On Saturday, June 12, an alumni panel convened, representing the fields of politics, community services, finances, and science. Above, Jarrett Barrios (r) makes a humorous point. Eli Newberger is at left.

The weekend was kicked off with a dinner that included the presentation of awards of merit by HSPH Dean Barry Bloom to honor three alumni who have made notable differences in public health. Introducing the winners was J. Jacques Carter, MD, MPH ’83, president-elect of the Alumni Council and chair of the committees for Alumni Weekend and the Alumni Awards of Merit. A total of 38 nominations were received–the highest ever.

At left, Hugh Tilson (second from right) accepts his award of merit from (l to r) Barry Levy, Dean Bloom, and J. Jacques Carter.

A nutrition expert, Johanna Dwyer, RD, SM ’65, SD ’69, has worked to help strengthen the role of human nutrition research in considerations for federal policymaking. She worked on the White House Conference on Food, Nutrition, and Health and as the Assistant Administrator for Human Nutrition, Agricultural Research Service, USDA. She currently directs the Frances Stern Nutrition Center at the New England Medical Center.

M. Cristina Leske, MD, MPH ’66, has researched the epidemiology of ocular diseases in people of African descent to help prevent blindness. She also studies the incidence and risk factors for breast and prostate cancer. She is former chair of the Department of Preventive Medicine at Stony Brook, one of the few Hispanic women in the U.S. to have led a medical school department. She is now a Distinguished Professor (Preventive Medicine and Ophthalmology) at the School of Medicine, Stony Brook University. Leske was the alumni speaker at this year’s HSPH Commencement.

	Johanna Dwyer

An epidemiologist and outcomes researcher, Hugh Tilson, MD, MPH ’69, DPH ’72, has a career spanning local and state health offices, the pharmaceutical industry, and academia. He served on the Institute of Medicine (IOM) Committee that wrote the landmark 1988 report, "The Future of Public Health," which helped define the field and served as a call to action for schools of public health across the nation. An update to the report was released in 2002, and Tilson served as liaison between the IOM Committee and the IOM Board on Health Promotion and Disease Prevention. He currently is a clinical professor at the School of Public Health at the University of North Carolina, Chapel Hill.

Keeping Risk in Perspective

"Why do our fears often not match facts?" he asked. This so-called "bounded rationality" has been studied by Paul Slovic of the University of Oregon, Baruch Fischhoff of Carnegie Mellon University, and others, Ropeik said. The researchers call it the "psychology of risk perception," which identifies a set of characteristics of risk that subconsciously affects what people fear and how much.

David Ropeik

Why does risk perception matter? Because the public wants protection from what frightens and concerns them, explained Ropeik. That desire affects policymaking and the distribution of funding and other resources.

Scientific literature also points to the relationship between risk perception and stress, noted Ropeik.

"The more worried people are, the worse it is for their health," he said. "There is a direct and important connection between the perception of risk and public health that needs more research and study," he added.

Understanding Health Care in the Country

	M. Cristina Leske

Four panelists from the fields of politics, community services, finances, and science presented their views.

"If we took seriously health outcomes, we would have a very different state budget," asserted Massachusetts State Senator Jarrett Barrios (D-Cambridge), AB ’90, JD, who serves as Vice Chair of the legislature's Joint Committee on Health Care.

The state cut $3 billion in spending on programs over the past three years, including slashes made to health care programs. The budget proposed for fiscal year 2005 seeks to restore some of that funding.

Nancy Kane

A majority of Americans are insured through employer health plans, yet those numbers are dropping–not because coverage is no longer available but because its cost is too high.

"A growing number of people don’t take advantage of employer-provided plans, in part because employers have added high deductibles or have raised premiums," said Kane.

Some people would rather take their chances and forego health insurance than pay prices they cannot afford. Consequently, more and more Americans are going into debt when they face health care emergencies, especially if they have charged medical expenses to credit cards.

"Some people have lost their homes or had salaries garnished," said Kane. "People are afraid to go back to doctors because they still owe money. I have heard of people restricting their children from playing sports, fearing injury. We have even seen non-profit hospitals lose their tax status because they were too aggressive going after debt."

	Sandra Lopacki

One program had great success matching dental students to second- and sixth-graders in need of tooth care in Cleveland; another in Indiana used school buildings at night to teach seniors and young people about physical activity and wellness; another in California helped immigrants from war-torn Eritrea cope with post-traumatic stress and other mental health problems.

	Eileen Kennedy

Eli Newberger, MD, SM ’72, lecturer in the Department of Society, Human Development, and Health, moderated the panel. Alumni Council President-Elect J. Jacques Carter introduced the panelists. Barry Levy, MD, MPH ’70, current Alumni Council President, welcomed attendees.

Disparities in Health Care

	Linda Clayton and W. Michael Byrd

Health care disparities in the U.S. persist in delivery systems, insurance status, access to quality care, and even clinical decision-making, asserted W. Michael Byrd, MD, MPH ’92, and Linda Clayton, MD, MPH ’92, during a keynote address following lunch. For example, Clayton said, African Americans frequently are not given the same diagnosis for the same symptoms presented by white patients.

The pair co-authored An American Health Dilemma, a two-volume history of the origins and consequences of racial and ethnic bias in health care. They embarked on their study because, "if we are to solve the problem, we must first understand it," Clayton explained.

To read more about An American Health Dilemma, visit www.hsph.harvard.edu/ats/Sep29/index.html and www.hsph.harvard.edu/now/feb22/book.html.

--PHC