Public Health as a Passion, as a Priority

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Christina Nieves. Photo courtesy of Loeb Center, Amherst College

On Thursday, March 10, Christina Nieves ‘10 gave a talk in Pruyne Lecture Hall called “Health Equity in Practice, in a Pandemic: A Career in Public Health.” Nieves was a biology major at Amherst, and she currently works at the New York City Department of Health in Harlem. She is pursuing her doctorate in public health. She told us her journey has been a “winding road,” and she laid out the steps that took her from Amherst College undergraduate to community change-maker.

Public health is the science of protecting and promoting the health of populations (large and small) through research, programs, and policy. It is a multidisciplinary field with people from diverse educational backgrounds and areas of expertise. The people in this field can be researchers, scientists, policymakers, program planners, clinicians, social workers, lawyers, or urban planners. There are many avenues to finding jobs in the public health sector. There are public health agencies and health departments at the local, state, and federal levels. There are also research positions at academic institutions, healthcare professions, pharmaceutical industries appointments, and places at non-profits and in the private industry.

Nieves attended Amherst from 2006 to 2010 as a first-generation student. She came to Amherst knowing she loved science and wanted to help people, so she thought she should be a doctor. She declared a biology major and was pre-med, but through the open curriculum, she explored courses in art history, sociology, English, and Black studies. She felt pulled between fields. She was a leader in La Causa, and their discussions around racism, classism, and discrimination led her to realize that her core interest was in social justice. The summer after her junior year she heard about “public health” for the first time and realized that wanting to be a doctor was misplaced. Nieves wanted to find out why certain communities got sick more so than others and “how to improve the health of populations at a larger scale.” She remembers taking the class “Medical Anthropology” with Professor Christopher Dole, which solidified her interest in public health and “broadened [her] understanding of what health is.” She realized that “health is everywhere.” She went to the first Public Health Collaborative at Amherst and saw that “at the core of public health is social justice.” However, now that she knew she wanted to enter public health rather than continue her premed track, her next steps were unclear. Nieves strongly suggests that current students “utilize all the resources that are available to you” at Amherst, such as the Loeb Center, Writing Center, and mental health services. She attests that Amherst is a very special place that allows you to discover your passions with your peers.

From 2010 to 2012, Nieves worked as a Green Dean in Amherst College admissions and as a Program Associate at a public health non-profit in New York City. This was a time for her to figure out what to do next, and to build up the required work experience to progress in her field. Nieves’ first job at the non-profit was as an event planner. She was dissatisfied with the role, but it was the perfect place for her to learn from others. After a year, she realized she wanted to go back to school to get her master’s degree. She started to look for an epidemiology degree.

Within public health and education, you can get a master’s of science (MS), master’s of public administration (MPA), doctor of medicine (MD), or a master’s of public health (MPH). Within the master’s of public health, there are many departments/disciplines: epidemiology and biostatistics, community health/population health, global health, health policy, environmental health, and sociomedical science. There are also numerous concentrations within those departments: infectious diseases, chronic diseases, nutrition, maternal and child health, cancer, aging, health education and community, injury prevention, mental health, social determinants of health, and many more.

Epidemiology was Nieves’ choice because she was interested in “what causes the health outcomes we see in a population.” She was accepted to the Harvard T.H. Chan School of Public Health, which she attended from 2012 to 2014. She got her degree in public health, with a focus on infectious diseases. Her thesis was on contraceptive choices of HIV-positive women in Uganda. However, Nieves felt disconnected from her research, and she realized that she was more interested in the communities she came from and knew personally.

Knowing that she wanted to work in a more applied setting, Nieves joined the New York City Department of Health from 2015 to the present. Her concern at this position is health equity. Nieves pointed out that racism has been officially declared a public health crisis in several cities, and this declaration gives funding to agencies to combat its effects. The NYC Department of Health made this declaration in 2021. Nieves’ work focuses on east and central Harlem, areas that have been historically divested, and in which poor health outcomes can consistently be seen. Nieves is developing place-based approaches to improve health equity by designing studies to measure the success of new programs: making surveys, conducting interviews, meeting with focus groups, analyzing data, and writing up results. 

Nieves’ next step was the CUNY School of Public Health and Health Policy, from 2019 to the present. She had initially applied to PhD programs after completing her MA, but she did not get accepted into any. However, after her work with the NYC Department of Health, she had a better idea of what she wanted to do and the necessary life experience to “get to the right place at the right time.” Her dissertation is on inequalities in infant birthweight by social position and residential neighborhood.

At this point in the talk, Nieves shifted to discussing the impact of COVID-19 on public health. She notes that people in her field felt both “very prepared and very unprepared” for a crisis of this nature. They had been taught extensively about epidemics and how to handle them, but no one had enough actual experience. The primary health challenges during COVID-19 have been public health authority, the politicization of public health, inequities, and mistrust of government due to a history and legacy of medical harm. The public health response to COVID-19 has included community outreach in the form of information, PPE, home testing kits, and collaboration with organizations; looking at social determinants of health in how the pandemic has affected different populations; vaccination; and “data, data, data.”

Nieves’ final advice on entering the public health field is that it is a diverse field with room for all. There is no one, direct path to a career in this sector. She says to not be afraid of entry-level positions, as they are a great learning experience and can connect you with more opportunities. She recommends students talk to as many people in public health as they can, and to utilize the resources at Amherst as a student and as an alum. They are giving you all the tools – it is only a matter of what you do with them.