Stanford University

Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

USING SMARTPHONES AS MEDICAL DEVICES: INNOVATION IN MOBILE HEALTHCARE

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More patients are living longer and developing chronic diseases, often managed with increasingly expensive technology.  Both healthcare providers and hospital systems are struggling to keep up.  Modern smartphones can be converted into powerful, inexpensive portable medical devices to improve the delivery of healthcare, particularly in low- and middle-income countries. 

 

Professor Chang will talk about his experience in developing a simple adapter to turn an iPhone into an “Eye-Phone” Camera. Chang is an ophthalmologist with a special interest in healthcare startups and online medical education. His clinical research focus revolves around understanding the association between high myopia and glaucoma. He is currently co-developing “EyeGo,” an iPhone imaging adapter system for remote eye care triage.

Stanford Center at Peking University

Robert Chang Assistant Professor of Ophthalmology Speaker Stanford University Medical Center
Lectures

Fisheries and Food Security in China - 2014 Symposium

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From May 13-15, the Center on Food Security and the Environment and the Lenfest Ocean Program welcomed leading Chinese and international scientists to the Stanford Center at Peking University in Beijing, to share research and insights on the role of ocean fisheries, aquaculture, and marine ecosystems for improving food security in China.

Given China’s demographic changes, evolving nutritional requirements, and dominant role in global fisheries, the key question of the symposium was whether marine ecosystems can be managed adequately to support the country’s future vision for domestic food security.

Nearly 30 participants from around the world shared research on the provision of wild fish for direct human consumption and for animal feeds. Participants also shared insights on China’s aquaculture sector, including the tradeoffs involved in using wild fish in aquaculture feed.

Agenda

Session I – Food security and marine ecosystems

Session II – Aquaculture, feeds and fisheries

Session III - Coastal fisheries & impacts on marine ecosystems

Session IV – Economies of the global marine fish trade

Session V - Critical issues and challenges 

Stanford Center at Peking University

Rosamond L. Naylor

(650) 723-5697
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Senior Fellow, Emerita, Stanford Woods Institute and Freeman Spogli Institute for International Studies,
William Wrigely Professor, Emerita, Department of Environmental Social Sciences
Roz_low_res_9_11_cropped.jpg PhD

Rosamond (Roz) Naylor is the William Wrigley Professor, Emerita, of Global Environmental Policy in the Doerr School of Sustainability; and founding Director of the Center on Food Security and the Environment (FSE) at Stanford University. Her research focuses on policies and practices to improve global food security and protect the environment on land and at sea. She has been involved in numerous field-level research projects around the world with her students and has published widely on issues related to global food systems, food policy, and aquaculture. She is the co-chair of The Blue Food Assessment, an international initiative aimed at providing a comprehensive scientific evaluation of the sustainability, nutrition, equity, and justice dimensions of aquatic foods cultured and captured in freshwater and marine environments within the global food system. She is a Member of the National Academy of Sciences, a Fellow of the American Association for the Advancement of Science (AAAS), Fellow of the Ecological Society of America (ESA), a Pew Marine Fellow, and a Leopold Leadership Fellow. She is also the Chair of the Board of Directors for the Aspen Global Change Institute and a member of the Scientific Advisory Committee for Oceana. At Stanford, she teaches courses on The World Food Economy, Human Society and Environmental Change, and Food and Security.
 

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Mobile Health in Ophthalmology: A View From Silicon Valley

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Mobile medical applications and portable medical devices are increasingly entering health care delivery systems as they push the limits of big data acquisition, secure cloud storage, and automated analysis of medical information. Smartphone technologies have advanced rapidly and are now in the hands of a large number of physicians and other healthcare workers, including individuals in low- and middle-income countries. Professor Chang will talk about the exploding mobile health space, his experience in developing a simple adapter to facilitate image capture of the eye, and emerging trends in wearable tech.

Dr. Chang is a clinician-scientist with special interest in mobile health development and healthcare IT startups. His clinical research focus revolves around understanding the association between high myopia and glaucoma. He is currently co-developing “EyeGo,” an iPhone imaging system for remote eye care triage.

Stanford Center at Peking University

Robert Chang SCPKU Faculty Fellow and Assistant Professor of Ophthalmology Speaker Stanford University Medical Center
Lectures

Why the United States Spends So Much More on Health Care than Other Countries: Economic, Institutional and Political Perspectives

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Abstract:

The United States spends over 17 percent of GDP on health care; the next six highest countries spend over 11 percent. This six percent differential indicates an excess spending of approximately one trillion dollars per year. Depending on the benefit from the extra spending, this suggests the possibility of a huge misallocation of resources. Also, because the federal government funds almost half of total health care spending, there are significant effects on the deficit and the debt. The main reasons for the excess are (1) the U.S. pays higher prices for drugs, devices, and equipment and higher fees to specialists and sub-specialists; (2) higher administrative costs; and (3) a more expensive mix of medical care. The seminar will focus on institutional and political explanations for the three proximate reasons.

 

Speaker Bio:

Victor R. Fuchs is the Henry J. Kaiser Jr Professor Emeritus at Stanford University, in the Departments of Economics and Health Research and Policy.  He is also a Research Associate of the National Bureau of Economic Research and a Senior Fellow at SIEPR.  He applies economic analysis to social problems of national concern, with special emphasis on health and medical care.  He is author of nine books, the editor of six others, and has published over two hundred papers and shorter pieces.  His current research focuses on male-female differences in mortality, reform of medical education, and the future of U.S. health care.

His best known work, Who Shall Live?  Health, Economics, and Social Choice (1974; expanded edition 1998, 2nd expanded edition 2011), helps health professionals and policy makers to understand the economic and policy problems in health that have emerged in recent decades.  Other books include The Service Economy (1968), How We Live (1983), The Health Economy (1986), Women’s Quest For Economic Equality (1988), and The Future of Health Policy (1993).  He is the editor of Individual and Social Responsibility: Child Care, Education, Medical Care, and Long-term Care in America (1996).

Professor Fuchs was elected president of the American Economic Association in 1995.  He has also been elected to the American Philosophical Society, the American Academy of Arts and Sciences, the Institute of Medicine of the National Academy of Sciences, and is an Honorary Member of Alpha Omega Alpha.  He has received the John R. Commons Award, Emily Mumford Medal for Distinguished Contributions to Social Science in Medicine, Distinguished Investigator Award (Association for Health Services Research), Baxter Foundation Health Services Research Prize, and Madden Distinguished Alumni Award (New York University).  ASHE’s (American Society of Health Economists) Career Award for Lifetime Contributions to the Field of Health Economics and the RAND Corporation prize for the Best Paper published in the Forum for Health Economics and Policy are named and awarded in honor of Professor Fuchs.

This event is sponsored by the Stanford Center on Democracy, Development and the Rule of Law and the Center for Health Policy/Center for Primary Care and Outcomes Research.

 

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Victor Fuchs the Henry J. Kaiser Jr Professor Emeritus Speaker Stanford University
Seminars

Public health leaders address global challenges

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In a recent discussion, Dr. Gro Brundtland, former director-general of the World Health Organization, and Dr. Helene Gayle, president and CEO of Cooperative for Assistance and Relief Everywhere (CARE USA), address some of the underlying causes of extreme global poverty and their linkages to global public health challenges.
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Air Pollution and Short-Term Mortality in Beijing

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Little empirical evidence exists on the health costs of air pollution in China, one of the most polluted countries in the world. Unsurprisingly, the lack of reliable data on pollution levels and health outcomes impede research. Because the pollution-health relationship is likely non-linear, it is difficult to extrapolate from existing high quality studies in developed countries to ascertain health costs. We address this deficiency by obtaining new data on Beijing’s daily mortality April 2008-April 2013 from the Chinese Center for Disease Control and Prevention. We combine these data with daily pollution measures from the US Embassy in Beijing, which records particulate matter of 2.5 microns or less in width (PM 2.5). We find that after controlling for weather conditions, year, month, and day of week fixed effects, daily PM2.5 indeed predicts daily mortality, particularly deaths from cardiovaslular disease. A 100 μg/m3 increase in daily PM2.5 is associated with 7 deaths daily, among them 4 cardiovascular deaths, and 0.8 respiratory deaths. Furthermore, deaths among less-educated and outdoor workers show a stronger relationship to PM2.5 levels. Notably, the relationship is robust to controlling for the official measure of Beijing’s air pollution, the average daily air pollution index (API), despite the fact that PM2.5 is measured by 1 monitor at the US embassy whereas API (and mortality) combine data from across the Beijing metropolitan area. Indeed, Beijing’s API does not have a significant relationship to mortality once AQI at the Embassy is accounted for. Our finding supports previous research arguing for measuring PM 2.5 and reporting it promptly to the public. 
 
Shuang Zhang is an assistant professor in the Department of Economics at University of Colorado Boulder. She works on various topics in development, including health, education, environment, political economy, etc,. with a focus on China. She holds a PhD in Economics from Cornell University and was a postdoctoral fellow in SIEPR of Stanford University in 2012-13.

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Shuang Zhang assistant professor in the Department of Economics Speaker University of Colorado Boulder
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Health care aid for developing countries boosts life expectancy, study finds

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Foreign aid for health care is directly linked to an increase in life expectancy and a decrease in child mortality in developing countries, according to a new study by Stanford researchers.

The researchers examined both public and private health-aid programs between 1974 and 2010 in 140 countries and found that, contrary to common perceptions about the waste and ineffectiveness of aid, these health-aid grants led to significant health improvements with lasting effects over time.

Countries receiving more health aid witnessed a more rapid rise in life expectancy and saw measurably larger declines in mortality among children under the age of 5 than countries that received less health aid, said Eran Bendavid, MD, an assistant professor in Stanford Medical School's Division of General Medical Disciplines and lead author of the study. If these trends continue, he said, an increase in health aid of just 4 percent, or $1 billion, could have major implications for child mortality.

“If health aid continues to be as effective as it has been, we estimate there will be 364,800 fewer deaths in children under 5,” he said. “We are talking about $1 billion, which is a relatively small commitment for developed countries.”

The study was published online April 21 in JAMA Internal Medicine. The study’s co-author, Jay Bhattacharya, MD, PhD, is an associate professor of medicine.

Bendavid and Bhattacharya are core faculty members at Stanford’s Center for Health Policy and Center for Primary Care and Outcomes Research at the university's Freeman Spogli Institute for International Studies.

Does it work?

Bendavid noted that there is much debate around foreign aid. Critics question whether it’s used effectively and reaches its intended recipients. They often argue that it discourages local development and displaces domestic resources that might otherwise be devoted to health. So the researchers devised a statistical tool to address the basic unanswered question: Do investments in health really lead to health improvements?

Bendavid said there are many reasons to suspect the answer would be no, though the findings proved just the contrary, with health-related aid leading to direct, beneficial outcomes.

“I think for many people, that will be surprising,” he said. “But for me, it fits with other evidence of the incredible success of public health promotion in developing countries.” In a previous study, for instance, he found that hundreds of thousands of lives were saved through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, in which the U.S. government invested billions of dollars in antiretroviral treatment and other AIDS-related prevention and treatment initiatives.

In the latest study, the two investigators used data from the Creditor Reporting System of the Organization for Economic Cooperation and Development, the world’s most extensive source of information on foreign aid. While aid programs for health grew during the 36-year study period, the largest period of growth occurred between 2000 and 2010, they found.

Stepped-up investments

It was during this decade that many governments and private groups stepped up their investments in health, including PEPFAR; the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; and the GAVI Alliance, among others, he said.

As a result, while health aid in 1990 accounted for 4 percent of total foreign aid, it now amounts to 15 percent of all aid, he said. And it’s become an important part of health budgets in recipient countries, accounting for 25-30 percent of all health-care spending in low-income countries, Bendavid said.

The researchers found that these funds were used effectively, largely because of the targeting of aid to disease priorities where improved technologies — such as new vaccines, insecticide-treated bed nets for malarial prevention and antiretroviral drugs for HIV — could make a real difference.

They observed the greatest health impacts between 2000 and 2010, when donor investments were at their peak. During the decade, under-5 child mortality declined from a mean of 109.2 to 72.4 deaths per 1,000, or 36.8 fewer deaths among those children in the countries that received the most health aid, the researchers found (a 34 percent reduction). In the countries receiving the least, under-5 mortality fell from 31.6 to 23.2 deaths per 1,000, or 8.4 fewer deaths per 1,000 live births (a 26 percent reduction), the researchers reported.

Life expectancy increases

During that period, life-expectancy figures also grew faster in countries with a greater infusion of health aid, Bendavid said. Life expectancy rose from 57.5 to 62.3 — an increase of 4.8 years — among the countries receiving the most aid. Among the countries receiving the least health aid, life expectancy increased by 2.7 years, from 69.8 to 72.5 years.

Bendavid said previous experience has shown that, on average, life expectancy has increased by nearly one year every four years in developed countries. But health-aid programs literally cut in half the time it took to reach this goal in developing countries. “In that same four-year span, they increased life expectancy by two years, rather than one year,” he said.

He said the results are not surprising if one considers some of the new health technologies made available to developing nations as a result of foreign aid. Childhood vaccines, including those for diphtheria, tetanus, polio and measles, have all but wiped out what used to be among the top killers of young children in the developing world. Health aid directed to providing insecticide-treated malarial bed nets also has been credited in recent studies with reducing malarial deaths among young children, he noted.

Among both adults and children, aid that has expanded the availability of antiretroviral drugs in the developing world has had a major impact on reducing deaths and improving overall life expectancies, he said. For instance, in a study published in 2012, Bendavid and colleagues found that PEPFAR’s health aid resulted in more than 740,000 lives saved between 2004 and 2008 in nine countries.

The researchers also found that the benefits of aid have a lasting effect: The telltale signs of aid’s relationship to reducing under-5 mortality were detectable for three years following the distribution of aid. The correlation between health aid and longer life expectancy overall was detectable for five years after the aid was distributed.

With aid commitments flattening amid the economic downturn, Bendavid said donors will have to be that much smarter in how they invest future dollars, focusing on the most cost-effective interventions and technologies.

“To date, there has been little consideration of how to use development aid in the most cost-effective manner,” he said. “That will have to change now that the funding level has reached a plateau.”

The study was funded by the George Rosenkranz Fellowship for Health Policy Research in Developing Countries and by the National Institutes of Health (grant K01AI084582).

Information about Stanford’s Department of Medicine, which also supported the work, is available at http://medicine.stanford.edu.

Ruthann Richter is the director of media relations at the Stanford School of Medicine.

 

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n Afghan child receives polio vaccination drops during an anti-polio campaign in Kabul March 24, 2014. | Reuters
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Jenny Bowen: What China’s Orphans Taught Me About Moving Mountains

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Jenny Bowen is the founder and chief executive officer of Half the Sky Foundation, which strives to enrich the lives of orphaned children in China. A former screenwriter and independent filmmaker, Bowen founded Half the Sky in 1998 in order to give something back to her adopted daughters’ home country and to the many children then languishing behind institutional walls. Half the Sky’s five innovative programs now provide nurturing, family-like care for thousands of children of all ages. In partnership with China’s Ministry of Civil Affairs, Half the Sky has embarked on a groundbreaking Integrated National Training Plan that will eventually make the Half the Sky approach the approved national standard of care for all children in the welfare system.

In 2008, Bowen received the Skoll Award for Social Entrepreneurship. She serves on China’s National Committee for Orphans and Disabled Children and on the Expert Consultative Committee for Beijing Normal University’s Philanthropy Research Institute. She is the author of the recently released memoir, Wish You Happy Forever: What China’s Orphans Taught Me About Moving Mountains.

About REAP

The Rural Education Action Program (REAP) at Stanford is an impact evaluation organization that aims to inform sound education, health and nutrition policy in China. REAP’s goal is to help students from vulnerable communities in China enhance their human capital and overcome obstacles to education so that they can escape poverty and better contribute to China’s developing economy.

The author will be available to sign copies of her book after the event.

Reuben W. Hills Conference Room

Jenny Bowen Founder of Half the Sky Foundation Speaker

Scott Rozelle

Encina Hall East, E404
Stanford, CA 94305-6055

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Helen F. Farnsworth Endowed Professorship
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Stanford Institute for Economic Policy Research
Director of the Rural Education Action Program, Stanford Center on China's Economy and Institutions
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
scott_rozelle_new_headshot.jpeg PhD

Scott Rozelle is the Helen F. Farnsworth Senior Fellow at the Freeman Spogli Institute for International Studies and Stanford Institute for Economic Policy Research at Stanford University. He received his BS from the University of California, Berkeley, and his MS and PhD from Cornell University. Previously, Rozelle was a professor at the University of California, Davis and an assistant professor in Stanford’s Food Research Institute and department of economics. He currently is a member of several organizations, including the American Economics Association, the International Association for Agricultural Economists, and the Association for Asian Studies. Rozelle also serves on the editorial boards of Economic Development and Cultural Change, Agricultural Economics, the Australian Journal of Agricultural and Resource Economics, and the China Economic Review.

His research focuses almost exclusively on China and is concerned with: agricultural policy, including the supply, demand, and trade in agricultural projects; the emergence and evolution of markets and other economic institutions in the transition process and their implications for equity and efficiency; and the economics of poverty and inequality, with an emphasis on rural education, health and nutrition.

Rozelle's papers have been published in top academic journals, including Science, Nature, American Economic Review, and the Journal of Economic Literature. His book, Invisible China: How the Urban-Rural Divide Threatens China’s Rise, was published in 2020 by The University of Chicago Press. He is fluent in Chinese and has established a research program in which he has close working ties with several Chinese collaborators and policymakers. For the past 20 years, Rozelle has been the chair of the International Advisory Board of the Center for Chinese Agricultural Policy; a co-director of the University of California's Agricultural Issues Center; and a member of Stanford's Walter H. Shorenstein Asia-Pacific Research Center and the Center on Food Security and the Environment.

In recognition of his outstanding achievements, Rozelle has received numerous honors and awards, including the Friendship Award in 2008, the highest award given to a non-Chinese by the Premier; and the National Science and Technology Collaboration Award in 2009 for scientific achievement in collaborative research.

Stanford Center on China’s Economy and Institutions

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Faculty affiliate at the Center on Democracy, Development, and the Rule of Law
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
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Health care aid for developing countries boosts life expectancy, study finds

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Foreign aid for health care is directly linked to an increase in life expectancy and a decrease in child mortality in developing countries, according to a new study by Stanford researchers.

The researchers examined both public and private health-aid programs between 1974 and 2010 in 140 countries and found that, contrary to common perceptions about the waste and ineffectiveness of aid, these health-aid grants led to significant health improvements with lasting effects over time.

Countries receiving more health aid witnessed a more rapid rise in life expectancy and saw measurably larger declines in mortality among children under the age of 5 than countries that received less health aid, said Eran Bendavid, MD, an assistant professor in Stanford Medical School's Division of General Medical Disciplines and lead author of the study. If these trends continue, he said, an increase in health aid of just 4 percent, or $1 billion, could have major implications for child mortality.

“If health aid continues to be as effective as it has been, we estimate there will be 364,800 fewer deaths in children under 5,” he said. “We are talking about $1 billion, which is a relatively small commitment for developed countries.”

The study was published online April 21 in JAMA Internal Medicine. The study’s co-author, Jay Bhattacharya, MD, PhD, is an associate professor of medicine.

 

Bendavid and Bhattacharya are core faculty members at Stanford’s Center for Health Policy and Center for Primary Care and Outcomes Research at the university's Freeman Spogli Institute for International Studies.

Does it work?

Bendavid noted that there is much debate around foreign aid. Critics question whether it’s used effectively and reaches its intended recipients. They often argue that it discourages local development and displaces domestic resources that might otherwise be devoted to health. So the researchers devised a statistical tool to address the basic unanswered question: Do investments in health really lead to health improvements?

Bendavid said there are many reasons to suspect the answer would be no, though the findings proved just the contrary, with health-related aid leading to direct, beneficial outcomes.

“I think for many people, that will be surprising,” he said. “But for me, it fits with other evidence of the incredible success of public health promotion in developing countries.” In a previous study, for instance, he found that hundreds of thousands of lives were saved through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, in which the U.S. government invested billions of dollars in antiretroviral treatment and other AIDS-related prevention and treatment initiatives.

In the latest study, the two investigators used data from the Creditor Reporting System of the Organization for Economic Cooperation and Development, the world’s most extensive source of information on foreign aid. While aid programs for health grew during the 36-year study period, the largest period of growth occurred between 2000 and 2010, they found.

Stepped-up investments

It was during this decade that many governments and private groups stepped up their investments in health, including PEPFAR; the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; and the GAVI Alliance, among others, he said.

As a result, while health aid in 1990 accounted for 4 percent of total foreign aid, it now amounts to 15 percent of all aid, he said. And it’s become an important part of health budgets in recipient countries, accounting for 25-30 percent of all health-care spending in low-income countries, Bendavid said.

The researchers found that these funds were used effectively, largely because of the targeting of aid to disease priorities where improved technologies — such as new vaccines, insecticide-treated bed nets for malarial prevention and antiretroviral drugs for HIV — could make a real difference.

They observed the greatest health impacts between 2000 and 2010, when donor investments were at their peak. During the decade, under-5 child mortality declined from a mean of 109.2 to 72.4 deaths per 1,000, or 36.8 fewer deaths among those children in the countries that received the most health aid, the researchers found (a 34 percent reduction). In the countries receiving the least, under-5 mortality fell from 31.6 to 23.2 deaths per 1,000, or 8.4 fewer deaths per 1,000 live births (a 26 percent reduction), the researchers reported.

Life expectancy increases

During that period, life-expectancy figures also grew faster in countries with a greater infusion of health aid, Bendavid said. Life expectancy rose from 57.5 to 62.3 — an increase of 4.8 years — among the countries receiving the most aid. Among the countries receiving the least health aid, life expectancy increased by 2.7 years, from 69.8 to 72.5 years.

Bendavid said previous experience has shown that, on average, life expectancy has increased by nearly one year every four years in developed countries. But health-aid programs literally cut in half the time it took to reach this goal in developing countries. “In that same four-year span, they increased life expectancy by two years, rather than one year,” he said.

He said the results are not surprising if one considers some of the new health technologies made available to developing nations as a result of foreign aid. Childhood vaccines, including those for diphtheria, tetanus, polio and measles, have all but wiped out what used to be among the top killers of young children in the developing world. Health aid directed to providing insecticide-treated malarial bed nets also has been credited in recent studies with reducing malarial deaths among young children, he noted.

Among both adults and children, aid that has expanded the availability of antiretroviral drugs in the developing world has had a major impact on reducing deaths and improving overall life expectancies, he said. For instance, in a study published in 2012, Bendavid and colleagues found that PEPFAR’s health aid resulted in more than 740,000 lives saved between 2004 and 2008 in nine countries.

The researchers also found that the benefits of aid have a lasting effect: The telltale signs of aid’s relationship to reducing under-5 mortality were detectable for three years following the distribution of aid. The correlation between health aid and longer life expectancy overall was detectable for five years after the aid was distributed.

With aid commitments flattening amid the economic downturn, Bendavid said donors will have to be that much smarter in how they invest future dollars, focusing on the most cost-effective interventions and technologies.

“To date, there has been little consideration of how to use development aid in the most cost-effective manner,” he said. “That will have to change now that the funding level has reached a plateau.”

The study was funded by the George Rosenkranz Fellowship for Health Policy Research in Developing Countries and by the National Institutes of Health (grant K01AI084582).

Information about Stanford’s Department of Medicine, which also supported the work, is available at http://medicine.stanford.edu.

Ruthann Richter is the director of media relations at the Stanford School of Medicine.

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