What Does It Mean to Start a Public Health Education Today?

Ashish Jha: 00:00:00

Hey everybody. Ashish Jha here from a cloudy, actually somewhat rainy, afternoon in Providence, Rhode Island. You are listening to the another episode of the podcast, a moment in health where we talked about one data point. We discuss a study, and then we ask someone a question, and I'm gonna jump right into it. The data point today is 75% 75% that's the reduction in the number of pathogens that Foodnet will be tracking. Like, you're like, Okay, what is that? What is Foodnet? What is it tracking? What are these things? What's going on? Tell you what's going on. So Foodnet is our surveillance system. The US is surveillance system for looking for foodborne illnesses. And generally, we're on the lookout for eight major pathogens, because those are the ones that cause most of the foodborne illnesses. But as part of a broader streamlining, some people would call it cutting of government services and programs. The CDC and the Department of Agriculture are now gonna just monitor two. They're gonna monitor Shigella, toxin producing E coli that is a pretty nasty bug, and the other one they're gonna monitor is salmonella. Again, we should be monitoring those two, but let me talk about the six that they're not going to monitor anymore, Campylobacter, cyclospora, Listeria, Shigella, Vibrio and Yersinia. Now you may have heard of some of these things. Vibrio is the bug we worry about a lot when you eat raw oysters. I will be honest with you, I'm a royal raw oysters fan, and we are now no longer going to be monitoring for Vibrio infections, Yersinia you get from raw milk. Raw milk has been touted by our health secretary, but what we're doing is we're doing the wrong thing here. Instead of going through all the pathogens, we actually should be increasing the number of things we are tracking. With climate change, with globalization, foodborne illnesses are going up, and the truth is that we should be having a more robust food illness tracking program, not

Ashish Jha: 00:02:06

less. And yet, we're seeing this 75% decline in the number of pathogens that the US government will be on the lookout for. More than that 75% we're now just down to two bugs important, but not nearly enough. So that's your data point of the week.

Ashish Jha: 00:02:26

Now I want to talk about your study of the week. And the study of the week comes from the journal BMJ, formerly known as the British Medical Journal, from the August 27 2025 issue. And the study is entitled, patient health care spending after no surprises act. Quasi experimental differences in difference study. Okay, so let's talk about the no surprises act. Before the no surprises Act was passed in 2020 people used to get a lot of surprise bills. You showed up to the emergency room. Let's say you got hit by a car. You were in the emergency room, and you might find that the hospital you're in is out of network, and you get a surprise bill. It got even more crazy where you might be in a hospital that's in network, but the doctor who saw you was out of network, or the radiologist who looked at your CAT scan or X ray was out of network. And what this meant was people got these crazy, exorbitant bills. It caused lots and lots of problems, and so Congress in 2020 passed something called the no surprises act to say we got to put an end to all of this. And what these colleagues from Harvard did was they studied whether it made a difference or not, and basically what they found was, and you won't be surprised to find this, they found that out of pocket spending dropped significantly, about $567 per year for patients who gained no surprise act protections. The bigger picture question is, did it make a big difference in terms of health insurance premiums overall? And the answer is, it didn't. So protect, provided individual protection in terms of out of pocket spending, but overall health insurance spending did not change. Why not? Because it's a small part of the entire health insurance spending, and a lot of this is being paid for by individuals, not by the insurance companies. So while this may or may not have helped insurance companies, the big beneficiaries of the no surprise Act were individuals who were having to pay a lot of out of pocket. So great

Ashish Jha: 00:04:24

study in BMJ showing that this policy intervention actually made a difference in the thing we care about, which is reducing out of pocket spending for individuals.

Ashish Jha: 00:04:40

All right. And now for the question of the week, and for the question of the week, I have a fantastic special guest, Melissa Ponce, who is a first year student at the School of Public Health. She just graduated from Brown as an undergrad, graduated magna cum laude, phi, beta, kappa, superstar. And as we begin the new school. Year, that'd be great to have a student to come and talk about what's it like starting in public health. So, Melissa, first of all, thanks

Unknown: 00:05:07

so much for being here. Thank you for having

Ashish Jha: 00:05:09

me. So my question is exactly that you are starting your studies in public health as an undergrad, you did, you took public health classes. But what's it like at this moment, when there is so much uncertainty, where there's so much confusion about public health. What's it like to begin your education in public health, to get in a master's What do you hope to get out of it? Why are you doing this?

Unknown: 00:05:32

Yeah, I think that's a great question, and a question I've been thinking a lot about going into my first semester. But for me, public health has always been about the people. I grew up in southeast LA, so I witnessed what a history of inequitable access to resources can do to a community, the impact it can have on families. And I think regardless of the circumstances, there's always people who are affected by our work, and behind all the numbers, there's lives that are being affected by the work that we do. So regardless, that's what keeps pushing me and what motivates me to pursue public health.

Ashish Jha: 00:06:13

I love that answer, but let me push a little further so. But what do you hope that public health education will do for you that will help you address the needs and and the challenges that are faced by people behind

Melissa Ponce: 00:06:27

those numbers. Yeah, so I want to study health policy, so I'm planning to do the interdisciplinary track, and for me, health policy is able to address public health at a systemic level. And what I find so interesting and intriguing about policy is that you're able to talk with different stakeholders, different communities, and really bridge evidence with practice. And I think that's what interests me is, how can we make sure that communities are getting the programs, the resources, and also growing up in southeast LA, the world of policy seems so distant, but since I've been here at Brown I've been able to get the opportunities to have a voice at the table, and I think that's super

Ashish Jha: 00:07:18

important. Yeah, and policy can seem dissent can seem like it's something that happens in Washington, but if you get it right, can really make a big difference in people's lives. Melissa, thank you so much for coming in and chatting with me. That was fantastic. A really good reminder for me of why I'm at a school, because people like you keep inspiring all of us to keep doing what we're doing, and I'm glad that you have not been deterred by the craziness of the public health world right now, and I'm really happy

Unknown: 00:07:45

you're here. Thank you so much for having

Ashish Jha: 00:07:47

me. All right. So there you have it, another episode of a moment in health where we talked about one data point, 75% the reduction in the number of bugs that the Foodnet program will be looking out for when it's tracking foodborne illnesses, really going from eight bugs down to two. My view, they should be expanding that list. We talked about one study this patient healthier spending after the no surprises Act, which found that after Congress passed this act in 2020 out of pocket. Spending for surprise billing went down substantially. Didn't make much of a difference in terms of overall insurance premiums, but it did help protect consumers. And then we asked one question, and for the question, it was a very special guest. We had a first year school of public health student, Melissa Ponce graduated from Brown undergrad just recently, and I asked her, Why is she going into public health? Why is she studying public health? She's a first generation student, brilliant student, and she talked about her motivation growing up in southeast LA, where she saw the impact of inequities and the lack of resources on families, on communities and their health, and so whatever politicization or all the craziness going on around public health, people like Melissa remind us that this reason to study public health, the reason to use public health tools, are all those people out there. They're still suffering, they're still being held back. They still have aspirations for a healthier life that is not being met, and public health has the ability and the tools to make that better, and people like Melissa are motivated, and they're going to take the tools they learn at our school and other schools of public health and use it to improve the health and well being of people around the country. So it was great to have Melissa on. Thanks so much for listening. That was another episode of moment in health. We'll be back next week. We'll talk another about another data

Ashish Jha: 00:09:44

point. We'll talk about a study. We'll answer a question music, as always, by Katherine Beggs. Thanks a lot for listening, folks. You.