A Q&A with St. Lawrence’s First Public Health Chairs | St. Lawrence University

A Q&A with St. Lawrence’s First Public Health Chairs

In 2017, St. Lawrence University developed a public health curriculum designed to help students build unexpected connections between more than 60 courses from across more than 20 academic departments and the public health needs around the world. An anonymous $15 million gift to The Campaign for Every Laurentian in early 2019 has funded two endowed public health chair positions, which were awarded to Associate Professor of Anthropology Mindy Pitre and Associate Professor of Global Studies Madeleine Wong. Get to know these faculty members, what they envision for the program, and their plans for empowering students to blaze new trails as they tackle public health issues.

Question (Q): How do you define public health?

Mindy Pitre (MP): Public health isn’t easy to define. It starts with understanding people, societies, and the environments they live in to decipher the biological, social, economic, and environmental determinants of health. It builds on this knowledge to design and implement bottom up and town down solutions e.g., public policy innovations and health promotion campaigns, to empower people to improve their health. It recognizes that the problems and solutions may be local, national, and/or global in scope. That being said, most people think of public health as concerned with present-day problems and solutions. As an anthropologist, I study ancient public health. Specifically, I attempt to understand the presence and experience of disease in the past through an interdisciplinary lens using human bone, material culture, and historical sources.

Madeleine Wong (MW): Global studies uses a critical ‘public’ approach to address contemporary health challenges facing populations and communities across the world. Within the U.S., we address issues ranging from the opioid crisis created by drug prescription practices, to urban air pollution and disease to gun proliferation and violence, to refugees being made unhealthy by mass detention, and so on. For us, public health is an interdisciplinary field that recognizes health as a ‘public good’ that is undermined by powerful interests. Thus de-naturalized, we draw on insights from disciplines in the humanities and social sciences, and health studies among others to understand political, economic and cultural aspects of health and illness. We consider how social relations such as those of class, sex and gender, racialization, and disability as well as social and environmental inequalities shape core public health issues with implications for prevention, protection and health promotion. We emphasize the importance of quickly learning of threats and addressing root causes with public consensus built via advanced communications and media strategies to work towards effective interventions locally and globally.

Mindy Pitre

Associate Professor of Anthropology and Public Health Chair Mindy Pitre

Q: How would you describe St. Lawrence’s public health program?

MP: The first word that comes to mind is ‘growing’. The program spans over 60 courses across 20 departments and programs. Currently, we have more than 35 minors and have recently graduated more than 15, numbers that easily place Public Health among St. Lawrence’s top five minors.

Q: What is the biggest misconception about what public health is and how does St. Lawrence’s program tackle it?

MP: The biggest misconception is that public health is all about science. Yes, science is a big and necessary part of public health, but it is just as important to understand the complexity of situations relating to individuals and public health. For example, with unsafe drinking water we need to not only understand biological toxicity processes, but also social processes such as environmental racism (how minority group neighborhoods are disproportionately overburdened by hazards such as water contamination). St. Lawrence’s public health program therefore takes an interdisciplinary focus on health, one that spans the humanities, social sciences, and STEM. Thus our students understand how a multidisciplinary approach can bring unique perspectives when answering questions related to population health and public policy.

MW: Building on the water example: You also have to understand the history of how minority populations have been disproportionately exposed to environmental hazards like contaminated water. Inequality results from a system of many different factors—environmental, economic, cultural. We prepare our students not only to understand these factors on their own, but also how they work together to perpetuate threats to public health.

Q: In what ways does St. Lawrence’s public health program differ from others?

MP: What most sets our program apart is our non-traditional approach. At St. Lawrence, students are pushed to examine health through a multidisciplinary lens, one that involves being exposed to the humanities, social sciences, and STEM. For example, we have a robust suite of humanities offerings (as a result, in great part, of support from the Mellon Wide-Angle Learning Grant and its director, Associate Professor of English Pedro Ponce). This is important because public health is more than just facts; it's about discovering, connecting, integrating, critiquing, and applying information across disciplines to understand health in all its complexity. St. Lawrence’s liberal arts approach to public health allows us to do this well.

MW: St. Lawrence has the potential to be at the forefront of innovative undergraduate public health education, preparing our alums to be leaders advancing socially just, culturally informed, equitable and enduring public health solutions that our world sorely needs. As an independent liberal arts college, St. Lawrence faculty can create a vibrant innovative public health program on our own terms, preparing students to think expansively and incisively, informed by multiple perspectives, to better understand health in our own communities and globally.

Q: How does anthropology inform and impact public health solutions in the context of the interdisciplinary mission of St. Lawrence’s liberal arts curriculum?

MP: Anthropology is the study of humankind. What really sets it apart from other disciplines is its holistic approach. Anthropologists study humans from a cultural, linguistic, material culture, and biological perspective and the way we approach public health is no different. We understand that health is multidimensional, difficult to study from only one viewpoint (e.g., anatomy, history, culture, environment). Through a holistic approach and one that incorporates multiple lenses, anthropologists can attempt to understand the lived experience of health across time and space.

Q: How does global studies inform and impact public health solutions in the context of the interdisciplinary mission of St. Lawrence’s liberal arts curriculum?

MW: Our approach in the Department of Global Studies is useful in four ways. First, we believe that thinking across and beyond disciplines is essential when seeking to understand social phenomena – and this includes the health of individuals and populations. Biomedical knowledge, while valuable, is not a sufficient foundation; perspectives from the social sciences, humanities, and arts are also essential. Second, we take a critical approach that emphasizes the human condition and the multiple ways that people in different social circumstances experience health and illness. This enables us to foreground the public interest when exploring how to manage scarce resources. Third, as our field is deeply committed to connecting the search for knowledge with the pursuit of justice, we always put social inequality at the center of our public health work. Finally, we believe that questions of justice always have a transnational character, and the role of the U.S. as a global empire can never be overlooked. When looking at the U.S. healthcare system, we recognize that what is happening “out there” directly shapes what is happening “here” and vice-versa. For this reason, we support a public approach that safeguards individual rights and liberties rather than handing those to large transnational corporations with no accountability for public health outcomes. What an artificially divided U.S. public has not fully understood so far is that the medical model that is currently operational, far from making us ‘healthy, wealthy and wise’, has made us sicker, poorer and less knowledgeable about how to achieve health and wellbeing. It is time to think creatively and proactively about change! For example, the dominant biomedical model recognizes addiction as a biomedical phenomenon, analyzes how certain chemical substances impact the brain, and prescribes. But addiction is also a social, psychological, historical and political phenomenon which requires analysis of the social and cultural factors that shape the way people engage with substances, and the conditions under which one becomes pathologically addicted. Thus, a more nuanced and robust understanding of addiction allows for approaches that can equitably address it.

Public Health Research at St. Lawrence: Neuroscience major Colin Hart ’19 spent his time at St. Lawrence researching ways to make health resources more accessible for local community members.

Q: How do you embed public health issues and research into your own scholarly work?

MP: I study health in past populations using bone, material culture, and historical sources. One of my research initiatives involves being part of the Aswan-Kom Ombo Archaeological Project (AKAP) in Aswan, Egypt. Since 2007, my role is to use skeletal remains to explore the impact that colonization had on the health and lives of Egyptians and Nubians at the site of Nag el-Qarmila during the Predynastic Period (5500 – 3100 BCE). The information that I am collecting is adding to our understanding of ancient health disparities and infant/maternal mortality in Predynastic Egypt/Nubia. For example, my team and I discovered the oldest case of Vitamin C deficiency (awarded as Egypt’s Top 10 find of 2016) and documented a case in which a young mother died late in pregnancy, perhaps while giving birth. The results of this project were published in the International Journal of Palaeopathology and appeared in Forbes, National Geographic, and Newsweek.

My second project, of which I am director, is the Death in St. Lawrence County (DSLC) project. DSLC is interdisciplinary in nature and involves students, academics, community partners, and various government agencies with the aim to better understand life and death in St. Lawrence County. Beginning at the St. Lawrence County Poorhouse, we have been transcribing and digitizing more than 2,000 “records of inmates” in order to examine health disparities and community health among St. Lawrence County’s most vulnerable residents during the late 19th to early 20th centuries.

MW: I have examined the pressures experienced by nurses migrating from Ghana to work in the British National Health Service (NHS). While NHS demands supports employment for healthcare workers, the demands of this work go beyond the doctor’s office and hospital shift work – affecting care workers’ relationship with their own children and family back in Ghana. As St. Lawrence’s London Program director last year, I was acutely aware of the debates and real concerns about healthcare in England with Brexit, and the need to prioritize public health in ongoing negotiations. For my sabbatical in Spring 2020, I plan to research how the final Brexit agreement will affect the migration of health workers to the UK, as well as the public health access and implications for African migrant communities living there.

Q: Why are you passionate about tackling public health issues?

MP: Public health issues are significant and worth investigating because they affect people every day all over the world. They affect not only the well-being of individuals but that of entire families, communities, and societies. The same is true for public health issues in the past.

MW: Health is crucial for everyone’s ability to build a meaningful and productive life. What could be more important? Yet locally, nationally, and globally, there are tremendous disparities in health experiences and outcomes. As a critical geographer, I emphasize how these disparities are shaped by longstanding inequalities in our global system. My passion for tackling public health issues also stems from my commitment to challenging uncritical assumptions about “overpopulation” that often fail to acknowledge the privileges and responsibilities associated with overconsumption. Similarly, I seek to help students think beyond the individualized, privatized conceptions of health that many bring with them to the classroom, such as the emphasis on rational choice and individualized personal responsibility to handle addiction, which disregards structural disadvantages (such as long term unemployment) or cultural factors such as particular cultures of binge drinking and intoxication. In my classes, we always ask critical questions about who is defining “health” and who is left out of such definitions. I also encourage students to explore how the arts, humanities, and social sciences can connect with and productively interrogate the biomedical model. For example, in the FYP course I co-taught with Dr. Pedro Ponce, we used cultural texts like Roxane Gay’s memoir Hunger alongside scientific studies to help students think critically about how and why obesity became an “epidemic”. Educating students in a more well-rounded fashion and offering them an array of tools to create change, I believe, are two important ways that we can begin to address the root causes of the huge health disparities we see around the world.

Q: What skill sets do you hope every St. Lawrence student who studies public health graduates with?

MW: I expect Public Health minors to graduate with a foundational understanding of public health principles, policies, programs and practices that foregrounds, promotes, and protects the health and well-being of the public writ large. With public health’s enduring focus on social justice, I expect public health students to be cognizant of, and to articulate how public health is embedded in historical and intersecting social structures and the realities of privilege and inequality that shape people’s lives and health outcomes. As such, students should graduate with critical interdisciplinary training and creative thinking that entails consideration of multifaceted experiences of health, illness and diagnosis. This awareness engenders a sense of responsibility as students engage in a sustained process of critical self-reflection as active global citizens through their course work, while at the same time cultivating written, oral and digital communication skills applied to timely contemporary issues. All of this is brought together through our experiential learning component–career-building opportunities such as internships designed to help students develop their skills more broadly at the local and global level through community health outreach.

Q: What most excites you about the future of St. Lawrence’s public health program?

MP: Three things. 1. Working with faculty and staff across the University to build a public health major. 2. Welcoming our new faculty member in Fall 2020 which will help increase our STEM course offerings in public health. 3. Collaborating with local, national, and global partners to build new and exciting internship and research experiences for our students.

MW: The Global Studies faculty are excited by the possibility of leading efforts to build a truly interdisciplinary program that appeals to the broad eclectic interests of St. Lawrence students. Imagine an aspiring medical student using “Black Mirror” to examine ethics in the operating room, or an art history major inspired by Introduction to Public Health – one of our gateway courses – to study representations of pain in Western art. The complexities of public health in the 21st century requires creative problem solving. We believe that this approach is perfect for students interested in addressing health and serving the public in innovative ways, as this is what is needed to ensure a healthier common future locally, nationally and globally.