Crisis in Vancouver

As I mentioned last week, I left Wednesday to attend the annual Association of Schools of Public Health Deans’ Retreat in Vancouver. Getting to Vancouver from the east coast, especially from RDU, is no simple matter. We had to leave our house at 4:30 AM to make an early morning flight. As I settled into my seat in the car, I realized I had left my pedometer behind, but too late to return to the house. It was worse than forgetting my watch, and I am addicted to my watch. At least, my multiple PDAs tell time. But none of them tell me how many miles I have walked. As I sat on the plane (and there was a lot of sitting for hugely delayed flights), I felt…naked. It is amazing how a device like a pedometer can become part of one’s body and one’s being. It is my feedback loop to assure that I do at least five miles a day. So, as soon as we checked in to our hotel in Vancouver (after a 12 hour journey), my husband and I set off on what we thought would be a simple quest to purchase a pedometer. After two top line sports stores failed to deliver, this looked serious. Here is a city that has to be one of the fittest places on the planet, and no pedometers. Finally, we located one in a drugstore, and my anxiety level began to approach normal levels.

Deans’ Retreat

This was my 4th retreat, and I co-chaired the meeting with Pat Wahl, Dean, University of Washington School of Public Health. I have come to value not only my fellow deans, but also the opportunity to share stories and learn from one another. Turns out so many of the issues we face are shared challenges, like the downturn of the Federal grants budget and its very serious impact on our schools. There now are 40 accredited schools and more likely to come.

One of our most interesting discussions was about how different schools and leaders define global health. I prefer the 2004 IOM definition that our Office of Global Health embraces—health problems that transcend borders (See our Office of Global Health’s site for the full definition and more background.). This is in contrast to more traditional definitions of international health. We’ve seen that most health problems now transcend borders. I emerged feeling even more strongly that our Office of Global Health is right on track, and that global health must be integrated throughout the curriculum; it should not be segregated into a department.

Talking with the other deans left me feeling that there is a tremendous global and national resource in these schools. And our school is one of the best!

Vancouver

Vancouver is one of the most beautiful cities I have ever visited. It is paradise for health-conscious people—a city of hills, surrounded by mountains and oceans. It seems everyone is walking quickly, biking or running. Maybe pedometers were so hard to find because fitness is such a part of many people’s lives. Here is a picture of Vancouver taken by a colleague at Duke University Penny Hodgson.

After the meeting ended, we were very fortunate to have a little time to explore the city on foot. It is truly magnificent. A very special moment was seeing the Nitobe Memorial Garden (a traditional Japanese Garden) at the University of British Columbia.

PhD students running the NYC Marathon

I was really excited to learn that four of our PhD students, Kiyah Duffey, Noel Kulik, Meghan Slining and Natalie The, are going to run the marathon to raise funds for Tar Heel Team for Kids. I plan to make a personal donation and encourage others to learn more about the cause and our runners and consider making a donation. I ran the marathon the year I turned 40 (quite awhile ago) and will always treasure it as one of the high points of my life.

Back to NC

Monday morning, we reverse the journey, starting again at 4:30 AM. Happy Monday! Barbara

Thanking our staff

Last Friday afternoon, we celebrated Brent Wishart, Facilities/Maintenance Coordinator, who received the 2008 SPH Staff Excellence Award. People spoke admiringly of Brent’s devotion to the SPH and its people, his unflappable dedication to solving problems and removing roadblocks and his kindness. Linda Kastleman choreographed a hysterical skit in which people were calling Brent to do things from all over the atrium—just the way it happens in real life. He has a wonderful ability to juggle multiple balls with grace and agility. I have grown increasingly impressed by the quality of the staff at the SPH and am grateful that I am getting to know many of the people who work here.

Stimulating transformational research

I just finished reading the new report, Investing in Early-Career Scientists and High-Risk, High-Reward Research from ARISE, Advancing Research in Science and Engineering, a project of the American Academy of Arts and Letters. The committee that developed the report is a stellar one that included highly respected academics as well as people from the business sector. They call for significantly more attention to developing the careers of our younger scientists and also to supporting transformative research. They argue that “leadership in science and technology is necessary to compete in the global economy” (p. 1). The report makes several recommendations to nurture early-career faculty. It also calls for encouragement of high-risk, high-reward, potentially-transformative research (p.1). “Science benefits greatly from work that has the potential to disrupt complacency and conventional thinking—innovations in methods, instruments and software and paradigm shifts” (p. 27). I am encouraged that many aspects of our recently funded Gillings Innovation Laboratories (GILs) are just what the report recommended to stimulate transformative research. You can watch several GIL, PI’s on our website as they discuss their projects.

The ARISE report shares some themes in common with Saturday’s (July 19) New York Times column by Bob Herbert entitled Yes We Can. He described reactions to Al Gore’s recent speech in which Gore issued a strategy challenge that the United States set a goal of getting 100 percent of our electricity from renewable resources and carbon-constrained fuels within 10 years. Herbert cautioned that “the naysayers will tell you that once again Al Gore is dreaming…” Then, he went on to say something very important.

“But that’s the thing about visionaries. They don’t imagine what’s easy. They imagine the benefits to be reaped once all the obstacles are overcome.” Herbert worries that the United States has become a “can’t-do” society instead of the “can-do” society we once were.

Al Gore is one of the world’s best, most well-known visionaries. But there are many others, and there should be even more. That ties back to the ARISE report. We must provide the means for our visionary researchers and teachers to turn their visions into new ideas, tools, methods, programs and solutions that change how we see problems and ultimately, benefit people (although not immediately for all discoveries). People in public health have a “can-do” past, and we must not lose sight of that, because there are huge problems waiting to be solved—by us!

Check the July 16th issue of the Journal of the American Medical Association, JAMA. It has some interesting articles on race, including one that tracks the history of African American physicians and organized medicine and an excellent commentary by R. M. Davis on the need for contrition, reconciliation and collaboration with regard to race issues. The same issue also has an article about physical activity from ages 9-15 years, documenting the yearly decline in physical activity after age 9. That’s one of our biggest public health challenges.

BIOS to the rescue

Kudos to BIOS Professor Fred Wright and former SPH BIOS Professor Michael Schell for their mentions in the current issue of Newsweek. It is not every day that biostatisticians are interviewed for weekly magazines aimed at the public. Wright said that “most of the literature (linking a gene to a disease) is riddled with false discoveries.” Behind Fred’s claim is transformational research. Way to go Fred Wright and colleagues!

I am off Wednesday to Vancouver to my fourth Association Schools of Public Health Deans’ retreat. I am co-chairing this one. It is always a good chance to find out what other schools are doing and concerned about.

Happy Monday. Barbara

Our School’s impact:

Each year, I submit a progress report to the Provost about my role as dean and my and the School’s accomplishments over the past year. Similarly, the School’s chairs and unit leaders provide me their progress reports. A couple years ago, I asked them to include highlights of their unit’s impact in research, service and teaching. As I have said before, as a public university, we must hold ourselves to a standard of making a difference. Just to be clear, impact could be a groundbreaking new type of statistical test for microarray analyses, a basic science finding that changes how people view a nutrient, an epidemiologic result that alters how we understand breast cancer risk, a new teaching program that is educating students more effectively or the effect of an intervention on health policy or population health. In each case, something changes because of our work. This year, I read the Chairs’ reports with real pleasure and enthusiasm as I saw the many ways in which we are making a difference across the School. I will share some of these impact stories over the next few weeks. It is one of the things that excites me so much about being dean—this opportunity to achieve impact and to communicate about it. For now, more about the SPH’s impact can be found on our Web site.

Developing our talents:

I really appreciated HBHE Assistant Professor Noel Brewer sending me an article I’d seen in the New York Times July 6, but hadn’t grabbed electronically. It is called “If You’re Open to Growth, You Tend to Grow,” by Janet Rae-Dupree. The article begins, “WHY do some people reach their creative potential in business while other equally talented peers don’t?” After three decades of painstaking research, Stanford psychologist Carol Dweck, PhD, believes that the answer to the puzzle lies in how people think about intelligence and talent. Those who believe they were born with all the smarts and gifts they’re ever going to have, approach life with what she calls a “fixed mind-set.” Those who believe that their own abilities can expand over time, however, live with a “growth mind-set.” Guess which ones prove to be most innovative over time.

“Society is obsessed with the idea of talent and genius and people who are ‘naturals’ with innate ability,” says Professor Dweck, who is known for research that crosses the boundaries of personal, social and developmental psychology. “People who believe in the power of talent tend not to fulfill their potential because they’re so concerned with looking smart and not making mistakes. But people who believe that talent can be developed are the ones who really push, stretch, confront their own mistakes and learn from them…”

As some of you know, I occasionally cite the wisdom of Group Fitness Coordinator Paula Brennan, spinning and fitness instructor/trainer extraordinaire at the UNC Wellness Center in Meadowmont. She has an expression which I have mentioned before: “We have to work our weaknesses.” It has a lot in common with Dweck’s conclusions. We have to develop the parts of us that don’t come easily. I’ve had to work really hard to develop my quantitative skills, but the more I’ve used these skills, the easier it becomes. Many of us, particularly those of a certain age (read: well over 50), grew up thinking that if we weren’t a natural at something, we just couldn’t or shouldn’t do that thing. For me, it was athletics. When I finished the NYC Marathon at age 40, I imagined every gym teacher who thought I was worthless at the finish line. And when I finish a session of ultimate conditioning, I still see those teachers. But boy, am I working my weaknesses!

I have watched some of our students struggle with their weaknesses, especially those who really have to work at writing or experience a setback in their work. Yet, when they put their hearts and minds to it and work with mentors, they improve in astonishing ways.

What’s striking is that sometimes the joy and satisfaction we get from surmounting our weaknesses is so much greater than performing in areas that come easily. I really resonated with Dweck’s message. It’s the kind of message that gives us hope that we can transcend our own weaknesses and limitations. After all, we are part of the university; we should never stop growing. I want this School to be the kind of place where people can work their weaknesses and get a lot of support doing so. That’s the ultimate strength training!

Happy Monday!

July 4^th holiday

Hope everyone had a good holiday. Aside from the fireworks and time away from work, it is good to spend a little time thinking about the history of this country and where we are today. I can’t imagine living anywhere else, but there are a lot of problems we must fix, including growing inequalities in health care, housing and income.

We had two days of really ferocious storms. Sunday morning, my husband and I rode our bikes along the Bolin Creek Trail, and it was staggering how many trees and really big branches were down. Periodically, we had to walk our bikes over trees and branches. I assume some of the devastation is the result of prolonged drought weakening the trees.

Visit from Chancellor and Provost

Last week, we hosted a visit from Chancellor Thorp, on his second day in his new position, and Provost Gray-Little. It was a great opportunity for us to inform the new Chancellor about the School’s strengths, current activities and some of the challenges we face. We talked about a couple of these challenges, including the need for more scholarship support for our students, especially multi-year awards that give students the peace of mind that comes from knowing they can focus on their education instead of juggling multiple jobs, as many of our students now do.

We also showed them how the downturn in federal funding is affecting our School and departments, some more than others. Thanks to three outstanding faculty members/Principal Investigators (Drs. Baric, Morrissey and Vizuete) and a number of people across the School (including Ramona DuBose, OJ McGhee and Tom Laney), we created brief videos with three PIs for Gillings Innovation Laboratories (listed above). Each of the PIs talked enthusiastically and compellingly about their GILs. These projects (and the others as well) aim to solve important, challenging public health problems using novel solutions and with a real sense that GIL support is letting the teams solve problems faster and better. We also visited Steve Meshnick’s lab. Both Provost Gray-Little and Chancellor Thorp were engaged throughout the visit, appreciated the School and asked excellent questions. We should have the videos available on our Web site later in the week. We will create videos for each of the GILs. Thanks to Mae Beale and Jenny Lewis for their help in creating briefing materials for the visit.

While I was sorry when Chancellor Moeser announced his intention to step down, I am confident that Chancellor Thorp is going to be a truly outstanding leader. His understanding of the University is deep and broad. In addition, he is an unbelievably smart, enthusiastic and intellectually curious person. Bernadette Gray-Little is a very important member of the UNC leadership team, and I really value her leadership and understanding of our School and the University.

Our changing Web site

Working with a local company, Jennings, we are in the process of dramatically redesigning, and I hope, improving our Web site so it is easier to navigate and more relevant to and useful for applicants and current students as well as others. We all agree we need more content that is engaging and interactive. This includes videos and access to social networking sites. I really want to encourage people associated with the School to unleash their creativity and to be part of the process so our website will be a living, breathing and evolving voice not just for our School but for public health.

Stay tuned for information from Assistant Dean Felicia Mebane about a photo contest, but don’t wait to send us your photos from work you’ve been doing this summer in North Carolina and around the world. We would like to post them on the School’s Web site and potentially print, frame and display them in our halls. (See “Send us your photos” on the SPH homepage.)

Happy Monday. Best, Barbara

In the journals

Over the weekend, I got caught up on some of the journals and magazines in my stack—JAMA, New England Journal of Medicine, Harvard Business Review, Wired, Annals of Behavioral Medicine and a few others. Joseph Cook, MD, PhD, an adjunct professor of epidemiology at our School, is the author of a fascinating NEJM article, Eliminating Blinding Trachoma. Trachoma is a horrible, blinding eye disease linked to poverty. It was a problem in the U.S. until the 1950s and is rampant in Africa and much of the developing world. Fifty-five million people are infected; about 3 million are visually impaired or blind as a result.

So, why wasn’t I aware of this before? How many of our students learn about it? What’s particularly tragic is that trachoma is largely preventable through access to safe water and good personal hygiene practices (health education) and is treatable with antibiotics. Yet, often the disease is neither prevented nor treated. The unjustness and unfairness of poverty-related conditions and diseases is so distressing, and the cycle of poverty is exacerbated by ill health. Surely, we can do better.

The June 28th issue of The Lancet, includes an editorial entitled “How to prevent a tenth of the global disease burden.”The article reflects upon a new World Health Organization report titled “Safer Water, Better Health.” (Jamie Bartram, one of the report’s three co-authors, spoke at our School last spring.)

The report concludes that 9.1% of the world’s global burden of disease could be prevented through better water, sanitation and hygiene. In 32 of the worst-affected countries, the estimate is 15%. Globally, that’s a huge potential impact, and the report does an excellent job of reviewing the data and estimating DALYs* and costs associated with possible interventions.

Anyone who cares about public health should read the report. It is brief, well-written and well-illustrated, and the case it makes is compelling. At the end of the editorial, The Lancet calls for an immediate water, sanitation and hygiene plan that should be discussed and implemented by the international community without delay. I’d like our School to be part of this effort.

*Note: DALYs (Disability-Adjusted Life Years) for a disease are the sum of the years of life lost due to premature mortality in the population and the years lost due to disability for incident cases of the health condition. The DALY is a health gap measure that extends the concept of potential years of life lost due to premature death to include equivalent years of “healthy” life lost in states of less than full health, broadly termed “disability.” One DALY represents the loss of one year of equivalent full health. – from the World Health Organization Web site.

Good books

I just read Blue Covenant (New Press, NY, 2008) by Maude Barlow. It’s about the global water crisis and analyzes causes and solutions. Nowhere is our planetary interdependence more clear than where water is concerned. Barlow cites the irony of Revelations 21.6: “To the thirsty I will give water without price from the fountains.” That is in contrast to the growing price and inaccessibility of water in much of the world. (Trachoma, which I mentioned above, thrives in areas where water is scarce and unsafe.) Barlow cautions that unless we “collectively change our behavior, we are heading toward a world of deepening conflict and potential wars over the dwindling supply of freshwater” (p. 142). While water is a public health issue, it also is a global security issue. That may lead us to new partnerships. I have been surprised how difficult it is to get federal funding for water-related research. It just doesn’t make sense.

Awards and Recognition

I am so excited that Professor Peggye Dilworth-Anderson (Department of Health Policy and Administration) was elected incoming president of the Gerontological Society of America. The GSA is a very influential organization that reaches across both theory and practice.

In the last week, Professor Mark Sobsey and alumnus Joe Brown, now assistant professor at University of Alabama at Tuscaloosa, were awarded the 2008 Project Innovation Award from the International Water Association. It is a major recognition of their efforts to bring low-cost ceramic water filters to people who lack safe, accessible water.

Congratulations to Vangee Foshee on her promotion to professor. Hope Associate Professor Linnan is having a great time singing her way through Italy.

Have a great July 4^th – and Happy Monday!

Barbara