Oregon Health Sciences University (OHSU) and Portland State University (PSU) School of Public Health

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Field experience

SPH Research Developmental Origins of Health and Disease

How moms’ stress affects babies

Jenna Ramaker has a Ph.D. in neuroscience and spent several years at OHSU doing post-graduate research on Alzheimer’s disease.

The work was fascinating. Still, she knew her true passions went far beyond what she was doing.

“I think throughout my years of bench science and working in the laboratory, I really had a strong interest in healthy equity and health access,” she says. “That’s what I’m most passionate about. Not so much the technical medical advances … but instead working to address health inequities at the most basic level.”

That’s why Jenna decided to pursue a Master of Public Health degree from the School of Public Health. That’s also why she was so enthusiastic about her School of Public Health “field experience” during the last half of 2016 — to work with Multnomah County’s Healthy Birth Initiative.

The Healthy Birth Initiative focuses on pregnant African-American women in the county, who as a group experience disproportionate rates of infant mortality and low birth-weight babies. The initiative tries to combat those issues by providing pregnant African-American women with a range of health services and support.

The initiative seems to be working; birth outcomes for women served through the initiative are comparable to birth outcomes for the general population of pregnant women in the county.

Jenna’s field experience job was to help initiative leaders better understand how the initiative might have been helping the women. And to provide program recommendations to address the “toxic stress” that many African American mothers experience.

She did that by helping to organize a focus group of women who were receiving or had received Healthy Birth Initiative services. “A big part of what I was doing hadn’t been done,” Jenna says. “And that was to ask: how do we assess stress in the clients? How do we ask about it? How do we ultimately mitigate it?”

She says she and initiative leaders discovered that past attempts to ask clients about stressors had not been done in a culturally competent way. In some cases, previous studies didn’t fully probe for stress due to racism or discrimination. And many surveys showed a relatively low rate of stress reported by African-American women, even with the presence of adverse events in their lives. That discrepancy may have existed because of how the questions were asked, Jenna says.

“That taught us a lot about cultural competency,” she says.

Jenna says her focus group work was of real value to the initiative. “This was something they had talked about doing for years … but didn’t have the staff to do it — until I came along,” she says.

She also learned a lot, she says — especially about how important relationship building is in doing this sort of work. She adds: “It was really cool to see something like this all the way through, from start to finish.”

Jenna says the experience “was a way to actually apply what you’re learning in the classroom and from a textbook into real life experiences.”

The experience also went a long way toward confirming her passions, and the direction she wanted to go with her career, Jenna says. “It helped me recognize that I really did like working at this more community level — and that the mission of who I’m working for is really important to me.”