Navigating Public Health Challenges: Leiema Hunt’s Mission to Improve Community Health

Public health isn’t just about policies—it’s about people. Leiema Hunt, MPH, talks about her work in American Samoa, the unique health challenges her community faces, and the role of cultural traditions in promoting well-being. From leading COVID-19 response efforts to tackling non-communicable diseases, Leiema shares her insights on public health, leadership, and the importance of staying connected to one’s roots. 

Recorded, Edited & Produced by Christy Gonzalez, Harper Xinyu Zhang, Kailey Hopkins, and Tanya Gale

Transcript

Cougar: [00:00:00] Welcome to Y Health, a podcast brought to you by the BYU Public Health Department. I'm Dr. Cougar Hall, a professor here at Brigham Young University. Whether you are a student, parent, or BYU fan, this podcast will help you navigate the world of public health. Our podcast strives to help individuals receive accurate information regarding public health.  So whether it's global or local, we will discuss how it pertains to you. Just kick back and relax. As we talk about Y Health. 

Cougar:  Leiema Hunt, welcome to the Y Health podcast. I have really been looking forward to this, Y Health, and I hope the technology works because I am in Provo, Utah. Where are you? 

Leiema: I'm an American Samoan. 

Leiema: I'm home. And I also hope the technology works as well. 

Cougar: So far, so good, sister. It's so nice to see you. I [00:01:00] think it's been four or five years since you graduated from the MPH program at BYU. Is that about right? Yes. 

Leiema: Yeah, I graduated May 2020, and right when COVID hit, we didn't have a graduation. 

Cougar: Oh my goodness. 

Cougar: Those were the days. I'm so sorry. Okay. Well, this is our celebration today, right? It's much belated. Yeah, it is. Will you give our listeners a proper introduction to who Leama Hunt is? Kind of your educational background, what you've been doing with your career. 

Leiema: Yeah, sure. My name, my full name is Leiema Suitumua Sachiko Hunt, and shout out to Dr. 

Leiema: Crookston, who pronounced my name perfectly for the online recording of our graduation. 

Cougar: Wow, that is cool. 

Leiema: Yeah, he did. And I'm, I'm from American Samoa. I've lived in American Samoa all of my life. I'm a local product of the education program from the high school, the elementary high [00:02:00] school, the community college, and then carried on to Brigham Young University, Hawaii. 

Leiema: Earned my bachelor's degree in health and wellness. Wasn't too sure what I wanted to pursue in a career, but I knew that Serving a mission would help me. So right after earning my bachelor's, I served in Indonesia. And then I knew that I wanted to continue school, but I needed to figure out how I could contribute to my community. 

Leiema: So I decided to work for government for four to five years and work specifically in the Department of Health. It was a huge challenge, but it helped me to see what the needs were locally. And that solidified my decision to earn a MPH. And I was very blessed to be accepted into BYU. Thank you for accepting me, by the 

Cougar: way. 

Cougar: We were, we were blessed to have [00:03:00] you, Y Healtha. Let's be honest. 

Leiema: Oh, no. I, well, I count my blessings every day and BYU, and the BYU MPH program is definitely among those blessings. Um, right after, actually, one of the highlights of my career, actually, is I didn't know Where I would work right after my MPH program, but the Lord gave me a job. 

Leiema: He literally did because I got a phone call from the centers for disease control and prevention and said, we're opening up a position in American Samoa. And we need you to go back home and we'll get you home. At that time, the borders were closed. No one could fly in and out of American Samoa and CDC flew me home. 

Leiema: So that I, yeah, it was, it was a miracle. Yeah. I didn't know exactly what I would do, but the Lord says. He said, I know what you're going to do, and I'm going to send you home, and you're [00:04:00] going to serve the community for four plus years through the Centers for Disease Control, helping through COVID and the border closure. 

Leiema: And, and yeah, almost five years have passed, and the Lord's provided. 

Cougar: Wow. God is good, Liemma. Oh my goodness. I'm tearing up. I'm glad this is just audio. That was really tender. I appreciate you starting with that and sharing that experience. So you've been working with CDC, well, since COVID. Can I ask, what was the impact of COVID in American Samoa? 

Leiema: We were fortunate in a lot of ways, because of the border closure, American Samoa was able to prolong it reaching our shores. But at the same time, the impact of closing the borders, there were Residents that were stuck outside of American Samoa for a year. So [00:05:00] that was difficult for a lot of our residents because they couldn't return home to work, couldn't return home to support their families. 

Leiema: And, you know, just not knowing of when the borders would open again was it, it had its impact in different ways. It was very different from what happened in the States. 

Cougar: Yeah. Disruptive, for sure, to families and to livelihood. Wow. What exactly did you do when CDC and how cool that they sought you out and you were able to return home and use the skills that you had developed? 

Cougar: You've always had a passion, it sounds like, for promoting health. And for reaching out to various populations and helping them where they are. But what exactly did CDC have you do when you returned? 

Leiema: To be honest, I was still trying to figure that out. When I was first hired, I was hired specifically out of the Office of Island Affairs. 

Leiema: And our role was to [00:06:00] help both the federal side understand local dynamics, you know, there's so much that happens across continental US that it's hard to keep track of what happens in the islands. So a lot of my job was to translate. How federal funding and how federal activities affect American Samoa, and at the same time, be on the ground to help American Samoa understand what federal expectations are. 

Leiema: So, and that that was different for each program. So, when I was hired, we knew that. There would be a lot of COVID funding coming to American Samoa and my expectation, or at least what was expected of me, was to help ensure that American Samoa stayed accountable for federal dollars. 

Cougar: That sounds important.[00:07:00] 

Leiema: I hope it was. I mean, I hope it was important. 

Cougar: No, you know, it's one of the things that maybe we don't. talk to our students enough about is really managing budgets and accountability, fiscal responsibility and accountability. Those are the things that get our program shut down prematurely. So it's incredibly important to take care of that. 

Cougar: Make sure all the T's are crossed, the I's are dotted, so to speak, right? It's a huge responsibility. 

Leiema: It is, I will say that Dr. Crandall's class program planning and evaluation was a huge help in that sense. I had the opportunity to work on a small grant prior to coming to coming to BYU, but the. The piece that was missing in my experience was the, I think it was called like the roots analysis, the, the roots cause analysis. 

Leiema: There was also just ensuring that there is community feedback and just the evaluation [00:08:00] piece really expanded my understanding of program planning and budgeting. So the, also the opportunity to work with lots of groups. You know, that really mimics real life work. We'll always be working in teams. We should be working in teams. 

Leiema: So I think, not, I think I know that the MPH program helped to build my understanding. 

Cougar: Well, that's wonderful to hear. I know we're not perfect. We're always revising and trying to, you know, reach out to stakeholders and what is it that our students need more of or need less of and how do we best prepare them. 

Cougar: It just really feels like in your situation, you were really thrown into the fire immediately and during a time of great uncertainty. With COVID as we're struggling, you know, on the continental United States to kind of wrap our brains around, you know, disease prevention and control and the spread and, and how we're different policies and, [00:09:00] and boy, we really, we had some breakdowns in communication and getting messaging. 

Cougar: So I can only imagine, like, literally right from your virtual graduation to you're on a plane that somehow CDC is able to get a plane in when others couldn't. Right. And like, here we go. I just, wow. Right there, right in the fire so quickly. 

Leiema: Yeah, there were a lot of aspects of the MPH program that helped me. 

Leiema: Another part, as well as Dr. Josh West's class, when I say that the Lord is mindful and he's in the details, I, you know, I was fortunate to be a TA for the behavior theory class and you know, going back a lot of the grants from CDC are based on health behavior theory. So I could look at the grant, look at further notice of funding opportunities and see how health behavior theory really influenced that.[00:10:00] 

Leiema: So the NPH program really helped me to understand CDC so much more better. 

Cougar: That's also good to hear. I have to tell you both for our public health students and the students I work with in school health education, we talk about theory. We teach the prominent theories. They have to try to problem solve using theoretical constructs. 

Cougar: It's so often when we get out into the quote unquote real world, we suddenly just start immediately program planning or You know, for my students, lesson planning, and we've kind of had this disconnect between, no, here's what the theory would support. Here's what we know about behavior change. Here's what we know about prevention. 

Cougar: Here's what we know about how to, you know. Utilize these, you know, these tools or pull these levers based on behavior change and theory. Sometimes there's a disconnect. I love that you're immediately able to get out there and realize, oh, okay, because of my understanding of theory, here's how this grant's been written or here's how the program needs to be implemented. 

Cougar: Here's going to be our [00:11:00] touch points. So, I'm really, I'm so thankful. I think that's a credit to you. Although I'll give some credit to Dr. West because he's amazing, but I'll give some credit to you as well. What, moving forward now, it's been, so that's been four or five years. What, what are the different health promotion efforts you've engaged in? 

Cougar: Has it all been COVID and recovery from COVID? Or have you been on some other specific programs related to maybe local public health needs there in American Samoa? 

Leiema: Yeah, it hasn't all been COVID. Let's see between 2020 and 2022, that was very COVID focused. Gosh, I don't even know where to start. Prior to BYU, I was working with the non communicable disease and prevention programs. 

Leiema: And because turnover is like the turnover rate in public health and in government in American Sound was really high, there's not much continuity. Between the [00:12:00] last program manager and the next program manager. So I served as the encyclopedia, just the person who had the historical knowledge for a lot of the NCD prevention, strategic planning work. 

Leiema: One of the specific projects was planning for the adult population based survey to assess for NCD prevalence in the community. Another project was the development of an NCD strategic action plan, and then because of my personal connections in the Department of Health, I was placed in the office of the director to provide support to him. 

Leiema: on, on many, on anything actually that he, he needed help with. So, 

Cougar: you're the go to person, huh? I love it. 

Leiema: I was, and I do need a break for four years in the director's office. Yeah, [00:13:00] we'll 

Cougar: talk about what's next for you in just a second. But let me rewind just a second. You're talking about non communicable diseases. 

Cougar: And here in the continental United States, we are year in and year out have cardiovascular disease as the number one killer. And we have cancer, stroke, diabetes, you know, there's a real pattern. It may vary by region, some of the prevalence and some of the rates, but pretty consistent. What are, what are the NCDs that you're dealing with in your population there? 

Leiema: You know, I should have this memorized considering how closely I've worked with the programs, but I will say that for non communicable diseases, specifically heart disease, diabetes, cancer, they're, they're high in American Samoa. We did a comparison between the overweight and obesity prevalence between American Samoa and the U. 

Leiema: S. And I think the, the last comparison we did was in [00:14:00] 2017, our prevalence was higher than that of continental U. S. And for diabetes, self reported diabetes, it was also, the prevalence was also higher. And that was the same with hypertension as well. 

Cougar: Wow. What is the public health programming then? What is the upstream approach to address, say, diabetes in this population? 

Leiema: Oh. Wow. Wow. There are multiple approaches, at least for the American Samoa Department of Health, with what funding is available to government. A lot of it is diabetes education awareness, and again, because that's what our budget allows for, government wise. 

Cougar: Leama, are there, are there specific aspects of diabetes and diabetes prevention and education that you're seeing as most, most vital, most crucial? 

Cougar: Is it, are we talking about [00:15:00] dietary consumption, meal planning, food prep? Is it the social determinants of health? Is it access to healthy foods, access to care, preventative checkups? I mean, maybe it's, it's probably all of the above. It's usually all of the above, but are there, are there one or two things that in your office are of greatest concern? 

Leiema: I will say that access to food is probably one of the problems in the sense where we have access to a lot of unhealthy food. Culture also plays a big role in that, you know, food is a big part of the culture. So part of local program efforts is to promote local, locally grown fruits and vegetables. 

Cougar: Is home gardening a part of that? 

Cougar: Is that, is that prevalent? 

Leiema: It's become, like home gardening has become. Less and less practice. [00:16:00] I do also I want to say that because obesity and, you know, the, because we're so heavy locally, there's been a rise in outside non government organizations that want to address healthy eating that also want to address more physical activity. 

Leiema: So there's definitely more of a local awareness. And we were talking about this the other day about. What we can do on the non government side and what the government can do on their side to be able to build healthy eating behaviors. What do we do to build that kind of environment? 

Cougar: To build that into culture and to have that. 

Cougar: To 

Leiema: build that into culture, yes, and particularly trying to build that into family life as well. 

Cougar: Yeah, well, as such, this is such, it's a [00:17:00] delicate dance. When in public health, we're, we're taking into account, you know, local culture, tradition, cultural norms, and preserving those. But with within that schema also saying, what are the things that maybe we've lost as we've imported more of a Western diet and the convenience, which I think you were, you were talking about earlier, just, it's just so easy to get calories and it's so easy to get calories that are less, less healthy for us. 

Cougar: And so, as we've kind of had this. This intersection of cultures and trust me, the continental United States has been very successful at exporting a junk food, fast food, you know, empty calorie culture to the rest of the world, not just to American Samoa. So that, that. That collision with traditional cultures and norms around eating, which should, by the way, be fun. 

Cougar: It should bring people together. It should be social. Families get together [00:18:00] and eat together. That's, that's every culture around the globe. But how has that been impacted by modern life and mass food production? And, you know, so there's, there's so many, there's just such great complexity when we talk about culture and preserving culture when it's been impacted. 

Cougar: My very, very inexpensive and not good for us. Yeah. I did 

Leiema: also want to mention that Brown University and Yale, they've done so many studies. I think the university is Arizona as well. That focuses a lot on. Diabetes among American Samoans and diabetes among Samoans, um, when I say that I mean Western Samoa, independent country of Samoan. 

Leiema: So there's, there's a large body of work regarding diabetes prevention, diabetes control, [00:19:00] specifically for Samoans. But having worked in government. For almost a decade, one of the biggest challenges that we have in facing that is just the amount of funding that is available to address those problems. 

Leiema: McGarvey from Brown University, as well as Yale, they put out so many evidence based recommendations. But then it's translating the research and those recommendations into public health practice, where that gets lost in translation. 

Cougar: That is the hard part sometimes, isn't it? 

Leiema: Yeah. So when, when you're asking what are some. 

Leiema: of the upstream strategies, which is like, oh, from McGarvey, I was just like trying to piece all the researchers recommendations, like we're, we're, we're, which one, just trying to [00:20:00] sort through that isn't coming as fast as I want it to. 

Cougar: Well, it's, it's a challenge in every population, in my opinion, and from my limited experiences, you know, that. 

Cougar: Translating the bench science or the, or the social science to the programs and really being able to, to implement those findings, you know, in a way that actually improves quality of life for individuals, for families. And so that, that is the work of public health in so many ways is making that translation. 

Leiema: I wanted to say that that's the big reason of what motivates me to go for a DRPH versus a PhD. There's just so much research about American Samoa and diabetes, but it's not finding its way as quickly as I would like it. Into public health practice, not that a single person can bridge [00:21:00] that gap, but I would like to make that my mission. 

Leiema: Should I ever complete a DRPH program? And should I ever be in a leadership position in American Samoan? 

Cougar: Hey, what is this should stuff? So, so this is a great transition, Y Health, as we talk about your future. So you're talking about a doctor of public health, which is given, we'll, we'll give you, I'm going to speak as if this has already happened. 

Cougar: We'll give you the tools to implement the research because you're, you're, you're already equipped to, you know, to glean. You know, the most important things from a research study, but this, this will give you even more tools for implementation, for writing policy, implementing policy, building coalitions. I mean, these are all the things I think about when I think about a doctor of public health. 

Cougar: Tell us, where are you at in that process? What's exciting? What's discouraging? Because it's, it's a hard process when you put yourself out there and you [00:22:00] say, Hey, I would like, I think I could contribute to, to your school. And I think that you could help me. And are we a good marriage, right? It's, it's, it's very much this dance, so to speak. 

Leiema: Yeah, the dance has been full of highs and lows. Uh, I've been applying for doctorates program for the past four years, uh, particularly with Yale. Uh, at first I wanted to Go the PhD route and then after four years of not getting accepted into a PhD program, like, okay, I think the Lord is helping me to decide to go the DrPH route. 

Leiema: Right now I've applied to four different programs applied to, I've looked at the Harvard Dr. Page program. I really like what they have as far as the curriculum goes. Another. Program the other 3 program whose curriculum I feel like would help me meet my [00:23:00] goals are the John Hopkins DRPH program, the GW DRPH program and then Emory University. 

Leiema: Third year page program. So, fingers crossed, if I don't get accepted this year, if I don't get accepted this year, I'll just be like, okay, Lord, you're in control. Yeah, one more, one 

Cougar: more year of experience will also help, right? Well, good for you. A, you're shooting for the stars. Those are the top programs that I can think of in the country. 

Cougar: So, and I, I believe knowing you, having researched with you, Leama, and been quite successful in our publication efforts. And then getting a feel for your work experience in American Samoa. You will add a lot to either, any one of those programs. And, and I'm sure you will gain a lot. It's exciting when you actually talk about, I want to come home and I want to be able to, to lead out. 

Cougar: To, to have, you know, a bigger megaphone. And to be able to really shape and implement policy. [00:24:00] To write the grants that you need to get beyond, you know, some of the low level health education efforts. And really make a difference, really make an impact. So, I think that's really exciting, and I'm always excited when one of our students goes on to, to A, exceed everything that your instructors have done here, but go and represent us well, and with, with the intent of really easing suffering, and allowing people to flourish, and enjoy. 

Cougar: You know, their families and their lives just to just to have this full experience here in mortality and and not be, you know, held down by any number of chronic diseases, which are so preventable for most of us, right? 

Leiema: Yeah. So I will say that if BYU opens the DRPH program, I'm here. 

Cougar: You have no idea how, if you were to poll the audience, you would find that I think it would be a hundred percent of the [00:25:00] faculty are like, Oh, we would love to do that. 

Cougar: But it sounds like BYU is pursuing a medical school at the moment. And we, we really do. I think, I think you'll see this across campus. We really do stay true to our charge to provide. a really solid undergraduate education for as many students as possible. Now, we're, we feel very blessed in our department in the last 20 or so years to, to be able to have the Master of Public Health program. 

Cougar: And who knows? I never say never, right, Liemma? At some point, we may have doctoral students and, and have a school of public health here. I sure feel like we have, I have amazing colleagues and I think it, I think at some point it's possible, but we're, we're doing our very best to produce awesome undergrads and a small number, but a wonderful cohort of MPH students every year. 

Cougar: So 

Leiema: the MPH program has definitely blessed my life and then working with the undergrad in the projects that we've had, that's also been a blessing. [00:26:00] I can think. Whenever I work on a project, I reflect on the experiences, the, the learning environment that I was a part of while I was at BYU. That's 

Cougar: awesome. 

Leiema: You've been a big part. Of my growth. I also, I wanted to mention something that's really helped me in my public health career, or the internships that I was a part of. So, I don't know if you have any minority students that might be interested in the project was 1 of the programs. I was specifically a part of this is based out of Atlanta and the internship is with Morehouse College also a very enriching. 

Leiema: experience there. 

Cougar: Oh, that's great. I, I am not familiar with that program, but that's something I'm sure that our student listeners will really enjoy hearing. And there's just so many opportunities, but sometimes students don't know where to look and where to go. And we've done a [00:27:00] good job, I think, in our department of hiring the right people as far as internship coordinators and really trying to get the information out there. 

Cougar: But I appreciate that plug for sure. 

Leiema: Well, yeah, I'll send, I think there's two other programs that I can think of. One's definitely out of the Centers for Disease Control and Prevention. They have a public health associates program, uh, where they're, and then another one for any Pacific Islanders that are looking to get more experience in the Pacific. 

Leiema: There's one with the Pacific Island Health Officers Association, which is a two year commitment. Yeah, it's a two year program. 

Cougar: Oh, and I know to 

Leiema: the Pacific, 

Cougar: I know that you've helped some of our interns last couple of years too. And appreciate that. Let me, in fact, let me stick with this. And maybe this is 1 of our final questions here. 

Cougar: I need to let you get back to work. But maybe 1st, do you have 1, 1 tip for a current student, [00:28:00] either undergrad or grad student? Something that will really make an impact for them. Something they can do now that will help them, you know, in the future. And, so here's the double barrel, because there's a second part. 

Cougar: And do you have one tip for a non student listener? Someone who follows the podcast, just looking for tidbits as far as health promotion, the way to, you know, to live a better life, to, to enjoy more wellness, more well being, to flourish, so to speak, is our word at the moment. So, so one for a student, one for a non student. 

Leiema: Oh man, the tip is not educational specifically, directly, it's more spiritual. Only because my, my career has definitely been guided by the Lord. So when President Nelson says to make time to hear the Lord. Make time to do that. I've had great [00:29:00] mentors to guide me along my path and the Lord has directed me to each of those mentors. 

Leiema: I will say along those lines, having a good support system is really important. I don't think we're meant to work on projects alone in our life. It's important to be able to get to know who's Who your support system is. And for me, it's when I was at BYU, it was, it was definitely my cohort, my roommates, the Lord, the faculty and staff. 

Leiema: So, yeah, not. I hope I didn't disappoint anyone in saying that it's not education, it's not directly an educational tip, but this has helped me find my job. The Lord found it for me. 

Cougar: Well, it's fantastic advice to not do it alone either, to pair up, pair up for success, whether at work or in school. I [00:30:00] love that. 

Cougar: Anything for another listener out there. Health related. 

Leiema: Health related, I will say. Gosh, I don't know how to quite. I've learned that each person has innate skills. And whatever skills that they do have can totally be used in public health. Fun fact, I grew up in American Samoa, but I didn't speak Samoan. 

Leiema: My first language is English, and I've always doubted that part of myself. But then I've Looking back in my career, I realized how English has helped me to really be used, useful in, in my field. And that's in reading, notice the funding opportunities, writing grant applications, you know, they're all in English. 

Leiema: So whether your strength is in [00:31:00] finance or whether your strength is in law. You know, those innate strengths that you do have can totally be used in public health. So I'm hoping that we can get more folks interested in public health, because there's a huge need for all of those skills. 

Cougar: I love it. Yeah, that's so cool. 

Cougar: And it is amazing. I can, I mean, there's a theme as we're talking. Today, Lima, that the Lord has really been guiding you throughout, and whether you knew it or not at the time, with the benefit of hindsight, you can see. How you've been directed in so many ways for the opportunities that he's then presented you with. 

Cougar: Timing is everything, right? And so I just want to say, I just want to say a huge thank you because your time is valuable. So taking some time out of, out of your busy day to chat with us, maybe as a final. Question for you, is there [00:32:00] something you're reading or listening to? Maybe it's a textbook for all I know, Y Health, you're, you're pretty academically focused at the moment. 

Cougar: Is there something you're reading or listening to that has you excited and get you up in the morning? 

Leiema: Yeah. So I'm not reading it for fun. I'm also an adjunct, adjunct professor at the American Samoa Community College. And so I teach public health classes. I was recently hired to teach human security. So the textbook is human security theory and action. 

Leiema: There's so much, there's so much research that's. That's driving this book and naturally as all textbooks are. I'm learning so much about how, you know, food security, environmental security, climate security, economic security, how that all impacts human security. So just It's really helped me to understand the purpose of the United [00:33:00] Nations. 

Leiema: It's really helped me to understand just the different global projects that are happening. And when I work, I usually work in a really small bubble. Everything is just public health related, CDC focused. But then in reading this textbook, I've learned so much about What's happening in the world today. 

Cougar: Oh, that sounds exciting. 

Cougar: Could you take one more student? I'm not, I'm not a very good student, but I at least come to class. I might look at my phone though, in the back. 

Leiema: Are you kidding? I'm waiting for when you start up a DRPH program so that I can come and be your student. 

Cougar: Okay. I love it. Well, Viemma, that's exciting and congratulations on that gig. 

Cougar: That's teaching is so much fun. It's stressful and it's so much fun. So I hope you're enjoying that. 

Leiema: I am. I am. 

Cougar: Well, let me sign off and I'll just say thank you, Lima Hunt, for all that you've done for BYU. You've represented us [00:34:00] very well and we're just really hoping to see and find out where you land in your Doctorate of Public Health program, Doctorate of, excuse me, and keep in touch. 

Cougar: Be a friend. Thank you for joining us today. Catch us on our next episode and don't forget to subscribe to future Y Health episodes.