From Good to Great: An interview with Dr. Tammy Bray
Dr. Tammy M. Bray wants to help change Oregon’s health from “good” to “great,” but she knows she can’t do it alone. A leader equally comfortable taking charge or collaborating, she is the Dean of College of Health and Human Sciences at Oregon State University, and is also a professor of Nutrition and Medical Biochemistry. A native of Taiwan, she has a Ph.D. and a master’s degree, both in nutrition. Her boundless energy and friendly disposition provided a stimulating conversation about a variety of aspects of health in this interview with Chris Palmedo which was held in her office on the OSU campus in July 2008.
How has Oregon State’s College of Health and Human Sciences changed since you arrived here in 2002?
When I first came here from Ohio State, my colleagues there asked why I wanted to come to a place where they’d just merged Home Economics and Health Performance. One is an outmoded and sexist term, and other just sounds like a bunch of jocks!
But I knew there was a future here related to the many aspects of health. Over time, my intuitions and thoughts turned into more clearly developed ideas.
First, I knew this college would have to develop programs of national distinction. As the book Good to Great points out, “good” is often another word for mediocre. In fact, “good” is really the enemy of “great.” “Good” is more of a state of mind, while “great” is more of a journey, and I knew I wanted this college to achieve nationally-recognized greatness.
Second, as a land grant university, we invest in our students right here in Oregon, and we need to give them the tools and curricula to make them engaged and successful. Students are ‘products’ of Higher Education, and they’re our future. Our job is to prepare our students to make a difference in the world.
The third part of my job was diversifying the funding revenues for this College. As the state financial support to public higher education is diminishing, our faculty is increasing their activities in seeking grants support to conduct research from various Federal and State agencies and private Foundations. The third important revenue is development and fundraising from donors and alumni. As you know that OSU is in the historical first Capital Campaign with a goal of $650 M by 2012.
So, while at first my focus was on building academic program distinction, enhancing student success, and raising money, I eventually realized how important it was to link all this together. The success of each is inter-dependent on each other.
Over time, the pieces all came together in my mind, and with the help of my administrative team, I started merging, restructuring, aligning, re-aligning and streamlining our programs, missions and functions. Lots of hard work and determination from our faculty and staff!
After five years of working toward these goals, we have built four distinctive departments: Department of Nutrition and Exercise Science — it is all about healthy lifestyle; Department of Human and Development and Family Sciences – it is the study of transitions across lifespan from early childhood to the end of life within the context of healthy family. Department of Design and Human Environment is focused on the functional design of our ‘built’ environment for healthy living. The fourth department is Public Health that focuses on the health of the communities in Oregon and beyond.
And these departments are all linked together?
Yes. The four departments that work interactively linking the health of the individuals and his/her lifestyles to the families, environments, and communities. It is a continuum model and relationship.
When you start linking human life together from the individual to the community, it becomes clear why we say we strive to enhance the health and well-being of individuals, families, environments and communities in Oregon and beyond.
We realize that this is the foundation of an ecological approach to the health of the public, and with this in mind, we simplified the mission the College of Health and Human Sciences to “Taking care of life.”
Where does faculty research fit in?
Faculty research is fundamental in building a distinctive program in a research extensive public university. We have decided to collaborate and build critical mass of faculty in signature research areas that could make a difference.
Collaboration is more important here than building individual empires. Over the years, I’ve seen that many of the most innovative researchers work in teams. They often get their great ideas from different overlapping disciplines. We have decided that this is an important value in building our signature research areas.
So far, we have built two signature research centers, the Center for Healthy Aging Research, and the Hallie Ford Center for Healthy Children and Families. We have chosen these two areas first because the problems in these two areas are socially significant, our approaches in solving the problems are holistic, trans-disciplinary, and collaborative, and we already have the faculty expertise in these areas.
This is why faculty from all the disciplines within the college participated in developing the Center for Healthy Aging Research - our first research center. This Center is one of six strategic investments funded by the OSU Provost for $1.5 Million.
Now people from different departments are all helping to solve problems such as:
• What do you want to eat to help you live longer?
• What kinds of exercise are most effective in preventing osteoporosis, fall and frailty in aging population?
• Psycho-socially, what are the issues facing the “sandwich generation” regarding stress and crises?
• How do we retrofit our built environments to facilitate healthy aging?
In June of 2007, Hallie Ford, a noted Oregon philanthropist made a gift of $8 million to our college shortly before she died at age 102, generously supporting a cause she advocated for throughout her lifetime – Oregon’s children and their families. Now we are recruiting the director and building a building to house the Hallie Ford Center for Healthy Children and Families.
The Center’s mission embraces Hallie’s values of integrity, independence, family and community by promoting healthy children and families through supporting high-quality research, translating research into practice and building the capacity of families, service providers, and communities.
With these two signature research centers, we truly are able to say that our mission is ‘taking care of life - from healthy children to healthy aging’ with preventive and holistic approach. Research of most of our faculty can easily fit into these two research centers. The way we view the health of public from an ecological and holistic perspective provided the foundation for a different way of enhancing the health of Oregonians.
What do you see as the most pressing needs among Oregonians today?
According to the Oregon Health Policy Commission, one third of deaths in Oregon can be attributed to just three unhealthy behaviors: tobacco use, lack of physical activity and poor eating habits. These behaviors often result in and exacerbate chronic disease. Heart disease, cancer, stroke, and diabetes account for two of every three deaths in Oregon. Furthermore, one out of every three years of potential life lost before the age of 65 is due to chronic disease. Chronic diseases reduce the quality of life of individuals, burden families and friends, and are responsible for massive health care expenditures.
And they’re all preventable.
That’s right. Most of the time, the factors that lead to these conditions are diet, exercise, tobacco use or environment. That’s why I say that we may be increasing our lifespan, but our “health span” is limited. We spend so much money on health care, but not enough on early detection, prevention and diagnosis.
It’s not the Twinkie you ate last night that will kill you. Our health span depends on the genes we have inherited, the overall diets we have been eating, the daily physical activity we have been doing, the stress level we have received, the quality of relationship we have with others, and the built environment and communities we have been living in, etc. Health is a holistic and ecological system. We have to think differently and re-think the bigger picture; we can make Oregon a model or prototype state for a healthier, safer, greener, more sustainable, etc, and a better living place for all.
And you have great programs in veterinary medicine here at OSU.
Exactly! Veterinary Medicine here on campus focuses on caring for the health and well-being of animals. Understanding the importance of animal welfare and the interdependent relationships between animals and humans is part of the holistic and ecological approach to public health. Together with veterinary medicine, we can study new and emerging diseases such as mad cow disease, West Nile virus, and bird flu. Safeguarding our nations’ food supply is also part of the health security. Recent scares in microorganism contamination of hamburger meat, spinach salad, tomato and jalapeño in salsa illustrated the importance in healthy food supply in the health of the public.
How does Oregon’s higher education system contribute to the health of the public in Oregon?
Oregon’s population is growing, aging and diversifying, and its public health needs are not being met. Oregon’s academic programs in public health cannot produce the workforce needed to promote and protect the health security of all Oregonians. In order to meet Oregon’s needs, an estimated additional 1,600 public health graduates are needed over the next 10 years.
In other words, Oregon lacks a robust system of public health. We’re the only west coast state without an accredited school or college of public health. A landmark opportunity to address the state’s lack of public health capacity now stands before us. Oregon has a successful track record of collaboration among the Masters in Public Health (MPH) programs at OHSU, PSU and OSU. The OMPH program is ranked second in the nation.
Our next step for our state higher education is to ‘kick it up a notch.’ For enhancing the state’s academic capacity to produce a trained public health workforce is to establish a national accredited school or college of public health in the state of Oregon.
In my opinion, the state of Oregon is too small and does not have enough resources for us to compete among various institutions in higher education. A collaborative approach that will maximize the assets we have in the state and increase each institution’s ability to leverage new resources is the better way to go.
What will differentiate the Collaborative School of Public Health in Oregon?
In my vision of this collaborative approach, Oregon State can take the lead based on the ecological model to study public health, but that is not enough. We need to have urban partners. OSU has capacity to take a holistic and preventive approach to human health within its context of human needs, animal health and agricultural and environmental conditions. Then if we collaborate we take advantage of applying the knowledge of urban studies that exists at Portland State, plus, take full advantage of and also bring to bear the medical expertise at OHSU, the achievements can be tremendous. That kind of trans-disciplinary collaboration would differentiate us from any other schools in the nation.
In addition to this added strength of a ‘trans-disciplinary’ approach to teaching and research, we will make it applied and practical. This is key for us to translate scientific discoveries into best practices that public health practitioners can use… something frequently called translational research. The way I see it, it has to be a collaboration of the state government, the academic institutions, and practitioners in local communities. It needs to be a balanced three-legged stool. Partnership and commitment at all three levels are necessary in order to improve and sustain the health of all Oregonians.
People ask me “how will you compete with the school of Public Health in University of Washington or UCLA?” and I tell them I don’t want to compete with those places because we will not build one like theirs. Look around Oregon and we are different - you see the unique beauty and diversity of its rural and environment throughout the state, as well as the innovation of its urban environment in Portland. But those unique attributes mean Oregon also has unique challenge protecting our environment while serving both urban and rural needs. We are committed to finding the solutions.
We can construct an exemplary system, which can be a leading prototype for the entire nation. We need to take on the challenges innovatively and collaboratively. How do we take advantage of all we know about natural food, agriculture, the environment, and the rural-urban interface? How can we collaborate most effectively? How do we use different government agencies and the land grant extension? How do we fully realize the promise of prevention and bring upstream knowledge and solutions to the people? How can we build a strong health security and enhance the health-span of all Oregonians? It is finding the answers to those questions that will take us from Good to Great!
Have you always been a collaborator?
I suppose so. Early on in my research program, I noticed that better ideas came from two heads than from one.
Diversity gives strength. I feel blessed to be surrounded with many talented faculty and administrators with whom I exchange ideas often. I fondly call the Office of the Dean my “Dirty Dozen,” because it is a team of twelve, including department chairs, associate deans, and professional staff. I rely on the help of all these people. Often when I present ideas to my team they get changed dramatically. However, the outcome is always better than my original proposal.
Also, people often complain about not having enough resource to make a difference. While it’s important to have money, it is more important to have innovative idea first, followed by critical thinking and problem solving skills. I found that resources or money tend to follow great ideas later. When you have a great collaborative team, you feel like you can face any challenge, including the one facing us today on building a collaborative public health college in the state of Oregon.
That’s why I appreciate the Northwest Health Foundation and its leadership. Because while they don’t have enormous sums of money, they provide assistance to launch important initiatives in the state, which often start small, but can lead to big things.
One of your continuing themes seems to be the importance of building interconnections between people and groups. These interconnections clearly have the potential to explode way beyond the sum of the parts. Leadership and management theory increasingly emphasize this.
You bet. The best way to capitalize on the strengths of individuals is to find effective ways to connect them to work together. Collaboration is a form of interconnection. And in Oregon, we can use these interconnections to apply our strength and knowledge to find solutions to improve the health and well-being of Oregonians, the rest of United States, and the world beyond.
I hope Oregon can be built as an ecological model or a prototype of holistic to community health for areas all over the world. For example, many of our own rural areas can be used as models for solving problems of global sustainability and development.
Just look at how advanced Oregon is with its forestry and environmental programs. China can benefit from what we’re have learned in Oregon. Many developing world should take advantage of all the research that is happening in places like Oregon. We might help them to prevent some of the possible public health disasters. I am very proud of what we do in the state of Oregon.
Do you have any thoughts on the Community Health Priorities project?
You’re seeking to change the public perception of the old image of or approach to ‘public health’. You are educating the general population on a new and emerging field for public health. You are also doing ‘interconnection’ – connecting individuals to communities. For the longest time, people associated public health with vaccinations, cigarettes smoke issues without personal and individual connections. But it looks like this project is trying to broaden the face of public health in an important way.
You’re saying the health of the public starts with all of us, and it’s a holistic health security system. If you look at cultures that live longer and happier, they have a holistic approach. They even die happily!
I am so glad to be a part of this conversation, because it is a project that places health and quality of life at the forefront. Health is for all of us. Treating disease is only part of the elements of health!
But efforts like this take time, patience and persistence. For many people the idea may seem strange, but eventually it becomes obvious, and you suddenly realize “this is it!” And then you become mainstream. But we’re not there yet.
Keep looking for the clues around you. Put those interconnections together. Be patient and be persistent. Think of it as a marathon, not a sprint! This is a valuable project, in my view; you are transforming the perception of public health from good to great in Oregon!