Reflecting On the 3rd Year of My PhD Program

Well, the Spring semester has been over for a month now, and this summer has been very go-go-go as I attend conferences and conduct qualitative research for the final chapter of my dissertation. But, it is necessary to stop and reflect on the previous academic year as I prepare to enter (what I hope) will be the last year of my PhD program.

I. Fall

Fall 2018 was the last semester of coursework. I took independent coursework and PATH 517, or “Principles and Methods of Epidemiology”. I could not have asked for a better class to cap off my coursework with. The course was in the Pathobiology department, so there was a strong emphasis on animal health and One Health more generally. I appreciated that, because my prior coursework in Spatial Epidemiology had a similar emphasis, so my understanding of human-animal health, political ecology of disease transmission, and so forth were greatly expanded by the course content.

While I fall under the ‘human geography’ tradition as a health geographer, it is important to recognize that the separation between human health and non-human animal health is an artificial one that is increasingly salient as expanding human development, climate change, and resulting suitable habitat changes affect the geographic spread of vectors for zoonoses like Chagas (common in Central America, now known cases in Delaware!). It’s also important because human and non-human animal mobility and interaction is a key variable in studies of disease transmission.

That said, I really didn’t mind hauling myself to campus on mid-day Tuesdays and Thursdays for lectures. I learned so much from the professor and my fellow classmates, who ranged from agricultural economists, to DVM candidates, to doctoral students in pathobiology. It was interesting to hear about cases where it was simply more economical to euthanize and dispose of infected agricultural stock than it was to treat them, because the cost and scale of treatment exceeded the gains of treatment. I also learned about anti-fungal resistance (-azole class anti-fungals, specifically) and its implications for both the food supply and human health (esp for mortality associated with fungal infections of the respiratory system). There’s a lot that people outside of veterinary science, agricultural economics, and farming generally don’t think about when it comes to the food supply.

On the research front, I submitted my Chapter 1 manuscript for publication in late August. and I spent a lot of time setting up and running the analysis for chapter 2 of my dissertation. It involved geocoding large batches of addresses for provider office locations, setting up network datasets, and estimating travel distances to care. I had a 1 December 2018 deadline for myself, because that was when the abstract submission portal for the International Medical Geography Symposium (IMGS) opened. I came very close to not meeting that deadline. Picture this: Donald and I were in the car, driving up for Thanksgiving, and my laptop was in the back, running analysis set-up tasks for the entire 3-hour drive. Yes, it was that close.

II. Spring

This Spring semester was… well, the adjectives I’d use to describe it range from “busy” to “exhilarating” and “harrowing.”

In terms of research, a lot of my time was divided between projects- manuscript revisions and lab meetings, specifically. I spent my Winter break working on a revise and resubmit (R&R) for my first dissertation paper, which involved re-running my analyses with newly-released data and redoing all of my figures and tables. It was worth it, because that paper was accepted and published in volume 222 of Social Science and Medicine.  Not long after that, my co-authors and I got another R&R for our systematic review study of mental health help-seeking and service use among African-American children and youth, and that involved about 2 months of reorganization and rewriting. That paper was accepted at Child and Youth Services Review.

All the while, I made steady progress on chapters 2-4 of my dissertation, along with my non-dissertation collaborative projects. It’s slow and steady work. One way that I manage multiple projects is Gantt charts. I know, it’s a bit old-fashioned, but it works well for me, because I can keep track of the different projects at different stages. It also helps when I switch tasks, enabling me to switch between similar tasks (like data management and analysis vs. manuscript revisions).

And my term was punctuated by travel to fellowship-related travel (RWJF Annual Leadership Institute) and conferences (American Association of Geographers meeting in DC). I presented work at both. At the Leadership Institute, I co-presented a table talk about the central importance of place in studies of health-environment interactions and outcomes- beyond areal units (e.g. zip codes) as simple proxies for race, toward places as socio-political and economic processes. For the latter, I presented the first chapter of my dissertation (entitled, “Hearing Healthcare Availability and Supply in the United States: A Multi-Scale Spatial and Political Economic Analysis”) as part of the AAG Health and Medical Geography Specialty Group’s Peter Gould Award competition. I am happy to say that I was one of the two winners of the award. It was… for lack of a better word, validating. It was, perhaps, the first time that I felt like I belonged in any discipline or subfield, and I’ve been in 3 graduate programs!

Since then, I’ve been conducting qualitative research for my final dissertation chapter and steadily writing my dissertation (125 pages and counting.) My dissertation introduction is an expanded version of a short essay that I wrote in 2016 about health care policy as an articulation of a nation’s (biopolitical) priorities, particularly in terms of who is considered a member of that nation. I framed it in terms of the deployment of ‘human capital theory’ in health policy-making and social policy more broadly. The 4 empirical dissertation chapters are past the halfway point, and will be completed by early Fall, so I feel good about this project.

Two weeks ago, I attended the AcademyHealth Annual Research Meeting in Washington DC with my RWJF Health Policy Research Scholars program cohort-mates and program faculty. There, I presented my second dissertation chapter (entitled, “Health Care Provider Interdependencies & Resulting Access Disparities by Race and Class: The Case of Primary Care Physicians and Audiologists in Chicagoland”) in poster format. I also got to meet a lot of people that I ‘knew’ from Twitter. It was lovely!

And next week, I am headed to Queenstown, New Zealand for the International Medical Geography Symposium (IMGS), where I will give a podium presentation of Chapter 2. I’m so excited to catch up with my fellow health/medical geographers there.
I’ll end there. More soon.