Guest Blog Post: Dr. Carla Alvarado was one of my interns in the International Training Program for Minority Students some years ago. Although I try to keep in touch with alumni of my programs, it is sometimes hard to keep track of where all of them are. Imagine my delight when I went to a meeting of the Roundtable on Environmental Health Sciences, Research, and Medicine at the National Academy of Sciences,of which I am a member and saw that the only other Latina face in the room was that of my former student, Carla Alvarado, who is a superb program officer there. I am extremely proud of Carla, who after overcoming incredible odds, has risen to such a great career that brings together so many of her diverse personal and professional experiences.
Here is Carla's story in her own words.
Looking back at my growing up in the US-Mexico border, I feel fortunate that I have a bicultural and bilingual culture. I can say now that growing up in a predominantly Hispanic community did not prepare me for life as a “minority” once I stepped out of the Southwest. But I believe that life had a way of having me experience everything I need to in order to land exactly where I need to be.
Seeing the Health Care System as a Nurse in a Minority Community
Fortune continued to follow me as I graduated from a high school that was a magnet school for health professions, where I pursued a practical nursing degree. I earned a Bachelor’s in political science with a minor in economics, a master’s in public health with a focus on management, policy and community health, and international health. Then I worked for a local health department in Texas before pursuing a doctoral degree in public health policy. After all these twists and turns, I am currently a program officer at the National Academies of Sciences, Engineering, and Medicine in the Roundtable on Population Health Improvement.
During my nursing clinical rounds, I observed many patients in precarious conditions, both in terms of the state of their health and in their living conditions. I saw patients with multiple diseases, and I noticed that those without health insurance were treated differently and released as soon as possible and often, within days, you would see them back again at the hospital. Being in a region where 30% percent of the population was medically uninsured, I witnessed the impact lack of access to healthcare could have on people’s lives. I will never forget how people diagnosed with stage IV cancer were being sent home to die because they didn’t have health insurance and they were not eligible candidates for cancer trials. I saw families that were put under severe stress because of the financial strain of hospitalization. I started questioning the fairness of the health insurance system or lack thereof.
Seeing the Health Care System as a Brain Tumor Patient
As fate would have it, I lived first-hand the need for health care. A few weeks after I graduated from the nursing program, I was diagnosed with a brain tumor and I had to undergo surgery. The surgery and the 2-year treatment that followed made me realize how lucky it was that I had health insurance that would cover the majority of the expenses, to this day I do not know how my parents were able to cope with the out of pocket expenses (nor will they tell me).
After being a patient and interfacing with the good, the bad and the ugly of the health care system, I needed to understand why the U.S. health care system was the way it was. I decided to study political science (to my parents’ dismay), and was subsequently dissuaded from a philosophy minor (because they said I’d starve) and encouraged to purse economics, which I did (but as a minor). As I completed my bachelor’s degree, I didn’t know what exactly I wanted to do after college, I knew I wanted (and needed) a master’s degree, but in what? One night, after going dancing I was venting to a friend about not knowing my next step, and she told me about her friend pursuing a master’s degree in public health, which embarrassingly I knew nothing about (I know, not even as a former nurse). To my delight, public health married all three streams of knowledge I had attained throughout the years, and so I applied to grad schools for an MPH program.
Putting it All Together
During my MPH I had a variety of experiences that (in hindsight) made me a well- rounded public health student: I was involved in environmental health research, health disparities research, as well as policy and international research. It was tough being involved in so many projects, but I loved not only learning about the different sub-disciplines in public health but also having hands-on experience. So hands on, that as a student I was approached to become a consultant for a binational entity to conduct HIV-related qualitative research. Upon graduation, I secured a job at a local health department in Texas where, in the span of 3 years, I held 3 different positions: I was a health educator, a public health preparedness community liaison and a de facto special projects coordinator. During the H1N1 response (ten years ago!) I was the crisis and emergency risk communications lead and the preparedness community liaison, and let’s just say that the experience left me wondering how the federal and state governments made their policy decisions and why they were implemented the way they were. The experience was the push I needed to decide to pursue a PhD in public health policy. I always knew I wanted a PhD, as a personal exercise of intellectual endurance, and the experience at the health department helped me refine the topic I wanted to commit to for the next several years. Pursuing a PhD was the most gratifying experience I have had, it was a challenge and it was taxing, but I’d do it again in a heartbeat.
I wish someone would have told me to relax. Honestly. I wish someone had told me that yes, although it is important to be methodical about pursuing a degree (or several), the degrees give you (in the eyes of society as we know it) much more flexibility than people know. For example, I see people who graduated with a degree in public health who now work at the Department of Justice, friends who graduated with an urban planning degree working in public health, and other sorts of arrangements. I wish someone had told me that interdisciplinary experiences are also valuable and valued, being a generalist is also an area of expertise in public health. I wish someone would have mentioned that knowing about political science, economics, ethics, nursing, and public health would render a worthwhile portfolio of expertise, to hush all the people who pressured students to pick one thing and one thing only.
The path to the National Academies makes sense to me in hindsight. For starters, I graduated obtained a practical nursing degree in high school because my mother is a nurse and I thought that being a nurse was a pathway to becoming a doctor, as many of us children of immigrants are *encouraged* to become (note the euphemism).
I am very fortunate to have found a job that allows me to apply the knowledge and multitude of experiences to the various projects we work on and even affords me the ability to keep learning about the maturing field of population health.
Some of the biggest obstacles that I have faced have been of the interpersonal kind. Interacting with people who are not open to someone with a different background can be challenging. But overall, it has been an asset to be a bilingual (Spanish and English) Hispanic woman, with experience in the clinical field, the research and practice-based public health field, and in health services research. I can navigate in and out of many different areas, both professionally and personally. However, the ability to navigate different terrains means I have had to make in-roads into each, and that takes work and patience because you have to establish and exercise your agency. There have been many times, both professionally and personally, when any of the social categories I am part of has been used against me. No need to exemplify such unpleasantries, but (sadly) it took me a long time to learn that those who use them against you are taking out their frustrations, ignorance, bigotry, and inferiority complexes on you, as opposed to there being something wrong with being any of the categories you represent.
I love learning and traveling. Internships, especially those like the Mount Sinai Training Programs directed by Dr. Claudio, are so dear and near to me because they are professionally and personally intense, challenging, and rewarding all at the same time. Those internship experiences helped me put my career together.
The National Academies is a great place to work for people like me, it is a learning incubator if you will. I am given liberty to pursue intellectual and professional endeavors that are aligned with our mission. There are days where I am at professional conferences attending or chairing a session, there are others where I spend most of the day reading familiarizing myself with a new topic because we are organizing a workshop, yet other days involve providing technical assistance to our innovation collaboratives, supporting the roundtable, writing proceedings, doing research for one of our reports, etc., etc. I especially enjoy the range of activities I get to carry out. No week is the same, and that is very helpful in terms of the quality of life within the workplace. I am truly honored and thankful that I have a job where I get to interface with so many of the great experts in public and population health. I get to nerd out and learn something new every week, meeting and interacting with experts from around the nation and learn about their work. I do however miss data analysis, but that I can do as an extracurricular professional exercise.
I was once told that degrees do not mean anything, this was coming from a much older coworker at the health department who had been trained on the job and been working longer than I had been alive. To which I said, “maybe you should tell your daughter that, isn’t she the first one in your family to obtain a college degree and is now pursuing a master’s degree?” Back then I didn’t realize that out of almost 400 employees, only 5 of us had a master’s in public health, including the Director and the epidemiologist, and I was the youngest, the amount of work and responsibility was too much too soon in most people’s eyes and so they would hit below the belt. At the time I was distraught and confused about their animosity, but now all I can do is be thankful that my degrees have opened doors to a breadth of experiences that I never knew existed, and that they still do not, or ever will.
“What?! You want to interview me for a podcast about fashion?” I said on the phone, incredulously.
I continued, “Before I say you are crazy, maybe what you mean is that you want me to talk about the environmental impact of the fashion industry?” (This is something that I have written about in one of my most popular research papers, so that would make total sense.) “No,” said Misha Kaura, the fashion designer, and podcaster who was calling me on the phone. “I want to interview you about the role of fashion in your professional life.”
Until that moment, I had not consciously thought that fashion played much of a role in my career. Sure, I like to look nice and presentable, but that is a long leap from being fashiony.
Misha’s invitation made me think. Hmm… I guess fashion does play quite a role in my professional life. I did mention in my TED Talk that when I present about environmental health to girls, they also ask me about my clothes, shoes, or hair. This can get annoying, until you think about it from their perspective. I don't fit the media image of a scientist, so the girls are curious.
For the podcast, Misha asked me to talk about my career path and when fashion entered my consciousness. So I had to recall that my biggest role models were my aunts. You see, I grew up in the mountainous countryside on the island of Puerto Rico. My aunts were all professional women, 6 of them were secretaries. That they had these glamorous jobs was pretty rare at that time. And I wanted to grow up to look like them.
I remember that my aunts would walk down our unpaved road with their work shoes in hand. When they got to the bottom of the mountain where the paved road started, they would wash their feet and put their heels on to go to work in the nice offices in the city. To me, that was what a professional woman did.
Now that I am an environmental health scientist, some people have the idea that I work with trees and forests and wildlife. But in fact, I work in an office and lab in a big hospital in Manhattan.
Passion for fashion is important to me because many people think that a woman scientist doesn't really care about fashion. Why would we, right? We tend to wear lab coats and anyway, a woman who is brainy can’t possibly care much about her appearance. That's if you believe the media.
For me, the concept of fashion is aspirational and also inspirational. Aspirational because being a non-traditional female underrepresented minority scientist, I needed to break those stereotypes to be taken seriously. Therefore, I started dressing more like who I wanted to be, a professional. Like my aunts. Carrying my high heel shoes in my hand until I get to the paved road. Literally and figuratively.
Inspirational because, as I said in my TED Talk, when I talk to my students, especially young women and girls, it's really important to them to see somebody they would want to emulate. Now that I have a 12-year-old daughter I see more clearly how important this is to them. I want to say to girls and young women: "you can dress and look anyway you want and still be a kick-ass scientist. If you don’t fit the stereotypes, so be it."
I personally don’t have a lot of clothes, but what I do have I like. Last year, I joined the No New Clothes for a Year pledge. I made the year, buying only a pair of walking shoes and underwear, but cheated by having my friend, Martina Dietrich make me a dress for my TED Talk. I got the jewelry from my friend Jane Diaz.
So in the podcast I said that fashion style is not about having a ton of clothes or being trendy. It comes with getting to know yourself and being able to reflect that knowledge in your own style. Style comes from being able to wear clothes that make you feel in control, whether those clothes are the kind you see on the runways or the byways.
Yes, being a woman scientist has the advantage of forcing people to see your brain power rather than only being measured by superficialities. That must allow for all styles to be represented. Once I was wearing a classic Diane Von Furstenberg wrap dress at work, when a colleague sarcastically asked me "are you coming to the seminar or to a cocktail party". In fact, I was going to both!
Fashion style is about wearing and looking like who we are and who we want to be.
Listen to the podcast here: https://passionforfashionwithmishakaura.simplecast.com/episodes/misha-kaura-interviews-dr-luz-claudio-ArYr0Fco
Since graduate programs are very focused on a specific subject, they are best for students who are pretty certain of what discipline interests them most.
For an article published in US News and World Report, Ilana Kowarski asked several experts in higher education to explain what is graduate school. Students must weigh the decision to pursue graduate education very carefully and this article is intended to help in that regard.
One common misconception about graduate school is that it is similar to college, but higher education experts say that graduate courses tend to involve more self-directed learning than courses at the undergraduate level.
"Too often, college students or people who only have had a college experience somehow think that graduate school is going to be more of the same, and it's not," says Thomas Plante, a professor of psychology at Santa Clara University in California. "It's going to look very different. So students might be tired of sitting in small plastic seats in large lecture halls and listening to professors drone on and then taking tests and things like that, and they don't realize that often graduate school is not that way at all."
Plante says graduate courses tend to involve small classes as opposed to large lectures, and he notes that grad students are typically engaged in academic research outside of the classroom.
In addition to Dr. Plante's comment, I was quoted as follows:
"Luz Claudio, a tenured professor with the Icahn School of Medicine at Mount Sinai in New York, says graduate school typically requires an abundance of motivation and personal accountability, since students are frequently asked to work independently.
"I tell college students that one of the keys to success in graduate school is self-discipline," Claudio wrote in an email. "There's generally no 'homework,' quizzes and few exams. Students need to learn how to learn class materials without such close guidance from a teacher. However, most graduate programs have a long-term project that students must complete, such as a research paper. These require a different kind of relationship with a teacher. For these, the teacher becomes more like a mentor and the student is more like an apprentice."
To read more, go to US News & World Report.
Do you have a friend who once did a frog dissection and now acts as if they were a surgeon? Well, I don't want to be like that friend.
I have done one TED Talk. Therefore, I am no expert. I am still learning and exploring how I can incorporate that experience into other parts of my professional life. But since this is what you asked in the FAQs, then I will tell you the things I learned that helped me. Hope that they may help you next time you have to give a scary talk:
You know that warm and fuzzy feeling that you get when walking on a lovely beach at sunset?
Giving a TED Talk was NOT like that.
Giving a TED Talk was more like riding a roller coaster, when you are not a roller-coaster- type-of-person. It was the longest 6:54 minutes of my life. I felt every emotion: fear, excitement, despair, focus, distraction, nausea... then, just like riding a roller coaster, as soon as it was over, I wanted to do it all again.
To answer your second most frequently asked question (FAQ), here are some of the salient points of this experience:
I know, I know. You've heard it all already. Climate change is happening. And it's happening now. But the issue is so important that it begs the question, can there ever be TMI about climate change (too much information)?
We were one of 5 scientists interviewed by Bustle about climate change. I talked about the worsening of air pollution and its effects of human health. Here is what I said:
" Dr. Luz Claudio, a professor of environmental medicine and public health at the Icahn School of Medicine tells Bustle, "The environmental challenge that I am focusing on in my research is to try to identify, prevent, and reduce the effects of environmental pollutants in vulnerable human populations, especially children. I do this work because children are particularly vulnerable to exposure to pollutants in the environment. Children tend to have higher exposures per body weight because they absorb chemicals more readily, they breathe more air, they are closer to the floor where there are often more of some classes of pollutants and they tend to put everything in their mouth, especially when they are really young. Also, exposure to a chemical pollutant early in life, even before birth, could have effects later in the life of children that can be unmasked as they grow.
"My team and I have investigated the asthma epidemic in children, especially children in minority and poor communities. We have also assessed how different other environmental factors can interact with poverty, diet, minority status, poor housing and other factors to cause disease More recently, we have also investigated the role of air pollution in causing neurobehavioral effects on children."
Human activity, she says, is culpable for these health issues, but we can do a lot to help. "Most of the types of air pollutants that we are investigating for their effects on children’s health are released through human activity." Air pollution can come from everything from domestic activities like cooking and heating to exposure to factory smoke, waste-burning, dust storms, and traffic emissions. "Collectively, we can as a society value the health of children by reducing emissions from traffic and other fossil fuels. For example, we are now in the process of estimating how small actions such as done by many people may quantifiably reduce the burden of disease in children.
"On an individual level, people have more control about their indoor air," Dr. Claudio tells Bustle. "Being aware of the role that indoor air can play on children’s health is a great step towards addressing this issue. Never smoking in the home, removing sources of VOCs [Volatile Organic Compounds] such as certain carpeting, reducing or aerating items that produce a lot of off-gassing, and wall treatments that contain volatile compounds can be small actions that significantly reduce some of the indoor air pollutants."
I'd do anything for my daughter, even a TED Talk!
When my daughter had the idea of having me apply to the TED Residency, it did not occur to me that I might actually get it. As a big fan of TED Talks, I have watched many, yet, I've never seen a Talk by someone I know. All the speakers seem so confident and knowledgeable, and famous. It all seemed so out of my league.
To say that I was shocked that I was selected for the TED Residency is an understatement. Once the shock dissipated, reality kicked in: How would I find the time to prepare? What is my idea worth spreading? What should I wear?! Reality check number 1.
Sure, as an academic research scientist, I have given talks, seminars, lectures, classes, workshops. I would say that I have been an average speaker giving the average seminar in which every statement is illustrated by a Powerpoint slide. The purpose of an academic seminar is usually to present data. It is very much like a scientific paper in oral form: the intro, the methods, the data, the conclusions. I quickly learned that I wasn't going to get away with that on the TED stage. Reality check number 2.
And as scientists, what do we ever feel sure about? We are trained to say "the data suggests" in our papers. We still call evolution a "theory". And we end every research paper with "more studies are needed". What can I say on the TED stage that I "know for sure", as Oprah would say? Reality check number 3.
The TED Residency program helped me check off all those realities. The program selected a VERY DIVERSE group of professionals and put us together in a pot, raised the heat to simmer, and stirred.
Twenty residents were selected, ranging in age from 21 to 70, different races and backgrounds, different areas of expertise, from different countries, working together in open cubicles at the TED Conferences Headquarters for three months. During this time, I continued working at Mount Sinai, submitting three research proposals to NIH. I was working 12 hours a day, 7 days a week. Thanks to my family and a flexible schedule at my job, I was able to do it.
At TED, I was quickly humbled by how much I needed to learn. Mostly, I learned from my peers in the Residency. I engaged in conversations with two veteran New York Times reporters about health information and the media, learned from two young African-American men about using technology for social good, and was moved to tears by two LGBT youth about how to tell their stories. The most helpful and surprising learning experience came from an amazing British rapper. This young red-headed woman taught me the value of every word I say in my Talk. I am forever bonded with all the residents in my group. It was like going skydiving with strangers, after that experience, you really can't call them strangers anymore.
I can honestly tell you that it was very hard for me to do this. It required a lot of unlearning and learning. It was truly a humbling experience. I am still not totally sure that I was deserving, and it took me a while to be willing to share the Talk with all of you. But I could not let my daughter down. She kept saying: "Do it Mamami, do it!" So I tossed the reality checks out the window. Shook off the impostor syndrome. And worked my butt off.
Thank you all for your support during this journey. I really need you to view and share this TED Talk with your contacts. Now we both can say that we know someone who did a TED Talk. ;)
By Kelly Bryant for Reader's Digest
Our previous research has shown that exposure to contaminants in outdoor and indoor air can affect respiratory health, especially in children. This is important because diseases such as asthma, bronchitis and other conditions are very common and affect many families.
We have also previously written about how children show exposure to endocrine disrupting chemicals from personal care products and other sources. Recently, I was interviewed by Kelly Bryant for an article in Reader's Digest. The article lists 14 ways in which toxins "sneak" into our homes in ways that may be unexpected or surprising for many people. I was quoted in the article as follows:
It feels good to put dry-cleaned clothing back in your closet, crisp and pressed for your next outing. But the process which made them look brand new could carry some trouble. “Perchloroethylene is a chemical used in dry cleaning,” says Luz Claudio, PhD, professor of environmental medicine at the Icahn School of Medicine in New York. “Although it’s not known how much of it may be released in the home when you bring dry-cleaned clothes in plastic bags, it may be best to open the bags and aerate them outdoors before bringing inside.”
The other 13 sneaky ways toxins may be entering your house, according to the article, are:
Guest Blog Post: Dr. Bahby Banks was one of my first students in the International Training Program. After completing her doctoral degree, she has become a successful business owner, motivational speaker, and consultant. She helps other women of color envision their futures and helps businesses evaluate their programs. She is always a welcome guest speaker for our group of new students.
Here is Bahby's story in her own words.
I participated in the inaugural Mount Sinai School of Medicine (MSSM) Exchange Program for Minority Students in 2006, shortly after I completed the first year of my doctoral studies at UNC Gillings School of Public Health. My research internship included placements at Fundacão Oswaldo Fiocruz in Rio de Janiero, Brazil and Hospital Alvarez in Buenos Aires, Argentina. Dr. Claudio did an amazing job of preparing us for our internships, including a week-long orientation in New York City. During this week, we were introduced to local researchers and scientists, provided with instructional language CDs and given literature that detailed the importance of inclusion of underrepresented populations in research. Every single detail of orientation week wreaked “love” and “investment” from Dr. Claudio and her staff.
After orientation, I made my way to my first placement at Fundacão Oswaldo Fiocruz, where I worked with Drs. Lucia Rotenburg and Rosane Greip to explore gender differences in work ability among Brazilian nurses. My lab consisted of about five young researchers—all women- who investigated various aspects of Dr. Rotenburg’s research. My work with the Fiocruz team continued after I returned to United States, and resulted in a peer-reviewed publication (Rotenberg L, Portela LF, Banks B, Griep RH, Fischer FM, Landsbergis P. A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel. Appl Ergon. 2008;39(5):646-52)! The following year, I traveled with Dr. Rotenburg to the 18th International Symposium on Shiftwork and Working Time in Australia—where I was the only delegate from the United States. Quite an honor!
My second placement in 2006 was in Buenos Aires with Dr. Diana Gilamberti, director of Obstetrics and Gynecology (OB/GYN) at Hospital Alvarez. I worked with another Mount Sianai intern to develop a survey to explore the use of petroleum-based lubricants among sex workers receiving services in the OB/GYN department. This was probably one of the most intriguing experiences that I’d as a budding researcher, as Dr. Gilamberti invited us to share the survey findings with two sex worker union representatives in Buenos Aires. The representatives responded with such passion and were adamant about prioritizing the safety and health of “their girls”. The response to raise awareness about the dangers of petroleum-based lubricant use was the quickest I hade seen for any public health effort. By the end of my internship, the local health department began supplying the hospital with condoms packaged with lubricants. They also made them available at the local health department.
My journey to become founder and CEO of Pillar Consulting, Inc. was a very non-traditional one. I knew very early on during my doctoral training that I wanted to serve as a faculty member and independent research consultant. I did not, however, have a “roadmap” to guide how I could navigate both of these roles successfully. I had a powerful network of mentors to guide my steps in academia, offering opportunities to contribute to research in historically oppressed communities. Opportunities did not always present themselves in “traditional” ways, but I was very proactive in seeking leadership and research roles that supplemented my academic training. Many of my mentors, including Dr. Claudio, were not in my department, but they were invested in my growth as a researcher.
The most powerful shift as a research intern was learning my role as a contributor to research. The Impostor syndrome is very real, particularly for people navigating industries that have historically excluded women and racial and ethnic minorities. I did not always feel that I belonged—despite doing all of the work to earn my seat in the room. But, sitting alongside senior women researchers who successfully navigated the academy was priceless. It was a mirror of sorts for where I wanted to be after I completed my studies.
Two things I learned over the course of my training: 1) Your work will always speak for you and 2) Think outside of the box. My applying for the Mount Sinai International Exchange Program for Minority Students was an example of the latter, as this type of training program was not available at my home institution. I participated in several internships over the course of my studies, and while the variation in topic areas appeared as a “lack of focus” to some faculty, I knew exactly how these opportunities could build my professional portfolio. I knew that I wanted to add international training to my professional portfolio, and these internships afforded the opportunity to supplement the training I was learning in the classroom. As a result of seizing these opportunities, I was able to conduct research at the World Health Organization, Fundacão Oswaldo Cruz, Hospital Alvarez, and ultimately worked with an amazing research team in rural North Carolina.
My love for program evaluation and mixed-method approaches led to my current career as a business owner and independent research consultant. During my doctoral studies, I enrolled in courses and took advantage of external training opportunities to develop my research skills (e.g., qualitative methodology, racial and equity training, community-based research). Business development took a little more work, as I didn’t know any researchers navigating the path of entrepreneurs! I did, however, reach out to several men and women in my network who were entrepreneurs to glean what wisdom I could to position Pillar Consulting as a competitive company. Networking was key!
I share with my mentees the importance of having a “tangible” when they complete a research internship—something that documents their contribution to the research. This “tangible” might vary from place to place: a conference poster, oral presentation, brief, video or peer-reviewed publication. No matter the case, the goal is to share your findings. Dissemination is key in ensuring your work, and the work of the communities you serve. As an academician, peer-reviewed publications are essential to building your tenure package. Scientific writing in essential to sharing your work with the Academy.
Now, as a business owner, I focus most of my work with Pillar Consulting on historically oppressed populations whose voices have not been part of “best practices” shared in the literature. That said, we work with clients to help build their capacity to lead and contribute to the dissemination of their work. We, as research scientists, continue to partner across the county to disseminate the work of our partners.
Participating in Dr. Claudio’s internship helped me achieve my career goals. There is power in being able to say that part of your academic training included contributions in national and international settings. By the time I completed my Ph.D., I had co-authored several peer-reviewed publications in national and international journals, presented at conferences around the world and had a vast network of colleagues around the globe. These opportunities laid the foundation for me to become the researcher I am today!
I would not be where I am today without mentors who were invested in my success and growth as a public health researcher. As a military dependent, I was accustomed to being in a variety of academic settings—public, private, predominantly White, or predominantly Black—but I was the first (but not last) member of my family to pursue doctoral training. In more ways than one, there was no a roadmap for me to follow. My mentors, near and far, were open and transparent about their journeys in research, and pushed me to raise the bar for myself. They believed in me when I didn’t believe in myself and challenged me to (literally) use my voice at the decision-making table. They helped me see my dual role as a trainee and contributor to research.
I continue to grow as a leader and evaluation researcher every day. My goal of building community capacity in research has not changed, but my approach has. My team is committed to working with an equity-based lens. We are working with partners whose approaches include social determinants of health and structural-based approaches to improving the human condition.
What I say to new students in these internship programs is this: Use your voice. In the words of the late Shirley Chisholm, “If they don't give you a seat at the table, bring a folding chair.”
Guest Post: Bringing it Full Circle -A child of immigrants now offers medical care to families detained at the US-Mexico border. Elizabeth Lopez-Murray, DHEd, PA-C, MSPAS, MPH
Photo credit: Jessica Valdez Outlasting Memories.
So proud to introduce you to Elizabeth Lopez-Murray, who has worked as a Physician Assistant for the past 14 years at the Clinica La Familia in Arizona. I had the pleasure of mentoring her in 2002 when she participated in my Short-term Training Program for Minority Students. Back then, I immediately recognized her potential, her work ethic, and her strong desire to help immigrant families, so I assigned her to work in our community-based asthma research projects in Harlem, New York. Inspired by her New York internship and her personal experience as a child of immigrant parents from Mexico, Dr. Lopez now also volunteers to provide medical care to detained immigrant families. She recently published an article for the American Academy of Physician Assistants about her volunteer work with asylum-seeking immigrant families at the US-Mexico border. As a physician assistant with a doctorate degree in health education who is also bilingual in English and Spanish, she exemplifies the many options that students can consider when pursuing careers in science and medicine. Here is Elizabeth's story in her own words.
I am the proud daughter of two amazing parents who emigrated from Mexico in pursuit of the American dream and the hope for a better future for their children. Despite their long work hours, my father as a factory worker and my mother as a seamstress, they always stressed the importance of education. We learned through their hard work and motivation that good grades and college were the only option for a better future.
I was the first person in my family to attend college. I earned a Bachelor of Science degree in health education at California State University, Northridge and furthered my passion for health education at New Mexico State University (NMSU), where I obtained a Master of Public Health (MPH) degree. But it was the opportunity, mentorship and influence of Dr. Luz Claudio that inspired me to obtain my Doctorate in Health Education after completing a physician assistant degree. Little did I know my pursuit of a doctorate would serve as the catalyst to that which makes me most proud: the opportunity and experiences of serving individuals and families in underserved communities. These opportunities have fulfilled my moral desire and innate obligation to give back.
While obtaining my MPH at NMSU in Las Cruces, I worked for the New Mexico Department of Health. Much of that work was spent investigating the indoor toxic pollutants that exacerbate asthma, specifically in the rural communities in and around Las Cruces. This work was so impactful to my life that I continued to conduct research on childhood asthma in vulnerable populations. It was during that time I learned of Dr. Luz Claudio’s Environmental Research Program. So after completing my first year at NMSU, I applied to the program and was subsequently selected as a participant for the Summer 2002 program.
This opportunity allowed me to further research childhood asthma as a participant of the Environmental and Occupational Fellowship Program at the Department of Environmental Medicine and Public Health at Mount Sinai in New York. This experience forever shaped my life as a health care provider and advocate for our most vulnerable populations. I attribute the success of this experience in large measure to the leadership and mentoring of Dr. Luz Claudio and to the other remarkable program participants.
As part of the program, my research involved developing and disseminating materials to families who repeatedly experienced asthma exacerbations and included developing and evaluating culturally effective asthma education programs for communities in and around Harlem, New York. Given the prevalence rate of childhood asthma, which was strikingly high, we noted alarming hospitalization rates in this population when compared with those living in affluent communities. We attributed much of these results to a lack of health care resources and information within these communities. Given the many families using the emergency room for medical care services coupled with the limited time emergency room physicians have to treat patients, we determined that this population had significantly limited comprehensive health care, which is necessary for treating chronic conditions like asthma, and required better patient education about the condition and preventing exacerbations.
My role in mitigating the disparities between the social determinants and inequalities of health and these vulnerable populations would be the beginning of a much greater task. For instance, many of the children lived in poverty-stricken areas with poor housing conditions, which exposed them to asthma triggers that often worsened their condition. Most families were completely unaware that environmental factors, outdoor and indoor, could trigger an asthma attack. Because of the knowledge-based perspective of research Dr. Claudio and the program experience provided, the other students and I were able to identify and provide solutions to problems.
The opportunity to work with these families and contribute to the overall improvement in the health of children with asthma in Harlem, New York, was an honor. Further, this experience served as a stepping-stone for the continuation of my research in the area of childhood asthma and investigations into the health disparities among children diagnosed with asthma living in underserved rural areas of New Mexico and Arizona.
As a physician assistant for the last 14 years, I continue my commitment to working with vulnerable populations and providing medical care to those with the most need. Although I mainly work in a family practice in a predominately Latino underserved community, during the past year I have been volunteering at various churches throughout Arizona to provide medical care for immigrant families seeking asylum. Every day, over 100 detained families are dropped off at these churches by US Immigration and Customs Enforcement officials. Many immigrants have been given no instructions on where to go or how to find relatives living in the US. Others are dropped off at bus stops, leaving them homeless and helpless in an unfamiliar country without money, cell phones, or information on where to go.
As the daughter of immigrants, I am privileged and honored to be part of this group of volunteers providing humanitarian assistance to these individuals and I recently wrote about this experience in an article published by the American Academy of Physician Assistants. I am also thankful that these churches have opened their doors and provided humanitarian assistance by allowing us to establish volunteer-run free clinics for these vulnerable immigrant families. Many of our medications are donated, but too often supplies run short for treating even the most common illnesses. Common conditions we frequently treat are upper respiratory infections, fevers, otitis media, fungal infections, and wound care. Because of the scarce medical resources, I have raised funds to help purchase medications and other medical supplies. In addition to bringing awareness to the current humanitarian situation with asylum-seeking immigrants, I have used social media to recruit medical volunteers. The largest challenges in this humanitarian relief effort are the political and social determinants that have further complicated their access to medical care and continuity of care.
As a physician assistant, the combination of delivering health care to patients and conducting research to identify factors that lead to health disparities and find solutions for those disparities is the most fulfilling and gratifying aspect of my career and is a way to better serve my patients. We live in a world where there are many impoverished communities that lack access to medical care. As a practicing physician assistant, I want to continue devoting my time to assist those who are most in need, and I hope that more physician assistants will be inspired to conduct research and develop effective educational interventions for underserved communities.
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Dr. Luz Claudio is an environmental health scientist, mother and consultant, originally from Puerto Rico. She is a tenured professor of environmental medicine and public health. Luz recently published her first book: How to Write and Publish a Scientific Paper: The Step-by-Step Guide. Dr. Claudio has internship programs and resources for young scientists. Opinions expressed in this blog are solely her own and may not reflect her employer's views.