Rafael Pérez-Escamilla
Professor of Public Health (Social and Behavioral Sciences); Director, Office of Public Health Practice; Affiliated Faculty, Yale Institute for Global Health; Director, Global Health Concentration
EMPH Course: Monitoring and Evaluation in Public Health: Principles and Applications
Rafael Pérez-Escamilla, PhD, is an internationally recognized expert in nutrition during the first 1,000 days of life and a leading authority on breastfeeding and early childhood development. His global public health nutrition and food security research programs have contributed to improvements in breastfeeding and other maternal, infant, and young child nutrition outcomes, iron deficiency anemia among infants, and household food security. His health disparities research involves assessing the impact of community health workers on improving behavioral and metabolic outcomes in vulnerable communities. He has published over 315 research articles, three books/monographs, and numerous journal supplements, book chapters, and technical reports. He is a member of the U.S. National Academy of Medicine (elected in 2019) and served in the National Academies of Sciences, Engineering, and Medicine (NASEM) Food and Nutrition Board from 2012-18. He has been a senior advisor to maternal-child community nutrition programs as well as household food security measurement projects funded by the World Health Organization, the Pan American Health Organization, UNICEF, the Food and Agriculture Organization of the United Nations, the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture (USDA), the U.S. Department of Health and Human Services (DHHS), the U.S. Agency for International Development, The U.S. National Institutes of Health (NIH), The World Bank, the Bill & Melinda Gates Foundation, the Robert Wood Johnson Foundation, and Governments in Latin America & Caribbean, sub-Saharan Africa, Asia, and Europe.
What drives you in the work that you do? What are you passionate about?
Rafael Pérez-Escamilla: I am passionate about finding ways for all infants and young children to have an equal chance to grow up healthy and develop to their full potential. My work concentrates on translating knowledge into public health practice by designing, implementing, scaling up, and evaluating large-scale maternal and child health interventions. I have also tested the integration of community health workers into health care systems to strengthen the continuum of care across the life course. My work is grounded in community-engaged implementation science following principles of equity and sustainability. I do this challenging work because I find it unacceptable for populations to have to wait for years to benefit from existing knowledge in the context of a very unjust world that constantly disrespects their human rights.
Why did you choose a career in public health?
R.P-E: Since childhood, I have aspired to devote my life to improving the health and well-being of the most disadvantaged people in society. Later in my life, I realized that this is precisely what the field of public health is all about. I also learned that my values were totally consistent with universal public health principles including equity and social justice. I also realized how interdisciplinary and “out of the box” systems thinking public health work needs to be to have an impact in the real world. Hence, in retrospect, my highly interdisciplinary background - chemical engineering, food science, nutrition, and early childhood development – is another reason why developing a career in public health became the logical choice for me.
What is the most significant challenge facing your field of study today?
R.P-E: The biggest challenge faced by public health nowadays is structural in nature. The pervasive market-driven political-economic systems and the colonial legacy of power imbalances across and within countries continue enabling huge health inequities. This is because these structures concentrate wealth and power in very few hands at the expense of much of the rest of the population. Sadly, these structures continue perpetuating structural racism, discrimination, and bias against the most socio-economically and socially isolated communities. As a result, in the 21st century, billions of people still lack access to the most basic social determinants of health such as nutritious foods, physical and mental health, proper housing, and sanitation. This in turn is incredibly harmful to the health and well-being of individuals, communities, nations, and the planet.