Public Health! Expanding beyond traditional public health research

Part 1: My journey into public health

I was born in India where public health had a completely different definition compared to its actual applications. Public Health in India was said to mainly deal with vaccinations, case reports or disease outbreaks, or assisting with family planning.  Plus, many consider it as a low paying and not satisfying experience, with many recommending against it. It was not until joining medical school and learning more about its application that I decided to pursue a career out of it.

I came to Bowling Green, Kentucky to pursue a master’s in public health at Western Kentucky University. I had no idea what to expect or what I was getting into. I started my journey by doing some groundwork research on measuring indoor air quality among refugee populations in Bowling Green, KY. That was my first understanding of widespread applications of pursuing a public health degree. Environmental Health was an important part of our curriculum and as I further progressed in my career, I saw its application into climate change, disaster preparedness, occupation health, nursing and disease outbreaks.  Not only did my MPH program give me a good overview of different aspects of public health, but pursing leadership roles with the Kentucky Public Health Association and Barren River District Health Department helped me meet public health professionals who were working at ground levels across rural and urban areas of Kentucky to provide effective primary and secondary prevention activities to local residents.

Taking this experience forward, I moved to Houston Texas with a goal to pursue a doctoral degree in Epidemiology with focus on worksite health wellness and occupational health. But my destiny had other plans, and I started working on men’s health and slowly my career trajectory changed towards cancer prevention and cancer screening research. This was a changing point in my career, where I realized that a degree in public health and Epidemiology opens up so many avenues in research, government, academia and even the private sector.

Though my PhD was a bit extended due to family and personal reasons, I feel that I did not waste a minute during this entire journey. I worked in areas of cancer screening, epigenetics, genomics, cancer prevention and outcomes research. Working with faculties from MD Anderson Cancer Center, I was challenged to expand my research and writing skills, work in team settings and multidisciplinary collaborators, and learn how research moves from bench to bedside and beyond.  My main work was in gastrointestinal cancers, but I pursued additional opportunities in men’s health, pediatric cancers and global health. I made networks and connections that are life long, and mentors who continue to guide me even after I graduated from my PhD. By the end of my PhD, I was very glad to learn that opportunities continue to grow and the demand for skills and trained Epidemiologists is far more then we had initially thought…and you can easily find your way to your choice of path as you graduate.

Moving to Washington DC, I started working as a postdoctoral fellow at Georgetown for my first year and then pursued my second year at NIH. It was at this time, that I further learned about the various career choices one can choose from: Academic, Industry, Publications Career, Pharmaceutical Agencies, Clinical Trials or work as a data analyst.

Opportunities are limitless, and it all depends on you. The more you make out of each opportunity, the more you see yourself grow! But, always choose a path that makes you happy and work in team that learns from collaboration, values everyone’s contributions, and gives you an opportunity to grow.

It is a journey! Make the best out of it!

Part 2: More about the work I do

I am a medical epidemiologist by training with research interests in areas of molecular epidemiology and health disparities with focus on chronic diseases including cancer and cardiovascular diseases. I pursued my MD from the University of Seychelles American Institute of Medicine at Mahe, Seychelles where I underwent preclinical training for my medical school and was exposed to diverse health challenges facing a largely middle-income population of African descent in the Indian Ocean. While pursuing my training in Seychelles, I also received honors in Epidemiology during my medical training.

I then moved back to India to complete my clinical rotations at a local government hospital where I worked with public health officials first hand on prevention activities including improving vaccinations rates among underserved and minorities, educating women and men about family planning including the use of non-scalpel vasectomy as an important method of improving male contraception among low income population in India. Soon after completing my MD, I moved to Bowling Green Kentucky to pursue a master’s in public health in Health Education and Leadership Studies at Western Kentucky University in the spring of 2009.

While pursuing my MPH, I worked with graduate students to address health concerns among refugees and immigrant communities. I conducted a needs assessment with the help of a graduate colleague to assess fruits and vegetables intake among refugee women. With this information, I helped develop appropriate interventions and materials to improve intake of fruits and vegetables and delivered this at refugee centers or international refugee offices in Bowling Green, KY. While pursuing my MPH, Dr. I also worked as the President of a local student public health chapter and contributed to increasing participation of students in local public health activities. Taking this experience, I moved to Houston Texas to pursue my PhD in Epidemiology from the University of Texas School of Public Health and focused my work on health disparities, cancer and genetic epidemiology and men’s health.

My primary line of work focused on colorectal cancer and molecular epidemiology; and my thesis explored the impact of lifestyle factors and epigenetic changes on clinical and quality of life outcomes among colorectal cancer patients. In addition, I also looked at global differences in prevalence of key genetic and epigenetic alterations in colorectal cancer to explore potential reasons underlying disparities in incidence and mortality associated with colorectal cancer globally. During this time, I was also part of the Indian American Cancer Network’s South Asian Health Needs Assessment Study that aimed to assess health status and needs of Asian Indians living in Houston Texas and neighboring areas.

In this study, I helped the PI Dr. Mala Pande with data collection of a health risk assessment survey (like BRFSS) from approximately 1500 Asian Indians between 2014-2016. This is first of its kind study conducted among Asian Indians in Texas, one of the fastest growing minority groups in the United States. Using data from this study, I presented my findings across several national meetings including American Public Health Association and American Association for Cancer Research on Health Disparities where I received the Susan Komen Training Award for innovative abstract in 2015. I am currently finalizing two projects from the SAHNA study: Impact of Acculturation on Cancer Screening Practices of Asian Indians, and comparison of lifestyle factors, chronic medical conditions and cancer screening behaviors of Asian Indians to other racial-ethnic groups in Houston Texas and surrounding areas. In addition, I also helped a graduate colleague on systematic review to assess racial-ethnic disparities in adherence to screening mammography guidelines among breast cancer survivors. I graduated with a PhD in Epidemiology in the fall of 2017 and moved to Georgetown University to pursue my postdoctoral fellowship with Cancer Prevention and Control Program in December 2017.

At Georgetown University, I worked under the mentorship of Dr. Dejana Braithwaite at the confluence of aging, comorbidities and cancer screening. He assisted our team with projects that focused on studying impact of aging, comorbidities and breast density on screening outcomes among older women undergoing screening mammography in the NCI Breast Cancer Surveillance Consortium and also assess downstream rates of biopsy and biopsy associated complications among older women. I was awarded two pilot grants as a coinvestigator:

a) To plan a cervical cancer screening workshop in Guatemala with Dr. Braithwaite
b) To develop baseline registry for patients undergoing lung cancer screening in Georgetown University.

After completing my first-year postdoctoral fellowship, I received a unique opportunity to further my interest in epigenetics and study impact of social determinants of health and social genomics on cardiometabolic risk factors among African Americans. Hence I moved yet again, this time to NIH, to pursue my second postdoctoral year at the Social Behavioral Research Branch of the National Institutes of Health under mentorship of Dr. Sharon Davis where I currently work on studying impact of social determinants of health on prevalence of cardiometabolic risk factors among African Americans and later aim to study the impact of these determinants on epigenetic changes (methylation) among African Americans.

During my year, I have been fortunate to have been able to publish my work over 20 scientific peer reviewed publications, including 5 as first author, with several under development. I also serve as an Associate Editor on the Editorial Board of BMC Public Health and have reviewed over 100 scientific peer reviewed publications for esteemed journals.

I plan to continue my training at the intersection of social determinants of health, epigenomics and screening behaviors on disparities associated with chronic diseases including cancer across and within racial-groups

Disclaimer: The views and opinions expressed are those of Dr. Advani only and not views of employer.


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