Celebrate the wins

In public health there is always more work to be done. It’s easy to get overwhelmed, and it often feels like you’re not making any progress. I think this is what makes it so hard to celebrate the wins, and so important at the same time. Celebrating the wins helps us see the progress we’ve made, builds our relationships with our teams and communities, and gives us an opportunity to reflect as we move forward.

In January 2020 I joined Mercy College with the goal of building the new health promotion major concentration in health science. In August 2020 I officially became co-director of the Health Science program. Since then, some great things have been happening.
1. PACT trainings
Perhaps most importantly, my former co-director, Dr. Fenn Esser, and I have led multiple trainings for Mercy’s PACT advising team . Our PACT mentors who work with Health Science students are more informed about the profession of public health & health promotion and aware of the differences between health promotion and the other health science tracks. The PACT team is more familiar with the health science curriculum which means that students are receiving better advising and moving through the program more effectively.

2. Curriculum updates
I proposed a new course, Intro to Health Promotion, to prepare students for upper-level health promotion courses and enable our health promotion graduates to meet the eligibility criteria to sit for the CHES certification exam . At the same time, I proposed removing required courses that were less relevant to health promotion (Physics of the Human Body, Standard Safety Precautions for Healthcare Professionals) to allow students to concentrate on courses that are more directly relevant to their major.

3. New adjunct faculty
As the only full-time health promotion faculty member at Mercy, I’ve taught A LOT of overload courses the past couple years. This fall, I’m not teaching overload. Thanks to outreach to other programs at Mercy, HR, community partners, and existing adjuncts, we’ve developed a deeper bench of adjunct faculty to teach health promotion courses. These folks are absolutely essential to the health promotion concentration; and I’m thankful that their classrooms are informed by the work that they do in their professional lives. While I’ve taught epidemiology in the past, that is a far better course now that it’s being taught by an epidemiologist!

4. Webpage updates
It’s fascinating how complicated the processes for updating university webpages and changing the images on them can be. When I started in January 2020, the Health Promotion webpage was basically identical to the pre-health professional concentrations in health science: Lots of pictures of anatomy models and language about preparing for the healthcare field. Bit by bit, I’ve nudged the health promotion webpage along to where it more accurately reflects the field of health promotion.

There’s so much more work to be done this school year- in the classroom, in university service, the partnership with Westchester County Department of Health’s Know Better, Live Better program, my own writing and research. But there’s progress happening, and in another year or two, I hope to be looking back and celebrating a few more wins!

Teaching public health in 2022....

To state the obvious, these are tough times in public health. It was tough long before the pandemic- the 2008 recession led to a major disinvestment in public health. This meant that prior to the COVID-19 pandemic there was a 20% reduction in local health department workforce and weakened public health infrastructure.

And things have only gotten worse for the public health workforce. The COVID-19 pandemic increased the visibility and workload of the public health workforce, then that increased visibility led to increased harassment. According to the deBeaumont Foundation, more than half of governmental public health workforce employees have symptoms of PTSD, over 20% describe their mental health as “poor” or fair” and nearly one in 3 are considering leaving their jobs in the next year (stress, overwork and burnout are commonly cited reasons). In a national survey of 583 health departments , 15% of health departments reported employees experiencing threats to individual or family safety. Black and Asian leaders of local health departments were disproportionately affected by this harassment.

Political conflicts have driven resignations and firings of public health officials throughout the COVID-19 pandemic. At the same time, student interest in public health has increased. The Association of Schools and Programs of Public Health reported a 40% increase in applications to graduate programs in public health from March 2020 to March 2021. As an educator, I love that a generation of students has discovered a passion for public health. As a public health professional, I’m worried about what will happen when these new students graduate and enter an overextended, burnt out workforce. Public health people are the best people I know- even in the current conditions, over 90% of the surveyed governmental public health workforce reports that their jobs are important and they give their best effort at work. How can those of us in the classroom train public health students so that they are able to make positive contributions during their internships and first jobs?

A big part of what I emphasize in my classroom is drafts and revisions- the importance of editing, revising, and making things better. I create opportunities to fail and to recover from that failure. In my experience, students find this approach scary and feel like things have to be perfect the first time. I also see a tendency to freeze in the face of any ambiguity- that often students are so afraid of doing something wrong they put off tasks til the last possible moment or don’t do them at all. I’m not sure how to respond to this- my approach is to review my assignments multiple times, revisiting those assignments each semester to remove ambiguity. I try to break things down into smaller pieces that students can ultimately assemble into a finished product. I’ve tried talking about tolerance for ambiguity in class, but that seems to backfire — undergraduates who have a higher tolerance for ambiguity seem more resistant to feedback and correction. Pandemic stress has shortened attention spans and weakened interpersonal communication skills. My response has been to lean even harder on scaffolding and repetition.

Carpe diem? In the next few years we’re going to be learning important lessons about training and supporting the public health workforce. This is exciting and also deeply hard for those of us in the trenches.

On the 2018 Congress of Qualitative Inquiry

Just after  final grades were turned in, I took off for the 14th annual Congress of Qualitative Inquiry meeting. One of my mentors (DeAnne Messias) brought this conference to my attention as one of the most diverse conferences there is. And she's right- it's incredible to get to see Kathy Charmaz and Norm Denzin at the same conference as people who have just carried out their first qualitative study. It's a welcoming, safe, creative place, and I always find it restoring. If you followed along on Twitter, you know I was in sponge mode, learning and soaking in everything I could!

One of the sessions I'm still pondering over most was titled "La investigación cualitiva en enfermeria para el logro de la equidad en salud" (Panelists included  Veronica Guerra Guerrero, Margarita Del Carmen Poblete Troncoso, Natalie Figueredo Borda, and Mirliana Ramirez-Pereira). It was a fascinating introduction to  the challenges of working for health equity in Chile's two-tiered public & private health care system, as well as the challenges of being a qualitative researcher in Latin America.  Three out of the four papers presented were auto-ethnographies, a category of research I know little about and have spent less time pondering. Margarita Del Carmen Poblete Troncoso spoke compellingly of auto-ethnography as a self-care strategy for nurses, and for a way to build empathy for patients by using one's own experience to connect with patients more effectively.  Nearly a week later I'm still thinking about this panel; I definitely want to spend more time reading and thinking about auto-ethnography in health research.

Wednesday  I attended Julianne Cheek's talk titled " Research programs:A way of countering the reductionist effect of "this work is part of a larger project" syndrome on the way qualitative research is thought about and published." Cheek stressed the importance of being honest in writing about mixed methods designs; acknowledging that generally in a mixed methods study one part of the design (usually qualitative, but occasionally quantitative) is supplementary. These supplementary pieces lose much of their meaning when separated from the larger study. Cheek stressed the fact that increasingly, supplemental qualitative components of mixed methods studies are being presented as stand-alone studies; and argued that this contributes to reviewers increasingly misunderstanding qualitative research as primarily being  narrow and descriptive.  Cheek shared that she had a paper rejected because the reviewer claimed that it did not adhere to "standard" qualitative methodology (Tip: there's no such thing!) and I'm not sure whether I felt more relieved or angry that I'm not alone in having had that experience.

Friday morning I was on my way to a photovoice workshop in the Noyes building. Due to ongoing construction it was hard to find the session room. I dodged my way around painters and scaffolding, and made it to a seat by the 9:30 start time. The moderator stood up and gave an introduction to how this session on "Interwanglings, encounters, interruptions, retellings" came about, and the strange things that come about when we find ourselves in the same place as others, oftentimes unintentionally. I smiled for a minute and lingered a bit to appreciate the irony, then slipped out as quietly and politely as possible to the photovoice workshop I'd intended to attend.

Arguably the most important highlight of the conference was being there at the closing session when Kathy Charmaz received the award for Lifetime Achievement in Qualitative Inquiry. Kathy Charmaz has been one of my research heroes since the first paper of hers I read in Fall of 2010. Her work on constructivist grounded theory has been the foundation of most of my thinking about how to go about doing research. Her insights to what is happening in a text and how to go about coding data are illuminating. 

So back to work-with a hundred new ideas about what to read, how to do research, and how to teach.

-charis

Gathering

I spent most of last week at the annual meeting of the American Public Health Association. This is my main conference each year, and I adore it. It's a conference that's larger than some of the towns I've lived in, and provides opportunities to learn about every possible aspect of public health. The 80F days in Atlanta provided an illustration of this year's theme of climate change (I'm almost grateful to be back in my office, layering wool sweaters, wearing knee-high boots).

This year I was glad to see efforts made to center the experiences of people on the margins. For me, this started on Saturday when I attended a workshop on racism, led by Dr. Camara Jones (immediate past APHA president) and hosted by the Public Health Nursing section. I've always loved Dr. Jones's use of allegory to talk about race and privilege . It's an approach that is immediately accessible and opens up more sensitive conversations; I'm hopeful using her work in my classes will help my students develop a deeper understanding of  social determinants of health. 

 Eriel Deranger's opening keynote on colonialism and the Alberta oil sands was the most powerful keynote I've ever heard. She clearly described the ways White entitlement to energy resources threatens indigenous food sources and tribal lands. The images she used were graphic and heartbreaking- a bison (which would feed a Native family through the winter) decapitated by an outsider and its body abandoned, $13 gallon jugs of milk. I'm mulling over the human and environmental costs of fossil fuels and looking for opportunities to reduce or change my energy consumption.

Gina McCarthy's keynote in Monday's general session was full of hope and fire. She emphasized the importance of our voices and the potential for change through local politics. Dr. McCarthy stressed the importance of highlighting human costs of climate change in our advocacy work and for scientists to learn to talk to laypeople about science. I am thrilled about Dr.McCarthy's announcement of her new faculty post at Harvard's School of Public Health- I can't think of anyone better to train the next generation of public health leaders.  (I really do believe that being a public health faculty member is the hardest & best job in the entire world).

I may write a bit later about some of the exciting things happening in the Public Health Education & Health Promotion section, but for now, I'll end by saying that I can't wait for APHA 2018 and its theme of Health Equity. 

-charis

Dreaming

At some point this weekend the president's words about DACA, and all the accompanying news coverage flashed across a screen.  I'm not sure how I reacted- I think I swore, I might have screamed, I might have cried. Whatever my response, it was enough to bring Sage the Cat flying to engulf me in a furry kitten-bear hug. 

There are students all over this country who were already living in limbo whose lives have become infinitely more precarious. Human beings who are being used as pawns in political posturing. I teach 120 students at the most diverse campus in the Minnesota State Colleges & Universities (MNSCU) system, the most affordable public university system in the state. It's not a question of if my students are affected, it's a question of which of my students are affected. These kids- who are bright, excited, terrified, stressed out, disorganized, full of hopes for the future- how am I supposed to teach them when they're worried about being deported?

Thankfully, the Minnesota Dream Act (aka Minnesota Prosperity Act) is still intact, and will not be affected by changes in federal policy.   I'm a big believer in Ring Theory (Comfort in, dump out) , and it's not my place to do a whole lot of complaining here. I *will* write my representatives, I will tweet about DACA, I will do everything I can to spread information about the rights of DACA recipients. I will also show up to class this week, and every week, attempting to keep things predictable and consistent, offering what stability I can in a crazy world. I will give my best to my students and my colleagues at all times, and hope that somehow, it is enough.
-charis

Home

A little while ago, the University of South Carolina's Facebook page posted a video that's resonated with me in a way that no other university promotion materials ever have (link).  It's that "Welcome home" at the end, I think.

I remember my very first day at USC, the way the crisp January air and the old trees welcomed me out after my intro to health promotion course. But it wasn't just the red bricks and the squirrels around the Horseshoe...it was that I finally had found my people. My bachelor's degree was in biology, from a small liberal arts school that didn't have a lot of options. I'd moved on from there to an internship in molecular toxicology, all the while wishing that I knew how to connect my interests in natural science to my interest in community. I wanted, desperately, to see how all that fascinating science actually affected people. I wrestled with next steps, tried to find volunteer opportunities and ways to dabble in community work on the side. Finally, a researcher in the lab next to mine asked if I'd ever considered going into public health fulltime. It was like a door swung open, and about six months later I was accepted into USC's MPH program.

And finally, I was home. Here were people who cared about science and also the nuances of how that science changes people's lives. As I get ready for my first semester at Minnesota State, I keep coming back to that feeling. Who will my students be? And for those whose home is in health promotion, how can I help them find their way there faster than I did?

-charis