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Population Health, Pandemics, and the Public Eye

Photo of Dr. Tonya Walker seated in a high backed chair, wearing a redish blazer, glasses, white blouse, and smiling into the camera.

Dr. Tonya Walker’s career from the ER to Netflix focuses on health inequities.

By day, Dr. Tonya Walker works for Netflix as its Chief Medical Officer and Director of Employee Health, helping to create strategies for Medical and Wellbeing matters for their workers around the world.

But at night, the National Medical Fellowships alumna’s background in public health keeps her awake thinking about how society might get out ahead of looming crises. 

“There’s always room to diversify the physician pipeline. We need more physicians who reflect the diverse populations in our country/world. But even more broadly, we have to think about how we train physicians these days. There are differences now in the types of illnesses we see in various populations and locations. Disease processes that were not as prevalent in the past are starting to become more common and common illnesses are starting to present differently than in the past. Even the way and types of illnesses that are passed between humans and animals are changing in various parts of the world.”

As a mother and lifelong resident of the densely populated New York City, Walker is right to be concerned – especially when it seems not much has changed from her upbringing in Brooklyn and Long Island.

“I didn’t have the best experience as a little Black girl on Medicaid,” she said as she recalled accompanying her younger sister to the doctor.  

“My little sister was diagnosed with Type 1 diabetes at the age of two, so from an early age, I was learning how to count carbohydrates, how to administer insulin, how to check her blood sugar. Many times, those in the health care system treated us like we were invisible — like they didn’t want to be there and could care less about us. So it was the resilience of my sister, mother, and these less than ideal interactions with the system, that inspired me to become a doctor who would take care of everybody – no matter their skin color or ability to pay.” 

Walker began by earning her bachelor’s degree in Public Health and Natural Science from The Johns Hopkins University.  

“I remember being ‘introduced’ to the concepts of health care disparities, social determinants of health, epidemiology, and the various hypotheses about why different illnesses impact different populations,” she said. “And I just thought …come on! It is glaringly obvious!” 

Walker grew up in a Jamaican immigrant family and occasionally lived in areas where she knew generations of people who simply couldn’t get out of poverty, let alone find access to quality education or nutritious food. 

“I often found myself raising my hand in class saying, ‘Let me tell you the real story,’” she said. “People would come down on certain groups, and I’d say, ‘You have no idea,’ because what about institutionalized racism? What about knowing what it would take to change it, but not doing so? 

“After graduating from medical school, also at Johns Hopkins I began my clinical rotations in Baltimore, I discovered there was this really beautiful model between the Hopkins Emergency Department, its School of Public Health, and the local community — even government agencies,” Walker said. “It was a melding of the strengths of these institutions and their people that could do greater things for the community and health equity.” 

Her next experience as a resident physician in NewYork-Presbyterian Hospital’s emergency room was a bit different. 

“It was a siloed experience working in a resource-constrained part of Washington Heights, where a majority of the population were non-English speaking immigrants,” Walker said. “And I realized 85 percent of the clinical cases we were seeing in the emergency room never needed to be there — the majority of the cases were absolutely preventable. The issue is that people did not have strong access to care outside the ER and no way to successfully navigate the complexities of the U.S. health care system. Then there were those who just needed a meal and a warm place to stay.”

As much as Walker loved the ‘organized chaos’ of the emergency room and its directive to care for ‘anyone and everyone regardless of their ability to pay,’ she also felt compelled to return to the field of more traditional public health. 

“I wanted to continue working on preventing most of what was clogging up the hospital system and driving up the costs of health care,” she said. 

Walker therefore became a Preventive Medicine and Public Health fellow with the New York City Department of Health and Mental Hygiene all while working as an attending physician in the ER and earning her Masters of Public Health degree from Columbia University’s Mailman School of Public Health. 

“I stayed on as faculty at Columbia and continued to work in the emergency room, but it was the Preventive Medicine fellowship – which required us to rotate through the World Trade Center Health program at Mount Sinai – that led me to pursue further training in Occupational Medicine, where the health of various populations, more specifically worker populations, and acute illness intersected.” 

In the years to follow, Walker would work as a physician consultant with Curve Health (formerly Call9), connecting emergency physicians and EMTs with nursing home patients, as well as an occupational physician with both the Virtua Health and the University of Pennsylvania Health systems.  

Walker then became the Head of Medical and Occupational Health for Unilever North America prior to the COVID-19 pandemic. 

“I never thought I’d work in corporate, but Unilever’s mission was to ‘Make sustainable living commonplace’, so I tried it out. The mission resonated with me, almost like that of a non-governmental organization,” she said. 

When the pandemic hit, Walker said she continued seeing COVID-19 patients while simultaneously building Unilever’s pandemic response.

“We were able to continue making hygiene products, hand sanitizer, toilet paper, food – we even increased our manufacturing and donated supplies to local hospitals, nursing homes, and more,” she said. 

Walker’s stabilization of Unilever’s workforce with core team hires and the development of protocols got the attention of Netflix.

“Employees were working from home and the filming of shows ceased due to COVID. Despite that, everyone I knew would say they didn’t know what they would do without Netflix during lockdown.”

 Netflix was helping people cope with being on lockdown and provided a mental escape from what was happening in the world, “I wanted to support that.” 

Walker helped to spearhead an operational pandemic response team with Netflix that allowed staff to work safely around the globe being sure to adhere to local COVID-19 guidelines and often, would go above and beyond those regulations. 

Today, Walker is focused on contributing to Netflix’s mission to “entertain the world”. She does this by supporting employee benefits, emergency medical services and crisis response, health promotion, staff wellbeing, safety initiatives, and any other concerns related to human health. 

Walker said she isn’t sure what her future holds next, but there is one issue she’s particularly concerned about. 

“Communities that will be disproportionately impacted by the rapid intensification of climate change are those located in urban and rural areas, where air and water quality are already poor, where a majority of people work in environments susceptible to temperature extremes, and where, when natural disasters hit, residents are often victims to poor infrastructure and slow response times.”

Walker said the entire health system would need to be flipped on its head to begin addressing many of the current inequities we see in today’s society. 

“But much like climate change, it will take a long time to ‘fix’ and people are apprehensive about fully committing because there are so many factors to consider,” she said. “Everything – from training to administration to insurance to pharmaceuticals to government policy – everything would need to change. For now, it’s critical to ensure a pipeline of culturally competent and diverse doctors, nurses and health care workers are available to care for the most vulnerable to address emergencies we see daily in the ER AND when another health care crisis inevitably happens…unfortunately.”