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PHI is home to more than 100 project directors and principal investigators that are leading innovative public health projects and programs. Here are the biographies of two of these leaders.

Barbara Cohn, PhD, MPH, MCP

Director
Child Health and Development Studies

A harsh reality snuck up on Barbara Cohn when, at the age of 19, she performed health screenings on cannery and migrant farm workers in the Central Valley one summer. Some workers she tested had lost partial hearing because of the din in the canneries. Too many looked old beyond their years and were seriously ill.

"I learned then that the health status of people I was seeing had less to do with what a doctor could do for them and more with what they do with their lives," said Cohn. "There was no way to fix their ill health and their cycle of distress and discomfort. It was a lesson for me that I wouldn't forget."

The experience set her on her career path in public health. Today an epidemiologist who directs the landmark Child Health and Development Studies (CHDS) in Berkeley, Cohn has been guided in her work by a love of science, a passion for women's health and a firm belief that complex social, economic and environmental factors figure profoundly in everyone's health.

Cohn eventually returned to school to earn her PhD in epidemiology at the University of California at Berkeley. She was and remains convinced that accurate information on what influences health is extremely important to deciding on policies and programs to improve public health. Epidemiology provided the tools for her work.

Cohn decided to study women's health in the 1970s, but because it wasn't yet a field unto itself, she was advised to study a disease instead. Undeterred, she approached women's health from another angle, studying women and heart disease, the leading cause of women's deaths.

She would go on to focus on identifying the factors during pregnancy that protect women from breast cancer. Although women who have been pregnant have a lower risk of breast cancer, most women with breast cancer are mothers. So, Cohn reasoned that it is important to know which events in pregnancy are protective. Perhaps these natural protections can be mimicked in some way to prevent breast cancer.

Cohn joined CHDS in 1997 as co-director and became its director in 2001.

Between 1959 and 1967, 15,000 pregnant women and their families entered the study that was intended to shed light on the many contributors to healthy and unhealthy pregnancies and early childhoods. As it has turned out, though, researchers since then both at the CHDS and outside have mined the blood samples and detailed medical and lifestyle histories of the CHDS participants for important follow-up studies about the health and illness of the women and their children. The studies have drawn on more than 50 years of information, covering such subjects as the development in CHDS mothers or their children of diabetes, obesity, heart disease, fertility problems, bipolar disorder, schizophrenia, breast cancer and testicular cancer.

Most recently, the CHDS has focused on environmental chemical exposures. The CHDS is well positioned to take advantage of a serendipitous opportunity: just like nearly everyone else at the time, the mothers who participated in the study experienced what many believe is one of the largest chemical exposures in history, to DDT. They were also widely exposed to PCBs. Both DDT and PCBs interfere with hormone functioning. Cohn's current task is to understand whether there are health effects for these chemicals, which may be a model for some of the tens of thousands of other chemicals now in use.

In one significant study, Cohn and her colleagues found a heightened risk of breast cancer among CHDS mothers who had had large exposures to DDT before they were 14.

The new Three Generations Study will examine whether there is a connection between exposure prenatally and breast cancer later among the CHDS daughters. It will also allow CHDS to contact daughters and granddaughters to understand whether cancer risk persists beyond one generation and to study contemporaneous exposures to many other chemicals. The "3Gs" will enable the CHDS to continue to give us vital information about multiple generations.

"I'm very proud that the CHDS helps to answer really important questions," Cohn said. "We have more than 80,000 chemicals in the world today and are constantly inventing more. We need to know whether there could be consequences from them. Information creates the power to protect ourselves and the next generations that will follow."

Cohn is the mother of three adult children and lives in Berkeley.

To learn more about CHDS, visit our Programs page.

Bethany Young Holt, PhD, MPH

Director
Coalition Advancing Multipurpose Innovations

Bethany Young Holt did not set out to be an advocate. But while she was in graduate school an experience working with Sudanese refugees around HIV prevention in Ethiopia spurred a resolve to lift up issues surrounding women's empowerment and their need to be in control of their sexual and reproductive health.

Amidst the war conflict at Ethiopia's border with Sudan, Young Holt's job was to encourage people in the refugee camps and surrounding towns to use condoms. The women in the camps, including wives and sex workers, were excited about and embraced the idea. But most women couldn't convince men to use protection and had little power over the outcomes of sexual activity.

"What women cared about was having tools that would protect them against pregnancy and sexually transmitted infections," says Young Holt. "What they needed was a one-stop shopping method for sexual and reproductive health."

Back at UC Berkeley, while working on her PhD dissertation in Epidemiology which focused on social factors that determine health and HIV/STI prevention among low-income women in the San Francisco Bay Area, Young Holt began a campaign to raise awareness about microbicides as a woman-controlled method of HIV/STI prevention in Berkeley, California. Microbocides are gels, creams or foams that can help prevent transmission of HIV and other sexually transmitted infections. It wasn't long before the Berkeley City Council embraced the idea. Soon after, the campaign attracted the attention of product developers, other researchers and advocates, which drew funding to the project and the California Microbicides Initiative (CAMI) was born.

What began as a grassroots movement has evolved into an international consortium. Aptly renamed the Coalition Advancing Multipurpose Innovations, the global initiative intersects science, industry and education to drive a new generation of technologies that address multiple prevention objectives.

"I'm a scientist by training, but I also see myself as an advocate," says Young Holt. "Using the evidence we have from science, I'm trying to educate people around the need and potential of prevention methods that address multiple sexual and reproductive health needs and why there should be more research and funding around this issue." Bethany's research has involved collaborations with product developers, mechanical engineers, market researchers, behavioral scientists, fellow epidemiologists, and policy experts.

To better address the intrinsic link between unplanned pregnancy and multiple health risks associated with sexual activity, including HIV, CAMI has expanded its commitment beyond microbicides and California. CAMI's work is done through collaboration, convenings, advocacy and research. Current activities involve tracking all the available and emerging vaccines and devices that would protect women against unintended reproductive and sexual health outcomes and planning for an international Symposium on multipurpose prevention strategies to be held in the fall of 2011.

"It makes me feel like I didn't just go there (to Africa) and forget them (the women she met)," says Young Holt. "Unfortunately many of them have died. I can't change life for them, but maybe I can change it for their daughters and families and their communities."

Bethany Young Holt is a principal investigator with the Public Health Institute and is on the faculty of the University of California at Berkeley School of Public Health. She directs the Coalition Advancing Multipurpose Innovations (CAMI), a partnership of biotech developers, researchers, health advocates and clinicians with common interests working in the area of reproductive and sexual health. She has worked at the National Institutes of Health in Bethesda, Maryland, Institute Pasteur in Dakar, Senegal, and with the Peace Corps and the U.N. High Commission for Refugees in West Africa.

To learn more about CAMI, visit our Programs page.

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Barbara Cohn, PhD, MPH, MCP

Bethany Young Holt, PhD, MPH

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