foster throughout the Emory community.

A long-time runner and nutritionist, Butler practices what she promotes in health. She's even set up a web resource:

Spring 1998 Issue | Dean's Message | Asthma Zappers | Cyber Class | Go Girls & Eat for Life
Flagging Cancer | School Sampler | Philanthropy | Alumni Sampler

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