Serving, Leading, and Healing: Odysseys through the Desert and Beyond
Matthew L. Boulton
Senior Associate Dean for Global Public Health, Pearl L. Kendrick Collegiate Professor of Global Public Health, and Professor of Epidemiology and Preventive Medicine
Matt Boulton grew up in rural Nevada where his father was a mine worker. He worked with horses on local ranches and developed a fascination with the plants and animals he encountered in the open desert. “It was an adventurous and unbound life,” he remembers.
Boulton studied zoology and botany as an undergrad at the University of Nevada, and was planning on a career as a physician when he entered UNR’s medical school. But his experiences as a medical student would lead him not only to the challenges of medical practice but well beyond.
Working on reservations is what first got me interested in public health. They were difficult environments in which to live and to provide health care.
Boulton spent a summer as an undergraduate on the Shiprock Navaho Reservation in the four corners area. Later on, during medical school, he worked on the remote Pyramid Lake Paiute Reservation in Northern Nevada. “Working on reservations is what first got me interested in public health. They were difficult environments in which to live and to provide health care but the experience started me thinking about a life of service as a physician,” Boulton says.
The insights into other cultures Boulton had gained made him ask what other perspectives he would need to work with underserved populations needing health care. “I knew I needed to leave Nevada to grow professionally and personally. The plan was to go away for residency, then return to Nevada to work on Native American health,” he says.
A Momentous Decision
A fourth-year medical elective rotation first took Boulton to the University California, San Francisco, where he worked with AIDS patients in the early phases of that challenging epidemic. But he then made what he calls a “momentous decision” to leave the Western US entirely for residency.
When he arrived at the University of Michigan in 1988, Boulton completed first a medical internship with the Department of Family Medicine, then the Preventive Medicine Residency in the School of Public Health where he obtained his MPH. “I was drawn to the seemingly endless opportunities Michigan afforded—including the School of Public Health,” he says.
I could see the tremendous impact one can have working in public health practice and the potential of combining it with an academic career.
Doing clinical work in a public health practice setting is ultimately what led Boulton to remain in Michigan. As part of the Preventive Medicine Residency, he was doing clinical work in Detroit-Wayne County, “when I began to revisit my plan to go back to Nevada,” he says. “I could see the tremendous impact one can have working in public health practice and the potential of combining it with an academic career.”
For a while, Boulton would stay busy both as a public health practitioner and as an academic.
From Clinic to Classroom to County
In Detroit and other locations around Wayne County, Boulton worked in clinical settings seeing large numbers of patients for infectious diseases, family planning, and reproductive health services. At the same time, he began teaching at the School of Public Health, first as an adjunct lecturer, then as an adjunct associate professor—and later becoming the school’s first clinical professor while still working in practice.
With Boulton’s ability to perform in both clinical and academic settings, it did not take local leaders long to identify him as a strong candidate for public service. For three years, Boulton served as regional medical director for the Washtenaw, Jackson, and Livingston County health departments. In the fall of 1998, he was recruited to Lansing to serve as State Epidemiologist and to run the Bureau of Epidemiology in the Michigan Department of Community Health. “Together with a staff of about 250 people, I oversaw communicable diseases, immunizations, vital records, and environmental health for the state. It was a significant transition from doing mostly clinical work in local health departments,” Boulton notes.
In 2003, Governor Granholm named Boulton the chief medical executive for the state, a more political role “where I served as a public health spokesperson for the governor, met with legislators and the media, led press conferences,” Boulton says. “I was still directing the state epidemiology department too, which I really loved, because it meant I was still overseeing scientific areas, working directly with the CDC, and staying engaged with clinical practice, health management, and research around the state.”
Boulton’s intercultural experiences as a high schooler in minority-majority schools and as a medical student on reservations would open up new vistas for him and the school.
In late 2004, Boulton became a tenured professor at the School of Public Health and was also named Associate Dean of Practice. At the time, Boulton had traveled little outside of the US apart from his time on Native American reservations. But his intercultural experiences as a high schooler in minority-majority schools and as a medical student on reservations were about to open up new vistas for him and the school.
Under Boulton’s leadership and working with a highly innovative staff, the newly formed Office of Public Health Practice at the School of Public Health initiated a variety of new programs, including the Practice Plunge as part of new-student training, the Academic-Practice Summit to explore connections between public health policy and academia, and the Public Health Action Support Team (PHAST), which deploys graduate students to locations throughout Michigan, the US, and globally to assist with various public health projects. “We wrote and received several grants to support all of this work, and it really added a vital dimension to the training we were able to offer to our master’s students,” Boulton says.
Global Translator, Local Advocate
As part of PHAST’s work, Boulton and the practice team had taken students to China three times. They had also initiated an international scholar exchange program, focused on China, that supported international student work here at the school and research collaborations between Michigan and partner schools abroad. In 2010, Boulton received a large multi-year NIH grant to work in China and decided to step down from his leadership role in the practice office to focus on his international research.
In 2014, Boulton was named Senior Associate Dean for Global Public Health and, to date, has made over 30 international trips on behalf of the school in his various roles. Despite the many challenges of global travel, Boulton says it is also very fulfilling work. “Working in global health has been transformative for me—working with many different faculty in our school and with international partners to build meaningful relationships that are co-equal partnerships and that contribute to public health capacity building in those countries.”
Future prospects for international research, training, and capacity building in our school are good, and student interest is overwhelming.
Boulton sees a bright future for global health training in the school, where internal capacity is constantly growing. Currently, more than 90 faculty members have a “global health” designation, and they are collaborating on public health research in 76 countries around the world. “Dean Bowman just returned from Africa and was in China last year,” Boulton notes. “Future prospects for international research, training, and capacity building in our school are good, and student interest is overwhelming.”
Boulton attributes some of his success in global health to having worked on reservations. “They are a world apart. Tribal health is not under the purview of US public health, and tribes do not answer to US governmental officials—they have their own systems and are considered a sovereign nation,” he says. Boulton also served for a number of years on Michigan’s tribal health advisory committee.
Intercultural experience does not have to mean leaving your home region, as Boulton’s experiences prove. “Much of my interest in global health and other countries’ cultures traces back to my time as a young student working on reservations and also my high school years growing up with and being close friends with kids from Native American, Latinx, and African American communities as well,” he says.
Vaccines Past and Vaccine Futures
Few public health practitioners go from pure practice into an academic career. “It simply has not been a common pathway, because the cultures of the two professions are so very different,” Boulton observes. Today, though, Boulton’s research keeps him deeply engaged with clinical and policy-related public health practice around the world.
Boulton’s research team looks at vaccination coverage and vaccine hesitancy in developing countries, where very little is known about why certain communities have low vaccine uptake. Hesitancy can mean not getting a vaccine at all or it can mean getting a vaccine after the recommended age. “A six-month delay in vaccine receipt exposes a child for six months to a disease when they are at the greatest risk for serious disease, which is dangerous and unnecessary,” he says.
In the latter 20th century, people actually thought we had infectious diseases solved.
Even as vaccine science advances, communication and policy related to vaccines has become more challenging. And many regions of the world still need major improvements in the most basic forms of health care, which includes vaccination. “The strategies we used before may not be as successful today. In the latter 20th century, people actually thought we had infectious diseases solved. The fact that we don’t means we have to continue to have a global view and impact through our work as epidemiologists and as public health professionals in many areas,” Boulton says.
Because of vaccine science itself and the implementation challenges surrounding it, Boulton’s research will keep him translating between clinical public health, health practice and management, and academic science—which is where public health at its best resides.
Recently, Boulton was appointed the Pearl L. Kendrick Collegiate Professor of Global Public Health by the University of Michigan Office of Research. The renewable five-year appointment was approved by the Board of Regents in February. “Kendrick was a pioneering vaccinologist but also very interested in the epidemiology of vaccine preventable diseases,” Boulton says. “At one time, she served as director of the Regional State Public Health Laboratory. I was drawn to her because, like me, she was a practitioner for many years, then transitioned to the Michigan faculty as an academician and taught in our school’s epidemiology department. I see intriguing similarities in our careers.”
Matt Boulton and his wife, Chitra, with the statue of Kendrick, Eldering, and Gordon unveiled in September 2019 in Grand Rapids. It is titled Adulation: The Future of Science and stands on the former site of the regional state public health lab, which Kendrick directed and where she, Eldering, and Gordon conducted most of their work on the pertussis vaccine. Kendrick is in the middle with Eldering on her right and Gordon on her left and is intended to depict them in 1944. The other part of the statue exhibit is a young girl and boy holding a bug jar and magnifying glass to symbolize the next generation of scientists.
Kendrick trained at Johns Hopkins University and was on the epidemiology faculty at the School of Public Health for nine years, from 1951 to 1960. With two other women—Grace Eldering and Loney Gordon—Kendrick worked at the state public health lab in Grand Rapids in the 1930s, developing the world’s first effective pertussis (whooping cough) vaccine and then improving it over the next several years. At the time, pertussis killed thousands of Americans every year, most of them children.
Faculty honored with a Collegiate Professor designation are invited to choose the name of mentor or other scholar who influenced their work. Boulton chose Kendrick, in part, because the work of women scientists, especially from that era, “have often been discounted or underappreciated, and this is certainly true of Kendrick,” he observes. “She was a pioneer in vaccine development and in the conduct of vaccine field trials and is grossly under-recognized for her contributions. In fact, Kendrick helped establish the first international standards for vaccine production. And given that she was on the faculty in the Department of Epidemiology at the time of the Salk polio vaccine trials, it’s likely her experiences in conducting a successful vaccine field trial with the pertussis vaccine at least in part informed the massive polio field trial headed up by Dr. Thomas Francis.”
In general, Boulton notes, there are far fewer professorships named after women. “I hope keeping Kendrick’s name and legacy in mind is a step toward honoring the many women scientists who have changed our world and contributed importantly to public health.”
From the open desert of rural Nevada to locations across the globe, Boulton's keen observations of public health at all levels and his willingness to serve in a variety of capacities have kept him focused on the most meaningful things—those places where he’s felt public health is needed most.
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