Cheryl Healton

Founding Dean of School of Global Public Health

Professor of Public Health Policy and Management

Professional overview

For the last ten years, Dean Healton has devoted herself to building GPH’s academic, service, and research programs. The School has been accredited by CEPH, increased the size of its student body and research funding, recruited top faculty, added doctoral-level programs, and made diversity, equity and inclusion a priority.

Previously, as the founding President and CEO of Legacy, a leading organization dedicated to tobacco control, Dean Healton guided the national youth tobacco prevention campaign, which has been credited with reducing youth smoking prevalence to record lows, and launched programs for smoking cessation, public education, technical assistance, and a broad range of grant making.

Prior to joining Legacy, Dean Healton held numerous roles at Columbia University including Associate Dean of its Medical School, Assistant Vice President for the Health Sciences and Chairman of Sociomedical Sciences, and Associate Dean of the Mailman School of Public Health. She is an Emeritus Professor of Columbia University.

Dean Healton has authored over 120 peer-reviewed articles and has been awarded multiple grants in AIDS, tobacco control and higher education. She was the founding chair of the Public Health Practice Council of the Association of Schools of Public Health. As an active member of the public health community she has given presentations around the world and is a frequent contributor to national and local coverage of public health issues.

She holds a DrPH from Columbia University's School of Public Health (with distinction) and a Master’s in Public Administration from the Robert F. Wagner Graduate School of Public Service at NYU.

Education

MPA, Health Policy and Planning, New York University, New York, NY

DrPH, Sociomedical Sciences (with distinction), Columbia University, New York, NY

Areas of research and study

Public Health Law

Public Health Policy

Tobacco Control

Publications

Publications

A decision analysis of mandatory compared with voluntary HIV testing in pregnant women

Nakchbandi, I. A., Longenecker, J. C., Ricksecker, M. A., Latta, R. A., Healton, C., & Smith, D. G. (n.d.).

Publication year

1998

Journal title

Annals of internal medicine

Volume

128

Issue

9

Page(s)

760-767

10.7326/0003-4819-128-9-199805010-00010

Abstract

Abstract

Background: The benefit of antiretroviral therapy in reducing maternal- fetal transmission of HIV during pregnancy has caused a public policy debate about the relative benefits of mandatory HIV screening and voluntary HIV screening in pregnant women. Objective: To evaluate the benefits and risks of mandatory compared with voluntary HIV testing of pregnant women to help guide research and policy. Design: A decision analysis that incorporated the following variables: acceptance and benefit of prenatal care, acceptance and benefit of zidovudine therapy in HIV-infected women, prevalence of HIV infection, and mandatory compared with voluntary HIV testing. Measurements: The threshold deterrence rate (defined as the percentage of women who, if deterred from seeking prenatal care because of a mandatory HIV testing policy, would offset the benefit of zidovudine in reducing vertical HIV transmission) and the difference between a policy of mandatory testing and a policy of voluntary testing in the absolute number of HIV-infected infants or dead infants. Results: Voluntary HIV testing was preferred over a broad range of values in the model. At baseline, the threshold deterrence rate was 0.4%. At a deterrence rate of 0.5%, the number of infants (n = 167) spared HIV infection annually in the United States under a mandatory HIV testing policy would be lower than the number of perinatal deaths (n = 189) caused by lack of prenatal care. Conclusions: The most important variables in the model were voluntary HIV testing, the deterrence rate associated with mandatory testing compared with voluntary testing, and the prevalence of HIV infection in women of childbearing age. At high levels of acceptance of voluntary HIV testing, the benefits of a policy of mandatory testing are minimal and may create the potential harms of avoiding prenatal care to avoid mandatory testing.

Directly observed therapy and treatment completion for tuberculosis in the United States: Is universal supervised therapy necessary?

Bayer, R., Stayton, C., Desvarieux, M., Healton, C., Landesman, S., & Tsai, W. Y. (n.d.).

Publication year

1998

Journal title

American journal of public health

Volume

88

Issue

7

Page(s)

1052-1058

10.2105/AJPH.88.7.1052

Abstract

Abstract

Objectives. This study examined the relationship between directly observed therapy and treatment completion rates in the years before and after infusion of federal funding for tuberculosis (TB) control in 1993. Methods. An ecological study of estimated directly observed therapy rates and 12- month treatment completion rates from 1990 through 1994 was undertaken for TB control programs in all 25 cities and counties across the nation with 100 or more incident TB cases in any year from 1990 to 1993. Three cohorts were formed: high treatment completion, intermediate completion, and low completion. Results. In 1990, the median 12-month treatment completion rate was 80% for the entire study population, with a median estimated directly observed therapy rate of 16.8%. By 1994, those rates had increased to 87% and 49.4%, respectively, and increases were shown in all 3 cohorts. Conclusions. Directly observed therapy has had a marked impact on treatment completion rates in jurisdictions with historically low rates. But TB treatment completion rates of more than 90% can be attained with directly observed therapy rates far lower than those proposed by advocates of universal supervised therapy.

Delivering HIV/AIDS services: The professional care provider speaks out

Lyndon Haviland, M., Healton, C. G., Weinberg, G. S., Messeri, P. A., Aidala, A. A., Jetter, D., Jessop, D., & Nelson, K. (n.d.).

Publication year

1997

Journal title

American journal of preventive medicine

Volume

13

Issue

6

Page(s)

12-18

10.1016/s0749-3797(18)30088-6

Abstract

Abstract

Background: This study evaluates the stresses and satisfactions experienced by health care and social service providers working in HIV/AIDS service agencies in New York City. This study was part of the Ryan White Title I Evaluation in New York City. Methods: This study is based on semi- structured interviews with 86 randomly sampled providers from a representative sample of 29 HIV/AIDS service agencies. Personal interviews were completed with a cross section of AIDS care providers. All staff interviewed were audiotaped to facilitate data analysis. Staff discussed their frustrations and their personal satisfaction at working in AIDS care. In addition, all staff completed the Maslach Burnout Inventory (MBI) to facilitate a structured comparison of their levels of burnout. Results: Using the three subscales of the MBI, we found that interviewed AIDS care providers experienced lower than expected levels of burnout. Compared to national norms, health care and social service providers showed above-average levels of personal accomplishment, below-average levels of depersonalization, and average levels of emotional exhaustion. Interview transcripts were analyzed focusing on three broad themes: unique stressors of HIV/AIDS services, positive aspects of HIV/AIDS services, and effective provider supports. The study confirms that HIV/AIDS care providers feel a high level of personal commitment to working with HIV-positive clients. Personal commitment to HIV- positive clients may blunt some of the stresses associated with HIV/AIDS care.

Mismanaged care: the warning signs.

Healton, C. G. (n.d.).

Publication year

1997

Journal title

American journal of preventive medicine

Volume

13

Issue

6

Page(s)

1-2

10.1016/s0749-3797(18)30083-7

A balancing act: The tension between case-finding and primary prevention strategies in New York State's voluntary HIV counseling and testing program in women's health care settings

Healton, C., Howard, J., Messeri, P., Sorin, M. D., Abramson, D., & Bayer, R. (n.d.).

Publication year

1996

Journal title

American journal of preventive medicine

Volume

12

Issue

4

Page(s)

53-60

10.1016/s0749-3797(18)30259-9

Abstract

Abstract

This study sought (1) to identify factors that influence women's willingness to accept voluntary HIV counseling and testing at New York State Family Planning Programs (FPPs) and Prenatal Care Assistance Programs (PCAPs) and (2) to evaluate the effectiveness of such a voluntary counseling and testing program. Telephone interviews elicited organizational-level data from 136 agencies; a combination of telephone and face-to-face interviews was used to gather provider data from 98 HIV counselors; and client data were gathered from 354 women in face-to-face interviews at counseling sites. Slightly fewer than 60% of women agreed to be counseled, and, of those, under half consented to an HIV test at the counseling site. Approximately two thirds of the women who were tested returned for their results and posttest counseling. Clients' recall of pretest counseling content was relatively poor. Bivariate and regression analyses suggest that client, provider, and organizational factors are all associated with rates of pretest counseling and testing. The current voluntary counseling and testing program is achieving only moderate success. Although a substantial number of clients accept HIV counseling, many women remain reluctant to consent to HIV testing, and many who accept testing do not return for their results. Moreover, among those who receive pretest counseling, many do not recall important informational content, which suggests variation may exist in the quality of counseling or that one-time HIV counseling interventions are insufficient to communicate complex information. Medical Subject Headings (MeH): AIDS, HIV serodiagnosis, women's health, patient education.

Gender differences in HIV-related self-reported knowledge, attitudes, and behaviors among college students

Dekin, B., & Healton, C. (n.d.).

Publication year

1996

Journal title

American journal of preventive medicine

Volume

12

Issue

4

Page(s)

61-66

10.1016/s0749-3797(18)30260-5

Abstract

Abstract

A survey of 265 college students was conducted to determine HIV-related knowledge, attitudes, behavior, and perceived self-efficacy with regard to engaging in HIV-protective behaviors. A self-administered 52-item survey was completed by 265 college students (60% response rate). Resident advisors in college dormitories distributed the survey, returned anonymously. Data were analyzed using SPSS to identify differential responses by gender. Although HIV knowledge was high, perceived self-efficacy differed significantly by gender, with men describing themselves as less able to insist upon condom use (P < .00001). Men were also significantly more likely to report using drugs or alcohol in situations likely to lead to a sexual encounter (P < .001) and to having lower self-efficacy in relation to HIV protection than women in such situations (P < .02). Men were also significantly more likely to believe that monogamy obviates the need to use condoms (P < .01). A substantial number of men (13) and women (14.6) say they do not use condoms because they are protected from unwanted pregnancy by the pill. Gender-specific HIV education and skills-building programs may improve the success of AIDS prevention efforts by confronting and addressing gender differences. The reliance on hormonal methods of birth control alone may be a barrier to condom use for both male and female adolescents and young adults. Medical Subject Headings (MeSH): AIDS; HIV; knowledge, attitudes, and practice; gender; condoms; birth control; family planning; teenage pregnancy.

Stabilizing the HIV/AIDS workforce: Lessons from the New York City experience

Healton, C., Aidala, A., Haviland, L., Stein, G., Weinberg, G., Jessop, D., Messeri, P., & Jetter, D. (n.d.).

Publication year

1996

Journal title

American journal of preventive medicine

Volume

12

Issue

4

Page(s)

39-46

10.1016/s0749-3797(18)30257-5

Abstract

Abstract

The Ryan White Title I Personnel Needs Study described here is an evaluation of the human resource needs of HIV/AIDS service agencies in New York City. The research presented here was conducted in collaboration with researchers from the Medical and Health Research Association and the New York City Department of Health and the Planning and Evaluation Committee of the New York City HIV Health and Human Services Planning Council. The assessment is divided into two components. The first component is a survey of 100 key informants from HIV/AIDS service agencies. The second component is a detailed staffing survey of 70 personnel directors of HIV/AIDS service agencies. HIV/AIDS service directors perceived staff recruitment as a more difficult process than staff retention, regardless of agency type. Vacancy rates at the surveyed agencies varied by professional category; they were especially high in the category of nurse practitioners (13%) and outreach/education workers (15%). Agencies stressed that incentives that would positively affect recruitment and retention should be tailored to address the concerns of varied health care and social service professionals. In addition, agencies were not routinely able to provide some incentives deemed effective such as higher salaries, housing subsidies, and smaller caseloads. To reduce recruitment and retention problems, agency informants recommended a variety of incentive programs including malpractice insurance for physicians, flexible hours for full-time employees (including case managers, nurses, physician's assistants), smaller caseloads, and a decrease in the proportion of staff time devoted to direct client contact. Overall health care trends including truncated federal budgets, state Medicaid cutbacks, and the rapid conversion to managed care all affect the quality of patient care and of the work setting for health care and social service providers serving persons with AIDS. Medical Subject Headings (MeSH): AIDS, health personnel, employment supported, employee workload, staff attitude.

The impact of patient education about the effect of zidovudine on HIV perinatal transmission: Knowledge gain, attitudes, and behavioral intent among women with and at risk of HIV

Healton, C., Dumois, A., Taylor, S., Loewenstein, N., Burr, C., & Kaye, J. (n.d.).

Publication year

1996

Journal title

American journal of preventive medicine

Volume

12

Issue

4

Page(s)

47-52

10.1016/s0749-3797(18)30258-7

Abstract

Abstract

The termination of the perinatal HIV transmission trial, ACTG 076, by the Data Safety and Monitoring Board in February 1994 because of the efficacy of zidovudine (ZDV) in substantially reducing maternal-infant HIV transmission has created a considerable need for efficacious patient education approaches and materials for women with and at risk of HIV infection. Complexities surrounding patients' decisions to use ZDV in accordance with the treatment arm protocol of this study must be communicated to women, especially the consequences for both themselves and their potential children. In March 1994, a public-private partnership was formed to develop and test the impact of patient education information on 076 and to explore cultural differences in decision-making surrounding ZDV use during pregnancy. Objectives were (1) to develop an efficacious patient informational booklet on the results of ACTG 076 and (2) to determine the differential attitudes and behavioral intentions of women toward taking AZT during pregnancy. A multidisciplinary group of providers and researchers developed the patient education booklet and field-tested it in five New York City area sites. Subjects were a multiethnic group of women of childbearing age who were predominantly HIV-positive or at risk of HIV infection (n = 120). This 076 education resulted in a substantial increase in intention to use ZDV to reduce perinatal transmission despite full disclosure of the unknowns (P < .001). There were differences in knowledge acquired between racial/ethnic groups, which must be viewed cautiously since the study did not assess socioeconomic status adequately. Attitudes toward ZDV (P < .05), trust in health care providers (P < .03), and opinions on whether testing should be voluntary (P < .02) also varied by race/ethnicity. Medical Subject Headings (MeSH): perinatal transmission, AIDS education, pregnancy, HIV, ACTG 076.

Recruiting Rare and Hard-to- reach Populations: A Sampling Strategy for Surveying NYC Residents Living with HIV/AIDS doi

Abramson, D., Messeri, P., Aidala, A. A., Healton, C., Jessop, D., & Jetter, D. (n.d.).

Publication year

1995

Journal title

Journal of the American Statistical Association

The effect of video interventions on improving knowledge and treatment compliance in the sexually transmitted disease clinic setting: Lesson for hiv health education

Healton, C. G., & Messeri, P. (n.d.).

Publication year

1993

Journal title

Sexually Transmitted Diseases

Volume

20

Issue

2

Page(s)

70-76

10.1097/00007435-199303000-00003

Abstract

Abstract

Eight intervention studies investigating patient education and treatment adherence in the sexually transmitted disease (STD) clinic setting are reviewed. Across the eight studies selected for analysis, meta-analytic procedures were applied to compare the impact of educational and prevention approaches. The effect of video was compared with that of other modes of health education on: 1) knowledge and attitudes about STDs and condoms and 2) treatment compliance, as measured by return for test of cure, drug compliance, premature resumption of sexual activity, and condom coupon redemption rates. The largest effects were those for video on knowledge and attitudes about STDs and condoms, followed by the effects of other non-video interventions on STD knowledge. Lower effects were found among video and non-video interventions targeting treatment compliance outcomes. These results are consistent with prior prevention studies that have demonstrated difficulty in achieving behavior change. Key words: sexually transmitted disease; treatment compliance; HIV, prevention of.

Cuba's response to the HIV epidemic

Pérez-Stable, E. J., & Healton, C. (n.d.).

Publication year

1991

Journal title

American Journal of Public Health

Volume

81

Issue

5

Page(s)

563-7

Abstract

Abstract

BACKGROUND: Cuba's response to the human immunodeficiency virus (HIV) epidemic has been to conduct mass testing of the population to ascertain seroprevalence, to enforce mandatory relative quarantine of persons testing positive, and to implement educational interventions using media and school-based programs.METHODS: Interview with the Vice-Minister of Health and review of available data.RESULTS: Reports to date show a very low seroprevalence rate without evidence of a widespread epidemic. Sexual contact with foreign-born persons is the primary risk factor. Possible advantages of Cuba's policy include rapid reduction in the risk of HIV transmission by infected blood products, an opportunity for focused education and secondary prevention, and limitation of new infections. Possible disadvantages include the restriction of individual freedom in those who are not guilty of any illegal act, quarantine of persons with false positive HIV tests, and ongoing transmission because of the incomplete nature of the quarantine. The policy is expensive and may displace other public health priorities. The content of the media-based educational interventions has emphasized rational medical information in unimaginative formats with a limited focus on prevention.CONCLUSIONS: The issue of personal responsibility for behavioral change versus government imposed regulations is at the core of Cuba's HIV policy. The quarantine policy may paradoxically permit most Cubans to feel that they are personally invulnerable to the HIV epidemic.

Computer-Assisted Instruction in Aids Infection Control for Physicians

Garrett, T. J., Gary, S., Dobkin, J. F., & Cheryl, H. (n.d.).

Publication year

1990

Journal title

Teaching and Learning in Medicine

Volume

2

Issue

4

Page(s)

215-218

10.1080/10401339009539463

Abstract

Abstract

A program to provide health care workers instruction in acquired immunodeficiency syndrome (AIDS) infection control was developed to run on IBM microcomputers. This program can be used by individuals with no computer experience. It was assessed by medical resident physicians who were randomized into a control and an experimental group. A 48-item true-false test on AIDS knowledge was administered to both groups. The experimental group completed a questionnaire on their views of CAI. The mean knowledge score for the control group (n = 33) was 35.9 (SD = 3.9), whereas the mean knowledge score for the experimental group (n = 24) was 42.4 (SD = 4.6), a statistically significant difference (p <.001). Questionnaire responses indicated that the physicians viewed the computer program as easy to use and as an effective educational tool that they would recommend to colleagues. Most preferred CAI to printed presentation of the material. The results of this study suggest that CAI may be a useful instructional method for updating physicians’ knowledge of AIDS infection control.

Controlling AIDS in Cuba

Bayer, R., & Healton, C. (n.d.).

Publication year

1989

Journal title

New England Journal of Medicine

Volume

320

Issue

15

Page(s)

1022-1024

10.1056/NEJM198904133201529

Abstract

Abstract

Unlike any other nation, Cuba has embarked on a program to control the acquired immunodeficiency syndrome (AIDS) that is designed to limit the spread of infection with the human immunodeficiency virus (HIV) by invoking the compulsory elements of the public health tradition. Widespread screening for HIV infection began in Cuba three years ago, and persons identified as infected have been sent to a sanatorium located in a Havana suburb. This unique reliance on a modified quarantine extends to all HIV-infected persons. A recent visit to Cuba as guests of the Ministry of Health permitted us to talk with Cuban officials…

Controlling AIDS in Cuba

Gordon, A. M., Paya, R., Healton, C., & Bayer, R. (n.d.). In New England Journal of Medicine (1–).

Publication year

1989

Volume

321

Issue

12

Page(s)

829-830

10.1056/NEJM198909213211212

Abstract

Abstract

To the Editor: The Special Report by Bayer and Healton (April 13 issue)1 on the acquired immunodeficiency syndrome (AIDS) in Cuba raises questions that should be considered in the light of the available information. Indeed, Cuba's approach to AIDS control is unique. It does not emphasize education, it has screened about 4 million persons and plans to screen the entire population of the island, and it has reported a seropositive rate that is comparable to that of Oklahoma. How a Caribbean island with a 500 percent increase in gonorrhea in the past 10 years,2 a contingent of 380,000 in Africa….

To the Editor Response to Gordon et al

Healton, C., & Bayer, R. (n.d.). In New England Journal of Medicine (1–).

Publication year

1989

Predicting the future of the AIDS epidemic and its consequences for the health care system of New York City

Alderman, M. H., Drucker, E. E., Rosenfield, A., & Healton, C. (n.d.).

Publication year

1988

Journal title

Bulletin of the New York Academy of Medicine: Journal of Urban Health

Volume

64

Issue

2

Page(s)

175-183

Abstract

Abstract

The point of this exercise is not to predict precisely the exact number of AIDS cases that will occur in any particular year. Rather, it is our aim to utilize existing data to develop a plausible scenario of the demand that this epidemic may place on the health care system of New York City in the very near future. To ignore the possibilities inherent in the empirical evidence currently available is to court a societal calamity even greater than the one already perceived. Even now, in the early phase of this epidemic, when HIV infected people occupy only 4.5% of the City's total of hospital beds, a set of emerging distortions and difficulties already threaten the integrity of the City's hospital system. A similar pattern is occurring in other cities with equivalent case rates, e.g. Newark and San Francisco. Innovation, particularly in a system so large and well established as New York's metropolitan health care establishment, which can protect the existing system while still meeting the challenge of AIDS, will be difficult and time consuming at best. But time is short, the need is great and is likely to grow rapidly.

Male and Female Applicants for Alcoholism Treatment: A Study of Differential Staff Attitudes

Shaw, J. S., & Healton, C. (n.d.).

Publication year

1984

Journal title

Journal of Drug Issues

Volume

14

Issue

4

Page(s)

677-686

10.1177/002204268401400407

Women at the Top - Problems Facing Women in Management

Healton, C., & Luther, L. (n.d.).

Publication year

1981

Journal title

MGMA connexion / Medical group Management Association

Chianti Bottle and Flowering Plants as Therapeutic Environmental Agents in State Hospital

Healton, C., Talbott, J., Stern, D., & Shaw, J. (n.d.).

Publication year

1980

Journal title

Hospital and Community Psychiatry

Effects of environmental agents on social behavior of patients in a hospital dining room

Talbott, J. A., Stern, D., & Healton, C. (n.d.).

Publication year

1980

Journal title

Hospital and Community Psychiatry

Volume

31

Issue

2

Page(s)

128-30

Selecting a Computerized Billing System

Healton, C., & Deutch, A. (n.d.).

Publication year

1979

Journal title

MGMA connexion / Medical group Management Association

Volume

26

Issue

4

Differences between nonprofessional recovering alcoholic counselors treating Bowery alcoholics: A study of therapist variables

Talbott, J. A., & Healton, C. (n.d.).

Publication year

1978

Journal title

Psychiatric Quarterly

Volume

50

Issue

4

Page(s)

333-342

10.1007/BF01064460

Pills and Alcohol Don't Mix

Healton, C. (n.d.).

Publication year

1978

Journal title

New York Times Sunday Magazine

The Destructive Three Martini Lunch

Healton, C. (n.d.). In New York Times (1–).

Publication year

1978

Planning Alcoholism Services - Survey of Eighty-eight New York State Out-Patient, Detoxification, Half-way House and Rehabilitation Facilities

Healton, C. (n.d.).

Publication year

1977

Journal title

New York State Division of Alcoholism