January 17, 2020
Baylor’s Department of Public Health seeks solutions to global health issues related to disease, lifestyle, community factors and more. In this Baylor Connections, Dr. Eva Doyle, Department Chair of Public Health and Professor of Community Health, discusses the ways Baylor Public Health professionals conduct meaningful research, enrich students through studies around the globe, and partner with other disciplines to solve critical health challenges.
Derek Smith:Hello and welcome to Baylor Connections, a conversation series with the people shaping our future. Each week, we go in depth Baylor leaders, professors and more discussing important topics in higher education, research and student life. I'm Derek Smith and our guest today is Dr Eva Doyle. Dr. Doyle serves as department chair of public health, Professor of community health in Baylor's Robbins College of Health and Human Sciences, part of a great team. They're doing a lot of research that we've seen recently in the news here around Baylor and look forward to learning more about public health with Dr. Doyle today. Eva Doyle, thanks so much for joining us. It's great to have you here on the program.
Eva Doyle:Thank you Derek. I'm very happy to be here.
Derek Smith:Well, it's great to have you here and learn more about public health. I think it's a topic we are seeing more about, whether it's in the news, whether seeing research coming from your department here at Baylor, when you talk about locally or globally. But it's one of those topics that I think people have a general idea, but maybe what it really is can be a little bit nebulous. Could you take us inside that to start things off? What falls under public health umbrella as an academic discipline and as a career?
Eva Doyle:Thank you for asking that question because public health is a very broad field. It's made up of a lot of different disciplines. And that's because Derek, the public health issues in our communities and our populations are so complex that it often takes a whole network of partners from a variety of disciplines to effectively address those. But there are some traditional academic disciplines within public health such as my specialty area of community health, or social behavioral health is what it's called sometimes, epidemiology, environmental health, biostatistics, health services administrations. The list is really quite long about different disciplines that fall under that umbrella, because it takes so many different specialties working together as partners to address the public health issues out there.
Derek Smith:What are some of the questions that you're trying to answer? I know that might be different in different places, but what are some of the baseline questions that divine as a public health practitioner, these are what I'm trying to get some of the answers to.
Eva Doyle:Most of the time we're moving into populations or communities and asking those communities about their public health issues. So the questions could be about infectious disease or chronic conditions such as heart disease, or it could be an environmental health issue where water quality is impacting the health of that community. So most of the time, we're moving into that community and asking questions based upon the health issues that we're seeing there, and then trying to develop approaches to addressing those issues in ways that can really impact the lifestyles and the environments in which those people live.
Derek Smith:What are some of the skills even in different areas? What are some of the skills that effective public health practitioners need?
Eva Doyle:There is a long list, Derek, of competencies that our accrediting body says that all public health practitioners must have, and I promise not to read those to you. Instead, what I'd like to say is that public health practitioners work with whole populations rather than just individuals or clients, and that's an important piece of what public health is and how that is distinguished from healthcare, for example, when you're working with one patient at a time. And we often do what I said before, we assess the population's health from within the context of what CDC refers to is where people live, learn, work and play. And we know of course that there were social determinants that actually do impact health. So we know that poverty and lack of education, poor access to healthy foods or safe neighborhoods as well as those individual choices that we often focus upon, all of those factors come into play. So the skills that we need in public health are very broad, and that is that we need to be able to understand all of the factors that can influence health, assess those, and understand them in a very clear way so that we can design interventions, we can work on advocacy, we can change policy, we can work with environmental specialists to change or improve the environment in which people live. It's very broad. So for that reason, we have to have strong partnership skills, good communication skills, and an ability to see the big picture.
Derek Smith:And you touched on this, but I would imagine it lends itself very well to a interdisciplinary scholarly collaborations, so whether across campus or in the different environments in which you go to.
Eva Doyle:Absolutely. And in fact that is expected in public health, that it is true that no one discipline can find all of the answers alone. So for that reason, partnerships are extremely important. And I will add that those partnerships should include members of the community, not just other disciplines.
Derek Smith:We are visiting with Dr. Eva Doyle, department chair of public health in Baylor's Robbins College of Health and Human Sciences, a growing program certainly. How long have you been here at Baylor? How have you seen that public health program grow over the years and especially it seems like particularly recently?
Eva Doyle:I came to Baylor in 2001. And at that point there wasn't a public health program, it was a health education program, which we don't really have time to unravel this morning and talk about. But our master of public health program was established in 2009. We then added an undergraduate degree at BSPH, a bachelor of science in public health. And since then, have been adding concentrations with that MPH. So we've already mentioned community health. We now have a concentration in epidemiology and we'll be launching a third concentration in environmental health with some other partners on campus from the department of environmental sciences. So we're very excited about all of that growth. And just last year, we became our own separate department within our college. It just became an important way for us to be able to manage all of this degree growth that we're doing.
Derek Smith:And what factors have led most specifically to that growth here at Baylor over the last few years?
Eva Doyle:I think Baylor has always been interested in health. You can meet lots of different students both at the undergrad and the graduate level on campus who are very interested in health care or some type of health related degree. So that's just a natural growth toward public health for Baylor, because we really care about populations and public health is a great avenue for us to make a difference, to truly make an impact in those communities.
Derek Smith:And we mentioned Robbins College of Health and Human Sciences, certainly that's played a role. In what ways has the formation of the Robbins College galvanized the work you and your colleagues do?
Eva Doyle:I cannot say enough about our college. It's been very exciting to be a part of this college because the leadership is so visionary and really open to new ideas. And for that reason, there've been so many new programs and departments that have come into the college. So it's been a lot of fun and we couldn't do all of the growth that we've accomplished without the support from the college.
Derek Smith:Visiting with Dr. Eva Doyle. For you personally, where did your interest in public health begin?
Eva Doyle:I started out thinking of myself as a health educator. I am a master certified health education specialist, which means that I'm trained in how to work with individuals and whole populations, to help them develop healthy lifestyles. So I started out in public schools. I was teaching adolescents in an at risk school right here in Waco and I learned very quickly, Derek, that the adolescents with whom I was working were really impacted by their home life and by the environments in which they live. That it wasn't as simple as I originally thought it would be to teach people how to live or develop healthy lifestyles. And from there, I went back and worked on graduate degrees that would equip me to see that broader picture so that I could be more of a community health promoter.
Derek Smith:So what areas in the broader umbrella of public health, you mentioned community health, what most speak to you? What have been your most areas of strongest interest?
Eva Doyle:I think the most important piece for me is the research paradigm called CBPR, community based participatory research. And CBPR is not about a particular health problem, it's about a process and how you should go into communities and truly partner with those community members, listen to them actively and engage them in the research alongside what you're trying to do. And then use that data, those findings, to actually develop interventions or advocacy efforts or policy development efforts, all of those things that are needed to really benefit the community. So that's the area of public health and even more specifically within community health, that gets me really excited.
Derek Smith:Are there some stories or examples that have been most meaningful to you that would be good to share here? Just kind of what that looks like in practice?
Eva Doyle:A good example of that that I did a few years ago is, I was asked to go in and work with women in a Kurdish village of Armenia. And those women were struggling with a lot of women's health issues. They had no access to health services in these villages and really didn't know how to take care of their own health. So what I did is I went in and trained members of the local community to do focus groups, to ask questions, to learn more about what the women really needed. And then with that information, I helped them develop a program where we could train members of the community, women in those villages to in turn become the community agents, the individuals who would teach other women about how to take care of themselves and their family. So that's a very concrete example of the kind of work that I do.
Derek Smith:So when you talk about being a... You mentioned earlier you need to be a good communicator in this role. It's cross-cultural, it's a multi all around the world and not just in terms of, you talked about public policy but just sometimes individually with the people that you are... Empowerment seems like a big part of that.
Eva Doyle:Yes, that's a key word, empowerment. And sometimes the word empowerment is not well received in some communities because it implies that they weren't doing the right thing before you arrived. So I try to be careful about using that word because empowerment is more... I like to use the term capacity building instead, so that we look at what they're capable of doing, what they're already doing and then enhancing that in a way that can make a difference.
Derek Smith:This is Baylor Connections. We are visiting with Dr. Eva Doyle, Department Chair of public health and Professor of community health in Baylor's Robbins College of Health and Human Sciences. We talk about your research and are there specific research projects or findings that have been most meaningful to you?
Eva Doyle:I think mentioning those women in Armenia, as you could hear, it really touched my heart because it actually was... It just opened my mind to how many populations around the globe really just need access to resources and information that can make a difference. So that work has been important to me. I've worked, partnered with groups among migrant and seasonal farm workers in East Texas in the past. I work in Brazil on a regular basis with at-risk adolescents in schools there, but predominantly partnering with churches, Brazilian churches in those local areas. And of course, have been fortunate to be a part of several different projects right here in Waco where there are underserved neighborhoods and people who are really interested in making a difference there.
Derek Smith:Visiting with Dr. Eva Doyle, and you mentioned Brazil, tell us a little bit about the Baylor in Brazil Program, what that is and what that looks like.
Eva Doyle:When you asked me about Baylor in Brazil, Derek, I could talk all day. Baylor in Brazil is designed for health interested undergraduate students and graduate students. And it's particularly designed for public health students who are interested in learning how to navigate that area that you mentioned, that cross cultural health communication aspect of promoting health in communities.
Eva Doyle:I co-direct that program with my husband, Dr. Robert Doyle. Robert is an Aquatic Ecologist in the biology department at Baylor, and he grew up in Brazil. As the son of missionaries, he's bilingual. Brazil has been a very integral part of our family's life because of that through the years. So we take students every summer. We spend five weeks in Southeast Brazil. And our primary goal is to partner with Brazilian churches, to help them promote health in their neighborhoods. And oftentimes, what that has meant in the last couple of years is that we're going into at-risk schools with those churches and we're talking to students about bullying and reproductive health and just important aspects of making good choices in their lives. So it's been very rewarding to do that work.
Derek Smith:What's that experience like for the Baylor students who were a part of it?
Eva Doyle:Our students often tell us that it's one thing to read in a textbook about public health and communities, it's another to experience it. And the exciting thing for them is that we train them to get up in front of those at risk adolescents and work with interpreters and teach the kids. So I don't do the teaching, the students do it. So we equip them to do that. And they often come back and say that that really impacted them in a lot of ways. They came back with a whole different perspective of what it means to promote health in communities. And even those students who are thinking about medical school later and they'll become healthcare professionals, they often contact me years later and say, "That experience in Brazil changed the way I practice as a healthcare professional."
Derek Smith:Visiting with Dr. Eva Doyle. And Brazil, certainly one place that you mentioned some of your international travels, but where are places both either around the globe or even close to home, that on a given day we might find Baylor Public Health students serving?
Eva Doyle:Our students are very active right here in Waco. As you might know, there are a lot of health issues right here in Waco. And there's some amazing organizations with which we partner, including the local Waco McLennan County Public Health District for example, which is a public health agency and there are a lot of organizations, family health center, there are a lot of health-related partners right here in Waco. So you'll see our students out there, they'll be doing course projects, they work as interns, they do research with our professors out there in Waco.
Eva Doyle:But they're also engaged in the communities where our faculty serve outside of Waco. So I've already mentioned Brazil, they do a lot there. But we have faculty who are working in Somali land, for example, in Ghana. One of our professors is doing a place streets project, I think it's funded by the USDA or the Robert Woods Johnson Foundation, and it's about play streets for children of Spanish speaking families across the US border. So the students may or may not always get to travel to all of these places, sometimes they do. But they also are working here with our professors to make sure that what's happening out in those communities is making a difference. And I'll add one more thing, and that is that all of our students do internships. So once they get to a certain point in their program, they're going all over the US. We've had students in Australia, we've had students in Kansas, you name the place, and they've been there.
Derek Smith:Talking with Dr. Eva Doyle here on Baylor connections. And you mentioned here in Waco, they work here in Waco. You mentioned project you did in East Texas. How does Texas, whether you're talking about Waco more specifically, or just the broader state, when we have students coming from all over. What sort of richness as an environment does it provide your students in which to study? Because it seems like almost anything you can find, you're going to find somewhere here throughout the state.
Eva Doyle:That's exactly true. Derek, I didn't mention before, we have a professor who is the Director of CAN DO Houston. Her name is Dr Jasmine Opusunju. And she works a lot in terms of advocacy and policy development in the Houston area. And so you think about the urban area of Houston and the opportunities there, but also, as you and I know there are a lot of rural communities in Texas. So when we talk about public health, you'll hear people say, "I'm a specialist in urban health or I'm a specialist in rural health." And our students have the opportunity to experience that right here in Texas in a lot of different ways
Derek Smith:Visiting with Dr. Eva Doyle. And we mentioned public health has grown quite a bit. The public health faculty has grown quite a bit. Lots of new hires who have been here, some in their first year, some in their first few, but we've seen a lot of great research taking place in recent months. I know I'm putting you on the spot here in the sense that as the Chair, you want to make sure you get everyone in, but we've got some time to do so. Tell us a little bit about your colleagues in public health and the work that they're doing.
Eva Doyle:I am so very blessed, Derek, to be working with a faculty that is so diverse and so gifted. They're gifted as teachers, they're gifted as community servants and they're strong researchers, so it's very exciting. I cheated and made a little bit of a list here-and I'm just going to quickly go through this. And this is not going to do justice to any of them because they have so many different projects so I'm just going to touch on a few. Dr. Kelly Ylitalo is an epidemiologist. She focuses on physical functioning, obesity, physical activity. And one of the things that she does is she works with the Waco Family Health Center and does a lot of patient education type data. She looks at the patient data and helps the family health center to understand their patient population and better serve them. Dr. Emily Smith is a global health epidemiologist. And she's working with an international partnership group to address pediatric surgery needs and policy related issues in Somaliland. And then Dr. Emeka Okafor is researching substance abuse among persons living with or who are at risk to HIV infection. And he includes clinical biomarker research in his efforts, which is pretty exciting to me. And then Dr. Beth Lanning researches the impact of animal assisted therapy on soldiers with PTSD and among children with autism. So it's a very specialized niche and a very important piece of work in public health. Dr. Jason Paltzer focuses on epidemiology of substance abuse in low income populations. He's worked in a lot of different community based settings and around the globe. And Dr. Matt Asare is interested in the links between cancer and HPV, that's the human papillomavirus. And he's working with partners in Ghana as well as here in Waco to research the promotion of the HPV vaccine to prevent cancer, which I think is a very important piece. And then Dr Renee Umstattd-Meyer focuses on physical activity. And one of her projects is one that I mentioned earlier where she's promoting the use of play streets for children in underserved Spanish speaking neighborhoods in the US.
Eva Doyle:So that's just a small taste of what this group is doing. They're an exciting group to work with.
Derek Smith:Very wide array of specialties. That does help us, you defined public health at the beginning of the show, but that helps us see even a little bit more, just the wide array of areas on which you focus.Let's say you look into the future just a little bit here to help us think public health from another angle. What factors are most intriguing, sometimes alarming or some combination of both, as they relate to public health. As you look on the horizon, what is going to be some of these areas that you think are important for you and your colleagues to focus?
Eva Doyle:Well, first of all, in terms of the public health workforce, that's something that I'm very interested in. We know that the cost of healthcare is rising, Derek, and as it does, it's going to continue to rise because chronic diseases such as diabetes and obesity and heart disease and cancer, all of that is emerging as a global health issue, not just an issue here in the United States. And along with that, of course the cost of health care for those chronic issues is rising as well. Infectious diseases are not going away. We know that that's becoming even more of an issue and particularly here in the US, as we come even more connected to our neighbors around the globe. Environmental issues such as water quality already is a major issue and will continue to be. And then mental health issues, particularly depression is on the rise around the globe. So when you think about all of these different issues that are on the rise, it's difficult to pinpoint one that we need to be focusing on. But we also need to understand that the public health workforce is getting smaller. A lot of people are retiring from that workforce. We're not necessarily replacing them as often as we need to be. So I think those are the issues for the future in public health, is that we need more students interested in public health so that we can put them out in the field, in those communities with the skills that they need to address all of these issues in an effective way.
Derek Smith:Well, those are big issues but it is encouraging to think of students imbued with that Baylor mission going out and serving and addressing some of these areas. For People who would like to learn more, the easiest thing would just be to Google Baylor public health and take a look at what you have online there.
Eva Doyle:Absolutely, yes. Then they can give us a call. We always have someone who'd be willing to talk with them.
Derek Smith:Well that's great. Dr. Eva Doyle, thank you so much. We appreciate your time today in painting that picture of public health at Baylor, which will continue to grow and we'll have to talk to some of your colleagues as well down the line to continue to see the work that's being done there.
Eva Doyle:Yes, please do. Thank you, Derek.
Derek Smith:Thank you so much. Dr Eva Doyle, Department Chair of public health and professor of community health in Baylor's Robbins College of Health and Human sciences. I'm Derek Smith. Reminder, you can hear this and other programs online. baylor.edu/connections. Thanks for joining us here on Baylor Connection.