March 2019 – Emily Chasco

“A former classmate who was working for the VA out in California sent me the job announcement. She said, ‘I know this research group, I think very highly of them, and I think you should really consider reaching out to them and seeing if this job would be a good fit for you.’” The research group was the Center for Comprehensive Access & Delivery Research & Evaluation (CADRE), the Veterans Affairs Health Services Research & Development’s Center of Innovation in Iowa City. And once Emily Chasco, PhD, met a few key members of the group and saw the scope of CADRE’s work, it was an easy decision. “I got really excited,” she said. After working at CADRE for 18 months, Chasco transitioned over to the university, though she continues to collaborate with CADRE colleagues.

Part of Chasco’s excitement was because, first at CADRE and then as an assistant research scientist in the Division of General Internal Medicine, she is able to serve as an analyst on multiple projects, exposing her to a variety of investigations. Among a number of projects, she is currently designing a qualitative evaluation for Michael Ohl, MD, and his TelePrEP program, which provides HIV preventive care to rural Iowans, as it expands implementation state-wide. Chasco has also begun to work on a project with psychiatrist Carolyn Turvey, PhD, on patient portal features designed to improve engagement and adherence to treatments for depression. Loreen Herwaldt, MD, has Chasco’s assistance in her work studying safe donning and doffing of personal protective equipment.

Chasco can nimbly move between infection prevention one day and infertility the next because her training is not in any one of those areas but in medical anthropology, which brings aspects of cultural and biological anthropology to bear on issues related to health and illness. What sociocultural factors influence a community’s rejection of psychotherapy? What is the health impact of a national mandate to vaccinate? These are the kinds of questions a medical anthropologist might work to answer, and Chasco’s training keeps her curious about a broad range of intersections between health and culture.

Shifting perspectives
Growing up near Detroit, Chasco says she became “enamored with castles and history” on family trips to Europe and set archaeology in her sights. But after completing three years at the University of Michigan and even field school, she “started to have second thoughts.” The idea of bouncing between summers in the field and academic years back in the lab grew less appealing. Her program at Michigan encouraged students to take classes across the sub-fields of anthropology, and courses in medical anthropology had sparked her interest. At the same time, she was also volunteering part-time at a health clinic and with the Alternative Weekend program and was seeing immediate impact from her work with adolescent girls in foster care. The desire to make a difference now felt stronger than her “passion for the past.” A switch to medical anthropology and then applications to graduate programs followed close on the heels of her Bachelor’s.

The program she entered at University of Colorado Denver appealed to her for a lot of reasons. She liked the expectation that after completing a Master’s on the Medical Anthropology track, students would enter the PhD program in Health and Behavioral Sciences. That plus access to the Denver Health medical center and a number of community organizations in the Denver area offered Chasco a wealth of resources and research opportunities with practical application. An outdoors enthusiast, from hiking to snowboarding to biking, she liked the idea of easy access to mountains too.

For her Master’s thesis, Chasco examined the decision-making process women went through in whether to enroll in a clinical trial testing two different breast cancer prevention therapeutics. Factors such as education level, scientific literacy, and income played a role, but Chasco also found that the relationship between the participant and her physician was significant as well. A recommendation from someone they trusted, she said, was really important.

Global skills
Chasco’s own trust in a recommendation was put to the test after she found her planned PhD dissertation topic crumbling. Originally, she intended to study utilization of cervical cancer screening programs in Bolivia, continuing to work in the urban setting where she had previously served as a research assistant on a professor’s high-altitude pregnancy project. But political upheaval changed visa allowances and her project became untenable. A Tanzanian paleontologist professor she knew recommended his country as an area for research, noting similarly high levels of cervical cancer there and a screening program that was just getting off the ground. Chasco, proficient in Spanish and familiar with South America, not Africa, took the leap.

After several shorter trips to establish relationships and learn more about local context, she spent nearly a year working in Tanzania. She started in an urban area continuing Swahili and culture lessons, then moved to her rural study site, where she examined existing knowledge about cervical cancer and barriers to screening for women. Though she had initially prepared for a completely different experience, she leaned on her training (as well as her mentors at Colorado and the generosity of local colleagues) and made insightful discoveries. “Part of being an anthropologist is sort of learning how to build rapport, learning how to serve, learning how to talk to people, in any culture.”

Because that field work had been sponsored by a Boren Fellowship through the National Security Education Program, Chasco had a one-year federal service requirement still to fulfill after she returned to live near her family in Champaign, Illinois. While she wrote her dissertation and managed the evaluation of a federally funded pregnancy prevention program at the University of Illinois Urbana-Champaign’s Center for Prevention Research and Development, Chasco began to consider her next move. She resisted the expectation that she would have to go to Washington, DC, and cast a wide net everywhere else.

A valuable team member
Which is where her friend’s recommendation of CADRE came in. “I had started thinking about the VA because I knew they were one of the biggest employers of anthropologists outside of academia.” And after talking with leading CADRE members like Samantha Solimeo, MPH, PhD;  Heather Reisinger, PhD; Eli Perencevich, MD, MS; and others, Chasco started to like the idea of focusing on infection prevention among other projects. “Working overseas you can’t escape the toll that infectious disease takes on people.”

Chasco’s colleagues feel fortunate she joined the group. Herwaldt said, “Emily is a great addition to our research team. She is very observant and she makes the research participants feel comfortable while she asks them questions.” Reisinger sees Chasco’s skill set as “increasingly in demand” in the field. “Her training and expertise in ethnographic methods allows her to integrate patient, healthcare worker, and community perspectives into understanding complex interventions,” she said. Ohl agrees: “She brings new methods, unique insights, and valuable perspectives that move our work forward.”

Chasco is “pleasantly surprised with how beautiful” Iowa City and eastern Iowa is. She likes to take advantage of both the cultural offerings downtown like the summer music festivals as well as the natural settings like Palisades near Mount Vernon. She and her fiancé, who is finishing his PhD in landscape ecology in Champaign, also like to explore some of the antique shops in the small towns around the area. “We would like to stay here awhile.” We would like that too.