Weekend observations

At the end of cycling class Monday morning, I talked with two men who have children of college age. They were bemoaning the fact that there aren’t going to be jobs for their children. We’d had a fabulous 90-minute workout, our endorphins had kicked in, we felt a positive sense of camaraderie, and yet we ended on a sad note about the economy. (It was good to be able to say that at least there are jobs in public health.) Liam O’Fallon, our fabulous instructor, commented on our downbeat conversation. It made me realize how easy it is to fall into talk about all that is wrong now. There is a lot wrong, and there are national and individual tragedies upon us. But still, there is a lot that’s good. And we must keep looking for the high notes without burying our heads in the sand.

Last night, my husband and I went out to dinner with our friends Ilene and Chuck. It was the first time my husband and I had been to dinner together in months. After about an hour or so of catching up with them on all sorts of topics, I looked around and realized, “This place is packed. Some people are still going out to eat, enjoying one another, and that’s a good thing.” Glasshalfull is a very smart restaurant. It serves small plates-which are smaller (obviously) and less expensive than large plates, the American too large plates that not only cost more, but as Barry Popkin, PhD, Carla Smith Chamblee Distinguished Professor of Global Nutrition; professor, Nutrition and director, Interdisciplinary Obesity Center, has shown in The World is Fat, also are contributing to our national obesity epidemic. (Of course, I am not attributing the problem to this restaurant’s large plates but to the American tradition of serving too much food and our tendency to eat too much food.) A good outcome of the economic crisis would be a return to smaller plates, healthier food, more local produce, more emphasis on the social aspect of meals.

Resilience and recovery

I read several recent speeches in Vital Speeches. The common theme, irrespective of the author’s affiliation or political orientation was resilience and how to create it-in the country, world and in our own organizations. Resilience is about the ability to adapt to a current situation and to emerge stronger and with one’s optimism and positive attitude and actions intact. If we can find ways to work smarter, to really focus on our core mission and values and to think inventively, we will emerge stronger.

UNC-Chapel Hill and our School are resilient. We have been through difficult times; we are not bloated organizations in which people are used to being indulged. We have a history of collaboration and cooperation. We care about the mission, and we are devoted to a higher cause. That gives people a reason to work together and come together to find shared solutions. It is a difficult time. There is no question about it. But in this School, the chairs and I have been really impressed by the willingness of faculty and others to sacrifice.

Late last week, Chancellor Thorp sent a very positive message to the campus. Among other things, he mentioned that our vice-chancellors have offered to take salary cuts and furloughs if these strategies will save jobs. I feel the same way and have told Chancellor Thorp, not only that I am gratified by his leadership and communications, but that I and at least my fellow deans with whom I have spoken are willing to make these commitments as well. We will come out of this crisis. I want to be sure that now, and in the future, we are prepared to do our jobs-to educate our students, conduct cutting-edge research and participate in engaged-scholarship across North Carolina and beyond. Read Chancellor Thorp’s message, or visit his blog.

In this School, Charlotte Nunez-Wolff, EdD, associate dean for business and finance and her team, Dave Potenziani, PhD, senior associate dean, department chairs, heads of other units, and business managers all have been working pretty much non-stop to deal with the budget crisis, respond to requests for information, adapt to new policies, respond to emergency requests and so much more.

Reducing our staff is the least desirable way to manage the budget crisis, and we are doing everything we can avoid it. We will have to be very inventive and think across the organization in new ways. How can we share services and be more efficient? If someone leaves, what is the best way to replace them? Are there courses or programs that have too few students or enrollees to be viable in a distressed economy?  Are we doing things that don’t fit the needs of 21^st century students? These are not questions we like to ask, but they are questions we must ask. If we have fewer resources, we cannot do everything we did before and prepare for the future.

I was very impressed by what Sam Palmisano, chairman, president and CEO, IBM Corporation, said in a speech to the Council on Foreign Relations, November 2008. He talked about how technology is changing lives, and how the world is not just getter flatter but more inter-connected and smarter. He said the thing that holds the most potential for a better world is that the planet is getting smarter. He also identified several global problems that are right in our domain-e.g., an antiquated health care system and water systems drying up across the world. His premise is that if we can develop smarter systems that emerge from collaborative leadership across sectors, we will not merely adapt; we will thrive. He ended on an upbeat but not unrealistic note: “The world now beckoning us is one of enormous promise. And I believe it is one that we can build-if we open our minds and let ourselves think about all that a smarter planet could be.” We should start by applying that advice within our School.

Men’s basketball

I was so disappointed in the game Saturday. I just could not believe we lost when we were comfortably ahead for a while. I love listening to Coach Williams in the post-game analysis. We could all learn from his ability to critique his own behavior. Of course, he also did not hesitate to critique the team as well. On to Georgia Tech next Saturday. We should win that one!

It’s a hard time but we are going to be ok-it’s just going to take a while to get there. Happy Monday. Barbara

Stimulus

It’s been a roller coaster kind of week. I participated in meetings in Atlanta for the CDC’s Task Force on Community Preventive Services. While the meeting was going on, e-mails were flying fast and furious about the stimulus package and what it might mean for public health. The good news is that it looks like funds will be included for a range of topics most of us in public health care about — e.g., preparedness, electronic health records, health promotion, community health centers and workforce development.

I encourage people to read the legislation and some of the background materials, because if the package works as intended, quick response to the forthcoming announcements will be required. Karen Regan, JD, UNC congressional liaison (director, Office of Federal Affairs), has been doing an excellent job of keeping us informed.

Below is some summary information about the bill from Nan Sanseverino, administrative assistant in UNC’s Office of Federal Affairs. The final package increases federal support for a number of health care initiatives, including:

• $19 billion to accelerate adoption of Health Information Technology (HIT) systems, including $2 billion in discretionary funds and $17 billion for investments and incentives offered through the Medicare and Medicaid programs to help the use of “health IT” in hospitals, doctors’ offices and other medical facilities;

• $86.6 billion over the next two years in additional federal matching funds to help states maintain their Medicaid programs;

• 65% subsidy for COBRA premiums for up to 9 months for qualified individuals;

• $1 billion for a new Prevention and Wellness Fund to fight preventable diseases and conditions with evidence-based strategies;

• $1.1 billion for comparative effectiveness research to help patients and doctors determine the effectiveness of different treatments; and,

• $500 million to the Health Resources and Services Administration (HRSA) for health professions workforce development, including $300 million for the National Health Service Corps and $200 million for Title VII and Title VIII and for grants to training programs for equipment.

Additional resources:

• The conference report for the American Recovery and Reinvestment Act (H.R. 1) (also see www.rules.house.gov)

• An Inside Higher Ed article, “The Final Stimulus Bill,” which includes a matrix comparing funding provisions of the House, Senate and final bills

• An interesting visual representation of the Stimulus in The Washington Post

Evidence

I am thrilled that President Obama has been talking about — and that the legislation reflects a commitment to – use of evidence in public health and medical decision-making. It’s about time. It is really crucial that we use evidence to determine how best to intervene on a variety of public health topics. The Task Force spends a lot of effort reviewing the literature on a variety of topics, and local public health communities should use the evidence. To learn more about the Task Force and see our recommendations, visit the Web site for The Community Guide.

Duke vs. UNC and Florida vs. UNC

I don’t know why I could not get the Duke vs. UNC game in my hotel room in Atlanta, but I could not. Fortunately, my husband texted me scores every couple minutes. The outcome was wonderful, but I hated missing the excitement of the game. That Florida vs. UNC game was exciting too. What a finish!

Global fashion show

I’d promised Chris Deery and Rushina Cholera that I’d model in the Student Global Health Committee’s “Fashion Show Your Love” 2009. So I raced back from the airport, dropped my suitcases off and came back over to the School to model at 8 p.m. And I am so glad I did! Last year, it was a spectacular event, and it was wonderful this year as well!

I loved seeing our students, staff and faculty in dress from countries around the world and hearing the inspiring stories that accompanied the clothes. There was wonderful music, silent auction, food and great spirit. It’s good I have a day job, because I doubt anyone is going to hire me to model! My husband Bernard took this picture of some exuberant Health Behavior and Health Education students. Peggy Bentley, PhD, professor of nutrition and associate dean for global health, looked great. Here she is with Shrikant Bangdiwala, PhD, research professor of Biostatistics.

Hometown Heroes

I don’t know who nominated me, but last year, I was pleased to be selected as one of local radio station WCHL’s Hometown Heroes and was presented with a Village Pride Award. It’s always nice to be appreciated at home! I still don’t know who nominated me, but whoever it was, thank you! The station held a lovely luncheon Sunday for all the year’s heroes. Bernard and I met some very interesting people, including an accomplished young woman who is interested in public health. (Six degrees of separation does not apply to public health!)

I was delighted to see that Laura Linnan, ScD, associate professor of health behavior and health education, was one of the heroes. Laura does wonderful work.

At the event, Patti Thorp did a fabulous job of reminding all of us what it means to live in a community that is a community, and how we all will have to work at it even harder in these difficult times. It may be our neighbor who loses a job, a house, and his or her income. It might be one of us! The work our faculty, staff and students do in our communities has never been more important!

I am going to ask our communications staff to work with us to get more people from our School nominated this year. I know you, and there are a lot of heroes out there!

Good reading

Check out A Wellness Trust to Prioritize Disease Prevention by Jeanne Lambrew, PhD, our alumna who is now deputy director for the White House Office of Health Reform. She authored the report for the Brookings Institution, which has some of the best data I have seen on the case for prevention.

Atrium exhibit

We had the opportunity to host the National Library of Medicine’s global health exhibit, “Against the Odds,” this past week (Feb 6-13). ASPH provided interested member schools free access, and Maggie English coordinated the exhibit travel schedule for ASPH. It’s an awesome display that is now on display at East Tennesee State University in Johnson City.

Have a great week.

Happy Monday.

Barbara

Sunday afternoon

It’s one of those magnificent Chapel Hill days that makes one wonder why anyone would live anywhere else. As I drove along Franklin Street on my way to the office, I was glad to see so many people out on the street. It’s amazing how a warm winter day brings people outdoors. For readers elsewhere, it’s 70° F, bright blue sky with a few clouds. That is pretty good for February. I did think twice about turning around and going home to work in the garden, but there is so much to do at School.

Last week

Last week was the kind of week I really like. In the midst of a lot of high stress events, including our budget presentation to the Provost’s team, I attended three really exciting, interesting lectures.

Larry Michaelson, PhD, is professor of management at University of Central Missouri and author of Team-Based Learning. Peggy Leatt, PhD, associate dean for academic affairs and chair, Health Policy and Management, invited him to visit. I participated in part of one of his sessions (had to leave for a meeting) to demonstrate team-based learning. Instead of lecturing, he practiced what he preaches. Instead of spending most of a class session with lecture and slides, he advocates spending only a small proportion of the time lecturing about content and the rest in learning teams. He argues that people learn better this way. After observing him in action and reading several chapters in his book, I find the argument pretty impressive.

Muhammad Yunus, Nobel Peace Prize recipient, visited UNC the same day. Several of us met with him in the morning to discuss potential collaborations. Julie MacMillan, MPH, managing director, Carolina Public Health Solutions, and I went to his lecture at Kenan-Flagler Business School later in the day. It was one of the most remarkable lectures I have attended — ever. Dr. Yunus walked to the microphone and spoke calmly but with passion for about 45 minutes, with no slides and no notes. Yunus received the Nobel Prize for his pioneering work in Bangladesh with microcredit, in which small loans (often amazingly small) are made to women to help lead them and their families out of poverty. He created the successful Grameen Bank which provides the infrastructure by which to offer the loans, as Yunus says, without collateral and without all the red tape that accompanies most loans. And well over 90% of the loans are repaid. Microcredit is now offered by many organizations, and Yunus claims in his new book, Creating a World Without Poverty, that millions of people have been helped as a result. Why is this interesting to people in health care? Of course, we want to help people out of poverty, and there are lots of data that provide painful evidence about the relationship between poverty and ill health.

In his lecture, Yunus talked about Grameen’s success, and he described a number of social businesses. A social business has a social goal, like reducing malnutrition. The company involved reinvests profits in the business, rather than getting a distribution, but does get a return on its investment. Yunus told a remarkable story about a partnership between Grameen Bank and Groupe Danone (Dannon) to create a super-nutrient type of yogurt to be sold in poor countries as an aid in reducing malnutrition. The idea of social business is a compelling one, at least under Yunus’ strong guidance.

If I only told you that Yunus has compelling ideas and data, it would not be the whole story. The way he delivers his message, with gentle strength, humor and a bit of self-deprecation, is so moving and transforming that it almost feels like a religious experience.  I left the lecture hall feeling so much better for having been there.

Barbara Sorenson Hulka Symposium

Andy Olshan, PhD, professor and chair, epidemiology, and his colleagues organized a symposium Friday morning to honor Barbara Sorenson Hulka for her work in pioneering the field of molecular epidemiology. Speakers included Bob Millikan, PhD, DVM, Barbara Sorenson Hulka Professor of Epidemiology, UNC, and two outstanding epidemiologists from other institutions — Margaret Spitz, MD, MPH, professor and chair at M.D. Anderson Cancer Center, and Nat Rothman, MD, MPH, MHS, senior investigator, National Cancer Institute. It was a wonderful way to honor Barbara Hulka, former Kenan Professor of epidemiology and chair of the department. Bob Millikan’s talk was superb. He did a terrific job of interweaving comments about Barbara and her multiple interests and talents with a synthesis of what he had learned from her and how he had applied those lessons to explain the different trajectory of breast cancer in younger, African American women. Unfortunately, I had to leave for a meeting before Nat and Margaret spoke.

These lectures represent the best of what we are — a place where we push ourselves to think about better ways to do what we do (teach), where we bring in ideas from outside the University and subject them to scrutiny and where we look backwards to celebrate our colleagues’ contributions so we may do even better going forward. That’s a pretty good place to be!

Happy Monday!
Barbara

Meeting Alumni

Last week, Peggy Dean Glenn and I went to NYC to meet with some of our alumni in the area. When I meet with alumni, I am always so impressed by what they have accomplished and the many worlds in which they work. One of the people we visited was Gary Toenniessen, MSPH, PhD, a 1968 & 1971 alumnus of Environmental Sciences and Engineering. Gary is interim president of the Gates-Rockefeller AGRA Initiative and Managing Director at the Rockefeller Foundation, and we visited him there. His office has a fabulous view of New York City and the Empire State Building. I have been very impressed by the Foundation’s long history of investing in transformative research and demonstration projects. When Judith Rodin, PhD, became President, the Foundation focused its efforts on demonstrating impact. Gary himself has had tremendous impact. One of his accomplishments is in being part of the team that developed “golden rice,” a nutrient rich product that could make a huge difference in the nutritional status of the developing world if it can be gotten to people.

The possibilities for what one can do with a public health degree are limitless.

We also saw Clarence Pearson, MPH, and his wife Laurie Norris. Clarence is a 1952 alumnus of Health Behavior and Health Education. I first met Clarence when he lectured to one of my classes at the University of Michigan. Clarence had a noteworthy career working for Metropolitan Life Insurance Company (Met Life). Recently, he has had fascinating experiences consulting with the United Nations, AARP and writing a series of books on global issues with Laurie Norris. Clarence and Laurie have been great friends of the School. Several years ago, they turned the very tragic death of Clarence’s son Scott into positive action when they helped to support the development of an advocacy program under now Interim Chair Jo Anne Earp, ScD’s leadership. A forthcoming issue of the North Carolina Medical Journal will focus on critical issues related to advocacy.

This week…

is going to be one of those non-stop weeks with back-to-back meetings every day. I am really looking forward to meeting Muhammad Yunus, the Nobel Prize winner who took microcredit to a national level and showed convincingly how it could improve lives. He will be lecturing at the Kenan-Flagler Business School this week.

Have a good week and happy Monday. Barbara