Bringing human voice to Public Health problems, with Andrea Mantsios

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In this episode, Sujani sits down with Andrea Mantsios, the Founder and Principal Consultant of Public Health Innovation and Action. They discuss Andrea’s career journey, how to navigate through jobs and experiences in your career, and how social justice and focusing on the human voice has been central through Andrea’s life. 

What You’ll Learn from this Episode:

  • How the concept of social justice was instilled on Andrea from an early age and how she found her way into public health 
  • Andrea’s various job experiences and research interests
  • Andrea’s experience doing global health in Tanzania and how it helped her connect theory to reality in health education
  • Things to consider if you are thinking about pursuing higher education to open up job prospects
  • Tips on crafting your career around your passions and personal lifestyle
  • Why Andrea created her own public health consulting company to pursue her passions in public health

Today’s Guest:

Andrea Mantsios, PhD, MHS, is Founder and Principal Consultant of Public Health Innovation and Action (Phia), a public health consultancy focused on amplifying the voices of underrepresented communities to promote equity in health research and programs. Her career has included working in government, academia, and healthcare institutions in settings around the world including the U.S., Latin America, Africa, and Europe. Andrea has a passion for qualitative research and focuses her work on the role of social and structural factors in shaping health outcomes. She has worked extensively on community-empowerment approaches to addressing HIV among female sex workers in Tanzania and conducting qualitative research in the U.S. and Spain on patient and provider experiences with long-acting injectable anti-retroviral therapy to inform programmatic rollout. Andrea’s previous work includes research on risks for HIV, tuberculosis, and syphilis among people who use drugs in Tijuana, Mexico, and large-scale program design for New York City’s jurisdictional efforts to scale up routine HIV screening in health care and community settings. Andrea received her Doctor of Philosophy (PhD) and Master of Health Science (MHS) degrees from the Johns Hopkins Bloomberg School of Public Health. When she’s not working, Andrea can be found in the kitchen making family recipes with her kids.

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Episode Transcript

Andrea 0:00
It’s always an opportunity at every juncture, whether you’re starting a degree program or a new job to explore, you know what you can get out of that particular opportunity in front of you, that helps propel you forward in whatever those areas you’re most passionate about.

Sujani 0:18
Welcome to PH SPOTlight, a community for you to build your public health career with. Join Us Weekly right here. And I’ll be here too, your host Sujani Siva, from PH SPOT.

Okay, Andrea, I’m gonna take you back to 1998. And it’s purely because I have your LinkedIn open. And so I’m curious to hear you know, you- you start a bachelor of arts degree in sociology in 1998. Did you know about public health at that point? Or was the word public health something you discovered later on?

Andrea 0:57
Yeah, no, I didn’t know anything about public health. I don’t think I knew public health existed when I started my bachelor’s in sociology. And what was interesting about my major in undergrad is actually it was a joint major between the sociology and psychology departments. So I got to dabble in kind of three main areas, sociology, psychology, and human development. And the coursework across those three made up my major and it was a really rich experience, but had really nowhere on my radar public health at the time. So no, that was not a word I knew when I was doing my bachelor’s.

Sujani 1:27
So what is it that you kind of you know, grew up thinking that you are going to do professionally your career that- that question like, this is what I want to be when I grow up?

Andrea 1:36
Yeah, it’s a great question, because I love thinking about how I’ve ended up where I am today, on the long path from where I was as a little girl sitting at dinner table conversations with my parents. My mom and dad are both social justice committed academics who live kind of with- Always lived their lives with one foot in like advocacy and activism and political activism and activism on campus, along with their very serious academic lives and what they were doing in academia to contribute to work in the departments they worked in. And my mom was a scholar of race, class and gender studies of white privilege studies, feminist thought, my dad worked, his whole life continues to work with labor unions, on workers rights. And so dinner table conversations growing up, were always kind of based on social justice issues and talking about the injustice in the world, and what kind of work can be done to address the social justice issues we were talking about in our conversations. So I always was conscious of, you know, what career path can I find to do kind of similar to what my parents are doing trying to make a difference in the world? Where will I fit into that picture? So while public health was nowhere on my radar, I was certainly interested in sociology, psychology, human development, in my undergrad coursework, because the big picture was what’s going on in the society? What are the social issues at play? What are the structural like, I don’t think at the time, I was calling them structural context, and all these words that I now use in, in my work, I did understand there was something about the structural context in which we lived, that made, you know, there’s people who were profiting a lot from other people not profiting as much my dad working with workers rights, these conversations were happening. My mom working in, you know, white privilege studies, we talked a lot about, like, you know, who are we in our society, I am a middle class white woman, and like, where do I fit into being able to make a difference with that privilege I have, and how can I use that privilege to make a difference in the world? So that was like, what was brewing in my upbringing, and in this very social justice minded family that I was part of as my whole life. That’s all we, you know, had as our focus. But public health ended up being kind of the channel through which I was able to embark on social justice work. And I don’t think I figured that out until after college in that- in those first couple couple years after college. Yeah.

Sujani 3:44
So I would go to guess that unlike kids your age, you probably had a better understanding of the word, social justice, especially because of those dinner table discussions, or, or was your understanding very different as a child? And then you kind of obviously, like you said, had the vocabulary now to speak about these things that you are learning at the dinner table from your parents?

Andrea 4:09
Yeah, I mean, I think my parents engaged with in conversations around social justice issues where I think they were, you know, using terminology that they were using in their classrooms as they talk to us as kids about, like, these are the issues we’re dealing with. But I think I came into my own understanding of it through the public health work I was doing in terms of kind of where I wanted to sit. And I guess I’ll just flesh that out a little further. We’re conscious of social justice issues in our everyday lives. And but we also did a good amount of traveling around the world, which is, I think, where my global health bug bit me, we traveled around the world quite a bit. And we’re always reflective on where we were and who we were in that space in the light- in light of colonization of those countries, in light of race and class and globalization. So those conversations were always happening and I am so grateful that I have the brilliant, insightful, supportive parents who wanted to unpack those things with us. And it laid a really good foundation. But what’s been satisfying is to not just think about how I, you know, had the privilege of embarking on those conversations with them, teaching me as I was growing up, but now I feel like I’ve had my own experiences, doing my public health work, delving deeper into those issues for my own understanding from a public health perspective, into kind of where are the social justice issues that I can most impact in my work. And so, yeah, it makes me feel proud and grateful that I had that upbringing and that today, I’ve evolved into my own version of that, I guess we’re all kind of within our own niche of that social justice commitment that is so much part of my family.

Sujani 5:38
And so what- at what point did you discover kind of that this field of public health exists, and it’s potentially a career path that you’d like to go into and explore further?

Andrea 5:50
Yeah, so I was starting to read about different kind of public health work, I had been trained as an HIV AIDS educator by the American Red Cross in high school. And just to give you a picture of that, I was raised in Suburban New Jersey. And so I was really interested in HIV and AIDS, I was really interested in what was going on globally, I was really reading a lot and certainly piqued my interest in getting involved in global health work on HIV. But right out of college, I actually got a job in a hospital in New York City. That was the other end of the spectrum. Here, I was in my first job out of college working in this, like, Top New York City Medical Center. And I ended up diving into and I’ll describe briefly what I did there. But I ended up diving into that world of, you know, a medical facility in a major metropolis in the US. And it was such an interesting first step before I then went to work in rural areas doing global health work directly after that, but I think the foil of those two is really was formative in those first few years of figuring out like, what public health means, what it means in different settings, what it means to do public health work in one setting versus another. What context means versus what, who I am in that context or not versus but in addition to who I am in that context. So my first view, I would say, those first two years right out of college is when my public health identity began to emerge.

Sujani 7:09

Andrea 7:09
I guess we can say. So I don’t know if that answers kind of like where, where it began, that public health journey.

Sujani 7:15
It’s interesting that you have that experience in high school working in HIV AIDS, and that you didn’t kind of automatically go into an undergrad program in health, but rather chose sociology. And I wonder if it’s because like, you had more influence around like looking at social justice issues? And maybe that’s what drove that decision versus this other part where you were being exposed to HIV work?

Andrea 7:39
Yeah, that’s actually a really good insight. I think there’s absolutely true to that, because I think I probably had like compartmentalized health as an area and the social issues that I was thinking about as another area, and I didn’t know there was crossover or this, like, you know, place where they met. And I think that’s really, you know, the public health work I do now lies, you know, at the intersection of all these social justice issues that I want to be addressing, and then through I now do it, that public health work I’m involved in, but at the time in high school, that was a really great program I was involved in, really enjoyed it, thought it was interesting and exciting to learn more, but actually, I don’t think I was able to make the connection. I thought too rigidly about what like a career path in the health sector might look like and I didn’t understand the world public health would involve exactly what I was hoping to do. And so I did go this sociology, psychology, human development major that was satisfying all those other needs. And it wasn’t till afterwards that I made the connection, oh, there’s this approach to addressing some of the social justice issues I’m most passionate about through doing public health work. And that’s what really transpired in those years after college.

Sujani 8:39
So that first job was working in the hospital as a case manager was that you kind of like applying to a job where you saw your degree, fitting perfectly into this role. And you were thinking, Okay, I graduated from a sociology degree, let me go and do this role as a case manager exactly how your brain was working, and then you kind of like, get introduced to the hospital system, then you’re like, Okay, there’s this whole other world and then your two worlds are colliding and like intersecting?

Andrea 9:09
Yes, you’re hitting the nail on the head in terms of how I kind of unfolded. So I thought it mapped really nicely onto what I had just been studying sociology, psychology and human development with a focus on adolescent development to then apply to this job that was in the Department of Child and Adolescent Psychiatry at a major New York City Hospital. And I thought, wow, this is like a great fit. And I was immersed in this world where and I think what was great about the job is yes, it put me on the frontlines of seeing what a major health care institution in the US study looks like. But it was actually quite a bit of outreach and working in the neighborhoods that that were part of the program I worked on. So in a very brief description that was a program where we were supporting families and children who had been admitted to the hospital for mental health issues and had been discharged. There was such a high rate of them being re-admitted that this program was designed to follow them home afterwards, follow them home kind of in a, not literally, but actually, yes, go to their homes, go to their schools, be with the kids, as they transition home to try to address or identify and support them in whatever could be done to help support them in that transition home and hopefully avoid them coming back to the hospital. So I loved that I was, you know, my mornings, I was reporting to this big hospital and I had to talk to the medical director and the social workers who are part of this and see how like that system worked. And then often I went right from there out to the neighborhood, I was working with largely a Spanish speaking population. So a lot of immigrant families in the neighborhood of East Harlem, where I was working to, you know, join the kids at school, go to their after school program with them, find out what services could support them. And I saw how comprehensive we could be in thinking about oh, okay, well, first of all, we certainly want to make sure there’s outpatient mental health clinics, you know, set up so that there’s ongoing support for these kids. And I could also see that there were problems, the family was needing help navigating immigration issues or housing issues, and the child might need another recreational activity that was a better fit. So I got a taste in that job of both, you know, what it looked like to work in a major healthcare facility, as well as what it looked like to kind of hit the pavement and get out there and start seeing how to program like that could help support a family and a child after that hospital stay in a more comprehensive way. So that was a really great first job, I loved it. But yes, to echo what you were saying, it seemed like this nice fit from where I was coming to apply to that I got the job, and I loved that job. But I had like a little itch in the back of me. Like I really do want to get back out there, I had been reading more and more about global health work about this HIV work that was so interesting to me. And I identified an opportunity for service learning, it was a placement in Tanzania, which is funny to think about, because I would have spent many years working in Tanzania, but at the time, I guess it was 2003, I had no idea I would end up spending a lot of time in Tanzania for my work. At that time, I did a placement in Tanzania for several months of a service learning opportunity. And again, there was an HIV AIDS education component to it. I was working in several clinics, both a private clinic and a public hospital. And that was my first real experience working in, in global health in the setting there in Tanzania, those two experiences back to back were wildly different and formative in terms of shaping the path forward, I think.

Sujani 12:11
And so that- that experience, like getting out into like Tanzania into the field, was that, I’m assuming that that wasn’t with your case manager role, right? Like this was so-

Andrea 12:21

Sujani 12:22

Andrea 12:23
Correct. Yeah. So I left the position there at the hospital to pursue this service learning opportunity to really try on for a fit what it would look like to do global health work and see what it looked like. And I ended up in Arusha, Tanzania in the foothills of Mount Kilimanjaro at a child and maternal health clinic one day at government hospital the next day. And interestingly, I was doing some HIV AIDS education workshops. And this was a really big turning point for me. Here, I was coming from, you know, suburban New Jersey, having done HIV AIDS education workshops in that setting, and being trained in that way. Flash forward several years post college, I’m in Tanzania in a rural community outside of Arusha, and I was leading some HIV AIDS education sessions totally different just to present a picture for you. In New Jersey, we were sitting in classroom settings. In Tanzania here, we were sitting like under a banana tree, you know, on the grass and a circle. And I’m going through the curriculum that is talking about HIV prevention methods, and I’m talking about condoms, and how effective condoms are at preventing HIV infection. And after the session, one of the women in the group came up to me, and in the kindest way possible, said, like, I get what you’re saying, I understand condoms, prevent HIV infection. But if I were to ask my husband to use a condom, my four kids and I would be out on the street looking for a place to live. And I’m paraphrasing, I don’t remember her exact wording, but it was along those lines. And it hit me like a ton of bricks. And here’s the I, in retrospect, I think I was somewhat conscious of like context and the differences in where we were and what we were doing. I had no freaking clue at that moment, how off base I was in what I was talking about and thinking. Now after years of working in different contexts, I’ve done a good deal of work with sex workers on my projects, in the last several years of my work, and to be so isolated in those workshops, as I talked about condom use and the importance of condoms and preventing HIV to be so disconnected to like, the structural context of what might make it difficult for a woman to use a condom to prevent HIV infection and how many social and structural factors are affecting or being at risk for HIV that I, as a young person, they’re doing what I thought was, you know, the curriculum that I was teaching like that was so so far from what made sense to her and to an idea of to her of what prevention could look like. And so I think that was a moment that I really reflected on and still continue to reflect on us like, wow, and not only was I so far from understanding the reality of her life, and why what I was saying didn’t really make sense, but also in terms of priorities. What I’m talking about and I’m thinking is the most important part of our conversation about why condoms are so effective at preventing HIV infection is really low on the priority list of her and her life of juggling the four kids and you know, just got to get dinner to her on the table tonight. And she has dynamic with her husband, where this idea of navigating condom use with him was like, out of left field, you know. So I just think that was a really important moment for me to reflect on at that time, and to continue to reflect on as a teaching moment for myself. That, you know, in retrospect, was definitely crucial in in me rethinking what am I doing here? Who am I? What am I talking about what does and does not make sense in doing this kind of work in this kind of setting? I think that’s that was a moment that was important for me, in my time in Tanzania for sure.

Sujani 15:44
And this was the first time ever that you’re working outside of New Jersey, right? Like this was your first experience?

Andrea 15:53
Yeah, so I had been working at the hospital in New York before that. And then this was my first experience in a setting outside of the US doing work.

Sujani 16:00
You mentioned a couple of times that you were, like, interested in the field of HIV and that you were reading a lot? And are these like books or these like blogs that you’re finding online? Or is it like articles? Like what are you what are you reading at this point to kind of like, that’s what ends up kind of giving you a bit more like context around this like area, and presumably maybe even like preparing you for this experience?

Andrea 16:24
Yeah. So I mean, I had been reading, like, in a broad way about the HIV epidemic, and, you know, rising rates of infection. And, and it all was, I want to say, in the abstract in my head, I think I wasn’t thinking concretely about the every day, people who are at risk for HIV and getting infected by HIV. And that is where the disconnect came to life from it. You know what I mean? Like, I was really

Sujani 16:48
Probably like the science that you are learning.

Andrea 16:51
Exactly. So the reading the science behind it, and this kind of larger issue that it seems scientists were trying to figure out how to, you know, with these rising rates of HIV, how are we going to address this problem, it seemed, this was fascinating to me. But this was not human for me until I was there, understanding the very end, like almost it’s, you know, it hurts me to even say that out loud. Because I’m someone who, at this point in my life, I pride myself on everything I do is actually centered on bringing human voice to solving public health problems. And so when I look back at this moment in time, I’m like, that was the moment where like, Yes, I had read these, like, you know, scientific articles on this epidemic called HIV. And it seemed like something I wanted to be part of addressing, but it wasn’t till I was in front of women at risk for contracting HIV, who were talking with me in the context of their everyday lives that it became human. And so I think that, and again, it’s so funny to say that now when right now, it’s so funny to say that now at this stage in life, where everything I’ve done in my career leading up to where I am today, has now led me to want to commit all my work to centering, you know, human voice and solving public health problems. But that was the younger me who like had that first point of connection, I think, from the meta to like the everyday personal, human lived experience.

Sujani 18:08
Yeah, absolutely. So I think you said, did you spend a couple of years in that role? And then you came back to the US? Is that what happened?

Andrea 18:17
No. So I was there for several months. And I actually started the Master’s in Public Health at Johns Hopkins in Baltimore. So I then moved back to the US after that period, in Tanzania, it was short. And it was very informative. And it was critical in several ways, because of being the first experience I had doing global health work in terms of the connection that were coming together for me, as I just discussed, and then I was suddenly in a Master’s of Health Sciences program at Hopkins, where we were all coming to our coursework with whatever experience we we had previous to that, and this is where I think I started to really get excited about what other people were doing about what the possibilities were in public health, because as fascinating as it was to learn from my professors, and the faculty were incredible teaching, using the studies that they’re involved in to teach us in our courses. It was actually my peers who like started to inspire me most. So everybody comes to the classroom with what they’re bringing, right? And so I had peers next to me and the classes I was attending that were raising their hands and sharing like, you know, well, I’ve just come back from working with the Ministry of Health in Iraq, or I was just working in Zambia, and this is what I saw. And as my peers and I were in these exciting conversations in our classes about, you know, application of what we were learning to what people had done, what people were thinking about, that’s when I really started getting so excited about what I could learn from others and what I could get could get involved in myself.

Sujani 19:49
And that’s not something that we think about when we decide to pursue a master’s program or any grad level, like studies right? That, you know, the biggest impact is going to be learning from your peers. And curious to hear like for you, why did you decide to go back to school at that point in your career?

Andrea 20:07
Yeah, yeah. So that was specifically to pursue a degree in global public health. Because I had seen, this was the direction I want to go in, I need further training in there. So I need training from and this is picking up on your last point, this is really important to think through, like what grad school can provide you with I mean, there’s methods that I think you can learn from a classroom setting that you cannot as easily learn out in the field, I say that with a caveat, because sometimes you learn methods in a classroom, and it doesn’t really come to life until you’re out in the field of carrying out those methods. But, you know, you can get rigorous training methods in the classroom. And I certainly felt I needed those. And the surprise that I got in the classroom was learning that like, wow, what my peers are doing around me what people are thinking about and moving towards and applying what we’re learning here to the work that they’re doing in their jobs, or the work that they’re involved in, outside of the classroom. That is- that is giving life to all of this. So I can, you know, read the papers they’re giving us and I can complete the assignments. But like, this is such an incredibly exciting field to be in when you hear what people are doing. So I think, you know, that was part of my experience, as a public health master student was just seeing it all come to life and feeling the excitement, of kind of how much impact can be made when you’re applying what you’re learning. And that’s why I ended up there, I wanted to be taught these skills and the methods that I thought I needed, but really an application, it all comes to life and shows you just how much you can do any kind of collaborations you can join in, turn about change. So that was- that was the beginning of my journey on the public health grad school track was the Masters of Health Sciences. And I love that degree. Yeah.

Sujani 21:42
It’s kind of like you go through these like periods of like applying what you learned, then you go back to school.

Andrea 21:47

Sujani 21:48
And apply. And then you kind of like had this one period that you had done that, and this was kind of your second period. And then you go out and work again, for another I think it was like seven years before you pursue your doctoral. So tell us about those kind of like seven years after your master’s program and what sort of decisions and things you are navigating as you’re building your career there.

Andrea 22:09
Yeah, great questions. And I think there’s ones I reflect on a lot in terms of kind of the path I’ve taken to come to today, where I am, I left the Masters of Health Sciences degree program, feeling ready and excited to go into what was my practicum placement at the University of California, San Diego School of Medicine, where we were working on an epidemiological study on the US Mexico border of HIV, syphilis, and tuberculosis, on people who use drugs along the border region there. And I went in for my practicum. And I was learning so much every day, it was literally that process you’ve just described of like, application, like, go back and learn, absorb, go out, apply, go back, learn, absorb, go back apply. This was like a really like kind of jumping right back into the deep end of being out in the world, making sense of everything I’ve learned in the classroom and trying to apply what I learned and learn from the incredible team I was able to be a part of during that time. So I really think that job was instrumental in my development, because it was kind of again, similar to the dichotomy I described earlier with like being able to work at the hospital in the morning. And then now I’m doing home visits in the afternoon and my first job in New York City. This similarly I was part of an incredible team of world class epidemiologists doing really impressive academic research by day and I was learning so much sitting there in the School of Medicine, understanding how this kind of study is done. And then by afternoon and evening, I was out in the field, I would drive down from San Diego across the border into Mexico and be part of a mobile outreach unit in Tijuana, Mexico, where we were conducting a study and partnering with an NGO, an NGO in Tijuana, who’s doing harm reduction off of a mobile ban and to be able to have my days split between these two worlds of seeing what it looks like to do academic research and all that goes into that and then what it looks like to do outreach to a hard to reach population and the issues around trust and rapport and how to conduct in an ethical way research and programming for population that we were reaching for two purposes enrolling in in a study and also reaching with harm reduction services. I learned so much so so much from those two years from getting a window into both of those kinds of places you could sit in the world of public health it’s a theme that’s continued throughout my public health career is kind of to look along the spectrum of at one end of it might be like an ivory tower academic for like in the strictest fashion who sits at their desk and crunches numbers and you know looking at an Excel spreadsheet making sense of data, maybe they’re you know, writing great manuscripts day in and day out and day in and day out. And I saw so much of that I looked up to and thought was incredible and impressive. And then the other end of the spectrum is doing outreach every day in the streets meeting a population that you’re working with, and trying to understand best how to serve their needs, support the work to serve their needs, and hear what they are looking for, in being supported by the work you’re doing. And so along that spectrum, I was able to, I think, in that particular job, see both try both on purpose, see where I wanted to fit, see what was so important to me and see where there are opportunities to bridge the gap between those two. And it’s not dichotomous, you’re either in academia or you’re on the ground, it’s really a matter of what combination of those, you know where along that spectrum you feel you can be most impactful, and then how you can serve in that way.

Sujani 25:35
And it sounds to me that you’re very intentional about that balance, you know, as you’re kind of looking for these opportunities and getting involved in these different roles. And I remember when we initially chatted, this was number of months ago, we talked about, you know, making thoughtful decisions about your career. And I’m curious, like, at what point in this journey, did you actually, you know, intentionally started saying, Okay, I’m going into this role, because it’s going to then build on this experience, and then it’s going to lead me here, like, Was that intentional decision making happening very early on? Or is it, you know, something that you’re reflecting on now? And then thinking, Oh, maybe I think that’s what I did.

Andrea 26:19
Yeah. So there was certainly intentional, you know, along the way, there were intentional moves, as I was becoming aware of which direction I thought I wanted to go in, I will say that I so much enjoyed that experience. I love that experience. And I was really looking forward to starting a doctoral degree back here in San Diego with that team, I loved that work. I love that environment. And I had identified Okay, the path for me now would be to pursue a doctorate. And my mom always told me to like, look at opportunities in terms of like, what opens doors that feel to most and what opens the most doors that look the best to you, and how can you take advantage of opportunities that would open doors for you. And at that time, that seemed to be an opportunity that would open doors to me, I thought, okay, I would love to now pursue a doctorate. And that was a decision I made and I enrolled in the program. And unfortunately, that same year, my mom got a terrible cancer diagnosis, she got brain cancer, we did my entire life, there was nothing I would consider doing other than moving home to be with her through treatment. So I withdrew from the program. And I said, okay, if I’m gonna go to a doctor, I’ll do it at some point. But right now, I just want to be with my mom through her treatments. So I moved back to New York, really, the only thing on my mind was being with my mom through treatments. And I was looking to see what can I do now back in New York with my family, while we’re getting through this really difficult chapter with my mom’s health. And it was at that point that I started the job at the New York City Health Department. And we can talk more about this job in a second. But to answer the question about intentionality, I think this was such a moment where like, I absolutely knew I wanted to withdraw from the doctoral program to be at home with my family, and I think more important than family and I was actually completely, it left my mind entirely that I wanted to do the doctor once I got involved in New York City Health Department, and I love that so much. That was about six or seven years I was there. My mom got through her treatments beautifully. It was an incredible moment in time where we were we had beat the cancer, we were all together. And my career path was, you know, progressing in a way at New York City Health Department where I was really growing and doing this incredible programmatic on the ground work that I loved. And I will say, at a certain point there, I really felt like I hit a ceiling. And I knew, Okay, now I really need to go back and do a doctor. I feel like I’ve hit a ceiling. I feel like I remember looking around at certain conversations that were going on that I just wanted to be a part of, like, I kind of wanted to sit at the big kids table like talk all the like high level kind of research related conversations and questions and dialogues going on about things that I wasn’t prepared to be part of, or speak about. And I recognized that I think I need a terminal degree I need to go back and get a doctorate in this is the methodology I need to learn this are the things I want to know. So I can keep up with these kinds of conversations. So that was, again, an intentional pivot where I was like, you know, this has been an incredible run several years. And that New York City Health Department job was incredible people doing work that I loved and adored. And at a certain point, it became clear to me that like, now I need to pivot back to the classroom and go back and learn a good deal more if I want to try to be as effective as possible. And again, I think I would go back to that being an opportunity to open further doors, because I continue to straddle the worlds of like, being in community being part of, you know, writing papers on what we were doing generating reports that were part of conversations we were having, at the state level with the health department, and you know, straddling that world of being a large health department and being everyday in the community in the work we were doing at the time on HIV testing. And so after struggling those worlds, I felt like I see how much I want to be part of both of these worlds, but I am definitely hitting a ceiling in one of these worlds and I think going back to school is the only way to kind of completely round out my understanding of what I can do, I where I can fit and how it can be most effective?

Sujani 30:02
You know, I meet quite a number of people within our membership community, a public health career club, and I’m always kind of stuck when I get the question of, I can’t land a job. So I think I’m going to go back to school. And, you know, the advice that I kind of think about is, like, that shouldn’t be the reason that you go back to school. And I don’t know, if you have an answer to any of anyone who’s listening who’s thinking, you know, I’m going to pursue a master’s degree or a doctoral degree because not because of like the experience that you’re explaining where you are in a job, and you’re kind of like looking for that next opportunity. And you’re kind of thinking, Okay, if I go back to school, I’m gonna open up more doors for myself, then these are individuals who aren’t able to land a job. And when they get to that point where they feel stuck, then the advice they may be hearing from others is maybe go back to school so that you can be a stronger candidate, for example, and I kind of don’t 100% support that advice. But I’m curious to hear from you. Because I think you’re a great person to ask this question too, because you’ve had two opportunities where you thought, you know, you may want to go back to school. And at each of those points, you were at a different point in your life. And I’m curious how you would answer that question?

Andrea 31:17
Yeah, that’s a great question. I would echo your sentiment Exactly. I think it’s important to be clear on what you can get out of an educational experience and what you can get out of a job opportunity. And I don’t think just because you can’t, you know, land the job that you’re looking to land, the pivot back to school and going back for a degree is, is necessarily the right move. Because I think as I was highlighting before, for me, I came to those points of deciding to go pursue graduate degrees based on identifying a gap and what I was able to do, and I could fill that gap by training methods, education I could receive on specific skills, those are like the things I saw that school could provide that I wasn’t getting in my work experiences. And my work experiences provided a wealth of things that school could never provide. So I’m a huge advocate of you need both.

Sujani 32:06

Andrea 32:07
You need to look through both of those lenses to see how they could complement one another and don’t rush into one or the other, just because the other isn’t coming through. If you can’t get into school right away, you’re going to get great opportunities through work that’s going to build you up. And then you can apply again, and you will be that much stronger for it for your next round of applications. If you can’t get a job and you apply for school and you get in, that would be going back to school with you know, you don’t have I want to make an assumption. But I would say a lot of people end up going to school before they have real world experience. And that too, I think puts you at a disadvantage, because of exactly what I was mentioning earlier, there is so much going on in the classroom where you can connect dots to what you’ve done, the work experience you bring to the table, what your peers are saying, find commonalities, the experience is that much richer in the classroom, a few come with some experience. So I would say not to rush back to school to learn, learn, learn, but be out in the world, to experience experience, learn on the ground, learn on the go learn from people, learn from community, learn from real world, and then you bring that much richness to the educational experience you go back to and another piece, I would say there is just as discouraging as it can be to not get those jobs. I remember being devastated when I didn’t get the first job I was so passionate about when I first got out of undergrad and I thought oh my god, I’m perfect for this. This is going to be great. I have so much I want to do with them. They are doing amazing work. I just want to support this work. And I see how perfectly often I’m sure they’re gonna see it too. And then they were like, No, and I’m like, Oh, I didn’t get that. Right. Okay, so that was devastating. And it hurts, it’s, it’s really hard to not get the positions that seemed like the perfect fit. But I would also say there is so much to be gained from ending up in a job that is related to what you want to do, you know, within the area of public health that you want to do, and may not seem initially like exactly where you want it to end up with. There’s so much to be learned from it anyway, in terms of what works well, what doesn’t work well how you know, folks are approaching work like you can always learn from those experiences in terms of The Good, the Bad and the Ugly. And- and you will take that with you as you develop into the public health professional that you become. I remember this was a great approach I saw modelled once this was an approach that like I saw it in action, and I am not on board, I think there’s a better way to do this. And that is how you become a public health practitioner that you will eventually be. So I think there’s something to be said for if you don’t land a perfect fit that you think is exactly the path that you want to go in, within public health to think a little bit more broadly about what could be a good fit and still, what a valuable learning experience that could be that you could then bring back to the classroom if you get to the point where you want to pursue a degree.

Sujani 34:42
Yeah, like I was one of those people who went directly from an undergraduate program into my master’s with very little work experience. Like I had worked in like a lab and a nonprofit during my undergrad but it was nothing like a full time employment where you’re completely immersed in that organization and when I went into my master’s program and quickly realized, by the end of the two years, I’m going to be in the exact same position with no experience right on my resume. So, like, I was just trying to get any amount of experience, I could in the two years, I was doing like three research jobs, because I knew very well that, you know, as soon as graduation came, my resume is going to look exactly the same with just one extra line, which was the master’s program. So I tell people, if I were to do it again, I maybe would probably spend a couple years working and then go pursue a master’s program. And, you know, I often think about going back to school, I’ve been out of school, maybe for over 10 years now, I think and, and each time I think about it, I always like I have to ask myself, like, what is the reason and I can’t come up with a great reason other than, like, I love to learn, I love to be in that environment. And that goes to kind of like this topic that I want to talk to you about, because we got into it a little bit. Last time we chatted and it was- it was around, like how do you design your career, right, like you have? And an interesting question, like somebody in the career club again, was like, I love to do this, like, I love climate change. I love you know, working in the community with individuals, maybe like maternal health, and I love epidemiology, and I love qualitative analysis. So it’s like, they have a lot of these interests, a lot of passion. And they’re kind of overwhelmed by being multi passionate, and not knowing, like, where to go. And the best advice I gave to them is like, find commonalities around all these interests that you have, because I assure you that there’s going to be one theme that comes out of all of these interests. And knowing that you’re kind of like building a path towards that one theme, is kind of confidence for yourself. And it kind of like reduces the overwhelm, because it doesn’t matter what first job or second job at because you’re kind of directing yourself towards that one area of like, work or population or whatever it is that you’re passionate about. Right? So I don’t know, if you if you kind of like think about that question in a different way.

Andrea 37:15
Yes, you can’t see me, but I’m like, have my hands up. This is so rare, because I am one of those multi passionate people who was like, how am I ever gonna choose? I love to do so many things. And I want to be involved in so much great work I see around me, where can I possibly find a place that is just right when I want to be and all these things at once. So all that really resonates. And I think that advice you have given is really signed, I think we absolutely can pave a path for ourselves that involves, you know, the things that we’re most passionate about. And I would say where we also identify, we can have the most impact, I think you have certain things that you know, right off the bat, okay, I love qualitative research I passionate about like amplifying the voices of underrepresented communities through doing qualitative research to inform research and policy and programming that is absolutely where I am today from a long journey of in being involved in qualitative research throughout all these chapters, we’ve just kind of gone through of my career. I felt early on like, you know, do I have to have a methodology that I become like an expert? And am I going to be a quant person? Am I supposed to do you know, these types of analyses that we’re doing? And in some of our courses, I also had the questions like, do I have to have like a topic like I had a lot of HIV work early on, as we talked about, and in the early days, but I had done a lot of HIV work in my master’s degree. And then also in my PhD, it was I’d be just a person working in HIV, that would mean my thing, and I would be wedded to that topic, or could I go broader? Or does that, you know, wed me to doing HIV work solely? Or could I explore these other things that are also of interest to me. So I remember thinking through this exactly. Like, you have just, this is your methodology. This is your top, you know, topical area that you’re an expert in and realizing that it didn’t need to be so black and white. And it was more of a journey that you could weave together experiences that allow you to dip deeper into those topics and methods are different, like times in your career path. And so you could also broaden the spectrum. I went from doing HIV specific work to doing more sexual reproductive health to getting involved in multi methods, research studies. So I feel like it’s always an opportunity at every juncture, whether you’re starting a degree program or a new job, to explore, you know, what you can get out of that particular opportunity in front of you, that helps propel you forward in whatever those areas you’re most passionate about are and I think, something that I know you stress that I’m passionate about as well is the role of mentorship and all of this right and if you have strong mentors, and I have been incredibly fortunate in the mentorship I’ve received which is what drives me to mentor other young women coming into public health. I think mentorship is so key to this because if you have a strong relationship with a mentor who is supporting you and supporting you really thriving in what you want to do most you can have those kinds of conversations around like, where your passion lies, and how different opportunities can be positioned to help you hone your skill set, hone your expertise in that topic. And similarly give back to that job or that educational experience of what you’re bringing to the table that is, you know, your unique public health perspective. So, I would say all of that around around how to manage multi passionate public health people, because I am one of you guys.

Sujani 40:32
Yeah, I had two individuals that I always go to whenever I’m, like, stuck at this, like, with my career, and, and I know exactly what both of them are gonna say, because they’re both in like, two extremes. One of them is like, yeah, like, quit everything and go do what your heart wants you to do. And then the other one is like, very much like carefully thought out, planner. And so I know exactly what they’re both going to say when I go to them with like, a dilemma about my career. But just hearing the two extremes, I then like, make my own decision. So it’s, it’s to say that your mentor is not going to have the answers. But they can give you different perspectives and ask the right questions so that you can take all of that information and make the decision for yourself.

Andrea 41:14
Absolutely could not agree more. I think mentors can be these incredibly helpful sounding boards, because they have a wealth of experience and perspective that you don’t have in your head, but can certainly feel your decision making as you get back in your head and make a decision. So they may not have the answer. But they have so much to contribute to the conversation that that helps you get to your own answer.

Sujani 41:36
Absolutely. Okay, so you know, you graduate from your doctoral program, you then like go off in this other, I guess, like journey of being a an entrepreneur and kind of doing something on your own. So tell us how that happened.

Andrea 41:53
I would love to take you on that journey. But I also want to circle back to highlight something about my doctoral work before we leave that chapter that you mentioned about when you were in your master’s program, you said you were getting all the opportunities you could get under your belt to make sure that when you get out of your program, you didn’t just have that one extra line on your resume. That’s not the Masters but you had you know, real world experience, I will say there was nothing, nothing more important about my doctoral work then, or my time in my PhD, then the work I did on my dissertation and the opportunity, I had to be involved in the research that I was- I was working on throughout that time. So I certainly learned skills like hard skills and classroom settings during my PhD that are extremely valuable, I understand the value they have in our field. And they are why I went back that intentional decision I made from the New York City Health Department to say I need to go back to the classroom and learn hard skills that was absolutely fulfilled in the classroom setting. But it pales in comparison to the real world experience I got through being involved in the research studies that I was part of as a doctoral research assistant. And that then became the work I did for my dissertation. So I would just echo what you mentioned earlier in terms of seizing the opportunities that are available when you’re in a degree program as stepping stones to work that you could then continue on after leaving the program because that’s absolutely what it was. For me, I, as I was beginning my doctoral degree was able to get involved in a National Institute of Health funded study in Tanzania bringing me right back to Tanzania, all those years later, just serendipitously on a community empowerment based HIV prevention intervention, which was an incredible opportunity to travel several times a year while I was doing my PhD to Tanzania to work on this community empowerment approach that became basically everything about what I wanted my public health work from there forward to look like and the idea of meaningful engagement of communities in public health work. So that was a hands down the most valuable part of what went on during my PhD. I learned in the classroom, the things I went back to learn, I did get hard skills, but there is nothing more important than the relationships that were built or getting involved in those research studies. The things I learned working on those research studies, and then that led to after the doctorate and after then working within I continued on, on those research studies. After I completed the degree. I was in a research scientist position at Johns Hopkins for two years after that, working on the studies learning a tremendous amount. And then we come to the pivot that you just raise, which is when I decided to start my own public health consultancy. And that was really a culminating moment of a few things. But as we’ve gone through the kind of history of my career, we’re seeing, like there’s a little bit of kind of all these sectors pop up like I was at a major health care facility then I was working in a rural Global Health position. Then I was at a school of medicine. Then I was doing, you know, epidemiological research. Then I was at a health department doing community outreach work. I was kind of in all these different sectors. And I realized at that moment in time after I’m having this stint also in academia and understanding what that life would look like and trying that on for fit. I realized that I didn’t want to work in any one of those sectors and I didn’t want to be within the confines of any of those kind of more structured worlds, what I really wanted to do was use my skill set, my passions, my area of expertise, to be able to focus on what I love doing and- and the kind of work that is meaningful to me across those sectors working in different ways to have impact whether it’s partnering with a health department or supporting academic research or working with community based organization, a local health clinic, like all the work that gets me so excited isn’t within one context, it’s really kind of the work that I want to do, can be done with various partners. And I identify one of my strengths was, I was able to do that I’m able to liaise between these different kinds of settings, across sectors. And honestly, the- the conclusion I drew was, I could start my own public health consultancy that would allow me to do this in a way that I can support whatever sector I’m partnering with, doing the work that I think is important and meaningful in a way that I could offer, you know, my skill set and my strength to support that work. And that would give me the freedom and flexibility to support a whole host of different kinds of projects going on, and it would be the best fit for where I am in my life. So the other factor I was going to mention in terms of saying it was kind of a multi factor. Decision there is is very honestly lifestyle, I had just had my first baby and I had that moment of what would it look like to continue on the path in academia and the kinds of grants I was going to be applying for to continue on that path. And I just, I saw clearly that that wasn’t really the path I wanted in terms of lifestyle fit. So I would say the- the pivot that I did to start the consultancy was based on both those factors, one zooming out and realizing I’ve had an opportunity to try on for fit kind of all these different sectors, and I’ve loved my time working in each of them. But I don’t want to be wedded to any one of them. And what I’m bringing to the table in terms of the skill set and expertise I have, I could really help support projects across the sector’s if I can have my own entity within a public health consultancy, to serve in that way, that would be really satisfying from a professional development perspective, that is where I see myself going. And simultaneously it mapped onto my personal life where I just had my baby and wanted to be available for a rich family life in addition to a rich professional life. And here I am now after my second baby, I feel like I’m able to maintain the balance with my husband and kids and my- The importance I placed on having dinner together every night, you know, with my professional life. And I knew at the time when I was considering what I go into academia and I knew that this lifestyle would not necessarily be achievable in such a way. So the freedom and flexibility of doing the work I love and I’m passionate about within a consultancy is part of what really appealed to me about doing that pivot.

Sujani 47:45
And super exciting that you were able to get back into the field too, right, like you just came back from a two week trip to Tanzania, which is pretty awesome.

Andrea 47:55
Yeah, yeah. So that was incredible. Being able to return to the work in the field, I had, again made an intentional decision to do most of my work and domestic based projects or the global projects I’m still involved in, I’m not traveling for in general, just as an intentional decision to be here while my kids are still so small. But I had this incredible opportunity when I got a USDA department and grant with my colleague in Tanzania to do this project, returning to the community I’ve been working with for almost 10 years now. And it was incredible to be there with my powerhouse colleague and miss my partner in crime as we work together to try to address this- this project specifically on offsetting the economic shocks that women in rural Tanzania experience around pregnancy and maternal health care costs. And it was rich full days with the about 70 women in the village who my colleague works with through her basket weaving collective and we were you know spending our days working together with the community on coming up with solutions. And it was incredibly satisfying to be able to be there and be part of this long standing work. So yeah, that was a- that was a nice little jaunt for me after much time now home with the kids.

Sujani 49:05
You know for a lot of our listeners kind of listening to this journey that you’ve been on. Especially a lot of our early career professionals are probably thinking like wow, I want- I want to build something like Andrea has, right, not not just on the professional side but also lifestyle and family and- and the thing that I try to talk about within PH SPOT is that you can build your dream public health career and what that like how I define that is that you can have the impact you want in the world, you can find fulfillment in your career and then also achieve your wildest dreams, whatever that is, right, like a rich family life, build your own consultancy or company or- or you know, work your way up into like State Department. So for a lot of our listeners who are kind of like listening to your story, we just like went through over like a decade of your work, your journey and they’re thinking like holy- This is overwhelming. I don’t know how I’m gonna get there. And it’s easy for us to say it’s just one foot after the other. I want to know like, what kind of advice you can leave us with, for- for a lot of us who are kind of like starting off and thinking like I’d love to build a career as joyful as yours.

Andrea 50:13
Oh, that’s so kind and lovely and exciting to hear. Because I feel like it’s been such a journey along the way to this point where I do feel I’m I’m in you know, the place exactly where I wanted to end up. And I can absolutely relate to the early professional mindset of like, where do I go putting one step in front of the other to get there, I as clear as this all sounds now, after this decade and change, I am speaking with such clarity on how I got here and where I am. But believe me, I can absolutely put myself back and 23 year old me being like, where am I going and which foot goes in front of which to get me on a path to where I shall end up. So I want to just first acknowledge that that this- this question is a very good one. And I think one of the pieces of advice I would stress is one of the strengths of public health, this is going to resonate, I think with you a lot, Sujani, to use one of the strengths of public health, which is its people, I think the field of public health is pretty awesome. Because I generally tend to find public health people are awesome. Like I’ve met so many incredible people in this field, who are ready to have a conversation about their experiences, the journey they’ve been on, you know, not in the formal mentorship way as in someone who’s far above you in their career and can give you guidance, the way you know, we talked about earlier in the conversation, oh, I have insights, because I’ve been in this longer, and I’ve had experiences that can help guide you. But just even peer to peer and the communities that forms, including the one that you have cultivated, I think community within public health can help open opportunities for jobs and thinking about going to school and creating a network of people who support you through decision making, as you figure out which foot to put in front of the other in those first steps. So I would say one piece of advice is honestly start cultivating relationships and networks that help support you in your thinking about where you want to go who you want to be. And that will expose you to different things out there that you can try on for a bit that you can assess, does that sound like something I want to do? Does that sound like something that’s interesting to me. And so use the wonderful people that make up our field of public health as models, as advice givers, when you’re seeking it, as sounding boards when you’re considering your next steps, as opportunities that may exist out there that they can bring to your attention. So certainly utilizing the incredible people that make up our field in public health. And this other piece that was a theme throughout our conversation of intentionality. And I don’t want to- I don’t want to be too rigid on that. Because I think there’s two things true at the same time. One, I do think it’s great to have ongoing reflection on where have I been, where am I now where am I going and make intentional choices based on that. But when I say don’t want to be too rigid about that, I also want to echo a comment I made earlier, which is if you find yourself in a job that’s not necessarily like this is my dream, there’s so much to be learned from that. And so I think it’s looking through the lens of every opportunity you are presented with whether you’re able to get into a program and go back to school at a time, that seems just right, whether you get a job that seems like the perfect fit, and then turns out to be disappointingly not quite right, whether you apply for a job that you didn’t think was quite right. And it turns out to be a great fit. All of those are opportunities to learn about what your path forward could be. And so I would say to constantly look through the lens of like, what am I learning about the experience I’m currently in, that could help me further hone either my skill set that I want to strengthen, help me get more, you know, expert level on a certain health topic or thing that I’m passionate about, or to get me closer to the lifestyle I want to lead. And in that I would actually include on that spectrum of like doing street outreach to being an ivory tower academic like exploring that spectrum. And like what really gets you jazzed? Where do you want to fall in that spectrum in terms of the work you want to do so I think that was like a circuitous, roundabout way of getting at some advice, but it’s all kind of merging in my head in terms of how I think you can be conscious as you’re starting your public health journey, the kinds of things you could think about in paving your path.

Sujani 54:15
I love it. Thank you so much, Andrea, this has been such a wonderful conversation. And as I glanced over at the clock, I hated that it was already kind of at the hour.

Andrea 54:25
I can’t believe it flew. It’s been so great to talk to you Sujani. I’ve loved it too.

Sujani 54:29
Thank you so much.

Hey, I hope you enjoyed that episode. And if you want to get the links or information mentioned in today’s episode, you can head over to And we’ll have everything there for you. And before you go, I want to tell you about the public health career club. So if you’ve been looking for a place to connect and build meaningful relationships with other public health professionals, from all around the world, you should join us in the public health career club, we launched the club with the vision of becoming the number one hangout spot dedicated to building and growing your dream public health career. And in addition to being able to connect and build those meaningful relationships with other public health professionals, the club also offers other great resources for your career growth and success, like mindset coaching, job preparation, clinics, and career growth strategy sessions in the form of trainings and talks, all delivered by experts and inspiring individuals in these areas. So if you want to learn more or want to join the club, you can visit our page at And we’ll have all the information there. And you know, as a space that’s being intentionally curated to bring together like minded public health professionals who are not only there to push themselves to become the best versions of themselves, but also each other. And with that, I can’t wait to see how it this is going to have a ripple effect in the world as we all work together to better the health of our populations and just have immense impact in the world. And I hope you’ll be joining us in the public health career Club.


About the Show

PH SPOTlight: Public health career stories, inspiration, and guidance from current-day public health heroes

On the show, Sujani sits down with public health heroes of our time to share career stories, inspiration, and guidance for building public health careers. From time to time, she also has conversations with friends of public health – individuals who are not public health professionals, but their advice and guidance are equally important.

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