Let's Talk About...

Let's talk about service:

Why I want to do this work:

Reading the two articles for this blog post really made me reflect upon why I wanted to get involved in service work and have a public-health-related internship this summer.  To name a few of the no-brainers of why I got involved, I wanted to experience public-health related work firsthand and develop a deeper understanding of what it encompasses. What these articles made me think about were my motivations for getting involved in public health in the first place.  One quote that caught my attention was in the essay published by Martin in 2016; it says, “don’t go because you’ve fallen in love with solvability.  Go because you’ve fallen in love with complexity.”  It stood out because, as many others also say, I got involved because I’m interested in helping others and solving problems.  But, if there’s one thing I’ve learned from my studies it’s that public health is complex.  Much more complex than a simple blanketing solution.   And this complexity is what has kept me hooked and excited to keep learning.  

But, what is missing is the conversation about service work.  In the essay by Davis (n.d.), he mentions that we don’t talk about service work enough.  I agree with him.  And I think he’s spot on when he mentions that it's under-discussed because it “would require us to look closely at inequality.”  Inequality rivals the common American Dream that every man is created equal and that there is equal opportunity.  I hope that by being aware of these essays we can continue to reflect and reassess our opinions, intentions, and motivations in public health.

References:

Davis, A. (n.d.). What We Don’t Talk About When We Don’t Talk About Service∗. Results.org. 

Martin, C. (2019, June 27). The reductive seduction of other people’s problems. Medium. https://brightthemag.com/the-reductive-seduction-of-other-people-s-problems-3c07b307732d 

Identities and Service

Identities and Service:

I will preface this post by talking about my own identities, and then I will move into how they influence my perceptions on service work.

So, by using the social identities worksheet published by University of Vermont (n.d.) I am a cisgender, heterosexual woman, assigned female at birth.  I am Chinese as I was born in China; I was adopted by two caucasian parents before the age of 1.  Because of this, I don’t have many identities concerning my asian heritage other than my appearance. I’m 20 years old, so a young adult in college.  Like many other individuals in college, I have anxiety but have recently developed PTSD.  In terms of physical attributes, I am athletic but petite (5 feet even!). 

Now that we have covered a bit of who I am, I will discuss how these identities influence my work and perspectives.  The largest one I can think of is being a minority (racially).  I have lived in Vermont for practically my entire life, and Vermont is not a diverse state, racially– most people identify as caucasian. So, growing up and being raised here there were very few Asians in my classes.  And, as psychology has shown time and time again, it’s natural for people to gravitate towards those who look similar to them (Sschrader, 2018).  So, I feel that I have a deeper understanding in some ways that allow me to connect with other minorities– especially in Vermont.  But, to put simply, my identities are a primary influence in how and what I choose to involve myself in.

Answering the question if service moves us closer to equality, my answer is as follows: It can.  If done correctly, and it doesn’t serve to further alienate various populations, it can be a powerful tool in bridging gaps.  But, on the flip side it has the potential to divide and widen the various inequities that are seen.  One subtle tool to ensure that our intentions are in the right place is to actively reflect upon why we are involving ourselves and how our identities will impact our service work. For me, being involved in a firearm injury prevention project has caused me to be aware that my lived experiences are very different from other target populations.  So, I cannot expect the changes that would be effective in my realities to work in others.  That’s where education and listening, not talking, will help. 

References:

Schrader, J. (2018, December 18). Why do we like people who are similar to us?. Psychology Today. https://www.psychologytoday.com/us/blog/close-encounters/201812/why-do-we-people-who-are-similar-us 

University of Vermont. (n.d.). Social Identities. Burlington.

Let's talk about Public Health:

What Public Health means to me:

Denotatively, public health is an interdisciplinary field whose goals are to protect, maintain, and improve upon the health of all members in a community or society (DeSalvo et al., 2017). This involves all members of the community– from healthcare workers and elected officials to those working at waste disposal and construction agencies. To me, public health needs to be viewed as a public good, meaning that it should be viewed as collective property where society and the government have the majority of responsibility– not the individual (Sandro Galea, 2016).  This is necessary because public health is extremely underfunded in the US.  Investing in public health means investing in ourselves and our youth.  It also has a plethora of other benefits including a high cost-benefit performance, improved qualities of life, and bridging the gaps in the major disparities in the US (DeSalvo et al., 2017).  Believing and advocacy in public health means elevating the standards of living not just the majority populations but minority and marginalized communities.

References:

DeSalvo, K. B., Wang, Y. C., Harris, A., Auerbach, J., Koo, D., & O'Carroll, P. (2017). Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century. Preventing chronic disease, 14, E78. https://doi.org/10.5888/pcd14.170017

Galea, S. (2016, January 10). Public health as a public good. Boston University School of Public Health. https://www.bu.edu/sph/news/articles/2016/public-health-as-a-public-good/ 

How is my organization doing PH work?

AHEC UVM, or Area Health Education Center (at UVM), is devoted to “improv[ing] the health of Vermonters” (UVM, n.d.).  As I wrote previously, they work to increase access to primary and preventive health services in Vermont, which strikes the core of public health. Part of this includes connecting students (like myself) to the professional field and communities and “connecting communities to better health” (UVM, n.d.).  In the following sections, I will focus on the 10 essential public health services and describe each aspect of it from the perspective offered by the social-ecological model,

The 10 essential public health services are broken down into three categories: Assessment, Policy Development, and Assurance (CDC, 2023).

Assessment: My project started by delving into the statistics, facts, history, and legislation surrounding firearm injury in Vermont. We assessed the health of the population by looking at statistics relating to gun-related homicide, suicide, and accidental injury (CDC, 2023).  We also looked into the current legislation and history of gun-ownership in Vermont.  To do so, we looked at by assessing individual perspectives, how accessible guns are, cultural norms, and public policy– basically starting from the ground up in reference to the social-ecological model  (US Department of HHS, 2020). Our team performed all of this research in order to investigate and address the health hazards and root causes of this issue (CDC, 2023).

Policy development: The goals of our project are to reduce firearm injury, with a special focus on preventing gun-related suicides through the relationship of health providers and their patients. We are working on effective communication to inform and educate and are in the process of strengthening, supporting, and mobilizing partnerships with other programs (CDC, 2023). Our end product, as of now, is a pamphlet aimed at educating patients on gun-related suicides and providing resources to increase safety around it.  For providers, a handout about appropriate language, framing, and guiding them through an effective conversation about firearms will be made.  These two products are being created by utilizing community level partnerships and building upon the current institutions in place.  They are aimed at individuals (the patients and providers) to improve the health of the target population (Vermont).

Assurance: While we have yet to see our efforts and work have an actual impact, we are working at improving and innovating through evaluation, research, and quality improvement (CDC, 2023)– we are a QI project! But, because we represent AHEC UVM I feel that it is important to mention them here; they are dedicated to enabling equitable access to health-related programs across Vermont.  They do this through building a diverse workforce  and proposing laws, policies, and plans (CDC, 2023).  The last two points mentioned are parts of policy development. So, the work done is targeted at the community and individual level, but is being done through all 5 levels of the social-ecological model  (US Department of HHS, 2020).

References:

CDC - 10 essential public health services - public health infrastructure center. Centers for Disease Control and Prevention. (2023, March 6). https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html 

University of Vermont. (n.d.). Office of Primary Care and Area Health Education Centers (AHEC) program. AHEC, Larner College of Medicine. http://www.med.uvm.edu/ahec/home 

US Department of Health and Human Services. (2020). Access to health services | healthy people 2020 - archive-it. Office of Disease Prevention and Health Promotion. https://wayback.archive-it.org/5774/20220414155345/https:/www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/access-to-health 

4.       Propose interdisciplinary solutions aimed to reduce firearm injuries for at risk populations

Our group worked to help facilitate the conversation between providers and patients on the importance of gun safety through the distribution of a pamphlet.  The pamphlet details safe storage practices, recent Vermont legislation, tips to discuss firearm safety with loved ones, relevance of mental health to firearm safety, and prevalence of firearm injuries/deaths in Vermont.  It is intended to be distributed throughout primary care offices across Vermont for patients, with an insert for providers on how to initiate conversations related to gun-safety.  

We decided on a pamphlet as it can be easily distributed and does not require internet access, like QR codes and websites.  This allows it to be more accessible for the older populations and those in rural areas. Additionally, we recognized and wanted to draw on the trust and relationship between patients and thier providers.  We found that engaging in conversations about firearms with trusted individuals increases the liklihood of beneficial behavior changes.  So, primary care settings were a great choice.

The brochure, which is in draft form, is shown below (left).  We completed this after having interviewed countless providers and community partners. I will also attach our abstract, which is shown on the bottom right.

Final reflection:

Before I give my last thoughts, I just wanted to note one thing.  Ideally, as a public health project, we focus on the structural and systemic root problems that contribute to issues.  For firearm injury and prevention, the issue is the firearm. A clear solution would be to limit access to such firearms.  But, there are many approaches to firearm-injury prevention.  Our group opted to focus on this issue through the perspective of primary care offices, as the internship program is geared towards medical students and health-related professions.

Okay, now for my last thoughts:

I found this experience to be exciting, surprising, and eye-opening.  Learning about public health is one thing, but being involved in creating change is entirely different.  I was surprised by the scope and influence of public health as well as its interconnected nature.  This project has taught me about the groundwork of quality improvement projects, research, and public health.  I have a deeper appreciation for public health, which will guide my education and future career endeavors. 

I hope to continue the work to distribute this pamphlet, but I'm not sure if the rest of my group is interested.  I plan on following up with the site supervisor to see if I can continue to work on this project or a related one.  While I'm not sure of the future classes that I will take, as most are predetermiend by my major requirements, I am in the process of looking for more internships. I will most certainly be involving myself in another one for next summer. But, in the mean time I will continue to network with community partners and public health advocates. 

All in all, I am very grateful for having the opportunity to work on this project. This particular course, SINT 190, guided me through thoughtful reflection and careful planning. It gave me the necessary tools to make the most out of my summer and I am excited to take what I've learned to class. 

Because I know you're reading this, Noah, I'll see you around this fall! Thank you for your help and for a great summer semester.