gpph rounds - tufts university school of...

GPPH Rounds - Spring 2006 1

An Alum’s Experience in the Hurricane Katrina Rebuilding Efforts

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GPPH RoundsGraduate Programs in Public Health - Tufts University School of Medicine Spring 2006

Tambra Stevenson, MS-Health Communication ‘04

In late August 2005, the news focused on Hurricane Katrina in theSouthern Gulf coast of the United States. Along with many Ameri-cans, I saw the images of despair and hope. To me the eye of thestorm revealed the opportunity for people to respond to thecall toimprove the living and health conditions for all, especially in therural and Southern U.S.

I wondered how and when an opportunity would arise, so that Icould make an ‘everyday’ difference in people’s lives. While I strivedto be in my current position at the U.S. Department of Health andHuman Services (HHS) in Washington, DC working on nationalhealth policy issues, I yearned to take a break and connect locallywith the people affected by our policies. Also by being buried un-der layers of bureaucracy, I felt removed from making an ‘every-day’ impact. Katrina gave me that reason and opportunity to con-nect. As many organizations found ways to reach out, HHS pro-vided grants and had U.S. Public Health Officers and federal em-ployees responding to the Hurricane efforts. I signed up to volun-teer through HHS. However, given the work needed to start up theOffice of Medicare Hearings and Appeals, a new HHS office, where I work, I agreed with my supervisor to wait until 2006 to

go down South to help.

An opportunity couldn’t have occurred sooner. In early winter, I received an announce-ment on the Volunteer Vacation Program with the student-run Leonard Carmichael Soci-ety to travel to the Gulf region of Mississippi from January 11-18, 2006 to help withrebuilding efforts in rural towns.

Joy and gratitude radiated over me. I finally had an opportunity to go and help in an areawhere I have family and with a group that I knew. While in Gulfport, we separated intoteams working on various community rebuilding projects coordinated by the Youth forChrist (YFC). YFC is a faith-based nonprofit organization that also provided us withhousing in their teen center.

My team worked with the St. James Baptist Church, which had a disaster recovery pro-gram in Gulfport. Unlike the once grand, now demolished churches located on the beach,St. James is a medium-sized Southern Baptist Church located literally on the other side ofthe railroad tracks. Post Katrina, St. James became a beacon of light serving as a make-shift hospital, shelter, food pantry, relief center, and volunteer center all in one.

Tambra Stevenson, MS-Health Communication’04 in Pass Christian,TX, where the infamous “tent city” provides shelter and meals for

displaced residents.

In This Issue

An Alum’s Experience inthe Hurricane KatrinaRebuilding EffortsImproving the NutritionEnvironment in the Work-placeProduct-Caused InjuriesNew Global Health Pro-gram Opportunities2006 Alumni PanelPublic Health Implicationsof Volcano Eruptions inEcuador

2 GPPH Rounds - Spring 2006

Director’s MessageJames N. Hyde, Jr., MA, SM

The director’s message will alternate between the MPH and MS-Health Communication Program Directors.

Any student who has passed through the MPH or HCOM programs in the last few years has heard meor other faculty talk about health literacy. The concept of health literacy is a broad one. One definitionoften cited in the literature co-authored by Drs. Ruth Parker and Scott Ratzan, defines health literacy as:1

“the capacity of an individual to obtain, interpret, and understand basic health information and services and thecompetence to use such information and services in ways which are health-enhancing.”

It goes without saying that the concept of health literacy transcends written communication and includesboth verbal and non-verbal communication as well.

The research is clear in showing that even people with average health literacy skills are at a disadvantagein our society. For example:

• They have difficulty navigating the health care delivery system (Just think about the difficulties the Federal government has had in explaining Medicare Part D to people with above average health literacyskills.);• they are hampered in their ability to communicate important information to care givers which in turn has adverse consequences for their health;• they are likely to have their rights infringed or not be equipped to make truly informed decisions about their health care options;• they may fail to receive vital information that would allow them to adopt behaviors that will protect them from adverse health effects whether from the misuse of medications or exposures to new pathogens or toxic substances.

What is truly astounding is the magnitude of this problem. Research has shown that in terms of plain text literacy and numeracy alone, roughly25% of the US adult population functions at a 5th to 8th grade level or below while another 25% function at a 4th grade level or below. Yet a chasmexists between what we know about the health literacy levels of the population and the bulk of the health information that is produced anddisseminated in practice. Producing and disseminating health and scientific information in forms that people can access and act upon is thesingle biggest challenge that we face in health communication today.

Here at Tufts we are beginning to address this issue in the following ways:

1. As faculty we have begun to look critically at our course offerings trying to identify opportunities for inclusion of additional contentand skills training that will help bridge this divide. In courses such as Health Behavior and Health Communication, Technology andHealth Communication, Health Communication and the Web, Survey Research, and Data Visualization and Presentation faculty aremaking a conscious effort to provide tools and teach skills that will enable graduates to communicate more effectively.

2. We are beginning to focus our research activities on issues that have a direct bearing on health literacy. My colleague Doug Bruggerecently received a grant from the NIH to examine health literacy issues as they impact the clinical management of asthma acrossdifferent cultural and linguistic groups, while I have a similar NIH grant to study health literacy and informed consent in clinicalresearch. These two initiatives have provided opportunities for students to work actively on health literacy research projects.

3. Last January we offered a week long two credit course in Health Literacy skills. Twelve students took this course, taught by SabrinaKurtz-Rossi, a well known health literacy expert at JSI/World Education in Boston.

4. We are seeking to explore new ways that communication tools e.g. computer graphics and visualization tools, web-based tools, andtraditional print media can be used to close the gap between producers and disseminators of information and the public. We plan tooffer a new course this coming Fall which explores the role of on-line, virtual, health communities as a vehicle for education andinformation dissemination.

This is an exciting time for health communication and public health practice. The information dissemination and communication challenges areenormous. The good news is that we have insights and tools to work with that we have never had access to before. Here at Tufts, we havepositioned ourselves extremely to become part of the solution.

1 For those who do not know, Dr. Scott Ratzan was one of the co-founders of the Tufts-Emerson HCOM Program.

James N. Hyde, MA, SMDirector, MS-Health Communication Program


Improving the Nutrition Environment inthe Workplace

Amelia Winslow, MS/MPH’06

It should come as no surprise to hearthat most workplaces in the U.S. to-day are not conducive to practicinghealthy eating and physical activity hab-its. Many working adults spend theirdays sitting in front of a computer,getting up only to grab a less-than-healthy lunch from a nearby fast foodrestaurant. This type of lifestyle is notonly detrimental to an individual’s qual-ity of life, but also leads to higherhealth care costs, increased workers’compensation costs, and reduced pro-ductivity. American businesses arepaying more than ever as a result oftheir employees’ suffering health, andthus many of them are exploring waysto help control these costs.

One way organizations are address-ing rising costs is through wellness pro-grams in the workplace. During thepast few years, the California Depart-ment of Health Services (DHS) hasbeen developing such a program,which it will make available to organi-zations throughout California so thatthey can more easily integrate nutri-tion and physical activity into theirworkplace environments. In the fallof 2006, the San Diego Regional Nu-trition Network (SDRNN), a divisionof the California DHS, will help fa-cilitate the implementation of this pro-gram in a variety of workplaces in theSan Diego area.

In an effort to lay the groundworkfor SDRNN, I conducted assessmentsof the workplace environments atthree organizations in San Diego dur-ing the summer of 2005. My Ap-plied Learning Experience included re-cruiting worksites using contacts pro-vided by the American Cancer Soci-ety, conducting assessments of their

nutrition environments using an estab-lished assessment tool with anamendment I created, and providingthem with recommendations forchange.

The assessments I conducted revealedthat two organizations represented av-erage U.S. worksites; namely, therewere few or no policies or programsin place that supported healthy eatingand activity habits among employees.The third organization seemed to bequite progressive: it had a gym onsitewith a full-time fitness staff, a varietyof health-oriented activities in whichemployees could participate, and fi-nancial incentives for employees whoexercised regularly. All three organi-zations, however, were characterizedby unhealthy food environments;candy jars, birthday celebrations, sweetpastries at meetings, and catered-inhigh calorie lunches were common-place, whereas access to fresh, healthyfood at a reasonable price was not.Even employees with a tremendousamount of will power would findhealthy eating a difficult task in envi-ronments like these.

After conducting the assessments, Ihelped my contact at each organiza-tion identify and begin to improve atleast one aspect of nutrition or physi-cal activity in their workplace environ-ment. One of the organizationsstarted a walking club among em-ployees, another agreed to begin of-fering healthy options at meetings, andthe third resolved to enforce a healthymeeting policy that theoretically al-ready existed within the organization.

One of the most interesting and help-ful things I learned during my ALE isthat changing the culture in an organi-

MPH AppliedLearning Experience

Fall 2005

Gretchen Duenas, MS/MPH’06 -Massachusetts Community Health Center Re-sources and Barriers Assessment for DiabetesSelf-Management Support, Preceptor:Patricia Daley, Massachusetts Depart-ment of Public Health (MDPH)

Sheena Kandiah, MPH’06 - The Roleof Race and Ethnicity in Research and Pub-lic Health, Preceptor: Bruce Cohen, PhD,MDPH

Paula Lueras, MPH’05 - Assisting Dia-betes - Teaching Nurses to Identify Barriersand Factors that Impede Medication Adher-ence for Diabetic Patients, Preceptor: HarveyBidwell, MD, MPH, Bowdoin StreetHealth Center

Jacqueline Lyons, MPH’06 - Health CareWorkers’ Attitudes and Perceptions of theRabies Virus in Chitwan, Nepal, Preceptor:Gretchen Kaufman, DVM, TuftsCummings School of Veterinary Medi-cine.

Tracy MacIntosh, MS/MPH’06 - Im-proving Substance Abuse Retention at theLatin American Health Institute, Precep-tor: Riche Zamor, MPH, Latin Ameri-can Health Institute

Susan Predaris, MPH’05 - ConsumerAccess to Prescription Drugs: A Comparisonof Publicly Insured Beneficiaries in FourCountries, Preceptor: Joshua Cohen,PhD, Tufts University, Center for theStudy of Drug Development

Alison Tovar, MPH’05 - An Assessmentof Capacity and Need of Local PublicHealth Departments in Massachusetts, Pre-ceptor: Justeen Hyde, PhD, Institute forCommunity Health

Amelia Winslow, MS/MPH’06 - Im-proving the Nutrition Environment in theWorkplace, Preceptor: Katie Bogue, RD,San Diego Regional Nutrition Network,USCD

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Product-Caused Injuries: Where Science Meets Law and Marketplace

Benjamin Kelly

Benjamin Kelly is a Visiting Clinical Instructor inthe Department of Public Health and Family Medi-cine at Tufts University School of Medicine

Late last year the Public HealthAdvocacy Institute, a policy andresearch group affiliated with theGraduate Programs in Public Healthat Tufts School of Medicine and withNortheastern University School ofLaw, launched a unique public-serviceeducational website, Motor VehicleHazards Archive. The site providesan array of information forconsumers about injurious motorvehicle hazards and vehicle safetycharacteristics. For public healthprofessionals and researchers, itprovides a growing collection ofvaluable historical documents thatchart the origins of injury control as acritically important public health goal.

What constitutes a public healthproblem? The commondenominators are well known toprofessionals: having a population-wide impact, being amenable toepidemiological study, andresponding to appropriatelydeveloped, widely applicableprevention and control measures.

Since Dr. Snow ordered the BroadStreet pump removed, public healththinking has more and more beencharacterized by systematic, scientificthinking that is unfettered byconventional wisdom about thecauses and cures of disease.

Well into the twentieth century, injurywas regarded as outside theboundaries of public healthconsideration and management.Conventional wisdom held thatinjuries were caused by “accidentproneness” on the part of injuredpeople. “Accident proneness”included a number of allegedbehavioral and attitudinal traitsdefined in unscientific terms such aslaziness, inattention, “unsafe” action,etc. Hanging over the wholemystique of injury was a kind oftheological-fatalistic aura, animplication that injury victims “gotwhat they deserved.” Indeed,“fatality” stems from the word“fate.”

With the advent of the modernautomobile, a struggle in bothsemantics and scientific rigor beganto change this behavioral paradigm.

Small groups of physicians andindependent engineers were seeing anddocumenting categories of injury thatwere explained by the laws of physicsrather than by conventional fate-basednotions of inevitability. Distinct patternsof biomechanical trauma wereshowing up on car-crash occupantsadmitted to emergency rooms injurytypes that could have been preventedor minimized by availability of seatbelts, elimination of hostile protrusionsfrom car interiors, energy-absorbingcar structures, etc. The notion that“accident” and “injury” weresynonymous, and thus unavoidable,began to go the way of non-scientificmedieval notions about diseasecausation and inevitability.

Automobile manufacturers resisted callsfor injury-reducing designs, which theyclaimed would be costly andineffective. The industry continued toinsist that “bad driving,” not hazardousvehicles, was the cause of accidents (andtherefore injuries) and that only bychanging driver behavior could injuriesbe prevented. Ultimately it took legalintervention, national auto-safetyregulation and case-by-case litigationagainst car companies by injury victims

With the leadership of St. James, ourmostly female, 30-person team workedon several projects particularly for theelderly who had no insurance and littleassistance. In one situation, a grand-mother who had Alzheimer’s forgot torenew her policy, so her adult childrenhad came from northern Mississippi toGulfport to oversee the home improve-ments. While in the Gulf, we hoppedfrom home to home gutting, painting,cleaning, and raking. On one site, we

worked with a volunteer team fromMinnesota to remove a 100-foot talloak tree from the roof of anotherelderly woman’s home. Within 72hours of our work, she finally got herFEMA trailer in her front yard after6 months. We also gave donations toa nonprofit called Katrina’s Kitchenin the tent city area of Pass Christian,MS.

Together, Tufts and the local com-munity volunteers served as ambas-sadors of hope and I’m grateful tohave worked with everyday heroes.

The experience truly had an impact onme and those around me. Some stu-dents plan to spend their summersworking with St. James. As for me, Iam working on a social marketingproject called ‘Postcards from Katrina’,to bring awareness on the need forvolunteers in the Gulf. Also the projectwill showcase photos and stories fromother volunteers who worked in theKatrina-impacted areas. To submityour story and learn more about theproject and the Gulf, please visitwww.postcardsfromkatrina.com.

Hurricane Katrina Rebuild-ing Efforts

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Faculty Notes

Sarah Anderson, MS, Instructor in Pub-lic Health and Family Medicine (PHFM)and doctoral student at the Gerald J. andDorothy R. Friedman School of NutritionScience and Policy, earns her PhD this Maywith the defense of her thesis "Psychologi-cal Antecedents and Consequences of Ado-lescent Obesity." Her first publication fromthat work appeared in the March issue ofthe Archives of Pediatrics and Adolescent Medi-cine.

Edith Balbach, PhD, Senior Lecturer inSociology and Assistant Professor ofPHFM, recently had an article accepted forpublication along with Elizabeth Barbeau,ScD, MPH, Adjunct Assistant Pro-fessor of PHFM, and A. Herzbergin Tobacco Control entitled “PoliticalCoalitions and Working Women:How the Tobacco Industry Built a Re-lationship with the Coalition of La-bor Union Women.”

Doug Brugge, PhD, Associate Pro-fessor of PHFM, edited a book withtwo Navajo community activists,Timothy Benally and Esther Yazzie-Lewis entitled The Navajo People andUranium: It was Like Herding Sheep intoa Field of Stickers, that was acceptedfor publication by University of NewMexico, Albuquerque, due to be pub-lished in fall 2006. In addition, Dr.Brugge will be presenting a series of talkson the environment and health to theChinatown Resident Association. Topicsinclude environmental justice, asthma, crime,construction, and laws and regulations.

John Kulig, MD, Professor of Pediatricsand PHFM, has been elected to serve a two-year term (2007-2008) as Subspeciality Chairof the Adolescent Medicine Subboard ofthe American Board of Pediatrics.

Sheldon Krimsky, PhD, Professor of Ur-ban and Environmental Policy and Plan-ning, recently published an article entitled“From Asilomar to Industrial Biotechnol-ogy: Risks, Reductionism and Regulation”

in Science as Culture.

M. Barton Laws, PhD, Assistant Clini-cal Professor of PHFM, conducted aworkshop on March 1, 2006 for the Alli-ance for Community Health on HealthCancer Disparities at the Roslindale Housein Roslindale, MA.

Barry Levy, MD, MPH, Adjunct Pro-fessor of PHFM, gave a presentation atAFL-CIO Headquarters in February entitled“The Health Consequeces of the Ware inIraq.” Dr. Victor Sidel, Professor of SocialMedicine at Albert Einstein Medical Col-lege, and Dr. Levy are beginning work on

the second edition of War and Public Health,which will be published by Oxford Univer-sity Press next year, and are giving lecturesin Boston, Lowell, and Atlanta this springon "Social Injustice and Public Health," thefocus of their recently published book. Dr.Levy has been re-elected Vice Chairman ofthe Board of Trustees of the MetrowestCommunity Health Care Foundation, onwhich he has served since 1999.

Dariush Mozaffarian, MD, MPH, Ad-junct Instructor in PHFM, was an in-vited speaker for Grand Rounds for theBrigham & Women’s Hospital’s Divisionof Cardiology and gave a talk entitled “Fish,n-3 Fatty Acids, and Cardiovascular Health- Current Evidence for Risk and Benefits.”

Aviva Must, PhD, Associate Professorof PHFM, was an invited speaker at the15th Annual Meeting of the EuropeanChildhood Obesity Group held in Viennalast fall. She spoke on “The Role of PhysicalActivity and Inactivity in Youth on the De-velopment of Obesity.” With DavidTybor, MS, MPH, Instructor in PHFM,and doctoral student at the Tufts’ Gerald J.and Dorothy R. Friedman School of Nutri-tion Science and Policy, she authored a re-view article on this topic that was publishedin the International Journal of Obesity.

Anthony Schlaff, MD, MPH, AssociateClinical Professor of PHFM, through a

grant from the Boston PublicHealth Commission and in part-nership with the Center for Com-munity Health Education, Researchand Service, is leading a series ofcity and state-wide discussions po-tentially leading to the replicationof the Sophie Davis MedicalSchool model in Massachusetts.Sophie Davis is a medical schoolbased at the City College of NewYork that has for 30 years success-fully recruited and trained inner city,low-income minority students inthe medical profession. The ac-tivities for the next year include vis-iting Sophie Davis and conveninga working group from the Uni-

versity of Massachusetts Boston, the com-munity, the state’s four medical schools,and the Boston Public Schools to developa blue-print and action plan for creating aschool.

Marva Serotkin, MPH, Assistant Clini-cal Professor of PHFM, is presenting atthe United Kingdom Multiple SclerosisSociety Conference, MS Care - InternationalPerspectives, in Manchester England onApril 21, 2006. Her session is titled, “Sup-porting Independence in Long-Term Care.”

l to r, Chinatown Resident Association Members, Tingwing Tso, Staff-JunXie, Dr. Doug Brugge, Co-chair-Siklun Yan, Co-chair-Henry Yee,

Jianhua Tang, Co-chair-Marie Moy, and Danxin Chen. Photo by BenRuan


New Global Health Program OpportunitiesThe Department of Public Healthand Family Medicine (PHFM) islaunching a new Global Healthinitiative including student internshipopportunities as well as a new MPHGlobal Health Concentration.

Dr. Harris A. Berman, Chair of thedepartment and Dean of PublicHealth and Professional Degree Pro-grams noted that “These exciting newprograms are being established to re-spond to the needs expressed by ourstudents, to learn and experience Pub-lic Health and medical care in a glo-bal setting. As the world becomesmuch more of a global community,the diseases of the developing worldtravel to our borders in matters ofhours, and the diseases of developedcountries are becoming more com-mon in the developing world. Thesenew programs will deal with these im-portant issues, and add an importantdimension to the education at Tufts.”

While the Global Health Concentration,will open in September 2007, theFellowship Programs will begin thissummer. Opportunities are availablefor students in the MD/MPH, DVM/MPH, MPH and MS-HealthCommunication degree programs. InMarch applications were solicited forthis summer and additional place-ments will be announced later this year.Opportunities include:

PanamaIn collaboration with the School ofMedicine at Panama University(Facultad de Medicina, UniversidadNacional De Panama), students willdivide their time between languageschool with an emphasis on medicalSpanish, and a community health centerin the Panama West Health Area. Theywill work as volunteers in activities suchas: Well baby clinic, prenatal care clinic,

school and environmental healthprograms. Dr. Odilia Bermudez,Assistant Professor of Public Healthand Family Medicine, [email protected], will direct the program.

East Africa (and soon Vellore,India)This project builds on Curriculum Co-Development (CCD) work done byDr. Jeffrey Griffiths over the past fiveyears. Placement sites will beacademically based at the Institute ofPublic Health at Makerere University,Kampala (Uganda), and the School ofPublic Health at Muhimbili UniversityCollege of Health Sciences in Dar esSalaam, Tanzania.

Students will work on public healthand environmental projects that willbe tailored to their interests.Secondarily, students will function as‘champions’ to assist faculty at theparticipating institutions with the useof TUSK (Tufts University ScienceKnowledgebase), up-loading content,and in organizing discussion groups.Public health faculty members fromthe host institutions use TUSK insubsequent courses linking East Africancurricula and students with their Tufts’counterparts.

We anticipate project expansion toChristian Medical College in Vellore,India as well. Students interested in aVellore summer project, or in AppliedLearning Experience funding in the fallor spring of 2006-2007 academicyear, should consider this route. Tolearn more, contact Dr. Griffiths,Associate Professor of Public Healthand Family Medicine, at [email protected].

Mangalore, IndiaFather Muller Medical College (http:// w w w. f a t h e r m u l l e r . c o m /med_mn.htm) is collaborating with thePHFM Department in planning anddirecting pre-clinical, clinical and publichealth experiences in India. Potentialeducational experiences range fromlectures about health, nutrition andsocioeconomic situation in India, localhospitals visits, community healthcenters, and other medical facilities,including traditional and uniquelyIndian health settings such as Ashrams.

Students at the pre-clinical level or whodesire a public health experience maywork in a Mangalore area communityhealth center, where they may workas volunteers in sites such as: Well babyclinic; prenatal care clinic; School healthprogram; Immunization campaigns inrural posts; and environmental healthprograms. To learn more, pleasecontact Dr. Harris Berman at [email protected].

Hickey-Peyton InternationalTravel FellowshipThe Hickey-Peyton Travel Fellowshipwas established through an anonymousgift to TUSM to support studentsinterested in public health research/activities in international settings. It ishoped that through this opportunity,

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2006 Alumni Panel

Doina Iliescu

The 4th annual Public Health AlumniCareer Panel, held February 15th, wasa resounding success for the 45 MPHand MS-Health Communicationstudents who attended. Five panelistswove their career tales and trails in acolorful narrative that included sageadvice on making contacts in the fieldand how to approach the AppliedLearning Experience (ALE) for thebest possible experience.

Alan Balsam, PhD, Commissioner ofthe Department of Public Health inBrookline, MA, and Adjunct AssistantProfessor in Public Health and FamilyMedicine at Tufts University School ofMedicine, moderated the panel ofMPH and MS-Health Commun-ication Alumni. Prior to joiningBrookline’s DPH, Dr. Balsam directedthe Office of Elder Health of theMassachusetts Department of PublicHealth. He was also one of theprincipal founders of CommunityServings, a meals-on-wheels program-serving people with HIV/AIDS andother critical illnesses.

The five panelists included AmyBranowicki, MPH’03 (Epidemiology/Biostatistics), Team Leader, DecisionSupport and Quality ManagementUnit, Massachusetts General Hospital;Rozanne Puleo, MS-Health Communi-cation’02, Research Associate,Massachusetts Institute of Technology(MIT), AgeLab; Amie Hillock, MPH’04(Health Services Management andPolicy), Manager of Pharma-covigilance for GenzymeCorporation; Eliza Lawson, MPH’04(Health Communication), PhysicalActivity Program Coordinator, RhodeIsland’s Initiative for a Healthy Weight;and Tara Mardigan, MS-Nutrition/MPH’02 (Nutrition Communication),Senior Nutritionist for Dana FarberCancer Institute/Brigham andWomen’s Hospital’s OutpatientNutrition Service and WellnessPrograms. Tara is also the founder ofTara’s Table, her own consultingbusiness, and Team Nutritionist for theBoston Red Sox.

Panelists described the road to theircurrent position. A. Branowicki used

l-r, Amy Branowicki, MPH’03, Amie Hillock, MPH’04, Tara Mardigan,MS/MPH’02, Alan Balsam, PhD, Eliza Lawson, MPH’04, and Rozanne

Puleo, MS’02

her strong analytical background inpositions that exploited her strengthsand broadened her playing field. R.Puleo stumbled into her position whena contact at MIT pointed out hermanagement skills and offered tocreate a job for her. A. Hillock, whobegan her post-college career with aset of very focused and specialized skillsin biochemistry, expanded heropportunities at Genzyme by obtainingher MPH. E. Lawson realized herinterest in public health after completingan undergraduate research internshipfor the Tufts Friedman School ofNutrition Science and Policy’s BONESProject. Her current role for the R.I.Healthy Weight Initiative employs thetheoretical knowledge as well as thetechnical skills she gained in herprevious positions. T. Mardigan hasengaged her background in nutritionin a variety of ways—as a clinicaldietician, a nutrition communicationsspecialist, an assistant research dietician,and a nutrition consultant.

The panelists’ advice ranged fromputting together a successful ALE; thefinancial investment of an MPH degree;important MPH courses; and tips onfinding a job.

As the panel drew to a close, thepanelists shared these last thoughts: ATufts degree is well respected in thefield. The skills you learn in yourprogram are very valuable to you as ajob seeker and to potential employers.Try to volunteer as much as you can;your experience will be rewarding andyou can make good connections. Keepan open mind as you look for work.Remember that everyone hastransferable skills. Dr. Balsam added,learn how to market yourself andpractice; you’ll get better!


Gauri Khurana, MD/MPH’06

In January, Elena Naumova, Ph.D.,Associate Professor of Public Healthand Family Medicine (PHFM) at TuftsUniversity School of Medicine traveledto Quito, Ecuador to present datarecently culled from emergency room(ER) records that investigated therelationship between pediatric visitsand the time course of volcaniceruptions at the Cities on VolcanoesConference.

Dr. Naumova, Jyotsna Jagai, MPH’05,along with Jeffrey Griffiths’, MD,MPH&TM, Associate Professor ofPHFM, and I have begun extensiveresearch into the long-term publichealth and social implications of thePinchincha Volcano eruptions thatoccurred in 2000. The volcano islocated 30 km outside of Quito, thecapital of Ecuador. Coupled with thecity’s unregulated air pollution, Quito

provides an unparalleledopportunity to study thesynergistic effect of the eruptionsand air pollution.

I gathered the data that includedthe initial presentation of childrenwho visited the emergency roomof the Baca Ortiz Children’sHospital. I specificallyinvestigated the chief complaint,vital signs and final diagnosis of5,000 medical records. Initialanalyses indicated that emergencyroom visits related to respiratorycomplaints (e.g. upper respiratoryinfection, asthma, etc.) increasedfollowing each eruption and weremost severe among childrenunder 3 years old.

Adjunct Associate Professor ofPH&FM, Berta Estrella, MD, of theCorporacion Ecuatoriana deBiotechnologia and a member of theUniversity of Quito’s medical facultyhas found evidence for a link betweenpersistently elevated carboxyhemo-globin levels following exposure tothe eruptions. I am conductingfurther research along with Dr.Naumova’s team in order tocharacterize both the severity of theinitial ER presentations as well asunderstanding which populationsappear to be most vulnerable interms of baseline nutritional statusand location from the volcanoes.

I am working on characterizing thebaseline severity of the initialpresentations for my fourth yearApplied Learning Experienceproject. Dr. Naumova’s goals includefurther delineating the relationshipbetween the distance from thevolcano to the child’s home in order

to bring about removal of the mostegregious injury-causing hazards.

Important lessons for public healthpractitioners have emerged from theexperience of car-crash injury control.Here are two of them:

Programs to control product injuries,unlike disease control efforts, canexpect strong resistance fromproduct manufacturers who believethat their sales and profits may bejeopardized by injury-reducingproduct and marketing changes. Thelesson has been learned in recentdecades as the health hazards oftobacco, dangerous toys, and motorvehicles have been recognized asmajor detriments to the nation’shealth.

Without federal auto safetyregulations, few if any cars wouldhave had three-point seatbelts andfront-seat air bags for the past decadeand thousands of Americans wouldhave died each year as a result.Without laws requiring the use ofseatbelts, most Americans would betraveling unrestrained on the nation’shighways, and death and injury ratesin car crashes would be even higher.

The mission of the Public HealthAdvocacy Institute is to energize therole of law in achieving public healthgoals, of which product injuryreduction is a critically important one.Both our websites, www.PHAIonline.org and www.AutoHazardInfo.org,are unique resources for public healthstudents, teachers and practitionersalike.

Public Health Implications of VolcanoEruptions in Ecuador

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Product Caused Injuries:Where Science Meets Lawand Market Place

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Pinchincha Volcano in Ecuador


zation can be somewhat difficult andalso slow. Proceeding cautiously, bybeginning a policy or workplace nutri-tion intervention with small, evensubtle changes, may be the most ef-fective way to gather the support ofleaders and other employees in an or-ganization. Opting for changes thatplace minimal perceived burden on em-ployees will likely increase the likeli-hood that further improvements willbe desired and pursued.

students will gain perspective about public health and medical care practice.Fellowships are awarded annually to first year medical students. Students mustarrange their own placements with a preceptor in the host country, and are free toselect whatever country they wish as long as there are no U.S. State Departmenttravel warnings in force. To learn more, contact James Hyde, MA, SM, AssociateProfessor of Public Health and Family Medicine at [email protected].

Global Health ConcentrationThe new Global Health Concentration will give MPH students an opportunity tofocus on global health by taking four global health courses and completing theircore MPH requirements. A complete description of this concentration will be inthe next issue of the newsletter.

Improving the NutritionEnvironment in the Work-place

continued from p. 3

New Global Health Program Opportunitiescontinued from p. 6

MD/MPH Class of 2006 ResidenciesSandra Bost, Medicine Preliminary,Morristown Memorial Hospital,Morristown, NJ, Dermatology,SUNY, Stony Brook, NY

Mark Fehr, Medicine Preliminary andNeurology, McGaw Medical Center,Northwestern University, Chicago, IL

Nathan Hudepohl, EmergencyMedicine, University of PittsburghMedical Center, Pittsburgh, PA

James Jacobs, Pediatrics, Tufts-NewEngland Medical Center, Boston, MA

Patricia Kapunan, Pediatrics, WalterReed Army Medical Center, Washing-ton, DC

Gauri Khurana, Psychiatry, Yale -New Haven Medical Center, NewHaven, CT

Marisol Luna-Pizano, Family Prac-tice, Kaiser Permanente, WoodlandHills, CA

Kusum Mathews, Internal Medicine,Yale - New Haven Medical Center,

Students’ CornerCongratulations to MarleneCamacho, MPH’06, who has beenaccepted into the 1-yr Master of Sci-ence Program at Harvard Schoolof Public Health within the Depart-ment of Society, Human Develop-ment, and Health. She will focuson Health and Social Policy withdouble concentrations in Maternaland Child Health and Health Com-munication. Following the pro-gram, Marlene will continue into adoctoral program for Health andSocial Policy.

Aaron Harris, MD/MPH’08, re-cently was in Quito, Ecuador work-ing on a project mentored by Jef-frey Griffiths, MD, MPH&TM.They were studying the effect airpollution and malnutrition have onpneumonia in poor infant Ecua-dorian children. The project issponsored by the National Instituteof Environmental Health Sciences.

New Haven, CT

Leon McLean, Internal Medicine,University of Maryland Program,Baltimore, MD

Jared Murdock, Surgery Prelimi-nary, Kaiser Permanente, Los An-geles, CA

Ekwutosi Okoroh, Obstetrics/Gynecology, Maricopa MedicalCenter Program, Phoenix, AZ

Sarah Rosenberg-Scott, FamilyPractice, Tufts University FamilyPractice Program, Malden, MA

Kevin Rufner, Internal Medicine,University of Colorado School ofMedicine Program, Denver, CO

Fatima Salas, Anesthesiology, NewMedical College/St. Vincent’s Hos-pital, New York, NY.

Edward Suh, Transitional, CaritasCarney Hospital, Boston, MA, An-esthesiology, Dartmouth-HitchockMedical Center, Lebanon, NH


Class of 1991

Samuel Stebbins, MD/MPH’91, ofPittsburg, PA, is married to Gail Merrelland has three children, Jonathan 9,David 7, and Annalise 3. He sends hisgreetings to his classmates.

Cynthia Morrow, MD/MPH’91, ofManlius, NY, and John Epling, M’92continue to enjoy teaching at UpstateMedical University. She was appointedCommissioner of Health forOnondaga County in June 2005 andJohn was appointed program directorfor the Preventive Medicine Programat Upstate at the same time. Their threechildren seemed to have survived hertransition to a full-time position. Over-all, she believes it is a phenomenal timeto be in public health.

Class of 1993

John Fitzgerald, MD/MPH’93, ofLos Angeles, CA, completed a rheu-matology residency and PhD in Health

Services at UCLA.He primarily con-ducts research onutilization of ortho-pedic procedures,policy analysis andoutcomes after jointreplacement surgery.

Class of 1994

Congratulations toK a t h e r i n e( M c G o w a n )Hesse, MD/MPH’94, of Guil-ford, CT, on hermarriage on Octo-ber 15, 2005 to Tho-

mas Hess, a mechanical engineer.

Josephine (Hooten) Lake, MD/MPH’94, of Charlotte, NC, is work-ing fulltime in a Med/Peds practiceand is actively involved with the NorthCarolina Partnership for Children aswell as several Diabetes EducationPrograms.

Class of 1996

Erica Pan, MD/MPH’96, is cur-rently living in Oakland, CA with herhusband, Steve Shochet, a pediatricianshe met during residency, and their twodogs Kona and Goofy. Ten percentof her time is devoted to clinical workat the University of California - SanFrancisco in Pediatric Infectious Dis-eases and attending in Pediatric Ur-gent Care at San Francisco GeneralHospital. Congratulations to Ericaand her husband who are expectingtheir first child in April.

Alumni Notes

Class of 1997

Dan Brugger, MD/MPH’97, ofDavis, CA, is producing health edu-cation videos starring pediatricians tobe used on waiting room televisionsand the internet.

Class of 1998

Charles Eastin, DVM/MPH’98,of Gaithersburg, MD, is married andworking for the FDA Center for Vet-erinary Medicine, Division of Surveil-lance.

John Espinola, MD/MPH’98, andhis wife Astrid Pujari, MD/MPH’98, are living in Seatle, WA withtheir two wonderful boys, Malachi (4)and Elijah (2). John is working asMedical Director for Evercare, aUnitedHealth Group subsidiary thatserves as a Medicare/Medicaid inter-mediary in the state of Washington.He also helps Astrid with her new in-tegrative medicine practice that sheopened last year, which as thus far hasbeen incredibly succesful. Visit thewebsite at www.pujaricenter.com.

Steven Kailes, MD/MPH’98, ofOrange Park, FL, has just returnedfrom a 6-month deployment to AlAsad, Iraq, where he served at a mili-tary level II trauma facility. At the fa-cility they cared for service members,coalition forces, civilians and combat-ants. He is glad to be home!

Lori Marcotte, MS/MPH’98, ofMelrose, MA, recently developed anafter school curriculum for theYMCA of USA which is supposedto be released this spring. It will be

Tambra Stevenson, MS-Health Communication’04 (r) received a LeadershipAward from the Health and Human Services (HHS) Secretary Mike Leavitt(c) for managing the Combined Federal Campaign for Headquarters and FieldOffices of the Office of Medicare Hearings and Appeals, which is a newlydeveloped office within HHS. On the left is HHS Deputy Secretary AlexAzar.


evaluated as part of a HarvardSchool of Public Health project.

Congratulations to Julia Robarts,MS/MPH’98, of North Reading,MA, who had a her third child, Geor-gia Mae Robarts, on September 23,2005 who was welcomed excitedly bybrothers Zachary (6) and Casey (4).

Class of 1999

ChandrasekharBasu, MD/MPH’99, of Houston, TX, is an AssistantProfessor, Division of Plastic Surgery,Michael E. DeBakey Department ofSurgery, Baylor College of Medicine.

Amy (Kirkpatrick) Brown, MD/MPH’99, of Providence, RI, is finallyfinshing her fellowship and is lookingforward to beginning life as an attend-ing this summer at Hartford Hospitalin Hartford, CT.

Congratulations to Marcy GleitCarty, MD/MPH’99, of Boston,MA, and her husband, Matt Carty(MD, Columbia 2002) on the birth oftheir daughter, Madison Agnes Carty,who was born in December 2005.Marcy notes that Madison is a hand-ful!! Marcy is a hospitalist at theBrigham.

Congratulations to Jeffrey Hamer,DVM/MPH’99, of Jim Thorpe, PA,on the recent birth of his second child,a girl named Kenzie Alyse.

Class of 2000

Congratulations to Luke Ascolillo,MPH’00, and Maggie Majewski,MS/MPH, of Maynard, MA, ontheir upcoming marriage on May 6,

2006.

Stephanie Miller, MPH’00, of Pem-broke, MA, will be completing herMaster of Science in Nursing degreein December of 2006 from the Uni-versity of New Hampshire.

Class of 2001

Rachel (Perchesky) Robins’,MPH’01, of Atlanta, GA, AppliedLearning Experience project at Cen-ters for Disease Control was finallypublished in the New England Jour-nal of Medicine in January.

Class of 2002

Pamela (Foster) Albert, MPH’02,and her husband, Keith Albert(PhD’02) live in Auburn, Maine andhave a one-year old little boy, CalebDeclan Albert. She currently owns andruns a fine stationery store, PapierGourmet, in Portland, Maine.

Arshiya Baig, MD/MPH’02, ofSanta Monica, CA, is finishing her firstyear as a Robert Wood Johnson Clini-cal Scholar.. She has happily recon-nected with many friends from herMD/MPH who live California!

Allison Doyle, MPH’02, of Bayside,NY, has been appointed Adjunct Pro-fessor at the Robert F. Wagner Gradu-ate School of Public Service for the2005-2006 academic year. She ob-tained a Master of Philosphy in Pub-lic Administration on her way to com-pleting a PhD in Public Administra-tion. Allison was one of five out ofhundreds of applicants for a year-longAdministrative Fellowship at the NorthShore Long Island Jewish Health Sys-

tem in New York.

Congratulations to Jonathan Epstein,DVM/MPH’02, of New York, NY,on his upcoming marriage in June toMs. Amy Klempner.

Maureen Farrell, MPH’02, ofHollis, NH, is the Director of Phar-macy Research Service at Health Dia-log Analytic Solutions, a division ofHealth Dialog, Inc. HD is a diseasemanagement company that is basedon the work of Drs. John Wennberg,David Wennberg, and Albert Mulley’s(Dartmouth Atlas) research into un-warranted variation in healthcare prac-tice.

Nihil Theodore, MD/MPH’02, ofManassas, VA, recently moved tonorthern Virginia and is married witha 21-month old.

Arthur Wendel, MD/MPH’02, ofMadison, WI, has a one-year old son,Evan MacRae Wendel, born 1/10/05.

Class of 2003

Jennifer Andia, MS/MPH’03, ofPhiladelphia, PA, has a new job, Com-munity Health Educator and OutreachCoordinator, for the 11th Street Fam-ily Health Services of Drexel Univer-sity. She is also a board member ofYoung Involved Philadelphia, a non-profit organization that aims to in-crease civic engagement among youngpeople and to facilitate reforms thathelp create a better Philadelphia.

Congratulation to Summer (Adams)Gulley, MPH’03, of Watertown,MA, on her marriage to Sean Gulley.

Alumni Notes (cont.)

Continued on p. 12


Tufts University School of MedicinePublic Health & Professional Degree Programs136 Harrison AvenueBoston, MA. 02111

GPPH RoundsThe Graduate Programs in PublicHealth of Tufts University School ofMedicine publishes the GPPH Roundssemi-annually. It reports on theactivities of the programs, students,faculty, and alumni. We welcome yoursuggestions, photographs and newsitems.

EditorRobin Glover

Comments should be sent to:Robin GloverPublic Health & Professional DegreeProgramsTel: 617-636-2497Fax: (617) [email protected]

Visit the PHPD Web site:www.tufts.edu/med/phpd/

to understand how far ranging theeffects of the volcano are in termsof geographical distance. Animportant component of theresearch will also be to understandthe chemical components andbiochemical effects of the toxinsreleased by Pinchincha. A long-termgoal for Drs. Naumova and Griffithsis to work with Ecuadoriangovernment officials to devisestandards for air pollution.

Public Health Implicationsof Volcano Eruptions inEcuador

continued from p. 8

Alumni Notescontinued from p. 11

Class of 2004

Congratulations to ChristopherChinn, MD/MPH’04, of Lebanon,NH, who is expecting his second childat the end of July.

Congratulations to Leslie Moser,MPH’04, of Cambridge, MA, on herupcoming marriage.

Keith Rafal, MPH’05, of Medway,MA, is continuing to develop his in-terdisciplinary integrative medicine pri-vate practice at the hospital (HealingChoices, P.C.). Since last year he hasadded three new clinicians to his clini-cal team and practice and is planninga formal presentation onFibromyalgia-Healing Options for thisMay to be held in Providence, RI andwill be open to both the public andprofessional audiences.

Congratulations to Lauren (Hacker)Roth, MPH’05, of Brookline, MA,on her recent marriage to Scott Roth.

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