11/17/2025
How Community-Based Education and Research Shaped My Career Goals
Karina Ascunce González
Avik Chatterjee, MD MPH
The Social Mission Alliance For Us All Campaign is a vehicle to activate our community and the communities they serve to advance structural changes aligned with SMA’s vision in health professions training. A part of the For Us All campaign, is a media narrative effort that will highlight the material impacts these kinds of advancements have on patients, communities, clinicians, learners, and educators. These stories are a template for what we should be striving for in our healthcare and health professional training institutions.
My name is Karina Ascunce González, and I am a PhD student in Neuroscience at Yale. I have learned so much from my education as a neuroscientist and molecular biologist. My education has provided me with the skills to understand complex scientific problems–the mechanisms of disease and how to interrogate them. Yet my classroom studies and laboratory research at Harvard and Yale did not teach me the skills I needed to engage with people who live with disease and whose illness is often exacerbated by social inequity.
As an undergraduate in 2020, I learned of a worrying trend: Latine populations had increased rates of opioid overdose deaths. I already studied global health and health policy as my minor and had learned about the social determinants of health, but my independent research project, under the supervision of Avik Chatterjee, MD, MPH, allowed me to understand and engage with these affected communities meaningfully–to understand what was happening and share it with other clinicians, institutions, and policymakers.
This project–where we sought to understand the barriers and facilitators to treatment for opioid use disorder–took place in shelters and residential treatment programs, where most participants were unhoused and/or formerly incarcerated, in addition to using opioids. We interviewed these Latine participants in both English and Spanish, using our own Spanish-speaking backgrounds to communicate meaningfully.
We found many opportunities for making access to treatment, particularly for underserved populations, more equitable at the healthcare provider and institutional level. Among the participants, forced detox during incarceration only reinforced their opioid use upon release; for others, housing stability was a major driver in both accessing treatment and maintenance. In a city like Boston, which is where this study took place, we found that many barriers often reported in other contexts regarding Latine health did not apply; for instance, participants rarely reported issues with language barriers, indicating successful institutional efforts to provide language-concordant care. Social workers and supportive healthcare providers also positively impacted views on treatment.
Our findings ultimately underscored the importance of community-based education and research outside of the classroom, as well as community-centered care. Health professionals can be agents of equitable healthcare, and students should learn the value of socially-focused health education through experiences that are within and beyond the classroom setting.
Institutions training future health professionals should share the findings of studies like ours and thousands of others, which focus on underserved populations with intersectional identities and how to implement equitable practices to reduce the burden of disease. Most importantly, institutions should encourage community-based health research and structural changes to improve social education among health professionals, with the ultimate goal of improving healthcare access and quality for all. Institutions have the ability to enact structural change in the way individual, community, and population level health concerns are addressed. We–as students, scientists, physicians, and healthcare professionals–can also advocate for and act on these structural changes.
This kind of qualitative, shelter- and residential-treatment-facility-based research and learning experience did provide me with the skills I needed to engage, empathetically and meaningfully, with people living with illness. This project also served as a catalyst for my own professional trajectory, making it clear that I wanted to pursue a career in social justice work through medicine, working for and with underserved individuals, communities, and populations, as my mentor Avik Chatterjee does on a daily basis and as do thousands of physicians, social workers, nurses, and other healthcare professionals. In large part due to this experience, I have decided to pursue a career in medicine after completing my training as a scientist, in order to be a future community-based provider and researcher, as well as an advocate for equitable health education and practice.
Mentor's Perspective
I am a primary care and addiction medicine physician and researcher. I spend half of my time in shelter-based clinics taking care of adults and children, and the other half of my time I spend researching addiction, homelessness, and equity in addiction treatment.
While my title is “Assistant Professor,” the teaching I do is not built into my schedule, but rather, is ad hoc, and on top of my existing workload. My clinical work and research is demanding, and so taking on an additional mentee can be a difficult decision. But when Karina contacted me to let me know about her interest in pursuing a qualitative project exploring the reasons Latine individuals with opioid use disorder do or do not engage in treatment, I knew mentoring her would be the perfect fit.
The third pillar of the Social Mission Alliance’s “For Us All” campaign is “Anti-Racist and Justice-Oriented Education.” Without having articulated it that way, this pillar encapsulates the motivation for the teaching I do, the community-based research I work on, and the students I choose to mentor, often students from backgrounds under-represented in medicine, for whom such projects are often of particular importance.
Karina flourished and grew as a scientist over the course of the project, learning about addiction medicine and qualitative methods, navigating the Institutional Review Board, designing the research plan and interview script, recruiting and interviewing a cohort of individuals who were experiencing homelessness (a challenge in and of itself), analyzing the data and writing the manuscript, and shepherding the paper through the rigorous review process.
It has been gratifying to watch her enter a PhD program, and now to hear that she has decided to pursue medicine afterward. As she articulated above, I know that social justice and commitment to the community will infuse her work as a physician and scientist. In part, I hope that that commitment comes from her experience working with me and with the people in shelters and treatment programs in Boston who shared their stories with her.
Thank you for reading this story emphasizing what this work means and why it is so important. We invite members of the Social Mission Alliance to share stories with us highlighting work aligned with the campaign pillars to be featured in our narrative campaign. Submit ideas through the form on our For Us All webpage.
