Today, the term “public health” is almost synonymous with “COVID-19.” Though his title might tempt questions about the pandemic, Assistant Professor of Public Health Ernesto Moralez is a specialist in chronic, not infectious, disease. He’s passionate about developing health education and chronic disease prevention strategies to address health disparities with holistic, empowered community care.
“I research chronic disease management, but I also do mental health research. To kind of sum it up, my early career research was focused on clinical research—hospital settings, family practice, clinical settings. I became interested in how to increase medical providers’ skill sets, so they don't ignore depression and anxiety and their patients actually feel comfortable talking about depression and anxiety,” he says.
According to Moralez, psychiatric care is a luxury for marginalized and rural communities. Not only can it be expensive, but it also requires taking time off or arranging childcare in order to attend appointments. For most people, that means the short amount of time they get with their primary care physician during their yearly physical is the only substantive medical care they receive all year.
Moralez advocates for more holistic care, equipping providers with the confidence and knowledge to address underlying issues and empowering community health workers. These issues shape the questions he asks in his research and guide the systemic change he advocates for:
“Can we increase providers’ confidence, if their patient happens to say something about depression or having psychiatric symptoms, that they feel comfortable to go ahead and talk about it? Is it about communication training?” he asks. “Do we need to change the medical school model to make sure that family doctors are getting hours in residency? Are they doing rotations for mental health?”
"I’m spending my time thinking about making sure every student has the rigor to go to the next level. How do I stay within the [liberal arts] model? How do I also make sure every student has a comprehensive exposure to the foundations of public health?" —Assistant Professor of Public Health Ernesto Moralez
Over the summer, Moralez relocated to the North Country from southern New Mexico, where his work included qualitative research with community health workers at the border between Mexico and the United States. He also recently co-authored a book chapter that argues for increased curricula on social determinants of health in medical residences. He believes in reframing common perceptions of health issues like obesity, heart disease, and addiction, and that a holistic understanding of public health is about more than just diagnosing symptoms.
“It’s about social determinants of health. It's about housing conditions—not just having heat but if there is violence in the home. It's about the income and income-to-debt ratio. That's a part of health, all this stuff that we silo or think exists in a vacuum,” he says.
As the St. Lawrence public health program’s first full-time hire, this approach and philosophy will help inform its framework. Moralez will play a major role in shaping the program, which continues to grow in popularity among prospective and current students. These days, he’s thinking a lot about how to contribute to existing offerings with a comprehensive foundational course load that makes St. Lawrence students competitive applicants for opportunities after graduation.
“I’m spending my time thinking about making sure every student has the rigor to go to the next level. How do I stay within the [liberal arts] model? How do I also make sure every student has comprehensive exposure to the foundations of public health?”
Moralez is a proponent of a top-down approach that educates students on broad, systemic topics and themes, like racism and health and socioeconomic status and health, before narrowing its scope. While investigating these themes with students, he plans to draw from his academic research as well as his lived experiences.
"If I ask a group of 100 third graders if smoking is a good idea, how many of them are going to raise their hand? It's not about knowing. It's about addressing people’s level of value about themselves and their communities. I want our students to understand that if we really want to make an impact, we have to make people feel like they're worth it." —Assistant Professor of Public Health Ernesto Moralez
“Being the son of a Mexican immigrant, growing up with a single parent, and being a product of several social service programs designed to assist families and mentor kids … I can bring those sorts of experiences to this position, which might be different than the lived experiences of some of our students,” says Moralez. “I am always open to sharing my lived experience with my students and creating a safe space to share theirs.”
Ultimately, he wants those who graduate from this program to grasp both the big picture and the individual nuances of public health challenges. He’ll encourage them to foster an inclusive set of practical skills while drawing on diverse perspectives, empowering them to approach problems with every tool in their kit.
“I want them to measure their success not on the outcomes of populations, but on the effort that they put towards their work,” he says. “If you measure your personal success on how much change people make when it comes to their health behaviors, it can be defeating. I think you have to measure it based on your effort—that you came up with every solution and did everything you could.”
He also hopes his students graduate with the belief that health is not a question of morality, and that they’ll seek to help future patients and clients understand the value of their life and physical wellbeing. He says this goes beyond a simplistic understanding of good and bad habits.
“If I ask a group of 100 third graders if smoking is a good idea, how many of them are going to raise their hand? It's not about knowing,” says Moralez. “It's about addressing people’s level of value about themselves and their communities. I want our students to understand that if we really want to make an impact, we have to make people feel like they're worth it.”