Q: Your career has revolved around studying the many intertwined influences on women’s health—biology, society, and behavior. Can you describe the early influences on your own life?
A: I’m the oldest of four. My family moved from Kingston, Jamaica, to Jamaica, Queens, New York. My 7-year-old brain kept asking, “How did we leave Jamaica and end up in Jamaica?” My parents wanted us to live in Queens, even if it meant living in a basement apartment, because the schools were better and it was a residential environment. It meant a lot for them that their kids had a yard to play in.
My father worked on Delancey Street, on the Lower East Side of Manhattan. Because he had worked in Guantanamo Bay as a civilian tailor for the U.S. military, he made connections with other tailors, many of whom were Jewish and had connections with owners of shops and factories in New York’s Garment District. His social and professional groups were recent immigrants as well, and they gave my father the guidance to help get us into the best school systems.
Q: You talk about a sense of gratitude propelling your life. Did your parents’ sacrifices forge this gratitude?
A: Familial gratitude is where it starts—but only where it starts. There’s also the gratitude toward teachers, neighbors, employers, students. Everything about my educational career has been punctuated by these chance moments of kindness or sharing.
The first teacher who put me on the path that brings me here today was a public school middle-school teacher—Mr. Gilbert, general studies. It was about seventh or eighth grade. He walked to the back of the classroom and tapped me on the shoulder. I thought, “Oh-oh, what did I do?” He said, “You belong in a more accelerated class.”
If you play sports and you play with a team that is well run and well coached, everyone’s better. I was moved to an advanced-placement classroom. We had the best of the best teachers in public school. We had our first servings of the best books. We had teachers who expected more of us, and we did more because of that expectation.
Later, a high-school teacher during senior year, Mr. Greenspan, asked me where I was going to college. I mentioned some schools that were offering me volleyball scholarships. He looked at me in a disappointed way and said, “I think you can reach higher. Here is an application for Princeton.”
This was back in the days when the movie and the TV series Paper Chase were all that most of us kids could see of the Ivy League—a guy walking across the Harvard Law School courtyard in a tweed jacket. When I was accepted at Princeton, I thought, “Wow, I’m in Paper Chase.”
Q: You studied developmental genetics in college. But afterward you shifted to public health. What inspired that change of direction?
A: I ended up studying developmental genetics because of a tremendous professor, the Nobel Laureate Eric Wieschaus. I loved the joy that he exuded when he talked about this work. He was so animated talking about how a single cell becomes a fruit fly that I decided I wanted to be in his space. He gave me my own section of a bench and an experiment to work on—my own mutation.
Outside of the lab, I took full advantage of being a student in a beautiful liberal arts school. I studied Japanese literature in translation. I studied social history. I took film classes. But as a person from Queens Village, New York, I kept saying to myself, “How do I make myself relevant?”
I’m the first in my family to go to college—it didn’t feel right that I would pursue knowledge chiefly for knowledge’s sake. It was difficult trying to explain to someone how studying Drosophila genetics was going to help them. Not that I want to diminish basic developmental biology and genetics, but some of us come to school wanting to discover but also wanting to translate, because we feel obligated to share knowledge and solve problems right away. Actually, it took my coming to the Harvard Chan School— where I could see life scientists and population scientists working side by side addressing real-world problems in real time—to help me see this knowledge translation taking place. For this reason, I like to think of our School as a “University within a School.”
Public health gave me the vision and the vocabulary that I could take home to Queens Village and explain to my parents and to my neighbors exactly how I was going to use my education to benefit people’s lives.
Q: What is your vision for the Harvard Chan School?
A: First and foremost, to recognize that the School is in great shape because of the leadership from previous deans. Julio Frenk used to say his mantra is, “First, do no harm,” because this is a school that’s already in great shape. I want to continue to attract the best faculty, the best students, and the best staff possible and to enable them to reach new heights. But how we get to the new heights matters, right?
I want us to do it in a comfortable and sustainable way.
Q: No Paper Chase here?
A: No. Because of Paper Chase, I used to think that excellence meant that one had to put up with working and learning in an abrasive, hard, uncomfortable environment. But that’s not true. One can achieve excellence and still have joy and balance in one’s life. I would like to support an environment that allows our faculty, students, and staff to find that balance and to enjoy their work—even as we invest more intellectual resources in solving the world’s most formidable problems.
I’m doing a listening tour of students and postdocs, as well as faculty and staff. And I’m hearing from all of them about the stresses and strains and this impossible burden we place on ourselves. I might expect to hear about some of those stresses from our faculty and staff. But it breaks my heart when I hear it from our students, because they should have the time for intellectual growth, development, free-range thinking, and discovery.
Q: You have talked about wanting to cultivate an environment at the School where people can make risky decisions, do bold things, even at times fail. Why is that important?
A: It’s our obligation to take those risks, because we’re Harvard. We have unparalleled intellectual and physical resources; I see these as gifts that obligate us to learn more, do more to eliminate global disparities. We can work like heck to avoid failure. But the truth is, if we never fail, it means we’re really not trying hard enough.
Q: In what specific areas can Harvard singularly contribute to public health?
A: First, let me say that the public health field is a big tent, and it continues to grow as we address myriad complex problems. Those problems are emerging at an alarming speed. Just in the last few months, we’ve been confronted with undrinkable water in Flint, Michigan; the Zika virus; bacteria resistant to last-resort antibiotics. Unsettled debates continue to demand our expertise as well: the impact of the Affordable Care Act on people’s health and wellness, threats to food security, the benefits and risks of e-cigarettes, to name a few.
These emerging threats and persistent debates in public health require us to be deep and broad, nimble and steady, all at the same time. That capacity resides within our big tent here at the School.
Second, in order to prepare future public health leaders, we have to continue on our path of leadership in public health pedagogy. We are reimagining what doctoral educa- tion should look like. In creating the new DrPH, we have integrated advanced education in public health with mastery of skills in management, leadership, communications, and innovation. This integration, which students achieve through hands-on experience in the field, is helping trans- late public health science into the actual practice of public health—on a broad scale and in real time.
Another new effort of the School, the new PhD in Population Health Sciences, will be welcoming its first class of students this August. Providing full funding to our research doctoral students has been a goal of the School for several years, and I’m grateful to former dean Julio Frenk’s leadership for getting us to a point where we will offer full tuition and a stipend to all incoming research doctoral students.
Finally, we absolutely will continue to reach new heights as the leaders in public health research. We will continue to support basic research, because we can’t anticipate what all the problems will be. We couldn’t have anticipated that studying fruit fly genetics, for example, would help identify genes that are important in oncology. We will also support research in public health practice, because we’re obligated to move new knowledge into the field and into communities where we can make a difference in people’s lives.
Q: You have also emphasized mentoring. Some faculty members are natural mentors; others may not be.
A: I think all faculty members have the potential to be exquisite mentors, and we have a high density of really amazing mentors here. What we also have, though, is a financial climate where our faculty are largely dependent on grant funding. As the funding support from the National Institutes of Health erodes, that puts more pressure on our faculty, and they run the risk of not being able to spend as much time preparing themselves to be outstanding teachers and mentors.
Part of the solution is placing greater emphasis on quality teaching in both how our faculty are paid and how and if they are promoted. The faculty and Julio Frenk did a fair bit of work on better aligning these incentives over the last few years, but we need to do even more. We need to remember that we are an educational institution and that our mission involves providing the highest-possible quality academic educational experience for our students. It means that faculty have to be well supported to do that work. And it means our alumni, donors, and friends will be called upon to support our being faithful and true to the mission.
We are a research-teaching institution. We are not an institute of research. My mandate is to continue to make this the best research-teaching institution for public health.
Q: The School has not always been attentive to our neighbors in Mission Hill. How do you plan to reach out to the community?
A: One of the best things that I’ve seen happen in this School is our reorientation over the last two years to embrace community engagement in a genuine, sincere, and systematic way. When Meredith Rosenthal became associate dean for diversity, I saw a significant pivot toward making this a priority for the School. It came about because of pressures from our student body.
We’ve hired staff and empowered them to reconnect with members of the Mission Hill and the Roxbury communities. When I was a student here a long time ago, the School was built in a way where the back of Kresge faced the street—it was a fortress mentality. That did not go unnoticed. As a school, we remedied that with the gift that allowed us to build FXB, and now we have a front door on Huntington Avenue. And we have a dean who is committed to reaching out.
Several months ago, I went on a walking tour of Mission Hill with State Representative Jeffrey Sánchez and then-Acting Dean David Hunter. I learned that the School used to host an annual community event called the Mission Hill Senior Dinner. It was a formal dinner held in Kresge cafeteria in which the staff served our guests. We stopped doing it during the financial crisis several years ago. In reconnecting with the community, we asked people, “What should we do?” The first thing they said was, “Bring back the Senior Dinner.” And we will, next year.
In Mission Hill, we are also involved in what’s called the Sneaker Project. At the Tobin Community Center, one of our DrPH students, Nazmim Bhuiya, is helping seniors find appropriate shoes for activities such as walking or fitness classes—so that they don’t wear winter boots or other uncomfortable footwear while exercising. Properly fitting shoes are an invitation to healthy physical activity. We can and will do much more with our neighbors in Mission Hill.
Q: How does your emphasis on service learning tie into these community efforts?
A: We cannot be hermetically sealed from the communities around us. We are public health educators, scholars, and students who came to the School to leverage our talents in ways to improve people’s health. For example, our quantitative scientists seek to develop methods and apply those methods with the objective of addressing real problems. They’re not locked away in ivory towers, oblivious to how their work affects actual human beings. I’d like our students in research degree programs and in practice degree programs to work together in what is called “service learning.” This is when students work on real-world problems in the community while they’re in training—because that’s their reality when they graduate and enter the workplace.
For example, if students are interested in health literacy, we have an after- school tutoring program at the Roxbury Prep School. If students are interested in health and wellness programs, and in understanding nonfinancial barriers to accessing interventions, we have a community that could potentially partner with us.
It’s said that a third of people with hypertension are undiagnosed, and a third of those who are diagnosed are untreated. If we want to be public health professionals who actually have an impact, then maybe the School can organize an education drive in our community that specifically addresses the problem of untreated hypertension and undiagnosed hypertension.
It’s one of my fantasies that we could build into our practice training a partnership with the Harvard Medical School’s Family Van, so that we have medical students and public health students working together to bring primary health care and health promotion and disease prevention services to Boston communities. Wouldn’t that be fun?
Q: If the students with whom you spoke on your listening tour reported lots of stress, might it be because their original impulse toward service had been thwarted?
A: You hit the nail on the head. What I heard from students is that the thing that brought them to public health is what brought me to public health: a desire to be relevant, to have a positive and lasting impact on the health of large groups of people. But often the balance between methodological training and opportunities to participate in field work—that is, to actually engage in public health practice—is not there. What compelled them to come to public health in the first place—the inspiration that lit up their soul—is the very thing they have to suppress or defer until after graduation. I think our expanded investment in service learning is a way to offset that.
Q: You have said that you don’t have a particular leadership style. Still, what do you think makes a great public health leader?
A: I did say that I don’t have a leadership style, but I’ve been interrogating myself about that. For me, style is not as important as the purpose for taking on a leadership role. For me, the purpose is service.
Q: You’re the first woman to lead this institution and you’re a person of color. There’s been much talk in the past couple of years about the need to introduce greater diversity in the faculty and the student body. How do you plan to increase diversity? And will your own personal story help change that?
A: My own personal story will help start the conversation. But it won’t be enough to change it. Diversity is critically important on several levels. One is social justice. We have had a long history of populations not having access to quality education across the pipeline, and we have used the small pipeline of minority students studying topics like science and math as an excuse for not seeing them in graduate school or in leadership roles in public and private sectors.
We can’t address the problems by ourselves. Our partners in K–12 schools have to work with us and we with them. In the spring before this year’s graduation period, our Office of Diversity and Inclusion and its student ambassadors held a session where they brought kids from middle school and high schools onto the campus. I was heartened by the fact that our students recognize that you have to reach down way at the other end of the pipeline and start to introduce to middle school kids the idea of “What is public health?” Bring them to the Harvard T.H. Chan School of Public Health, give them a Harvard ID, have them hang out in the cafeteria and listen to talks from faculty like Meredith Rosenthal and David Williams and Nancy Krieger.
Closer to home, we need an admissions procedure and a commitment to student support that means not just getting the numbers right, but also creating a climate that is welcoming and enabling of individuals from all walks of life, domestic and international, to reach their maximum academic potential.
The key thing that will make all this work—the early pipeline, processes and procedures, and the climate—is that they’re not sequential activities. They all have to happen simultaneously. We have to have a faculty that looks like the students we want to serve. I’ve heard throughout my career that increasing numbers of underrepresented minorities in a school’s student population is inextricably coupled with the diversity of that school’s faculty. They are interconnected. It’s a feed-forward, feed-back loop.
Q: Public health has always been underappreciated and underfunded. How will you leverage your new position as dean to overcome that attitude?
A: I like to say that public health is everywhere and nowhere. No one worries about clean water; it’s something that we expect and may have even taken for granted here in the U.S. and is therefore invisible and overlooked—until there’s a lead-contamination crisis in Flint, Michigan.
So we have to change our messaging. Public health is everywhere. It touches everything, including national security and economic development. I’d like to reframe public health in a way that says, when the right things are in place to enhance life and enable development, “Brought to you by public health!”