Monthly Archives: July 2010

Q&A with Public Health Interns

Public Health Interns, Abby Lowe and Alison Mendoza

This summer, the Community Health Promotion and Advocacy Division (CHPA) of the Chatham County Public Health Department has been privileged to host two Masters of Public Health students from the University of North Carolina Gillings School of Global Public Health, Department of Health Behavior and Health Education. They are both completing their practicum (similar to an internship) with us, a requirement of their academic program. In this blog post, Alison Mendoza and Abby Lowe will share why they chose to work at CHPA, what their projects are, and lessons learned from the experience so far.

Why did you choose to work with CHPA for your summer practicum?

Alison: I chose to spend my summer with CHPA because I wanted to gain experience working in public health initiatives that were not part of university-supported projects.  I was specifically interested in government work because I have been inspired by the progressive strides of the New York City Health Department, and I see great potential in the ability of a health department to affect the lives of millions of people.  Finally, my interest in community engagement made assisting with soliciting community input for Chatham County’s Community Health Assessment (CHA) an excellent match. I’ve been working with Healthy Chatham Coordinator/Communications Specialist, Marissa Jelks on the health assessment.

Abby:  I wanted to work at a health department for my practicum because I had never worked for a government agency in any capacity. I had worked for the past four years for a non-profit promoting school-based physical activity programming before, during, and after school in cities around the country. However, I wanted to gain experience with other health education activities about topics besides physical activity. Working with Chatham County’s School Health Liaison, Ellie Morris  provided that opportunity.

What is the focus of your work?

Alison: My main role, as part of the Community Health Assessment (CHA) team, has been to conduct interviews with community members about quality of life and health matters.  The CHA is conducted every four years to determine the health department’s priorities and direction for the coming four years.  In order to assist with identifying the top health priorities in Chatham County, my next major task is to compile fact sheets, based on information from approximately 40 community interviews, for various health and community issues such as obesity, recreation, and transportation.   You can learn more about the 2010 Chatham County CHA here: www.chathamnc.org/Index.aspx?page=1331.

Abby: The summer started with a literature review of effective instructional strategies for school-based health education.  Pulling information from many sources, I’ve been able to compile some useful information to provide CHPA’s Public Health Educators support in preparing engaging and impactful health presentations for students in Chatham County. From this research, I have helped develop several tools and resources to help health educators plan and deliver effective presentations. This week, I will co-facilitate a two-hour interactive training for CHPA and other health department staff to learn about these new tools and get some practice using them.

I have also written lesson plans for sexually transmitted infection (STI) prevention that classroom teachers can implement after a CHPA educator has presented, and helped mastermind a new School Wellness Constitution that will be unveiled this summer and fall to principals. The School Wellness Constitution is a written commitment from the school that they will pursue particular actions in order to support the health of students, staff, families, and to create a healthy school environment.  

What have you learned so far from your work with CHPA?

Alison: I have learned a great deal from my mentors and colleagues at CHPA.  The people with whom one works can be just as important as the work itself, and having an enthusiastic team backed by strong leadership is necessary to make any significant advances in public health.  I am learning how to balance the limited time and resources available in the field with the rigorous theoretical methodologies learned in class, a challenge that all public health professionals must handle.  Finally, through my interaction with the community members and analysis of interviews, I have learned about the strengths, challenges, joys, beauty, and hardships of the people of Chatham County. It’s this “human side” of public health that drew me to this field in the first place and inspires me to continue working in public health.

Abby: One hundred and sixty hours in, I have learned a few things. First of all, literature reviews are challenging. Secondly, in school we learn a lot of theories about why people behave in certain ways or make particular health decisions; in the classroom, it doesn’t seem all that useful. Doing the literature review and writing lesson plans both allowed me to experience applying theory in useful ways. Third, public health is desperate for more “practice-based evidence,” rather than solely evidence that comes from randomized control trials in distant places. People who do this work on a daily basis – health department health educators, health teachers, etc. – have insightful things to say about what works and what doesn’t. We should listen to them when designing health programming. Finally, in a broad sense, it’s clear that coordination, cooperation and a common vision are integral to achieving better quality of life among residents of a place. Lots of folks have to work on similar issues from different angles in order to move the mountain.

We have both learned a lot and will continue moving forward with these projects and the dissemination of results in the fall. Stay tuned!

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What is Health Equity?

Health inequities are differences in health or healthcare that are systemic, avoidable, unnecessary, and considered unfair. These disparities in health equity are the result of “unjust social and economic policies and practices that create barriers to opportunity.”  (http://www.vdh.state.va.us/healthpolicy/healthequity/unnaturalcauses/healthequity.htm)

An example of a health inequity is infant mortality rates. African-American professional women with college degrees and higher have worse birth outcomes than white women with less than high school diplomas. There is also a gap between highly educated black and white women. (Centers for Disease Control and Prevention WONDER, 2003-2005)

It would seem that highly educated black women would have better birth outcomes than less educated women, and that black and white women with similar educational backgrounds and incomes would have similar birth outcomes, but this is not the case. What causes these inequities?

Social determinants of health are factors in a person’s life that are more than an individual’s lifestyle choices. Examples of social determinants of health include socioeconomic status, housing, physical environment, child development, transportation, and working conditions. When these social determinants are unfairly or unequally distributed, it leads to health inequities.

We know that health inequities exist. What next? Health inequities can be addressed by looking at changing societal, institutional, and policy level changes to get at the root cause of these inequities.

 Key actions from the Wisconsin Center for Health Equity that can be taken include:

  • Form broad partnerships between government, private sector, health professionals, political parties, community organizing groups, and community members to address the causes of health inequities.
  • Identify social and economic policies and factors that influence health inequities.
  • Build capacity of community- have the community develop solutions.

Once public health and the healthcare system begin to work together with community partners to address health inequities can we start to eliminate them.

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Grant awarded to support physical activity in Chatham County Schools

Hopscotch by Jan Tik

This June, the Chatham County Public Health Department (CCPHD) was awarded a grant from North Carolina’s Eat Smart Move More Community grant program to increase youth physical activity in the county. With this funding, the School Health Liaison, Ellie Morris, and other staff members from the Community Health Promotion and Advocacy Division of the CCPHD will work with the non-profit organization, Be Active North Carolina and three Chatham County Schools, Moncure School, Bonlee School and Horton Middle School. The partners will implement Be Active North Carolina’s Just Push Play Program.

This is an exciting opportunity that will support these schools in making innovative and sustainable changes to increase their students’ physical activity.  Through the Just Push Play program, schools will form wellness teams to assess their current capacity to promote physical activity and will plan for healthy change.  The teams will work toward physical changes to their schools that encourage exercise and active play (for example, building a walking path, or painting a hopscotch board to encourage active recess) as well as program and policy changes.  Each school will receive a mini-grant to make these changes a reality. 

The implementation of Just Push Play at Moncure, Bonlee and Horton schools fits nicely into the array of programs and initiatives already in place in the county.  Chatham County’s Team Fit has been helping to organize staff wellness programs with schools throughout the county (see our post on the successful partnership between Bennett School and Team Fit at http://www.chathampublichealth.com/programs/team-fit-helps-bennett-school-get-fit/) and many schools have taken the initiative to offer staff wellness opportunities on their own, including fitness competitions and free fitness classes.

With new interest and new programs springing up all around the county, the state, and the nation, this is an exciting time for school health. Chatham County has great partnerships in place to support this expanding focus—the School Health Liaison and other staff from the Chatham County Public Health Department and other community organizations will continue to work with Chatham County Schools and with Chatham County’s School Health Advisory Council to ensure that our schools are health-promoting places to learn, work, and play.  

To learn more about school-based health promotion, please contact Ellie Morris, School Health Liaison with the Chatham County Public Health Department, at 919-545-8514 or elizabeth.morris@chathamnc.org.

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