- We talk about women's health. In the United States, disparities among minority populations when it comes to maternal and child health issues are pretty negative, right? - Right. - And in Ghana, you know, well, the government is doing its best to try to reduce maternal mortality and to improve upon the health of infants and children. And that's the same that we find here in the United States. HIV-AIDS is an issue here in the United States and is also an issue in Ghana. Maybe the difference is that here in the United States, people feel more at ease to talk about it. Whereas in Ghana, for cultural reasons, it's a little stigmatized, right? - Sure. - So people don't wanna talk about it, but they see that there are similarities and some differences because that's what they do. It's not just to learn about what happens in Ghana, but to also compare what happens to Ghana, what happens in Ghana, sorry, to what pertains in the United States, so they can see where the similarities are and what the differences are. - [Announcer] This is the ORISE Featurecast. Join host, Michael Holtz, for conversations with ORISE experts on STEM workforce development, scientific and technical reviews, and the evaluation of radiation exposure and environmental contamination. You'll also hear from ORISE Research Program participants, and their mentors as they talk about their experiences, and how they are helping shape the future of science. Welcome to the ORISE Featurecast. - Welcome to another episode of the ORISE Featurecast. As ever, I'm your host, Michael Holtz, in the Communications and Marketing Department at the Oak Ridge Institute for Science and Education. And I'm really excited today to be speaking with Dr. Elizabeth Armstrong-Mensah. Dr. Elizabeth Armstrong-Mensah was recently honored by the Association of Schools and Programs of Public Health for her work as a Clinical Associate Professor at the Georgia State University School of Public Health, a role that she's held since August, 2017. She is a former ORISE fellow at the Centers for Disease Control and Prevention, and we're gonna talk about all of that. But first, Dr. Elizabeth Armstrong-Mensah, welcome to the ORISE Featurecast. - Well, thank you for having me. - So, if you would, I know I've talked a little bit about your role at Georgia State University in the School of Public Health. Tell me what you do as a clinical professor. - So, as a Clinical Associate Professor at Georgia State University, I wear three different hats. - Okay. - So, I'm doing teaching, I'm doing research, and then I'm providing service. So 88% of my time goes into teaching. - Okay. - 6% goes into research and 6% goes into service. And every semester, I'm teaching graduate or undergraduates. In the fall, I'm teaching four, three courses. In the spring, I'm teaching four. In summer, I'm teaching three, including a study abroad to Ghana. And I usually have about 45 students. That's at the most, in my class. That's the max that I'm allowed to have each semester. - Okay. - And with regards to research, I try to publish at least five manuscripts in peer review journals every academic year. - Wow. - And, yes, and I'm sometimes mentoring students either as a member of the Thesis Committee or a Chair of the Thesis Committee, or a member of a Dissertation Committee. I also work with students at the graduate and undergraduate levels to hone in their writing skills. They work with me, they co-author papers with me. With regards to service, I serve on various committees at the university level and at the school level. And I also offer volunteer services to community members on issues related to public health. - Wow. So you have a full plate, all the time. - Oh, yes. I mean, it's, yeah. I mean, I'm always busy. - You are always busy. - There's always something to do. - Yeah. - Well, so, recently, you were honored by the Association of Schools and Programs of Public Health with their Early Career Teaching Excellence Award, which recognizes a junior faculty member for outstanding teaching and mentoring of students. What was it like, I guess, how do you feel about that honor and being recognized for all of the work that you do? I mean, you have a full plate, so you are, it sounds like you're doing all of the things that would certainly qualify you for this honor. - Well, yeah. I mean, it was very humbling, or it has been a very humbling experience. I came into this profession with a mindset of wanting to help the next generation of public health students enter the workforce and maybe even pursue higher education. Mine was anybody that I interacted with, I was going to give my best. Right. - Okay. - To make sure that they would excel, you know? So I wasn't doing this work with the mindset that maybe someone is watching. I was doing it because I was passionate about it, and I really wanted to see my students succeed. And these are some of the things that students would write in my, and of course, evaluations that they see that I'm really interested in their welfare. I'm really interested in seeing that they succeed, right? So, in as much as I was doing it because I really believed in my students, and I wanted them to make it, it was an honor that it was recognized, and that I was given this award, and given this kind of recognition, you know, but. - Right. - Honestly, it's humbling. - Right. - Really. And as you said, you have a passion for public health and for mentoring students. So, was public health something that you've always been interested in? Was that something that came to you in high school, in college? Or was it always sort of there? - Never. - Never, really? Okay. - Never. You know, I didn't start out wanting to be a public health professional. - Okay. - You know, when I was about to complete high school, I had a conversation with my father, and it was about my next steps. - Right. - Okay. - And he said, "Well, I mean, I wanna propose a career in law, you know?" And I was like, "Okay, well, if that's what you think, I'll do it," because I mean, I really admired my father. And I say, I admired because he's no longer with us. - Right. - And he always gave me good advice. And so, my whole purpose at the time was to become a lawyer. - Okay. - But unfortunately, law wasn't offered when I started my college education. And I didn't wanna wait for a semester, you know, and not do anything 'cause they said they would offer it the next semester. And I was like, "No, I'm not about to wait." So then I decided to enroll in the Sociology program. I didn't know anything about Sociology at the time, - but someone- - Okay. - had advised me says, "Well, if law is not available, how about sociology?" 'Cause I mean, that individual was already enrolled in the Sociology program at the University of Ghana. And so I did, but I'm very happy that I did, because I really came to love and enjoy that discipline. After graduation, all my colleagues were thinking of going back to do their master's. I was like, "Okay, if they're going to do their master's, I must do mine as well." - Okay. - But the thing is, I didn't do law, and now I'm done with sociology. What am I gonna do with a sociology degree, right? So then I thought for, while I said, "Oh, my dad." My father is a career diplomat, and I find his job very cool. - Right. - So I said, well, then let me just go get a degree in International Affairs and Development, then I can become a diplomat like my father. Right. - Right. - So after two years, I'm done, and then I'm ready to apply. Well, I did apply to the Foreign Ministry, which would be your Department of State here. And I was really looking forward to be hired. And guess what? They come to me and say, "You know what? We are not hiring. There's a hiring freeze." They're not hiring in the next two years. So I was like, "What's going on here? I mean, I didn't get to do law. I did sociology now, then international affairs, I don't get in?" You know? And I didn't wanna be a burden to my parents, and I knew I had to work. And so, I accepted a position as a trainer. - Okay. - With the trained group in Komasa. Komasa is an administrative region in Ghana. And I'd never been to that state before, but I just went because I mean, I thought I had to work. And this group actually provides or provided consulting services on rural water supply and sanitation to international, I mean, to international development agencies, like the World Bank, DANIDA, JICA, et cetera. So that was my first introduction to public health. - Okay. - And I loved what they did, you know? And that began my long career in this field. - Wow. - Yeah. - So you sparked this interest in public health. I'm assuming at some point, then you moved to the United States. - Yes. - Right? And I know that you were an ORISE Fellow at the CDC in the National Center for Environmental Health. How did you find out about that fellowship and get involved at the CDC? - All right, so when I finished my PhD, there was a follow period. I couldn't find a job, Right? - Okay. - And so, I reached out to one of my former professors. He was at Morehouse School of Medicine at the time. And so, he was able to find me something to do. It was just a placeholder. I mean, it didn't pay much, but I mean, I was content with it because at least I had something to do. - Right. - I was doing HIV-AIDS work. I was a Project Manager on an HIV-AIDS project. And the Prevention Research Center had an evaluation unit. And I really admired what the people on that team did. Right. So I began to teach myself evaluation on the side. - Okay. - Right. And so I spoke to a colleague who was at CDC, and I was telling her that, "Hmm, you know, I'm looking to expand my horizon, and if she knew of any opportunities?" And says, "Well, this announcement just came out. It has to do with evaluation and would you wanna try it?" I was like, "Well, what do I lose?" You know? And so, I put together a packet, and I tendered my application, and I got in. You know, so that was how I got to become an ORISE Fellow. - Okay. Yeah. And tell me about that experience. I know, you know, ORISE's experience, fellowship experiences are mentored opportunities at the CDC and that National Labs and other locations around the country. What was that experience like for you? - Oh, it was a great experience. Honestly. I was there for three and a half years with the National Center for Environmental Health. And my mentor, Carol Selman, great, great mentor. And I also had Tom Chapel, the former Chief Evaluator of CDC. He was also a mentor as well as Goldie MacDonald, who's also very well known for her evaluation work at CDC. You know, when I got in there, I knew I had to do my best because I mean, I had been selected among, I mean, a number of people. - Sure. - So it's like the expectations were great, and I wasn't about to disappoint anyone, right? So I put my best foot forward, and I would have these monthly meetings with Tom Chapel, you know, and he would ask, "What are you doing?" And et cetera. And then I got to meet with Goldie MacDonald who does a lot of work in evaluation. And she gave me lots of opportunities. I mean, Goldie mentored me, especially when it came to logic models and monitoring and evaluation plan development. And she gave me the opportunity to go to South Africa to represent her, to work with the South Africa CDC office, to design a logic model, and then a monitoring and evaluation plan for HIV prevention for the country, you know? - Wow. - And she also gave me the opportunity to do some work with the, it was with the laboratories. I mean, they had a first lab forum, and she kind of like nominated me, or brought my name up. And they called me and asked me if I would be interested in assessing that event. And it was a great opportunity because then I got to work with people like, Laurie Wingate. She already reviewed the questionnaire that I designed. So it's like, there were lots of learning opportunities along the way, and it was a very supportive environment. So I have nothing but pleasant thoughts, and I'm very grateful and thankful for that opportunity and those years that I was there. - Wonderful. If I can go back just a little bit, you've talked a little bit about, you grew up in Ghana, you went to school in Ghana, moved to the US to pursue your PhD, if I understand correctly? - Yes. I did my first and second degrees in Ghana, and then I joined my husband. So I got married and I had to come over and join my husband. And so then I, while waiting to sort my papers and things out, I decided to do a PhD. It wasn't on the radar at all. I just went to school- - Okay. - and did the PhD, and, you know, yeah. - I gotcha. Tremendous culture shock between Ghana and the US? - No. - Or, no? - No. My father was a career diplomat, so we traveled a lot. You know? - You said that. That makes sense. - Right. And working in the sector, I traveled every year to conferences and made presentations, so there wasn't a culture shock at all. - Great. - At all. Yes. - Okay. And you mentioned earlier you have classes that you teach in Ghana currently, if I understood that correctly, right? So I guess, is that a way of sort of giving back to your home country to be teaching students who are still there? - Okay, so just to correct it, I don't teach students who are there, but I take students from here, there. - Okay. I gotcha. Okay. - Yes. As part of my study abroad program. - So you take students to Ghana. - Yes. - I gotcha. - Yes. - Okay. - To learn about contemporary global public health issues, specifically water and sanitation issues, HIV-AIDS, and women's health. We talk about these things here in the United States. We look at it from a global perspective, but it's only theory. - Right. - So I take them down to Ghana where theory meets practice. They go to Ghana, actually before they go, they've designed their questionnaires around these three areas. We go to Ghana, we interact with in-country partners, provide lectures, and then they go into the community and collect data around these three contemporary public health issues, do data analysis, do representation, and provide recommendations from a culturally sensitive point of view. What could Ghana do better in these areas? Supposing they had the chance to change anything, what would they do? - Right. - Yeah. - How meaningful is it for your students to be on the ground in Ghana to see, as you said, you know, it's theory in the classroom, but it's practice when they're there. What does that do for your students to be on the ground, to see that firsthand? - First of all, I think it erodes some of the erroneous concepts they have of a developing country. Just recently, I was talking to one of the students and she asked me, "Do you have Uber in Ghana?" I'm like, "What? We have Uber in Ghana," right? - Yeah. - Yes, we do, and we live in houses. We don't live in huts. - Right. - You know, so it's to kind of like get rid of some of those negative thoughts that they have, and also to sharpen their cultural sensitivity and global fluency. Right. So when they go to Ghana, they realize that Ghana is like, I mean, like, it's not anything different from the United States. It's just that maybe the United States, it's more developed than Ghana, but it's not like people are living in huts, and there are animals on the street. Right. - Right and the roads aren't paved, and yeah. - Right. And they see that, I mean, that people drive, people ride in cars, and people live in nice places, you know? - Right. - And then they come to realize that some of the issues that pertain or that occur in Ghana also happen here. Right. You talk about water and sanitation issues. Flint, Michigan had a water issue. - Absolutely. - Right? We talk about women's health. In the United States, disparities among minority populations when it comes to maternal and child health issues are pretty negative, right? - Right. - And in Ghana, well, government is doing its best to try to reduce maternal mortality and to improve upon the health of infants and children. And that's the same that we find here in the United States. HIV-AIDS is an issue here in the United States and is also an issue in Ghana. Maybe the difference is that here in the United States, people feel more at ease to talk about it. Whereas in Ghana, for cultural reasons, it's a little stigmatized. Right? - Sure. So people don't wanna talk about it, but they see that there are similarities and some differences because that's what they do. It's not just to learn about what happens in Ghana, but to also compare what happens to Ghana, what happens in Ghana, sorry, to what pertains in the United States. So they can see where the similarities are and where the differences are. So it kinda like changes their perspective a little bit. - Right. - To see that it's not like the United States is perfect, right? - Sure. - That some of the problems here are some of the ones you see in Ghana. Some of the problems you see in Ghana are some of the ones you see here, but maybe on a different level or different magnitude. - Right. But public health issues are public health issues. - Public health, yes. - Regardless of the country that you're talking about. - Yes. - So. - Yes. - It adds that, as you said, that cultural perspective of understanding that- - Yes. - this is happening everywhere. - Yeah. - Right? You've talked about being mentored, particularly as an ORISE participant. I hear you talking about mentoring and showing students the cultural connections, but also mentoring students on a daily basis with their papers and with the work that they're doing. What does it mean to you to pour your passion for public health into other students? - First of all, I think it's a privilege, right? Because, I mean, not everybody gets the opportunity to share what they love to do with others, right? And it's also a privilege because I'm participating in educating and preparing the next generation of public health students who will join the workforce, and who might even wanna pursue higher education. So it's something I take seriously and something that I put all my strength, that I target all my strength and efforts at. Because if they are successful, I'm happy. If they are successful, it reflects positively on me. - Sure. - If they're successful, I know that they're not gonna go out there and be mediocre in what they do. That they will excel and then that excellence will rub off society, right? And hopefully, we see some changes in some of the areas that we are mentoring them in, right? So for me, it's a privilege for me. It's a great opportunity. - Wonderful. I love hearing that I have a little bit of a background in public health, so. - Oh, okay. - I worked for the, the county health department here in Knox County for a couple of years, and just fell in love with the people that are on the ground every day doing the education and doing the evaluation. - Yeah. - And epidemiology work. So, which I guess leads me to, we've, as a country and as a world, we've gone through a pretty substantial public health crisis, right? The last few years. Is that helping bring more students to public health? Are you seeing more interest in public health as a course of study because of the pandemic? Or has it always just sort of, there's always been an interest in public health? - I think there's always been an interest. I mean, it's too early now to tell whether there's been a spike in enrollment because things just normalized, right? - Sure. - But I wouldn't be surprised if next academic year numbers go up because thing is, public health has become even more relevant in today's world with these things that are happening. You know, I was just talking to some students about global health security, right? When we talk about global health security, we're talking about the fact that the way countries manage health issues in their spaces pretty much determines health outcomes in a different place, right? Gone are the days when you say, well, it's happening in your country, sorry, take care of it. You can't do that nowadays, because due to globalization, somebody is gonna get in a plane, you know, and within hours, if they have a condition, they have a disease or carrying a pathogen, they're gonna introduce it into a different space, right? So you can't be complacent. You can't sit there and say it's okay. Right. So students continue to show interest. And even as we, I mean, as I give them assignments and ask them to talk about how global health is relevant in today's world, they're all talking about the COVID, you know, pandemic and how, in as much as public health focuses on what's happening in a community, you see that different communities at the same time are experiencing the same thing, right? And it becomes necessary to begin to focus on what communities can do to protect their populations, right? What can we do in such situations to make sure that there's equity, to make sure that minority populations are protected, right? All of these things have to do with public health. So the interest is there. And I wouldn't be surprised if there's a spike in enrollment for next semester. I know that with our master's programs, there's some increment, right? But I'm waiting to see what the undergraduate numbers look like. And I'm sure the numbers will go up, but there's always been an interest in public health for these reasons. - The pandemic really laid bare for our country and the world really. But the issues with health disparities and health equity, not just in the public health system, but really, in the health system as a whole, that not everyone has the same access. Not everyone has the same ability necessarily to get the help that they need or the information that they need, and really a host of other things. You know, we now have a, I think, a better understanding of, basically how where you live often determines if you live and how long you live, and the quality of life where you live, you know? Those things that we had been talking about, you know, we talked about them for a long time, but we have a much better understanding. Does that seem to be true from your perspective? - Well, yeah, to some extent. And it's sad that it should take a pandemic for the country to begin to see. I mean, these disparities and inequities have been around for a long time, like you said. It only took the pandemic to bring these things to the fore, right? We have minority populations that have preexisting conditions that become risk factors for COVID-19. And these people were experiencing these conditions before the pandemic struck. - Absolutely. - So what were we doing? You know? These minority populations are people who are frontline workers, who can't take time off, right? When COVID-19 came around, and the instruction was to stay home, right? Okay, stay home, and how do they make a living, right? - Right. - And it wasn't like they could work from home. They had to be on the front lines, right? Why did it have to take COVID for this to happen? Right. - Yeah. - So it only goes back to the fact that, I mean, are people really willing to look at health inequities and disparities, and look at it from not the superficial occurrence, but look at the root cause, right? Because there are things at the very foundation of these disparities that have to be looked at, right? Inequities. I mean, when we talk about health equity, we're talking about the opportunity for people to realize their full health potential, but what opportunity is there for minority populations? We're talking about, when we talk about health disparities, we're talking about differences in health outcome due to social, environmental, and economic disadvantage. And this is what minority populations experience day in, day out. - Absolutely. - Right? So these are things that have been there all this while, but why did COVID-19 have to come to make it more of a greater issue, you know? - Right. - It's just that it just became, I mean, things just became more obvious, you know? And now, we couldn't run away from it. But the question that still remains is what have we really done? - Right. And have we learned from it? - Yeah, to change the situation. Have we really learned from it? Maybe at that moment, we saw the need to do something, but are they sustainable? - Right. - You know? It took a while for minority population to have access to vaccines. Some couldn't go get tested because they had to be at work. By the time they closed their jobs from their jobs, those sites were shut down. Has any of that changed? - Right. - Have we set up systems where minority populations can also take some days off and rest, and still be paid some money? No. - Right. - You know, they have to be at post to make money. - Absolutely. - And that hasn't changed. - Yeah. They still have to work and sometimes, they're working two or three frontline jobs. - Yeah. - To make ends meet. Right? - Yeah. - So yeah, we still have work to do, don't we? - Yeah. I mean, during the pandemic, we saw the need to do something, but now, COVID-19 is no longer a threat, right? So have things gone back to business as usual, or have we started to put in place mechanisms? And I think that it's not just coming up with this intervention or with that program. I think there's a bigger problem, the systemic issues that have to be addressed. If the systemic issues are addressed, then chances are, we might be making our way towards, decreasing or removing these barriers that create inequities, and therefore disparities in the long run. - Right. So a lot of work to do. - Yes. I mean, there's got to be a reckoning that there are disparities, sorry, that there are inequities, right? Because the inequities shouldn't only show up or shouldn't be recognized when there's a health emergency, right? We should realize that people are at different stages in life. Certain people have opportunities, certain people don't have opportunities. And with equity, we are not saying give everybody the same thing. We are saying with somebody, what they need is transportation to get to the health facility. With someone, it's insurance that they need. With someone, it's maybe I need someone to take care of my kids, so that I can go to the hospital. - Right. - So people have differential needs, right? That if met, will help them realize their full health potential. Question is, I'm not sure we are there yet, and I don't think we are giving it the attention that it needs post-pandemic. - Gotcha. So we have work to do. - Yes. - Basically. We have work to do at all levels, really. It's- - Yeah. - public health, but it's policy, and it's societal. - We have work. - Yes, yes. It's just recognizing that we are not all equal. - Right, - And that there's a social structure and that some at higher levels than others, people have better socioeconomic standing than others. The determinants of health don't play out the same way for everybody. - Right. - Right. But how, I mean, we may not be able to meet everybody's needs, but how do we narrow the gaps that people are at a point where it's not as bad as it is right now? - Yes, yup. And hopefully, we can get there and we will learn hope. The hope is that we will learn from the pandemic what to do next. - Yes. - And to help even the playing field for everybody. - Yes. I mean, I can see us going back to this period to come up with strategies should there be, God forbid a million times, another global health emergency, we would know that, okay, we need to do this, but it shouldn't be for those times alone. - Right. - Right? When there is peace time, when nothing is happening, there should be some equity across, so people can realize their full health potential. - Right, absolutely. Dr. Armstrong, then, so last question for you. What brings you joy? - That's an interesting question. Well, lots of things bring me joy. You know, the fact that I have a job in an area that I'm passionate about brings me joy. You know, the fact that I'm able to connect with my students brings me joy. You know, the fact that they can write to me, even when they've graduated to tell me what's going on in their lives, bring me joy. - Right. - When they are having issues deciding which college to go to, what's courses to enroll in, brings me joy. When they do well academically, brings me joy. When they're confident and bold enough in class to say to me, Dr. Armstrong-Mensah, I don't understand this concept, brings me joy. Because it tells me that they're comfortable enough with me that I've succeeded in creating an environment where they're comfortable. You know, they feel free to participate, to ask questions, right? - Right. - Those things bring me joy. - That's wonderful. Dr. Elizabeth Armstrong-Mensah, thank you so much for spending this time with me. I really appreciate it getting to know you and to talk about some really important issues for our country and for Ghana as well, for that matter. So thank you so much. - Well, thanks for having me. It was a pleasure and a great time having this conversation and sharing all these things with you. So thank you once again for having me. - Wonderful. Thank you so much. - Thank you. - Have a great day. - Yes, you too. - [Announcer] Thank you for listening to the ORISE Featurecast. To learn more about the Oak Ridge Institute for Science and Education, visit orise.orau.gov or find us on Facebook, Twitter, and Instagram @ORISECONNECT. If you like the ORISE Featurecast, give us a review wherever you listen to podcasts. The Oak Ridge Institute for Science and Education is managed by ORAU for the US Department of Energy.