Do the Change: Episode 8 - Ashley Smith, MPH (Part 1)

Our newest podcast guest is Ashley Smith, MPH! Ashley is a recent graduate of UC Berkeley's MPH program and has spent the last 3.5 years as a researcher at UCSF, focusing on research projects that examine health disparities. Her projects have included navigation programs for African American men, COVID-19 and housing insecurity, and lung cancer prevention for minority populations. Tune in now to hear her story on how she entered the field, how she utilized her network to expand her experiences, and how she uses her research to make an impact on community health.

See full transcript here: https://www.coeh.berkeley.edu/do-change-ashley-smith-mph

Transcript

TYRA PARRISH: 0:00

Hi everyone, welcome to the Do the Change podcast, where we're challenging you to reimagine OEHS, so in this podcast we do focus on highlighting upcoming leaders in their field and how they got to where they are today, with a special focus on the field of Occupational Health and Environmental Health. We also talk about health equity in other fields as well. Yeah, so we're going to be talking about the hills and valleys of their journeys, get some insight into non-traditional paths into the field. So my name is Tyra Parrish, I'm a recent graduate here from the MPH program at Cal, and our guest speaker for this episode is Ashley Smith. So welcome, Ashley.

ASHLEY SMITH: 0:31

Thank you, hello, hello.

TYRA PARRISH: 0:34

So, I'm going to do, I'm gonna read her bio real quick. So Ashley Smith received her undergraduate training from San Francisco State University where she earned a degree in Health Education. She is also a recent graduate from UC Berkeley's MPH program here at Cal, so congratulations.

ASHLEY SMITH: 0:51

Thank you.

TYRA PARRISH: 0:53

And she has spent the last three and a half years at the University of California, San Francisco, working on multiple research projects focusing on examining health disparities, which includes breaking out projects spanning from navigation programs for African-American men, covid-19, and housing insecurity, and lung cancer prevention for minority populations. So yeah, Ashley, Ashley got an nice little resume. She has done so many great things just for our community and from what I know about Ashley she is just like a super advocate for just black people and the black community. So I'm super excited to have you here on this.

ASHLEY SMITH: 1:37

Thank you, excited to be here thank you Tyra, appreciate it.

TYRA PARRISH: 1:41

Yeah, so we're gonna start with a check-in question as always. So the check-in question for this episode is, what is one thing that surprised you recently either in a positive way, or I don't even say in a negative way or maybe it just like shocked you?

ASHLEY SMITH: 1:57

I would say something that kind of shocked me and then subsequently impacted me in a positive way would be the mandates in Florida about the teaching of black history, and then the subsequent, the subsequent speech that Kamala Harris, the Vice President Kamala Harris gave out essentially speaking against these new mandates that the State of Florida Board of Education has put into place. Kind of repainting history as this idea of, or repainting history in a way that they kind of want history to be painted not as it actually happened. Which is really problematic for people of color and it was just refreshing to see that Vice President speak up against it because I haven't really heard much formal outcry outside of like the really insular communities that it impacts. So to hear the Vice President to talk about it, was like yeah, finally.

TYRA PARRISH: 3:09

Yeah, and I feel like, I feel like to add to that I feel like some people- I feel like there's not that much discourse over it. Maybe because people are like: oh it's Florida, like Florida does crazy stuff, it's Florida. But it's like yes, it is Florida not to bag on Florida folks like it's Florida, but it's also like the bigger message behind that, and I think Kamala was really intentional about like, no like y'all this isn't this isn't funny. This is serious. Like look at what they're talking to, history and I think like also bringing attention, like if they're doing it to Black History what makes you think the other problematic histories in other communities isn't coming next? And I think she was really just trying to wake, like shake people up. Like come on, see what's happening.

ASHLEY SMITH: 3:55

Yeah.

TYRA PARRISH: 3:55

Yeah.

ASHLEY SMITH: 3:56

Yeah, so yeah, to your point I definitely agree. It's a definitely, a bigger picture thing going on here, but yeah I would say that that was something that kind of shocked me most recently.

TYRA PARRISH: 4:11

Yeah, yeah. I'll say for me, it would be the movie not, not Barbie. Barbie was good. Oppenheimer. I haven't seen it, but when I heard that that man went to Berkeley I said ain't no way, he's a Berkeley alum. And like also, like God bless TikTok, because TikTok, like some of the family members or descendants of family members who were impacted by that testing and stuff like that,

they spoke out like: 4:46

yeah they didn't mention like who were like the first victims of that kind of nuclear bomb developing and that's how I came up on that information. I was shocked I was like-

ASHLEY SMITH: 4:59

Yeah. TYRA PARRISH: How have I not, I've heard, I haven't heard the specific name of the project, but I have heard about it and so reading up on that and seeing like how it was talked about from one perspective- Yeah.

TYRA PARRISH: 5:12

Hearing the voices of the family like uh no, no, we are still dealing with this right now. I was like oh, I was horrified and then I was like, and then I was like Berkeley like he's a Berkeley alum, and then just thinking like other folks who built like notorious legacies like the Unabomber too, was a professor at Berkeley too. Not to say that, I'm not implying that like folks, like that all folks who go to Berkeley come out like that but it is very interesting going to Cal and then seeing on TikTok, oh my gosh like Oppenheimer or Oppenheimer all this good stuff, and then like wait- like there's a whole other side to this man's story.

ASHLEY SMITH: 5:55

Yeah.

TYRA PARRISH: 5:56

But I think it's like, it connects to what you were talking about because it's just the way that the history is being taught, where it feels now, now with this information like it feels very intentional that you're not talking about all the lives that were lost. All the stories that are being erased because of the way it's being taught. So yeah, yeah. Very similar experience too where it's like a woah.

ASHLEY SMITH: 6:20

Yeah. I gotta check that out, I definitely gotta check that out.

TYRA PARRISH: 6:25

Yeah.

ASHLEY SMITH: 6:26

Yeah, yeah.

TYRA PARRISH: 6:26

All right, so we're gonna get to the the good part of this podcast, I mean it's all good but we're gonna get into your journey. So if you can just walk us through your journey into the field of public health, why public health? And can you also maybe walk us through your decision to, or how did you settle on the health and social behavior concentration of your MPH?

ASHLEY SMITH: 6:50

Yeah, yeah, yeah, sure. So essentially, a lot of my formative years kind of led to the decision of wanting to become like a public health practitioner. So I grew up in a neighborhood in the southeastern portion of San Francisco known as Bayview-Hunters Point. And even as a, as a young child I began noticing, and then also like into my earlier youth like teenage days, I'll began noticing like very stark differences between the neighborhood that I lived in and that I would play you know, grew up, shared experiences, and versus like other neighborhoods in San Francisco. So a lot of that kind of just first-hand observation led me to one of my first jobs as a, as a youth it was with an organization based out of Bayview-Hunters Point call Literacy for Environmental Justice. So the, one of the main goals of LEJ was youth advocacy essentially to kind of get, to kind of rebuild the Bayview economically, kind of get in some stable infrastructure, just trying to kind of help, like the residents. So for context, the Bayview is a predominantly black, low-income neighborhood, which has a relatively comparative to other parts of the city, relatively high crime rate, so worked at LEJ as a youth. and did a lot of advocacy work. We actually worked to get one of the first farmers markets in the Bayview, which was really dope and I recall as a youth we actually wrote Starbucks corporate and we inquired as to why there were literally Starbucks almost adjacent on some corners in in downtown San Francisco literally like blocks within each other, but there were none in the Bayview.

TYRA PARRISH: 9:14

Yeah.

ASHLEY SMITH: 9:15

They, it took them a while to respond to I remember it took them about two to three months to respond but their response was bad. Basically they didn't view the Bayview as an economically viable location for Starbucks. And so we were kind of like, we were like, we were pissed because like well you know that's what we need. We need businesses to come in, and we need the money to slow in so start working um start working as a youth moved on to another non-profit as I got about a little older about probably about 17/18 years old I started working for a organization in the western edition of San Francisco, which is known as like the Fillmore area I started working for a non-profit organization called Brothers for Change. So Brothers for Change was essentially like a program for re-entry men of color who had been formally incarcerated and looking to kind of, just kind of get back on their feet essentially. So we provided them with like resources such as like mental health resources, parenting courses, connecting them with Health and Human Services, CalFresh, Cash Aid, what have you, Medicaid, just connecting them with resources like housing resources, helping men, black men get stable.

TYRA PARRISH: 10:51

Yeah.

ASHLEY SMITH: 10:52

So worked there for about a year or so and then I know this is super random, kind of got interested in Pharmacy. So went to school to become a pharmacy technician, worked as a pharmacy tech for about four years. Worked at a hospital which I won't name here, but I did work at a hospital for about four years as a, as an outpatient pharmacy technician and started working for a program called the MTM, which is the Medicare Therapy Management program. And so as a tech this was really a different type of role, rather than like working at as like a pharmacy tech at like Walgreens or CVS. So with this role you really talked directly to the patients to help them manage their medication, and I started noticing something that was really peculiar to me, that a lot of the patients were having trouble with adherence and a lot of the reasons for that, the adherence, or problems around adherence were due to factors that were outside of their control, right? So it was like issues with insurance, issues with transportation to the pharmacy, some even cited patient provider communication issues: well I don't know what, I don't even know what this blue pill is the provider didn't explain it to me thoroughly, so I'm just not going to take it. So my job as a pharmacy technician is that I had to check a box, right? This person isn't taking this medication, but there was not really room, much room for me to kind of, there wasn't much room for me to kind of provide context as to why they were they were not compliant with their medication. So I then just really became started becoming more interested less in the clinical and the visualized scope of health, and became a little bit more interested in the broader idea of health and how it like, how it affects populations and it was then I took a course at City College, Introduction to Public Health, and I made the connection between social determinants of health and that kind of like the issues with non-compliance that I've seen at Kaiser. And I would say after taking that course that was one of the most relatable courses that I've ever taken at that point in my academic career, right? And I was sold. And everything started to make sense, it started to make sense that everything kind of came full circle, it started making sense why as a child or a youth I was noticing stark differences between the way my community looked and other neighborhoods in San Francisco look. And it started to make sense why some people have health issues that are beyond their control and or are caused by larger systemic factors that are you know, that they literally have no control over. So all these things start kind of getting the the wheels turning and it just was a really super interesting field, that that really caught my, that really kind of snagged on like my heartstrings, but also because I'd seen it firsthand living and growing up in Hunters Point I felt like this is it. After taking that class at city college, I was like yeah this is it. This is what I'm gonna do. I, and I hated to be a traitor, I always have a place for pharmacy, but after taking that course I said this is it. I literally quit my job as a pharmacy technician and I decided to pursue a career in public health and here I am now.

TYRA PARRISH: 14:52

I mean we are glad to have you. Like me, I feel like the field needs, needs you and needs your insight. I love how you said that like even as you were like, I think that you taking that extra time to even like reflect on, it's not just folks not complying it is like other things that impact someone's ability to do that that is not in their control. And I think just even having that conscious thought process is needed and yeah. And I just appreciate how you're also trying to contextualize like what is going on it's not just you're being non-compliant and you're right that sometimes with, not sometimes, ninety percent of time with medicine it's like they blame the individual on not doing something rather than taking the responsibility of like you said, like someone came in and said the doctor didn't even explain it to me so we're not going to take it. That's a very reasonable and logical like reason to not take something you shouldn't be taking something that you don't know what it is, like that makes total sense but then the the way in which it's then like communicated in the medical space, it's person doesn't listen and doesn't take medication but no one dares to put I didn't even bother explaining it, therefore they decided not to take it. That makes a lot more sense. Yeah, I'm, I, it's just hearing your journey of like, you made the joke about traitor, which is like I was like, but I get it, I get it where it's just like public health is I don't want to say it's the opposite of medicine, because it's not. But it's a it's a version of how you can center people in medicine and like what's happening with them, so yeah. And I guess my follow-up question is, is that what led you specifically to the concentration of health and social behavior? Did you feel like that particular concentration was more so getting at like social determinants of health and like things that's going on that impacts it, or yeah I guess that's-

ASHLEY SMITH: 17:04

Yeah, yeah. That's almost exactly it. So I became interested in the field specifically or the concentration of health and social behavior just because. I mean when you, when I've taken courses on like, before my time at Cal, just courses on like anthropology and thinking of like the ways in which the environment and the ways in which we kind of interact with people on a personal, on an interpersonal level, how those kind of impact health and behavior and like subsequently outcomes, health outcomes, always kind of really interested me more so than the other concentrations that were like Global Health, Maternal and Child Health, Epi. I just felt like that's where my interests specifically lie, just because of my formative years growing up in Bayview and seeing how like the, how folks interact with their environment and the subsequent outcomes, health outcomes, health and social outcomes, so yeah, if that makes sense.

TYRA PARRISH: 18:14

Yeah, no. No it totally makes sense

ASHLEY SMITH: 18:16

Yeah, yeah, yeah, TYRA PARRISH: I also just want to pause and further uplift like Bayview-Hunters Point particularly in SF, where like the government has failed them a lot particularly, like the, was it the Navy? Yeah. The Navy, Tetra Tech, Go ahead, go ahead.

TYRA PARRISH: 18:34

Okay. Tell the story, tell the story.

ASHLEY SMITH: 18:34

There's a multitude of-

TYRA PARRISH: 18:37

Right now. It's still not solved right now!

ASHLEY SMITH: 18:40

Yeah.

TYRA PARRISH: 18:40

Sorry.

ASHLEY SMITH: 18:41

Yeah, no yeah. There's like a multitude of players that have kind of led to the the way that the Bayview is kind of overlooked as a community. One of my biggest goals is to kind of use our strengths or rather like our assets and our skills as a community to kind of build up the community, but I think we can we can go into that a little bit later. But yeah that's one of my main goals.

TYRA PARRISH: 19:10

Yeah. I'll definitely, I'm gonna circle around to that because I know you got ideas. So I guess were, so in that journey and even now kind of post-grad were there any mentors or folks who helped kind of push you along during that journey, offered guidance or support, and how did that support kind of help your growth that's like a leader in your field?

ASHLEY SMITH: 19:35

Yeah, I would say one formidable role model that I had that'll always stand out for me was a pharmacy student, her name was Nani, Nani Waneri. She was a pharmacy student at UCSF in about 2005 to 2006 and she personally mentored me, and I'm talking real mentorship like literally would come to my home in the Bayview to kind of talk with me. This is kind of when I was still a little struggling within some like interests in Pharmacy, but nonetheless less content focused and more overall, just in the realm of mentorship and guidance. It was super literally, almost like seeing a real life someone from like a movie screen or a TV, in real life because until that time I had no, role models, right? I knew of literally no one who graduated from college, not anyone in my family, not anyone in my immediate family. So to have Nani, she was actually tabling at my school for folks, I think at like career day, and she was originally from the East Coast, I think like the DMV area but like, yeah, I just, that one-on-one mentorship really, and also seeing her, her professionalism, her work ethic was super, was super refreshing to me as well and I kind of got a peek at the UC system at a very early age and how like the UC system worked. And I think that's why I was always, I think she's another reason why I was always super interested in attending a UC and you know subsequently I would go on to both attend and work at a UC so shout out to Nani.

TYRA PARRISH: 21:39

Yeah. You know what's so funny, I was literally gonna ask like what made you choose like UC Berkeley, because I feel like the UC system itself if you weren't in it, choosing to be in it is a whole other thing. So like what, what made you, I mean you said that the influence of like your mentor and also that allowed you to get a taste of the UC system, so I guess how was your experience applying and being in the UC system?

ASHLEY SMITH: 22:07

Yeah.

TYRA PARRISH: 22:08

What you've experienced and yeah I guess like what would you rate it like out of ten? Just-

ASHLEY SMITH: 22:12

Yeah. I think that honestly speaking, working in the UC system after having had worked in another major hospital system, it's literally like night and day. The UC work-life balance is, it's unmatched. I feel like as, like an employee, from speaking from the employee side first and then I'll get to the student side. From the employee side I think that UC really values their, the contributions of their staff, their faculty, their employees at all levels, all levels like regardless of like where you fall, your contributions and your inputs are like seriously, they're appreciated and I have not and the work environment is it's just A1. I, this is not, this is not an ad for it-

TYRA PARRISH: 23:12

This recruitment, this is lowkey a recruitment.

ASHLEY SMITH: 23:14

The recruitment, I don't work for HR. But like I can honestly say that my work experience here it's been like, it supersedes any position that I've had before. On the student side, I would say that, because I can't really compare within, and I feel like being able to compare my undergrad to Cal, I don't think that's a really fair comparison, so I'll just say that my, as a student I think that the rigor of the program was very intense. And I feel like it did adequately prepare me for taking on a role, particularly so a leadership role in public health. There- are there issues within the UC system school system? Yes, there are, there are. There are a lot of issues. So much so that you know I won't, I won't get into that rabbit hole here, but yes there's definitely issues within the system, but as a whole I think that it it was a really, really great program.

TYRA PARRISH: 24:16

Yeah, yeah. No I mean I agree where there are some problems, but I think overall I feel like there's not a lot of things that can knock me off now. Like I feel like-

ASHLEY SMITH: 24:28

Yeah.

TYRA PARRISH: 24:29

You know what I'm saying where it just teaches you different skills-

ASHLEY SMITH: 24:33

Yeah.

TYRA PARRISH: 24:34

And I think because the UC system is such a bureaucracy too, that it also gives you a taste of like that type of system is definitely replicated in other fields and parts, so once you get a- I, yeah. Berkeley was my first experience with like a fully built out bureaucracy, where I was like whoa I got to go through five-six people, which was I mean it's eye-opening and I would have rather did it in an academic setting than like at a off- like a job or something and getting a taste of that, that might have been- But yeah, so I'm gonna do a little topic shift

ASHLEY SMITH: 25:11

Sure.

TYRA PARRISH: 25:11

Not what we're talking about, but more so about your current position right now, which is research data analyst at UCSF. You did kind of- I mean you touched on like the work culture particularly there, and so if you could also touch on one, like how I guess, how did you first kind of get your feet into the UCSF system, like what was that application job process or if you did networking or things of that nature, and like what, I guess what would you recommend for folks who maybe are interested in getting in the US- not US, UC system in regards to work? And yeah also if you want to touch on like the work that you're doing currently in that position, too, because it's really dope too. Sorry that's a lot of question.

ASHLEY SMITH: 25:57

Yeah, yeah, yeah, no worries, no worries. Okay, so how I got into the UC system, so I actually it's a funny story I got to the UC system by default, so during my last semester, during undergrad at San Francisco State University we were required to complete a externship in which we had to complete I think if I recall, I think it was a 400 hour externship. So we had to do that, and so I started in as a, they put me in working as like a research coordinator. And this was super interesting to me, because I recall my interview with the PI, the principal investigator. I literally from, aside from coursework, I had almost no experience with research at all like none. Like I didn't I don't even think I knew what IRB meant. What an IRB or process looked like or meant. So, completed my 400 hours, the person who was mentoring me was actually, she worked there at UCSF but she was leaving for medical school to go into medical school so I was then offered the position, to fill her position. So I was super hesitant at first, I even talked with the preceptor at San Francisco State University even first for being placed there, and then also for taking this position, because initially I wanted to, I'll be transparent I wanted my first choice for my externship was to, I wanted to go to the San Francisco Department, I wanted to be placed at the San Francisco Department of Public Health, so when I got placed at UCSF, I literally called a meeting with me, with the preceptor and I'm like no, she's like yes, I'm like no, she's like no, yeah, you're going here and you're gonna you're gonna excel. I'm like dude so I'm going in every day I'm just like, I'm seeing my other cohort members they were there, they were there as well working in on different projects and so I started kind of feeling like something was up when everyone else was leaving, but I was still there. I kept being asked to come in and finish different things, I'm like okay what's this, what's this about? So eventually the person who was mentoring over me, she left, I filled in her position, and I've been at UCSF out there ever since. So I was then, I worked as a clinical research coordinator for about a year or two and then I then transferred into my now role as a research data analyst which is a little bit more of a hands-on role as far as like the data analytics side goes, less so of the clerical side a lot of the clinical research coordinator work is very clerical. You have to there's a lot of administrative, high-level administrative work that comes along with being a CRC, and now I'm the role as a, as a research analyst, a lot of what I do is really, really sitting down with the principal investigator of research projects, really getting a very solid understanding of their, what they want to do of their like what they want to investigate, what question, what research question it is that they want to pose. They present to us like an outline, from there we kind of draft the protocol, the methodology, of course all under the eye of the PI right? We're not doing this work by ourselves. I would I would liken it to like they're the doctors we're the nurses of research

TYRA PARRISH: 30:24

Okay.

ASHLEY SMITH: 30:24

Yeah, yeah. I work primarily on the qualitative side, I'm less on the the quant side of things. We have a whole team dedicated to quant so that's not necessarily a worry and I enjoy, I'm on the side that I like to be, I love qual.

TYRA PARRISH: 30:49

Yeah.

ASHLEY SMITH: 30:51

But yeah, a lot of what I do is just kind of really supporting the the PI's and and their research projects from whether we're interviewing, whether we're drafting surveys for the interviews, whether we're analyzing analyzing data, whether we're reviewing the literature to help guide our work. For example right now with a lot of the work that I'm doing is proprietary, so I'll just talk at, talk about it at like a very high surface level without giving away too much because a lot of these projects are still currently underway, but for example right now we're conducting a scoping review for programs for black men with prostate cancer and we're really working alongside, we have a developed CAD, a developed Community Advisory Team of black men facing or who have experienced prostate cancer, and we're really, really incorporating their viewpoints into a lot of the work that we're doing. A lot of the research that we're doing we're including them essentially at every formative step. So if you, you could look at it as kind of like community-based participatory research but not necessarily because there are certain things that we do, like they're not involved with like the data analysis specifically but they are involved in a large role, like a large formative role of the project. Also working on a project now kind of examining the landscape of housing programs, specifically like subsidies, the way subsidies kind of work and whether or not they help or hinder folks. Yeah, and without getting into too much detail those are kind of like some of the larger pieces of work that I'm that I'm doing, yeah.

TYRA PARRISH: 32:54

Hi guys this is Tyra Parrish, your host for this episode and we have reached the end of part one of this conversation with this amazing speaker. Don't click out yet because part two to this conversation has already been posted so go ahead and click over to the next page and don't forget to subscribe to our YouTube channel and Spotify page.