(2) Self Advocacy in Women’s Health and the Ecological Model

One of the most impactful things that I have learned at Brandeis came from the class Public Health: U.S. History and Policy with Professor Sarah Curi. The class quickly became a favorite of mine for its rich discussion, relevant material, and its holistic view of public health in American both then and now. It was there that I learned a theory that has become a mainstay in my approach to my internship: the ecological model of public health. This model claims that public health measures may be implemented at many different levels of society, starting with the federal government, and specifying all the way down to the self. In the same way that the U.S. government can create legislation to strengthen the wellbeing of all citizens, individual communities can work to care for its members, and vice versa. Learning about the ecological model of public health can be empowering for many people. In the same way the outside world impacts our everyday lives, we can be just as impactful through self-advocacy and education. 

One great example of individuals applying the ecological model of public health is the health non-profit GirlTrek. Started by T. Morgan Dixon and Vanessa Garrison, GirlTrek was founded with the mission of addressing the growing rates of preventable obesity-related diseases among black women in America by arranging daily walks in neighborhoods across the country. This is a prime example of the ecological model because it is just two people noticing a health disparity in their community and starting a movement that radiated outward to their state, and then the whole country. Learning about this model and this example are incredibly meaningful to me. If these two women can create meaningful change, there is nothing me or anyone else doing the same.

This lesson has been crucial to my internship with NNABI, a women’s health company currently developing a natural holistic treatment for women in perimenopause.  Perimenopause is the hormonal stage that women starting at age forty experience and can last several years. However, because it is not as well-known or researched as its successor stage, menopause, many women seeking medical guidance for their symptoms are often misdiagnosed by physicians. The psychological symptoms like brain fog and irritability are often misdiagnosed as depression or anxiety. The hormonal symptoms are often confused with other conditions like a thyroid disorder. Using the ecological model of public health has helped me consider how NNABI can make an impact among women going through this stage.

One project that I am working on is a conversational “cheat sheet” that details to women how to initiate a discussion about perimenopause with their healthcare provider, giving them the tools to advocate for themselves to ensure they are not misdiagnosed. One example of these tools is to advocate for hormonal testing in the long term. Since perimenopause is categorized by undulating hormone levels, one blood test may be just a snapshot, and if levels were normal that day, perimenopause may be disregarded as a possibility. Information and advice like that is essential to the ecological model, because once one woman is informed about their symptoms and how to address them, that knowledge spreads to other women as well. The goal of NNABI is to empower women to be responsible for their own wellbeing, and to radiate that empowerment outwards to larger communities and even towards legislative change. My internship and my class have both taught me that social justice, in public health or otherwise, often starts with the self.