Avi Kenny

Avi Kenny

  • Program: PhD, 1st year
  • Hometown: New York City
  • Advisor: Jim Hughes

What led you to pursue a career in global health?

I first became interested in global health during my junior year at Brown University, when I did some work with Gardens for Health International (GHI), an organization operating in Rwanda that helps to build community gardens for HIV-postive individuals in the hopes of decreasing rates of malnutrition, allowing for antiretroviral drugs to be more effective.

That summer, I took a two-month trip to Rwanda to continue my work, and witnessed firsthand just how bad things were in terms of primary healthcare access and quality. This experience led me to refocus my career path on global health, and when I graduated college, I knew I wanted to work abroad with an organization working to fight the dramatic healthcare inequity that pervades the developing world.

After graduating, I landed a job in Liberia with Last Mile Health, a nonprofit that helps improve healthcare access for remote populations by partnering with governments to recruit and train networks of community health workers.

GMI Health, montage images of people
For over a decade, Gardens for Health International has been working hand-in-hand with local communities to end chronic malnutrition. Over 90% of their team is Rwandan and most of the staff is recruited directly from the communities they serve. Photos courtesy GMI website.

How did your experience with Last Mile Health impact you and/or your studies?

My time with Last Mile Health fundamentally shaped my career goals, both because of the nature of the work we did and because of where we did it. Liberia is a country that ranks among the worst in the world in terms of maternal and child mortality, with a healthcare system that was shattered twice in recent history, first by a fourteen-year civil war, and second by the Ebola outbreak of 2014.

Those who work directly within the health system are often confronted by a seemingly-insurmountable set of challenges, from health worker shortages to faulty infrastructure to supply chain issues. This can certainly be frustrating for someone trying to help fix the system, but for the people trying to use the system, it’s a matter of life and death.

My experience in Liberia left me with strong motivation to continue working towards global health equity, but also opened my eyes to the huge potential that lies in quantitative work. There is tremendous opportunity to leverage data resources in the developing world to benefit health systems, but doing so requires a nuanced understanding of how to draw the correct conclusions from available data. For example, during the Ebola outbreak, we performed an analysis of sick child treatment data to guide the design of our "no touch protocol," which allowed for our community health workers to safely continue to treat children for malaria, diarrhea, and pneumonia.

Last Mile Health image of two women and a baby
Last Mile Health’s vision is global: a health worker for everyone, everywhere, every day. Photo courtesy Last Mile Health website.

Why did you choose biostatistics?

I’ve been a math nerd my whole life, and at Last Mile Health, I was able to apply mathematical thinking to real-world problems. But the more I learned about research and data analysis, the more I realized just how much I didn’t know, and I concluded that the only way I could attain the level of skill I desired in terms of working with data was through graduate study. Biostatistics was a natural choice given that it allows for the simultaneous pursuit of theoretical rigor with practical application of methods.

Why did you choose UW?

I chose to attend the University of Washington because of the world-class rigor of the biostatistics program, the focus on practical applications of research in real-world settings, and the number of faculty involved in global health and causal inference research. Purely theoretical research projects, while intellectually interesting, are not what I came here to do; I want my research to have an actual impact on people’s lives. And I believe that the faculty at UW will push me to sustain this focus.

How would you describe your experience as a UW Biostatistics student?

So far, so good! I’ve been very pleased at how much time the faculty and staff here invest in students’ academic and professional development. Multiple faculty members have told me that training students is their number one priority, and I feel lucky to be a part of the program. The work is certainly challenging, but if it weren’t, I wouldn’t be learning as much.

What kind of research are you doing?

My primary research interest is in developing statistical models and techniques that aid in causal inference. I became interested in this particular subfield after reading a book called “Counterfactuals and Causal Inference,” which I purchased attempting to learn the logic behind the choice of including or excluding possible covariates in a regression model. This introduced me to the work of Judea Pearl and to models that implement Pearl’s framework in specific epidemiological situations. My interests lie at the intersection of biostatistics and epidemiological methods, but being a mathematician at heart, I’d love to deal with the statistical side of things, while keeping epidemiological applications in mind.

How would you describe the benefit of your research?

If we are trying to understand the effect of some sort of new intervention or treatment, the “gold standard” study design is the randomized controlled trial (RCT). However, it is often the case in global health research that RCTs are not affordable, ethical, or logistically feasible. Instead, we often rely on observational (or quasi-experimental) data, in which individuals are not randomly assigned to a treatment group or control group. Advancing the subfield of causal inference can help us to extract meaning and draw causal conclusions from data within a wider variety of settings, allowing decisions to be made about whether the intervention or treatment in question actually had an effect on a particular outcome.

What are your future goals?

After earning my PhD, I hope to pursue a career as a biostatistician, designing and applying research methods with the goal of improving public health in the developing world. That being said, as a first-year student, I am trying to do my best to keep an open mind and learn as much as I can about the various paths that a biostatistics degree can lead to.

What advice would you give to a student who is considering a UW Biostatistics program?

Talk with as many students and faculty members as you can to determine if biostatistics is the right path for you and if UW is a good fit. I probably talked with two dozen individuals—professors, statisticians, epidemiologists, students—before making my own decision.  I’d also say that taking time off between undergrad and grad school (in my case, seven years) to live and work outside the context of academia was essential. Had I gone straight from undergrad to grad school, I almost certainly would have ended up in the wrong field.

What extracurricular activities do you enjoy?

Outside of school, I like to play acoustic/electric guitar, grow plants from cuttings, road trip to music festivals, backpack in the mountains, identify birds and trees, and make things out of wood.

What do you like most about living in Seattle?

I love that on any given weekend, I can always find people who are down to go climbing or backpacking, and there’s even a public bus that goes from downtown Seattle to the mountains. The summer here is truly amazing given all the outdoor opportunities as well as events within the city, such as the Fremont Solstice Festival. And after living in Monrovia—the wettest capital city in the world—the rain here really doesn’t seem that bad.