Thursday, July 23, 2009

My Public Health Passion: Round 1

What is my public health passion?

When I arrived at HSPH in August, I was asked this question by Dr. Howard Koh, who is now sitting down in DC working on health care reform and preparedness for the Obama administration as Assistant Secretary for Health at HHS (Health and Human Services).

Dr. Koh has had a clearly articulated public health passion related to cancer prevention and tobacco control. He became involved in disaster preparedness as the Commissioner of Public Health for Massachussets. His energy and excitement permeated every part of his being, you could see it in his eyes and hear it in his voice. He no doubt inspired many others to enter public health careers because of his work and mentoring.

In my original -- and first Veritas Health! -- post on the topic I wrote that

Public health is the science and art of increasing peoples’ well-being and quality of life through promoting healthy lifestyles and increasing access to health services.

My broad definition reveals my own struggles with pinning down my public health passion. These past few months have made me confront this issue head on. After some pre-summer job searching, I traveled for 24 days contemplating my desire to commit to a doctoral program with a focus on gender-based violence/human trafficking. While my part-time research position came to fruition, the seeds of doubt and confliction did not die away. Was I ready for a doctoral program? Had I figured out my public health passion?

My month-long trip to Central America to explore the feasibility of conducting research on sex trafficking and health resulted in great success in the short-term, but I returned to the US more certain that becoming an 'expert' in a field that required substantial travel and time abroad was not for me. I also started wondering if I was getting more interested in the 'social' aspect of the 'social determinants of health' than the 'health' itself. And does that even matter?

After the past few months of soul searching and reflection I have yet to clearly articulate my public health passion. Could something as broad as "research" "prevention" or "communication" be it? Does it need to be articulated as a problem statement or research hypothesis? Must it be a particular aspect of health or disease - obesity, diabetes, HIV/AIDS? Finally, can I be a public health 'generalist' yet still have a public health passion?

Many questions. Few answers. This is where I stand right now, today. It is almost embarrassing to admit that I still wonder where I 'fit in' in the public health landscape. I know I am not (and do not want to be) a clinician. I still love research, but am unclear what type of research I want to be doing (epidemiology? policy? evaluation?). I sometimes think I could well enjoy monitoring and evaluation (that's research, right?) or even advocacy work.

What have I learned? I need time to work in a different area of research and practice to help confirm or disqualify these different public health career options. Maybe I will discover the health issue that I care most about or the type of research that ignites my public health passion.

Most importantly, I have learned that my family and my community (friends, church, and environment) are more important to me than my career. I may have always known this, but was too achievement-oriented to admit it. Maybe it took two cross country moves to realize that one would have been good enough.

No matter what, I know my public health journey will not end when I graduate in May. It is most likely only the beginning...again...

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