Fall 2022, Issue 7, pp. 28-36
[Online 4 Nov. 2022, Article A039]
[PDF]
Dynamic Dialogue: Mimi Kiser and Stephanie Doan-Soares Reflect on Their Journey in Religion and Public Health – Past, Present, and Future Opportunities
Ashley Meehan[1] and Angela Monahan [2]
Editors’ Note: We are pleased to present an adapted group-conversation version of the PHRS Bulletin’s series of featured interviews with influential contributors who have shaped the field of public health, religion, and spirituality.
We present a conversation between Drs. Mimi Kiser and Stephanie Doan-Soares. Mimi Kiser recently retired from the Rollins School of Public Health at Emory University, where she spent thirty years teaching and working with the Interfaith Health Program (IHP)[3] and on the leadership team of the Religion and Public Health Collaborative[4] for the university. Stephanie Doan-Soares completed her Master of Public Health degree at Emory University, working closely with Mimi and others at IHP. Stephanie recently completed her Doctor of Public Health degree at Harvard University’s T.H. Chan School of Public Health.
Mimi and Stephanie were engaged in conversation for the PHRS Bulletin by Ashley Meehan, a PhD Student at Johns Hopkins Bloomberg School of Public Health and a co-editor of the PHRS Bulletin. Ashley received her MPH at Emory University’s Rollins School of Public Health, with a certificate in Religion and Health. Ashley worked with Mimi at the Interfaith Health Program during her time at Emory.
Ashley Meehan: Mimi, it would be great if you can kick-off our conversation. Can you recap a bit about the history of religion and health at Emory University, and how you got started at this intersection?
Mimi Kiser: Yes, I’ll start with some historical context for the Interfaith Health Program (IHP). In the 1980s and 1990s, there were two important themes emerging in public health. One was eliminating health disparities, and the other was around exploring social and behavioral determinants of health. At this time, there were two key people that helped shape this larger context, specifically for religion and health: Dr. William Foege, who was the director of the Centers for Disease Control and Prevention (CDC) from 1977-1983, and Dr. Gary Gunderson.
In 1984, Dr. Foege had just left his position at CDC, and President Jimmy Carter had asked him to be the executive director of The Carter Center. One of Dr. Foege’s early leadership activities at The Carter Center was a convening called, “Closing the Gap.”[5] The convening was one of the efforts to frame this social and behavioral knowledge and sector engagement that later informed a lot of new thinking of social determinants of health and setting a call to action addressing health inequities.
About ten years later, in 1993, Dr. Foege and Dr. Mike McGinnis published an article[6] in JAMA on lifestyle factors underlying the leading causes of death – not the diseases themselves, but the factors in people’s lives underlying those causes. That was really a seminal representation of the shift at the time to a focus on lifestyle and social determinants of health that undergird disease in a pretty significant way. This opened the doors for new strategic thinking and research about social contexts. I think this was partially spurred by the HIV epidemic, too. The emergence of HIV really forced public health to take the social and behavioral aspects of health more seriously.
So, that hopefully paints a picture of the context in 1992, when IHP was started at The Carter Center.[7] At its founding, the IHP was called The Interfaith Health Resources Center. It was oriented around the “Closing the Gap” conversation and practical in terms of guiding congregations and faith-based organizations in how to do public health. Dr. Foege brought Dr. Gary Gunderson into the mix, which is significant because Gary had a background in faith-based work, oriented in the social experiences of communities and the natural inclinations of congregations and religious institutions.[8] In the late 1990s/early 2000s, IHP transitioned from The Carter Center to the Rollins School of Public Health at Emory University where it continues to live today and has been a really great fit all these years.
So who am I, what called me, and how did I find this intersection? In the early years of IHP, I had gone back to school in a mid-career shift and was getting my MPH at Emory. Whenever there’s a new field emerging, a lot of what moves and shapes it are the people who are inclined to generate ideas and put seemingly unconnected pieces together in new ways. In 1990, that is what was happening at The Carter Center and Emory. I was really drawn to think about the social environment, particularly around meaning and how one understood and valued oneself in making decisions about risk, as well as how the social environment, structures, and systems that influence peoples’ learning and conceptualization of who they are and the value they have. I got involved in a faith-based youth sexuality education project, evaluating a middle school age program, and ended up doing my master’s thesis on that. This was happening at the time when HIV/AIDS was really at the forefront in the early 1990s, and people were trying to think about how people could make different decisions about their risk. It was exciting for me to be thinking about social environments, particularly congregations and faith-based organizations, that youth find themselves in as they are discovering their emerging identities. Because of my work in that space, there was clear alignment with what IHP was becoming. I started working with IHP during its first year, and the rest is history!
I have never seen this many federal agencies take religion as seriously as they did during COVID-19.
– Mimi Kiser
I now want to shift to Stephanie, because a really big part of the work that grew at Emory was the interdisciplinary learning opportunities for emerging leaders, and Stephanie is now one of those leaders. Stephanie, you had some pretty unique experiences in the context of religion and public health learning and practice. I want to know how you came into this emerging environment and how it strengthened and built who you are today.
Stephanie Doan-Soares: I could say I feel a sense of calling to this work, but it’s not always very tangible. I grew up in a very Christian home and my faith has been very important to me. For most of my life, I wanted to be a doctor. I was on the pre-med track in college, majoring in biology and I ended up taking this class in religion. It turned into a minor in religion, and eventually a double major in biology and religion. While that was happening, I realized I didn’t want to be a clinical doctor.
I took a trip to South Africa to learn about the racial reconciliation efforts that were happening, and got to spend time at an HIV clinic. On that trip, I realized that public health was an entire field, so I came back for my senior year of college and finished out my dual degree in biology and religion, and started applying to public health schools. I applied to Emory and a few other places but when I went to the accepted students’ day at Emory, Mimi introduced herself, IHP, and the work they were doing. This light bulb went off in my head that there was actually a way to put together the two things that I had been doing – biology, health systems/health structures, and religion. Trying to make sense of how all these things fit together was always a goal. I want my life to feel integrated and connected, so all of a sudden, meeting Mimi and hearing about the work of IHP made it clear that it was possible to put these things together. I ended up coming to Emory and during the summer before I started, I sent an email to Mimi and Gary and said “I heard you talking at the accepted student’s day. I would love to get a job with you at the Interfaith Health Program.” They interviewed me and decided to take me on as a graduate assistant. And that’s how I got my start in this work.
Mimi Kiser: We are very happy that that happened. You started in 2005, and in 2006-2007, two things were happening. One was that we were being much more intentional about the academic environment around religion and health. We were trying to think through how to navigate interdisciplinary education between the School of Public Health, the Department of Religion, and the School of Theology. Out of this strategic planning came the Religion and Health Certificate and the Religion and Public Health Collaborative. I’m wondering, Stephanie, if you could speak to some of these applied experiences you had with IHP and how they’ve strengthened who you are and built capacity for the kinds of leadership positions that you’ve been in. What are some distinctive moments you remember in this applied religion and public health work? Now, we have a lot more courses in religion and health and students are doing extensive research projects, but your experience was really heavily immersed in the applied areas.
Stephanie Doan-Soares: One thing that was really important was being able to connect with your network of people. I was really influenced by you and Gary and others within IHP, but there was a group of people who were sort of on the fringe or the next level out. I think of Deb McFarland, who did so much work on health systems, which brought in the conversation around faith-based organizations and their involvement in health systems. There was Roger Rochat and his work in reproductive health, and Rafael Flores – it was really powerful for me to see how different people were applying these concepts across fields and topics and in different ways. That was a really important piece of this work.
These connections were also important for being able to connect to their work, too. I did a lot of work around mapping religious health assets[9] in Zambia and Lesotho with Deb, which was really applied research that was community and practice driven. These applied experiences really shaped how I saw my role. How do I take what the scientists are saying and turn it into things that someone on Capitol Hill wants to read, or one of our partners wants to read? That thinking that emerged for me at Emory was needed in my future work, for example, during my time at the CDC Country Office in Bangladesh – where I led a research portfolio of practice-based research. So you’re spot-on, Mimi, the opportunity to do really applied work was instrumental in setting up my career. I want to be doing things that are practical and applied and really make a difference. A lot of people are doing things to gain and create knowledge, which is important, but I like being able to be the bridge and have that make sense in practice.
Mimi Kiser: During that time period, there wasn’t a big welcome mat to these ideas of practice-based programs and applied research in religion and health. But there was power in this translational and relational role. Through its Faith Health Consortium partnership relationships with universities in Africa, IHP was able to bring in people like Deb and Roger who had been doing relevant work, in a clear way and helped us demonstrate the different possibilities.
Stephanie Doan-Soares: I was also thinking about the time I traveled with you and Gary and the team to South Africa, as we were presenting the final version of our report on mapping religious health assets. I think one thing that was important about that trip was there were people from the World Health Organization there, along with all of these different players. Even ten years after that trip when I was in Bangladesh leading a CDC team, those partnerships and understanding the dynamics and how all of these players fit together was really important for me. I don’t know how I would have navigated some of the positions I was in without understanding their context earlier on.
I remember we also had a grant from CDC around engaging faith-based organizations around pandemic preparedness and influenza.[10] Through that, I got to know Dr. Scott Santibañez, and that relationship has been important throughout my whole career at CDC.
Mimi Kiser: Something that was underlying that grant, and the whole concept that came out of the work of the IHP with key partners, was this concept of understanding the different religious health assets and how the strengths of faith-based organizations could contribute and be understood in their role in community health. You became involved in that more in some way as you developed and built your thesis. You were very creative in how you did that. Can you say more about that?
Stephanie Doan-Soares: For my MPH thesis, I focused on a book[11] that Gary Gunderson had written, describing the eight strengths that congregations have[12] for impacting the health of their community. One thing that we had talked about was that it would be helpful if there was some sort of tool for congregations to use to either assess their strengths or to think about how they could build them. I really focused my thesis on talking to congregations to understand how they might view their own strengths and whether there was some overlap between how they talked about it and how Gary had sort of theorized it based on his experiences. The strengths of congregations in building and maintaining social capital are what, in many ways, position them to contribute to health and be a health asset in the community.
In addition to his book on congregational strengths, Gary also had a book[13] on boundary leadership. That term, boundary leadership, really sticks with me as something that has always defined my career. It is a way of thinking about how you go across boundaries and figuring out how we do cross-sector collaboration in meaningful ways.
Mimi Kiser: What’s becoming clear is how in an emerging field like this, particularly an interdisciplinary one where there are lots of different kinds of ideas, it’s important to have people like you bring a new way of thinking, to put ideas together and make them work. I could feel all these pieces coming together to build the substantial body of work that contributes to the health of the public.
So I know that after you graduated, Gary asked you to come to Memphis and work there,[14] so you had more time to grow and develop in a significant way. You had this learning at Emory, and then you went to Memphis, and had experiences at the Department of Health and Human Services (HHS) and in Africa, stepping into some fairly high-level roles and responsibilities.
Stephanie Doan-Soares: I left the job in Memphis to start a fellowship program at CDC that included an opportunity to do three-month rotations in different offices across HHS. I had lined up a rotation at the Center for Faith-based and Neighborhood Partnerships at HHS and got there maybe a week or two before H1N1 happened. One skill that has continued to follow me in my career is how to quickly adapt. This ability to change plans really quickly had been a part of my learning with IHP, and it was really helpful when I ended up being tasked as the coordinator of a guidance document for faith-based organizations and congregations on how they could support the H1N1 response. That included collaborating between IHP and Dr. Scott Santibañez and others at CDC who were leading the H1N1 response, and the partnerships with IHP’s Institute for Public Health and Faith Collaborations and the HHS Faith-based office were instrumental in activating vaccination sites. We benefited a lot from the expertise of the folks activating these sites as we were writing the guidance documents.
Then about a year later, I still had one rotation left. I was talking to Mimi and the team at IHP when Sandy Thurman, director of IHM at the time, came up with this idea that I should go to Kenya. There was a big need in the PEPFAR office to do some coordination—but also an asset mapping project that IHP was involved in that could use some help. This, yet again, helped set me up for a job I took later in Bangladesh. I credit that opportunity to Sandy and her relationships in the PEPFAR world.
Then about another two years later, Sandy called me up again and said, “Stephanie, I need you to go back to Africa and help with this meeting we’re planning.” Sandy organized this elaborate swap of people so my job was covered, and I went to Kenya for several months to help plan a big meeting that brought together faith leaders from four east African countries to get their insights for the reauthorization of PEPFAR. We were really trying to include country and local leadership to move the HIV response forward in East Africa—something you can’t do without working with faith leaders.
Mimi Kiser: I remember that you had a significant role in coordinating the convening for East African countries, and you had this unique responsibility of connecting with religious leaders from four countries. That is not a small endeavor. I had this view into the relationships that you had built and you were kind of facilitating my connection to them. It was really extraordinary, I think, to be on the other end of what you built across the religious leaders and other faith-based and public health organizations and government entities that were there.
So, there’s organizational relational and there’s human relational, but there’s also a cross-cultural dimension of that, which I think you naturally had. But you really blossomed with the cultural and religious pieces, which was likely developed from the engagement you had with religious leaders during your time with IHP. That was quite a moment for me to see that.
This has led me to reflect on how the religion and health idea grew at Emory before the Interfaith Health Program. But then with The Carter Center’s engagement and the leadership at the level of Dr. Foege and President Jimmy Carter. Having the kind of inroads and connections and relational connections with the CDC, the HHS Faith-based Office, and other partners really helped amplify religion and public health because of those organizational relationships. There was pretty significant institutional and structural amplification of religion as a part of public health programming.
Stephanie Doan-Soares: What do you think helped build those connections from IHP to these pretty big institutions?
Mimi Kiser: My first thought is around the credibility of Dr. Foege and his position, but there was something kind of hidden and unspoken historically. The nature of a lot of faith-based work aligns pretty closely with the values of public health, this idea of doing good for the public in the social realm. Many of the important leaders in public health – Dr. Foege, Dr. Tom Droege,[15] and some of the other surgeon generals, for example – got their start in public health as missionary doctors. So there’s been this commitment to serve and do good, and enough leaders had that familiarity to give some credibility to this work. When Dr. Satcher was CDC Director, he put a lot of his authority and directive towards faith-based work. Do you have thoughts about that?
Stephanie Doan-Soares: I think that’s true, but also it might not be the case now. The ecosystem for this new field that’s emerging is different than it was, even thinking about the healthcare sector. There used to be a lot more hospital systems run by the Methodist Church or the Catholic Church. I mean, there are still organizations with connections to these churches, but the connectedness isn’t as strong as it used to be. Maybe another question for reflection might be what that means for the field of faith and health as this work moves forward, right?
Ashley Meehan: Yeah, I had a similar question for both of you. Religion and public health, as an explicit area of focus in schools of public health, really started emerging at the same time as we were navigating HIV/AIDS, and you talked about going through influenza and H1N1, and now we have COVID-19 and monkeypox. I’m curious how you see religion and health playing out in these two concurrent pandemics right now. What do you think is going to happen? What do you think the role of religion is both structurally but also in communities and in people’s daily lives? What do you think it means that religion and health are maybe a bit more settled now, and not emerging alongside these pandemics?
Mimi Kiser: So the environment has changed considerably, including the religious environment and changing church membership. I would say that religious leaders became very important during the COVID-19 pandemic in addressing vaccine hesitancy and misinformation, and I think that kept religion and health alive in a particular way. I’m really curious about how that stays alive in pandemic preparedness because I have never seen this many federal agencies take religion as seriously as they did during COVID-19, investing staff and programmatic resources, time, materials, strategies, and partnerships. It has been phenomenal – I’ve never seen it in my whole career. So, I don’t have a prognosis for that. I’m really curious about where it will land.
“Now that the pandemic is less intense, one of the questions we have is, “How do we continue all of the energy of the public health and healthcare systems working together with these faith communities in a practical way?”
– Stephanie Doan-Soares
Stephanie Doan-Soares: During the COVID-19 pandemic, I worked at a health system, the University of Massachusetts Memorial, a safety net hospital in central Massachusetts. I worked closely with a local task force that focused on the equity as part of the response to the virus. This task force came together with multiple interfaith partners, non-profits, and the city. Now that the pandemic is less intense, one of the questions we have is, “How do we continue all of the energy of the public health and healthcare systems working together with these faith communities in a practical way?” We’ve been having conversations about how we can transition this really effective task force to focus on the opioid epidemic or another high priority area. We want to make sure we learn from COVID-19 and maintain some of that momentum, but we’re also not sure how much of that momentum is going to just fade away because everyone’s really tired. I think a lot will depend on thoughtful and creative leaders who have the energy to carry this forward.
Ashley Meehan: I think that sets the stage really nicely for a call to action. How are we going to commit ourselves to this work, moving forward amidst a really overburdened public health workforce and communities that are stretched thin?
Mimi Kiser: I’m going to be curious to see how it unfolds. I will say, the Religion and Public Health Collaborative at Emory is still very active and alive at Emory, and there have been a number of leadership changes across Emory that I think are bringing in new momentum. Those leaders that are still here, Dr. Ellen Idler in Emory’s College and Laney Graduate School, Dr. John Blevins in the Rollins School of Public Health, and other faculty in the Candler School of Theology have worked to create a really solid, interdisciplinary curriculum. They provide a significant amount of support to students. I like to think we were starting the platform and creating the basis for this work, particularly with Dr. Idler’s work around religion as a social determinant of health. Over the last ten years, a number of doctoral graduate students from the Department of Religion have engaged in this curriculum, so I’m really curious about how they’re shaping their roles and the field as a whole.
Now, I’d like to switch gears and reflect with you, Stephanie, about what you experienced in graduate school at Harvard. Can you say what may be distinctive about the work at Harvard, and any predictions you may have about its future?
Stephanie Doan-Soares: Yeah, so I came to Harvard for my DrPH for a few reasons, one of which is because Harvard’s program is really incredible and focused on the leadership aspects in addition to public health science. Pretty early on in my time here, I had a meeting with Dr. Howard Koh, who I had connected with while I was at HHS when he was the Assistant Secretary for Health at HHS. Dr. Koh talks quite openly about religion as a social determinant of health and how we think about a culture of health.
After I finished my first year at Harvard, Dr. Koh asked me to join a project for a few hours a week – writing this systematic review about religion and health. It ended up turning into a much bigger project than we expected. Our team of incredible research assistants reviewed all of the literature from 2000 to 2020. Our team looked at the impact of religion and spirituality on health outcomes from a public health perspective, both for the general population and among patients with more serious illnesses. We presented our findings to a group of experts, including Dr. Idler and Gary Gunderson, and many others, including what our recommendations were for the future. And the manuscript was published this summer in JAMA.[16]
I think the approach at Harvard focuses a bit more on understanding the causality of religion on health, or how religion is a contributor to well-being and purpose and what that means for our health, as well as the role of spirituality among patients with serious illnesses. These themes are really central to the work led by Dr. Tyler VanderWeele, Dr. Tracy Balboni, and Dr. Koh. To me, that feels a little bit different from the approach at Emory, which might be more applied and focused on the social environment of communities, and also different from approaches at schools like Duke and Berkeley. All of these play an integral part in understanding religion and health, but they have slightly different angles.
Ashley Meehan: So, we are almost to the end of our time together. Are there any last-minute things you want to make sure are included? Any words of wisdom for new leaders or people considering this intersection?
Mimi Kiser: I am really glad that we are able to share about my and Stephanie’s journeys, and that we got to see how Stephanie has really come alive in her work and in her leadership. But there is one more thing I want to make sure is captured in this conversation. In a new field, we have really great scholars, academics, and researchers, but I don’t want us to miss out on the piece related to teaching and mentoring and supporting the creation of new students in this field. Investing in course development, supporting students in fieldwork, and advising students through this interdisciplinary study is critical to ensure the expansion and success of the field.
Stephanie Doan-Soares: Such a good point. That makes me think of one additional thing – I think another big piece of my learning at IHP was walking alongside you, Mimi, as I was going through all these experiences. I still vividly remember a conversation we had at Panera Bread about listening to myself and having more confidence in who I was. And that’s just one example. I’m curious about what it was like for you as a faculty member, not only mentoring me but mentoring all of the students that you were able to mentor. What was the intentional work that went into creating a space where new leaders could grow and flourish in this new interdisciplinary field?
Mimi Kiser: What a great question! I cared a lot about the field and realized that I could make a great contribution to the field by supporting the next generation of leaders. I have a natural tendency towards a supporting and developing role, and it’s rewarding for me to engage in reflective conversations with people who have this commitment and who want to develop themselves in a way to make a difference. It’s really inspiring for me to think about how people are becoming while the field is being created – it’s not just the field, but co-creating possibilities for what this field can do. There’s a need for this integrative thinking that can bring about change and create environments for people to thrive, and thrive equally.
This conversation with Mimi Kiser and Stephanie Doan-Soares took place over Zoom on August 16, 2022. The transcript has been edited for clarity and brevity.
[1]^Ashley Meehan, MPH, received her MPH in Global Health with a Certificate in Religion and Health from Emory University in May 2019, and worked at Emory’s Interfaith Health Program (IHP) during the 2-year graduate program. She is currently a PhD student at Johns Hopkins Bloomberg School of Public Health (Ashleymeehan20@gmail.com).
[2]^Angela Monahan, MPH, is a contractor at the Department of Human and Health Services, and a graduate from the Infectious Diseases and Vaccinology master’s program and the Public Health, Religion, and Spirituality Traineeship at the University of California Berkeley (angela.grace.monahan@gmail.com).
[3]^Emory University: Interfaith Health Program
[4]^Emory University: Religion and Public Health Collaborative
[5]^Foege, W. H., Amler, R. W., & White, C. C. (1985). Closing the Gap: Report of The Carter Center for Health Policy Consultation. JAMA, 254(10), 1355–1358. https://doi.org/10.1001/jama.1985.03360100105023
[6]^McGinnis, J. M. & Foege, W. H. (1993). Actual Causes of Death in the United States. JAMA, 270(18), 2207–2212. https://doi.org/10.1001/jama.1993.03510180077038
[7]^Interfaith Health Program: IHP History and Milestones
[8]^See, for example, “A Movement Toward Wholeness”, by Gary Gunderson and the IHP in The Carter Center’s Fall 1998 Issue of Faith & Health, highlighting the early energy around this work: faithanfhealth-10011998.pdf (cartercenter.org)
[9]^Stakeholder Health: Religious Health Assets Mapping
[10]^Santibañez, S., Davis, M., & Avchen, R. N. (2019). CDC Engagement With Community and Faith-Based Organizations in Public Health Emergencies. American Journal of Public Health, 109(S4), S274-S276. https://doi.org/10.2105/AJPH.2019.305275 PMID: 31505142; PMCID: PMC6737812.
[11]^Gunderson, G. & Cochrane, J. (2012). Religion and the Health of the Public: Shifting the Paradigm. New York: Palgrave Macmillan.
[12]^Gunderson, G. (2022, May 2). 8 Strengths found in any congregation. FaithHealth. https://faithhealth.org/8-strengths/
[13]^Gunderson, G. (2004). Boundary Leaders: Leadership Skills for People of Faith. Minneapolis, MN: Fortress Press.
[14]^Bobby Baker and Gary Gunderson. “Strengthening and Aligning Religious Health Assets in Memphis: A Conversation with Gary Gunderson and Bobby Baker.” Practical Matters Journal (March 1, 2011). http://practicalmattersjournal.org/?p=1581.
[15]^Assorted Writings and Presentation of Thomas A. Droege (ihpemory.org)
[16]^Balboni, T. A., VanderWeele, T. J., Doan-Soares, S. D., Long, K. N. G., Ferrell, B. R., Fitchett, G., Koenig, H. G., Bain, P. A., Puchalski, C., Steinhauser, K. E., Sulmasy, D. P., & Koh, H. K. (2022). Spirituality in serious illness and health. Journal of the American Medical Association, 328(2), 184-197. https://doi.org/10.1001/jama.2022.11086