California Gold

I seem to be on a media kick with my blog posts lately. Here is another such post!

I have noticed on my Bart rides home that there is a new ad campaign in Berkeley encouraging residents to use their "green bins" to recycle food scraps, as well as soiled paper/cardboard. These can then be composted to enrich the soil, aka "California gold."

Image source: http://www.readysetrecycle.org

Did you know that California produces about half of the nation's fruits and vegetables in our central valley region? For some items, such as artichokes and walnuts, it is as much as 99%! That's why we care about soil.

The ads are produced by Ready Set Recycle, a campaign in Alameda County to help people learn how to properly sort their refuse. They even offer prizes, like gift cards, gardening compost, and fresh  food boxes from local farmers, for engaging in certain activities that support learning to recycle.

Image source: http://www.readysetrecycle.org

One tricky thing is that businesses in Alameda County can contract with private recycling companies, which may not follow the same rules as the curbside program. For example, where I work, a Starbucks coffee cup can be composted (green bin) and the lid can be recycled (blue bin). In other places, the lid may not be recyclable and would go to landfill.

So what does recycling and composting have to do with public health?

As it turns out, the environment affects our health! Things we do to and for the environment can have lasting impacts on our health. For example, according to the EPA, recycling can play a role in reducing GHC emissions, which are associated with chronic illnesses like asthma. For more information on waste disposal and public health, see here, here, and here.

Image source: http://www.readysetrecycle.org

Does your town, county, or region offer large scale composting? How has it changed your thoughts about waste or the environment?

Smoking Policies

For whatever reason, smoking has been the topic of many conversations, viral videos, and policies popping up in my life lately, and I wanted to share some of the interesting things that have been coming up. Feel free to leave a comment letting me know what you think about any or all of these issues!

Berkeley Campus Smoking Ban

U.C. Berkeley recently became a smoke-free campus, meaning that you have to physically leave campus to smoke a cigarette. My prior workplace implemented a similar policy during my first year there, while at the same time offering increased smoking cessation support. As an asthmatic with lots of allergies who does not smoke, I personally feel in favor of the ban. Cigarette smoke has often been a trigger for me. 

At the same time, I know that some of my peers have expressed "feeling judged" by the campus administration and fellow students. Whether you believe this judgment is ultimately a bad thing or not, they obviously perceive it as injurious in some way. Having never been a smoker, I cannot say that I personally know how hard it is to quit. Based on what I do understand, however, it seems that for many people, the relaxation associated with smoking, the reflexive association of cigarettes with certain experiences, the reduced appetite that makes weight management easier for some smokers, and especially the addictive power of nicotine, make it difficult for many to stop. In my prior work place, the smoking ban did serve as an added motivation for some people who were on the verge of deciding to quit, and I heard many stories of people who had made the change through smoking cessation programs shortly after the ban went into effect. On the flip side, I also recall that as a result of that smoking ban, instead of smoking in front of our building, many people simply crossed the street and smoked in front of other businesses, thus exposing other employees and customers to more second hand smoke. And since our company no longer provided ash trays on site, many people threw their cigarette butts in the street outside of said other businesses. Suffice it to say, we received some complaints. I am not sure if this will be the case near our campus or not. It seems that only time will tell. All in all, I appreciate and support the policy, but I recognize that for some, it remains controversial.

City of Berkeley Residential Smoking Bans

Then there have been even more controversial smoking bans, such as the City of Berkeley's law against smoking in apartments or condos, where neighbors may presumably suffer the effects of second hand smoke. And more recently, there is a more restrictive proposal on the table to ban smoking inside single family homes where children, seniors, or lodgers are present. (I'm not sure what the law says about seniors who are smokers.) When I first learned of the latest proposal, I felt outraged at the heavy-handedness and immediately concluded it was going too far. But after sitting on it for a couple months, I cannot help but wonder why I jump to so adamantly defend the "right" to expose others to potent known toxins, including allowing a person to expose their kids, just because they are their kids. We do have plenty of laws in place mandating that you send your kids to school, seek medical care when your child has a serious illness, and do not abuse your child, so it is not as if our society as a whole believes parents can simply raise their kids in literally any fashion. While these cigarette laws are certainly paternalistic, I believe there is room for debate about where we draw the line between necessary paternalism and going too far, especially when it comes to exposing kids to things we know to be poisonous carcinogens. Right now, I find myself in the void on this particular issue and still trying to make up my mind.

Hiring Practices

Also related to the topic of smoking, I recently had a conversation about employers who do not hire smokers at all (e.g. Cleveland Clinic). On the one hand, I always found it hypocritical for healthcare professionals to smoke while telling their patients to quit. On the other hand, as a general hiring policy, one could argue that this is discriminatory, especially as we were discussing whether this standard might be applied to other fields not directly related to health. The other people with whom I was discussing the policy emphasized that smoking is a choice, unlike many other personal characteristics that should not be used as reasons for not hiring. I am personally not swayed to their side and will cautiously say that I still see this policy as discriminatory. However, I was clearly in the minority in the discussion I was having, and I am open to having my opinion changed by a compelling argument in future.

CVS to Stop Selling Cigarettes

CVS Caremark recently announced that it will stop selling cigarettes in retail locations by October 14. The CEO stated, "The sale of tobacco products is inconsistent with our purpose." (See this article on the CVS site.) As pharmacies are playing a greater role in not only dispensing drugs, but also providing a certain level of patient care (such as walk-in clinic sites), it seems to be even more off-mission to continue to sell a product known to cause so many illnesses and deaths. CVS Caremark specifically is branding itself as a "pharmacy innovation company" that is "working to make health care better." According to their website, they also aim to exercise ethics, abide by principles of corporate social responsibility, and influence health policy. With regards to this latest decision, I have to say that I am impressed at their willingness to lose a portion of their revenue to maintain integrity. Bold move, CVS Caremark. Bold move!


In my next post, I plan to share about some interesting anti-smoking commercials, both old and new. In the meantime, what do you think about the above policies? Which ones are good ideas and which ones go too far?

Berkeley Application Essay #2: Statement of Purpose

Yesterday, I posted my first application essay for the Berkeley Masters of Public Health program in Health and Social Behavior. Today, I want to post the second essay, which is the longer of the two and is called the "Statement of Purpose." I hope that these two essays can give you a sense of where I hope to go in the future and may even inspire you to pursue your own passions and dreams. The prompt for this application essay was as follows:

Your Statement of Purpose should explain what has brought you to pursue graduate training in Public Health. It should also explain your eventual career goals and why you need a degree in your specific program. It may also explain why you are pursuing this degree now, and why at Berkeley. Please be sure to check your program’s page, as some programs have specific prompts they like you to follow. If a prompt is not listed, please follow these guidelines.

My specific program in Health and Social Behavior also added the following:

[We are looking for a] Statement of Purpose that explains why the applicant is interested in HSB versus other areas, and how this program would build on prior experiences (if applicable) and contribute to his or her career goals. 1500 Word Limit.

In reality, I am not 100% certain what I want to do in future, although I hope that it will have something to do with serving people or communities who have been treated with or have otherwise lived with a sense of indignity due to circumstances related to health concerns. However, to write a compelling and concise essay, I felt that I had to focus on one potential career path that I found particularly interesting, so I chose to focus on  mental health as a result of traumatic events. In large part, this was an issue that was on my heart at the time, and I think it is highly likely that my career will take me in this direction in actuality. However, as I enter my two years at Berkeley, I am also very open to learning about other aspects of human health and wellness, and I have open hands for any calling that comes through this learning.

I also want to give a special thanks to the loved ones who read my essays, highlighting the strengths and commenting on areas for improvement, all of whom really helped me hone in on exactly what I wanted and needed to say: my husband Matthew (probably the most prolific reader of my essays), my parents, my in-laws, and especially my dear friend Christine, who helped me see which areas could be cut out and which ones needed to be elaborated, resulting in a work reflecting my own heart and interests in a much better way.

One last note: I had to remove portions of one sentence and alter a couple of other sentences below for the blog-version of this essay, in order to protect the privacy of programs and people mentioned. I included certain details about my experiences in the original essay to highlight my background and exposure to various health topics, but did not reveal personal details about the identities of those involved. However, in this version, I would like to provide further protection for those programs and individuals, since this is a public forum.

So anyway, here it is:

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Statement of Purpose: Trauma and Mental Health Justice

Throughout my life, I have had three core parts of my identity that I have actively incorporated into my activities and choices: (1) an intense enjoyment of mathematics and analytical thinking; (2) a love of creative expression; and (3) a profound desire for justice in the world. These aspects of my nature have often come into conflict, vying for my time and attention. After considering how these characteristics might cease competing and instead work together to make me a more effective agent of change, I am confident that attending Berkeley’s prestigious School of Public Health will enable me to harness my wide-ranging experiences and thrive in the promotion of health justice.

During my undergraduate career at Duke University, each of the facets of my identity was manifest in a different area of my life. When I was selecting a major, for example, I had difficulty choosing between the formidable analytical challenge of mathematics and the creative outlet of English. Ultimately, I decided to major in mathematics and minor in English, mirroring the diversity of experience I have intentionally pursued. Furthermore, I engaged these various aspects of my personality through collegiate extracurricular activities. My most meaningful endeavor was membership in a campus ministry, through which I was able to put my desire for justice into action from a spiritual foundation, by guiding a team of students in planning community service events.

In addition to my on-campus activities, I studied abroad in Ecuador. During this time, I explored the social sciences exclusively (all in Spanish) and learned about the application of justice in another society. As I studied Ecuadorian colonialism, I began to recognize how a country’s history and culture can foster pervasive systemic injustice for generations. When I traveled to the Amazon, I saw how the health and livelihoods of entire people groups were disregarded as corporations inappropriately disposed of toxic waste; I learned that virtually no Afro-Ecuadorians attain a university education, largely as a result of ongoing racism, lack of resources, and coastal isolation; I visited Baca Ortiz Children’s Hospital and was shocked that the free public facility not only had few antibiotics or surgical supplies available, but also no hand soap, so that poor families who had traveled great distances had to purchase these items independently or go without treatment. These experiences began to cultivate my passion and desire to alleviate health disparities.

I have now held two roles at Aetna, a national health insurance carrier, most recently as a medical economics consultant. When I began working full time three and a half years ago, I knew that I would develop my analytical skills and business acumen. What I did not anticipate was how my newfound broader understanding of health care would make me increasingly distressed by the gaps in care that plague our world. The injustice I first glimpsed studying abroad has been even more starkly highlighted through my career, as I work in health insurance, volunteer locally and internationally, and conduct research to write my health issues blog (www.mindbodymusings.blogspot.com).

Although I have enjoyed the challenge and success of my time at Aetna, I now realize that my work is almost exclusively focused on the use of my analytical skills and not on the other aspects of my identity. And more importantly, my current role is many steps removed from the insurance members I am serving, even more isolated from the fifty million Americans without health coverage today (before the landmark health care reform bill takes effect), and still more remote from the billions of people receiving inadequate health care worldwide. I am now certain that many health concerns need to be addressed at the community level. And this is where I would like to be involved.

In particular, I have seen that mental health is a crucial part of overall well-being that is not given the priority it deserves. The Mental Health Parity Act was signed into law in the United States in 1996, yet sadly, recognition of the importance of mental illness is still in the process of gaining traction in our culture; many other parts of the world have no such laws, offer fewer services, and/or lack a conception of mental illness as a public health concern in general. Therefore, my husband and I have a vision to go abroad for at least two years to work with an international non-governmental organization, assisting women who have mental health afflictions as a result of traumatic experiences, such as rape, abuse, war, or trafficking.

On a recent two week trip to Cambodia to work with Agape International Missions on the issue of child sex trafficking, I learned that the Khmer Rouge government of the 1970’s killed one fourth of the population of the country, including nearly all health care professionals. For the last forty years following this traumatic period, Cambodia has had virtually no mental health services and retains many scars from the time of the regime. Children who were once persecuted by the Khmer Rouge, or even those who were recruited to torture and kill, are the parents of today. This backdrop has contributed to a high prevalence of post traumatic stress disorder and to cultural views about human life that feed into the pervasiveness of human trafficking. After my experience in Cambodia, I am confident that community-focused mental health programs have the potential to alter the course of this nation.

Locally, I have volunteered for almost two years as a Court Appointed Special Advocate (CASA) for abused youth in San Mateo County. Through this role, I have spent time mentoring and advocating in court for a child -------[rest of sentence removed for privacy]--------. I have seen the overwhelming consequences of trauma on the mind – and this in the lives of a children receiving intensive health services.

What happens, then, to women who have no such support?

In their book, “Half the Sky,” Nicholas Kristof and Sheryl WuDunn share the stories of women who have endured great tragedy. I was particularly moved by their chapter about obstetric fistula, in which the authors explain how women without access to emergency obstetric care may endure life-altering injuries which they call the modern day leprosy. Many are then rejected by their families and communities, with no access to the surgery necessary to repair their bodies, nor to the mental health services that can mend their unseen wounds. As a first step to end this injustice, I have written about the issue on my health blog to raise awareness. But what I desire more deeply is to develop solutions that can help communities deal with the mental health consequences of child sex trafficking, obstetric fistula, or other such injustices.

A public health degree from Berkeley will equip me to take action that empowers women and communities to heal. Moreover, the health and social behavior concentration will enable me to understand how violent, neglectful, or discriminatory behaviors take root as accepted norms in communities, and to evaluate which interventions are effective in changing these practices or attitudes. I see a dearth of leaders engaging in community need-finding, researching what has worked elsewhere, formulating creative ideas, implementing programs, and analyzing the efficacy of steps taken. I want to stand in that gap.

On a longer term basis, I envision myself playing an ongoing role, either locally or internationally, in helping people and communities respond to traumatic mental health problems. I have seen first-hand that there is a continuing mental health crisis in the United States and the world, and I want to be a pioneer in creating solutions.

The health and social behavior program at Berkeley is among the best in the nation, and it is uniquely suited to help me evaluate and intervene in the social climates that contribute to traumatic mental health concerns. I am especially intrigued by the research of Professor Ozer, which spans mental health topics as diverse as maternal depression, relational violence, PTSD, and even “Micro-credit and mental health” in South Africa. I am also impressed by the work of Professors Herd, Corburn, and Holmes. Additionally, attending Berkeley will enable me to continue volunteering as a CASA with abused youth, and the Bay Area offers a plethora of local opportunities to help victims of trauma (such as human trafficking) or others suffering from mental illness.

In the future, I envision programs that acknowledge the importance of both physical and mental health needs. I envision communities that work together to overcome traumatic histories and unite to prevent trauma from afflicting multiple generations. I envision women who are empowered by freedom from the health consequences of traumatic experiences and who are actively engaged in changing the patterns of abuse in their communities. I desire to use my analytical skills, creativity, and heart for justice as catalysts in designing such social interventions. And I believe that my admission to the Berkeley School of Public Health is critical to making this vision a reality.

Berkeley Application Essay #1: Personal History Statement

I thought it might be fun to post the application essays I submitted for the MPH program at Berkeley to give anyone interested a small glimpse into where I hope to be headed through this degree. (Yes, they let me in!) This first essay I am posting is the shorter of the two and is called the "personal history statement." The prompt was as follows:

Your Personal History Statement gives you an opportunity to add some individuality and depth to the basic information contained in your Statement of Purpose. You may write about who you are as a person, about your family, your ethnicity, and the experiences that make you unique. This essay will play a large role in consideration for fellowships.

There is also a "personal statement guide" that lists other suggestions, such as discussing non-traditional educational backgrounds, cross-cultural experiences, ability to articulate the barriers facing women and minorities, etc. The limit for this essay was 4800 characters (which amounted to 649 words in my essay).

So without further ado, here is my personal history statement for the Health and Social Behavior concentration:

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A Cambodian proverb: Men are like gold; women are like white cloth. 

The implication of this axiom is that women have little intrinsic value, and once a woman is “dirty,” there is no way to redeem her. Men, on the other hand, are portrayed as naturally valuable, and their transgressions are easily erased. Some read this proverb and see a concise explanation for gender-based injustice in Cambodia; I perceive a complex set of circumstances, of which this is but a single layer. Recognizing the complexities of a problem, however, falls short of a plan to restore dignity. My passion is to help those regarded as “dirty cloth” realize their infinite worth, and I believe a graduate degree in public health will equip me to develop solutions that change lives. 

I recently had the opportunity to volunteer in Svay Pak, Cambodia, a destination village for pedophiles. Looking into the faces of young children, some of whom were sold nightly for sex, I saw a juxtaposition of beauty and human depravity. While the injustice of trafficking is evident, one of my greatest gifts is an ability to see the hidden complexities in a problem; Cambodia’s challenges are no exception. Let me explain. The issue of child sex trafficking is a mosaic with roots in dictatorial oppression, war, culture, poverty, and a lack of mental health resources. Among other factors, attitudes of disrespect for women (as described in the proverb) have contributed to the prevalence of trafficking in Cambodia, as well as the inability of victims to reintegrate into communities. These attitudes have allowed exploitation to perpetuate as a societal norm, creating a public health crisis. 

A simple-minded approach is to outlaw underage prostitution. But historically this alone has done little to change the environment. I believe a complex problem necessitates a multi-faceted solution, and it gives me hope that an organization such as Agape International Missions (AIM) has fostered change by taking this requisite seriously. Through victim recovery programs, job creation, community-building activities, and even a gym where perpetrators can interact with aid workers, AIM is having a transformative impact in Svay Pak. AIM’s efforts reveal that my eye for complexity need not lead me to despair, but can be a valuable tool as a public health professional in discerning how to assist women in mental health recovery toward becoming advocates of change in their own communities. 

I also recognize that complex situations resulting in disregard for human dignity are not unique to Cambodia. During my time studying in Ecuador, I saw my classmates disrespect their indigenous heritage, and I learned that few Afro-Ecuadorians attend college. In reading “Half the Sky,” I have been deeply troubled by indifference for women’s reproductive rights worldwide, including poor prenatal and emergency obstetric care. Through my job in health insurance, I have become critically aware of the millions with inadequate healthcare here in the United States. Locally, as I have volunteered as a Court Appointed Special Advocate, I have been grieved by the roles of mental illness and poverty in the child welfare system. I have even personally experienced the effects of being a “lesser-viewed” person, as a woman in the male-dominated field of mathematics. 

I believe my diverse experiences are not random, but have coalesced to uniquely shape my heart for all cultures, to open my eyes to intricacy, and to develop my desire to serve. As long as any person is perceived to be lesser than any other, or is held captive to unjust institutions that remain from such views, I feel called to dedicate my life to restoring human dignity through public health justice. Graduate school at Berkeley is a critical step in transforming my eye for complex problems and love for people into an ability to create adaptable solutions. One day, I hope to see the “white cloth” of the world revalued based on the “gold” inherent in every human spirit.


Update: Be sure to check out my second application essay, the "Statement of Purpose."