Season 3, Episode 5: Monica Wang on the Collective Cure

In this episode of the podcast, Joseph Harris sits down with Dr. Monica Wang, an award-winning researcher whose work has been featured in the New York Times, Washington Post, NPR, Harvard Business Review, Forbes, and National Geographic. Dr. Wang currently serves as Associate Professor of Community Health Sciences at Boston University School of Public Health. Her new book - The Collective Cure: Upstream Solutions for Better Public Health - is a personal, story-driven account of how social and structural factors, like income, race and ethnicity, neighborhood, and social networks - shape our health and well-being. They discuss the book, her motivations for writing it, collective responsibility, and politics and misinformation.

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Global Health Politics Podcast
Season 3, Episode 5: Monica Wang on the Collective Cure

SUMMARY KEYWORDS

Public health, Social determinants, Health disparities, Community health, Population health, Racism, Institutional racism, Interpersonal racism, Internalized racism, Food insecurity, Housing insecurity, Misinformation, Health communication, Upstream solutions, Health equity

SPEAKERS

Monica Wang, Joseph Harris

Joseph Harris  00:01

Welcome to the Global Health Politics Podcast, where we go beyond the articles and books and have real, intimate conversations with people working in the field of global health today.

Joseph Harris  00:19

I'm your host, Joseph Harris.

Joseph Harris  00:26

Today, I'm really pleased to be here with Dr. Monica Wang. Dr. Wang is an associate professor of community health sciences at the Boston University School of Public Health, adjunct associate professor of health policy and management at the Harvard T.H. Chan School of Public Health, and also executive editor of the Public Health Post, an online population health daily written by students and leading experts in public health. Her new book, "The Collective Cure: Upstream Solutions for Better Public Health" explores the impact of social determinants like race, class, and the environment on population health, putting personal stories, including from our own life, into conversation with statistics and important concepts, the book sheds light on enduring health disparities in the U.S. and what we can do to change them. Dr. Wang, welcome to the podcast.

Monica Wang  01:17

Thanks for having me.

Joseph Harris  01:19

So, how did you first become interested in public health?

Monica Wang  01:23

Well, there's a story behind this, and we're going to go all the way back to my parents. So, both of my parents are from China, and they both grew up in food insecure households. And for them, education was the key path towards building a better future and one that was more economically stable. And when my dad was in college, he really excelled in the English language. And a visiting professor-from Boston University-was there and recognized his talent. And I'm saying that because we're sitting here over at the Boston University School of Communication, so this story has BU roots, and that mentor encouraged my dad to apply for grad school at Boston University. And my dad applied and was accepted with a full scholarship to get his PhD in language arts and a very small stipend. So off to Boston he went, and he decided he wanted to bring my mom and I over to build a life here, and they came with nothing, and again, pursuing education as the path towards greater education. So we lived in Boston in Jamaica Plain to start with, and then we moved to Roslindale. And my parents couldn't afford private school, but they looked for the best public schools that were available to us, and they stumbled across a program called METCO, which is one of the longest-standing voluntary school desegregation programs in the country. So it allows students who are of color or who are economically disadvantaged to live in Boston, but bus or take public transit to other public schools in nearby suburban school districts, and I applied and was accepted. So from elementary through high school, I lived in Boston, but I commuted to Belmont. And even though those two neighborhoods are about 10 miles apart, they looked and felt completely different. So my neighborhood in Roslindale, we lived in rent-controlled housing. There were a lot of fast food places, a lot of corner stores, but not a whole lot of grocery stores. We lived by a major artery called Washington Street, so there was a lot of vehicle exhaust from buses and cars. There weren't a whole lot of wide sidewalks or bike paths, and the parks weren't always safe to play at. So opportunities to be healthy were very different. And then when I went to Belmont, the houses were different. They were bigger. There were bigger backyards. People walked or rode their bikes to school. There were a lot more trees too. So I noticed there the air felt and, you know, smelled cleaner. There was a lot more shade, and my peers in Belmont they were able to participate in after-school sports and arts programs, and some of them got brand new cars for their 16th birthday. And not only were these neighborhoods economically different and environmentally different, they were also different health-wise. So I noticed my peers who lived in Boston struggled with more chronic disease issues like asthma or diabetes, but my peers who lived in Belmont didn't seem to have the same health issues. And that experience early on showed me how living in two different neighborhoods can really shape your your health trajectory. And as I got older, I realized. I wasn't simply commuting between two places. I was moving between opportunity, and that was the impetus of my interest in community health and how the environments around us shape our well-being.

Joseph Harris  05:13

Well, your new book, "The Collective Cure" helps readers who aren't necessarily familiar with public health understand how health is shaped by important social factors in our world beyond medical care and genetics. How did this book come about?

Monica Wang  05:28

So, I've been teaching and doing research in public health for over 15 years, and much of academia is rooted in academic articles and research grants in higher ed institutions where you're teaching to undergrad or graduate students, but the work of public health is incredibly interdisciplinary. So that means if we want to actually improve public health, we have to speak to other sectors, other stakeholders like those in government, those in industry, those in the community, and who are business leaders, because those are the people who can make decisions on how to actually improve the different kinds of environments around us: whether that's our work environment, our physical environment, our healthy food access, and part of this book came about because I had spent so much of my career writing scientific articles, but I always wonder, you know, who is reading this besides other academics, besides people who are already like-minded and interested in these topics? And with a book like "The Collective Cure" it's really written by blending stories and science together to really make it accessible, so you don't have to be in academia and you don't have to have a healthcare background to understand the concepts and to learn about what you can do about it.

Joseph Harris  06:56

Well, much of your previous work did come in the form of scientific articles. How was writing "The Collective Cure" different? What did a book allow you to do that these journal articles didn't?

Monica Wang  07:09

It was a painful process, and I worked with a writing editor, so there were two main parts for writing this book. One was unlearning academic jargon and learning how to write and unpack the science in a way that's engaging and accessible to everyday people. So in academia, we love multisyllabic words, and the longer the word, the the more impressive we think we sound. But I think the harder skill is to understand something so deeply that you can explain it clearly and concisely. So that was one part. The other part is how can you tell a story and match a story to convey the science that you want to communicate with different audiences. And when I first started, I realized I wasn't really telling a story. I was reporting a story. I was listing the order of events in which they occurred, and that can be fairly dry because that's no different than, say, a news reporter. But telling a story means you're painting a picture and the scene for the reader to visualize and feel what it means to be in that moment, because when you can do that with visual imagery, with how a character is feeling, with dialogue, that allows people to really connect with the character and to develop empathy and to really see themselves as part of the story. And when that happens, then you grab people's attention, and then that's a way for you to pull through the data through that story.

Joseph Harris  08:48

Well, one of the great strengths of the book, and there really are many, is how beautifully written it is. So congratulations on that, as well as its tremendous clarity. It's filled with rich stories, anecdotes that connect larger ideas and concepts to concrete problems in the real world, and it makes real real terms like social determinants of health and explaining why factors like class, race, environment matter so powerfully in people's lives really concrete. Some of the stories told in the book are personal stories that discuss your own experience and that of your family. Could you share with our listeners some of those stories?

Monica Wang  09:30

Sure. So I write about different events in my life and how those events or experiences really shaped a health trajectory, and so one example of that is around work stress and health. And I write about being a working mom in academia, and I pull through and I showcase the reader. You know what happened when COVID hit, and my kids were three and five. In 2020, and so they were both still in daycare at the time, not quite yet in kindergarten. And even when kindergarten started, you know, virtual kindergarten is not supposed to be a thing. And so, it's it was an incredibly challenging time for everybody, and especially for parents with really young kids, because you really can't leave them alone and be independent. And like many households in the U.S. we're part of a dual income earning household. And when you live in a city that's expensive, like Boston, it really does matter when you have both people who can pull in different sources of income, and so that can be a vulnerable experience to share because it's not necessarily always applauded to share about the struggles that you have when you're trying to engage in work-life balance, particularly for women. And I also talk about experiences with with my husband and my father-in-law, my mother-in-law, because we're a multiracial family. So I'm Chinese American. My husband is Irish American on his mom's side, and Black and Native American on his father's side. And so our kids have a multitude of different kinds of families and ancestral histories, and as part of that, you know we also look pretty different from each other. And from a very early age, kids start to understand and recognize that people treat you differently based on what you look like, based on your height, what you're wearing, your eye color, your skin tone, your hair texture, if you speak with an accent, and so part of the book also unpacks, you know, what does that mean when I'm not only writing about these topics but I'm also living them?

Joseph Harris  11:55

Was it difficult to share such personal stories? How did you decide which personal stories belonged in the book?

Monica Wang  12:05

Yeah, there's a there's a professional vulnerability that comes with sharing something so personal in such a public way. I think for my stories, I knew which ones I wanted to share because there are pivotal moments in your life that you remember that maybe changed a decision that you made, so it wasn't difficult for me to find a story of my own to share with my family and with the women I interviewed. I always asked permission and asked them if they felt comfortable sharing details, and for the most part, every single person loved talking about their experiences, and they gave me many more stories than I could fit into the book. And so then it became the issue of which story do I want to match to which chapter?

Joseph Harris  12:55

And you share stories not only from your own life but also those of other people who figure prominently in the books, such as Marielis Rosa, Dorothy Oliver, and Rosa Tupina? Could you share with our listeners a little bit about their stories and what their stories bring to the book?

Monica Wang  13:11

Yes, and so some people might be wondering, you know, why did you even interview other people, and why not just write this book from your own personal lens, and part of that is because public health is ultimately shared, and that means it's not my story, but it's all of our stories. And I wanted to interview different people from different parts of the United States, from different economic backgrounds, who live in different geographic regions, who have different ethnic backgrounds, and who have different occupations. And through each of their stories, it's to show how each of us have been touched by social determinants in some way. And each of these people are also contributing to making their families or their community lives a bit healthier, even if they're not working directly in public health. So Marielis Rosa, she's a first-generation Latina student who graduated from Boston University, and she grew up in New York City. Rosa Tupina is an indigenous licensed clinical social worker who grew up along the Texas-Mexico border and who now still lives in Texas. And Dorothy Oliver is a semi-retired African-American woman who lives in Panola, Alabama, which is one of it's a very rural town in Alabama. And through their stories, I showcase how each of them experienced a particular moment or event that changed their health trajectory, and I end each chapter with solutions and programs and policies on how we could improve that particular factor.

Joseph Harris  15:01

As the book's subtitle suggests, the book helps acquaint readers with solutions for better public health. What are some of the problems that the book addresses, and what do you find to be some of the solutions?

Monica Wang  15:14

I would say, broadly speaking, one of the main challenges is that many people often view health or public health as solely the responsibility of the healthcare sector or the public health sector, and that it isn't anybody else's responsibility. And that's where we hit problems because if we start to unpack, you know, what actually impacts our health, up to 80% of it is beyond our genetics and our lifestyle choices. They include, you know, the air we breathe, the water we drink, what kind of food access we have, the neighborhoods we live in, if they're safe, the social relationships and connections that we have, and also our economic and financial stability to weather storms throughout life, and if you think about all of those factors impacting health, it isn't within the realm of healthcare to address all of those issues. So it can be unrealistic and overly ambitious to say, expect your doctor to diagnose a health issue, prescribe medication, and also solve housing insecurity or food insecurity, it simply isn't within their capacity or their training or their leverage points to do so. So one of the key points that we could make as a field is to help everybody recognize the part that they could play, whether that's on an individual level, or an organizational or institutional level, that every single entity has some role and ability to make their communities, their employees, their neighborhoods a little bit healthier.

Joseph Harris  17:00

In the book, you also acquaint us with Dr. Camara Jones' three levels of racism, and this I also share with students in my sociology, health, and healthcare class. Could you talk a little bit about that framework?

Monica Wang  17:12

Yes, I really find this framework helpful for breaking down a very complex issue, and you can also apply this framework for other forms of discrimination. And in grad school, I learned about this framework, and so she breaks down racism into three levels. There's institutional, interpersonal, and internalized. So institutional refer to the larger policies or social norms that can disadvantage one particular group and advantage other groups solely based on race or physical attributes. So these can include laws and policies like Jim Crow laws and the U.S. history of segregation, where there were segregated hospitals and schools, slavery is another example where discrimination was structurally embedded as part of society, and along with that, there are also socially accepted norms and policies that go along with what's legally coded, and so for a long time, people of color were continually discriminated against in terms of applying for certain jobs, being able to afford or be able to apply for a loan to get a mortgage, and that goes back to the history of redlining. And I make a point to also note that you know we often talk about African American families or Black populations in the U.S. as experiencing health disparities, but there are also other forms of groups that have also experienced different forms of discrimination, including not being able to get jobs or houses, and that includes Italian immigrants, Irish immigrants, Jewish communities, and so the U.S. has a longstanding history of favoring certain groups over others. And institutional is one of the forms that can be a bit hard to recognize and untangle, if you already accept it as part of what the status quo should be. Interpersonal is when you would typically expect to see when you think about the term racism. So between two parties, and that's when one party might say or have actions against another party that is disrespectful, that favors one party over another. Say, for example, you're interviewing different candidates, and you routinely go for candidates who are male, or let's say who are taller, or who are white, than candidates who are female and who are of color. So that would be a form of interpersonal discrimination. And then internalized is when people from a particular group believe the negative stereotypes about that particular group. So an example of this would be, let's say, Latina students not applying for their reach schools because they don't believe they would get in, or female students avoiding taking advanced math classes because they believe that they're not going to be as good at it, and so all three of these levels of racism can play out in in shaping people's health trajectory and their life trajectory.

Joseph Harris  20:45

You started writing this book in 2021. A lot of policy changes have taken place since then. Many of them, not particularly friendly or supportive of addressing the needs of vulnerable people, such as low income people, communities of color. How has the current political climate and administration made addressing some of the problems you note harder, including embrace of some of the upstream solutions you point to?

Monica Wang  21:13

Yes, it certainly has been a dispiriting and disheartening year in terms of setbacks, in terms of investments and public health prevention programs, you know, moving away from prioritizing health equity or health disparities-focused initiatives or programs. So we've had to do a lot of pivoting because funding has changed, priorities have changed, which means people have to change the the projects or proposals that they're working on, and it has made it a bit difficult because all of these changes have come through fairly abruptly and without a clear transition in terms of what to do with existing projects and initiatives, on the other hand, I I will say I have found more opportunities to move forward from a solutions-oriented framework, and part of that is because I'm seeing the conversation move away from disparities focused on specific populations, say for example, black-white disparities, and move towards actually naming the structural issue that's impacting all different kinds of communities. So instead of focusing on health disparities around food insecurity or diabetes, it's now we have food deserts, and they are impacting rural communities, low-income communities, all across the U.S. And they cut across race and geography. Now, it doesn't mean that it cuts across every place or every racial group evenly, but we're now moving away from broad, vague terms like social determinants and actually naming. You know, we have housing insecurity. There's food insecurity, and not only food insecurity but nutrition insecurity. Because even if you have a corner store, a fast food restaurant, that doesn't mean you have access to nutritious food, and people are much more likely to galvanize and support issues that they can actually picture and name, and that I think is really promising, and that's something that we should continue to move towards because I'm seeing more support from bipartisan aisles when we name the specific issue, as opposed to keeping it broad or vague.

Joseph Harris  23:49

What has it been like to work on these issues and in public health more generally during this challenging moment?

Monica Wang  24:00

That's a great question. It has been challenging, dispiriting at times, but also incredibly motivating and mobilizing because it has hit home for me that these are where my values are, and this is where I think I can do the greatest good. And part of that is that when you know that your your field is undergoing tremendous instability, and you're not quite sure where you can make movement at the national or federal level, it reminded me that we can also do things locally, and in fact, everything that was national or global started out locally. And so, what that has meant for me is continuing to move beyond academic circles. So, continuing, yes, to write research papers and submit grants and teach courses. But so much of the work of public health involves bringing people from other fields and other sectors, and the book has really allowed me to engage with conversations with people that I normally don't engage with. So they can include people who work in the library, local business leaders, local councils, different kinds of policymakers, where healthcare might not be their particular specialty area, but they're interested in improving the lives and the well-being of their communities, and so this has really helped me think about how can I take what we learn in academia and identify leverage points and key stakeholders to continue these conversations, so that we take the evidence and we move it closer towards the finish line in the real world?

Joseph Harris  25:54

So it sounds like the local is quite important for you in this time. Are there other things that give you hope that upstream solutions for better public health will be embraced in the future, including at the national level?

Monica Wang  26:08

Well, I think part of it is that so usually whenever people hear the terms social determinants or health disparities, they immediately think low-income populations, people who are uninsured, perhaps people of color, and they may not be thinking this is me and this is what I deal with. What the book really lays out in a sequential matter is that it's not simply about income or health insurance or your racial ethnic background. The broader issue of public health also has to deal with things like job stress. You know, how much flexibility or autonomy do we have in your work environment? How socially connected are you with your friends, your families, your coworkers, people in your community? And those are the two, I would say dark horses of public health determinants that people don't typically think about, but really impact everybody. No matter where you grew up, what your upbringing was, everybody is navigating their own social network and social relationships, and is dealing with some kind of job stress. And it could be that you're looking for employment, and those are the factors that people across the board can have some agency over. So one example is if you're a manager or CEO, you're also responsible for the well-being of your employees because if you have sick employees who are stressed out, they keep missing work, they keep getting sick. That also impacts the health of the company overall. And if you are living in a neighborhood, you want to be a part of a neighborhood where there's high trust, such that, for example, if there's a major heat wave or a major snowstorm-which Boston gets both-and you are perhaps somebody who recently had an injury, or you're elderly, is there somebody in your neighborhood that you know who can check on you, who can help you shovel, who can give you air conditioning if you don't have any? And those forms of social support are really critical whenever we hit crises.

Joseph Harris  28:24

I haven't heard you use the word politics so much yet in this conversation. But how should we think about politics in relation to the problems and solutions you discuss in the book? Are the changes that are needed ultimately political ones?

Monica Wang  28:42

I certainly think that they're part of the picture because much of the public health infrastructure and investments that need to take place they require time, money, and resources, and that means you need buy-in from all different sectors, and the political sector being a major one. I remember one colleague saying to me at one point in time, "You know, what is politics besides getting two parties to come to consensus?" And that is the root issue of it, and it's it's become more challenging as we've delved into the era of social media and major politicization. It's much easier for people to criticize each other anonymously, and we moved away from having civil discourse the majority of the time. To if you're on that side and I'm on this side, I'm not only going to disagree with you on the issue that I don't agree with, I'm also going to disagree with you on all of the issues that you support, and we're moving away. From the issue and moving more towards identity or the personas, and I believe that we need to actually make it more specific because when you make it about a persona or an identity, it can be really difficult to find middle ground. But what we're actually seeing with certain movements like Make America Healthy Again, there's a lot of agreement that people deserve access to healthy, nutritious food that's affordable. I think it's hard. You'd be hard pressed to find somebody who's against that. Most people want to have clean air and water, and to have fewer toxic pesticides on our produce. And when people mobilize around a key issue, that's where you start to see more collaboration and more creativity. Another example is the moratorium on data centers. So many communities are concerned about with the rise of AI that requires building more data centers, which places enormous strain on local water supplies. And New York recently passed a moratorium, and so it's really setting the stage for recognizing that there are other factors that we need to consider besides just you know further developing one area, and there are real trade-offs in terms of thinking through as we're making decisions around business, AI, and development, there's real health and environmental trade-offs.

Joseph Harris  31:45

Looking back at the book as a whole, what were your big hopes in writing it, and and what do you want readers to really take away?

Monica Wang  31:56

My hope was that people can start to see that they also have a role to play, no matter how big or small, and it doesn't have to be, you know, major in terms of donations or protesting or starting a particular initiative. It can be really small, like checking up on a friend who recently had a baby, or if you're a manager, making sure that your employees have an appropriate amount of balance so that if they need time to go see a doctor or a dentist, that they can do that. And so the goal is for people to recognize that each of us has a role to play in improving community and public health, and each of one of us has different gifts to offer. And so I bring it back to the concept of community, which means shared gifts. And that means that each person can think about the different kinds of gifts that they have. So doctors have gifts of being able to diagnose and provide treatment, whereas they can partner with food pantries or with local produce suppliers to provide healthier, more affordable produce options for their patients who are struggling with diabetes. Or, in the case of some healthcare systems, they partner with Uber or ride share apps because the major barrier that patients were having to getting to their appointments was transportation, and so the work of public health is instead of each person saying "that's not my problem" or "that's my doctor's problem" or "that's somebody's willpower problem," moving towards "what gift can I give?" towards making this a a shared solution?

Joseph Harris  33:47

I love that. You had mentioned there was a lot of great stories that were left on the cutting room floor. This happens. We can't include everything. Is there a story that didn't make it in the book that you'd like to share with our listeners?

Monica Wang  34:00

Yes, and I try to share this often, especially if I'm speaking in a library. So when I was growing up, my parents couldn't afford, you know, full-time childcare, and when they had my brother, the way they managed was they took opposite shifts. So my dad had a typical job in higher education, so he had more flexibility, and my mom worked as a nurse aide in a nursing home. So she would take a 3p.m. to 11 p.m. shift on the weekdays, and on the weekends she often worked double shifts. And so that meant for most of my waking hours, I really didn't get to see my mom. So my dad was the primary caregiver, and he's great at many things, but raising a girl from childhood through adolescence is, you know, challenging for most people, and certainly perhaps not the greatest strength he had in his toolbox. But what he did do, and I so appreciate, is that every week he would take me to our local public library. And there was a librarian there named Miss Sheila Scott. And she would set aside books for me every week that she hand selected, and after a period of about a couple months, she I met her when I was about six or seven years old, she got a feel for the kinds of books that I would like, and she would leave a post-it note for me. So even if she wasn't there, I got to take a stack home of books. And as I grew older, from elementary through middle school, she changed the developmental age range of the books to match my needs, so she really understood children and child development, and that was wonderful because it really cultivated my love of stories, and it also helped me grow up in a way, because you realize you know I'm not going crazy. Everybody's going through all of these feelings and changes as they're getting older. And when I published the book and it came out, my publisher brought it to the Boston Public Library event, and there were lots of librarians there. And she was explaining the story. And at the end of the event, an older woman comes up and she goes, "I know this author. I was her librarian!" And she's still the head librarian at the local Boston Public Library branch. And I got to reconnect with her. She's come to all of my book events in Boston. She's bought multiple of my books, and it goes back to one of the themes in the book, which is when you're raising a family and raising a child, it really takes a village. And she was such a key part of supporting me while I was growing up, and she's still doing it 35 years later. And so, I just want to really thank librarians like Miss Scott, and to also recognize that libraries are also a major public health ally. You know, they offer resources and comfort and safety. It's where people can get their work done and apply for jobs and access internet, and so people who can be allies to public health-they're everywhere.

Joseph Harris  37:26

Yeah, I love that so much. My mom, as well, spent a lot of time taking me to the library when I was a kid, and those story hours, I think, left a huge, huge imprint on my imagination. And I, I too, I'm a champion of libraries, but I love that story just so so much. You you talked about the issue of politicization a little bit ago. I understand one topic you research apart from the the wonderful book is public health misinformation. Could you share a little bit about that and what you're working on currently?

Monica Wang  38:00

Yes, so I started doing more work in this area during COVID because there was so much false or inaccurate or misleading information that was coming out, and it had been on the rise in the areas of vaccines for quite some time. And part of that goes back to communications, which is we have so much data and evidence in scientific articles, but when we publish it, it's not necessarily accessible or engaging or digestible or even freely accessible to people. So, how can we change that so that we're moving away from you know you have to pay for the truth versus misleading information is free and abundant? And so I also think it's important for scientists and academics to also really focus on communicating in ways that land, and that means meeting people where they are, and that means social media, that means short form videos or op-eds, that means podcasts or different YouTube Shorts. And the work of misinformation: some of what I'm doing now, it's not simply understanding what it is or how to identify it, but how do we partner with different entities to communicate clearly in ways that can save lives and help people become healthier? And that means, you know, we don't have to expect every academic to all of a sudden become an influencer or every doctor or you know health researcher to have all of these channels. Some of our recent work has been in collaboration with the Harvard Chan School Center for Health Communication, where we partner with content creators. And so we've worked with them to identify a key area where there's a lot of misleading information, like supplements. There's a lot of marketing, a lot of money to be made in the supplement industry, but a lot of it, it's either it doesn't work or it could lead to serious health consequences like liver or kidney damage, stroke, need for transplants. And so we partner with content creators and we gave them a training toolkit on what are evidence-based claims about supplements. How are they different from drugs? What is the regulation or lack of regulation around supplements in this country? And what should people look out for when they come across a sponsored content or paid ad where someone is promoting a supplement that sounds almost too good to be true? And what we found is that evidence-based claims went up, and they certainly had far more reach than any academic article could have, because between a small handful of content creators, they reached millions who are watching their platforms. And the most interesting part about this is that we combined the the credibility and the science from the academics with the creativity and the authenticity of the content creators. And so they got to create messages in whatever way they wanted. It wasn't: "here's the script. Here's what you need to cover." It's: "you can take it and run with it and cover as much or as little as you want." So some had stories, some did role play and humor, others talked about their own life journey around body positivity, and so each one got to tailor the message based on what they found interesting or what would resonate with their audiences, and I think that pairing is what made it work so well.

Joseph Harris  41:49

That's so fascinating. I I can imagine that being very effective, and at the same time, you know, being somewhat afraid of this is, wait a second, this is not going in the direction that I'd hoped. Anything you could say about that? There's a lot of dynamics that are are going on there.

Monica Wang  42:09

Yes, there are. I would say, you know, part of science is taking some risks and seeing what will work, and if there is a chance for there to be more benefit, more accurate information to be disseminated, versus the status quo, which is we do nothing or we keep doing the same old, same old, which is continuing and leaving an information landscape that is is filled with information that people find hard to parse out. And so the alternative is that we keep going this way, versus let's try it, see how it works. If it works, let's try scaling it, and we can always adapt.

Joseph Harris  42:55

You're a professor in school public health, also an adjunct professor at another. If you could give just one piece of advice to a first-year student studying public health or global health, what would it be?

Monica Wang  43:12

It would be to focus on gaining transferable skills across industries, because, as I mentioned, public health is incredibly interdisciplinary, and we are at a moment where jobs are being cut in the public health workforce at the federal level, and that has led to people who are more senior, or more established looking for jobs at the local level, and so the competition is higher. And what I would say is, when you invest in transferable skills like communications, like leadership and management, like being able to manage conflicts, negotiate, think creatively about solutions-whether they're policy solutions, they're technological advancements-if you can work in teams and develop ideas, those skills can take you in almost any sector. And so, you don't need to have public or health in your job title to do the work of public health. And in fact, many people who are working in industry or government, but not directly within public health, are working towards initiatives and projects that are directly shaping the health of communities.

Joseph Harris  44:32

That's such an expansive and wonderful way to sort of think about the kinds of change that people can make in the service of public health. Today, we've been speaking with Dr. Monica Wang. She is an associate professor of community health sciences at the Boston University School of Public Health, adjunct associate professor of health policy and management at the Harvard T.H. Chan School of Public Health, and executive editor of the Public Health Post. Her wonderful new book: "The Collective Cure: Upstream Solutions for Better Public Health" is out now. I can attest that it is wonderful. Go get it. Monica, thanks so much for joining us.

Monica Wang  45:10

Thanks for having me, Joe.

Joseph Harris  45:23

This podcast and transcript was produced by Sophia Leggoe. Thanks for listening.