As a doctor working in one of the most technologically sophisticated areas of medicine, the Intensive Care Unit, Dr. Jessica Zitter has witnessed firsthand the power of life-prolonging treatments. Using them, she has been able to pull many patients from the jaws of death. She has also seen the profound harm that can come to patients when doctors focus on these high-tech treatments instead of the whole patient. This practice feeds into what she calls the End-of-Life Conveyor Belt, where patients are treated as a package of organs to be kept alive rather than as human beings with preferences and values. Dr. Zitter makes the case for bringing communication back into the patient-doctor relationship, encouraging doctors to step out from behind their catheters and breathing machines to engage in honest conversations with patients and their families. In 2005, she co-founded Vital Decisions, a telephone counseling service that helps patients and their families participate actively in making decisions about their medical care at end-of-life.
Frank Williams, chief executive officer of Evolent Health, discusses managing risk in a changing health care marketplace. Communities nationwide are battling with the issue of the cost of health care. Payers are responding with new products that put more financial burden on the consumer and tier or narrow networks. There is also recognition that integrated networks that assume risk can reduce cost while providing high-quality care. Over the next few years, health systems will have the opportunity to prove whether this model can work. Every market and individual situation is different, and there are strong opportunities for payer partnerships as well as provider-sponsored health plans. The question for health systems is how to participate in this new world as a leader vs. being led by market forces. Williams provides real-world examples from systems that have employed the spectrum of options available.
Paul A. Offit, MD, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and Maurice R. Hilleman Professor of Vaccinology and Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania, discusses the science behind the fear that vaccines cause autism and addresses the manner in which politicians, celebrities, scientists, and the media portrayed this story to the public. He also discusses the challenges involved in communicating science to the public.
This talk is part of the 2015-2016 UC Berkeley School of Public Health Dean’s Speaker Series and the 2015-2016 Kaiser Permanente Lecture Series. It is co-sponsored by UC Berkeley Graduate School of Journalism.
Population health science is the study of the conditions that shape distributions of health within and across populations, and of the mechanisms through which these conditions manifest as the health of individuals. Population health science is hitting its stride, as several leading schools of public health are launching doctoral programs in population health science and trainees in these schools are increasingly thinking of themselves as population health scientists. But what is “population health science”? Is it simply public health in a new cloak? Sandro Galea MD, DrPH, dean and professor at the Boston University School of Public Health, argues that population health science is a pragmatic science that aims to marshal evidence as a way to inform interventions that improve the health of populations. He presents the foundations of population health science, providing formative core principles around which to organize our thinking and scholarship in this area.
Scientific retractions are on the rise, which has led to concerns that fraud—the reason for the majority of retractions—is growing. But is it, or are we just better at finding it? And are more retractions really bad news? In this talk, Dr. Ivan Oransky, vice president and global editorial director of MedPage Today, contends that today's trends are a sign of science working the way it should, warts and all, with important implications for reporters and editors who cover science and medicine. He also introduces some of the players who are helping keep all of us, researchers and journalists alike, more accountable.
Marcia Angell MD, MACP, is a senior lecturer in the Department of Global Health and Social Medicine at Harvard Medical School and faculty associate in the Center for Bioethics. In this talk, she discusses how dying in America changed greatly after World War II, mainly because of the development of new drugs and technologies. Although that resulted in many welcome cures, it also created great suffering in patients who were terminally ill. Starting in the 1970s, the problem began to attract attention, and by 1990, the right of patients or their proxies to refuse life-sustaining treatment became recognized. But the right to forego life-sustaining treatment left the problem of what to do for terminally ill patients not receiving such treatment. In the 1990s, a controversial movement argued that physicians should have the right to help such patients end their lives faster and more peacefully. Now, assisted dying (also known as physician-assisted suicide) is legal in five states, including California.
Camara Jones MD, MPH, PhD is a family physician and epidemiologist. She is president of the American Public Health Association and senior fellow at Morehouse School of Medicine. In this talk, Dr. Jones presents analogies and allegories to help illustrate the three levels of racism and the impacts of racism on the health and well-being of our nation. She seeks to broaden the national health debate to include not only universal access to high-quality health care but also attention to the social determinants of health (including poverty) and the social determinants of equity (including racism).
John Thackara, author of a widely read blog, doorsofperception.com, and of a new book, How To Thrive In The Next Economy: Designing Tomorrow's World Today (Thames & Hudson), spoke at Sutardja Dai Hall as part of the School of Public Health’s Dean’s Speaker Series. He argued that health and well-being are best thought of as properties of a social and ecological context, not as the outcome of procedures paid for in hospitals. Re-imagined this way, public health is determined by the vitality of soils, plants, water, air, and other ecosystems. When the health of social and ecological contexts is the priority, quality of care can replace money as a better measure of value in an economy. Health, within this new frame, is best looked after as a commons at the scale of a bioregion.
Sir Michael Marmot, author of The Health Gap: The Challenge of an Unequal World and director of the University College London Institute of Health Equity, spoke at the David Brower Center as part of the School of Public Health’s Dean’s Speaker Series. He argued that creating the conditions for people to lead flourishing lives, and empowering individuals and communities, is the key to reducing health inequalities. Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives.
Venture out into the fields of Salinas with Mark Bittman as he interviews UC Berkeley School of Public Health's Brenda Eskenazi, chair of the Community Health Sciences Division. She leads the CHAMACOS (Center for the Health Assessment of Mothers and Children of Salinas) study, which follows children born between 2000-2002 and assesses the impact of pesticides and other environmental chemicals (like flame retardants) on their long-term health.