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Former Surgeons General Speak

Dietrich Bonhoeffer argued that the morality of a society could be measured by how it treats its children. By that standard, Marian Wright Edelman told an audience of public health students and practitioners on the UM campus in January, the United States “flunks.” Edelman, the founder and president of the Children’s Defense Fund, spoke at a day-long symposium on “Public Health Leadership to Improve the Health of Young People,” presented by the SPH Office of Public Health Practice. Edelman told the crowd the richest nation in the world must reorder its priorities if the 1.3 million American children who now live in poverty are to have a chance at a healthy future. Her theme was echoed later in the day by fellow speaker and former U.S. Surgeon General Joycelyn Elders, who said America must “develop policies to fit a millennium generation.” Former U.S. Surgeon General Richard Carmona and SPH Professor Vic Strecher also spoke at the event, which was webcast to 541 attendees. To hear the webcast, visit www.umsphpractice.org.

Dingell: Health Care Reform Needed Now

The stars are aligning like no other time in history to reform our health care system, U.S. Rep. John Dingell, D-Dearborn, said during a visit to the School of Public Health in February. “With our economy under strain, our patients, businesses and states suffering, it is apparent that we need to act now to reform the health care system that hemorrhages money to stabilize our economy,” he said. Dingell, the longest serving House member, represents Michigan’s 15th District including Ann Arbor, and participated in “A Discussion on Health Care Reform in the 111th Congress” with two panelists at SPH (watch webcast). Marianne Udow-Phillips, MHSA ’78, director of the UM Center for Healthcare Quality and Transformation, talked about “Setting the Stage for Meaningful Reform.” Christopher Jennings, former White House senior health care adviser to President Clinton, 1993–2001, spoke on lessons learned during the Clinton administration.

Audience members packed the school’s auditorium and overflow rooms during the event, moderated by Paula Lantz, who chairs the Department of Health Management and Policy.

“There is no question that the time is right for the most developed country in the world to catch up with our competitors around the world,” said Dingell, who has introduced HR 15, a bill that would provide universal access to health care, at the start of every Congressional session since his first year in office.

Compounding the problem for many people nationwide and in Michigan is lack of health coverage due to job losses, Udow-Phillips said. Premiums and co-pays also have climbed in Michigan from 2000 to 2006. The annual family premium cost $11,452 in 2006, up 68 percent from 2000.

Jennings agreed with Dingell that people want affordable health care, and it’s important for them to convey this individually and collectively to elected officials. Like Dingell, Jennings said he’s optimistic about the Obama administration’s ability to implement universal health care despite opposition scare tactics similar to ones in the past. —by Jared Wadley, UM News Service

In the News: BPA

Last fall, SPH Senior Associate Dean Martin Philbert chaired a Food and Drug Administration subcommittee charged with evaluating the FDA’s assessment on the safety of bisphenol A, commonly known as BPA. At the time, Philbert was acting director of the UM Risk Science Center, which derives a significant amount of its funding from outside donors, one of whom had publicly disputed the risks of BPA. All gifts to the University of Michigan are bound by rigorous restrictions relating to academic freedom, and donors give gifts knowing that they will be used for the independent and objective study of a subject. Nevertheless, some reporters and lawmakers questioned whether there was a conflict of interest in Philbert’s service on the committee because of the gift to the center. The FDA maintained that Philbert’s conduct had been ethical and professional.

The subcommittee report, released on October 31, 2008, raised important questions about the FDA’s initial draft safety assessment and concluded that the margins of safety defined by the FDA as adequate were, in fact, inadequate. Further study to address the potential low-dose effects of BPA was recommended. Those who had initially questioned the legitimacy of the report quickly reversed their position and praised its findings.

Philbert says the experience taught him “that at the intersection between science and policy, science is only one element that feeds into decision-making and into the garnering of public support for a particular position.” The science must therefore be “absolutely sound.” But at the same time, scientists must understand “that the science is just a point of departure. A wealth of other considerations are brought to bear on whether or not the public perceives a scientific pronouncement to be fair, to be appropriate, and most importantly, in their interest—no matter the finding.”

Going forward, Philbert says, the challenge that he and others face will be “to do the very best science with the available resources while maintaining public trust.” He believes this will require greater transparency in the funding process, in stakeholder engagement, and in the collection and dissemination of data during and after the completion of a given study. Read the FDA subcommittee report on BPA. <

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More SPH Digest...

> During Barack Obama’s run for the Democratic nomination and later the presidency, members of his campaign staff tapped Paula Lantz, the S.J. Axelrod Collegiate Professor and chair of Health Management and Policy, to serve as co-chair of the campaign’s Public Health Subcommittee. Cliff Douglas, an adjunct lecturer in HMP and director of the UM Tobacco Research Network, also served on the subcommittee. He and Lantz helped advise the campaign on policy and substantive is-sues related to public health, and in the build-up to Election Day organized a statewide campaign of letters to the editor and op-eds focused on health care and public health issues. Lantz believes Obama’s election, together with the nation’s apparent readiness for change, has opened a “political window” for health care reform. “My goal would be to have reform in our public health system come along with that,” she says. “This is not just about health insurance.” A third SPH affiliate, Don Vereen, director of community-based public health at SPH, served as a team leader for the Obama-Biden Transition Team, reviewing and advising the Executive Office of the President on drug policy issues.

> Among the 29 students enrolled in the school’s new Certificate in the Foundations of Public Health program are a U.S. soldier in Iraq, a dental surgeon in India, and a public health nurse in Michigan’s Upper Peninsula, who says she hopes the program will help her address issues affecting the UP and the country at large. Students in the program take one to two online courses per semester and meet with SPH faculty and their fellow certificate students via synchronous online discussions. The 16 credits they receive after completing the program may be applied to a residential or executive MPH program at SPH.

> In November, Sandro Galea, a professor of epidemiology at SPH, became the founding director of the UM Center for Global Health. His biggest challenge as director, he says, will be to help “build a center from scratch” while determining ways to capitalize on the extraordinary range of global health work already taking place at Michigan. “But that’s also what’s most exciting about the job,” he adds. The center will concentrate on addressing global health equity in four key areas: noncommunicable diseases, human resources for health, the health effects of urbanization, and global environmental climate change. The Bill and Melinda Gates Foundation recently awarded the center a $3 million grant to support its efforts related to human resources for health.