Voting and health outcomes: the cycle doctors ignore

I apologize if the article reads a little word-salady, but with midterms just wanted to throw out a reminder that the American Public Health Association, the American College of Preventive Medicine and others have all commented on the importance of voting and voter representation on public health, so please don't forget to get out the vote!

I include a collection of statements from various professional organizations along with all the appropriate associated links for anyone interested or who might find it a helpful reference.

Hi everyone!

I am writing a novel about a catastrophic societal collapse caused by a pandemic which destroys peoples’ ability to read and write, and want to make it as realistic as possible. Specifically, I have a character who is an epidemiologist with the CDC and I want to know more about how her job would work, what her priorities would be, the attempted institutional response, etc.

So, some context: the virus is a mutated strain of chickenpox / VZV. Already highly contagious, but this mutation is far more dangerous because 1.) it has a longer incubation period (4 - 6 weeks), 2.) it has an even higher R-0 (maybe 5-6), and 3.) in almost all cases, it causes a focal encephalitis after the first few days of symptoms. The virus targets the Visual Word Form Area and other parts of the brain associated with literacy. I’m not a neurologist, but the areas would be, as far as I can tell, the angular gyrus and parts of the left temporal-occipital lobe? I think?

The initial symptoms are similar to a flu: fever, severe headache, photophobia, as well as a stiff neck and some neuropathic pain. This is the prodrome period, which persists for a few days, and then develops into confusion and delirium, olfactory and right-side visual hallucinations, right-side motor weakness and loss of control, focal seizures, (usually) transient aphasia, and permanent alexia with dysgraphia (loss of ability to read and write).

Young people and children are more often spared the encephalitis, though they can still get sick. A handful of people are genetically immune, largely due to overactive immune systems, which have their own side effects (chronic brain inflammation, specifically). Generally the virus itself doesn’t kill its hosts, unless their immune systems are already compromised. The deadly part is the secondary social effects.

The virus, with its long incubation and high transmission rates, spreads silently around the world via air travel before symptoms begin, and by the time they do, it’s already everywhere. As far as I can tell, this would rather efficiently cause a catastrophic meltdown of society within a month, because our entire civilization is based on the written word. Take that away, and the systems we would use to even summon a response begin to collapse very quickly.

I think the very first signs in the US that bring it to the attention of the CDC are an air-traffic controller (working sick) suffering the encephalitis symptoms (a collision is narrowly avoided), and a truck driver (also working sick) crashing and causing a massive pileup, but surviving. Rapidly, similar cases start to pile up all across the country.

As far as I can tell, the CDC’s first move would just be trying to figure out what the hell this thing is. They’d perform spinal taps on the patients, and probably find out pretty quickly that it’s a strain of VZV. The problem is that a.) by the time severe symptoms start, antivirals won’t do much, b.) for every person showing symptoms there are likely thousands of asymptomatic carriers, so containment is basically a joke, to the point that the people in the CDC offices themselves may already be infected, and c.) the tools they use to organize a response all involve writing, which is rapidly going to erode.

So, you’re an epidemiologist working for the CDC. How do you attempt to respond, even if that response is, ultimately, futile?

I'd also love to hear any other feedback, thoughts, questions, or critiques of this concept!

Thanks so much!

Hi everyone,

Please bare with me as I am new to the field and am unsure what my path forward should be. I have a Bachelor's of Science in psych w a minor in history, and I have extensive research experience in my target field of study. I always thought that I wanted to do a PhD in clinical psych, but always wondered why I wasn't necessarily that interested in faculty's research. I realized that I am interested in macro-level social determinants of a certain facet of health (which I work on a clinical trial for right now), and that has brought me to realize that I want to combine my psych and history backgrounds and do public health.

I was never planning on getting a masters, and honestly i don't find it necessary, but I wanted to come here to ask what others think. I conducted macro-level social research at the PI level for my thesis, developed my own scales, and also have a very strong working understanding of research, stats, the US health system, and clinical work. The field that I want to go into is quite niche, and my current PI has some connects to public health faculty that I am interested in working with at big programs. I'm just honestly not sure if I should get my MPH first (it seems like people suggest that when you're not exactly sure what you want to study). Any advice is really appreciated.

As you look at the maps of wastewater surveillance results, remember that large counties with small populations can make it look like there's more viral activity than there really is. This happens all the time when we map data. (I teach a course about it, and it still boggles the mind of the brightest public health students.)

Here's a good article that proposes a different way of looking at election data (which you can translate to other data, like public health data) a little more multi-dimensionally. Essentially, what question can a map actually answer?

(And we can also talk about the lack of surveillance data from the federal government, leaving us with an information vacuum we have to fill with incomplete or missing data.)

(Part of the article requires free membership.)

https://stemlounge.com/muddy-america-color-balancing-trumps-election-map-infographic/

Hello public health community! I’m trying to figure out how to transition into global health from clinical PT and would love advice from people who have made a similar career pivot.

A little about my background:
I'm a Doctor of Physical Therapy with clinical experience in acute care and neurorehabilitation.

I have a bachelor's degree in Human Physiology with a minor in Global Health.

I served as a Peace Corps Volunteer in Indonesia for two years, where I taught English and helped implement community projects.

I have research experience from undergrad and PT school, teaching experience, and recently started volunteering with a global surgery non-profit writing patient stories.

I'm particularly interested in improving access to healthcare for underserved communities, health systems strengthening, rehabilitation in low-resource settings, child and maternal health, and noncommunicable diseases. I'm also drawn to health communications and patient storytelling.
I've been looking at entry-level program coordinator, program associate, and research/project support roles, but I'm finding it difficult to identify positions I'm actually qualified for. Many seem to require previous global health work experience or an MPH/MSc.

I'm considering pursuing an MSc in Global Health or an MPH, but I'm hesitant to spend two years and a significant amount of money on another degree when I've already studied a fair amount of global health theory. I'd ideally like practical experience and a path into paid work.

For those working in global health, especially those who transitioned from clinical practice or another field:
How did you get your first paid global health job?

Was a master's degree necessary, or could you have gotten there through work experience and networking?

What kinds of entry-level roles or organizations should I be looking at?

If you were in my position, what would you do over the next 6–12 months to become a competitive candidate?

Thank you in advance! I'm trying to make an informed decision about my next steps rather than defaulting to another degree because I don't know how else to break in.

Hi everyone,

I'm a doctor based in Australia with a background in communicable disease surveillance and outbreak response.

Over the past year I've been independently developing Sentinel, an open-source platform for communicable disease surveillance, contact tracing and outbreak management.

The project was born from frustrations in limited adaptable technology available (exacerbated during COVID-19) to help manage routine surveillance and outbreak management.

Surveillance requirements can change quickly especially in a pandemic. Case definitions evolve, new questions need to be asked during contact tracing, investigations grow, and can scale from a few cases and contacts to hundreds quite quickly.

I wanted to explore what a surveillance system might look like if it were designed around those realities from the beginning.

Sentinel is now in beta, with functionality covering case and contact investigations, laboratory results, configurable questionnaires, outbreak management and public health follow-up tasks.

I'm at the stage where I'd really like to involve more people in its development, particularly those who understand the practicalities of working in public health.

That might mean testing the software, reviewing investigation workflows, contributing code or documentation, or simply pointing out things I've overlooked (there's probably a few).

I'm organising an introductory webinar in November to demonstrate Sentinel and hopefully bring together a few people interested in where it could go.

Register your interest in the webinar (date TBC):
https://sentinelsurveillance.app/webinar/

More about the project and ways to contribute:
https://sentinelsurveillance.app/get-involved/

I'd also be interested to hear what surveillance systems others have worked with, and what you'd change about them if you could.

[Advice]

I'm looking for some advice. I am a junior biology major and public health minor looking to apply to MPH programs in about a year. I am super passionate about women's health as well as infectious disease, specifically loving how the life sciences can be applied to that. Long term, I'd like to work in a field where the two are combined (STI research, Infectious diseases in pregnancy or pregnancy outcomes) I am wondering what concentration would be best for this? I am deciding between Maternal and Child Health, Infectious disease epi or just epi. Any advice or insight from anyone in these niches would be much appreciated!

Hey r/publichealth,

We thought folks here may be interested in our latest. Here's a summary:

For the last four years, bird flu has ripped through American barns, killing two people who caught it from sick animals. But as far as anyone can tell, humans could not spread this strain.

Under the right conditions, however, that could change. A single mutation could give the bird flu a foothold in people and spark a pandemic that experts fear could be deadlier than COVID-19. 

For that to happen, this bird flu would likely need to find an intermediate host — an animal vulnerable to viruses that infect both birds and humans. These animals would be crowded together, each infection raising the odds that a new strain could arise through mutation. Then, for that strain to jump across species, it would have to have access to humans and time to spread among them undetected.

That perfect petri dish exists right now, our investigation found. For over two months, an outbreak of bird flu has raged uncontrolled on C&T Fenn Farms, a Utah farm about an hour’s drive south from Salt Lake City that raises thousands of mink for fur. Mink have lungs and airways that on a cellular level are remarkably similar to those of people; they have caught and spread other flus and infected some humans with COVID-19.

But federal officials have brushed off the issue, and Utah has prioritized the fur industry’s interests. Little has been done to stop the spread of the virus and ensure it can’t spread to humans, a failure that experts called “irresponsible’’ and “astounding.”

The owner of the farm, Chad Fenn, said his conversations with state officials had made him less worried about spread: “... The state people we reported to, they said you don’t need to worry too much.”

“My guys wear masks every day. They have glasses they can wear,” Fenn added. “Me? I don’t wear it at all. Never have, never will, because I’ve been doing it for 40 years.”

You can read our full investigation here: https://www.propublica.org/article/bird-flu-mink-farm-utah-human-risk

State veterinarian Amanda Price, who handles Utah’s response to outbreaks, said she sought guidance from USDA officials. But they said they didn't regulate mink, or have a vaccine approved to give them. No one at USDA flagged mink depopulation as an important step for public health, and no one from CDC reached out to her, Price said. She also told ProPublica she did give an order to the farm to keep its animals and byproducts on its premises.

Per state policy, Utah does not proactively monitor workers exposed to animals infected with bird flu. Price said the policy is meant to allow farmers to decide whether to contact the health department. “If we started seeing people actively dying from this, obviously that would change how we respond to this,” she said.

hi, for reference i’m currently in undergrad majoring in public health.

i’m at an institution that offers a 4+1 for an MPH, but not sure if this is somewhere i see myself being for 5 years. i would like to get my masters in PH as fast as possible, but if i don’t stay here, i don’t know what or where to do it.

in theory i could transfer to another school junior or senior year, but im unsure if that’s the wisest choice especially given that i want to study abroad

i don’t know what i want from you lovely people, but im curious if anyone has any recommendations or has done anything similar.

thanks guys

Only share if pertinent. Thanks :)

Hi all. I'm a first year MS student in EOHS and I'm uncertain about the prospect of continuing on to a PHD program. I did a ton of research in undergrad (I was also in EOHS) and I absolutely loved it and I was so excited to start my masters and so far it has been... underwhelming. I'm also not entirely sure what jobs I will be qualified for once I graduate as I am not occupational health focused. I was super excited to get involved in new research but right now I don't have much direction and my advisor is somewhat absent. My original plan was always to continue onto a PHD program but now I am just not sure. I am hoping that I am able to get more involved in research but there is much less of a wet lab culture in the lab than I thought when I accepted my offer (there is some state dept. PH practice mixed with the lab but not much research per say). Any experience or advice in this area would be greatly appreciated.

Hi everyone! I started my mph in epidemiology this semester at a T20 school. I’m also working full time as an oncology clinical research assistant at the school’s clinical trials office. I’m curious to hear any thoughts about roles I would be competitive for once I graduate in 2028. I don’t want to go the government route really (worked as a disease investigator for a LHD for a couple years) but more so big pharma or clinical trials. I’m planning on working with biostatisticians to do some sort of data analysis project for my practicum. What are some job titles/roles I should be searching for towards the end of my degree that I would be a competitive candidate for?

Researchers at the University of Bath’s Tobacco Control Research Group studied documents leaked by a former British American Tobacco employee who worked on the company’s anti-illicit trade team in the Horn of Africa. Their findings suggest BAT’s anti-smuggling efforts were focused on increasing its own sales and gaining access to policymakers rather than eliminating illicit trade.

One 2013 memo from Ethiopia said anti-illicit trade operations “would only be creating contestable space for either PMI [Philip Morris International] or the illicit trader.”

Allen Gallagher, one of the researchers, told us the threat of illicit trade “is one of the most common arguments made in opposition to virtually every tobacco control policy that has ever been proposed or implemented by a government.”

Full interview here.

BAT didn’t respond to our request for comment but has previously said it “emphatically rejects mischaracterisation” of its anti-illicit trade activities.

I'm in the MPH application cycle right now. Infectious disease epi is what I want to do, and I could definitely see a career for myself working at local/state health departments and the like.

But an unusual question popped into my head recently, and I haven't been able to find an answer. Just bear with me here. But in my state (and I'm assuming most if not all others), if someone tests positive for certain STIs then by law it must be reported to the health department. Then the health department contacts the patient for contact tracing and partner services. At least in my state, the process is not anonymous, i.e. the health department employee contacting you knows who you are.

Anyway, what on earth is supposed to happen if you are a health department employee, possibly even working in the STI division, and you yourself test positive for an STI at some point? It's supposed to get reported to... your coworkers? And then you get a call from about it from... your coworkers?

Are there generally any procedures in place to prevent this kind of situation? Or are you genuinely just supposed to be a completely celibate monk throughout your career as a health department infectious disease epi, because otherwise I don't see how else you're supposed to avoid running the risk of your colleagues being provided highly sensitive details information your sex life directly from your doctor.

You got a BSPH thinking it would be a ticket to a useful, stable, meaningful career without needing to take on extra debt for grad school.

Or maybe your school had an accelerated MPH program option after your BSPH, but for whatever reason, by the end of undergrad it didn′t make sense for you to go that route.

Now you′re in debt, won′t even be considered for an entry level PH job, AND public health in multiple countries (especially the US) has been eviscerated, meaning for every open grant funded health educator position you′re competing with 600 PhDs recently laid off from the CDC. You′re 13 months into a job search. You′re at your wit′s end.

What′s next?

The suggestion I see most often is to swallow that extra debt for an MPH (the obvious answer), but for those who are still skeptical of their chances in today′s absolutely floundering PH landscape, what else is out there?

The next most common options I see are:

Infection preventionist

Nursing

Healthcare administration

(The issues with these are that many BSPH grads chose PH partly because clinical medicine wasn′t up their alley).

Some more:

Entry level lab tech (anywhere) and work your way up

Environmental field tech

(Hard if your sham BSPH program didn′t offer enough lab science credit hours to qualify).

One tangential option I′ve personally considered is teaching - just like an MPH, your employer may fund grad school later on for a nice pay bump.

(Anyone done this or know someone who has? Feedback welcome!)

Paralegal work seems realistic too.

For now, I′ve taken an even more tangential path: I′m hardcore into environmental restoration and native plant ecology, so I′ve been working in ~40k/yearly invasive species management and permaculture landscaping jobs. It ain′t much, but my bills stay paid, and as a DINK we do have some money to squirrel away now - but my spouse is in the trades, not a super stable 401k′d up corporate or tech gig like most people in this field tend to have, and we both have to consider that our physical ability to do this work won′t last forever.

Now that I′ve gotten a few years into outdoor work I can′t imagine going back to working indoors. Having sun on my face, plants in my hands and a nice little workout every day keeps me from going any more insane than I already am. So, I am now considering tracks like ISA certification and a career as a consulting arborist, which especially in municipal and NGO positions is directly related to public health through issues like nature equity, heat island mitigation, greenspace access, and air quality - even if most people don′t think of it that way.

Just like I believe that widespread education in public health would benefit absolutely everyone, I think if masses and masses of people were engaged in hands on ecological restoration work, we′d be a long way toward solving the planetary polycrisis. Health in all fields isn′t just a slogan and I wish education was publicly funded everywhere, uncoupling your degree choice from your future economic stability, so that a BSPH could be a sensible option for everyone.

Alas, it is not. So we have to strategize.

I′d LOVE to hear stories, advice, and feedback here. Do you know anyone who′s found their feet after falling for the BSPH trap - without just biting the bullet and getting an MPH? Have you? Let′s talk about it!

Sidenote/disclaimer: no chatbots or AI were used in the making of this post. I promise this is just how I write!

For five years, the New York State Health Department has been locked in battle with three tiny Amish schools upstate. The dispute: whether students must be vaccinated.

Amish families say that New York’s immunization rules, which allow no religious exemptions, threaten their religious freedom and way of life. The state insists that unvaccinated children — which would include most of the students at the three schools — must be barred from the classroom.

In a petition filed on Sept. 28, the Amish asked the U.S. Supreme Court to force New York to grant religious exemptions to immunization rules, as most states do. A previous ruling gave the Amish reason to think they might have a chance at prevailing.

https://www.nytimes.com/2026/10/20/nyregion/measles-amish-school-vaccine-requirement.html?unlocked_article_code=1.KFE.t0Zk.ZUAidvGDsST7&smid=url-share

Hello everyone!
I’m a senior for my school’s public health undergraduate degree!

I have a class assignment where I need to interview from somebody who is working in public health to get an understanding of the general scope of a public health career which includes career pathways; daily responsibilities, challenges and skills to succeed! I unfortunately don’t know anybody who works in public health and honestly, I forgot to do this.

Anyway if you’re interested please answer the following questions:

1)What is your job, place of employment(like at a hospital) , and responsibilities of the role for your job?
2)How has this role been essential to the public?
3)What skill sets are needed to do your job?
4)What was your experience like going to school and building the pathway you are now?
5)What were the challenges that you saw going to into the field and how would you describe it now over the course of your career?
6)What types of background does your colleagues come from and is there a common trait or passion you all have?
7)How has misinformation and complex data affected your job’s responsiblities?
8)What types of changes would you like to see happen to better improve your job’s role and why?
9) What advice would you give anyone thinking about entering the sector vs to a young child at like 8 years old?

Thank you!

Hi everyone,

I am a microbiology PhD student participating in a public health non degree program at my institution. I have completed my classes and now need to complete my public health experience. I previously was set to work with the local heath department but that has fallen through due to some ongoing legal issues collaborating with local universities and students.

I am now having to resort to cold emailing organizations (which I despise) and am here asking how you would like to be approached if you were to receive this email? Or if you had a similar experience of setting up a public health experience, how did you go about it?

Unfortunately, there is not much institutional support so I am trying to figure out the best way to approach this.

For context, the project is flexible. The requirements are writing up a deliverable for my program about what I did, how I went about the experience, etc. and identifying a public health mentor. Past students have done everything from publishing articles to recruitment to communication based projects.

Hi all!

I’ve always wanted to be an epidemiologist or an IP. every single listing for an IP I’ve seen requires you to be an RN or have a nursing license. Does anyone here work as an IP without a nursing license and if so, how did you get your job?

Thanks!

Edit to add more background info: I currently am a certified pharmacy tech AND a certified clinical medical assistant with 6 years of healthcare and clinical experience and I’m finishing up my bachelors in PH

Hello I wanted to write this that I may share my families story in hopes that it might help others. My 9 year old little girl was diagnosed with Cushing’s disease about a month ago. Her case of Cushing’s was extremely fast progressing and many professionals told us it was the fastest progression they had seen yet. My daughter gained 30 pounds in 3 months and went from a petite 45 pounds to 75 pounds in that time. We took her to a primary care physician when she had gained about 15 pounds and she said it could be normal but let’s run tests. All her numbers were good but cortisol was high. She said it may still not be anything but referred us to an endocrinologist at phx children’s hospital. He said he doubted it was Cushing’s because it was so rare and he had never seen a case before and suspected increased adrenal activity that starts before puberty but he ordered another type of cortisol test to be safe. At this point her blood pressure was still normal and her only symptoms presented were weight gain and moon face. The 2 cortisol tests came back extremely elevated at greater than 30 times the normal cortisol level. He called us and said he suspected Cushing’s but was still skeptical because of its rarity. He ordered a MRI and the MRI showed a 4.3 millimeter mircoadenoma on the left side of her pituitary gland. This confirmed the diagnoses. At this point my daughter was still gaining weight and now she had terrible heart burn, severe gastrointestinal issues, chest pains accompanied by high blood pressure (had to be put on blood pressure meds), severe mood swings, she was more quite and her immune system was suppressed and sicknesses were very hard to get over. It seemed like for a while we were experiencing a daily progression in symptoms with many starting at the night time. Our endocrinologist said they didn’t have any surgeons there that were familiar with the surgery required for this and that he was searching for answers. Around this same time we told the Priest of my church our struggles and he mentioned a member of our community was the head of neurosurgery for a large hospital in the valley. We met him days later and he mentioned he was familiar with Cushing’s and he had worked at the NIH (National Institute of Health) and the best surgeons in the world for Cushing’s were there and that he would make some calls. Oddly a couple days before meeting him I googled the best surgeons for this condition and came across a name Dr. Prashant Chittiboina. The next day after I had talked to and met the parishioner head neurosurgeon I get a call and it’s Dr. Chittiboina and he mentions they want to include my daughter in a study for Cushing’s and would treat her. The NIH is at the head of medical research and breakthrough and they specialize in the rare things like Cushing’s. Within another week we were on a plane to Bethesda Maryland to the NIH. We were admitted into the children’s inn which has been wonderful an our accommodations were covered as far as travel, lodging food in addition to the treatment my daughter would received at the NIH. We have been here not almost 3 weeks and my daughter had her surgery 4 days ago. She spent 2 days in ICU after. They had to remove part of the cavernous wall since the tumor had grown onto that as well. She has been in pain and very swollen but is starting to improve. We are in another room of the hospital. They are constantly monitoring her cortisol levels, potassium, sodium, urine, hormones and so much more. The level of care and attention to the details is on another level. I never imaged this level of care existed. Dr. Chittiboina and his team are superheroes. We have met children with Cushing’s and other rare diseases from all over the world. Some whom it took years to be properly diagnosed, some who came here also had surgeries which were unsuccessful elsewhere that Dr. Chittiboina was able to succeed in. We are currently still monitoring her cortisol which has crashed and they have started to supplement with cortisol now until her body can regulate itself which can take up to a year. The pituitary gland is vitally important and impacts so much of what happens in the body. I am afraid to go home because I can’t monitor her the way they are and we have been on such a roller coaster. I trust that they will not send us home until she is stable and they have us on a solid plan that we can follow. I hope this can help others and if you are struggling with this condition please look into the NIH and ask them if you might be able to join a study. It is so important the NIH is funded for the sake of humanity and these breakthroughs. Cushing’s is rare today and they don’t know what causes it which it partially what the research here is for and in the event in the future it does become more common the research done here at the NIH can save countless lives the way it has my daughters. The research and these skilled surgeons are saving lives today. During our struggles we have had a lot of angels around us. Sometimes a miracle is not miraculous healing but rather the pieces falling into place and finding the right person at just the right time. We are forever grateful to the NIH and Dr. Chittiboina and his team. We are also grateful for the prayers of many and our community and I truly believe God orchestrated this through the prayers and hands of many involved.

Hello all, I’m an undergrad student/healthcare worker looking into pursuing a degree/career in public health. I know there are many avenues and opportunities in this field so I was curious as to what your experiences are? What job did you end up going into and what’s your day to day at work like? Thank you all!

Health in Partnership and several partner organizations are hosting a one-hour webinar on October 26, 2026, at 3 p.m. (Eastern) about the role of public health in election integrity ahead of the November 3 midterms.

Organizations listed include Protect Democracy, the American Public Health Association, HealthBegins, the National Public Health Coalition, and the Health Equity Community Collaborative.

The webinar will be recorded and shared afterward, so you can register and still watch it later if you can't make it live.

https://healthinpartnership-org.zoom.us/meeting/register/oqDUQNbHQn6XSrk8IYMi9Q#/registration