C2: Critical Conversations that Lie at the Heart of Health Justice

Across the country, immigrants contribute to the fabric of our society. Working essential jobs, raising families, and enriching our neighborhoods. When it comes to health care, however, many face barriers that go far beyond the doctor’s office: language obstacles, limited access to insurance, fear tied to immigration status, and cultural differences that can make navigating the system overwhelming. In today’s episode, we’ll discuss how our most vulnerable communities are navigating these challenges to health equity.Today, I’m joined by Dr. Sarah Kimball, Director of the Immigrant & Refugee Health Center at Boston Medical Center and an Associate Professor of Medicine at Boston University School of Medicine. She completed her medical school training at Harvard University Medical School and did residency training in Internal Medicine at the Brigham and Women’s Hospital Residency Program in Primary Care and Population Medicine. She joined the faculty at Boston University Chobanian & Avedisian School of Medicine in 2014. Dr. Kimball has expertise in immigration-informed medical care, where she has helped to research and build health systems that are responsive to the needs of im/migrant patients. She is currently the Director of the Immigrant & Refugee Health Center (IRHC) at BMC, a comprehensive medical home that addresses the barriers that immigrants face to being holistically healthy. She has served previously as the Medical Director of the Boston Accountable Care Organization (BACO) Complex Care Management (CCM) program at BMC. In addition to a love of primary care, Dr. Kimball’s main interest is in teaching social justice and advocacy skills. She is an associate editor at the Journal of Immigrant and Minority Health, with an expertise in Health Services Research. She was a founding member of the Society of Refugee Health Providers and serves at the co-Chair of the Research, Evaluation, and Ethics Committee.

Our discussion today focuses on Disability Justice, a movement that centers the voices and experiences of those most marginalized, recognizing that disability is not a single, isolated experience. Disability inclusion is vital for social justice. It is deeply interconnected with race, class, gender, and other systems of oppression. Their slogan ‘'Nothing About Us Without Us' is a powerful statement that reminds us why centering those with disabilities in this fight for justice is imperative. Today I’m joined by Mallory Cyr. Mallory combines lived experience as a disabled woman with a rare disease and professional expertise in healthcare policy and transition to adulthood. She earned her MPH in Maternal & Child Health from Boston University and a BFA in Creative Writing from the University of Maine at Farmington. A nationally recognized expert, Mallory has provided ADA consulting, technical assistance, and over 50 workshops and keynote presentations to state and national organizations. She previously served as a policy specialist and contract manager for Colorado Medicaid, overseeing the statewide Non-Emergency Medical Transportation benefit and advancing systems and benefits for individuals with disabilities and medical complexities. From 2008 to 2020, she contributed to the National Center on Healthcare Transition Improvement, co-authoring a textbook chapter on health care transition published by Springer in 2018 (Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability). Mallory has been honored with Boston University’s 2021 MCH Alumnae Award for Outstanding Service and the DeBeaumont Foundation’s 2023 40 Under 40 in Public Health. Mallory lives in North Carolina with her husband and their rescue dog, Tinsley. To learn more about Mallory and her work, visit MalloryCyr.com.

Fellowships are a wonderful way for students to pursue additional hands-on experience during their academic career. They’re defined as any amount paid or allotted to, or for the benefit of, an individual to aid such individual in the pursuit of study or research. There are two types of fellowships that the Center of Excellence offers: practice and research. Practice fellows work closely with community leaders, while Research fellows work closely with faculty members. Having a fellowship can provide even the most unlikely of skills, for example, hosting this podcast has been an incredible practice fellowship. I’ve had the chance to meet and interview incredible practitioners in various fields of public health. Luckily, the MCH fellowships are open to all on-campus MPH students. Today I’m joined by 3 different MCH Student Fellows who have spent the last year working on various projects. 1 Research fellow: Jennifer Madu; and 2 Practice fellows: DeJah Fleurancois and Margaret Jones. They will explain the work they’ve been doing and how this has impacted their public health journey.

There have been a lot of public health topics that have become widely discussed, dissected, and debated within public discourse: Vaccines, Climate Change, Nutrition, and especially Autism. Autism or Autism Spectrum Disorder diagnoses have increased in recent years, sparking a variety of positive, but also negative, responses. Over the years, increased research has led to more understanding about how to support our community members on the spectrum  I’m joined today by Dr. Emily Feinberg, ScD, CPNP. Dr. Feinberg is the Director of Emerging Projects for the TEAM UP Scaling and Sustainability Center. She is currently a professor at the Hassenfeld Child Health Innovation Institute, Department of Health Services, Policy, and Practice at Brown University School of Public Health. Emily is a pediatric nurse practitioner at DotHouse Health. She has served as core faculty on Boston University’s Maternal and Child Health Bureau-funded Maternal Child Center of Excellence, mentoring MPH and DrPH students. The impetus for her research has come from the disturbing inequities in access to developmental and mental health services that she has witnessed among the children and families with whom she works. The overarching theme of her work has been the redesign of community-based child health systems. She has applied this lens to several public health priorities, including maternal depression screening, management, and prevention; autism services; and the integration of child mental health services within pediatric primary care. Her work has been funded by the National Institute of Mental Health, the National Institute for Nursing Research, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, the March of Dimes Foundation, and the Health Resources and Services Administration.Links to Dr. Feinberg's organization:https://www.teamupcenter.org/

I am joined by Dr. Uchenna Ndulue. Dr. Ndulue is a public health professional with over 30 years of experience in designing, implementing, and evaluating programs that support young people. He is the Bureau Director for the Child, Adolescent, and Family Health Bureau at the Boston Public Health Commission, the public health agency for the city of Boston, and provides oversight over programs that support maternal and child health, adolescent health, and violence prevention. Before this role, he served as the Executive Director of Peer Health Exchange Boston and as an instructor in public health at Tufts University.BPHC Mission: "To work in partnership with communities to protect and promote the health and well-being of all Boston residents, especially those impacted by racism and systemic inequities."Check out:Father Friendly: https://www.boston.gov/government/cabinets/boston-public-health-commission/childrens-and-newborn-health/father-friendlyFamily Nurturing Center: https://familynurturing.org/Doula Program: https://www.boston.gov/government/cabinets/boston-public-health-commission/doula-services