Thanksgiving 1905

Wednesday, November 22nd, 2006“It oft behooves a State, as well as an individual, to look at the past, that it may realize the mercies for which it has to be thankful, and to give expression to its gratitude by words and acts of praise.”

Thus begins Governor R.B. Glenn’s 1905 Thanksgiving Proclamation. It’s a rather long document, listing many things from the previous year for which North Carolinians should be thankful, including, “we have been blessed with fair crops, and prices for farm products have been above average,” “the settlement of our outstanding debt upon a just and honorable basis,” “no scourge of disease or pestilence has to any great extent visited our State,” and “temperance and sobriety in all things are being practiced by our citizens.”

In his closing, Governor Glenn asks that North Carolinians take Thanksgiving Day to gather, pray, rejoice, and, above all, “while enjoying this holiday, that they do nothing unworthy of the reputation of the State.”

As we celebrate the traditional American holiday of Thanksgiving this year, we may find ourselves wondering what’s to celebrate given the economic bad news. I believe there is much to be grateful for, despite the hard times facing us now. While many feel buoyed by the steps President-elect Obama has taken to date, even he has cautioned that there are no easy fixes, and that we are in for a challenging time ahead. There is uneasiness in the world, and no one knows quite what will happen next. Our students and others worry where their tuition will come from. The world as we knew it a year or so ago is gone, and we are trying to hang on as the roller coaster rushes forward. It is scary, and the destination is unknowable. But from what I have seen of our School and this University, we are going to deal with these challenges in a fair, forthright and deliberate manner. We will survive this economic assault.

We feel the global economic crisis in North Carolina. At the School, we have spent weeks trying to allocate our 5% budget cuts (taken in several increments since the summer) fairly in a way that will cause the least pain to people and the least damage to our infrastructure. Each unit of the School has had to absorb these cuts, some more than others, as we follow the mandate from the Provost’s Office not to undermine our educational mission. Of course, that is difficult since everything we do ultimately is related to the educational mission. Nevertheless, we have delayed critical hires across the School, reduced some services, cut non-essential travel, and taken other actions to reduce costs. We are taking steps to save dollars wherever we can. For example, we are sending an online holiday card to save printing and postage and may have to cancel the spring issue of our magazine, Carolina Public Health, unless we are able to find a sponsor. These all are difficult choices, but protecting the people in the School is most important. I have been impressed by the way leaders in the School have come forward in unselfish ways to do their part. We are all working together.

Although units in the School have a tradition of great autonomy, it will be critical for us to work even more closely together to optimize our resources and to look out for employees and protect our mission. For example, if one unit has insufficient funds to support a particular full-time employee,  then perhaps another department can step up to share. I have seen this model work in other institutions. We have amazing faculty and staff, and I intend to do everything I possibly can, along with the School’s leaders, to preserve their futures here at the UNC Gillings School of Global Public Health. Our collective commitment, ingenuity and flexibility will be required to confront the financial challenges ahead.

We realize that the difficult economic environment is having a negative effect on everyone but on some more than others. Our retired faculty and staff are especially vulnerable. They worked hard all their lives, and now the safe harbor of retirement has become an icy inlet with little room to maneuver for the future. They, my parents and their generation lived through the depression and now may live in fear of the future. Will their savings last through their lives? I also have talked with staff and people in the community whose spouses and families own small businesses that are now one or two months from bankruptcy because of the cascade of financial fallout.

Our students and many others worry that they won’t have enough funds to pay their tuition and living expenses. When our students were hit with an unexpected tuition charge earlier in the term, they were appropriately outraged, and our departments stepped up to help, backed by the School. We won’t always be able to do this.

In the midst of so much angst, is there a reason to give thanks? Unequivocally, emphatically “YES.” First, we know from our colleagues who work around the world that however bad it seems here right now, it is not nearly as bad as it is in some parts of the world. We know historically that down markets are cyclical, and up markets do return. For all of us who have our health, we give thanks. As I walked home from a very intense workout at the gym Sunday, I realized how grateful I am that at an age that once was seen as really old (and still is in the eyes of the young), I am healthy and can work out for an hour and a half and still have energy left to do other things. For those of us fortunate enough to work in public health, we have the good fortune to know that we are doing work that matters. We live in a remarkable community in which people can be who they are and be accepted.  On the political scene, we saw a sea change in how Americans felt about elections, and we went to the polls in record numbers (for recent years). Our President-elect is a man of character, intellect, thought and action, and whoever we voted for, we will rally around him.

I am grateful to be Dean of this amazingly wonderful School and thankful for the wonderful staff, faculty and students who make this place excellent on a human scale. I am grateful to UNC leaders like President Bowles, Chancellor Thorp and Provost Gray-Little as well as to our School’s leaders. I am grateful to Robert Weaver, Joseph Love, Mae Beale and others who jumped in to help me get back up to speed after my computer was stolen a couple weeks ago. I also am grateful for the many generous friends who support the School through their financial gifts and concrete assistance. I am grateful to the alumni and friends who’ve met with me and our external affairs staff in the past year and shared their stories about what our School has meant to them. The deep feeling of our friends and colleagues for the School and the commitment to work with us to advance our goals is awesome. I have been impressed by the many people who have come forward in the last year to help us. And last but not least, I am grateful that basketball season is upon us!

Best wishes to you all for a very happy, healthy holiday. My thoughts are with those of you who are ill and those who lost children, spouses, parents, friends and others in the last year.

As I look out on a very crisp blue Carolina day, I cannot help but believe that better days are coming. Happy Monday and happy holiday with my warmest wishes. Barbara

Meeting with the Alumni Association Past Presidents

Friday, I met with 10 past Presidents of the Alumni Association, dating from 1981 and the current President Jacky Rosati, PhD, MA. As people know, I don’t love meetings, but I love these kinds of meetings, because I learn about the School’s history, and get to know the people who made it what it is today. I was so impressed not just by their love for the School and their fond memories of it, but also by their commitment to work with us to solve some of today’s challenges. I also was struck by the stories they told about their faculty mentors—people who’d opened their homes to them when they’d arrived in town, invited them to dinners and been there for more than just perfunctory advice. There is no question that one of the strongest attributes of our School are the strong connections between faculty, staff and students. As we grow and as money becomes even tighter, we will have to work extra hard not to lose the characteristic that sets us apart from most other schools.  Thanks to Cutler Andrews for his excellent work engaging the Presidents and reaching out to alumni. Thanks also to Lyne Gamble, Janice Periquet and Steve Couch for their work with alumni.

Movie Producers at UNC

Earlier in the week, Professor Tom Linden, MD, Director Medical Journalism, emailed me to say that his (current and former) students and he had produced a short movie “Environmental Heroes” that was selected to be shown at the Carrboro Film Festival. My husband Bernard and I decided to go, and we were impressed. Team members from the SPH included Kathryn Barr, Jessica Hughes, Jiang Li, Kevin McKenna, Julea Steiner and Emily Waters. The movie focuses on three environmental heroes in North Carolina—one who has developed an impressive composting business for environmentally sound waste treatment; another worked with the Concerned Citizens of Tillery and others to fight unfair practices of the hog industry and to promote regulations on hog lagoons and other threats to environmental and human health, and another person who has created a very successful organization to protect Bogue Sound. Each of the stories was moving and reminds us how many ways there are to take positive action that can make a difference. I was especially moved by the interview with Gary Grant, the hero from Tillery who talked about the efforts there. Associate Professor Steve Wing, PhD, MA, who has conducted important research on hog waste in the community, was interviewed. It is a terrific project. Now that we have a certificate in health communication with several schools, including Journalism and Mass Communication, I hope we will see even more efforts like this production.

Happy Monday.
Barbara

Visiting the Columbus Water Works

Last week, I visited the Columbus Water Works (in Columbus, GA) which is managed by an ESE alumnus, Billy Turner, who is President of the system. It was really interesting. I was fascinated to see how biosolids are dealt with and how water is managed and delivered. Never having been to a water works, I never really appreciated how much is required to process waste and assure that water is provided with impurities removed. Columbus has done some very creative work to use the land, e.g. by creating a trail system that covers some of their property and runs through the downtown area—it’s 16 miles in all. Looks like a great area for biking and hiking. They also have designed a state-of-the-art processing plant that Mike Aitken, PhD, MS and Mark Sobsey, PhD advised on. It uses a new system for treating raw sewage and putting that into a digestion unit that ultimately produces class A biosolids and green power. The process is called Biosolids Flow-Throw Thermophilic Treatment.

There is a very interesting article in the November 2008 AJPH issue  about sanitation in Alaska—where the proportion of people without household sanitation is higher than elsewhere in the US as a whole. According to the press release from the Alaska Native Tribal Health Consortium:

“A lack of running water in the home is linked to severe respiratory infections among Alaska Natives. These findings are a first, to the authors’ knowledge. Health professionals have thought the benefits of clean water were primarily gastro-intestinal. This study shows that lung and skin infections among Alaska Native persons are also associated with inadequate water service.

‘For decades, there hasn’t been enough money from federal and state sources to address the problem of clean water and sanitation,’ said Alaska Native Tribal Health Consortium Chairman and President Don Kashevaroff. ‘It’s time to build the systems needed throughout rural Alaska.’

‘The study highlights the need for sanitation infrastructure in rural Alaska, where about one third of the homes lack modern sanitation facilities,’ said Alaska Native Tribal Health Consortium Chief Executive Officer Paul Sherry. ‘It confirms that flush toilets and piped water lead to improved health status.’ The study’s findings are important because of the seriousness and rates of respiratory illness among Alaska Native infants and children. About 75 percent of all hospitalizations for Alaska Native and American Indian children are due to respiratory problems.

The findings may have international significance as well because acute respiratory infections are the second leading cause of child deaths worldwide where many communities lack adequate sanitation facilities.”

This is a good example of the connection between U.S. and global. Water problems aren’t just somewhere else. They are here in our country as well. Solutions apply here and elsewhere.

Visitors from ULM

Last week, we hosted 7 faculty members from University of ULM in Germany.  Several people from the SPH have had long standing collaborations with UULM.  It’s always interesting to see how graduate education is alike and different around the world.

Visiting the Nutrition Research Institute

Monday, November 17th, about 25 people from UNC visited the Nutrition Research Institute (NRI) in Kannapolis, NC. We heard from Steven Zeisel, MD, PhD, Director, Nutrition Research Institute, Kenan Distinguished Professor of Nutrition and Pediatrics and Chancellor Holden Thorp, among others. Steve and Holden both did a great job! It was impressive to see legislators, citizens and a number of senior officials from companies, foundations and other agencies come together to support this enterprise. I spoke at length to a young woman who’d grown up in a mill home. Some of her family members lost jobs after the Pillowtex Corporation plant closed. She was so positive and excited about what Mr. Murdock is doing to create this renaissance in her home town. Our discussion made me appreciate even more how science and public health can be economic engines.

I remember my first visit to the campus when it was just bare structure and mud everywhere; I stepped in one hole that left my shoes covered in mud. Today was a very different experience. In this small town there now are magnificent buildings that house the people and laboratories that could transform what we know about the relationship of nutrition to diseases, health, performance and longevity. They have some of the best equipment anywhere. For example, the NRI has a ‘BodPod’ to measure body fat. It looks a little like a cocoon one sits in to be measured. This is a great alternative to the traditional gold standard measure in which one must lie on the bottom of a tank with a weight on one’s back and remain underwater for over a minute and what seems like hours. I know, because I tried to do that a few months ago, and became claustrophobic. And I am a decent swimmer! (By the way, I heard afterwards that a lot of people don’t like to be submerged under those conditions. At the time, I felt like a real failure!)

My stolen computer

I have heard from many of you who expressed empathy about my stolen computer. Thank you. It really has been traumatic (though not nearly as bad as what many people are going through with bad health, lost jobs, deaths in the family and the like). I am having a lot of trouble getting used to the larger keyboard of the loaner, and keep thinking that maybe I will walk in one morning, and my little Lifebook will be sitting there waiting for me. So far, no such luck.  But my new computer should arrive this week, and Joseph Love will do wonders to get it ready.

Have a great week. Happy Monday. Barbara

A Thief in the Night—or Early Morning

Someone stole my wonderful Fujitsu Lifebook, the only computer that became one with me and an essential part of my life. Friday morning, I walked into my office and immediately noticed that my docking station and computer were gone. Usually, I take my computer home but knew I was going to be tied up Thursday night and so I left it. I realize I am not the first person whose computer has been stolen, but it is a really miserable experience. On top of everything else, it is really awful to have to spend funds on a replacement. My message receivers may find a lot of typos in the next week, because I have become unused to the immense keyboard on the ThinkPad (compared to Lifebook).

Health Care Reform

Now that we know who will be President, the public health community should mobilize with other groups to assure that finally, we develop a rational approach to health care in the U.S. Of course, this won’t work unless it is bipartisan. I just read a very astute report from the Center for American Progress and the Institute for Medicine as a Profession. The authors stated several goals for health care reform.

• Safety: Avoiding injury and harm from care that is meant to aid patients.
• Effectiveness: Assuring that “evidence-based” care is actually delivered by avoiding overuse of medically unproven care and underuse of medically sound care.
• Patient-centeredness: Involving patients thoroughly in their care decision-making process, thereby respecting their culture, social circumstances, and needs.
• Timeliness: Avoiding unwanted delays in treatment.
• Efficiency: Seeking to reduce waste—low-value-added processes and products—in all its forms, including supplies, equipment, capital, and space.
• Equity: Closing racial, ethnic, gender, and socioeconomic gaps in care and outcomes.

It is an excellent report that covers issues related to informatics, quality of care, patient activation, population health, reimbursement and several other topics. The report makes a strong case for enabling electronic medical records. I was pleased to see the strong focus on patient activation and patient centeredness. I’d suggest reading it if you haven’t already. Our School should be prepared to help the reform process. We all have a stake in it!

Okun Symposium

Friday Nov. 7th, about 125 people gathered for a scientific symposium to celebrate the life of the late Professor Dan Okun by focusing on several issues related to water and its access around the world. I was able to stay for the first few talks. Once again, I was impressed by how prescient Dan was in thinking ahead to today’s water challenges and needs. I was moved by how many of the attendees had been touched by Dan as their mentor, teacher and colleague.

Football

It was a packed stadium again for the Saturday football game, and lots of dignitaries were there, including Senator Burr, Governor Easley and Governor-Elect Perdue. But the real attention was down on the field where our team beat Georgia Tech. Hey, we are getting pretty good!

Losses

Ron Davis, MD died last week at age 52. Ron was a remarkable and courageous person who led the Office of Smoking and Health, under Surgeon General Koop and was President of the American Medical Association in 2007. He was a tireless advocate for anti-smoking causes. At the end of his life, after having been diagnosed with pancreatic cancer, a death sentence, he showed his courage in another way—by writing honestly, personally and compellingly about his struggle with cancer. His death is a great loss. We also mourn the passing of Albert (Bert) Loro, PhD, who died about two weeks ago at age 59. Bert was known fondly to many here in Durham and Chapel Hill not just for starting the behavioral weight management program at Duke more than 20 years ago but also for his community service, love of life, commitment to the environment and much more. Both these men were known for going the extra mile for people, for their integrity, for being good listeners and good people. They’ll be missed. As a late 50-something, I’m noticing that these untimely losses seem to be coming more quickly.

Hope

Still, there is a lot to be hopeful about. As a person who grew up on “I think I can, I think I can” from The Little Engine that Could, I want to believe that irrespective of who we voted for, we can embrace the mantra, “Yes, we can,” and set about fixing what must be fixed in this country.

Happy Monday. Barbara

Recently, I wrote about the importance of tolerance as we looked ahead to the end of a campaign that had become increasingly mean-spirited and divisive. We have talked about voting, and I was so proud of people across the SPH who were excited as they reported that they’d voted. It felt like a new experience whether we were voting for the first time or after many times.

Before I left last night, I walked into Rosenau Auditorium where folks in IIS had arranged two large screens with CNN, and talked with one student who said he’d had chills in the morning just thinking about what a momentous day it was. Whether we voted for Barack Obama or John McCain, the American people sent a clear, strong message. It’s time for a change. Barack Obama spoke eloquently of hope, inclusion, determination and the need for hard work. John McCain conceded with dignity and a promise to continue working for this country he and Obama both love. Now, together, we face hard challenges in rebuilding so much in this country. Our School should play a leadership role in confronting some of the fundamental tasks before us, like providing health care and education for all and addressing climate change in a serious manner. The election is behind us, and our eyes should be focused on the future.  I am ready to help, and I know you are, too. And to quote our President-elect, Yes, we can!

Tomorrow’s the big day

It is hard to believe that after all these months and months, election day is tomorrow.  I can barely stand to listen to the radio, because I am so nervous about the election’s outcome. We are going to have a television tomorrow in the Mayes Center (230 Rosenau Hall) until 5p.m. and then in the Rosenau Hall auditorium (133 Rosenau Hall) so people can come and see what’s going on nationally and locally. It is exciting and gratifying to see how seriously people have taken this election.

Yesterday was the NYC Marathon

Several of our Nutrition students ran it for a great cause—Tar Heel Team for Kids. I look forward to hearing how they all did. Running the NYC Marathon the year I turned 40 was one of the most gratifying experiences of my life. It was exhilarating to run through all the NYC boroughs and be greeted by throngs of people all along the way.

Meeting our alumni

The past week has been an alumni meeting marathon for me. I have met wonderful alumni from different departments. One of the striking realizations is how many different fields and settings these alumni are in—from international health care consulting to cancer centers to pharmaceutical companies to start-up laboratory companies and so much more. I hope our students realize how many possible careers are out there for people trained in public health. Many are unconventional and very exciting. I am struck by how many alumni tell me that going to the School changed their lives for the better and gave them futures they never would have thought possible. Many of these alumni are giving back to the School to show their thanks for those life-changing experiences.

Check out the Dan Okun Memorial Symposium

This Friday, Nov. 7th, ESE celebrates the global impact of Dan Okun’s work with a memorial symposium.  ESE is also co-hosting Sustainable and Safe Drinking Water in Developing and Developed Countries: Where Science Meets Policy Wednesday and Thursday, Nov. 5-6, 2008.  It will be a great way to learn about important issues and trends in water policy and research. I am going to try to attend a few of the sessions.

Happy Monday

If you haven’t voted already, remember that tomorrow’s the day. As we know from past elections, every vote counts, so let your voice be heard. Best, Barbara