By Lorraine Twohey-Jacobs
I interned at Insure the Uninsured Project (ITUP) this summer as a Health Policy Intern through UC Berkeley Labor Center’s Summer Internship program. I have an undergraduate degree in public health and statistics from American University. I am currently a graduate student at the University of Washington pursuing an MS in Epidemiology – the study and analysis of the distribution, patterns, and determinants of health and disease conditions in defined populations.
This summer at ITUP my primary project was to conduct research for an upcoming ITUP report on the importance of the social determinants of health (determinants) in health care and health policy. The determinants are the conditions in which we are born, live, learn, work, play, grow, and age that affect our health and well-being. I explored different definitions of the determinants and the factors impacting access to health care and health outcomes. I identified different data sources on factors such as employment, food insecurity, education, and poor housing conditions on the national, state, and county levels. I also researched options for state health care programs like Medi-Cal to address the social determinants.
My interest in the social determinants began in my undergraduate public health education. Prior to this internship, I conducted academic research on the social factors affecting individual and population health. Interning at ITUP complemented my education by giving me an opportunity to research the issue through a health policy lens. Importantly, I had the chance to examine the nuanced role of health care in the determinants. There are opportunities for the health care field to affect social factors for some individuals and to consider the impact on individual health when providing health care services. However, addressing the determinants will also require investment in social services, public health, and other sectors, as well as a shift in the American mindset regarding the welfare state and health as a human right.
My summer at ITUP provided me with new skills in health policy analysis and research, increased my understanding of state and federal health care programs and legislative processes, and gave me the experience of working in a nonprofit organization that engages with state health care leaders as well as local health care stakeholders.
In addition to conducting the determinants research, I flew to Los Angeles to attend the ITUP LA Health Collaborative on July 8 which focused on care coordination in the Medi-Cal program. I also attended Senate and Assembly Health Committee hearings, the Department of Health Care Services Medi-Cal Stakeholder Advisory Committee, and a meeting of county and city health department and agency directors across California. I met the State epidemiologist of California and other professionals working at the California Health and Human Services Agency, the Department of Public Health, and the Department of Housing and Community Development. Through these meetings with stakeholders in public health and health policy, I received advice on the determinants research as well as my future as an epidemiologist.
When I began my ITUP internship, I was planning to pursue a Ph.D. at the University of Washington after completing my master’s degree. Now I hope to first work in a state or county health department, research institute, or other nonprofit after graduation to bolster my skills and receive more “real-world” experience. While I still plan to eventually get a Ph.D. and pursue a career in research, I want to work with community stakeholders to better understand the issues faced by different communities, identify what solutions are needed, and help implement effective change. This summer at ITUP convinced me that to advance progress in health care access and coverage, and a variety of other health care issues, both research and collaboration with community stakeholders will be necessary.