Dr. Ana Diez Roux: A Champion of Population Health
With her decades-long career in public health, Dr. Ana Diez Roux is an internationally-known advocate for addressing the challenges affecting people’s health.
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Health is one of the most critical elements of life, as without health, it is very difficult to function effectively in the many components of everyday life.
While there are various components leading to healthy and sustainable lives, there are also many factors that play a role — negatively and positively — in a person’s health.
Throughout her professional career, Dr. Ana Diez Roux has been a key leader in public health, studying and addressing social determinants and the effects neighborhoods have on health.
Given the number of roles and titles she presently holds — Dana and David Dornsife Dean and Distinguished University Professor of Epidemiology at the Dornsife School of Public Health of Drexel University, and Director of the Drexel Urban Health Collaborative among them — Dr. Diez Roux is able to be very involved, becoming a strong and influential voice on the matter.
“My interest in public health has been largely around how social, economic and environmental factors affect health and generate health inequities between groups of people,” Dr. Diez Roux said in an interview with AL DÍA.
Her interest started fairly early in her professional training, and progressed as did her desire to make a larger impact for her and her community. Since realizing that interest, she has spent the majority of her career working to address those very factors.
Throughout the duration of her youth, Dr. Diez Roux spent parts of her life living in three different countries.
Born in Buenos Aires, Argentina, her father, who worked at a university, moved his family first to Venezuela as a result of his work and a complicated political situation in Argentina.
At the age of seven, the family moved to the United States, where Dr. Diez Roux lived in Lexington, Massachusetts for five years.
Then when she was 12, she and her family returned to Argentina’s capital where she attended high school and obtained her university education.
Spending a handful of her years in both Argentina and the United States has made her feel deeply connected to both nations, as she was often, as she described, “in between countries.”
While in Argentina, Dr. Diez Roux studied medicine and received her training as a pediatrician at one of only two pediatric hospitals in Buenos Aires.
In addition to working at the hospital, she and the other pediatricians would rotate work at health centers, often located in the more impoverished and economically disadvantaged areas of the city.
That experience prompted her to gain a more specific interest in public health, as the reality and impact she could potentially make became more clear.
“I realized that there was so much that doctors couldn’t really address in people’s lives that have to do with their health,” she said.
As a pediatrician, she could treat certain ailments, often just temporarily, but not directly address the fundamental causes that drive those health ailments.
After that realization, Dr. Diez Roux gravitated toward public health, leading to her eventual return to the U.S. to pursue a graduate degree in the field.
Once her decision was made, Dr. Diez Roux started applying to graduate schools in public health in the U.S.
She earned a scholarship and enrolled at Johns Hopkins University School of Hygiene and Public Health in Baltimore, Maryland, to pursue a graduate degree in public health.
The reality of moving between countries and continents at a young age proved quite beneficial as she sought to obtain higher education opportunities.
“Since I spent a lot of my childhood in the United States, I knew how to speak English very well and when it became time to think about where I could get training in public health, it was easy for me to think about coming back to the United States to graduate school because there were many opportunities here,” said Dr. Diez Roux.
Together with a group of medical residents, they’d often organize meetings and invite sociologists, anthropologists, community leaders and nonprofit representatives to discuss health issues facing their communities.
“As part of that, I became more aware that there was so much more that we could do, and that I needed to get my training in public health,” she added.
While attending Johns Hopkins University, Dr. Diez Roux also developed an interest in public health research, accentuating her later decision to pursue a doctorate at the university, as well.
It was at that time that she became drawn to the field of epidemiology; the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations.
“I was very interested in understanding how social and economic things affect health,” said Dr. Diez Roux.
“So epidemiology is a perfect tool for that because you can study differences in health across different population groups and… what we can do to [create] change,” she added.
Some of her work in the public health sphere include looking at how neighborhoods affect people’s health, developing mechanisms on how to change neighborhood environments and health outcomes, and collecting and analyzing data to understand patterns of evidence within those neighborhoods.
“It’s very interdisciplinary,” Dr. Diez Roux said of her work. “It integrates things from sociology, from psychology, from medicine, from biology… to understand what the main drivers of health are.”
Throughout her career, she has been able to work with and learn from teams of individuals from diverse backgrounds, which, she said, has made “an enormous difference in the work that we were able to do.”
One of the focuses of her work has been understanding how race and ethnicity plays a role in impacting population health. The topics of race and ethnicity then branch out to other factors, such as residential segregation, class, economic status, acculturation and more — all critical determinants of health.
The work is done through both a physical and societal environmental lens, and aims to unpack the systemic structures that pave the way for these realities impacting health and, in turn, creates these disparities.
“When we think about improving health, we need to think about not just health care… but also about the environments that people are living in,” said Dr. Diez Roux.
After stints working on the faculties of Columbia University and the University of Michigan, where she was Chair of the Department of Epidemiology and Director of the Center for Social Epidemiology and Population Health, Dr. Diez Roux joined the Drexel University staff in 2014.
She is currently the Dean and Distinguished University Professor of Epidemiology at the Dornsife School of Public Health at the university.
As Dean, her goal is to provide students with the tools and skills to think critically about health, and the factors most important to health by relying on scientific evidence.
“Because the foundation of public health is science,” she said.
She also wants those students to be able to partner with communities, nonprofits and stakeholders to work effectively in teams, and become advocates and key voices for public health and society.
“So much of public health is related to the way society is organized,” said Dr. Diez Roux, noting the broader public societal discussions pertaining to the economy, social policy, and issues such as climate change, inequity and racism and seeing how those factors connect to health.
Dr. Diez Roux is also the Director of the Drexel Urban Health Collaborative, where she is able to expand that work more globally.
In this role, she has been able to focus on health in the more urbanized cities across the U.S., Latin America and beyond, and generate a broader understanding about the factors that play a role in public health in those areas, and develop ways to reduce inequities and the challenges those communities are facing.
This also led to her role as Principal Investigator of SALURBAL (Salud Urbana en América Latina) study, which focuses on the factors impacting residents throughout Latin America.
Whether it pertains to issues of transportation, air quality, segregation, or access to healthy foods, those are common challenges that populations face across the globe. Therefore, the Drexel Urban Health Collaborative has been able to analyze those challenges within those areas and work to find ways to address them.
“It’s really important to think about how we can design and manage and govern cities so that they can promote health and also protect the environment,” said Dr. Diez Roux.
The pandemic has brought out many challenges. However, one silver lining in it lies on the fact that it helped shine a light on the underlying health inequities that have been prevalent for decades, bringing epidemiology to the forefront.
“COVID, by highlighting those things, gave us the opportunity to speak about the health implications of systemic factors like racism and economic inequalities more forcefully,” said Dr. Diez Roux.
The work has continued all throughout the pandemic.
When asked what she believes is the most fulfilling part of her work, Dr. Diez Roux said it’s the opportunity to work with young people and, “seeing them carry forward new ideas, new and critical ways of thinking about the world and what we can do to make it healthier.”
Having the opportunity to see the younger generation of diverse backgrounds come together and work in unison to achieve a common goal adds more purpose to her work.
On a more personal level, if there is one end goal to the decades of work she has put into the cause of addressing population health, it’s that, and also to make a profound positive impact for individuals and communities alike.
“I hope that I have helped create environments where everyone can develop and thrive and where people from many different backgrounds can come together, find commonalities and work together on a shared mission,” she said.