Research in Action: Promoting health, preventing disease

By Alec Rosenberg

The H1N1 flu pandemic and Haiti earthquake highlight the life-saving role public health professionals play when a crisis hits. Whether preparing for an infectious disease outbreak or the next big earthquake, the University of California's two public health schools at UC Berkeley and UCLA have been at the forefront of efforts to promote healthy communities, prevent disease and create a safer world.

Here is a look at ways UC public health is making a difference working on some of California's biggest health issues: obesity, environmental health and disaster preparedness.

Obesity

More than 60 percent of adults and 30 percent of children in California and nationally are overweight or obese. The estimated cost to California for overweight adults, obesity and physical inactivity has nearly doubled in six years to $41 billion a year, according to the California Center for Public Health Advocacy.

UC public health schools are stepping up to the challenge. At UC Berkeley, the Dr. Robert C. and Veronica Atkins Center for Weight and Health conducted research that provided evidence for state policy to remove sodas from schools.

At UCLA, Dr. Antronette Yancey is tackling the obesity problem 10 minutes at a time. Yancey, a professor of health services, board-certified physician in preventive medicine and former college basketball player, has developed 10-minute routines of fun, simple, low-impact movements called Lift Offs! and Instant Recess!
 
"For somebody who is not very active, you could be doubling or tripling their activity," said Yancey, who co-directs the UCLA Kaiser Permanente Center for Health Equity. "The public health approach is not how to get a few people to do a lot; it's how you get a lot of people to do a little."

Her routines get people marching and moving, whether in the workplace or classroom. She tailors programs to appeal to all ages and ethnicities, using music from big band to gospel and incorporating African, Filipino and Latin dance. She has partnered with pro athletes such as football player Allen Rossum and teams such as Major League Baseball’s San Diego Padres and the WNBA’s Los Angeles Sparks to help spread the message.

"We're interested in prevention," said Yancey, whose "Instant Recess" book will be published this fall by UC Press. "If you start early and you engage the majority of the population, then you can actually prevent heart attacks and strokes."

Yancey would like to see government funding for schools to implement exercise breaks. Also, she supports employer tax incentives for certain wellness programs. "It's not just altruism," she said. "These employees become more productive. Their health care costs go down. Their morale goes up."

Environmental health

Chemicals in industrial products and industrial processes pose another set of risks to public health. The health and environmental impacts of some 80,000 industrial chemicals used in the United States are largely unknown despite their ubiquity. Where good information exists, there is cause for concern: A recent UC Berkeley study authored by Kim Harley linked reduced fertility to flame-retardant chemicals commonly found in household consumer products such as foam furniture, electronics, carpets and plastics.

"The concern is that findings like these may be just the tip of the iceberg," said Dr. Megan Schwarzman, a UC Berkeley research scientist.

In fact, chemical and pollution-related diseases among children and workers in California cost the state an estimated $2.6 billion, according to UC Berkeley and UCLA researchers.

Such concerns have led to action. Informed by the work of UC researchers, the California Environmental Protection Agency launched an ambitious Green Chemistry Initiative in 2007 that was designed to spur the innovation of chemicals and products that are safer for human health and the environment.

One initiative goal is to prevent the unintended health consequences of chemical substitutions. UC Berkeley research scientist Michael Wilson studied auto mechanics disabled by a neurotoxic blend of hexane and acetone used as a brake cleaner. The product had been substituted for chlorinated solvents phased out for their contribution to dioxin pollution. The next reformulation was no better: Hexane was swapped out for bromopropane, known to cause sterility, Wilson said.

"The current approach to managing chemicals is akin to an emergency response system, which is not enough. You also need to have a prevention system in place," Wilson said.

That's starting. In 2008, following recommendations from California EPA's Green Chemistry Initiative, the Legislature passed two landmark bills to create an online toxic clearinghouse and accelerate the quest for safer products. These efforts were prompted by a 2006 green chemistry report authored by Wilson that the Legislature requested and a second report authored by Schwarzman, Wilson and UCLA colleagues, which outlined the case for transforming chemical management policies.

Chemistry education also is going green. In 2009, UC Berkeley established the Berkeley Center for Green Chemistry, a collaboration of the colleges of chemistry and natural resources and schools of business, law and public health. The center, which recently received a $500,000 curriculum development award from the state, will train the next generation of synthetic chemists, chemical engineers, business leaders and policymakers to design products and make decisions that are better for the environment and human health.

At UCLA, a multidisciplinary team has established the UCLA Law and Environmental Health Initiative on Sustainable Technology to tackle key environmental sustainability issues from a policy perspective. Additionally, the School of Public Health plays a central role in a federally funded national effort to learn more about the implications of nanotechnology for the environment and human health.

Meanwhile, California's green chemistry laws are bolstering efforts in other states to address the issue and could lead to reform of the federal Toxic Substances Control Act, Wilson said. "There's opportunity for a whole new business approach," he said. "California has the potential to be way out in front on this."

Disaster preparedness

From the H1N1 flu pandemic to the Haiti earthquake, it has been a busy year for public health professionals who focus on disaster preparedness and emergency response.

The H1N1 vaccine "is safe as far as we can tell" and its effectiveness is being evaluated, said UC Berkeley Dr. Arthur Reingold, who co-directs the federally funded California Emerging Infections Program, a collaboration of local, state and federal partners. The program, which studies infections from influenza to meningitis, has developed preventive strategies against diseases such as food-borne illnesses and pneumonia. "As things come on the radar screen, we devote more attention to them," Reingold said.

The United States has invested in pandemic flu preparedness for several years. Still, there have been several surprises with H1N1, from its broad spread in our "backyard" before being detected to vaccine manufacturing delays, said Dr. Tomas Aragon, director of UC Berkeley's Center for Infectious Diseases and Emergency Readiness (CIDER), which does public health work force training and collaborates closely with the state Department of Public Health on pandemic flu planning for vaccination prioritization and implementation.

"The novel H1N1 influenza-A pandemic is testing our preparedness and response systems, which will lead to longer term improvements in our capabilities," Aragon said.

CIDER and UCLA's Center for Public Health and Disasters each received federal funding this fall to conduct research to evaluate public health systems for preparedness and emergency response activities. Kimberley Shoaf, an associate professor-in-residence and assistant director of the UCLA center, said the tragedy in Haiti highlights the importance of responding quickly to an emergency with medical care, food and water.

It's also a reminder to prepare for California's next major quake. Shoaf designed the health and medical impacts of the 2008 Great Southern California ShakeOut exercise, which simulated a magnitude 7.8 quake.

"I think it raised a whole lot of eyebrows to the length of time it would take us to recover from something of that magnitude," she said. "We need to look at preparedness at all levels — the individual, the family, the community."

Alec Rosenberg is the health communications coordinator in the UC Office of the President's Integrated Communications group.