New to the College of Public Health and Human Sciences in 2013, Public Health Assistant Professor Sangeeta Ahluwalia also serves as an assistant adjunct professor at the University of California, Los Angeles Fielding School of Public Health and as an adjunct affiliate research staff member at RAND Corporation – a nonprofit institution that helps improve policy and decision-making through research and analysis. She is a researcher in the CPHHS’ Center for Healthy Aging Research. She earned an MPH from UCLA and a master’s degree in Political Science and a PhD in Health Services and Policy Analysis from the University of California, Berkeley.
What made you decide to get into this field of study? Is there one specific moment that inspired your career path?
“Growing up in a family full of doctors, I saw firsthand the failures of our health care system from the provider perspective. I saw my mother, a child psychiatrist, burnt out from trying to squeeze up to 15 children a day into meaningful therapy sessions and then working all night to chart her notes. I heard my father, a hospice and palliative care physician, on the phone late at night trying to arrange for a patient to be admitted to hospice before it was too late. I was fully aware that the only reason health care was as accessible as it was to me was because of what my parents did, and that for everyone else health care often meant inadequate information, long waiting times, barriers to effective treatment and impersonal relationships. It made me think that there had to be alternatives to how we deliver care.”
What does your current research entail?
“My work focuses primarily on improving patient-physician communication about end-of-life care, through better integration of advance care planning and palliative care services into routine primary care. I want to know, ‘How can our health care system support conversations about the end of life that lead to care that is consistent with a patient’s preferences and ultimately results in a higher quality of life near death?’”
What sparked your interest in this topic?
“I’ve always been interested in how we as a society approach death, and it’s fascinating to me that we are so afraid to talk about it. Seeing the satisfaction that my father derived from working with hospice patients and helping them achieve a good death encouraged me to think about opportunities for bringing this model farther upstream.”
How will this make a difference?
“Having more and better conversations with our caregivers and our health care providers about what we want out of the end of our life will help us to get the kind of care we hope for, the peace we want to achieve and the dignity we deserve. From a systems perspective, these conversations are associated with greater patient and family satisfaction with care, improved quality of life and decreased utilization of burdensome and potentially inappropriate interventions at the end of life.”
What would you say is the most fascinating aspect of this research?
“Probably the fact that every single person I talk to about my work has a personal story about death that they want to share. It never ceases to amaze me that even though we hope death is optional, it will touch every one of us eventually. How we choose to deal with it and prepare for it is up to us.”
What do you hope is the outcome of your research?
“For so long, our country has socially and culturally ignored the final phase of life in favor of extending it beyond our wildest imagination. Now, with an ever-expanding population of older adults who are living longer but not necessarily better, we can no longer afford to overlook how we take care of our dying. I hope that my work contributes to our understanding of how we might optimally honor the dying process, improve patients’ quality of life and support healthy bereavement and closure near the end.”
Are you working with anyone else in the CPPHS on this project?
“I have been lucky to collaborate with CPPHS colleagues in the short time I have been here. Michelle Odden and I wrote a pilot grant for the Roybal proposal on social health and resiliency among older adults with heart failure, and I collaborated with Sheryl Thorburn and Viktor Bovbjerg on an NIH grant application to evaluate disparities in complementary and alternative medicine use among breast cancer survivors. I am currently working with Jangho Yoon and Jocelyn Warren to explore the impact of Medicaid expansion under the ACA on women and infants. These projects have allowed me to expand my current research portfolio into new areas of interest to me and have given me the chance to interact with some stellar researchers!”
Why is research important in the field of public health/health management and policy?
“Understanding current systems problems, evaluating ways to improve them, testing the effectiveness of our approaches – this is the only way to advance our health care system. Whether it is about policies, delivery models, financing structures or management approaches, the research process gives us the information we need to make things better.”
What’s next for you? Do you have any future research projects lined up?
“I have two projects lined up for the next year. The first is a pilot evaluation of group visits in primary care for advance care planning, focusing on patient and caregiver communication about preferences. The second is also a pilot evaluation of a coaching intervention from the management literature to improve care team dynamics in the ICU, particularly communication between nurses and physicians regarding end of life treatment decisions.”
What is the best advice you’ve ever received, and who gave it?
“My postdoctoral mentor at Yale once told me that an academic career was long and difficult, and I would probably doubt myself and my career choice several times along the road, as she herself still did. But she advised me to always take a big step back during the challenging times and remember the big picture – that it was not so much about my professional success as it was about improving the care of older adults with chronic illness. That advice keeps me going through manuscripts I have to revise, grants that get rejected and ideas that die before they get off the ground!”
What advice would you give to current students and recent alums?
“Whatever you do, make sure it’s something that you really are passionate about and personally invested in. That’s probably a platitude that’s easier said than done, but it truly makes the difference. Nothing is going to get you through difficult workdays other than knowing deep down that you are doing this because you love it.”
What are your favorite activities to do outside of work?
“I’m a sucker for bad TV! It helps get my mind off my research for a bit. I also love hanging out with my 2-year-old daughter – her mind is fascinating, and it’s so much fun to watch her navigate this world. A child’s perspective on life really reminds one of how simple everything actually is. Finally, I love running; half-marathons are my distance of choice. Running is truly the best way to get to know and love a city.”