Things I didn’t learn in my program when it comes to actually working in public health
Lessons from COVID-19 Relief Work
In July 2021, I took on a contract through the CDC Foundation to work at the Oklahoma State Department of Health (OSDH) as a relief worker. I was attached to the surveillance team for acute diseases to help with their collection and analysis of COVID-19 data. When I got there, there were a number of challenges that I know have been issues at other departments around the country, so I felt like there was some merit in posting my experiences and potential solutions.
In a previous post I discussed some data science tips, but for this one, I thought I would provide some insight based on my experiences just working at CDCF and OSDH. If you wanted more technical advice, please check that previous post!
Challenges you might face
So, for this post, I’m mostly talking to students who are considering careers in public health, or who haven’t really worked in public health practice just yet. I’d also hope that anyone reading this that has already been working in public health practice would feel a bit encouraged, or at least that you aren’t alone in facing some of these challenges.
During my recent work experience I felt like for the most part, I was lucky to be hired by the CDCF and attached to OSDH - I likely had a unique position that allowed me to observe local health department goings-on as well as work along side public health practitioners on a more national level. I could see the expected issues of small US health departments, and also discuss them with supervisors in Atlanta that worked with entire regions of the US.
I also will probably have fewer actual solutions; I made a post earlier that has to do with systematic changes in the workplace and I feel like I was led to that based on these experiences. Mostly, this will be just me reporting what systematic challenges I encountered.
Identifying systematic issues
When I was brought on at OSDH as a CDCF relief worker, I was there to… well provide some relief of course. By the time I got there, the pandemic had been hard on the team I was attached to. There were many burned out, many had left or moved to other departments, and there was excessive political pressure on them and reckless management by state officials. They were not having a good time, despite giving it their bet efforts. They had been in emergency overdrive for months and were just not being supported by… anyone really.
I definitely benefited from joining with a fresh mind and an alternate perspective. With an untenable workload for everyone, one of the best things I could do is take a step back and look at some of the biggest challenges in the department. Where did all the man-hours go? What was most difficult to accomplish each day?
Luckily it was pretty obvious. In this case, it had to do with data processing - which would of course become my specialty. I wasn’t too good at what I needed to do, but had an idea of how to accomplish it. I’m being vague but I’ve covered technical aspects in a previous post, but my point is that I found the clearest need and dedicated myself to fixing that. When I did, my OSDH coworkers claimed I “revolutionized” their jobs, and seemed to think that I had some kind of special skills or gift. The secret was simply that I looked for their greatest challenges. Then I just did a little bit to ease their burden, just bits at a time, finding ways to work smarter. However, it’s true that in the end I contributed to bringing down the time spent on burdensome tasks by hours each day through learning and applying the data science tips I mentioned in the first post.
Just a side note; taking a step back and just thinking about what was going on on systematically was also really useful in meetings, especially some of the more emotionally charged ones.
#Learning on the job
I feel like I have to emphasize that I learned the skills on the job. That’s pretty much it for this section; I strongly encourage learning on the job and not being afraid to step up to challenges that might seem a bit intimidating. I didn’t shirk my other duties, but I knew how it would shake out; if I developed skills that made mine and others’ jobs move faster, spending a bit of time extra to learn those skills would pay off. Essentially… with proper planning, a little time today gets me back time every day from now.
#Facing criticism or skepticism
The last section may lead to the question of, if it was so easy, why didn’t someone else do what I did? Well aside from the burnout and pressure I mentioned earlier, the department was skeptical that it was a tenable solution despite being fairly standard stuff in data science. I was immediately shot down in the first meeting I mentioned some of my ideas.
In time, I produced a long document with a planned process for the changes I was proposing that I don’t think anyone really looked at, but when I started following it and producing some good initial results I began to achieve buy-in from the department and I had some backup from higher-ups when I needed it down the road. So, I had something to show, and also a plan if they asked questions about next steps. I was simultaneously demonstrating and proposing a solution over a period of weeks.
Working across departments
It’s great to say that I learned on the job, made a clever deduction on key challenges in the department, revolutionized the team’s jobs… but I could not have done a lot of things if I didn’t recruit other people to help me. I had some really key assists from people in other departments - these were the capstone challenges in my solutions. There were two departments in OSDH in particular that I needed to work well with my department. One was the IT group that was… well… probably doing their best. The other was a capable sister department that unfortunately had become estranged to ours during some infighting at OSDH.
Both challenges took time to improve relationships, bring people to being focused on the task, and encourage cooperation between all involved parties at OSDH. I was usually asking IT techs things that were beyond what they knew how to do, and eventually a security issue had to be resolved essentially through me asking them persistently to help us find a solution. Eventually they found multiple solutions! They even suggested some solutions I didn’t know we had available to us, so it was well worth it to be persistent… I just needed to find that one engineer that knew how to help.
As far as smoothing over things between the two sister departments, I’m actually not sure I did a whole lot. I tried to encourage communication, share ideas, reach out, and showcase how the two were helping each other and could help each other in the future. At least as far as what I did, I recruited help from both departments, and it was necessary - one department had skills the other needed and would need even more when my contract was up and I couldn’t continue to fill the spot that I did.
I was lucky
I was lucky. While I had been doing my best to work with OSDH, I still reported to, and was supported by, my managers at CDCF. For the most part, I got to have chats about how my work at OSDH was helping the departments, showcase my efforts, etc., but if I had issues with anything at OSDH I had managers at CDCF that were more than able to smooth things over and advocate for me, or simply give me some advice if OSDH wasn’t sure what they wanted me to do.
So, I suppose I have to say that it was also key that I had advocates and mentors that were great. I’m sure we have all heard about how important mentors or advocates are, but I’m here to say it just one more time.
Let’s Wrap it Up
When moving into a public health practice job, you will be stepping into a team or department that comes already siloed, already facing pressure, and already facing challenges. I’d suggest stepping back, making a personal evaluation, and addressing some of the challenges that allow you to make everyone’s jobs easier and maximize your impact. Not only that, but even better if you get to learn some skills along the way (just don’t get pigeon-holed in a lower level job!). Be aware, you’ll likely face some criticism, and perhaps some mismanagement, but… as cliche as it sounds, rely on your team, mentors, advocates, and do everything you can to encourage cooperation. Make friends, even with grumpy directors of other departments. Keep it up and you’ll see things start to happen for the better.
Most importantly, don’t despair. There are other people at other departments going through something very similar, and we’re still here if you need someone to talk to.