As an associate professor of public health and director of Moravian University’s public health program, Colleen Payton works tirelessly inside and outside the classroom, educating students and contributing to solutions to public health issues. At Moravian, in addition to teaching courses including biostatistics and epidemiology, she advises the Public Health Club and the Society for Public Health Education Collegiate Champions. Beyond campus, she is cochair of the Research, Evaluation, and Ethics Committee of the Society of Refugee Healthcare Providers, section councilor for the American Public Health Association’s Maternal and Child Health (MCH) Section, and cochair of the MCH Section’s Professional Development Committee.

What drew you to your academic discipline?

Public health has added 25 years of average life expectancy over the past century. Public health focuses on preventing disease and promoting health within communities. It is a broad discipline that influences many aspects of our lives. We can thank public health professionals when we access healthy food in our neighborhood, brush our teeth with fluoridated water, receive immunizations to protect against infectious disease, drink clean water, receive blood pressure screenings in the community, breathe air that is free from tobacco smoke, and wear a seatbelt while driving in the car. Public health interventions can save millions of lives at a time. For these reasons and many more, I am passionate about public health. I was drawn to public health because it provides me with an opportunity to work with organizations in my community on health projects. I enjoy analyzing health data, problem-solving to find feasible solutions, and advocating for social justice and health equity.

Tell us about your current research.

My main area of research focuses on refugee health. Refugees are people who have fled their country due to persecution, war, or violence. Less than 1 percent of refugees resettle to third countries like the United States. Refugees arriving to the United States receive a domestic medical exam within the first 90 days to treat existing conditions, identify new health conditions, promote wellness, and connect with the healthcare system. I have conducted public health surveillance and quality improvement projects to examine the prevalence of health conditions at the domestic medical exam and longitudinally over time such as latent tuberculosis infection (LTBI), hepatitis B, hypertension, immunizations, and cancer screening.

For example, refugees are screened for tuberculosis before and after arrival in the United States. LTBI is a health condition in which a person is infected with Mycobacterium tuberculosis but does not experience any symptoms. LTBI is not contagious, but it is important that people diagnosed with LTBI get treatment to prevent the development of active tuberculosis in the future. Part of my work involves examining how many refugees are screened for LTBI through a tuberculin skin test or interferon-gamma release assay (IGRA) blood test. If a test result is positive, then we follow patients to determine how many received a follow-up chest X-ray and finally how many completed the follow-up treatment. My role is related to managing and analyzing this data so that there is a better understanding of the needs of the population and interventions can be applied to address those needs.

In public health and refugee health, I’m very much a proponent of how we can all collaborate—the health systems, health department, community-based organizations, resettlement agencies—to improve outcomes. That’s when we’re most successful.

What we hear from refugees is that they are committed to getting their kids into school and that they want to be able to work and contribute to the local community. If the health outcomes are addressed, they can do that. And there has been a lot of research to show that refugees have a positive impact on the community where they live and its economy.

Each refugee has a different lived experience. In more recent years, refugees have arrived from countries such as the Democratic Republic of Congo, Syria, Afghanistan, and Myanmar. These are all people who have been persecuted or fear persecution due to reasons such as race, religion, nationality, political opinion, or membership in a particular social group. I feel passionate that we should welcome these individuals to the United States and make sure they have quality healthcare.

Sharing stories about refugees with students in class gets them excited to welcome refugees. In the past, I have worked with students on clothing drives in the winter for refugees who recently arrived and may not have warm clothes or winter jackets. There are ways that we can all make a difference in our local community, such as learning about refugees and their lived experience, donating clothes and furniture for when refugees first arrive, teaching English as a Second Language, volunteering with a local refugee resettlement agency, and shopping at immigrant-owned businesses.

What would you say is the most pressing concern regarding public health in the United States?

There are many significant public health issues, but maternal morbidity and mortality is a top priority. The United States has the highest rate of maternal deaths of any high-income country, and most of these deaths are preventable. Racial disparities play a significant role in our maternal morbidity rate. Black women are two to three times more likely to die in childbirth compared with white women. Systemic and structural racism in every aspect of the health system has led to differences in health outcomes, including inequities related to quality of care, clinician bias, access to hospitals, and paid parental leave. The United States is the only high-income country without a national paid parental leave policy and without universal healthcare. To reduce maternal morbidity and mortality, we need to address the social determinants of health, treat underlying comorbidities like hypertension and diabetes, increase access to OB-GYNs and midwives in healthcare and home settings, and decrease the closure of maternity units. We also need to work to change policies related to universal healthcare, Medicaid postpartum coverage extension, contraception access, paid parental leave, and workplace lactation support.

What’s one thing you want all students to take away from their classes with you?

To think of evidence-based solutions to health problems. It’s not enough to just raise awareness or educate people. What we want to do is ensure equitable access and change people’s behavior, whether that’s patients, healthcare providers, or community members. A lot of public health involves high-level and multilevel interventions to address a problem. We need to look at solving problems across the whole social-ecological model to create solutions through interventions at the individual, interpersonal, community, organizational, and policy levels. For example, healthy eating is influenced by individuals knowing which foods are healthiest and how to cook them, the foods our family members buy and cook, the food and beverage environment within organizations like schools and workplaces, access to grocery stores and farmers’ markets in our community, and policies related to food safety, nutrition labeling, and nutrition standards.