Graduates
Global Reach, Local Leadership
Ensuring Equity for Veterans
Margaret Crotty, MPH ’14
Ernest Moy, MD, MPH ’91
Margaret Crotty launched her career at Save the Children in Indonesia after getting her undergraduate degree at Princeton. It was the start of a successful career that included a decade as CEO of Partnership With Children, which provides community health and schoolbased behavioral health across New York City. It was during that time that she enrolled in the Health Policy and Management executive program. In 2022, Crotty became president and CEO of JSI, an international nongovernmental organization that oversees $750 million of programs that strengthen the capacity of local systems in 42 countries to deliver high-quality services and ensure equity in access to healthcare, education, and socioeconomic opportunity. “We work with governments, the private sector, and civil society to identify and implement solutions to the biggest public health and education challenges,” she says. Crotty sees a change underway in global public health in response to the pandemic, the effects of climate change, and the increasing commitment to programs being locally designed and implemented. She notes that many countries that managed their own pandemic response, making decisions on the ground, have had strong outcomes. “Zambia reached an 85 percent vaccination rate among its vaccineeligible population,” she says. Her leadership spans multicountry programs and community projects. The common thread is listening to the community, building trust, leveraging local resources, and adapting to change, all approaches taught at the School. “We think hard about our role,” Crotty says. “What’s the best way to measure impact and sustainability? How do we build a global system where resources shift to local stewards? We want local experts to set the agenda.”
Ernest Moy came to Columbia more than 30 years ago for an internal medicine fellowship program for physicians interested in public health. He quickly dug into how socioeconomic factors— education, job stability, neighborhood—could affect patients’ health, something that he is still immersed in today as executive director of the Office of Health Equity of the Veterans Health Administration (VHA). While earning his MPH, Moy focused on healthcare equity and disparities of care. He found a mentor in Oliver Fein, MD, at what was then called ColumbiaPresbyterian, who had opened five satellite health centers to assist the largely Dominican population in Washington Heights. “He recognized that the social needs they had, especially if they were unmet, were more impactful on their health than anything we could possibly do,” Moy says. Moy also saw firsthand how bifurcated the U.S. healthcare system can be between those with money and those without. When the hospital decided to take fewer indigent and Medicaid patients, he and the other fellows conducted a study. They found that some were able to pay a new fee, and others found new providers. But some slipped through the cracks. Of this group Moy says, “Their high blood pressure and diabetes were often under poor control.” Moy went on to work at the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention, where, among other things, he studied rural health disparities. Finally, in 2018, he moved to the VHA. Moy analyzes standard quality metrics—such as safety, effectiveness, and equity—for veterans groups defined by sex, age, race, ethnicity, and other factors. He shares the results with Veterans Affairs (VA) medical centers and clinics around the country. One recent analysis revealed that minority veterans and white female veterans were not receiving newer, more effective diabetes medications at the same rate as white males. “We take that information and tweak our programs,” Moy says. “We might need to customize communication for those groups or connect them to social services.” Making these targeted adjustments to the healthcare program at a VA center, he says, can really move equity forward.
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COLUM B I A P U BLI C H E A LT H
Nancy Averett is a science writer in Cincinnati, Ohio.
2023–2024 EDITION
