"Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover."
These words could not ring any more true as the 17 newest members of the Pittsburgh Health Corps filed into the Allegheny Health Department for their first day of orientation. Thankfully several of us knew each other from a brief get together on Sunday afternoon so things were not as awkward as they could have been. As things began to settle and people grabbed breakfast we were greeted by Dannai, our Program Coordinator, with a cheery "Good morning and welcome to your 46 week interview." As we had previously discussed in our phone interview the next 11 months would be a great way to not only gain some hands on experience, increase our knowledge and skill set, but also network. You never know who you will meet, who will see your work and most importantly who might offer you a job at the end of our service.
The majority of our group grew up in the Pitt area and there are some repeat AmeriCorps members. All in all the group seems like it is going to mesh well. After all the group work I have done I can say that with some confidence. While the majority of members have not worked in the health arena before, many are looking to gain some hands one experience before jumping into med/dental/nurse practitioner/nursing school or the field of social work (myself included ... maybe). I will admit that I was not that surprised.
Sadly the first lecturer was not able to make it to her presentation, but I was spared a "What is Public Health?" lecture. Next up was a cultural diversity and competency lecture. After the diversity shuffle (my GW readers who worked for some university department will be all to familiar with this activity) we got down to it. I was surprised at how much I remembered from my COPC classes, including Preventing Health Disparities and Soc and Behavior.
One of the core concepts for any Public Health Professional. It is important to intervene at a variety of levels if one wants to insure any kind of change occurring at the individual/community level.
While this 45 minute talk only began to skim the surface, it was a good starting point for those who have never thought about these kinds of issues in a public health/clinical setting. Hopefully we will gain some more tools, either from future lectures/trainings and/or our sites, which will help us to address these issues once we start working for our sites.
The last lecturer was AMAZING. You will be amazed to hear me say that once you know that the lecturer was the Chief of Epi and Biostats at the Allegheny County DOH. For those of you not in the loop these two classes caused more angst during my MPH career than possibly my other classes combined (capstone included). Dr. Voorhees was not only captivating, but had several great takeaways that I will share to those of you still reading this post:
- He had one of the best definitions of public health I have ever heard of. Public health is "constantly defining the unacceptable." GENIUS!!
- He also (re)told us the up stream story. Now we got a bit more of a dramatic one, but the point is still driven home in this link. Much of health care in the United States comes from down stream thinking - we have a sick care system in the US where not much money is placed on primary prevention with some money being thrown at secondary and tertiary prevention.
Sadly many of these changes are not seen in the program evaluations that organizations submit to state and federal funders. One of the main reasons is that most grant periods are for two, maybe three years. In such a short span of time it is hard to show any major behavioral/attitude changes. Studies really need to be funded for much longer periods of time to see these kinds of returns. Unfortunately it is hard to make people think in such long terms. (See I was paying attention during Professor McDonnel's evaluation class).
One of the reasons why I am writing this blog is to inspire you to think about how public health plays a role in not only your daily life, but also (and maybe more importantly) in your local/state/national communities. The other reason was to SPARK DISCUSSION. Feel free to write your reactions, post links to articles/stories/pictures.
I want this to be as much of a learning experience for you as it will be for me.
Em! Any post that includes an image of the Social Model of Health is my kind of post!! I really appreciate you sharing what you learned...allows me to nerd out. Plus, I think it is inspiring, as a current MPH student, to see how our courses transfer into the "real world." Would love to hear where your clinic is placing primary prevention funds and for what types of programs... also does Dr. Voorhees work with the clinic? If so, does he think the clinic is doing a good job at 1.) primary prevention and 2.) showing through evaluation a ROI?
ReplyDeleteHey Em,
ReplyDeleteI'm glad to hear the stat lecture was MUCH better than you expected. Also, I came across this on CNN this morning, you've probably seen it, but just thought I'd share: http://www.cnn.com/2011/OPINION/09/07/gergen.brown.americorps/index.html?eref=mrss_igoogle_cnn
First thanks to who ever shared the CNN article (your name popped up as a bunch of numbers). My only beef with the article was it just looked at the NCCC program, not the State/National and Vista programs. KEEP THEM COMING.
ReplyDeleteNow to Breanna: We are still in Pre-Service orientation so I have not been to my site. Dr. Voorhees was one of the guest lecturers the Pitt Health Corps Director brought in to help give some background for those who had never worked in the public health arena before. As I start to find some parallels in my clinics I will definitely keep you posted. From my understanding the majority of their work is clinical with their focus on secondary and tertiary prevention. One of the things in my job description is to do some health promotion work, but I won't know what areas until I start working with clients (oh COPC how you follow us everywhere).
I will also ask around if they have any ROI studies with what they are doing. I do know that there is a lot of work being done with worker wellness programs in some of the larger corporations i.e. having gyms on location, giving cash/incentives for working out, losing/maintaining weight etc. I would assume that if the site is short staffed/has limited resources they might not have the ability to do these kinds of assessments.
Another thought that came to mind about the CNN article was about employment. The majority of those I am serving with decided to join AmeriCorps because they could not find a job. The year of service would allow them to not only gain great hands one experience, but to network and determine what kind of career they would like to go after
ReplyDeleteIt should be noted (and it is something that we hear all the time) that this IS NOT A JOB. We do not get paid enough for the work we do to consider it a job.
Prevention is key without a doubt. I am sure education plays a big role in that, and education of many disadvantaged populations is a challeng in and of itself. Add to that an environment that doesn't encourage personal accountability and it becomes a really intractable problem. One option would be legislation. Have you have wondered why you need a liecense and insurance to drive a car. The collective wisdom, if we can call it that, had decided that cars are dangerous and if not well managed (and taxed) that they become a drain on society. So we "teach if we can call it that" people how to drive and then we follow up with enforcement of a wide variety of laws to make sure that people stay between the pervervial lines. If you stray too far, you get the "opportunity" to pay a fine and many times go back to driving school to brush up on what you might have forgotten. Imagine if that were somehow applied to public health, the lack of which I am sure cost society more than uninsured and unlicensed motorists.
ReplyDeleteIt might look like this. Early in school, you health class instead of being a BS course taught once, would be a class you took every year. Women having babies would be given education on nutrition and health for their unborn child. Then there would be enforcement that would tie to annual or acute Heath checkups. If your BMI is too high you might get fined and have the chance for more education.
Wellness care and check up would be no different than your annual car inspection and you would be fined if you didn't get it. We could encourage with tax incentives employers to ties these checks to anniversaries of employment or something that would "encourage broad participation" he tax incentives would be offset by the lower cost of care on society. For those unemployed we could tied to unemployment benefits. And for the severely unemployable and disabled, we could use our saved resources t take care of them and still be net ahead. 17x return is ahuge amount of money to work with and it would be put to tremendous uses.
Bottom line, if we are so careful to regulate the machine we drive with notions of enforcement against the laws of use doesn't it stand to reason we should regulate health rather tahn throw money at care?
And if you don't like all of your personal freedoms taken away, perhaps a valid concern in our country, than consider a more Darwinian solution to those that don't take care of themselves thereby placing burdens on others. Perhaps not such a great place to live.