Interview with Alice E. Welch, DPH, MPH, RPh: The First Graduate of the CUNY School of Public Health at Hunter College, The Graduate Center, Doctor of Public Health Program
CUNY School Public Health at Hunter College: Dr. Welch, you achieved quite an accomplishment receiving your Doctor of Public Health degree. Congratulations. I've found that each person has a unique reason why they were drawn to the public health profession. What's your unique pull towards public health?
Dr. Welch: It was extremely frustrating to be a front-line health care worker and witness incredible disparities in access to and quality of care and not be able to do much about it. I knew I needed to work to eliminate disparities in care---but didn’t know how. Plus, I was particularly interested in HIV—treatment, education and prevention. My pharmacy education hadn’t provided me with the tools to affect change beyond the pharmacy, so I knew I needed to further my training and education. Furthermore, as a pharmacist, I had a limited amount of time to spend with patients, so discussions about prevention often took a backseat to pressing treatment issues. However, it became evident to me that most of the conditions my patients had could have been prevented. That was another factor in my decision to leave pharmacy and begin a career in public health.
CUNY School Public Health at Hunter College: Was it difficult to do after being out of school for Eight (8) years?
Dr. Welch: It was weird to go back at first. A lot can change in 8 years--especially registering for classes on the internet instead of having to go in-person!!! But, the MPH program at Hunter College was wonderful! The students ranged from just having finished undergraduate the year before to working professionals that were coming back to school after 10 or more years. I fit right in! I waited 2 years after I finished the MPH program before starting my DPH, because I was waiting for the CUNY School of Public Health to start a DPH program.
CUNY School Public Health at Hunter College: What was the most difficult part of going to school and working full time?
Dr. Welch: I did work full time during my DPH. In the beginning, I only took 2 classes a semester, but when I started my second year I was taking 3 to 4 classes a semester. It was definitely a challenge to find a balance between work, school and fun (because you need some fun!) I was fortunate to have a lot of support at work--so that I could leave early for classes and schedule my time off around exams and assignment deadlines.
CUNY School Public Health at Hunter College: What about those that are interested in getting their DPH at CUNY School of Public Health at Hunter College -- any advice?
Dr. Welch: I think public health is an interesting field to get into—as an interdisciplinary field, it is made stronger by the myriad of perspectives practitioners from different backgrounds can bring to it. The DPH program at the CUNY School of Public Health at Hunter College is perfect for public health professionals whether you are just starting out or you have been working in the field for many years. It is ideal for working professionals, as you are able to set the pace that’s right for you (within reason, of course). I would encourage anyone interested to go to one of the information sessions or contact current students or faculty members to find out more about the program.
CUNY School Public Health at Hunter College: What advice do you have for those looking to go into the field of public health?
Dr. Welch: There are a few things anyone considering a career in public health should do. First, get a solid foundation in public health by pursuing an MPH or a DPH. Second, think about what type of work you want to do---such as community-based participatory research, epidemiology, policy work or health education. Then, get out there and do it---the best way to learn is to immerse yourself in the field.
CUNY School Public Health at Hunter College: CUNY SPH has a mission, most organizations, both public and private have a mission -- how would you describe your own personal public health mission?
Dr. Welch: At the high school I attended, we recited the Ephebic Oath (originally recited by citizens of Ancient Athens) every year. In this oath, we pledged to fight for the ideals and sacred things of the city and to leave our city greater than we found it. As silly as it may sound, I guess 20 years later, that is how I see my role in public health---making NYC better, by trying to improve the health of its residents, and leaving it better than we found it.
CUNY School Public Health at Hunter College Can you tell me one anecdote or specific experience that occurred at the CUNY School of Public Health at Hunter College which is reflective of your overall educational experience? Also, explain your overall experience.
Dr. Welch: One of our professors told us that the concepts and skills that we learn in a given class may not make sense or feel relevant at that particular moment in time, but that somewhere down the road we’ll have an “aha” moment where something we read months ago will just click. She was right…my educational experience has been a series of “aha” moments.
I think a good example of a time that everything came together was working on a group project in one of our final classes in the program. The assignment was similar to projects I knew I would be working on in the “real world”, so I thought of it as good practice. Because the four of us knew each other so well, we were aware of our strengths and weaknesses. As a result, we assigned tasks accordingly. The experience taught me that I had the skills necessary to be one of the lead analysts on a project and reminded me that it is okay to ask for help when I need it. It was a great confidence booster and learning experience.
My overall experience in the DPH program has been fantastic. By creating the SPH, CUNY has been able to assemble a faculty with a wide range of research interests and specializations. As a result, students in the program are able to find research opportunities and a mentor with similar interests.
CUNY School Public Health at Hunter College: Based on your experience, education and new level of awareness, where do you see the future of public health?
Dr. Welch: I think the next few years are going to be challenging for public health. For example, in my work, we are closely watching the Senate debate on the Zadroga Bill. If the bill fails to pass, it will be challenging for us to find care for 9/11-affected rescue and recovery workers and community members.
CUNY School Public Health at Hunter College: You're currently working at the New York City Department of Health and Mental Hygiene (NYC DOHMH), how did you come about working for the health department?
Dr. Welch: After finishing my MPH, I decided that I really wanted to work at the DOHMH, but I wasn’t sure at which Bureau. I was interested in both epidemiologic studies and health promotion programming. When the position at the World Trade Center Health Registry came up, it was a really exciting opportunity to do both.
CUNY School Public Health at Hunter College: At the NYC DOHMH you work specifically for the World Trade Center Health Registry in the health promotion unit. What do you do there?
Dr. Welch: I serve as the lead of a team of public health nurses and health educators that conduct active outreach to Registry enrollees (that were not rescue and recovery workers) with 9/11-related physical and mental health conditions, in order to connect them to care. Our team also accepts inbound calls from all enrollees and any others affected by 9/11 that are searching for resources. In addition, I work as a data analyst at the Registry and am involved in several studies---including my dissertation research.
The work my team does is extremely rewarding and emotionally draining at the same time. When I look back over the last year and realize that we connected over 300 enrollees with providers that are experts in 9/11 health care, I can’t help but feel a sense of accomplishment in the program that I helped design. There are so many stories of enrollees that have been extremely ill and not receiving appropriate care for 9/11-related conditions until we contacted them. They are so grateful for our intervention and we are glad we are able to help. It can be tough sometimes though. We occasionally have calls with enrollees that are really distraught or depressed, for example we had an influx of calls around the anniversary and after the incident earlier this year in Times Square—that triggered an anxious reaction in many people. It can be difficult to listen to someone’s emotional account of their 9/11 experience and then try to help them find some resolution for their concerns.
CUNY School Public Health at Hunter College: What are some of the key concepts, lessons learned - if you will - that you were able to draw from your education at CUNY SPH at Hunter and apply to your current job?
Dr. Welch: Without a doubt, the epidemiology and data analysis skills I learned, as well as survey design---I fall back on those often. For example, when I started my job at the Registry, one of my first assignments was to create a questionnaire for a tobacco cessation project. Coincidentally, I had just finished a summer course in survey design, which made a tremendous impact on my ability to create the questionnaire. Also, earlier this year, I began working on a paper with two of my colleagues using data from the Registry. The analyses were fairly complex and I relied heavily on the analytic skills I learned in the DPH program to complete them.
CUNY School Public Health at Hunter College: Can you explain the World Trade Center Health Registry?
Dr. Welch: The Registry was established in 2002 by the Agency for Toxic Substances and Disease Registry (ATSDR) and the New York City Department of Health and Mental Hygiene to monitor the short and long term physical and mental health effects of 9/11 on those directly exposed. It is the largest post-disaster registry in the US with 71,437 enrollees, including rescue/recovery workers, and lower Manhattan residents, area workers, passers-by and students and school staff.
CUNY School Public Health at Hunter College: Can you explain your research focus and tell me about your study?
Dr. Welch: My study focused on the association between posttraumatic stress disorder (PTSD) and problem alcohol use at the time of the Registry’s Wave 2 survey (2006-07). Specifically, are enrollees with PTSD more likely to problem drink than those without PTSD?
CUNY School Public Health at Hunter College: What were your findings in relation to Post Traumatic Stress Disorder (PTSD) and alcohol?
Dr. Welch: The prevalence of problem drinking was more than twice as high among enrollees with PTSD compared to the general NYC population (NYC Community Health Survey, 2007). The relationship between PTSD and problem drinking was significantly greater among enrollees with late-onset PTSD compared to those without PTSD after adjusting for peri- and post-disaster experiences, suggesting that a significant portion of directly affected individuals are still at-risk for negative mental health outcomes several years after a disaster.
CUNY School Public Health at Hunter College: Was this finding unexpected, or was it more about creating empirical data to support what appeared to be a problem amongst 9/11 registrants?
Dr. Welch: Some of the findings were a bit unexpected. The goal was to gain an understanding of the problem and determine if PTSD was a significant risk factor. We also learned that some groups may face an increased risk of problem drinking when they have symptoms of PTSD.
CUNY School Public Health at Hunter College: In your study, you said the following: "These findings suggest that problem drinking in this population may be driven more by post-disaster experiences rather than PTSD in this population." What other experiences are happening to 9/11 and disaster victims?
Dr. Welch: Disaster victims, specifically those affected by 9/11, face numerous post-disaster complications—the loss of close family members or friends, homelessness, unemployment or underemployment. Subsequently, they experience numerous mental health problems, have a lack of social support and limited access to health care and other resources.
CUNY School Public Health at Hunter College: What are the implications of your findings for public health?
Dr. Welch: I think my findings, along with other published Registry findings demonstrate that the effects of complex disasters on urban populations are both acute and chronic. Both Hurricane
Katrina and the oil spill in the Gulf of Mexico highlighted the impact of disasters on the mental health and drinking patterns of those affected. Together, this reinforces that the effects seen after 9/11 were not unique and highlights the importance of including mental health issues in emergency planning. It is crucial that services be available to disaster victims in both the short and long term post-disaster periods. Services should include mental and physical health care, substance abuse counseling, financial services, career services and programs to insure that those displaced from their homes find suitable alternatives.
CUNY School Public Health at Hunter College: Just curious -- As a child you wanted to be:
Dr. Welch: A lawyer
CUNY School Public Health at Hunter College: Lastly, what's next on your "to-do" list?
Dr. Welch: The Registry is getting ready to launch its third survey, so that will keep me busy! Also, I am looking to expand our outreach project to include rescue and recovery workers.
Name: Alice E. Welch
Current Location: Woodside, Queens, New York
Position: New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Project Manager, 9/11 Active Referral and Health Promotion Unit, June 2008 to Present
Birthday: February 11th
Hometown: Woodside, Queens, New York
Education: Doctor of Public Health, CUNY School of Public Health at Hunter College, The Graduate Center, City University of New York: Master of Public Health, Hunter College, City University of New York, May 2005; Bachelor of Science in Pharmacy, St. John’s University, May 1995
Must Read Book: To Kill a Mockingbird
Favorite Movie: The Princess Bride
Favorite Web Links: Corporations and Health Watch (http://www.corporationsandhealth.org/); 9/11 Health Info (http://www.nyc.gov/html/doh/wtc/html/home/home.shtml); NYC DOHMH (www.nyc.gov/health); National Center for PTSD (http://www.ptsd.va.gov/index.asp); The American Public Health Association (http://www.apha.org/); NIAAA (http://www.niaaa.nih.gov/)
Your Favorite Saying: "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." - Margaret Mead.
Note: This interview was conducted over the course of several days via email by Charles Platkin, Ph.D., J.D., M.P.H, Assistant Professor (Visiting) at the CUNY School of Public Health at Hunter College