About a month after the novel coronavirus was first detected at the end of 2019, the U.S. Secretary of Health and Human Services declared a public health emergency under the Public Health Service Act.

A year earlier, with very little fanfare, Rear Admiral Sylvia Trent-Adams of the U.S. Public Health Service Commissioned Corps quietly took up an assignment as principal deputy assistant secretary for health at the Department of Health and Human Services. One of America's uniformed services, the U.S. Public Health Service Commissioned Corps fills essential public health roles within government agencies, such as Health and Human Services, which works to protect the health of all Americans, as well as foster advances in medicine, public health, and social services.

Since joining the U.S. Public Health Service Commissioned Corps in 1992, Trent-Adams has been part of an elite team of medical, health, and engineering professionals dedicated to caring for patients in underserved communities and conducting research. Currently, as principal deputy assistant secretary for health at Health and Human Services, Trent-Adams works with the assistant secretary for health to plan, coordinate, and direct program priorities covering a range of public health activities within the Office of the Assistant Secretary for Health. The office oversees public health offices and programs, several presidential and secretarial advisory committees, 10 regional health offices, the Office of the Surgeon General, and the U.S. Public Health Service Commissioned Corps.

Speaking to Women of Color magazine via an online meeting shortly after she was nominated Women of Color 2020 Technologist of the Year, Trent-Adams said SARS-CoV-2 (the virus that's causing outbreaks of the coronavirus disease COVID-19) is still a "new, emerging, and changing virus."

"It's still critical for all of us to protect ourselves, our families, and communities," she advised. "Be informed about COVID-19, and practice safety measures that have been put forward by the Centers for Disease Control and Prevention (CDC)," she said. Guidelines from the CDC, which is the nation's health protection agency, include social distancing, routine handwashing, and wearing a face-covering in areas where you're going to be exposed to others. "Take heart," the rear admiral added. "We must believe the science."

Trent-Adams' career in science began at Hampton University, where she earned a Bachelor of Science in nursing. The school has prepared nurses to serve humanity for over a century. As a high school senior, she won a scholarship from the United States Army Reserve Officers' Training Corps (ROTC), which offers financial aid to students who promise to serve as an officer in one of the uniformed services after they graduate.

"I chose Hampton University School of Nursing because I thought it would give me the best preparation for a nursing career," the rear admiral told Women of Color magazine. "The nurturing and mentorship that I received at Hampton I would put up against any in the world," she said proudly.

Trent-Adams gave credit to Elnora D. Daniel, who was dean of the Hampton University School of Nursing in 1980. Dr. Daniel went on to serve as administrator for the Interdisciplinary Nursing Center for Health and Wellness at Hampton in 1985 and earned the rank of colonel in the U.S. Army Reserve Nurse Corps in 1991.

"She emanated positivity," Trent-Adams recalled, adding that it was expected each cohort would go on to be nursing leaders and create a space for excellence in nursing care.

Another of her role models at Hampton University was Dr. Pamela V. Hammond, who also served as the dean of the School of Nursing. Through her efforts, Hampton implemented the first Ph.D. program in nursing at a historically Black college or university in 1999, increasing the numbers of racial and ethnic minority nurses with doctoral degrees. After graduating from Hampton, Trent-Adams went on to earn a master's degree in nursing and health policy from the University of Maryland, Baltimore County, and a Ph.D. in public policy, also from the University of Maryland, Baltimore County.

In addition to preparing her with education and training to enter the career of her choice, Trent-Adams said the Hampton University program helped her to not only survive in the workplace but thrive as a nursing executive. Prior to joining the U.S. Public Health Service Commissioned Corps, Trent-Adams was a nurse officer in the U.S. Army Nurse Corps for five years in the oncology unit of Walter Reed Army Medical Center. She also worked as a research nurse at the University of Maryland and completed two internships in the U.S. Senate, where she focused on the prospective payment system for skilled nursing facilities, community health, and infectious disease. Trent-Adams began her career in the Commissioned Corps in 1992. Since then, she has held several leadership positions in the Department of Health and Human Services, including her current assignment as principal deputy assistant secretary for health.

"I can't say I consciously made decisions about all these choices,” Trent-Adams said of the jobs she has held over the last 30 years. “Some of them were opportunities that came with some challenges, and I like challenge,” she said. “I started off in the Army primarily because I had received a four-year ROTC scholarship. The ROTC opened my eyes to many things outside just being a clinical nurse,” she said. “It taught me about leadership, building teams, and running an organization.”

From doing voluntary work as a student nurse on campus, she grew to understand the importance of access to health care and the policy decisions that drive health care, which clinicians were not always a part of. As a clinician and administrator, she has had a direct impact on building systems of care to improve public health for marginalized populations as part of the Commissioned Corps in the Department of Health and Human Services.

“It seems that for much of my career, I was hopscotching all over the place, but it was tying all these areas of the clinical world into this larger, problem-solving matrix,” she said.

While working in the emergency department of one hospital, she found some of the trauma was caused by violence, unmet healthcare needs, and chronic conditions that should have been addressed. Moving to the oncology area, she observed bad decisions made from a public health standpoint.

“Well, how do I solve that? Let’s go to community health, and on from there. So, it was this continuum of learning that I developed over my career,” she said. “At some point in the clinical arena, especially in the uniformed, military, and public health services, you have to make a choice. Are you going to stay in the clinical area, go into research and policy, or get on a leadership track?”

For Trent-Adams, leadership was important, because it helped her develop the skillsets to help others find their way to decision making and a seat at the table.

“If I could do that, then I could open the door for so many junior officers and civilians who were trying to create a path and share that knowledge with those coming behind me,” Trent-Adams said. “There were hurdles; there were walls that I either had to climb or knockdown,” she continued. “You’ll work for people who are not so nice sometimes. You’ll work for people who are disconnected from the mission of public health and lack the passion that you have. But you can’t lose sight of your goals and the mission of public health, clinical science, or research.”

Trent-Adams also learned that it wasn’t just about getting to the next level. For career progression to be beneficial, it is important to learn the lessons of each job to become skilled and competent, with the help of mentors, colleagues, and senior leadership. Prior to joining the Office of the Surgeon General, Trent-Adams served as the deputy associate administrator for the HIV/AIDS Bureau of the Health Resources and Services Administration, also part of the U.S. Department of Health and Human Services.

At the Health Resources and Services Administration (HRSA), she worked with many agencies to help provide health care to people who are geographically isolated and/or economically or medically vulnerable. This includes people living with HIV/AIDS, pregnant women, mothers, and their families, and those otherwise unable to access high-quality health care. HRSA supports the training of health professionals, the distribution of providers to areas where they are needed most, and improvements in healthcare delivery.

Asked about HIV/AIDS in the time of coronavirus, Trent-Adams had a big reveal: “COVID-19 is affecting the same population that is impacted by HIV,” she said. “The poor, the underserved, and those who have underlying health conditions. We have longstanding health conditions in this country that we have not been able to address. As a community, we must galvanize support for diabetes, hypertension, sickle cell, and the high rates of asthma in children in underserved communities,” she said.

The rate of sudden death has also increased, as well as heart attacks because people are afraid to go to the emergency room. According to one study by doctors who looked at data from general hospitals in Massachusetts, many patients with cardiac disease were fearful they would contract the coronavirus at a doctor’s office or hospital, and that led to more severe complications—even death.

Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women—and this disparity increases with age, CDC researchers said in a recent Morbidity and Mortality Weekly Report. Mental health is also an issue, with a sharp increase in suicide rates. A recent paper from the Center for Public Information on Population Research (CPIPR) at the Population Reference Bureau said nearly one-quarter of all applicants to the military are medically disqualified because of excessive weight and body fat.

“We must be more focused on disease prevention. Everyone has to know how to prevent disease,” she said.

The rear admiral also hopes more people of color will take part in clinical trials, which are currently overrepresented with white males. Thus, researchers can’t be sure that Black males, Black females, Hispanics, and Asian communities are going to respond the same way to medications and treatments that are developed by the pharmaceutical industry. However, she acknowledged that not enough work has been done to address the bias that drove decisions in the tragic Tuskegee study. In 1932, the Public Health Service, working with the Tuskegee Institute, began a study to record the natural history of syphilis in hopes of justifying treatment programs. Although originally projected to last six months, the study went on for 40 years. According to the CDC, the men were never given adequate treatment or the choice of quitting the study, even when new treatment became widely used. However, Trent-Adams is confident that with more researchers of color, and research in poor communities other than the populations that scientists have worked with, things might begin to change.

Career Peaks

In 2015, Trent-Adams was selected to serve as deputy surgeon general of the United States, a trusted and critical advisor to the surgeon general, helping support a variety of critical issues, including efforts to combat the opioid crisis. The rear admiral served as the deputy surgeon general from Oct. 25, 2015, to Jan. 2, 2019. Trent-Adams also served as acting surgeon general of the United States from April 21, 2017, to Sept. 5, 2017.

During May of that year, she was part of a historic photo taken during the Uniformed Services University of the Health Sciences commencement exercise, when graduating medical students recited their respective service commissioning oath, led individually by each of the surgeon generals. The 2017 photo shows Trent-Adams, the acting U.S. Public Health surgeon general; U.S. Air Force Surgeon General Lt. Gen. Mark Ediger; U.S. Navy Surgeon General Vice Adm. Forrest Faison; and U.S. Army Surgeon General, Lt. Gen. Nadja West.

"Becoming the deputy surgeon general was one of the truly humbling experiences of my career," she told Women of Color magazine. "I was shocked and stunned that I was selected, but one of the things I took away was the opportunity to shape the future of the Commissioned Corps and to help the surgeon general provide the best science and public health advice to the nation.”

Working in that office helped her understand the importance of one voice, she continued. “The importance of messaging that was received in a way that was non-partisan, scientifically based, and evidence-based for the health of the nation.”

For young professionals working toward senior-level jobs or high school students aspiring to careers in public health, the rear admiral offers these tips and advice: