Dr. Jessie Satia dead at 39

We are so disheartened by the passing of Jessie Satia, PhD, Associate Professor in the departments of Nutrition and Epidemiology and Special Assistant to the Dean for Diversity. Jessie had built a national reputation for her research on health disparities, especially in areas such as colorectal cancer and prostate cancer. She had a strong global presence, not surprising for someone who grew up in Cameroon and whose accomplished parents worked internationally. She served on an AHRQ study section, was PI on several grants, mentored students and so much more. Her active role in helping to make the School more diverse, particularly in terms of faculty, is one I am going to miss deeply.

I first got to know Jessie about seven years ago. She had left the School to work at Amgen. With the chairs of Nutrition and Epidemiology, I recruited her back to UNC where I knew she would make major contributions. She was well on her way. Jessie and I became even closer over the last two years, when she became increasingly ill. We talked about her hopes and dreams, her love for her family and her bedrock commitment to her research projects.  Jessie was very close to her parents Benedict and Philomena and had recently created a scholarship in their name. As one of three sisters, I can only begin to imagine how I’d be affected by the loss of a sibling. When I called the Satia’s phone today and got Jessie’s sobbing sister, I could barely keep from crying myself.

A private person, Jessie did not share much about her illness. When I visited her in the hospital last summer, she had her laptop at hand. I worried about her, helped her find doctors, brought her food, as did many others at the School (Nutrition did a great job of organizing help.), and talked with her regularly. Others helped by driving Jessie to appointments, going shopping and the like. Lynne Brody was heroic in the way she reached out to Jessie. We are a community, and when one of our own is ill, we come together in remarkable ways.

Jessie was way too young to have died. She should have had many productive but also enjoyable and satisfying years ahead of her.

Minority Health Conference is almost here!

Register this week for the Minority Health Conference! Rates go up after February 12. Don’t miss out on a great event. This year’s topic is especially salient.

The Minority Student Caucus will be holding its 31st Annual Minority Health Conference Friday, February 26 at the Friday Center. The conference theme this year is “Building Community in the Age of Information: Fighting Health Inequality in the Modern World.” It’s hard to imagine a much more interesting, timely and relevant topic!

Dr. Robert Fullilove, Professor at the Columbia University Mailman School of Public Health will be the keynote speaker. His talk, “Community Organizing and Community Building: Public Health Watchwords for the 21st Century” is sure to be fascinating and provocative. (His keynote will also be broadcast online at 2 pm on Feb 26). See a youtube video of Dr. Fullilove in action.

Dr. Fullilove will kick off a great day of sessions and poster exhibitions, including a presentation by CeaseFire, a hands-on health literacy workshop, and a presentation by Minister Robert L. Campbell, co-founder and president of the Rogers-Eubanks Neighborhood Association. I am so awed by what the association is doing, in partnership with our Engineers without Borders and other organizations.

Be well and keep Jessie Satia’s family in your thoughts and prayers. Barbara

State Health Directors’ meeting, etc

A whirlwind week: chairs’ meeting, a fascinating ASPH conference call with Linda Birnbaum, PhD, director NIEHS, School of Dentistry dean search committee, meeting with one of three candidates for Provost, and many more meetings dominated while we were finishing our budget submission to the Interim Provost. A highlight was speaking to the annual meeting of the 2010 North Carolina State Health Director’s Conference. Every time I interact with this group, I come away awed by how much they do with so little. The economic crisis of the last year manifests as a local crisis — people out of work lose their health insurance and need public services; then, there’s a cascade of other needs that result. Meanwhile, health departments took massive cuts so they’re doing less with less. Every health director I have met is committed, enthusiastic, optimistic in the face of what others would see as calamities, and really smart about public health. These are real heroes. Several health directors got awards, and when they were introduced, I was so impressed by the number of community activities in which they participate and the boards on which they serve.  It’s exciting that thanks to Leah Devlin, Dorothy Cilenti and some other people, more of our students are going to have paid internships in local health departments all over the state. Students want this, and it’s good for North Carolina.

It snowed…and snowed

Friday night, I came back from Raleigh and got to the office after 5 pm. About 7 pm, I looked out my window and realized it had been snowing for quite awhile, and I’d been oblivious while everything was turning white. Not having a 4-wheel drive car anymore, I started grabbing my things to head for the road. The drive home was pretty unnerving, but I cannot complain; we live close by. The snow just kept coming, and by morning, the streets, sidewalks and trees were covered. It looked beautiful. Here are a couple pictures, one from our backyard and one from the Meadowmont center area after the plows. The Wellness Center closed for two days, and I kept running into people who looked like they were in a state of shock, me included! It’s not like we can’t walk, and we did, but my days really are structured around the great start I get at the Wellness Center.

Hundreds of students gathered on McCorkle place this past Saturday to enjoy the weekend snow day.

While we look a lot like our peer schools of public health, none of us are sufficiently diverse, particularly, in terms of minority staff, students and faculty. Most of us are in the 18-22% minority range although a few urban universities are higher. We are about 18% minority (including Asian but excluding international students), a number that was touted as a real achievement for one school as reported in Monday’s New York Times.

What we are most concerned about is the fact that only about 10% of our students are African-American, and about 4% are Hispanic. We are not talking quotas, by the way. But when we look at a state that is now nearly 22% African-American and 7% Hispanic, we see a gap between where we are and where we should be (not that we are trying to mirror state precisely). Public health lives in a diverse world, and we are faced with huge health disparities we must overcome. We’ve looked a lot at our data and believe there are many reasons why we (and our peer schools) don’t have more minority students. Support for student scholarships is necessary, and we don’t have nearly enough scholarships. But it’s rarely only one thing that accounts for insufficient diversity.

Last Thursday evening, our School’s Minority Student Caucus and Student Government convened a Town Hall to focus discussion on diversity at the school. The student-organized event gave people a chance to talk about the issues and to suggest actions. I was impressed by how the students had organized the event—thoughtful, polished and professional. Stephanie Baker, Yasmin Cole-Lewis, Patsy Polston and others did a terrific job! I am proud that we have a school where students and others could talk about their feelings openly, as one young woman said, without fear of retribution. Some students talked about how it felt to be in departments with few minority students. There were great examples of the good that can come when departments take on the issue and confront it.

People said we should work more actively with historically black colleges and universities on recruitment; we should work harder at connecting with UNC undergrads; make sure our interviews reflect diversity when we meet students for the first time; get our alumni more involved; share best practices across the School. As our illustrious alumni,Professor Bill Jenkins said, “It’s not rocket science.” He went on to talk about commitment, effort, investment and everyone owning the problem.

There’s a tendency for people to identify one program as the potential solution, the Holy Grail, to increase diversity. I am convinced that our diversity won’t change just because we add one more program. It will change if we add multiple programs aimed at removing roadblocks to diversity. I am committed to that. From what I have seen, we don’t need to worry about lowering standards, a specter often raised as a threat. There are plenty of great minority applicants. We need to encourage them to apply here and then find ways to support them, not only financially. We can enhance our excellence if we increase our diversity! We’re all in this together.

We can do this! Barbara

Shock and dismay reverberated around the country last week as people took in the enormity of the impact of Martha Coakley’s Massachusetts loss. I remember sitting in my driveway very early Wednesday morning and thinking, “No way, Ted Kennedy’s seat, the year he died. It’s just not possible.” Well, it was, and it is. And now it’s déjà vu all over again. Having been through this several times, I have been optimistically skeptical about health reform from the start. Now, I am left with a sad, fundamental conclusion. Maybe Americans don’t really want to provide health care for the 47 million of us who lack it, and the millions more who could lose it at any minute. When the George Clooney clone (Up in the Air) enters your office, mine or a family member’s office and delivers word of an impending layoff, we’d be without health care. I don’t want my country to treat people that way; it’s about fairness and justice.

Well, anger will get us only so far. Read what our own stargazer Professor Jon Oberlander and other have to say about health reform. It’s not over yet, but it’s not going to look like it did last week. Democrats, Republicans and Independents should get together and start building a health reform plan that can work.  Let’s get past politics and be practical!

Haiti — a public health nightmare

In the devastation of Haiti, what appears from the pictures and first person accounts, is hell on earth, a public health nightmare, a human tragedy. Yet, public health forces on the ground, along with our medical colleagues and search and rescue forces, will be the potential salvation of the country. With only a thread of infrastructure and little government, the challenges will be immense.

In our School, with business and NGO colleagues, Kenan Professor Mark Sobsey has developed several effective water filters which could be deployed to Haiti immediately; check out FilterPure Filters. More recently, through a Gillings Innovation Laboratory and a large USAID grant, Dr. Sobsey and Tom Outlaw have been scaling these innovations for wider use. Dan Okun Distinguished Professor of Environmental Engineering Phil Singer has spent much of his career designing point-of-use water purification systems. Getting these innovations and others into practice is a life and death issue. While we wait, people die.

I am drawn to the stories on Haiti and, like many of you, feel helpless in the face of such a massive tragedy. I am grateful that medical colleagues like Mike Cohen, MD (J. Herbert Bate Distinguished Professor of Medicine and Microbiology, Immunology and Public Health, School of Medicine and Director, UNC Center for Infectious Diseases), have offered to help. A UNC student, Laura Wagner, was in Haiti living with a family while working with Epi Associate Professor Frieda Behets, as the earthquake struck. Fortunately, after some frantic worrying and emails from Peggy Bentley and others, we heard from Laura. Although the house in which she’d been living had collapsed, she and the family escaped with minor injuries.  Jennifer Nomides, a second year Master’s student in HBHE, has strong ties to Haiti and has been sending information from the ground.  I hope that once the immediate crisis has ended, our Team Epi Aid will be able to help.

Amber Munger’s Update on the Coordinated Rapid Response to the Haiti Earthquake: I have yet to see a better or more detailed look at Haiti from the perspective of relief workers already there. (You need a Facebook account to get the update.)

SPH Student Body President Jeff Nguyen had a letter to the editor published in the Daily Tar Heel covering all the efforts of our School’s student organizations.

People have asked me to recommend charities for donations. The charities my colleagues in the know recommend are Partners in Health and Doctors without Borders. I gave online to the former.

Tuesday, January 26, Mediterranean Deli ( 410 W. Franklin St.) in Chapel Hill is donating ALL proceeds from ALL sales to help victims of the earthquake. Their #:  967-2666. The Med Deli people are great!

There is a Supercourse SWAT Team lecture about the disaster that is very informative.

Health insurance reform — not perfect but better than the status quo

We had very lively presentations on Tuesday January 12th. Director Tim Carey, Deniese Chaney and Professor Jon Oberlander spoke about electronic medical records (EMRs) and how they would be affected by health reform. It really is a no-brainer that health care quality is better with EMRs. The NYT had a fascinating article about how they are used in Copenhagen–which is ahead of us. Accenture generously sponsored the meeting. Thanks to our alumna Deniese Chaney for making the forum happen.

Many people I respect have concluded that health reform without a public option is worse than nothing at all, because it will delay necessary action. I disagree. This country, unfortunately, isn’t ready for a public option. I don’t want to end up with nothing at the end of the day. How long would it be before politicians would risk their careers again to take up the issue? Possibly, a very long time.If Congress overcomes differences within and across branches and passes health reform, this country will have crossed an important threshold. It will be far from a perfect package, but it will be a great improvement over what we have now: more than 47 million Americans without health insurance, and many more living in fear that if they lose their jobs, they could lose their health, homes and more.  Hendrik Herzberg wrote in The New Yorker that the final bill, if it passes, will be flawed and messy. He recounted how John F. Kennedy, in advocating a bill to provide hospital care for the aged, agreed that his bill would not meet every need and concluded that We’ve got great unfinished business in this country. Herzberg asked if Democrats and Barack Obama are doing enough and answered the question. No but they are doing what’s possible. That may be pathetic but it’s no fallacy. Read the article. It’s good.

This blog has some good information about health reform, including how the quality of US health care compares to other countries.

Increasing diversity — still

As we celebrate Martin Luther King’s life, we should try harder to realize his dream. In our School, we are going to try harder. Last week, we had a dinner with some of our most distinguished diverse alumni. We asked their help in devising new strategies to increase diversity and finding new sources of support for students. We’ve got a fabulous School, with truly great faculty, staff and students. As good as we are, we will be even better if we can become more diverse.

To paraphrase John F. Kennedy, We have great unfinished business in this School!  Happy Monday. Barbara

Celebrating our Executive DrPH students

Last week, one of the School’s great friends held a celebration for our Executive DrPH students at his house. It had been a long day, it was a cold night, and I was dragging. Bernard and I drove out to the party, and as we walked into the warm, vibrant house, full of the conversations of committed people, I got a second burst of energy. These students are amazing. One is the president of a company, another works for the Clinton Foundation in Papua, New Guinea, another works for the Agency for Health Research and Quality, and yet another runs a major community health center program. And that’s just a few of the class members!

They go to their jobs during the day. By night, they log onto their classes and participate in a distance learning format in which everyone can see each other in this global, virtual classroom. They come to UNC twice a year which enables groups of students to get to know one another and the faculty. Having worked full time my first two years as a doctoral student, I appreciate the need for flexibility without sacrificing rigor or quality. I’ve met these students on several occasions; and they’re fabulous. The life and work experiences they bring to class enrich the experience for everyone.

Professor Ned Brooks and Associate Professor Sue Havala Hobbs have done a great job building this program, and the numbers of applicants have grown rapidly. After beginning the program domestically, Ned and Sue now are expanding it globally through the Global Doctoral Health Leadership Consortium.

This is a great example of how teaching and learning can change to meet learners’ needs and opportunities.

Reading

See the excellent article about intentions to get the H1N1 flu vaccine in MMWR. The underlying survey was a collaboration between the North Carolina Division of Public Health, CDC and our North Carolina Center for Public Health Preparedness.

The week ahead

It is going to be an interesting week. We are holding a fascinating group discussion about electronic medical records Tuesday night. Thursday night, we are bringing a small group together to help us increase our School’s diversity, a very important challenge.

Meanwhile, I am sitting in my office with a keyboard on my lap. My laptop keyboard has failed, and after trying without success to fix the keys, I found another keyboard and hooked it up. Hopefully, our capable computer staff can fix the problem. Happy Monday! Barbara

It’s been a very good year; it’s been an awful year.  Next year has to be better. It’s been a year of many contradictions; researchers, in general, have benefited from stimulus dollars. But declines in state funds have left many universities and the people who work for them suffering. Ours is no exception, but we have fared better than many states.

Good year

More grants

In spite of a horrible economy, our faculty members competed successfully for funds from NIH, CDC and other agencies. In the past year, our grant support increased 44%.

Marci Campbell, PhD Professor, Nutrition, was awarded a National Institutes of Health Challenge Grant; only 2% of applicants were successful. Even more important for North Carolinians, Dr. Campbell’s project aims to improve health behaviors among people in eastern North Carolina. Among other strategies, she’ll be using micro-credit to help bolster people’s lives. This is one example of many exciting projects awarded to faculty across the School. The real point of all of this, of course, is not only to win grants but to improve health.

Grace under pressure

Our faculty and staff have adapted to challenging budget reductions with grace and a can-do attitude. I wish we could do more for them.

It seems like every day I have a conversation like the one I had recently with a fellow professor, checking into the Wellness Center. “Hi, how are you?” I asked him. “Great,” he said. I commented that his work seemed to be going well; he’d gotten several big grants and a lot of recognition for his research. He did not talk about his work as might have happened a couple years ago. Instead, he said, “I’m so glad to be working.” This was from a very senior, distinguished professor. I am grateful too. Wherever I go, from our wonderful maintenance staff to our star professors, we are grateful to be working.

Health reform

It really looks like health reform will pass. No one will love the final plan, but it will be more than an incremental improvement if the outcome of Senate and House deliberations goes as predicted. Covering an additional 31 million people is a major advance for health equity. It probably won’t do enough for prevention. People who wanted a single payer will be disappointed. And there aren’t likely to be enough measures for controlling costs. But it will be a big step.  Check out these.

• “Medicare for 50-Somethings?” by Jonathan Oberlander, PhD, associate professor, Health Policy and Management and Social Medicine

• Alternative perspectives from those offered by more liberal sites

• A side by side comparison of House and Senate proposals

• NEJM’s site re Health Care Reform 2009

• Health Care: Big Gains Come with Small Steps by Kate Kelly

Bad Year

Budget cuts

It was a terrible year. We had deep budget cuts that shook but did not topple our infrastructure. In the School, we have laid off some staff – painfully for us and even more so for them. With 10% unemployment in the U.S., there’s hardly a person who has not been touched, a family that has not felt the sting of layoffs.

I know someone who worked for a company many years and recently was laid off, I thought about how the closure that is often present when one leaves a job is denied in most layoffs – no goodbye party, no speeches, no public parting words about the person’s contributions, no gifts, and, often, apparently, no thanks for years of good, maybe great, work and no health insurance. It’s a violation of the way most of us were brought up to think about our relationship to work – that good work and loyalty beget loyalty. I hope we’re near the end of this. For every person who was laid off, thank you for all your efforts.

The Wall Street Journal 12/29 had an interesting article about how the Netherlands is dealing with the recession by allowing some companies to reduce workers’ hours to 85% instead of laying people off. Their unemployment rate is 3.7% vs. ours at over 10%. It’s an interesting idea.

Next year

As 2010 approaches, I wish everyone good holidays, good cheer and good health. Among us are those who have lost family, friends and partners to illness and accidents. My thoughts are with you. Others are battling serious illnesses. We wish you good health in 2010.

Public health’s importance will continue to increase in the next decade. This School will be on the front lines in training the next generation of public health leaders, fighting obesity, preparing the country for infections and natural disasters, getting clean water to people everywhere, developing better health policies, and so much more.

A public health equation for better health.

Happy new year! Warmly, Barbara

Saturday was a beautiful, crisp winter day in Chapel Hill, with just a hint of the light snow from the day before.

Sunday was winter commencement – always fun to see the joy the event brings students and their family and friends. It was great to see public health students among the crowd. Lisa Carey, MD, gave a terrific commencement speech. She singled out JoAnne Earp’s and colleagues work in eastern North Carolina that reduced disparities in mammography use among white and black women there.

Monday, we met with Delton Atkinson, PhD, one of our Bios alumni; his son graduated from UNC yesterday Congratulations to all December graduates!

It’s been a very good year; it’s been an awful year, and next year has to be better: more next week. A great Christmas present would be health reform that gives all Americans the assurance that that none among us would be denied health, because they lack insurance. It’s looking better, but there are no sure things where Congress is concerned.

Best wishes for safe, happy, and most of all, healthy holidays. Happy Monday. Best, Barbara

Developing diversity

Our School must become more diverse in our faculty, staff and students. (We follow UNC-Chapel Hill definition of diversity outlined in the Diversity Plan. This includes the many kinds of structural and contextual ways in which people differ, including race/ethnicity, gender, culture and disability.) Lack of diversity is a problem in US higher education. Most schools of public health are grappling with how to become more diverse. As a result, we’re now competing with each other for diverse faculty and students. Some schools, particularly private schools, have a lot more scholarship money, and that gives them a competitive advantage. But it is not only or all about money.

Going forward, academic institutions cannot rely solely on the increasingly diverse demographic eligible for higher education.  They must acknowledge and address the cultural and economic barriers that may prevent students of color and first-generation college students from pursuing a college degree, ensuring that the student body more accurately reflects the population that the academic institution serves. From Fast Company, Tony Clark author, Diversity and Academia.

We have been at this for a number of years, and we’ve done a lot. We’ve examined our data to understand where the roadblocks are and what could be done about them, changed the message in our ads to be more direct about our interest in recruiting women and minorities, done diversity training for leaders in the School, asked chairs to focus especially on recruiting diverse faculty and students and benefited from UNC-Chapel Hill programs to recruit diverse faculty members. We’ve also created funding opportunities especially (but not exclusively) for diverse students (not enough, for sure). Some departments have done even more—established pipeline programs, tried to change the internal culture, and created committees to enhance diversity. Our Office of Student Affairs is leading several exciting new activities. But still, the dial hasn’t moved enough.

2010 initiates the Diversity Decade in the School.  We are committed to building diversity across the School and obtaining more scholarships for diverse students. In January, our Minority Student Caucus will lead a town hall to discuss what the School can do to enhance diversity. We also are hoping to get some of our minority alumni together to advise us on strategies. In February, our student-led Minority Health Conference once again will showcase not only the research being done to overcome health disparities but the phenomenal students here at our School.

Making the School more diverse is really important to me personally. Most public health problems are exacerbated in underserved populations, and minorities are disproportionately represented in those groups. If we are going to eliminate health disparities, as our mission states, then we need a better cross-section of North Carolina, especially, in our School, as well as the international populations we aim to serve. I don’t want to be remembered as the dean who did not increase the School’s diversity.

Check out:

• In September 2008, the Association of American Medical Colleges (AAMC) published “Diversity in Medical Education: Facts and Figures 2008,” which is the 15th such databook in their Facts & Figures Data Series. The 147-page report is available online (at no cost) from AAMC.

• The Association of Schools of Public Health’s Health Disparities Research & Diversity Resource Center

• Duke University’s Office of News and Communication’s five-part series on Diversity & Excellence

We’ve got a lot of work to do! Happy Monday! Barbara

First, thanks….

We can only be said to be alive in those moments when our hearts are conscious of our treasures. ~Thornton Wilder

Even in a difficult year, there’s a lot for which to be grateful. I’m especially grateful for the opportunity to be dean of this outstanding School, for my family’s health, for a wonderful leadership team in the School, and fabulous faculty, staff, students, alumni and donors. I am really grateful to the people who work in my immediate office and how often they go way above and beyond, because they really care about quality and service. I am also grateful that so many people in this School have borne the year’s pain with grace and fortitude. What could be better than living in Chapel Hill where we have had three magnificent days of sunshine! And while our football team lost by a heartbreaking one point Saturday, the basketball team made up for it Sunday!

Diversity

It is ironic that while diversity is central to public health, most of the top schools still are far behind some of the country’s top businesses in creating truly diverse environments. I’ve learned a lot from watching and interacting with Dan Amos, CEO AFLAC, and observing the way he has made diversity a central value and integral to how the company operates.

He rewards and incentivizes diversity, trains for it, hires for it and celebrates it. While diversity encompasses the full range of individual characteristics on which people differ (e.g. age, gender, culture, sexual orientation, ethnicity, disability), I mean, particularly, race/ethnicity. UNC has an excellent diversity plan and an outstanding leader in Associate Provost Archie Ervin.

To understand problems facing people around the world, including in our own state, we must have more faculty, staff and students who represent the populations with whom we work-and this, increasingly, means ethnic diversity. Our state is 21.6% Black and 7.4% Hispanic. We’re not there, and it’s not for lack of trying, caring and wanting.

Still, what we have done to date hasn’t gone far enough, produced enough change, or made enough of a difference. So we are going to enter a new phase. Unfortunately, we don’t have the kind of dollars to put into this that Fortune 200 companies can commit (if they make the choice). I want to engage our School, including our extended network, in figuring out together what we can do to change the status quo. We’ll all be better for it!

Martin Fishbein

Over the weekend, Martin Fishbein, PhD, Harry C. Coles Jr. Distinguished Professor in Communication and Director of the Health Communication Program at the Annenberg Public Policy Center, U Penn, died of a heart attack in London while traveling. Marty and his colleague Icek Ajzen developed the Theory of Reasoned Action, one of the most widely-used theories of health behavior. Their new text was just published in September, 2009. I got to know Marty when we served together on an Institute of Medicine committee. He had a wonderfully impish personality, and the ability to see the limitations of his own theory while improving it. I’ll miss him!