Finding My Bearings in Public Health Research

Children’s National Hospital & Research Institute

By Lauren Afong

Before I began my research fellowship at Children’s National Hospital & Research Institute, I understood healthcare equity as a concept grounded in lived experience and academic interest. I was aware that access to care often depends on factors outside of a family’s control—such as income level, neighborhood, and insurance status—but I had not yet fully confronted how deeply these issues are embedded in the structure of our healthcare system. While my project still has much to explore and will undergo many adjustments, I understand that equity in care is not simply a matter of policy, but a reflection of how systems, geography, and resource distribution dictate such.

This summer, I have been conducting a comparative assessment of how the Affordable Care Act has impacted pediatric primary care utilization in Washington, District of Columbia, from 2010 to 2020. My research focuses on regional disparities in access to care across the eastern, western, and central sectors of the city. I am using a combination of Medicaid claims, community health infrastructure data, and the Child Opportunity Index to examine how the availability of services, nonprofit organizations, and full-time medical staffing vary by neighborhood—and how these variations influence whether or not a child can receive timely, routine care.

Inside Children’s National Research Institute

When I entered the Global Scholars program, I initially felt uncertain about the direction of my research as it pertained to healthcare equity and accessibility. I was unsure as to how I would contribute to research of this scale. Over time, I have come to realize that my lived experience is not just relevant, but essential. I was raised in a community where navigating the healthcare system was often confusing and discouraging. My family encountered barriers related to language, limited provider options, and inconsistent follow-up care. These challenges now shape how I approach this research and inform the questions I ask. They have helped me understand the stakes of this work and reminded me that behind every data point is a real child, a real parent, and a real system that may or may not be working for them.

Living in the District of Columbia this summer has provided a powerful backdrop to my work. The city is home to world-renowned medical institutions and forward-thinking public health initiatives, yet it continues to experience striking disparities in access to care. In neighborhoods with lower Child Opportunity Index scores, families often face limited access to pediatricians, fewer nonprofit health resources, and a shortage of full-time medical professionals. Even with health insurance coverage through Medicaid, logistical barriers—such as limited transportation, difficulty navigating enrollment, and low provider reimbursement—can prevent children from receiving consistent primary care. These are not hypothetical concerns. They are systemic realities that shape a child’s health trajectory from the very beginning.

What has made this experience particularly valuable is the support and mentorship I have received from the team at Children’s National. Through conversations with researchers, physicians, and policy experts, I have been able to refine my research framework and connect it more deeply to both local and national conversations about health equity. I now understand how institutional decisions—such as whether to invest in full-time providers or establish community-based partnerships—can have direct consequences on a child’s ability to access preventive care. These insights are helping me translate academic data into actionable policy recommendations.

As my research progresses, I have made several decisions that will guide the development of my Capstone project. I plan to structure my final analysis around both a policy timeline and a geospatial representation of pediatric primary care utilization by neighborhood. I will examine how the Affordable Care Act unfolded over the decade and how regional healthcare ecosystems responded. I am also in the process of drafting a policy brief that will include recommendations for improving equity in primary care delivery, particularly in areas with low opportunity scores. When I return to Florida State University, I hope to continue this work through undergraduate research initiatives such as the Center for Undergraduate Research and Academic Engagement and the Collaborative Environment for Learning and Leadership in Science. I am also exploring the potential for publication or community dissemination of findings in collaboration with Children’s National.

More than anything, this summer has reaffirmed my long-term commitment to pursuing both medicine and public health. Intertwining the two has clarified for me that healthcare equity requires more than policy change and finds itself in every facet of medical care. I now see myself not just as a student or aspiring physician, but as someone who can contribute to a future in which every child, regardless of neighborhood or background, has access to the care they deserve.

Residentials in Washington, D.C.