One of my passions is to coach public health students and prepare them for the new frontiers of public health. Much of this coaching draws from my experience of having worked as one of the senior leaders in obesity science and policy at the National Institutes of Health (NIH), in combination with my own academic career. The unique blend of experience in policy, practice, and science has significantly shaped my worldview and how I approach my career. With regard to students, first off, what I tell them is that there is not one single career path for graduates in public health. Second, I see it as our duty as leaders in public health to give our students the diversity of skills to be marketable and competitive in all sectors of society, not only in academia, public health agencies or other health organizations. In fact, if we want to improve public health, we must have foot soldiers and captains throughout society. How else would we able to build a coalition of change agents to effect change in every corner of the system? My work at the NIH taught me that science or academia alone cannot solve the most pressing challenges we face today, such as climate change or chronic disease morbidity and mortality. Politics is a big part of the equation. So is the private sector. During my time at the NIH, I had the fortune to lead or co-sponsor several cross-sectoral forums. I learned a lot about the complexity of sectoral and organizational change and that there is a need for public and private sectors to support and prod each other to build a better, common society for all. We also need to delegate responsibilities so that each sector and organization can leverage its strength to play a part in shaping our future. This solution-oriented perspective is what I wish to instill in the next generation of public health scientists and practitioners.
One of the things I have learned and come to terms with is that all public health and social challenges are complex, and such complexity requires different frameworks to address than the simple cause-and-effect model that we have all learned growing up. You see, being able to tease out what causes of obesity -- for example, eating too many calories -- doesn't necessarily tell us what to do about them. To this point, we can probably all relate to the personal failures of trying to count and reduce our caloric intake.
The reality is that to achieve the goal of reducing calorie intake, we would first need the motivation and education to do it, accompanied by social support, tools to help us manage food purchases and intake, and an environment that makes it easy to accomplish this in all the different settings in which we function. And, on top of it all, we will need to exercise to keep up our metabolism and offset the natural decrease in our metabolic rate when we lose weight! How rare is it that all these factors are aligned to help us maximize our chance for success?
This brings me to the point that it is futile to look for simple solutions for public health challenges. It is not about any one thing but how all the different factors line up and interact to shift the outcome one way or another. There are tools -- qualitative and quantitative -- that help us manage this complexity. However, I find that the key to embracing complexity is a shift in mindset, and this takes practice. The shift involves not playing the blame game (i.e., looking for the single culprit), not being afraid of the unknown, being okay with the surprising and unanticipated, and recognizing that there are many others outside our comfort sphere who can bring different expertise and tools to help us figure things out. This is why I have become such a firm believer in working to find solutions to obesity or other challenging problems in society through cross-sectoral collaborations and innovation -- at the nexus of science (of all forms), business and design and creativity.
I was a psychology major in college. In my final year, I worked on a health psychology thesis focused on the mental health of breast cancer survivors. That research was part of an emerging field called psycho-oncology and it helped me appreciate the interconnection between the mind and the body. As I delved into the research, I began to ask more questions. I wondered how social and environmental conditions might influence the mental or physical health outcomes of those patients. That research experience was instrumental in pushing me to look for graduate programs that were truly interdisciplinary and that entailed research linking the biological and psychosocial sciences. By chance, I stumbled upon an applied health research program in Preventive Medicine at the University of Southern California, which seemed really interesting and had many of the interdisciplinary features I was looking for. The program was offered by the medical school and qualified students could go from a bachelor's degree directly into the PhD program. Fortunately I got in, and that was how I ended up in public health.
I initially started my work in tobacco and drug abuse prevention. Then I gravitated towards childhood obesity research as the health consequences were starting to really emerge as a major public health concern. What I love most about the field of obesity research is that it truly requires the knowledge of diverse fields, from the biological sciences to the social and behavioral sciences and even business, engineering, policy, and law. It is a perfect model to train one's mind in navigating and managing complexity and to be creative in thinking outside the box. Through my experience in the obesity field, I have come to see public health in all places and across the ages. Everything is related to public health!
I am glad I found public heath, as it has offered me a multifaceted window to critically examine the world. In the process, I have also come to appreciate that there remains so much potential in public health that is yet to be fulfilled. Doing so will require ever more intensive integration of expertise from other fields. However, the future is full of possibilities, as knowing what we don't know is the first step towards achieving the next innovation in public health.