The U-M School of Public Health was the lead organizer of this year’s annual health disparities lecture in honor of the Reverend Dr. Martin Luther King, Jr. Day Symposium on campus. Each year, many of the health science schools (Public Health, Social Work, Medical, Nursing, Pharmacy, Dentistry) work together to bring a speaker to discuss an aspect of health disparities. This year’s speaker was Dr. Sherman James, Susan B. King Distinguished Professor of Public Policy at Duke University, a former SPH faculty member and one of the founders of U-M SPH’s Center for Research on Ethnicity, Culture, and Health, one of the first centers of its kind in the United States. The annual MLK Symposium is one of my favorite things about being a U-M student: classes are officially canceled so students can attend the multitude of events celebrating the work of MLK. I got to attend two more events in addition to the health disparities lecture: Shirley Sherrod’s keynote and a screening of Bilal’s Stand, a community-made film about a friend of mine from the Detroit area who struggled with deciding whether or not to attend college or take over the family taxi business.
Shirley Sherrod MLK 2011 Keynote Address in Hill Auditorium
Dr. James’ lecture focused on health disparities in the Civil Rights era and today. He started by showing many images of public places in the US South, highlighting how they were related to health disparities then and now. Then he started talking about specific issues, one of which was maternal and infant mortality rates. In the Civil Rights era (1960), Black women died giving birth at a rate of 31.7 women per 100,000, while White women died at a rate of 22.9 per 100,000 (Chay et al., 2003). This relates to today, where here in Washtenaw County, Black babies are three times more likely to die before their first birthday than White babies. I’m doing my social work field placement at the Washtenaw County Public Health Department, where they have a campaign about this very issue, called the 3X More Likely Campaign. Michigan Radio, the University of Michigan-based National Public Radio station, recently did a story about this disparity (and interviewed my supervisor!). The suspicion is that babies are being born with very low birth weights, because they are being born premature. According to the Washtenaw County campaign site, Black women may have their babies early as they age because of the chronic, low-level stress that has been building up over the duration of their lives. This really highlights the need to continue studying the social determinants of health.
Dr. Sherman James' MLK Memorial Health Disparities Lecture
The American Public Health Association has posted videos from Dr. Cornel West’s speech from the opening general session of the annual meeting. It was great to be there and hear what he had to say in person, and I’m thrilled that they posted these videos! Many of the sessions are being recorded and uploaded online, but one must pay extra and have a login to access them – so I feared that it would be the same for this session.
It appears that the APHA YouTube channel won’t allow me to embed the videos here, but you can click the links to view them nonetheless. Enjoy!
Since September 2009, I’ve been working with over 30 other U-M students from schools and departments as diverse as engineering, public health, philosophy, economics, social work, medicine and nursing to create the campus-wide Student Handbook for Global Engagement as part of our work as Student Associates of the Center for Global Health. After a year of meetings and revisions, we published the first edition in August 2010, using a Creative Commons license instead of copyrighting the Handbook. We published using the Attribution-Noncommercial-Share Alike License, meaning that others may edit the work and use it as long as they attribute the appropriate sections to us, that they don’t make money on the resulting work (just like us), and that they share their work using the same Creative Commons license as we did.
Since we finished the Handbook, we’ve been trying to distribute it across the nation and globe for others to use. We’ve presented at multiple conferences, and will continue to do so. Eventually, we hope that this Handbook could be part of the basic training students will have to complete before departing for global work. We’re currently working with University of Michigan offices, such as the Center for Global and Intercultural Studies and the Open.Michigan office, to get the Handbook distributed across U-M campus.
One aspect of the annual meeting I’m excited about is how much social media is being incorporated into the meeting. You can follow the conversation on Twitter by searching the hashtag #APHA10 (and I’ll be tweeting with my handle @crheinga). The two highlights so far were the opening session and the Aaron Neville concert last night. The opening session had two keynote speakers talking about increasing health parity: Dr. William (Bill) Jenkins and Dr. Cornel West. I’ll write more about these activities later, as well as give a recap about how my poster session went and the two U-M networking events I’m attending later today – one for the HBHE department and alumni, and one general U-M SPH reception. Today will be an exciting day!
Dr. Cornel West fires up the crowd at the opening general session of APHA 2010
You know you’re a public health dork when… you leave a two-hour meeting at your internship with your head buzzing about the possibilities of health promotion programs in your community. For my social work field placement this academic year, I’m placed at the local health department, Washtenaw County Public Health. On my first day of orientation to SPH, I remember hearing someone say that if you’ve seen one local health department, you’ve seen ONE local health department – meaning that each local health department is so different from the next that there aren’t many generalizations that can be made about them. WCPH is fortunate to be able to do many health promotion programs that are in addition to their mandated public health duties as required by state or federal regulations.
Our division meeting included updates on a number of health promotion programs, from smoking cessation and healthy eating to biking to work and substance use prevention. It was reassuring to hear a lot of terms I’ve been learning in my graduate studies, and to see how health programs operate in my local community – instead of just reading about it from research articles. One staff member gave a report from a presentation at statewide conference she had recently attended in which a health communication campaign out of Jackson, Michigan was discussed. I had heard about this campaign before in my health communication course last fall – it was a final project option for some of the students in my class! It was nice to see it come to fruition and be lauded across the state. You can learn more about it on their website – Most Teens Don’t!
Most Teens Don't Logo
Another major topic of the meeting was a big grant we’ve been writing for the last couple weeks for the Michigan Department of Community Health (MDCH). It’s been a fun process being part of this grant proposal. The MDCH has funded 16 community organizations and local health departments over the last year to do planning in their communities for addressing health disparities among various ethnic populations. Washtenaw County was funded to work with African-Americans and Latinos, and we just submitted our proposal for the next phase of the grant – implementation. Even if we don’t get funded, it was a great learning experience to be able to work on developing the programs for the Latino-focused part of the proposal, as well as the evaluation plan. I got to apply what I learned in HBHE 651 (Program Development) and what I’m learning right now in HBHE 622 (Program Evaluation), in addition to many of the theories I learned in HBHE 600 (Psychosocial Factors in Health-Related Behavior) and SW 502 (Organizational, Community and Societal Structures and Processes).
My current social work field placement is really bringing my two degree programs together. I’m a dual degree student – doing a Master of Public Health in SPH (in the department of Health Behavior and Health Education) and a Master of Social Work at the School of Social Work. I’m studying Community Organization and Community & Social Systems in social work. There are many dual degree options for students in public health, and it can be a really great investment if you want to work in multiple fields.
This is my third and final year of the dual degree program, and I’m happy that my courses and field experiences are really coming together in my learning. For my public health department, students usually do a 3-4 month field placement between their two years. I did a year-long placement at the HIV/AIDS Resource Center as an AmeriCorps member for the National AIDS Fund’s national direct AmeriCorps program in Detroit. For a social work degree, students can elect to do either two field placements (one each during each academic year) or one longer-term placement (from January – December of one calendar year). Most students elect to do the single placement, but I elected to do two.
This year’s placement is at the Washtenaw County Public Health department and I’m working with a number of community members to develop a Latin@ community center, Casa Latina, for Washtenaw County. I’m applying coursework in both schools that has covered grant-writing, program development, program evaluation, community participation, multi-level interventions, social marketing, survey design, materials creation, leadership development, and community organization and development. It’s nice to be able to apply what I’ve learned, and even combine some tasks at my field placement with current coursework. For example, for my program evaluation class, my final project is to create an evaluation plan for a health program – which is one of my tasks for a grant I’m writing at my placement. For another class, my final project is to create a community participation plan, which is something we need to do for Casa Latina anyway.
It’s great when I get to do public health practice during the semester and apply the things I’m learning in the classroom to the real world. Sometimes I wish there was a larger field component in public health, but there are definitely options for getting more real-world practice if you look for them.
Professor Hu was discussing how the environmental health scientists would collect information about the exposures people have to something in their environment, and how the epidemiologists would design studies to compare various populations’ health outcomes based on that exposure. Biostatisticians would evaluate the data and create reports in conjunction with the epidemiologists. Health behaviorists and educators would interpret these studies and figure out ways to help people change their behaviors to avoid exposure to things that negatively impact health. People who write health policies would also interpret the epidemiological studies to make policies that can make structural changes to help people be able to change their behaviors to improve their health.
A great example that illustrates all this is smoking. Recently, in Michigan, public places went smoke-free. This was a health policy change, and many of the people working for that law change are actually staff and alumni of U-M SPH! Prior to that, lots of other parts of public health had been trying to reduce people’s exposure to smoke – either first-hand or second-hand. Epidemiologists and biostatisticians had been collecting data for years about the detrimental effects of second-hand smoke on people who work in smoky environments. Health behavior change specialists were working with individuals to quit smoking, or to learn to avoid second-hand smoke if they were non-smokers. In the end, all the fields of public health worked together to bring about individual, community, and state-wide changes that will improve the public’s health.
Today’s my last first day of school and it’s been a great one so far! It’s sad to think that this long journey will be over in eight short months, but I know I’ll be happy to be done and start applying all the wonderful knowledge and skills I’ve learned in my two degree programs, public health and social work.
I always feel so optimistic at the beginning of a new semester – like maybe this time I can actually do all the reading! I’m very excited about my two public health classes this semester (EHS 500 – Principles of Environmental Health and HBHE 622 – Program Evaluation in Health Education). The environmental health class interests me because of the material and my background in the biological sciences, and the program evaluation class because it’s a valuable and transferable skill in the field(s) in which I’ll be working upon graduation.
I’m also excited to start teaching again. Last semester was my first being a graduate student instructor (GSI), and I really learned a lot, both about being a teacher and about being a student. I gained a lot of patience and improved my skills for speaking publicly and making sure people are following what you’re saying. I also learned how to better manage my time as a student, as well as what amount of work goes on behind the scenes in the classes I take. I also learned that while teaching is fun, grading is NOT fun. The worst part is that my midterms are at the same time as the ones I have to grade – which doesn’t make it easy to study for my own classes.
The other exciting development this semester is my field placement for social work. I’m working with the Washtenaw County Public Health Department to help develop a Latino community center for our community (Washtenaw County, the county in which the University of Michigan is located). Currently, there is no such organization that caters to people of Latino/Hispanic ethnicity or Spanish speakers.
I hope to write posts this year about my public health and social work classes, my field placement, teaching, and my passion, HIV and AIDS. Stay tuned!
As a health promoter, I often think about how to prevent disease from even happening. One characterization I heard about the U.S. healthcare system was from former U.S. Surgeon General Dr. Joycelyn Elders at last year’s Public Health Practice Symposium was that the U.S. doesn’t even have a ‘health’-care system – we have a ‘sick’-care system. I think that is really true – we as a country fund treatment a lot more than prevention activities. I see this same priority in in the field of HIV too. It’s relatively easy to prove that you’ve served the health needs of people living with HIV compared to how much HIV you prevented from happening (measuring what didn’t happen gets tricky, right epid people?!)!
Healthcare reform made me remember something that was said at orientation in fall 2008 when Health Behavior & Health Education (HBHE) Chair Marc Zimmerman was introducing us to the U-M SPH. He gave a general overview of each of the five U-M SPH departments and how they work together. When he got to the Health Management and Policy (HMP) department, he said that we in HBHE really work closely with them. At first, I found this absurd, because I had the impression that HMP was all about making money in the healthcare business and HBHE was all touchy-feely and focused on really working with individuals to cater to their health behavior change needs (neither is entirely true; they are both much, MUCH more than that). His point was that the research that comes out of HBHE can inform the policies that are made – incentives and disincentives (=fees) for example.
All that being said, I really appreciate that this new bill adds more of a focus on prevention and funding prevention research and programs. I have a suspicion that the strength of two large businesses – health insurance and drug companies – has had an effect on the over-focusing on treatment and under-focusing on prevention. Politicians are the ones who make these laws, and they want to keep their jobs, so they vote and make laws in the interests of those who fund their campaigns (which sometimes are their constituents, but are often large, profitable companies). Don’t get me wrong; I’m not a business-hater. We obviously need health insurance and medications with this new bill.
As someone in public health, it’s difficult to argue that over 30 million more people having health insurance is a bad thing… and with the new funding of prevention activities, there may even be job security in my future! Dean Kenneth Warner sent a reflection email to all SPH students, faculty and staff the day after the bill passed claiming “This is an occasion for public health celebration”. On Tuesday in my intro to the U.S. healthcare system class I’m taking this semester with Dr. Richard Lichtenstein in HMP, he was happy that the bill finally passed, though he jokingly lamented having to change all his lecture slides for future semesters. I think that’s a small price to pay for a better quality of life for millions of people living in this country
Tiffany’s recent post about the 2010 U.S. Census reminded me of some of the reasons it’s important to fill out your Census forms completely and properly. Just this year alone, I have had multiple class projects that use Census data – for project development, community profiles, and tracking health disparities. I also participated in a community education event in English and Spanish in Detroit that I wrote about last semester. I recently received my Census forms and thought I’d share them so you can see what they look like if you’re not filling them out at your household (see below). One thing I appreciate about the Census is that they are trying to make the forms accessible by those who do not speak English very well. This is very important for me as a person designing social work and public health programs, because there is such disparity in health outcomes between English-speakers and non-English-speakers.
Census Envelope (English only)
Census Form & Letter (mostly English)
Census Language Assistance Letter (multiple languages)
Unfortunately, the Census has not asked for races the same way across all times it has collected data, so it is sometimes difficult to determine trends. This year, the “Hispanic/Latino” category allows respondents to enter their ancestry, which will be very useful for my work next year in my new social work field placement (I’ll be working with local community partners to create a Latin@ community center in our county).
