Switching Careers Into Public Health and Following a Non-Traditional Path

For some people, career paths are a straight line – they know what they want to do and stick with it their whole lives. For many others, including me, professional journeys are not a straight line. Not too many young people grow up thinking about public health careers – becoming an epidemiologist for example. Public health career options are usually discovered after exploration.

Launching a Non-Traditional Career in Public Health

Growing up, I always loved science and teaching. In college, I majored in biology with a chemistry minor and enjoyed experimenting in the laboratory. I went to work for a pharmaceutical company, where I found that combining molecular biology with chemistry was fun. While in college, I also developed a passion for protecting the environment, stemming from a Christian view of humans as caretakers of creation.

When I graduated, I was unsure how I would combine these interests. My first job was a continuation of my work at the pharmaceutical company—developing nanoparticles for drug delivery technologies.

Switching Career Tracks: A Foray into Education

Eventually, a friend who was working in a Honduran elementary school invited me to teach there too, which I did for about six months. It was a wonderful experience living in a different environment. Teaching second graders was enjoyable, but I wanted to stay focused on my love of deep, rich science.

So next, I went to the University of Michigan to earn my PhD. My program with the School of Public Health combined all my interests—science, medicine (without patient care, which was not my interest area), and the environment. I chose a toxicology program because I was interested in how environmental toxicants impact health.

By chance, I ended up in a reproductive lab, researching pregnancy outcomes with different environmental chemicals. Through my experience in this reproductive lab, I realized pregnancy is the final frontier in biology. Surprisingly, it has not been explored much. For a long time, we assumed that pregnant women were physiologically similar to other adult females. But all the various systems are regulated differently during pregnancy. Only now are we finally understanding some of those changes.

The other reason pregnancy goes largely unstudied is that pregnant women are frequently protected under many clinical trials. For good reason, drugs are not tested in them, because we want to ensure vulnerable populations are protected. On the other hand, pregnant women still need pharmaceuticals. They are still exposed to toxins, and we need to know how they react.

My interests grew in how environmental chemicals and pathogens interact in pregnant women and potentially lead to adverse birth outcomes. Nobody is exposed to only one thing — people do not live in a vacuum. Biology frequently takes a reductionist approach, examining one thing at a time—which is good for experiments, but it’s much more complex in the real world.

Answering the question of how that interaction between chemicals and pathogens works in the context of pregnancy was the focus of my PhD. When I started my research, I found it was too big a question to answer well. I needed to concentrate on something more specific.

Focusing on Reproductive Study: Investigating Group B Strep and Chemicals in Pregnancy

I decided to focus on one pathogen: group B streptococcus. Somewhere between 10% and 30% of women can carry it naturally. It doesn’t cause any issues in adults typically — until you get pregnant, and then it becomes the leading cause of neonatal morbidity and mortality in the United States. It makes babies sick and can kill them. It may lead to outcomes like preterm birth.

I spent a lot of time exploring gestational membranes—parts from the mother that surround the baby and rupture when the mother’s water breaks. Those critical membranes create a barrier to stop infections and other things from making their way into the fetal compartment. I was interested in looking at the way group B strep interacts with those membranes and what the immune system in the woman is doing at the same time as the pathogen.

Eventually, I started adding in the study of chemicals. A chemical that became intriguing was called trichloroethylene, or TCE. In industry, it is commonly used as a metal greaser — but it’s also a contaminant that gets into groundwater and is widespread in the environment.

TCE is found in up to 50% of Superfund sites, which are manufacturing facilities, processing plants, landfills, and mining areas around the United States that have become contaminated as a result of hazardous waste being dumped, left out in the open, or incorrectly handled in some other way.

TCE is a known carcinogen, but we didn’t know what was happening with it during pregnancy. It gets metabolized once in the body, so we were looking at some of the metabolites and what they were doing to immune function. We found that one of them, dichlorovinyl cysteine, or DCVC, inhibits some immune pathways that are critical for fighting off infections. I’m still working on trying to untangle this today.

Doing Post-Doctorate Work

My postdoc was at Seattle Children’s Research Institute, in collaboration with the University of Washington. I worked in the global pediatric infectious disease division, focused on group B streptococcus. We were fascinated by what was happening in the bacteria, with a particular interest in which genes the group B strep had. Some people have the pathogen and don’t experience any issues as a result; others, including babies, are killed by it.

In the United States, pregnant women are tested for group B strep between 35 and 37 weeks of gestation. Women who test positive for group B strep will usually be given an IV drip with antibiotics at delivery. That has reduced the incidence significantly over the last 20 to 30 years. However, the bacteria is still a significant issue, which is why it’s so important to keep studying it.

These experiences helped me find my passion and expand my skills and knowledge, leading me to a fulfilling public health career, full of unexpected opportunity.

Switching Career Focus: From Writing to Lab Work to Teaching…and Back Again

The tasks I perform in my job vary, which keeps things interesting. Sometimes, it’s writing-intensive. I just tendered an R01, a grant proposal for a research project in collaboration with the University of Michigan, which I spent a lot of time drafting. At other times, it’s much more experimentally intensive. And during the school year, a lot of my time is spent in the classroom. So, a substantial amount of my research waits until the summer.

In 2019, we generated several RNA samples, treating cell cultures with our toxicant and pathogen of interest and then extracting RNA. My students did that work, and then we sent it over to our University of Michigan colleagues to complete RNA sequencing. The data is currently being written up as a manuscript.

At Calvin, I have a wet lab where we do cell and bacterial cultures. We conduct protein analysis, performing ELISAs and Western Blots quite frequently, and figure out which proteins are up-and-down-regulated. That goes along with some of the RNA sequencing work. We use the microscope for anything from basic cell counting to flow cytometry to immunochemistry and immunofluorescence, determining where proteins are being localized.

Additionally, I have taken a dive into epidemiology over these past 18 months during the COVID-19 pandemic, working closely with a lot of epidemiologists. I could not do my job without them. As a contact tracer for the university, I’m also in charge of compiling numbers so we can look at trends on a daily dashboard. We’re tracking students and faculty, looking at the number of new cases on campus and the prevalence.

On the teaching side, one of our priorities is training undergraduates for the master’s in public health program and their future careers. Consequently, my research is done with students, who often work in the lab for multiple years. It is rewarding to see students learning research lab techniques. I spend a lot of time training them, and then I let them do the experiments independently.

My career is multi-layered and always changing. I get the chance to learn and share the knowledge I’ve gained through my varied experiences, which is rewarding.

Dealing With Challenges in Public Health

Science — in public health and in general — is time-consuming, and it doesn’t always work the way we think it will. Often we’re met with failure and we have to figure out what went wrong. Is the experiment or study just not giving us the answer we thought we would see, or is there a technical problem?

All good science is frustrating because it opens more doors than it closes. Every time I finally understand one thing, I have seven more questions to address, but that’s exciting.

There are many things wrong with the world that we need to address, but, at least in the US, things have gotten significantly better since we started introducing environmental regulations in the 1970s, when the EPA was founded. For example, air pollution is still one of the leading causes of morbidity and mortality, but it has gone down in the US; the same is true of water pollution in many cases. A lot of the research that scientists do has contributed to our understanding, and those regulations have improved our environment.

In terms of epidemiology, numbers are a big challenge. Because the media tends not to do well in representing or talking about numbers, students will frequently ask me, “How reliable is the COVID case count?” or “Do we really understand the mortality rates?” It’s always interesting to talk to them about surveillance systems, where those numbers come from, how they get calculated, what level of uncertainty we have, and whether that level is enough to change our perspective on what’s happening.

The challenges in the field of public health keep it interesting and allow me to make a positive impact on my students, society, and science.

Advising Learners About Public Health Careers

One question I get from students is related to career pathways. “What do I do with public health?” This is a daunting question but a good one, since professionals in the field can have such varied roles.

The classic example is working for a local public health department. But even within that, there are various fields. You can conduct experiments in the laboratory or run the lab; the epidemiologist, who does anything from going out to collect samples to performing the analysis and crunching data at a computer; or the contact tracer or other professional looking at health behaviors.

Public health experts also go into all kinds of other fields, including the nonprofit realm. I have friends who got their master’s degrees and went to work for corporations like BP in occupational health- and safety-related roles such as ensuring that people weren’t exposed to certain chemicals with which they were working.

You can do just about anything with a degree in public health, which means there are tremendous opportunities for starting, maintaining, and switching careers.

Considering a Future in Public Health?

For those who are interested in embarking on a career in the field, the online Master of Public Health program from Calvin University features curricula taught by accomplished faculty with extensive real-world experience. The program encourages non-traditional applicants and embraces the philosophy that career changes are simply part of the journey — and can be both intriguing and rewarding.

Designed for ultimate flexibility, the MPH track allows learners to study on their own schedules while still giving them the ability to interact with their professors and classmates. Students can choose a concentration in global health or infectious disease.

To learn more, please fill out the form located here or call 616-200-4403.

About Erica Boldenow, PH.D.

Assistant Professor of Biology & Co-Director, Master of Public Health online program at Calvin University

Dr. Boldenow loves the interdisciplinary nature of public health, pairing science with medicine, human behaviors and policy in order to prevent disease and promote well-being. She views the practice of public health as one way to enact her faith and “care for your neighbor”. She enjoys spending time in the classroom teaching and having deep moral and ethics discussions about health with her students. In addition, Dr. Boldenow enjoys working with students in her laboratory.

Dr. Boldenow’s research focuses on understanding the mechanisms of adverse birth outcomes such as preterm birth. She has worked extensively on Group B Streptococcus (GBS) infections at the maternal-fetal interface. Dr. Boldenow is also interested in how environmental contaminants potentially lead to adverse birth outcomes.

Currently she is investigating how trichloroethylene (an industrial solvent and common ground water contaminant), contributes to changes in host immune response during pregnancy related infections. When Dr. Boldenow is not teaching or in lab, she can usually be found spending time with friends and family. She enjoys cooking for lots of people and canning. She also enjoys the outdoors: canoeing, camping, and hiking. Life always seems better in a canoe.

Research/Interest areas:

• Molecular mechanisms for adverse pregnancy outcomes.
• Group B Streptococcus infection during pregnancy.
• Toxicant-pathogen interactions during pregnancy: specifically focused on how tricholorethylene and its metabolites modulate infection and inflammation.
• Bicycle safety interventions.
• Health and religion: how religious institutions have responded to COVID-19 and how COVID-19 has reshaped worship practices.

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