Episode 2: Marcelle Dougan

In the latest episode, SJSU Provost Vincent Del Casino speaks with Dr. Marcelle Dougan, who originally envisioned herself as a chemical engineer only to become an international leader in public health.

Episode Transcript

Vincent Del Casino: Hi there. My name is Vincent Del Casino. I'm the provost and senior vice president here at San Jose State University and the host of this podcast, The Accidental Geographer. Today I'm talking to Dr. Marcelle Dougan, an assistant professor in public health and recreation here at San José State University. This is going to be a really exciting conversation because Dr. Dougan's work crosses a number of important areas, including maternal health, the COVID-19 epidemic, questions of food insecurity, as well as children's mental health. So I'm really excited for this conversation. Look forward to digging in here with Dr. Marcel Dougan. All right, well, I'm really excited to be here with Dr. Marcel Dougan from Public Health and Recreation here at San José State. Thank you so much for taking the time to be part of this conversation. 

Marcelle Dougan: Thank you for having me. I'm excited to be here as well. 

Vincent Del Casino: Yeah, it's great. I love being able to dig into your work a little bit. We've had an opportunity to interact in a number of different venues, but I haven't had a chance as much to really engage with your scholarship, so I'm excited to have that conversation today. So I always like to dig in a little bit of, kind of what got you to what you're doing now. And I noticed that you started as a chemical engineer. That was your undergraduate degree and you were in the UK. 

Marcelle Dougan: Yes.

Vincent Del Casino: And you made your way. So what got you interested in chemical engineering? And then how did that turn into an interest in public health related questions? 

Marcelle Dougan: Right. So I actually grew up in Sierra Leone in West Africa. At that time, I thought I was going to be an oil engineer because we had refineries and all of that, and I was going to be a petroleum engineer. But then, so even then, and even when we were little, my sister and I, we would always make stuff. We tried to make our own nail polish, for instance, with Vaseline and glue, you know, all that kind of thing. So I was always interested in the mixing of things. And so chemical engineering seemed like a logical choice. We had refineries. I would see all the oil refineries going by, growing up in Africa. And so when I went to England at 17, then I decided to study chemistry. And so once I finished, mine was a straight master's degree, so they combined the bachelor's and the master's program. And then at the time there was a civil war going on in Sierra Leone. And at that time, my parents moved to the U.S. And so when I finished, I came over to the U.S., you know, and I was just looking for jobs everywhere. And the one that ended up, I ended up getting was in the pharmaceutical industry, at Merck in the middle of Pennsylvania and so that's where the journey started. 

Vincent Del Casino: Oh, that is so interesting. You know, I was really interested in chemistry in high school, and my uncle worked at Pfizer. And so I had a very similar-- my father's like, “you'll study that, and then you'll get your MBA. You'll be an executive at Pfizer someday.” I totally relate to that. So you were in Pennsylvania. Where in Pennsylvania? Just out of curiosity 

Marcelle Dougan: So in the middle, so I guess halfway sort of between Pittsburgh and Philadelphia. So close to State College about an hour east of State College, Danville, Riverside was where the Merck plant was. I lived in Danville and Bloomsburg in Central Pennsylvania. 

Vincent Del Casino: Yeah, I went to Bucknell, so I lived in Louisburg so it’s so interesting to me

Marcelle Dougan: Yes we used to hang out in Louisburg, it was much more fun than Danville.

Vincent Del Casino: So you're doing this work at Mark. You're really interested. in that, but then I noticed that you got like a certificate in technology, and then what got you interested in kind of shifting gears in looking at Columbia for that and masters in public health and then onto Harvard to do a doctorate?

Marcelle Dougan: So I worked at Merck for about 8 years, so initially I was in first-line manufacturing, there I worked on drugs my first drug was a nth stage drug for childhood leukemia. I also worked in the HPV vaccine and also a drug for heart disease. And so while I was there then and then so after that in first-line manufacturing, then I worked in the technology side and so we were doing manufacturing control systems, we were building the control systems to support the manufacturing process. And then after that, you know, tired of living in the middle of Pennsylvania, then I decided to move to New Jersey. And there again I went into more first-line manufacturing. I worked on Vioxx, the pain medicine that eventually it was pulled from the markt, and then move to the corporate headquarters where I combined the technology aspect with manufacturing aspect to do automation projects across Merck. So while I was there, then I began to think, well, by the time somebody needs a heart disease drug, could there have been some way that we could have intervened earlier on in the process and so then I started thinking about public health I didn't know much about it was either that or study chemical genetics but then public health really spoke to me. Because then it tied back to my roots growing up in Sierra Leone, and the high maternal mortality rate in that region. - Yeah. - And so then, you know, so I decided to go to Columbia. We were in New Jersey, so it made sense. Columbia was only two hours away. I had a two hour commute each way for two years, but you know, here we are. And so, and then, so I decided to study public health, and epidemiology was a natural fit, 'cause I think of that as the engineering side of public health. - Right. - It's the data, it's the analysis, it's the study design, So that fit me really well. 

Vincent Del Casino: And that's really interesting, and when you were at Columbia you decided to look at malaria, right? Does that again connect back to your own historical roots in Sierra Leone and the issue? And interestingly, the intersection with climate change because… climate change happen the geography of mosquitoes starts to change and more people are all of a sudden finding themselves in malarial areas, right? 

Marcelle Dougan: Yes, yes exactly. You know, it's interesting I hadn't actually really thought about it like that. I thought about it in the sense of the present climate, not necessarily climate change.
It's an interesting observation. Yeah. 

Vincent Del Casino: Yeah. So you did that work and then and then you moved on to Harvard. Yes. And what it was, what was your key focus there in your doctoral work and what are the kinds of things you, that got you excited as a next step in that intellectual journey?

Marcelle Dougan: So, yeah, so actually, While I was at Columbia, so I focused on, you know malaria and then pregnant women because I was always interested in maternal health issues and maternal health, yes. And so after Columbia, then I worked for a year at Mount Sinai School of Medicine and then originally it was going to be two years, and I decided I didn’t like being told what to do, so I decided, well, after one year, during that year, then I would apply for a doctorate. And so when I so I applied I looked at many different places. I got into Harvard, I had two babies at the time, one was, well by the time I accepted Harvard I had a two-week-old my second child was two weeks old and so it must have been the hormones to make me think I could actually do a doctorate with two babies but I accepted and so we moved from New Jersey to Boston and there my my area of focus was reproductive epidemiology and and then I had done, so in addition while I was at Columbia I had the malaria focus for my thesis, but I also worked as a research assistant for a professor who was looking at the effects of the nuclear explosion the Chernobyl disaster in Ukraine and looking at— cancer outcomes as related to that. So at Harvard, when I went there then I was you know I studied reproductive epi, and then my thesis was on endometrial cancer, which was a combination of cancer epi and reproductive epi. And so yeah, that’s what I did there. 

Vincent Del Casino: And that's where you got into interest in diet as well right? 

Marcelle Dougan: Yes. 

Vincent Del Casino: And what are the intersections there, like what were you looking at exactly in that intersection of diet life course and cancer? Yeah what's going on.

Marcelle Dougan: Yes. So, with diet, a lot of the foods we eat end up having internal effects in the body on some of our hormones. And then some of the hormones then can also lead to the increase in cancer. And so I was exploring those pathways in gynecological cancers. 

Vincent Del Casino: Oh, that's really interesting. Does that overlap with the kind of work with. epigenetics that's going on now, or is that a different field? You know, because there's a lot of conversation now about the plasticity of the genetic form and things like that. 

Marcelle Dougan: Yeah, to some extent, but it’s also separate because we sometimes look at interactions between those two and how they affect disease. But I also did separate work on related to epigenetics, looking at intergenerational transmission of smoking and how that could relate to obesity a couple generations later. -

Vincent Del Casino: And for those who don't know what epigenetics is, 'cause I realize I threw that out there. You know, when we're talking about that is that sense, going on that we had assumed that the genetic code, the form was set and we've learned over time that that may not be true. In fact, I think it was in the area of reproductive health that a lot of that first came to bear.Right?

Marcelle Dougan: Yes with the Balkan hypothesis that looked at, you know, early life changes and how that programming could influence adult disease. 

Vincent Del Casino: That first thousand days discourse that came out. Very powerful, actually.

Marcelle Dougan: Yeah, yeah, for sure.

Vincent Del Casino: It affected a lot of out community health programs and things like that as people started. It’s also really interesting, a lot of ways in which that got played out. So you focus on that. And obviously you bring that here and then you know. know, during your career here as a assistant professor, the COVID pandemic hits, you start to engage, you take those interests in food and diet, they start to go in different directions for you. So how has your career evolved? Maybe, and that's really where the accidental part comes to be honest for me is, like, I've always felt there was a series of things that sort of happened, and then all of a sudden I found myself doing something I hadn't really expected to be doing. So is that what happened because your work on Covid 19 it overlaps but it’s a different path a little bit. 

Marcelle Dougan: Yes it’s a different path and I think early on in the pandemic it became clear that it wasn't an accident who got COVID or not. And so in that sense, we could see very quickly that certain groups were more at risk and they did not have the structural conditions to protect them from disease. And so we saw a lot of hate crimes among Asian-Americans for instance because of the public discourse in that area. Right. saw that people of color were more likely to develop the disease and die from it. That they could not stay home where we all had, I mean, as hectic as it was, we all had that privilege to stay home and do our work from home. Well, our grocery store clerk does not have that privilege. They have to go to work. And so just looking at all of that, I knew I had to engage in that discussion. And a lot of things, you know, I had, some work that I got support for through the central risker. And then while I was doing that... some collaboration opportunities came through as well. And I was actually, while I was presenting that work during the RSCA in five another faculty member from nutrition and Gisele Pignotti reached out and said would you like to work on, on the food access together yeah and that was a perfect fit for all my nutritional epi experiences those were my experiences, those were actually my favorite classes in, in, in grad school. So I just jumped at the opportunity. 

Vincent Del Casino: Yeah. That's really interesting. And what I, what did I find interesting too about public health scholarship, It's very, very collaborative. Yes. But you have a lot of authors. What about your work really demands that team approach to research?

Marcelle Dougan: I always tell new students who come in, public health is everything. you know and it lends itself to interdisciplinarity you know because we look not only at the immediate causes of diseases, but the causes of causes of diseases. And, you know, for instance in order for us to do, we can do all the great research if we want, but in order for us to make any change, we have to be able to intervene at a structural level. So we have to talk to the policy makers and we have to engage in advocacy. We have to understand viruses, so we have to engage with virologists. And, you know, we need to be able to communicate properly, we have to engage people who know how to communicate and get messages across. 

Vincent Del Casino: Yeah, no. It really is interesting and I have found over time that I've enjoyed much more collaborative work, and then, you know, the traditional for me, you know, oh, be in a hole and write your thing, and I ended up doing some, I was on a public health dissertation when I was at Arizona, and I really loved it because because of that conversation which really demands that. So you also did work on the willingness of people to take up the vaccine, which, that  was a very big issue. Yes. It's amazing how much that doesn't come up right now. But what did you find in doing that work? What were some of the things going on and what were the challenges you saw as a public health expert when you thought started to think about that question of the willingness to use vaccines. 

Marcelle Dougan: Well, I think people had a lot of legitimate concerns about the vaccine. And, you know, for instance, they were worried about the speed at which they were developed. A lot of people were worried about the provisional approval by the FDA and said well when we have the full approval then I will feel comfortable to take it. At the same time we saw differences in political affiliation and it was unfortunate that the tension in the country around the COVID-19 and the vaccine, It became, I remember once on CNN and, and, and I think the way, the, the media functions, sometimes it's more about creating a frenzy, you know. I remember somebody saying on CNN, well, Republicans say this and Democrats say that, but I'm just sitting there and saying, well, “what does the science say?” That's the conversation we should be having. It's not a political issue, but you know, when we did our study of students, college students across California, there are very clear political differences that relate to the willingness to get the vaccine or not. And so it just shaped the discourse in a way that wasn't necessarily helpful.

Vincent Del Casino: Yeah, no. And there's a couple things, you know, across the California State University, depending on where the university was there was a different uptake on students I imagine you found that as well through that work. Yes. And well so I hadn't thought to ask this question but I'm going to ask it now. So as someone with a background in chemical engineering who worked in the pharmaceutical industry and is now studying this question and the question of the science. You know I'm just curious how you were approaching that whole knowing what that process looks like for that kind of development and so forth, and what's going on around provisional and these other kinds of things. And the MRNA, which is a relatively new mechanism, right? - Right. - For vaccine delivery. Which also I think complicated some of this, right? - Yes. - It was not the traditional way that people, and I know most people don't fully understand that science, but it became part of the discourse, I think a bit.

Marcelle Dougan: And I think its a part of that issue as well when something is not very clear then it raises a lot of mistrust and suspicion and it's not like we don't have a history in the US and globally of doing things in that we know are harmful that end up causing you know sometimes causing harm for generations to come. And you know, in terms of - oh, I lost my train of thought. Where was I going with this? But in terms of - of that whole process. I think for me, the first thing I did... was go and look at the data. - Right. I was healthily suspicious as well, and so when the results came out, I actually pulled out my calculator and looked at the data, you know, to see how if they had addressed some of the concerns that I had and looking at the Pfizer vaccine again you sort of have to  weigh what was currently happening, which was people were dying disease at a very high rate, especially certain groups. And then with the limited knowledge, because it was still limited, we did not have years and years of efficacy and long-term studies. That was has always been missing because all of this is new and just weigh those against each other. And I still think that there's still more that we’re continuing to find out about the vaccine, about the disease, about different variants of the disease. And so this is a different kind of time in which we find ourselves. When we were all young, we got all the vaccines, but it was a very different time. - Right. - In terms of the way it was processed, and what we knew about the disease. Now it's sort of more fluid, and I think we have to adapt to that.

Vincent Del Casino: I have two children and I remember at the time when they born you know 16, 14 years ago now, the conversation around the intersection of autism, right, and vaccination, because they're attached to metals and whether or not aluminum and other things in the vaccines and even having a conversation as a family, like should we do them all at once? You know, so there's been a conversation that's gone on for two decades around sort of vaccine questions, right? Yes. That I think also informed this you know got politicized. 

Marcelle Dougan: Right yes and I feel that's the unfortunate piece where political affiliation affects something like this.

Vincent Del Casino: Yes, yeah. So I wanna pull on a couple of threads that you picked up on, which is, is the importance that public health plays in the conversation around these structural questions, 'cause you brought up the whole vaccination thing, I mean, the history of the Tuskegee Project in the United States, but even the, I spent a lot of time studying the HIV epidemic, and you know, the vaccine trials that come out, and many of them happening in Sub-Saharan Africa, right? Where the question of whether or not people are fully prepped, you know, and there's a lot of, there's a lot of work that goes on where, well, we don't have the FDA regulations we have and all of a sudden there's a global movement, right, around how these companies sometimes do that work. I imagine... you know, played into some of your own thinking about some of this stuff as well. 

Marcelle Dougan: Yes, you know, so thinking about who is studied, why they are studied do they actually even have the agency to say yes or no. So all of that plays in and we... testing vaccines on certain people and not on others yeah 

Vincent Del Casino: Well and even you know it's sort of around public health in general, right. The ways in which some population health plays like, Oh, we have a, we have a whole management regime, but you go, Oh yeah, but you haven't looked at all the diverse ways in which people are interacting with that. And I imagine some of your own work too, in the maternal work, has been trying to understand some of those nuances and complexities, right? Because there are nuances and complexities of how different bodies relate to different regimens of food and access to right?

Marcelle Dougan: Yes. Yeah, for sure. And I think it's ongoing. So it's a double edged sword, right? So because of the historical abuse, then people are less willing to participate in these trials, but then if they don't, we don't have the data to support or dispute any recommendations. 

Vincent Del Casino: So, when you think about some of your, so paralleling that, this COVID conversation was this, uh, question of food insecurity. Yes. Right. And again, it goes back to your work on I think metabolic work right around women and diet and cancer potential and things. So there's there's connection, there's lots of venn diagrams. Yes. But the food insecurity is it's another set of questions. Yes. So tell me a little bit about that work and how you got into it and what you're finding around that question of food insecurity and how it plays out in overall population health. 

Marcelle Dougan: Yeah, so you know, food insecurity is an important issue and especially here in the Bay Area where the cost of living is so high, sometimes people have to make the decision between food and rent. Right? And then so, people who are food insecure have higher risk of chronic diseases like diabetes and heart disease, partly related to the food insecurity but also related to food choices that they have to make as a result of the food insecurity. And so, you know, related to that, then we found, so as part of a national nationwide collaboration, we found that across 27 centers across the U.S., in every part of the country, food insecurity increased as a result of the pandemic. The Bay area was one of the worst nationwide. Thats understandable, we found that households with children were more likely to be food insecure. We found that people who had lost their jobs, a lot of people lost their jobs and are continuing to lose their jobs in the economic fallout, they're also likely to be food insecure. And also communities of color are also likely to be food insecure. - 

Vincent Del Casino: And this you mentioned is the national studies like 28,000 surveys. or a little less than that. Yeah. But it's a big, how did you get involved in this national study and brought San José State into that conversation with this larger project? Like how did that even come to be? 

Marcelle Dougan: So it was actually, when I presented atthe RSCA in five that Giselle Pignotti in nutrition had collaborators that she was working with at the University of Vermont I believe, and in Arizona as well and just made those connections and I joined them when I joined her then I became part of this larger group.

Vincent Del Casino: I love it too because I'm looking at, there's like eight lines of people involved. It's so amazing how many people are involved in a study like that. There must be 30 authors on this one paper on the multi-site. 

Marcelle Dougan: Yes, a lot. Yes, more than that, yes. Yeah, it's fascinating. Because each site had multiple authors as well. 

Vincent Del Casino: That's right. Yeah, no, it must be so interesting to be in that national conversation as well with all these colleagues asking the question. Again, I mean, geographer, so I’m a little geeky that way, what are those geographic differences and how do they intersect with demographics and income and the other things? That starts to emerge as a set of issues. 

Marcelle Dougan: Yes it does and I believe the one state New Mexico out of all of them that did not experience any dramatic shifts actually. So what is going on? We have, I haven’t dug into that, but that is interesting why is that so different?  Is it a sampling anomaly or is there something really different going on there relative to the rest of the US? 

Vincent Del Casino: Well yeah I mean when I was doing some work on it, I did some things around aging and the question of aging and the US-Mexico border actually has historically higher life expectancy they call in public health I think it's called the Hispanic paradox. Yes. And I wonder to what extent New Mexico having a very large Latinx community, that’s a possibility of something that plays into that.

Marcelle Dougan: Yeah, yeah, it's interesting.I don't know. Yeah, I would I would be interested to dig into into that a little bit more to understand why that was so different. Also to understand why this bay area was so dramatic in its shift.

Vincent Del Casino: We know from our own student experience and others the margins are so thin here because the costs are so high so I suspect when you suggest when people are trying to balance between those things we actually saw an increase in house prices and everything during the pandemic here. Like, this place is fascinating for that. Yes, talk about paradoxes. Yes. Exactly, exactly. So, you got a sabbatical coming up. Yes, I know you're excited. I'm jealous. You know, I was like, why did I do this provost thing? I could, you know, I wish every six years I could apply for a sabbatical. What are you working on during that sabbatical time? 

Marcelle Dougan: So, yeah, so it's a gift. I will. I'm really looking forward to it, to have the time. One of the things I'm going to be working on is-- I mentioned our Bay Area study and how we collected data from nine Bay Area counties and Santa Cruz County. And it was, it was was small, relatively, we just used a convenient sample and so we had a lot of missing data, and we had some valuable information, but it needed to be expanded. And so as part of that, last year, Dr. Pignotti and I put our central risk of money together to fund, to get support for Qualtrics to actually do panel interviews for us. So we have around 1200 participants now. With complete data on food insecurity, we have-- area-level measurements and so I'm going to be doing going to be analyzing some So looking at some neighborhood and county level characteristics in relation to food insecurity, we collected information on mental health changes across the pandemic, on emotional eating and intuitive eating, and all of that. So going to be digging into that data quite a bit.

Vincent Del Casino: What is emotional eating and intuitive eating? What does that mean?

Marcelle Dougan: So these are measures that look at how well people use food in order to cope, you know? So do they eat when they're bored, when they're stressed, when they're lonely? How well do they do? with emotions without turning to food. So looking at that in relation to food insecurity and also mental health as well across California. 

Vincent Del Casino: Well that's really interesting and these are statistically proven measures, right? These are measures that are out there and have been used and so you're testing them against some of the other data. 

Marcelle Dougan: And within the context of the pandemic as well. I think it adds a whole new layer of differences and uncertainty and stress that is ongoing and unfolding. Yeah.

Vincent Del Casino: What's exciting that I've seen as well, that you've really developed yourself as a public intellectual now. You have like, you're in the Mercury News, you got a piece in Inside Higher Ed. And you know tell me a little bit about that part of your work because it's a great
Opportunity for you to expand your thinking and put it out there in the world in a different way. 

Marcelle Dougan: Yeah, so that has been a gift, you know, to be able to participate in the in the public discourse because I think that oftentimes as academics, we know our work, we're quite good at it, but oftentimes we don't necessarily have the vehicle to translate it to a broader community. And so as part of, I was fortunate to be in the second cohort of the Public Voices Fellowship. And through that, then I was able to have an opportunity to engage in those discussions at a broader level. 

Vincent Del Casino: I found it when I wrote my first piece that got published in the LA Times, I was like, it was a different level of engagement. And I really enjoyed it because it is an opportunity. And it really is what we are about as an institution. We've got to be doing that science. But it's also, how do we, you know, because of the pandemic there was so much public debate, we should be bringing that information out in a biggerway. What are some of the things you've written on then and gotten out there? Because I know you've written a little bit about faculty life even, right?

Marcelle Dougan: Yes, yes, so my first, you know, I've always tried to write, so I have a bunch of things that I've never published, but…

Vincent Del Casino: - I just, I don't mean to interrupt, but I was with Dr. Barrera our Vice Provost and I opened up my folder of all the things I’ve- it’s huge, -Yes, yes, good -it’ gigantic, - I totally get it. -Yes, so that's good

Marcelle Dougan: Yeah. So being in the Public Voices Fellowship helped me amplify that voice. So early on in the pandemic I had worked with Robin McElhatton in the president's office on especially when the vaccine came out, on some areas that I could talk about, and I was interviewed in the media quite a lot, and then on TV, but then I also wanted to do some writing as well. And so, the first time I applied for the public fellowship, I didn't get it, but I did the second time because I never give up. While I was in there, then I began to think about areas that I could connect my experiences, both personal and professional,  and elevate that, that discussion. And so the first thing I wrote about was a piece that ended up being published in Newsweek was about mental health of children as a result of the pandemic. Because at the time during Shelter in Place, I had, a sixth grader and a fifth grader at home when we went into lockdown, and then through that year, they went into sixth and seventh grade. I remember one time, once they were back in school, my meeting alarm went off and my son, my oldest son, he was 13 said, "I hate that sound." And I said, why, he said, because it reminds me of Zoom classrooms. And so that for me was very powerful in the way that trauma and in many ways unrecognized, right? That children dealt with, even though they had food, clothing, and shelter, and they were in a safe place, they still had that trauma of being in Zoom classrooms. And so, my first piece was thinking about the effects of the pandemic. on children, especially now adding to that children of color who were more likely to experience a family member's death, unemployment, all of those things, and how that could impact their long-term health. 

Vincent Del Casino: Yeah, thats really fascinating. I just want to end up just real quick talk a little bit about your participation in honors X. Taking that interdisciplinary approach to a new program really challenging because you were piloting that with us as well. What has been like to try to think through those big interdisciplinary questions and then translate it into a classroom? 

Marcelle Dougan: Yeah, so it was messy. And I think the biggest thing was just being okay with the mess and the uncertainty and just rolling with it as it came. I think it was fun because it forced each of us and each of the faculty we all have our ways of even setting up Canvas, right? And so just even navigating “I can’t find the assignment” and all of those things. I think the biggest thing was understanding that, and then also communicating often. And then again, I think, you know, the business, the public health and the engineering, they all fit together in different ways. And just having that make sense for the students, I think, was the gift in all of this. Because, you know, and we saw this also during the pandemic. Left to me I would have just kept everybody home safe until the disease died but obviously for the economy from the business perspective. It's not helpful. And so just forcing yourself to think. in those ways throughout, only I think
developed my own sense of a teacher and a scholar as well. 

Vincent Del Casino: That's awesome. I could probably spend another two hours talking to you. I really appreciate it. Thanks for taking the time and for exploring some of your own work and giving me a chance to have this conversation, I really appreciate it.

Marcelle Dougan: Thank you for having me! It’s been a pleasure and I’ve enjoyed the opportunity to talk with you and learn a little more about yourself.