It is National Public Health Week! A week put coordinated by the American Public Health Association to dedicate an entire week to Public Health. Two years ago I remember anticipating this week as part of the George Washington University Public Health Student Association board. Coordinating events – academically and socially relevant – and truly encompassing all of public health in one week. The truth it public health is so broad, it’s hard to talk about all aspects of it in one week! Anyway, within this post I am going to 1) define public health, 2) discuss how I was first introduced to the field & 3) why I fell in love with it!
Hey Krit, define public health
Before I could start with discussing my MPH and how I fell in love with public health, we all have to get on the same page with what exactly is public health. So let’s break it down:
According to good old Webster’s dictionary,
(noun) the health of the population as a whole, especially as the subject of government regulation and support.
– the branch of medicine dealing with public health, including hygiene, epidemiology, and disease prevention.webster’s dictionary
Okay, so it’s the health of a population that is subject to government regulation, hmmm? Let’s delve a little deeper with the American Public Health Association definition,
Public health promotes and protects the health of people and the communities where they live, learn, work and play.
While a doctor treats people who are sick, those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors.
From conducting scientific research to educating about health, people in the field of public health work to assure the conditions in which people can be healthy. That can mean vaccinating children and adults to prevent the spread of disease. Or educating people about the risks of alcohol and tobacco. Public health sets safety standards to protect workers and develops school nutrition programs to ensure kids have access to healthy food.
Public health works to track disease outbreaks, prevent injuries and shed light on why some of us are more likely to suffer from poor health than others. The many facets of public health include speaking out for laws that promote smoke-free indoor air and seatbelts, spreading the word about ways to stay healthy and giving science-based solutions to problemAmerican public health association
This definition gives us more context and gives concrete examples. Public health is so much more broader than we originally think about and discuss. Here’s some important developments, that we use on a daily basis, that we have to thank Public Health for:
- The seat-belts that you don’t think twice about putting on before you start to drive.
- The clean water that you use to shower, brush your teeth, or even drink!
- Sewage, yes we don’t think twice before we use the toilet, but thank you public health for flushing all the nasty stuff.
- The fact that school systems even provide lunches to their students – the fact that many schools have banned sugar-sweetened beverages on campus.
- Why many of us millennials are repulsed by cigarettes, we’ve been trained that cigarettes cause cancer, that campaign came from public health professionals!
- Car seats for infants and children – thank you so very much public health.
- Banning driving under the influence – public health.
- ALL THE VACCINATIONS that have prevented measles, polio and meningitis from killing future generations (PLEASE VACCINATE YOUR KIDS) and that will be the end to this pandemic.
- & much more!
There is a long-list of public health achievements that continue to grow as we continue to support our public health professionals. More recently, the public is starting to realize a truth that us public health professionals have known for a long time – social determinants of health (SDOH) are the reason why there are so many health disparities. One of the biggest SDOH being racism. This is a topic we will dive into very soon, but I digress.
Public Health x Krit : A Match Made in Heaven
So now that we know how freakin’ amazing public health is, how did I learn about all of this awesome field? Apparently, I had always lived in this world and part of why I went into medicine was because of public health…but I didn’t realize it.
Rewind to college Krit, she had never heard of the field of Public Health. It was not discussed at all as she started undergrad in 2009. Although she found herself in the world of public health upon entering the Emergency Department as a medical scribe. Witnessing social determinants of health at play as patients entered to Emergency Department with fatal circumstances after 20 years without being seen by a primary care physician. Why not? Because no insurance. Because lack of trust. Because lack of knowledge. Because, “I feel fine, why go?” It was not until I worked in the Emergency Department that I saw the injustices within healthcare. It was not until I saw remnants of my childhood within the Emergency Department – and saw how many providers reacted to these families. Hmmm…
Although I was seeing components of public health in play, right in front of me at the Emergency Departments, I did not realize what the field was until I took an Epidemiology class during my post-bacc program. I only took the course because I heard it was an easy A, hahah yes, premed mentality I know I know. The first day of class I was hit with hard public health facts. This professor KNEW that all of us were just using his class to move into fields of healthcare that did not really talk about public health. He knew this was his only opportunity to reveal to us the truth behind healthcare here in the states and globally. He gave us a crash course on public health within the first course of epi and I was shook to my core.
How is it that this field existed and I knew nothing of it? Why wasn’t this course the basis of medicine? Why does your zip code define how long you will live? Why haven’t we found a cure to the diseases of social injustices? Why is our infrastructure nationwide so poor even if we have all the resources? Was capitalism really the reason why so many people were dying of things that others seemed to be cured from? Are we as a society truly monetizing off of sick people?
During the time that I was taking my epidemiology course I was also volunteering for a local Federally Qualified Health Center (FQHC). A little background about FQHC: Federally Qualified Health Centers are community-based health care providers that receive funds from the HRSA Health Center Program to provide primary care services in underserved areas. Their goal is to bridge gaps of care for those who truly need it, they rely solely on federal funds and in some cases, state funding as well. At the time I started volunteering at the FQHC I saw it as an opportunity to dabble within a primary care setting, since I had all the Emergency Medicine experience. I quickly realized how different it was. This particular FQHC blew my mind. They were a family. They were collaborative. They cared about their patients. They were in it to improve health, not just treat symptoms. I also realized, while taking my epidemiology course, that the patients I had grown so fondly of at this FQHC had a dramatically shorter lifespan compared to their counterparts who lived in a more affluent neighborhood. And this one thought is what fueled my path toward intertwining public health with medicine. I was livid when I learned my patients, my friends, have a less likely chance of living as long as a white counterpart in a different zipcode. WHY?
This lead me to put in more hours into volunteering at this FQHC, and allowed me to gain a summer Health Advocacy Internship at the same site, and eventually I served a year at this FQHC through a Community Health Fellowship. During my two years as a volunteer, intern and Fellow I gained so much community health experience that was essentially my first professional public health experience.
Community Health Fellowship!?!
So what was this fellowship? It was a pseudo-Americorps program – modeled after the Americorps CommunityHealth Corps program (at the time politics got in the middle of the funding for the program so it was put on pause). What did I do? I worked directly with Director of the FQHC’s “Wellness Program” and put on programs for patients that would improve their control over their health. I also did a lot of various support roles. I learned what it was like to be a Medical Assistant, a primary care scribe, a communications director, a front desk receptionist, an internal medicine physician, a patient coordinator, a quality improvement coordinator and more. I learned how it took a whole entire village to maintain and improve patient health. I worked with the community directly to bring more healthy vegetables to my patients. I got to witness and create interventions on social determinants of health. I learned that these determinants of health are not in the patient’s control. They can’t control that there aren’t any local grocery stores carrying produce? They can’t control that there are more liquor stores than healthy foods? They can’t control how long the bus takes to get to their appointments.
I learned how to create interventions to address these social determinants. For example, my patients did not have access to vegetables because of the aforementioned issues. So what did we do? My clinic established relationships with local farmer’s markets and they donated their unsold produce to us. We make cute little produce bags to distribute to our patients week. Another example was utilizing innovated shared medical visits. We found our patients needed a support system that would foster relationships and promote health. So what did we do? We started to create weekly “classes” in which patients would learn more about their chronic health issue while supporting each other – and yes a physician would be present so they would be able to bill insurance to maintain a sustainable model for the clinic. In our Diabetes Management shared medical visits we would collaborate with dentists, podiatrists, ophthalmologists, nurses, nutritionists and more – in order to provide holistic care and stress to importance of taking care of your body through the understanding of what diabetes is and how it affects your body. We learned quickly that patients were more likely to take part in their healthcare if they understood what it was. If you take the time to explain to a patient what is occurring in their bodies and a step-by-step on how to address it they will make changes, all you have to do is give the tools.
During my Fellowship I also attended weekly seminars that taught me various components of public health. This is when I expanded my public health knowledge beyond the one epidemiology course I took. These seminars taught me about the various social determinants of health, the role of health advocacy, the role of health policy and how I can become a change agent for my patients. My community health fellowship changed the trajectory of my life. It open my eyes to a world beyond medicine that many pre-meds do not get to witness until after they’ve become physicians. This experience has informed my future practice. This experience also reminded me of how physicians must be political. It taught me the importance of social justice because there are so many injustices in healthcare and medicine.
It was life-changing and I knew after this experience I needed to get an MPH at one point of my medical career. Whether before, during or after medical school, I needed my MPH. Life happened, and I ended up getting my MPH before medical school and it was the best experience of my life, to date. More on that later 🙂
Anyway, I love public health. I love community health. I love health advocacy. All for my community. All for my patients.