Tuesday, May 30, 2017

Capstone 2017 – Madeline Ruhl

Presented May 4, 2017, Madeline Ruhl explored the realities of individuals entering the U.S. via the U.S.-Mexico border from Mexico and other Latin American countries. Examining migration trends can uncover important insights that can help public health officials and human rights advocates on both sides of the movement. However, while this topic has garnered much political attention over the past 50 years, Madeline’s research focused on a specific reality—the use of smugglers (called coyotajes in Mexican-Spanish)—that is not as well researched.

Coyotajes are routinely recruited or hired by individuals to assist them in traveling from Mexico to the U.S. They are paid a fee for their service. The increased use of coyotajes since the mid-1960s is associated with a complex web of political, economic, and social factors, along with increased surveillance along the U.S.-Mexico border. The number of visas extended by the U.S. has also fluctuated significantly over the 20th century through legislation including the Immigration and Nationality Act, which additionally contributes to the rate of undocumented immigration.

Madeline’s research aimed to uncover whether the fee paid to coyotajes could uncover important patterns in other life effects. Utilizing data obtained from Princeton University’s Mexican Migration Project (MMP), Madeline’s research yielded some interesting results.
  • The average fee paid to a coyotaje is as high as $1,929 in some regions. 
  • The majority of individuals traveling are male.
  • Group sizes tend to be small averaging two individuals.
  • Fees paid by women are approximately 18% greater.
  • Those in better health paid less.
  • Acculturation contributed to lower later self-reported health.

While research in this area may be difficult to gather, Madeline’s project reminds us of its continuing importance. Investigating relationships like those between fluctuating coyotaje fees paid and associated life effects or health outcomes can reveal important information about at-risk populations. This information could then lead to the development of more effective health initiatives, and a better understanding of a path forward for health officials and human rights advocates on both sides of the border.

Learn more about Madeline’s capstone experience.

What led you to your topic?
In 2015, I received an email blast from Loyola’s Public Health department about a volunteer opportunity with an organization called Community for Children, located in the Rio Grande Valley. I applied and attended their January 2016 program. That opportunity not only changed my life, but it fundamentally shaped my career. It sparked my passion for immigration health.

Why was the content or theme important to you?
When I returned from Texas, I dove into studying immigration law, health, and the factors and outcomes associated with the movement of people. I joined organizations like the Migration Policy Institute to help me further my understanding of global immigration legislation. I focused closely on movement into the U.S. from Mexico and the Northern Triangle countries—with a special interest in the movement of unaccompanied children. 

Did you encounter any challenges during your project?
There are always challenges associated with obtaining the data we need as Public Health scientists, and even more so when what those data are extraordinarily sensitive, both ethically and politically.

Where are you headed with your career?
My practicum and capstone projects at Loyola led me to continue my career in immigration health. I currently work as a program evaluator with an organization providing support to unaccompanied migrant children. This summer, I will also be participating in a one-month research project through the American Anthropological Association doing fieldwork in pediatric clinics in Antigua, Guatemala. 

What coursework did you apply to completing your project?
Biostatistics and epidemiology were at the technical core of my project, but I believe that Loyola’s well-rounded curriculum gave me the opportunity to explore the undeniable humanity of my work as well. Fields such as bioethics and research ethics, human behavior and health policies all strongly informed my project. 


A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Thursday, May 25, 2017

Capstone 2017 – Ashley Hess

Presented May 4, 2017, Ashley Hess took the opportunity to explore the relationship between access to legal services and health outcomes. In her presentation, Ashley reminded us of some of the key social determinants of health. These include, but are not limited to, access to quality housing, education and healthcare as well as employment/income, legal status and even family responsibilities. It should be no surprise that access to legal services is subject to many, if not all, the same limitations as good health.

Ashley’s project centered around examining how medical legal partnerships (MLP)—collaborations among medical and legal services with the aim of addressing legal, social and health related issues for vulnerable patients or those underserved in a clinical setting—have been applied to address the social determinants of health. The Erie Family Health Center, a partner of Loyola’s School of Law and the Beazley Institute for Health Law and Policy, regularly refers patients that meet a list of criteria to the Health Justice Project. By probing the open and closed case data—available since the program’s 2010 inception—Ashley was able to extrapolate the data to the city of Chicago as a whole. The case data revealed case outcomes included enrollment in Medicaid, receipt of SNAP benefits, abatement of substandard housing conditions and eviction defenses provided. Cases were often closed due to immigration status, employment or other family law issues.

Overall, the MLP examined is making a positive impact in this community, however, there is much work to be done to further its effectiveness. Besides increasing staffing, Ashley’s research suggests that MLPs could benefit by expanding their education and legal education offerings, developing a more open communication process between participating entities as well as establishing a more holistic approach to addressing social justice.

Learn more about Ashley’s capstone experience.

Why did you choose to pursue an MPH?
I participated in two public health trips to Honduras through Global Brigades during my undergraduate career. While there, our group was responsible for building a latrine, stove, water storage unit and shower as well as installed concrete floors in the homes of the families we worked with. We were also responsible for preparing an educational program about proper hygiene and hypertension for children at the local school. After having this experience and working with community members, I knew I wanted to do more with public health and empower those around me to better their circumstances. 

What led you to your topic?
I worked with the Health Justice Project during my practicum in the fall of 2016. During this time, I helped research health outcomes related to lead and arsenic exposure through contaminated dust and soil. Through our work, we were able to change HUD’s requirements for blood lead levels to warrant intervention. The legal side of health was something I did not know much about at the time, but as I immersed myself more into the work, I wanted to make sure I incorporated it into my capstone.

Why was the content or theme important to you?
Legal services are not a right for individuals pursuing civil cases but are a right for those involved in criminal ones. When first researching my topic, I was very surprised to see what a difference legal aid has on health outcomes. By simply addressing legal needs in a medical setting, vulnerable populations can gain imperative services such as Medicaid, Social Security, WIC, and receive assistance for paying utility bills.

Where are you headed with your career?
I am currently looking for a job that utilizes my degree and incorporates the legal aspects of policy development. 



A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.