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.