Originally published in the Harvard School of Public Health Magazine.
[ Spring 2013 ]
When Raul Ruiz was growing up in California’s Coachella Valley, his parents—both migrant farm workers—couldn’t afford health insurance, so they relied on home remedies and nutritious meals to stay healthy. His mother served herbal teas and lentil soup fortified with vitamin-rich onions and bell peppers, a dish Ruiz would eat to gather his strength before college exams.
“She taught us to appreciate food as a vehicle for feeling better and promoting a happier life,” says Ruiz, MPH ’07. “More important than the science of the food was the motivation and the inspiration and the worldview of nutrition as remedy, food as medicine.”
That experience of material deprivation and common-sense care helped shape Ruiz’s thinking about public health and medicine in the years that followed. Now 40, he plans to put those insights to work as a newly elected U.S. congressman representing California’s 36th District, the same area where he grew up. Ruiz, a Democrat, won the seat that Mary Bono Mack had held for 14 years.
9,000 residents, 1 doctor
Ringed by mountains and known for its grape, date and alfalfa crops, Coachella Valley has long faced a shortage of doctors in poorer areas. Even if more physicians practiced in the area, some residents would still be unable to afford a visit to the doctor. “That’s one of the main reasons I decided to become a physician,” explains Ruiz, who returned to the valley to work in emergency medicine after earning three degrees from Harvard, including medical and public policy degrees in 2001.
Coachella Valley faces “one of the worst health care crises in the state of California, possibly in the country,” he says, “not only in the lack of health care access but also in disparities to access.” Low-income areas have just one doctor for every 9,000 residents, while more affluent areas have one per 300 people. The national standard is one doctor per 2,000 people. “We’re way below that target.”
In 2010, Ruiz founded the Coachella Valley Healthcare Initiative, an organization dedicated to expanding access to health care for disadvantaged residents. For Ruiz, widening access to health care also means offering education that will help people “make the right decisions to live a healthier life, not only for themselves but for the entire community.” He cites childhood obesity as one of the valley’s most urgent public health challenges.
A pledge to return home
This concern for community has been a recurring theme in Ruiz’s life. Born in Mexico and adopted as a baby by his aunt and uncle in California following the death of his biological mother, he credits much of his success to his upbringing in the Coachella Valley. He raised funds for school by soliciting money from local businesses and pledging that he would return to the area as a doctor—a profession he had chosen at age 4.
After graduating magna cum laude from UCLA, Ruiz went on to Harvard, where he worked on public health projects in Mexico, El Salvador and Serbia. At HSPH, he focused on humanitarian and disaster aid, assisting in the aftermath of the 2010 earthquake in Haiti. “I always knew, even when I was in medical school, that in order to make a larger impact in a community I would have to leave the exam room.”
Ron Walls, chair of the emergency medicine department at Brigham and Women’s Hospital in Boston, knew Ruiz when he was an international emergency medicine fellow at the hospital in 2006 and 2007. “Raul saw the little things we do as part of bigger things and was always thinking of those bigger things. He’d try to figure out the context of the problem,” Walls says, adding that Ruiz was an exceptionally compassionate doctor who was also “very charismatic” and “instantly likable.”
Curing a sick health system
Now that he’s embarked on a career in politics, Ruiz says he will miss being an emergency medicine doctor and shaping students into a new kind of physician focused on community wellness and advocacy. “But policy is a toolbox where I can fix and build the pillars of the American dream.”
As part of his agenda, Ruiz wants to preserve the Medicare benefits and services that many of his constituents depend on. At the same time, he wants to streamline the system by “cutting off the fat.” He supports allowing Medicare to negotiate drug prices with pharmaceutical companies, as the U.S. Department of Veterans Affairs does, and eliminating unnecessary lab procedures by improving the sharing of medical information.
In the Coachella Valley, Ruiz plans to work with the public health and medical communities to boost the number of doctors serving the area. Already, he’s collaborating with the University of California, Riverside, School of Medicine on residency programs that encourage students from disadvantaged parts of the valley to return and serve there as doctors. He has also launched a mentorship program for pre-med students who want to work in the valley.
Congress Resembles the ER
Ruiz expects that working in Congress will resemble working in an emergency room, with its urgent and sometimes conflicting demands. In a sense, he plans to treat constituents as patients. “I will always put people before politics,” he says. He likens policy development to a medical work-up, explaining that both require a diagnosis, an evidence-based treatment plan and—what lawmakers often overlook—a measurement of the outcome.
His path through the worlds of public health, medicine and now politics seems as clear to Ruiz as his mother’s formative advice on good nutrition. “This is a dream come true for me: to incorporate the best public health school in our country into the farmworker trailer parks and in the poorest areas of our district, where I grew up,” he says.
“I feel comfortable working in the barrios of the eastern Coachella Valley. I feel comfortable in the jungles of Chiapas or Port-au-Prince in Haiti. I feel comfortable in the halls of Congress. It’s just a matter of being true to my values and understanding that we’re all fundamentally humans, made up of the same fabric of life.”
Daniel Lovering is a Cambridge-based journalist who has reported on public health issues and other subjects from nearly a dozen countries.