Happy Monday guys!
I’ve had this topic on my list of blog topics relating to public health for quite some time, and I thought that it’s a really good topic to post about.
One of the unique features when it comes to the health and public health industry is that it follows what the academic industry has been doing for several years when it comes to research. For those who aren’t very familiar with academia, research happens a lot of times through donations and grants.
With that said, the public health and health industries have really jumped on to the band wagon of promoting health in communities through the application of grants that come from various sources that include federal (through an agency like the Centers of Disease and Control and Prevention), state, nonprofit agencies, and research industries. A good source for grants can be found here.
The benefits of applying for grants and getting them is that you and the team you work at whether it’s a nonprofit agency, hospital, or local health department, is that you have the unique opportunity of really advancing work that can be innovative, tried and tested (i.e. evidence based), and hire individuals/contract with local organizations that can help improve the health of a community (large or small).
One highlight for instance, for the team I’m working with, is the start up of a pop up produce stand at our public health campus. Believe it or not, the location of where I work at is a food desert in which employees (about 200-300 employees) don’t have access to healthy food. Strange right, considering I work for the public health department. So, a small team started the conversation of trying to increase healthy food access at work, and success! A couple hundred people stopped by and actually purchased fruits and vegetables. I think this reveals what’s possible with grants. There are a lot of other stories, but given that this is one of the more recent wins, I think it’s worth talking about.
However, with every good thing, there’s also its disadvantages. Grants are unfortunately temporary. There are such things as long and short term grants that have various ranges. However, the fact that grants are temporary, causes several issues. If you don’t work for a local health department, it’s hard to keep a steady job. While a full time employee given all the benefits of a normal government employee, the chances of me working with the same team past the grant work is not always going to happen. On a personal level, I think that can be difficult. Once you’re use to working with a team, when its time to move on from a project, you’re going to work with potentially a new team and boss. What comes with this, is different work ethics, way things are done, performance measures, etc. It’s different. In addition, there’s a risk that you won’t be keeping your job. When one works at the health department, chances are, you will be keeping your job. Unless there’s a drastic economic recession, lay offs working for the government is rare. However, in other agencies, I don’t know if I can say that one may or may not have a job after a grant ends. Which is unfortunate, because this leads to high turn overs as well as one needing to find a job after a certain period of time.
Speaking from personal experience, where I’ve worked several contracting jobs (specifically in the realm of clinical research), it’s tough. It’s tough on two spectrums — as a person, you have to job search when you’re about a year out when the grant or contract is up. To do so later would potentially equate to you being jobless. Secondly, those who are doing the contracting….don’t often treat you as nice or as a valued entity in their departments. I was speaking with an old colleague of mine today, and let me tell you that this person and other contractors were quite upset by the drama that unfolded over contract negotiations based on how the work they do was funded and how much of the funds went to salary and wages.
On another level, one disadvantage of grants, is that once the grant ends, depending on funding, there’s also a chance that the work itself stops. Part of it has to do with loss of people that had done the work (no money, no worker/contractor) but part of it also has to do with the approach of grants and the lack of sustainability when it comes to its initiatives. I had a conversation recently about how grant usages in the hospital setting is different from doing work within a local health department. We all want the same thing (i.e. within hospitals as well as health department), but the approach to the work is different. Implementation in a hospital upon administrative buy in takes off easily because resources are available (space, staffing, etc). Yet, in a local public health department that focuses both on getting our hands dirty as boots on the ground cavalry as well as policy, the work is contracted out. Essentially, once funds runs out, if there isn’t an opportunity to get more funds or if there isn’t buy in from the community, the work becomes nonexistent, despite the fact that it’s impacted a small percent of a community. Obviously, the larger the impact an initiative has, the more buy in, thus the more funding.
A lot of times, one ponders why certain initiatives that once existed are no longer around or perhaps aren’t heard of. For those of us who went to elementary school in the 90s (so…dated myself), who remembers (at least in the US), who remembers D.A.R.E? This was the Anti-Drug program that was in many of the schools that was trying to teach kids to say no to drugs and why drugs are harmful. I honestly forgot about them until recently when I saw young college students outside a local Starbucks trying to raise funds to keep the programs going. It occurred to me, that I not only forgot about the initiative, but I hadn’t heard much about it since my days as an elementary school student. Essentially the program was defunded, and while I don’t know the history of what happened, the program is now reliant on outside funders from the local community to stay afloat. The thing is, there are many stories of various initiatives that have the same flow — it started and ended. There’s history yet no sustainability. Why? Grants.
I’m either going to get some back lash for what I’ve just posted, but I wanted people to be aware that we need to think these initiatives that public health is putting out there beyond what is grant oriented work. Research within academia and private industry will always in some way or form have an end point. If research proves or disproves a hypothesis, we have an article (peer reviewed or not). Research is expanded and another grant can be applied. However, program implementation is not simply execute and give results. That’s not how it works, that’s not how public health works, and most of all, it doesn’t help the community if grants only last for 2-4 years tops. It doesn’t help. Yes, new grants can be applied, potentially guaranteed, and work continues. However, there are few programs that does that.
So, my ask, to whoever reads this post, for those who are in the public health field, would you consider better means of program implementation beyond policy and grant work….because our work is important…we want these tried and true research and evidence based initiatives to impact the communities we work in and with. Yet, there has to be more than grants as an available funding source for the work we do.