Disservice to Public Health

If I ever have the opportunity to have kids, I really want them, boy or girl to have play with building contraption like toys. The things that came to mind, when I was a kid that fall in this category include Legos, K’Nex, etc. I find that these toys bring about creativity, problem solving, building up dexterity, critical thinking skills, and more.

Think about building Ikea furniture. It’s not the easiest. I’ll give you that. There aren’t very many, if any, instructions with words. Rather, there are objects and pictures. One follows the pictures to the best of their ability to build what would become a shelf, bed frame, table, etc. However, as frustrating as such is, one actually is doing the adult version of a K’Nex hotrod car, a roller coaster, even a Ferris wheel.

Public health is a profession where you are thinking about issues relating to health in a community. This can be as small as 5 people to hundreds, thousands, and millions of people. This requires a lot of problem solving, working with others, brain storming, critical thinking, science, data, technology, and a whole range of other things that I’m sure I’m missing. This also happens to include $ and politicians who care about the health of their communities.

So when I hear on various occasions and observe certain things that relate to public health, which I’m about to describe, I think it’s a complete disservice to those entering a profession that are so passionate and want a part in helping to create healthier communities for future generations.

Before I start, I just want to say this — public health is a difficult yet incredibly rewarding job. In many ways, it’s an under recognized profession that does so much with so little. Building up infrastructure that incorporates policies relating to public health such as gun violence, parks and recreation for physical activity, active transportation, health and wellness, etc, it’s hard. It’s not something done overnight. It’s most certainly not done without a lot of partnerships and creative solutions to limited resource availability.

So when I hear that a program isn’t doing well and observe it’s slow unfolding and collapse, I ask the question “What happened?” Seems logical right? So today I asked. It was clear that the foundation built for the program was weak from the start. I pointed it out, and no one did anything about it. When it comes to building up a program, one must do the hard work of planning, altering, brainstorming, and going over all the nitty gritty details before its pilot and later full implementation and integration. It’s your basic public health program planning and implementation class. In fact, it’s a core curriculum that most public health students take (bachelors or masters). So when I asked and talked with a coworker about this program, it was concerning to find out that the way it was planned out was set for failure. They may now see it, but I saw it a while ago. So I asked weeks ago about why certain things were thought through. No response. I ask again, and today I’m told to talk to the team.

Do we have to wait for things to slowly crumble to start a change? The whole point of the theory behind program planning and implementation, is that we look at the basics of the who, what, when, where, why, and how before we start any roll out. It’s why it’s a core class, and it’s why it’s often taught in one’s first year, if not early 2nd year. Any public health professional (especially the recent grad), understands a need to plan before one acts. Otherwise, one is set up for failure. So, it’s a disservice, when one has these tools that they’ve not only spent a lot of money on and can use, yet doesn’t use it. Why go to school for public health, and not use the tools learned? I’m not saying that each program plan and execution has follow all the steps, because not all programs and policy are one size fits all. It’s not exactly a science. Science is — like epidemiology, biostatistics, and even some environmental health components are. But program planning, it’s not a dessert recipe. Yet, to not use tools that we learned, tried, and tested, is in my personal opinion a waste of what little resources are available for the betterment of a communities’ health.

The flip side to this, is when older more experienced public health professionals don’t give the younger and more recent public health graduates an opportunity to learn how to build up infrastructure. My biggest pet peeve is when a health care professional or someone who is not in the public health field calls public health folks glorified secretaries that coordinate the advancement of health in a community. That is such an offensive thing to say. Yet, for one colleague of mine, such is the case. She holds an MPH, has been in her position longer than I’ve been, and works in what I would say a pretty important division that works with young moms with kids. Her sole job Monday thru Friday, 8 to 5PM is plan classes for moms. She doesn’t teach them. She doesn’t even help build infrastructure around the classes. She doesn’t do much except schedule classes and makes sure that all the materials are available (i.e. printing and stapling). Now that, is what I would say a glorified secretary’s job. She’s not using any skills that she’s learned. She’s most certainly not learning much from it either. Management wouldn’t allow her to do this either, despite her persistent ask of wanting to be challenged in her work. Is that not sad or what?  If one isn’t even allowed to apply the skill sets learned, again, a disservice to what can be improved upon. Let’s face it, when it comes to the health the community, we have enough to fix (i.e. there are a lot of problems and we don’t have enough resources to fix it). This again is resource wasted. We don’t have a lot of resources in the field of public health. Yet, we waste resources and cause such disservice to what we’ve learned and are committed to do for the community.

It’s funny, when I look at this because it wasn’t too long ago, when I thought about how it would be incredibly neat if we had more healthcare providers such as doctors, nurse practitioners, and physician assistants know more about the realms of public health, to understand that there’s more to a patient besides what’s discussed in a patient room. Public health professionals are trained through schooling and experience to problem solve issues that may arise. For instance — if there’s an outbreak, we start asking questions (who, what, when, where, why, and how). Obviously it’s a lot more complicated than that, but for the sake of the blog and for those who may not know that much about what public health does, I’ll break this down as your basic 5 W’s and the H. When we see a spike in people dying of cancer, again people come to the table, we we talk about what we’re going to do about it. It’s interesting, now looking at these areas of disservice among many, that even in our own field, there are individuals that don’t use skills learned and those who don’t have the opportunity to used such skills learned.

Public Health already lacks necessary funds to do what ought to be done in helping our local, state, and national community. We lack resources. We lack man power. So to see what’s available improperly used, I find, that as public health professionals, we are being a disservice to the field of public health. Let’s go back to our roots, our tools and skills learned, things we’ve invested blood, sweat, tears, endless nights of sleep, lack of social life, and so much more to the betterment of our communities. And for those of us who don’t fall in this category, let’s give the newest generations of public health graduates an opportunity to help improve our communities by listening to their ideas, including them in our work of program planning and implementation, and challenge them so that they can take on the next generation of professionals to help our communities.

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