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Becker’s Healthcare Podcast
Building the Future of Public Health at UC Irvine with Dr. Bernadette Boden-Albala
00:27:13
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- [00:00]
A
This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined by a brilliant leader, really remarkable. We're joined today by Bernadette Bowden Abala. And Bernadette is the founding dean of the UC Irvine Josie Wen School of Population and Public Health. So we're going to talk about that in how this came to be. And for people that are not following UC Irvine, they have done an incredible job over the last decade or so becoming just an absolutely first class health system and a first class innovation engine as well. Tremendous leadership at UC Irvine. Bernadette, can you take a moment and introduce yourself and tell us about the school of Population and Public Health?
- [00:46]
B
Sure, Scott. Well, it's really a pleasure to be talking with you today. So I'm Bernadette Bowdoin Alballa and I have a doctorate in public health. And, and as Scott, as you said, I'm the founding dean of the New Josie Wen School of Population and Public Health. I came I'm a New Yorker, so you can hear it in my accent. Came to California in 2019, brought on by the University of California to really build this important school focused on population and public health. And there's about 215 schools and programs of public health in the country and they're still growing. Real goal at UC Irvine was to bring in public health to complement this College of Health Sciences mission, to try to be very integrative when we think of health and health systems. So we have a medical school, we have a nursing school, we have a pharmacy school, and now we have a school of public health. And so I came in, we have an undergraduate program in public health. We which is very unique, but trending upward because really it's important that students understand public health, really the foundation of health. When we think about health care, we often think about health as part of a hospital or clinic situation, as opposed to health being part of everything you do from the day you're born to the day you die. And so public health is really that foundation so tasked with building the school to nurture a large undercurrent. We have 1500 undergraduates in public health right now. And then the Master's of Public health is our professional degree. There are folks that come and run programs throughout the country, really and throughout the world. And then we have a doctorate in public health. And so we're doing a lot of workforce development, health care training. Some of our students will take that and go right out into communities to do work to try to optimize health and well Being others will use this as a framework and foundation for doing great things in areas like law and clinical medicine, nursing, pharmacy, occupational therapy, teaching, politics. And so we are strong with almost 100 faculty members, as I said, 1500 undergraduates, a couple of hundred masters in public health students, and a strong 100 plus doctoral students. So that's who we are. And the most important thing, Scott, I would say, is that we're serving our community. We're partnering with the community, the large, diverse community of Orange County. And as we're training our students, we're training them to address the needs of the health care needs in Orange County.
- [03:48]
A
When you think about public health and population health.
- [03:51]
B
Yeah.
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A
Where does your mind go to in terms of the core of public health and population health? How do you think about that? Is it global health care, more prevention? Is it vaccines? Is it socioeconomic? How do you sort of look at an approach, you know, public health and population health?
- [04:14]
B
Yeah, no, that's a great question. I mean, I think about it as, number one, prevention. How can we optimize the health and well being of our communities? And so then you start thinking about how can we leverage the really important components of these communities. Right. What do they have? What resources do they have? And resources don't just have to be money. They can be incredibly strong networks, they can be geography. There's beautiful green space to walk. How can we leverage that? And so prevention to me comes first. The truth is we're all going to get sick. It's just unfortunately one of those things in life. But even if we find ourselves sick, whether it's the flu or whether it's hypertension, we want to be as healthy as we can as we find ourselves sick so that we can prevent something worse. And so I really think about how to optimize environments, how to work with communities towards prevention, number one. And I would say, Scott, you mentioned global, something that we're doing a lot of work in and really focusing to some extent on that. But global is local and I know that's a cliche, but it really is. Global is local and local is global. And we can learn from folks around the world, communities who have had less resources, whose health in certain areas is actually better than ours. And so we have to know what's going on. We have to use other folks as models to do the very best prevention type work that we can do.
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A
When you think about the great public health successes, you think about the project for AIDS in Africa, you think about vaccines, you think about polio and Dr. Salk what else comes to mind when you think about some of the great, great wins? I mean, the tracking of disease done by the cdc. What are some of the things that you. Obviously the MMR vaccines, you know, and the evolving vaccines. When you think about public health, what do you think are some of the great victories and some of the greatest challenges ahead of us?
- [06:32]
B
Oh, that's a great question. So biggest victory ever in public health sanitation, that people had clean places to go to the bathroom. That's probably still the biggest public health thing that we can do in there. So that's a change of environment, right? We literally build bathrooms in the United States. And it's interesting, I've been to other places globally where a bathroom in your house is actually not required to sign off on a certificate of occupancy. And so here in the United States, sanitation was really one of the biggest victories. Clearly, vaccines within the framework of prevention, you know, are really critically important. I think a lot of work around cardiovascular disease, around people understanding they need to take their blood pressure, they need to understand that heart disease is a problem for everyone, not just for men. Those were actually very, very big victories and expanding healthcare systems so that people were able to get the kind of treatments that they needed when they needed them. The focus on, you know, I don't know how much you know about this, but sort of comprehensive, comprehensive centers, comprehensive centers to treat stroke, to treat, to heart disease, to, to treat cancer. The, the notion that, that these diseases are not just, you know, one pill or one surgery and you're done, but that it really is about the whole environment, the whole lifestyle. I think that those are really important things that we've done in the last 50, 60 years. And those are really public health things because they're comprehensive. I think our biggest challenges are around how to deal with movements that are anti science, anti evidence, not understanding the scientific process and really, Scott, not being able to adequately translate results of evidence based studies out into communities. So the communities understand that we do evaluate evidence and this is the evidence that we have to, you know, that we really need to work with. And so, you know, in terms of training, I think these are things that we need to do better at in public health. Communication, communication, communication about the science that we do.
- [09:17]
A
Thank you. No, and I love that. And talk a bit about when you look at this next year, what are you most focused on? What are you most excited about? And let me ask you one real question before that. When something like the hantavirus, this thing on the cruise ship arises, like it did this. This week?
- [09:34]
B
Yes.
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A
Does that sound. Does that send a pulse of energy? Does that enliven the whole public health program where people start to think about, oh, my God, we got to start figuring out another crisis. How does that. What does that. What does that mean at an institute of public health and community health.
- [09:47]
B
Yeah, Great question. I knew you were going to ask it. You know, I have to say a couple of things. One, not a surprise to all of us, folks who did and who have been doing public health, not a surprise. You know, there's always going to be emerging infectious diseases. They're just going to happen. The important surveillance system that's really been kneecapped on a global sc. That was designed not just to say, oh, you know, we. We think that there's this new virus, or we think that something is emerging, we don't understand it, but also to, you know, to model out, you know, what happens when we're really a global world and everybody's traveling and bird watching, you know, and on these little islands that no one really knows too much about. And then, then this whole surveillance system taking it to the step. Okay, so we're gonna. There's gonna be more of these expeditions. Everybody wants to do it. So how do we think about what are the strategies we use to reduce things like exposure to hantavirus? And so I'm saddened when I hear about hantavirus because I think that we could be doing better. We have the technology. We have AI, for example. Fabulous. AI should help us together with people to really deal with issues like hantavirus and to absolutely stop it dead in its tracks, to prevent it. But our system obviously is broken. And, and, and also, you know, it's. It's really not thought of in a positive light right now. So. So, yeah, I mean, I want to do everything I can. There's so many. I mean, we had. We've had what, cow pox. We've had monkeypox, I should say. We. We've had influenza. We had measles in Orange county again and again. I mean, yeah, this is it. It's why I do public health. Right. But it's also. We should also not be in this place where we're encountering these things. In 2013, 1213, I was in. I was at NYU. We were working with UNICEF and the UN and we were really trying to eradicate polio. Scott, you remember when we use the word eradicate, we. We don't use that word anymore. And we had gotten so close, so close. We knew the number of Polio cases really in, in the world. And we, we were so close to, to working with families and communities to just, you know, increase uptake of polio vaccine and then conflict and war and everything else that followed Ebola. And we're no longer anywhere near eradicating polio. So it's bittersweet, Scott, really, it's bittersweet.
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A
100%. Where are you sort of like in building the school, the school population, the school of public health. What excites you most about that? I mean, what a fantastic undertaking.
- [12:57]
B
It is great. Well, what excites me is to be building something now at a time when there's all of these challenges. But it lets you think about the opportunities that I have that we have here at WEN Public Health, to really be flexible, to really go out and do things that others can't do anymore because they're siloed in their institutions that are 150 plus years old. And so we are making sure that our students can communicate. So I, when I started, I said, I want every student here to be able to defend climate change because climate change and health are critically important and are associated, but to defend climate change. You'll love this, Scott, at the Thanksgiving table, right? You know, Aunt Mary, do you really believe in that climate change? Our students have to be able to defend the science that they're trying to move forward. And so that's one thing that we're doing. We're doing a lot of great work with having them feel comfortable being able to do that. Our students need to be able to get in and use large data to help us. Large data. I mean, we've amassed so much data in the world around public health now we have to be able to use that data, optimize it so that we can get out there. And so our communities are healthier. And so we're working, we're really working a lot on that. We're talking about working on preventive care with our communities. Not just sitting in our offices designing things that we think will work, but really getting out there listening to and talking with all different communities and saying, do you think that this is going to work? What do you think this is what we need to do? How can we do this together? And so those are the kind of things. And yeah, we have had pushback. You know, the federal landscape of funding has changed, so we have to be more flexible. And I think that's what you have to be in public health. And so I'm excited that despite all the challenges, we get to be able to tackle them in a very, very dynamic, flexible, and sort of engaged way.
- [15:05]
A
Let me ask you maybe the most important question, Bernadette. You've got this tremendous energy, tremendous intelligence and focus, and that itself seems to me a huge part of success or achievement in anything that somebody does. How do you keep yourself motivated and focused and engaged over a really effective, successful career? Because I think that passion shines through. It's so important because you don't have that energy and excitement about something. It's hard to do almost anything great. But talk about how do you maintain that and cultivate that, you know?
- [15:40]
B
Well, I mean, so I'm a public health person, so I'm going to tell you, I actually do try to do things like personally mindfulness and wellness. I swim five days a week. I train, because there's just a lot out there. For every positive thing I think we can do, there's the challenges that we. I think the challenges. And sometimes that just gets in your head, you know, Scott. And so you just need to have a space, a place to work it, to work all of the issues through your challenges in life and then get back and be refreshed. So I think that everybody should. Whatever it is, yoga or walking or sitting, whatever, people just need to clear their mind. But the other thing I think, for me that's been so exciting is what working with communities and, you know, listening to people who really have much have. Have really hard lives, and that, you know, there's something that you can do with them to change that. Working with students also who have. Who have encountered tremendous barriers and challenges. You know, the thing that. That I'm so excited about is that even though we're in a terrible time for public health in this country right now, it's not, you know, the biggest supported out there. As you know, Scott, more students than ever are applying to do public health. And so that's just incredibly heartwarming to me. And so I'm excited that they're excited and that continues with this passion. At a time like this, you have to have passion, right? Because if you don't have passion, you'll be defeated. We're really excited about things like women's health, which I think if you looked at women's health and funding and not funding in the last. Last year, it's been a very much of a rocky road. But we even decided here at WEN Public Health to take it on. We're building this comprehensive women's health center. And I don't just mean great treatment, which is important. I mean, Soup to nuts. Somebody tells me you have breast cancer or you have, I don't know, diverticulitis, whatever, and you don't know where to go, right? Or, you know, you're, you're a young woman and you're pregnant and you have hypertension. Not preeclampsia, just hypertension. You know, I don't think you know that your risk for having heart disease or stroke later on is high. And so where do you go? Who do you talk to? And so thinking about women's health, because women's health becomes key for everything else that we do. I'm very excited about this because women we know historically are the folks that keep their families healthy. So if we keep women healthy, we keep the kids healthy, we keep the husbands healthy, we keep the families and our communities healthy. So having these, having these things, Scott, to really focus in on, to try to, for me, raise money, to really think about creating infrastructure, that's what passion is all about.
- [18:47]
A
Thank you, Nolan. And I absolutely love that. Take a moment. I'm going to ask you one more question and it may be the most personal and important question of the day, at least from my perspective. Okay, now bear with me on this. So you are Columbia graduate, Columbia University of New York, one of the great schools in the country, one of the great places in the nation. Also spent several years there, if I have this correct right, at Columbia. So my commonality is I have a daughter who's in grad school at Columbia. I'll be in a different program. So the most important question of the day, which is very shallow and very provincial, is what advice do I give my 27 year old Columbia daughter who's at Columbia in the grad program now about having a great meaningful career.
- [19:31]
B
Oh my goodness, I love Columbia. Shout out to Columbia University. They are just the most fabulous institution, really. So what advice? Okay. To get. So study hard, okay. Be the very best that you can, but at the same time work very hard to cultivate networks of people, people that you respect, people whose work you're passionate about, people who support you and you support friends. Right? Because the network, Scott, become critically important as you advance your career. Right. Somebody knows somebody else. I'm going to give them a call. Maybe they can help. Hey, there's a community. There's. And it doesn't even have to be in the same area. So that, that's the first thing. Study hard. Anything. What? Scott, can you tell me what her, what her area is?
- [20:23]
A
Yes, she's in international affairs right now. Bernadette, just so you're aware I'm taking notes and sending them to her. Do great in school. Study hard. Really cultivate your network. I've got two so far, but this is great. Keep on going.
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B
Yeah, really, really, really cultivate your network. And anything that you're passionate about, dive deep. Really try to understand it. Don't be afraid to lean into conversations. Go to the meetings for international finance. International affairs.
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A
International affairs. Master in International Affairs.
- [20:58]
B
Okay, well, I'm going to say it. Travel, travel, travel. And that's what I did. Travel, travel, travel all around the world. Right. So I have really great perspective. What we do well here, what we don't do well here. Oh, she's so lucky. International affairs. That's so fantastic. And then don't be afraid. When an opportunity comes, you know, it's really. Life's about no regrets, right? So take. Take the plunge. Take the jump. If she's passionate. If she's passionate about it, that's what she has to do. And the same thing, if you're not passionate about something, then just don't do it. Just move to things that you really want to do. I'll give you one example. When I was at Columbia, early on, all of my work was with the community, and I was doing work in stroke and cardiovascular disease. Early on, nobody did community engagement. And I did. And I was asked to lead a big community engagement project at Columbia University. And everybody said to me, don't everybody? My mentors, my peers, don't do it. Don't do it, because tenure is what it's all about, and that's the most important thing. And I said, no, no. I really think the most important thing is working with community to try to decrease cardiovascular disease and stroke. And, you know, so I'm a little bit of a dreamer, a little bit naive, but they said, but then you might not get tenure. And I said, that doesn't make sense. If you do the right things, you should be able to get tenure at the same time. And so I did work really hard. And obviously that decision led to everything I did in terms of academic leadership and administration going forward. That led me to go to Alaska and work with tribal nations, to go to Grenada, to go to Moldova, to do work in Africa, all of that, because I learned about how to partner and really listen to communities, all about health. And as far as my academic career, I'm a dean, so I think I did okay. And so there was the. There was this moment, right? And she's going to have this pivotal moment when people are going to say, I don't know if that's a good way, but in her heart she's going to say, but this is really what I. What I want to do. And Scott, even though you may close your ears on this because you're her dad, let her do what she wants to do, because that's where the passion comes from. And if you don't have passion, then what's it about?
- [23:27]
A
So I love that. And I'm going to summarize, and I'm only going to edit one bit because I don't want to hear part of this, but I'm going to summarize almost all of it, almost verbatim. Do great in school. Study hard. Really cultivate your network. Lifelong connections and relationships. Three, dive deeply into things that you're really interested in. And I'll add on to that. Cultivate your passions. Dive deep into your passions. Take on opportunities. Fourth is where I'm going to edit because she does too much of this. Travel, travel, travel. But I think that the dean means travel only to safer places than you've been traveling the last several years. That's her father's edit, which is, we don't need to be in the most dangerous places in the world. Travel is great, but we could avoid the most dangerous places in the world. And that comes right from the dean, Chloe. Not for me. Don't be afraid to take an opportunity to do the right things. Don't go for the resume. Go for what is great to do and what you think is really needed. And finally, six, and I agree with that wholeheartedly, is follow your heart, follow your passion, cultivate your passions. Because if you don't do that, you got nothing.
- [24:27]
B
That's exactly right. That's perfect, Scott. I would just add one other thing, which probably I should have added at the very beginning, which is always listen to what people are saying and hear them. So there you go, though, Scott. You've got everything else.
- [24:41]
A
Thank you. What I heard there is always listen to people and travel to safe places.
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B
Yeah.
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A
Love you, daughter.
- [24:48]
B
You know, Scott, we could go on. I. I've got some stories that, you know, my mother, who I don't even know if she knew her geography, would like, call me. I would be in the middle of Africa with students, and she'd say, you know, there's a. There's a. There's some hostile movement going on in the country next to you. And I'd say, mom, how do you even know where I am? She's like, I'm tracking you.
- [25:11]
A
No, no, I can't even tell you. We'd have my. My. You know, the State Department does things in level 1, 2, 3, 4. And every time she goes to level 4 area, my mother, her grandmother, is like. It's like, you know, it's a level four area. I'm like, I. I know, Mom. There's only so much I could tell my daughter, who's 27, about where and where she should go to and stuff like that. But it is what it is. She's done remarkably well. We are so proud of her. So it is what it is.
- [25:38]
B
No, no, that is great. My daughter worked for the World Food Program. My daughter Sarah, who lives in London and is finishing her PhD from London School Hygiene Tropical Medicine now. So she spent a year in Tanzania with the World Food Program. And she. And I was, like, devastated, Right. Even though I had taken her everywhere in the world, it was that she was going to be there alone. I mean, you know, I think, you know. And so she says to me after, like, five days, because it was World Food is. Is part of the un and she calls me up, you know, we had a. We had a time on WhatsApp. And she's like, well, here's the good news. If I get carjacked, I know exactly what to say and do because we've been trained. And I thought. I'm not really sure I needed to hear any of that. But anyway, so, Scott, I gotcha. I know.
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A
No, I love that story, though. Like, you know, the good news is, if we get carjacked, I know what to do. Well, the bad news is don't get carjacked, you know.
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B
Well, that's exactly right. That's exactly right. Yes, yes. And I. Yes.
- [26:40]
A
So, Bernadette, I loved getting a chance to talk with you. The work you're doing at UCI Health and the work that UCI is doing is just remarkable. We're huge fans of what the whole system is doing. Just phenomenal. Huge fans of Tatiana and Chad and the whole group there. Amazing leadership team.
- [26:56]
B
Fabulous. Oh, yeah.
- [26:58]
A
Thank you so much for visiting. And I loved everything you said about advice for my daughter, other than the travel. Every place. She's done too much.
- [27:04]
B
No, I'm just kidding.
- [27:05]
A
It's a pleasure. Thank you so much. And, Chanel, thank you very much. Our producer. Thank you.
- [27:09]
B
Take care. Thank you. Bye. Bye.