Katrina Diaz, the daughter of two physicians, had a good idea early on where she was headed.
"I was raised in a very academic household," she says, "and these are the kinds of things that I really grew up thinking about: medical issues, public health issues."
Hot Zone, Richard Preston's nonfiction thriller about Ebola and other deadly viruses, was an early read. "It happened to be on my science teacher's desk when I was in the 6th grade, and I said, 'Oh, that looks interesting.' " The book remains on Diaz's all-time favorite list and had a considerable impact on her future interests.
"I fell in love with medicine and epidemiology and exotic disease and public health containment strategies," she says. Ever since, she has been interested in "disease that affects our community as a whole. It's essentially a view that hasn't changed."
Given this 6th grade introduction, it's no surprise that when this Michigan youth reached high school age, she was accepted by the Kalamazoo Area Mathematics and Science Center, a no-nonsense magnet public school with an accelerated curriculum and emphasis on scientific research.
In her junior year, news reports about avian flu and fears of a pandemic piqued her interest in the subject of vaccination strategy. Specifically, she wondered what factors most influence parents' decision to have their young children vaccinated against seasonal flu.
Mentored by Annie Wendt, MPH, Kalamazoo County epidemiologist, Diaz surveyed parents at five Michigan daycare centers on that issue. The strongest influence? A doctor's recommendation, the responses showed. Diaz used that and other findings to analyze populations and organizations that should be targeted to foster good vaccination practices.
At the suggestion of the school's research director, John Goudie, EdD, Diaz, 16, entered her study in the 2006 Young Epidemiology Scholars (YES) Competition. She ended up as a national finalist with a $15,000 college scholarship.
Today, Diaz is 23 and about to enter a combined MD/PhD program on her way to what she foresees as a career in clinical research. Of that earlier research experience, she says:
For me, the YES competition was an affirmation. It let me know that I was on the right track. I came away thinking, 'I thought before that this is what I want to do, but now I know.'
YES: "The best and the brightest." YES was a competitive scholarship program aimed at encouraging talented high school students to investigate public health issues and ultimately pursue a career in the public health field. Epidemiology—the study of the causes, distribution and control of disease among populations—is the basic science of public health.
Initiated in 2003 by the Robert Wood Johnson Foundation (RWJF) and managed by the College Board, YES ran for eight years, attracting the participation of nearly 5,000 high school juniors and seniors—"the best and the brightest from across the country," in the words of RWJF Senior Program Officer Pamela G. Russo, MD, MPH.
YES contestants identified a health problem, gathered data about the problem, and proposed a solution based on what the data showed. Survivors of the initial review process presented their research in person to expert judges from the health field at a three-day Washington conference.
When the annual competitions ended in 2011—a casualty of the nation's economic recession and a change in RWJF's grantmaking strategy in the public health area—a total of 976 YES participants had collected some $3.7 million in college scholarships, ranging from $1,000 for semifinalists to up to $50,000 for each year's top two winners.
But while the program is now over, its impact is not, as the story of Katrina Diaz illustrates. Diaz's experience is one example of how YES could and did make a difference in young people's academic and career choices. It's also evidence of what Russo says is the program's lasting legacy:
YES is definitely going to influence who's going to be in the lead in public health in the next 10 years.
Perspective: Driven. Born in the Philippines, Diaz was about a year old when she moved to the United States with her parents. Her father had earned a medical degree at the University of the Philippines and came for a residency. Today he practices at the Veterans Affairs Medical Center in Battle Creek, which is near the family's home outside Kalamazoo. Her mother also trained as a physician but does not practice, Diaz says.
It is hard not to be struck by the number of first and second generation Americans who excelled in the YES competition—an observation that draws this response from Diaz:
I think there's like a hunger or a drive that immigrants have … Your parents sacrifice a lot to be able to come over here. It's scary (for them) to come to a new country and not know anybody and have to make a new life. I think a lot of immigrant children learn a lot from their parents about working hard and achieving goals.
The road after YES. Following high school, Diaz went to the University of Michigan in Ann Arbor, majoring in what might seem like an unlikely combination: biology and English.
In addition to enjoying English as a subject, she says there was a practical reason for majoring in it—one that her YES project reinforced:
I was very interdisciplinary, having learned from epidemiology that it's important to have good communications skills. It's important to be able to reach a wide audience as a medical professional.
YES also influenced the research she did as an undergraduate, she says. While initially focused on lab work, she gravitated toward epidemiology, particularly in the context of hospital care.
In collaboration with staff of University Hospital in Ann Arbor and the university's medical school, Diaz assessed the use of central venous catheters in the hospital's emergency department (ED). Her main goal was to see if the risk of infection from the procedure was greater in the ED than elsewhere in the hospital.
The data indicated no increased risk—a result "not as exciting as I thought it would be but still useful information." Diaz was lead author of a paper on the study, published in the American Journal of Infection Control. ("A Prospective Study of Central Venous Catheters Placed in a Tertiary Care Emergency Department: Indications for Use, Infectious Complications, and Natural History." American Journal of Infection Control, 40(1): 65–67, February 2012. Available online.)
As an undergraduate, Diaz also had paying jobs in research—some the result of contacts she made through YES and the continuing network of students and professionals involved in the YES competition. "We are really a family," she says. "We all look out for each other."
After getting her bachelor's degree in 2011, Diaz took a year off from formal education and worked in a medical school lab that researches genes that cause pediatric kidney disease.
She also used the year to apply to medical schools—a process that resulted in plans to enter the combined MD/PhD Medical Scholars Program at the University of Illinois at Urbana-Champaign in fall 2012. Her PhD will likely be in molecular and cellular biology, she says.
Does all of that mean her interest in epidemiology and public health has dropped away? Definitely not, she says:
Everything can be tied back to epidemiology. As long as it has something do with a group of people, you can't take it away from epidemiology…I totally believe there's no way you can separate epidemiology from medicine as a whole.