In this month's feature Interview, we speak with Shelley Hearne, DrPH from the Johns Hopkins Lerner Center for Public Health Advocacy. Below is an edited version, but you can read the full interview here or at the link below.

First, Shelley, thank you so much for taking the time to talk with us here at the Simmons MPH program. I wanted to start by asking you about your role in the public health sphere as a force who is challenging the field to remind it that a tremendous part of the work is advocating for policy change. How do you tend to view the history of the field progressing to this point?

Public health had its heyday back in the 1800s, right at a moment when there was a convergence of critical social and health movements–women's suffrage, the anti-slavery movement, many pro-union developments, a desire to establish labor laws and also to improve public tenement housing. That’s when public health emerged as a field, and it was absolutely in lock-step about the importance of relying on evidence and engaging directly with decision makers to get law and policy on the books to improve overall health and living conditions. It was that way for a long time, but that ethos has, in a sense, been abdicated in the last few decades. Public health has become great at research, identifying problems, and building knowledge, but we’re no longer as skilled in the solving of those problems and putting knowledge to action.

If I'm understanding correctly, at this current point it's almost as if many in the public health field are assuming, or hoping, that someone else will take up that mantle. Does that sound accurate?

Many in public health like to think that if we shout the facts really loud, that somehow it will be heard, and people will believe it and move on their own accord. That's not how it ever works. Public health is trusted to take the facts, deliver them, and actually become a part of the process to make sure that good policies are being made with the evidence.

Could you tell us a little bit about some of your initiatives or your overall initiative in building consensus around advocacy in public health education?

A few years back, the Council on Education for Public Health (CEPH) added a new very specific accreditation requirement for public health programs that reflects what the field had determined through a lot of work and research: We need to have the skills to advocate for public health as a core competency of our profession. The accreditation body took that and said  “OK, if you’re graduating with an MPH degree, you have got to be able to advocate for public health.” It’s built in now. You cannot be a school or a program unless you’re teaching advocacy in your MPH program. 

New research in the Journal of Public Health Practice and Management, spearheaded by Glenn Schneider, provides an analysis of every syllabus at every school and program. Many schools say that they are teaching advocacy, but the findings show that very few places are actually giving a full insight or even a full introduction to the basics of advocacy. It’s not happening out there. That’s actually how we stumbled upon Simmons, because it’s one of the exceptions, a really good exception, in that advocacy is actually being taught as a full course. Students are coming out of the Simmons MPH program with the kind of skills and knowledge that every MPH student across the country needs. 

It seems to me like advocacy is an overlapping or an additional skill set and, as you are saying, it’s not the same set of skills as publishing research.

Advocacy is built into so many of the competencies that you need to have in public health. 

Understanding who the deciders are is critical, rather than more naively thinking, “if I yell my facts really loud and say, ‘this is the ethical thing to do,’ change will take place.” You’ve got to understand your audience in terms of the information they have so far, their values, and their needs. You also have to build a strategy around who you build coalition with–whether it’s local ministers, a local Chamber of Commerce, the PTA or others. All of this is variable depending on the issue, but it will always be based on doing your homework and understanding how these individual decisions get made and how policy is put in place. 

Different scenarios require different advocacy tactics, from organizing to polling to earned media. There are a variety of things that you have to figure out and then target in order to move a specific policy forward. 

For me, as a social work student, it is always interesting to compare and contrast social work and public health. It’s interesting how the roots of fields or schools of thought still have a big impact decades later. 

The reality is that the next generation coming in to get their MPH are hungry for this training. Yes, they want to be versed on technically understanding the issues, but this generation is a generation of change. They're a generation of action. It is not enough to talk; you have got to do, Our field needs this skill set. Surveys are showing this change, and it's starting to happen again. Both the old leaders and the incoming future are saying, “we have got to get this skill set back in our wheelhouse.” That's what the new initiative that we're putting together is about; to give some more structure to [advocacy training] so that we can have everyone thrive as an effective policy advocate.