How the School of Public Health cultivated two legacies

UTHealth Houston School of Public Health, founded in 1967 as The University of Texas School of Public Health, has educated over 8,000 students to reshape population health. Their educators have worked diligently to train a diverse network of global public health leaders.

Two standout alumni from the school’s first decade, now husband and wife — Charlene Hunter James, MPH, and Andrew James, MS, DrPH — heavily contributed to its growth and evolution. These inspirational public health professionals were among a small group of minority students at the university. Charlene and Andrew’s 50-year personal and public health journey began in the 1970s when the two were navigating the challenges of continued postgraduate work as well as the broader societal and cultural issues impacting minority populations.  
 
Charlene’s interest in public health stems from her time at Fisk University and her internships with the Tennessee Valley Authority and the Tennessee Tuberculosis Association, which had developed a consortium with Fisk, Tennessee State University, and Meharry Medical College.

“I was one of the first students to express an interest, and I had the opportunity to get hands-on experience in rural health and exposure to rural health care challenges in both northeastern and southwestern Tennessee,” Charlene said. 

Andrew’s journey began in Mississippi, working with his mentor, researcher H. Jack Geiger, MD, MS. Their research focused on Mississippi’s high infant and maternal mortality rates — a problem that persists today. In 1970, the infant mortality rate in Mississippi was among the highest in the nation (Singh, 2019). Andrew’s work identified that access to clean and safe drinking water greatly reduced the mortality rates of infants and women.

“Women had to walk for miles to collect clean water,” Andrew said. Geiger and Andrew’s work in Mississippi started their legacy of examining systems of health care aimed at improving health in underserved communities. Geiger established the Delta Health Center, the nation’s first rural community health center. Andrew initially served as the first Black sanitarian specialist in Mississippi where he identified risks and enforced environmental, health and safety regulations. He would later serve at the Delta Health Center as an environmental engineer, environmental improvement director, and center director. 

Andrew and Charlene met for the first time in 1973, at a conference of allied health schools in downtown Houston. While pursuing his doctorate at the School of Public Health, Andrew actively worked to recruit more minority students after noticing a stark lack of racial and ethnic representation in Texas and public health across the nation.

Charlene, a Fisk University senior at the time, vividly recalled that first meeting.

“Andrew talked to me about how the school was relatively new and was recruiting students of color,” she said.

Charlene had always known she would pursue a graduate degree with aspirations anchored in aiding vulnerable communities and promoting access to health care. “He asked about my interests, considered my response, and later wrote me a letter of recommendation,” Charlene said.  

Andrew recognized that Charlene and he shared the same ambitions. The two leaders sought to enact small shifts in public health, hoping their work would benefit the low-income communities that did not have access to health resources.

During a challenging time in U.S. history, when the color of one’s skin often determined societal expectations and treatment, Charlene and Andrew banded together with their peers to face the tribulations, examinations, and pressures of academia as people of color. Each desired to graduate and enact changes to aid the public and bring their diverse perspectives to the forefront of this field. 

After completing his doctoral degree, Andrew continued to advocate for access to health care and essential public health needs, a pursuit that would define his career in public health. His work in Houston included positions as the first fair housing administrator, assistant director of the Houston Health Department, and associate professor at Texas Southern University College of Pharmacy and Health Sciences. Andrew’s dedication to the improvement of the population’s health would reunite them through his own postgraduate research. 
 
Andrew’s and Charlene’s lives continued to converge. Research projects, friends, and other instances of fate would consistently bring them together. Andrew recruited Charlene and another colleague to help him collect data for a study on immunization rates in children under the age of 3 while she was still a student. She remembered knocking on doors in the summer heat of Houston. After collecting information, Andrew would call at the end of each day and say, “How many babies did you get for me today?”

Public health, at its core, is aiding people. In this research, they worked tirelessly; this memory served as one of the early pieces of their history together, shifting from being classmates to a new stage in their lives together. They married a few years after Charlene completed her MPH. They would both enter new experiences in public health, continuing to advocate for the underserved. Together they championed the benefits of public health and instilled their devotion into the child they welcomed into the fold. They will celebrate 42 years of marriage in 2023.

 After graduating, Charlene worked alongside one of her professors, Hardy Loe, MD, MPH, retired associate professor and associate dean for community health, by providing technical assistance, health planning, and access to health care services across the state. Charlene spent 32 years at the Houston Health Department, with 15 of those years as the director of the Harris County Area Agency on Aging.

Charlene’s graduate studies allowed her to view health impacts holistically.

“It made me realize that I could not look at just health services,” she said. “You have epidemiology and environmental health; it all comes together. Especially with health disparities, and public health policies, you must look across all disciplines. I just could not look at only medical services in public health; there’s a broader field of health services.”

Charlene was also a devoted advocate through volunteering and served as the state volunteer president of AARP Texas, the nation’s largest advocacy organization for older adults. Charlene said she views the elderly as an often overlooked population. Using her background in health administration, continued her devotion to creating an impact in Texas through these planning agencies. 

Charlene and Andrew held different focuses in public health but understood how each could create a shift to remedy the factors that influenced the population.

“Being people of color gave us a broader perspective in understanding issues impacting the quality of life of people of color — prevailing public health issues, access, availability of care, rural and urban health issues, infant mortality, and environmental impact,” Charlene said.  

Charlene and Andrew dedicated their life’s work to assisting the public. Through their higher education from the School of Public Health, they were able to focus on accessibility, gain lifelong friends, aid in matriculating minority students, and advocate for healthier outcomes for vulnerable communities. The school holds these same pursuits today.

Since its doors opened in 1967, the School of Public Health has cultivated a learning environment to develop future leaders and foster the field of public health, while contributing to the formation of lasting relationships.

While Charlene and Andrew spend their lives together in retirement in Houston, they continue to advocate and promote the field they helped revolutionize. Fifty years after meeting at a conference in Houston, the hum of their service to public health continues within the walls at the School of Public Health and in their family.

During the summer of 2022, they welcomed their first grandchild. When asked what legacy they would like to leave in public health for their future generations Charlene responded, “I’d like to see the visibility of public health soar — focusing on education, the role of public officials, adequate funding of public health, and policy issues.”

An aspiration well worth the effort.