Creating Lasting Change as a Public Health Attorney by Sean

Creating Lasting Change as a Public Health Attorney by Sean - June 2020 Scholarship Essay

The lively, sometimes chaotic, atmosphere of a specialty clinic in inner city Baltimore can be overwhelming. There is often a shortage of private spaces and an abundance of background chatter from boisterous patients, which can make moments of silence rare and intense. Of these powerful and infrequent moments, one remains prominent in my mind, if not the most influential. It was the first research rapid test that unexpectedly came back positive for Hepatitis C.

As I entered the room after a seemingly routine start to a study visit, I was immediately struck by the stillness of the space, broken only by the sharp inhale of erratic snivels. Within our research about people who inject drugs, Hepatitis C test results are commonly perceived as formalities due to the endemic nature of the virus within this marginalized community. At the start of this visit, however, this participant had emphatically assured a negative diagnosis, making the results all the more tragic. The sunken, hallow face that I had introduced to the Hepatitis C rapid test counselor had reddened and filled with tears. The somber, desperate pleading of a different result remains emblazoned in my memory. I left the room with a feeling of helplessness, with a futile wish to reverse a diagnosis.

I was shaken by the experience, but somewhat consoled that this participant was linked into high-quality care within the clinic. Although that moment remains upsetting today, it was this opportunity to support people who were disparately affected by Hepatitis C that drew me into my current position.

For a similar reason, I was pulled into studying public health at Ohio State University. I was motivated to work closely with ostracized communities that were too often ignored by society and most negatively affected by public health disparities. At the core of the curriculum was an understanding that broad institutions shape public health, emphasizing the importance of evidence-based policymaking.

I graduated with a strong appreciation for the principles of public health and possessed valuable skills from my experiences outside the classroom, but remained unsure of the specific way I would fit into the field. I was confident that I wanted to improve public health; yet, my lack of a clear avenue to pursue limited my ability to significantly accomplish this goal. In my experience, this clarity came from reflecting on the poignant moments that defined my research work with marginalized communities.

As I finalized the study paperwork from the impactful visit earlier in the day, I contemplated the diagnosis and the helpless feeling it provoked within me. Testing is commonly viewed as a culmination of individual health behaviors, the climax to a series of risky health decisions that expose people to disease. But my education and experience pushed me to look at the diagnosis in a different manner, examining the upstream origins of this infection. I was motivated to explore the policies that had failed to keep this participant Hepatitis C negative and to examine my role in shaping these policies.

More recently, I have spent time investigating these upstream policy factors, including the burdensome prescribing requirements for the treatment of substance use disorders. Despite these therapies having demonstrated effectiveness in treating substance use disorders and subsequently lowering the risk of infections, the regulations surrounding their prescription are more restrictive than the opioids themselves. Above all, it has become apparent there is a surplus of policy-level solutions, but a lack of concrete plans and examples of enacting them.

In reflecting on my career path, the thread of public policy was seemingly woven in each of my experiences, though it may not have been apparent at the time. I worked in a legislative office to gain an understanding of the policymaking process. But I have also provided health education to people who are poorly equipped to protect themselves because of ill-informed health education policy. In working closely with people with substance use disorders, I have particularly seen the lasting damage caused by punitive drug policy and restrictive healthcare policies.

I am applying to law school to be a public health attorney. We need health policies that acknowledge and incorporate evidence-based health principles and protect population health; but importantly, we need skilled attorneys who will enable this. In my future work, I intend to assist nonprofit organizations in advancing policy changes within government bodies and healthcare companies; collaborate with local governments on solutions to issues affecting their communities; and research and respond to the creation of problematic laws that harm health. Above all, I hope to be an advocate for communities most affected by poorly developed public policy and fight for their health, whether it is in the courtroom, boardroom, or legislative chamber.

When policies are constructed without recognizing the importance of promoting and protecting health, the most vulnerable people suffer the harshest consequences. Too often, the high-quality findings of public health research remain isolated within ivory towers. But, there are abundant and promising opportunities to integrate evidence-based research into practice. With my law school education, I am confident that as a public health attorney I can capitalize on these opportunities and contribute to improving population health.