Alumna Highlight: Ayanna Johnson, MSPH '12

Thank you Ayanna for sharing memories on being a MSPH student in our department and your current work.

Current position: Public Health Analyst

Organization: US Department of Health and Human Services, Health Resources and Services Administration (HRSA)

What memories do you have as a student here in the department? 

Some of my fondest memories of being a student in PopFam are the thought provoking courses I took on adolescent health and development, MCH policy, international health, reproductive health, demographics and spatial statistics. Those courses helped orient my thinking to see the interconnectedness of health, policy, place, and resource distribution and the importance of taking all of those factors into account when planning public health interventions.

I loved living in Baltimore. So, naturally, many of my fond memories include finding great places to eat in the Market behind the School or in Fells Point. I enjoyed working with SOURCE as a Diabetes Health Educator in Baltimore City and bonding with classmates as we applied our skills in service to the broader community. My MSPH practicum with the Bill & Melinda Gates Institute for Population and Reproductive Health, under the leadership of Dr. Amy Tsui, took me to Malawi to conduct population and family research. Dr. Tsui placed me with a mentor, Dr. Frank Taulo, who was one of the few providers trained in cervical cancer screening in Malawi. Being able to work in a different country and learn how health care systems outside of the US operate, was a highlight of my graduate program.

Did you consider public health during your initial training?

I always knew that I wanted to be a public health practitioner, with an emphasis on policy. I wanted the work I did to have a population impact and to reach underserved and racial/ethnic minority populations. I believe that we have to create systems that make it easier for individuals to achieve their fullest potential and take advantage of a wide range of opportunities. During my undergraduate studies, I majored in political science and double minored in psychology and biology. That trajectory was really the underpinning of my graduate studies. I knew that in order to improve the health of our nation, we needed supportive policies and programs, backed by science and a clear evidence base. I also participated in a program through the Kennedy Krieger Institute and supported a home visiting research project within the JHU School of Nursing focused on maternal mental health and perinatal outcomes with the Baltimore City Health Department that exposed me to public health in practice in the MCH field. 

What advice would you give to current students in the department?

My advice would be to fully “lean in” to the work and experience during your Master’s or Doctoral program. Ask intelligent questions, but only after listening and learning from diverse perspectives. Engage with fellow students and your classes as much as possible. I would suggest taking a chance – joining a club, taking on a leadership position, working as a research assistant, or helping a professor with a publication. Most importantly, I would experience public health in action at the local or community level. The more experiences you can have, the better professional you will be post-graduation.

You have many accomplishments – does anyone stand out in particular?

Working for the Office of the US Surgeon General and being part of a team that launched the Surgeon’s General Report on Walking and Walkable Communities and also organizing a conference on Emotional Well-Being in partnership with the Department of Veterans Affairs, stand out. However, I always come back to my time in Malawi where I joined forces with a former classmate to raise money to train a new set of STI clinic nurses, at the main hospital in Blantyre, to conduct low-cost/low-tech cervical cancer screenings.

What do you foresee as challenges and opportunities in the future for the field of population, family, reproductive, maternal/child health?

I think we have many opportunities to continue building a more equitable public health system and society. As our communities are becoming more diverse and reproductive decisions look different than a few years ago, the field must continue to center the person and their community in all care decision making. This translates to holding space for doulas, community health workers and non-traditional birthing plans in the MCH and reproductive field. It also means that we should work to develop training and systems that support the integration of these care providers and also ensures that best practices are followed – wherever a person decides to seek care.

I am also concerned by the rising rate of Black maternal mortality. Figuring out how to reverse this trend and train health care providers to spot early warning signs, to create safe birthing and delivery spaces and to prevent excess morbidity are going to be key challenges in the next few years.

I am excited about the opportunity to build on successful models of MCH pipeline training to continue attracting highly qualified candidates to the field and prepare individuals who are ready to work in interdisciplinary teams, who are diverse and representative of the communities they serve.  When we think about the future, we need to strategize how to continue this important work in sustainable ways, with limited funding.

There is also great work coming out of Title V programs across the nation that is improving maternal and child health

What lessons have you learned from the pandemic from a Public Health perspective? 

This year, we have seen, so plainly, how the social determinants of health affect health outcomes, morbidity, and mortality, during the COVID-19 pandemic. We also see how unequal distribution of resources can disproportionately affect one group over another. The pandemic highlighted the inequities that most of us in public health knew existed, but laid it bare.

I learned that there is still a need for better coordination and that our most important asset will be a proactive and strong public health system. We saw the burden placed on many in our nation who are food insecure or socially isolated or caring for children, and the need for targeted assistance during public health emergencies and improved access to care, diagnostics, and screenings for vulnerable populations. 

Nonetheless, I have seen that public health is up for the task, using innovation and tried and true techniques to support communities, even with limited resources. The swift action of public health officials to get out clear and accurate information during this pandemic was invaluable. As a public health advocate and practitioner, the pandemic underscored the need to continue basic health education and delivering preventive services in the midst of an emergency.

How has your work evolved to address public health challenges related to equity and the social determinants of health?

My work has always centered on addressing health equity and eliminating health disparities. However, there is a wider consensus that achieving equity requires breaking down silos. More sectors outside of public health are recognizing the impact that they can have on health outcomes and broader quality of life. Education, housing, the built environment, the legal system, faith based organizations, the financial system, planning and development etc. all have a role to play in helping to create and sustain health in our communities.

I think we are also seeing the evolution of thinking around health equity that is much more nuanced. Since my graduation in 2012, there have been many seminal reports that have evolved our collective thinking on these issues from academia and organizations like the National Academies of Medicine and Robert Wood Johnson Foundation. Recently, newly released federal initiatives, Healthy People 2030 and the 10 Essentials of Public Health, both emphasize equity and addressing the social determinants of health at a systems level.

It is no longer enough to say that someone has access to insurance, or prenatal care, but we must also look at whether one can afford their medication, lives in an area with access to affordable healthy food, can pay their utilities, or have a job with a living wage. We also know that structural barriers like racism and sexism pose real challenges to living a healthy life. 

Public health organizations and our partners in diverse sectors must be involved in efforts to improve health. We need laws, policies, housing, education, built environment, and many other conditions to change to achieve healthy equity.