TAG: "Public health"

Tweet your way to better health


UCSF study of social media shows potential to convey health messages.

Eleni Linos, UC San Francisco

Twitter and other social media should be better utilized to convey public health messages, especially to young adults, according to a new analysis by researchers at UC San Francisco.

The analysis focused on public conversations on the social media site Twitter around one health issue: indoor tanning beds, which are associated with an increased risk of skin cancer. The researchers assessed the frequency of Twitter mentions related to indoor tanning and tanning health risks during a two week period in 2013. During that timeframe, more than 154,000 tweets (English language) mentioned indoor tanning – amounting to 7.7 tweets per minute. But fewer than 10 percent mentioned any of the health risks, such as skin cancer, that have been linked to indoor tanning.

That offers a potentially valuable forum for conveying important health information directly to the people who might benefit the most from it, but the authors said further research is needed to explore whether that would be effective.

The analysis will be published as an editorial letter in the July 12 issue of The Lancet

“The numbers are staggering,” said senior author Eleni Linos, M.D., Dr.P.H., an assistant professor in the UCSF Department of Dermatology. “With 500 million tweets sent each day and over 1 billion Facebook users, it is clear that social media platforms are the way to go for public health campaigns, especially those focused on young adults.”

Linos has previously published influential research on the harms of indoor tanning beds. The research found that indoor tanning beds can cause non-melanoma skin cancer, with the risk rising the earlier one starts tanning. Indoor tanning has already been established as a risk factor for malignant melanoma, the deadliest form of skin cancer.

In their social media study, the researchers used a Twitter programming application to collect in real time all tweets that mentioned indoor tanning, tanning beds, tanning booths and tanning salons. During the study period in March and April 2013, more than 120,000 people posted at least one tweet about indoor tanning. Altogether, more than 113 million Twitter “followers” were potentially exposed to tweets about indoor tanning, the authors reported.

“Indoor tanning has reached alarming rates among young people,” said Linos. “And tanning beds account for hundreds of thousands of skin cancers each year. Through social media, we now have an opportunity to talk about these health risks directly with young people.”

Co-authors include Mackenzie R. Wehner, a Doris Duke Research Fellow at UCSF; Mary-Margaret Chren, M.D., professor of dermatology at UCSF; Melissa L. Shive, a medical student at UCSF; and Jack S. Resneck Jr., M.D., associate professor and vice chair of the UCSF Department of Dermatology.

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Eat, tray, love? Not for L.A. school kids and their vegetables


Many students didn’t even eat a bite of new, healthier items added to school lunch menus.

Cajoling, pleading, even blackmail — just a few of the tactics parents have used when their children refuse to eat vegetables they haven’t tried before. Now it appears that the nation’s second largest school district is facing the same problem.

The Los Angeles Unified School District, which serves more than 650,000 meals each day, has become a national leader in offering healthy foods to its students. In September 2011, LAUSD launched a new lunch menu that features a variety of more wholesome food items, including fruits and vegetables, whole grains, vegetarian items and a range of healthy ethnic foods.

Two months after the new menu was introduced, researchers from UCLA and the Los Angeles County Department of Public Health wanted to understand how students were responding to the new offerings. Their research, conducted at four Los Angeles schools, found that many children didn’t eat even a bite of the new, healthier items.

William McCarthy, a professor of health policy and management at the UCLA Fielding School of Public Health, and colleagues, measured the quantities of food left unselected in cafeteria food lines and the amount of food left over on students’ lunch trays. Almost 32 percent of students in the cafeteria lines did not select fruit, and almost 40 percent did not select vegetables. Among those who did select a fruit or vegetable, 22 percent threw away the fruit and 31 percent tossed vegetable items, without eating a single bite. Boys consistently threw away more fruit and vegetables away without tasting them than did girls.

The results appear in the current online edition of the journal Preventive Medicine.

“Eating a variety of fruits and vegetables every day is essential for optimal health, and implementing changes to school menus, as has been done by the LAUSD, is an important first step to increasing students’ repertoire of acceptable fruits and vegetables,” said McCarthy, the study’s co-senior author. “But increasing students’ consumption of fruits and vegetables is clearly a challenging task. Given the rising rates of obesity among children in this country, getting students to expand their range of acceptable fruits and vegetables is an important goal.”

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Diabetes linked to a third of state’s hospitalizations


UCLA study highlights impact the disease is having on California’s health care costs.

Patients with diabetes account for one in three hospitalizations in California, according to a comprehensive new study on the prevalence of diabetes in hospitals and its impact on providers and spiraling health care costs.

The study of hospital discharge records, conducted by the UCLA Center for Health Policy Research with support from the California Center for Public Health Advocacy, found that among all hospitalized California patients aged 35 or older — the age group that accounts for most hospitalizations — 31 percent had diabetes.

Although diabetes may not be the initial reason for these hospitalizations, the disproportionate share of patients with diabetes highlights the impact this disease is having on California’s health care costs.

The research also showcases the percent of hospitalizations of patients with diabetes and related costs by county.

“If you have diabetes, you are more likely to be hospitalized, and your stay will cost more,” said Ying-Ying Meng, lead author of the study and a researcher at the UCLA Center for Health Policy Research. “There is now overwhelming evidence to show that diabetes is devastating not just to patients and families but to the whole health care system.”

Diabetes is one of the nation’s fastest-growing diseases and one of the most costly. It adds an extra $1.6 billion every year to hospitalization costs in California, with hospital stays for patients with diabetes costing nearly $2,200 more than stays for non-diabetic patients, according to the study. Three-quarters of that care is paid through Medicare and Medi-Cal, the study authors found, including $254 million in costs that are paid by Medi-Cal alone.

The disease is responsible for a long list of complications, including blindness, kidney disease, cardiovascular disease, amputations and premature death. Since 1980, diabetes cases have more than tripled nationally to 20.9 million. In California alone, diabetes cases have increased by 35 percent in 10 years.

“For far too many families, diabetes has become a common and painful reality,” said Dr. Harold Goldstein, executive director of the California Center for Public Health Advocacy. “In very stark terms, this study shows local health care providers and policymakers the enormity of the diabetes epidemic in their counties.”

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Big Ideas@Berkeley launches new generations of social innovators


Winning entries demonstrate strategic blend of technology, social innovation.

Berkeley Ph.D. student Pablo Rosado, part of a team that developed ReMaterials to bring roofing systems to impoverished communities, explains the project at last week’s awards celebration.

Every year, thousands of students come to Berkeley with vague ambitions to change the world. The annual Big Ideas@Berkeley competition is inspiring some of them to do just that — by launching globally life-changing innovations even before they graduate. Last week, the program honored this year’s winning projects with an awards celebration at the Blum Center for Developing Economies.

From building Africa’s first wind- and solar-powered radio station to promoting yogurt for improved child nutrition in Nepal to creating an app to show the safest nighttime routes on the Berkeley campus, the competition’s winning entries all demonstrated a strategic blend of technology and social innovation.

“We’re teaching our students to face a challenge, take a risk and use their educations for real-world impact and social good,” said Phillip Denny, Big Ideas program manager and chief administrative officer at the Blum Center. “We’re helping them to get ideas out of their heads and to put actionable plans on paper.”

In contrast to most other business-plan competitions, Big Ideas@Berkeley is focused on social change. The yearlong program, started in 2006, offers training and mentoring for teams of undergraduate and grad students. They learn critical thinking, market analysis and presentation skills to develop real-world projects that are both feasible and scalable.

The competition is supported by several Berkeley centers and institutes, as well as key sponsors such as the Andrew and Virginia Rudd Family Foundation, the Charles Schwab Foundation and the Center for Information Technology Research in the Interest of Society, or CITRIS. This year, the program also formed a new partnership with the crowdfunding site Indiegogo to better promote and fund the projects.

“It’s a very Berkeley-esque idea,” said sponsor and judge Andrew Rudd, who earned his MBA at the Haas School of Business. “These students are doing something positive with what they’ve learned, to bring the 21st century to parts of the world that don’t share our good fortune.”

The competition drew proposals from 187 teams of more than 600 students from 75 different majors, five UC campuses and four other universities nationwide. Judges recognized a total of 40 projects with awards from $1,000 to $10,000 across nine categories including open data, human rights, clean and sustainable energy alternatives, social justice and information technology.

“The diversity, quality and overall execution were really extraordinary this year,” said Denny. “The winning entries were chosen based on the combination of personal passion and a commitment to improving the world.”

Advancing the lives of those in poverty

First place in the “global-poverty alleviation” category went to ElectroSan, a system that improves public health and the environment by converting human waste into income-producing by-products. The process applies electrochemical cells to recover nitrogen from human urine and to disinfect feces, bringing affordable sanitation to poverty-stricken communities.

Inspired by a visit to the urban slums of Nairobi in 2013, Ph.D. student William Tarpeh seeks to introduce waste treatment to the 4.6 billion people in the developing world who currently can’t afford adequate sanitation facilities. The project is in the technology- development phase to ensure maximum nitrogen recovery.

“Connecting technology and international development was a great part of this experience,” explained Tarpeh, who’s working toward a doctorate in environmental engineering. “Big Ideas helped me to think at both the molecular level and the business-model scale to bring this to fruition.”

Rami Ariss, a junior in chemical and biomolecular engineering, and Othmane Benkirane, a junior in energy engineering and structural engineering, won first place in the “clean and sustainable-energy alternatives” category. Their project, Solidge, is a solar-powered refrigeration system that doesn’t rely on an electricity grid. Refrigerators are the most sought-after appliance in low-income communities; by integrating energy generation, storage and use into the same appliance, Solidge enables users to store food, unsold crops or vaccines for longer periods. The project will initially launch in Benkirane’s native Morocco, but will ultimately be deployed in developing countries globally.

Benkirane credits the Big Ideas competition with changing his career focus from new technologies to pressing energy needs in developing countries. “The Solidge project taught us to really listen to the end user,” he said. “Whether they’re graduates of prestigious universities, blue-collar workers or rural farmers in eastern Morocco, all of these people have equal insights, and Solidge taught me to look for the hidden ones.”

Scaling up

“Scaling up Big Ideas” was the category for previous contest winners who are further along in implementing their projects. First place went to a team led by Charles Salmen, a recent graduate of UC San Francisco’s medical school, for a wind- and solar-powered radio station that reaches 200,000 listeners across Kenya, Uganda and Tanzania. An all-Berkeley team of Pablo Rosado and Hasit Ganatra, both Ph.D. students in mechanical engineering, and Caitlin Touchberry, a master’s student in development practice, took second place for ReMaterials, which provides roofing systems for communities in poverty.

More than a billion people currently live in slums worldwide, and adequate roofing is a critical issue for public health and comfort. The team has already developed a natural, recycled material mix and manufacturing process at the prototype level, and is now working on scaling up the manufacturing process, improving the supply chain and developing a sales and marketing strategy to attract investors and key partners.

“Last year we were focused on the engineering side, developing the materials and building small-scale roofs,” explained Rosado. “Now we’re looking for a mentor in law and finance to help us get the product to market. We’re going to India this summer to do a first round with our target audience.”

Participants uniformly credited mentorship as a critical component of the Big Ideas ecosystem. Tony Stayner, an angel investor and nonprofit board member, served as a Big Ideas judge and as a mentor to the ReMaterials project. He credited the program with increasing his own body of experience and his interest in social entrepreneurship.

“If you ever get depressed about the future of the world, go spend some time with the Big Ideas students,” he said. “They’re bright, creative, big-hearted and very passionate about making the world a better place.”

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Public health prep


Freshman thrives in research program.

Working with HERMOSA (Health & Environmental Research on Makeup Of Salinas Adolescents) helped build UC Berkeley freshman Maritza Cardenas' passion for research. (Photo by Robert Durell)

For Maritza Cardenas, life as a Berkeley freshman is exciting, and more than a little daunting. She is majoring in molecular and cellular biology, and plans to go to medical school. But there’s a minor hurdle: Freshman chemistry is the first laboratory class she’s ever had.

Growing up in the central California agricultural town of Salinas, Maritza didn’t get as much science prep as most of her fellow Cal classmates.

“I wasn’t very exposed to the idea of science in high school, but as I was applying to college and seeing how competitive it was, there was always this word ‘research.’ I think one of my main drives was being part of research — even though I really didn’t have a clear sense of what it meant.”

She got her chance to learn what it meant the summer after high school as one of 16 Salinas teens participating in a two-year program that trained them in public health and biomedical research while at the same time focusing on a potential health hazard to young women in the community.

The project, funded by UC’s California Breast Cancer Research Program, taught the students to design and carry out public health research and how to best reach out to their community to gather data and inform people about health risks. The teens also collected and prepared material for laboratory analysis.

The training focuses on potential dangers posed by chemicals known as endocrine disrupters, found in shampoos, face creams and other personal care products. Endocrine disrupters interfere with normal hormonal function, and are thought to pose a particular threat during the teen years when hormone-driven development accelerates.

The project, called HERMOSA (Health & Environmental Research on Makeup Of Salinas Adolescents), is a collaboration between Berkeley’s School of Public Health and Clinica de Salud del Valle de Salinas, a network of clinics providing primary health care to low-income and agricultural communities in Monterey County.

The team effort drew on a Salinas-based youth council developed by the public health school’s Center for Environmental Research and Children’s Health, or CERCH, where teens gain leadership experience and focus on environmental health issues of particular concern to the community. Public health school professor Kim Harley is a co-director of HERMOSA.

Kimberly Parra, the project’s other co-director and herself a Berkeley grad, praises Maritza’s discipline and persistence, but singles out one trait that she thinks has mattered most:

“The No.1 quality — the reason Maritza has been able to flourish — is that she really cares about her community and she’s very confident that she can influence it. She’s very humble at the same time.”

Growing up in Salinas, Maritza says her family was on Medi-Cal.

“We were receiving a lot of assistance. Being in that position, and seeing that it’s a big part of Salinas, I’m hoping to return home after medical school and start a clinic there.

“I see myself as the kind of doctor who has relationships with patients. I feel like I could be the kind of health provider that can educate patients, focusing on prevention, helping them help themselves.”

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Healthier choices score at campus vending machines


UCLA finds healthy snacks sell well on campus.

UCLA doctoral student Joe Viana

You get a case of the mid-afternoon munchies, and all you want is something salty, sweet or crunchy. (Or, better yet, all three.)

With about 100 snack vending machines on campus, UCLA has no shortage of options to satisfy your craving — some more nutritional than others. But what if there were snacks that were better for you? And what if they were clearly identified as healthier alternatives? Would you choose them?

Joe Viana thinks you might.

A doctoral student at the UCLA Fielding School of Public Health, Viana recently concluded a study on whether people at UCLA would pick items like trail mix, nuts and air-popped snacks — if those healthier products were better promoted — or continue buying potato chips, cookies and candy bars. He found not only that consumers are interested in having healthier items available in vending machines, but that offering them did not hurt the vending machines’ sales.

The study, believed to be the first of its kind on an American college campus, was initiated by UCLA’s Healthy Campus Initiative — a program launched in 2013 to promote a culture of mental and physical health and wellness — and was conducted in collaboration with UCLA Dining Services and UCLA Vending Services.

“What we aimed to do was methodologically identify healthier products and encourage customers to choose them, all without compromising the machines’ financial performance,” Viana said.

In 2013, 35 of UCLA’s 100 snack vending machines were stocked with either one or two rows of healthier options. Each machine was marked with a Healthy Campus Initiative sticker, and stickers in front of each row of healthy snacks identified the wholesome options. The other snack machines contained some healthier snacks, but fewer than the HCI-marked machines, and all of the machines continued to carry the traditional snack options.

“The idea is not to tell people what they can and can’t eat, but rather give them the option to choose,” said Michael Goldstein, associate vice provost for the Healthy Campus Initiative.

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Grad students to present research on STDs, parasites in Latin America


UCLA Blum Center conference to feature latest research on health, poverty in Latin America.

UCLA graduate student Claire Bristow conducted research at a Peruvian university.

In Peru, HIV and syphilis are more widespread among transgender women and men who have sex with men, and so ensuring that these groups get tested and treated is crucial.

A research project supported by UCLA’s Blum Center for Poverty and Health in Latin America is contributing to efforts in Peru to make this happen.

Claire Bristow, a UCLA Ph.D. student in public health who conducted research in Peru, and Rebecca Foelber, a master’s student in public health who worked in Brazil on another project, will present their research on behalf of the center at its Second Annual Spring Conference May 6-7 at UCLA’s De Neve Auditorium. Bristow and Foelber were selected for the Blum Center’s inaugural Summer Scholars Program.

Conference participants, who include UCLA students, faculty and staff as well as policy and health professionals from 10 Latin American countries, will discuss the latest research on health and poverty in Latin America. The conference will also highlight solutions and projects such as Bristow’s.

“The Summer Scholars Program was developed for students to examine how poverty, government practices and policies, and other factors impact poor health in Latin America,” said Dr. Michael Rodriguez, Blum Center director. “More importantly, the scholars’ research can lead to better health practices and solutions in a region that is so desperately in need of them.”

Bristow spent last summer in Lima, Peru, where she developed a study that asked people in these high-risk groups what type of HIV and syphilis testing they would prefer.

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Harm-reduction program optimizes HIV/AIDS prevention


Stonewall Project helps decrease stimulant use, reduce sexual risk behavior, study shows.

Adam Carrico, UC San Francisco

New research from UC San Francisco and the San Francisco AIDS Foundation has found that clients participating in a harm-reduction substance use treatment program, the Stonewall Project, decrease their use of stimulants, such as methamphetamine, and reduce their sexual risk behavior.

Harm reduction is a public health philosophy and strategy designed to reduce the harmful consequences of various, sometimes illegal, human behaviors such as the use of alcohol and other drugs regardless of whether a person is willing or able to cease that behavior.

“We found that even when participants were using methamphetamine, they reported engaging in HIV risk-reduction strategies such as having fewer anal sex partners after enrolling in Stonewall,” said the study’s lead investigator, Adam W. Carrico, Ph.D., UCSF assistant professor of nursing.

The research findings appear online today (April 18) in the Journal of Urban Health. The Stonewall Project, a San Francisco AIDS Foundation program, serves substance-using gay and bisexual men as well as other men who have sex with men.  Stonewall implements evidence-based, cognitive-behavioral substance use treatment from a harm-reduction perspective. At Stonewall, clients have the option of abstinence, but also may use harm-reduction strategies such as transitioning to less potent modes of administration (e.g., injecting to snorting) or reducing sexual risk taking while they are under the influence.

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Community-based HIV prevention can boost testing


Prevention efforts also can help reduce new infections, study shows.

Thomas Coates, UCLA

Communities in Africa and Thailand that worked together on HIV-prevention efforts saw not only a rise in HIV screening but a drop in new infections, according to a new study in the peer-reviewed journal The Lancet Global Health.

The U.S. National Institute of Mental Health’s Project Accept — a trial conducted by the HIV Prevention Trials Network to test a combination of social, behavioral and structural HIV-prevention interventions — demonstrated that a series of community efforts boosted the number of people tested for HIV and resulted in a 14 percent reduction in new HIV infections, compared with control communities.

Much of the research was conducted in sub-Saharan Africa, which has particularly high rates of HIV. The researchers were interested not just in how the clinical trial participants’ behavior changed, but also in how these efforts affected the community as a whole, said Thomas Coates, Project Accept’s overall principal investigator and director of UCLA’s Center for World Health.

“The study clearly demonstrates that high rates of testing can be achieved by going into communities and that this strategy can result in increased HIV detection, which makes referral to care possible,” said Coates, who also is an associate director of the UCLA AIDS Institute. “This has major public health benefit implications — not only suggesting how to link infected individuals to care, but also encouraging testing in entire communities and therefore also reducing further HIV transmission.”

These findings were previously presented at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta.

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UCLA hospitals serve up antibiotic-free beef, chicken


New menu additions further medical center’s focus on healthier eating.

UCLA Health System's Patricia Oliver and Chef Gabriel Gomez with antibiotic-free menu items

Patients, staff and visitors to the Ronald Reagan UCLA Medical Center and UCLA Medical Center, Santa Monica can now enjoy a healthier version of the traditional burger-and-fries lunch. The hospitals’ menus now include burgers made from antibiotic-free, grass-fed beef and herb roasted potatoes, as well as antibiotic-free chicken breasts.

With the changes, the hospitals are helping lead the trend toward serving healthier, antibiotic-free meats.

This move is in line with other initiatives instituted recently by the health system to promote a healthier community, including banning fried foods, offering “meatless Mondays,” and using biodegradable utensils and plates.

The menu enhancements were spurred in part by concern about bacteria’s growing resistance to antibiotics. According to Dr. Daniel Uslan, an assistant clinical professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA, an overuse of antibiotics in cows, chickens and other food-producing animals has helped make bacteria resistant to commonly used antibiotics, which in turn has led to more antibiotic-resistant infections in humans.

“With the effectiveness of key antibiotics dwindling, bacterial resistance presents a major public health challenge,” said Uslan, who also is director of the antimicrobial stewardship program at the UCLA Health System. “It’s critical that we reduce unnecessary antibiotic use in agriculture and support appropriate antibiotic use by clinicians and patients.”

According to the Food and Drug Administration, 80 percent of all antibiotics sold in the U.S. are used for food-producing animals. There is a growing public health concern that the antibiotics are being used mostly to promote faster growth in otherwise healthy animals and to compensate for unsanitary and overcrowded living conditions.

Meanwhile, the health care community is increasingly instituting policies to help combat antibiotic resistance in patient care and to minimize exposure to unnecessary antibiotics as part of broader environmental sustainability plans, including in food service.

“We are excited about this new initiative,” said Dr. David Feinberg, president of the UCLA Health System and CEO of the UCLA Hospital System. “Serving antibiotic-free beef and chicken is another way for us to do our part and support our vision of a healthier community.”

The UCLA Health System has been recognized nationally for its efforts to promote wellness and sustainability, receiving awards in 2013 from Practice Greenhealth and Health Care Without Harm for offering more vegetarian menu options, increasing its use of composting, reducing food waste, launching energy- and water-conservation programs, and other initiatives; and it participates in national campaigns including the Healthier Hospitals Initiative. The health system’s adoption of antibiotic-free beef and chicken complements University of California system-wide sustainability policies.

“We serve more than 3.4 million meals annually between our two hospitals and are always looking for ways to enhance and improve our services,” said Patricia Oliver, UCLA Health System’s director of nutrition services. Oliver also is the Los Angeles area coordinator for the Healthy Food in Health Care program, through which more than 30 local hospitals and 128 hospitals state-wide leverage their combined health expertise and purchasing power to promote healthier food systems.

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Most injuries and illnesses in agriculture are not counted


Study shows the problem is about three times bigger than previously suspected.

J. Paul Leigh, UC Davis

Federal agencies responsible for tracking workplace hazards fail to report 77 percent of the injuries and illnesses of U.S. agricultural workers and farmers, new research from UC Davis has found. The lack of complete data greatly reduces the chances that safety and health risks for the nation’s food suppliers will be corrected.

Published in the April issue of the Annals of Epidemiology and led by J. Paul Leigh, professor of public health sciences and researcher with the UC Davis Center for Healthcare Policy and Research, the study confirms the long-held belief that government reports dramatically and routinely undercount agricultural injuries and illnesses, ranging from chemical exposures to musculoskeletal injuries.

“Whatever anyone might have assumed about gaps in government statistics for agriculture, our study shows that the problem is actually about three times bigger than previously suspected,” said Leigh.

According to Leigh, the primary reasons for the discrepancy are the government’s focus on mid- to large-sized farming enterprises, which represent less than 50 percent of employment in the agricultural industry, along with the part-time nature of farm work and undisclosed information about injuries.

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Looking to the future


A conversation between deans of the UC Berkeley School of Public Health.

Stephen Shortell (left) and Stefano Bertozzi

Dr. Stefano Bertozzi began his service as dean of at the UC Berkeley School of Public Health in September 2013, succeeding Dean emeritus Stephen Shortell. Previously Bertozzi was at the Bill & Melinda Gates Foundation, where he directed the HIV program and led a team that managed the foundation’s portfolio of grants in HIV vaccine development, biomedical prevention research, diagnostics, and strategies for introduction and scaling-up of interventions. He serves on the scientific advisory boards for the President’s Emergency Plan for AIDS Relief, the National Institute of Health’s Office of AIDS Research, and the World Health Organization’s HIV Program.

Prior to joining the Gates Foundation, Bertozzi worked at the Mexican National Institute of Public Health as director of its Center for Evaluation Research and Surveys. He has also held positions with UNAIDS and the World Bank and was the last person to lead the WHO Global Program on AIDS before it metamorphed into UNAIDS. He holds a bachelor’s degree in biology and a PhD in health policy and management from the Massachusetts Institute of Technology. He earned his medical degree at UC San Diego, and trained in internal medicine at UC San Francisco.

Read the conversation between the deans.

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