Public Health in Philadelphia and Beyond: An Interview with Ana V. Diez Roux, Dean of the Drexel School of Public Health
Ana V. Diez Roux, M.D., Ph.D., M.P.H. a physician and epidemiologist, became Dean of the Drexel School of Public Health in early 2014. I interviewed her about her vision for the Drexel School of Public Health, her views of the public health needs and opportunities she has found in Philadelphia, her conception of local and global opportunities for the School of Public Health, and her goals for the education of students in the Drexel School of Public Health.
Ana V. Diez Roux, M.D., Ph.D., M.P.H. a physician and epidemiologist, became Dean of the Drexel School of Public Health in early 2014. Her biographical details and information about her scholarship can be found here.
I interviewed her about her vision for the Drexel School of Public Health, her views of the public health needs and opportunities she has found in Philadelphia, her conception of local and global opportunities for the School of Public Health, and her goals for the education of students in the Drexel School of Public Health. Listen to the full interview here. What follows is an edited and excerpted version of that interview.
What excited you about coming to Drexel and to Philadelphia?
I was very excited about the mission of the Drexel School of Public Health. It was founded on the idea of health as a human right, implicitly recognizing all of the social and economic circumstances influencing health. The School of Public Health has lots of connections to the larger world of public health practice and to public health communities in Philadelphia, which is interesting to me because of the work that I've done about how neighborhoods and communities affect health. The possibilities for contributing to an understanding of the effect that cities have on health was very interesting to me and also the fact that Drexel has a history of cooperative learning and practice-informed learning, which I think is very relevant to public health.
As you look to deepen the ties that already exist between the School of Public Health and the community where do you see the School of Public Health dealing with some of the problems of deep poverty and other systemic issues in Philadelphia? Where do can the school play a role?
I think the School of Public Health can play two important roles. One is that although we know that poverty is linked to health, (and this has been a staple of public health since its origins) we don't have a lot of evidence about the best way to tackle this issue. What kinds of policies work and what are their health effects? Contributing to the evidence base through rigorous research on a variety of policies that may not be thought to be related to public health—early childhood education or neighborhood politics—and being able to quantify and study their health impact is something I think schools of public health need to do in order to provide stronger evidence and justification for various policies. Research has to be done in partnership with policy makers and communities. Another role has to do with practice and implementation—how do we make changes? How do we work collaboratively with communities and policy makers to make things happen once we know what works?
We have many kinds of health problems in Philadelphia. We have infectious diseases and with our aging and poor population, we have chronic diseases, related to poverty, food intake, lack of access to care, and pollution. How do you see the Drexel School of Public Health addressing these problems?
That is the big challenge of public health in many countries and in many cities. An Institute of Medicine report from last year that I was involved with, found that the United States has health disadvantages with respect to many wealthy countries in Europe. The US does very poorly with things like teenage pregnancy, sexually transmitted diseases, and also obesity, diabetes, and many chronic diseases. So we need to think about common underlying causes or systems that are generating these things and figure out how to grapple with them. They may have to do fundamental causes like the social determinants of health, and so they are related to both infectious diseases and chronic diseases. Sometimes there are similar pathways and sometimes there are different pathways [to chronic and infectious diseases] so understanding the systemic nature of these coexisting problems is really important. Next, we need to look at what can be done for a particular condition. There are strategies for infectious diseases. Increasing vaccination rates is something that we have to do, regardless of whether we are able to identify the more general causes. For other conditions there are other strategies. The city of Philadelphia is trying to improve the environment so that people can be more physically active, can be eating more healthfully, and interacting socially with other people, which have lots of health benefits. We need to address systemic problems but that should not stop you from taking concrete actions that we already know work.
How is the Drexel School of Public Health engaging in world of global health?
We have a number of activities ongoing with a number of organizations. In Africa there is a big effort to provide access to safe water and there is work going on in Asia and Israel as well. Going forward I think there are three things important to the school. First is the idea of understanding health in cities; next are issues of health and social justice and eliminating health disparities, and third is generating evidence relevant to policy and practice. I see all those things as having a global health projection, particularly the idea of health in cities globally.
Many cities have similar problems so expanding our global urban health presence is a direction in which we will be moving. Another is being part of a network of schools of public health or public-health-oriented institutions grappling with improving health in cities. We are dealing with emerging infectious diseases that, if they don't originate in cities end up in cities. We have problems of chronic diseases that have to do with structural factors that condition and in many ways constrain how people live their lives.
One of the big issues in cities is the very big inequality in health, spatially by social class, and by race and ethnicity, and by immigration status. To improve health in cities we absolutely have to grapple with those inequalities.
I want to mention that so many places are doing global health and it is important to think about how we partner with other countries and groups in other countries. We have to make sure those partnerships are equitable and mutually beneficial.
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