Season 1 Episode 15
Laurie WalknerWelcome to Share Public Health, the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country, highlighting that we all share in public health. Thank you for tuning into this series of interviews with public health leaders as we learn about different perspectives on current and emerging public health issues.
Today, Suzanne Hawley from Wichita State University talks with Jennifer McKeever of the National Network of Public Health Institutes about how our stories impact our work and the value of authenticity.
Suzanne Hawley Hello, welcome to the Public Health Leadership series, my name is Suzanne Hawley, and we’re with the Midwest Public Health Training Center. Today I have the pleasure of talking to a real public health leader, learning about public health skills and ideas from a personal perspective. So, thank you for joining us, Jennifer, it’s really great to be here, and uh, tell us a little about yourself and what got you into public health.
Jennifer McKeever Sure, so, as you know, right now I work with an organization called the National Network of Public Health Institutes. And at that organization I am director for a national coordinating center for public health training. We work with regional training centers based at accredited schools of public health across the country and our common mission is to insure that the workforce has access to high quality learning opportunities. Um, so I sort of actually came to public health by accident, if you will. I studied spanish and french in undergrad, and wasn’t quite sure what I wanted to do with my life after that. I actually applied for jobs in human resources because, at the time, at 22 I thought that that meant “resources for humans” and “this is something you can do to help out humans.” And um, help serve people in need. So I actually ended up spending a year working in Honduras as a volunteer at an orphanage. It was called an orphanage but it was really for people, for children, who had been neglected or whose parents were unable to afford to continue to care for them. I spent a year there and got a really “up close” look at real poverty, at real discrimination, at real um, lack of even adequate or basic healthcare, um, amenities. And I remember, at the time, feeling somewhat cavalier as a young person off to change the world saying, you know, gosh I get to live how the majority of the world lives. And a friend of mine said, um who was there with me, she said, Jennifer, no you’re not because you can leave at any time. And it just sort of struck me how unfair it was that because of the economic situation in which I grew up; because of the color of my skin, because of the county I lived in, um, I was able to have opportunities that others weren’t. Um, and so it was there where I started learning about public health and um after my year in Honduras I went straight to Tulane University and um sought a Master in Public Health as well as Social Work.
Hawley Wow. So, then once you graduated where did you go after that?
McKeever Um, to Tulane? After Tulane? Where did I go? I got a job after I graduated from Tulane. I worked, um my first job was more on the social work side of things I worked at a residential facility for people living with HIV. Um, and so we were a small facility with about 18 rooms, um, and it had started in the late 80’s when, um, people were coming and needed sort of a homey place to live out the end of their lives. At the time I worked there in the early 90’s it was sort of at the advent of all of the medications for people living with HIV and they were extending their lives so we ended up dealing with lots of issues related to um, substance abuse, mental health, and making sure that the folks that lived there had access to adequate care.
Hawley So, I was curious about that, just because um, hearing you say social work and MPH, I don’t know that that’s always a common intersection, but to me, that’s as public health as you get, or can get, when you think about mental health. So, um I guess, you know- I’m thinking about what what excites you and where your passions are with public health. And what are you most excited about, when you think about public health?
McKeever Yeah. So, you know when I did the degree in social work and public health there were only three schools in the county that did that dual degree, and now there are many more. Um, but I’m super excited that I’m, I was able to find that because I think social work and public health, um, have proved to be a really excellent compliment. And so in terms of what I’m excited about now in public health is this shifting of our understanding of the true underlying impacts of health. And so that it’s not about individual choice necessarily, it’s not about um, whether I have access to the greatest healthcare in the world, but there are underlying factors such as oppression, such as racial injustice, um, things that this country quite frankly was founded on, um, that are impacting our health today. Um, and in social work, we sort of always knew that. You know, so in the world of social work when we would work with individual clients but we would do what we call biopsychosocial assessment. So we were understanding the individual in their context and as a product of their context versus um, an individual with complete control and autonomy in their lives. And so as I’ve watched this discussion over the last few years in public health go to understanding “oh, wait a minute there are other factors like where somebody lives or whether they have access to a grocery store or whether they have access to healthcare or educational opportunities, economic opportunities. It’s been kind of an interesting journey for me to see that discussion happening in public health when we’d already had that a while ago in social work. So I find that really exciting that we are starting to look at people in their context and not just as individuals completely responsible for their own health choices.
Hawley Sure and you know it’s kind of off topic, but listening to you talk about your background and training gets me excited about my own- I forgot that I guess incommon with you I was in a psychology public health dual degree program- it was the only kind in California. But maybe now more and more have come out. These kind of dual degree, cross pollination, what ultimately allows us to have a bigger, better context for public health and, um yeah, so definitely with social work I can see how the things you’re excited about go back to your history. So, public health is changing, and you know for us to anticipate the issues that we will face in the 21st century is going to require a lot of different things. I’m wondering what you think some of the things are that are needed in terms of skills for managing change, leading change, um, what do you think about that idea?
McKeever So a couple of things, I mean I think the big areas of shift right now are related to moving from individual health to population health, and sort of what that means exactly. So for a health department leader, that might mean how do I go from a primarily clinical services approach to where we have nurses who are checking [inaudible] seeing patients on a regular basis to how do we really actually reach into the community and engage the community and serve the community at a higher level than just individual care. So, I’ve seen, I’ve experienced a number of health departments go through that transition and, you know, it’s difficult for leaders to navigate, but many have done it successfully. And then the other area that I’m thinking about is navigating this understanding that I work in public health, my degree is in public health, I understand the epidemiology, I understand the history of public health, um I understand the basic public health sciences. But now you’re telling me I have to like, do something about poverty? And now you’re telling me I have to focus on racial injustice? How do I even do that? Where do I even begin?
Hawley Yeah. Where?
McKeever Well, I don’t know the answer to my own question, but you know I think that there is this sense of, I think what I’ve seen is almost this gut reaction to that as: “Well that’s not my lane.” You know that’s that’s somebody else’s lane. And so I think the leadership challenge is being able to bridge “What is the public health lane?” with those other lanes. So, in short I think multi sector partnerships are hugely important. We tend to focus on partnerships within our own comfort zone and not necessarily engaging partners that we wouldn’t normally work with like organizations that are fighting for racial justice– like organizations who are engaged in criminal justice reform or mass incarceration or educational opportunity and things like that. So, for leaders, I think the challenge is really how to meaningfully engage with those other sectors. And that goes beyond, um, you know a phone conversation to learn about what each other does, it goes beyond, you know, signing a memorandum of understanding that we will support each other to get funding for a grant, etc. And so um I think from my perspective the leadership opportunity there is really about going to those other tables. Not inviting others to your table but actually taking the time to go to those tables. And then for the staff you manage, how are you allowing them or encouraging them to engage other partners in their work. How are you encouraging them to go out to attend other partner meetings to learn about what else is going on in the community. Is that a metric of success? Is that something that you put on a performance review, for example. How many new partners have you made this year? How have you engaged a partner in your work? Um, and so I think really thinking about how do we get out of our comfort zone and out of our, you know, sort of our usual day to day work to think about issues and partners that we can engage with to impact those upstream determinants of health.
Hawley It sounds like you know you’re kind of, you know, you have to have some faith in the process. You know, I’m imagining doing what you’re saying, going to these organizations, um, finding a way to offer my time– if there’s a way I can learn before I visit them, and then really not knowing where it’s going to go and, um, having some faith that, you know, you’re going to need those experiments to see where things stick, where connections may exist that you don’t understand at this point. But to still kind of trust that process that you’re outlining.
McKeever Yeah. And it really goes back even to funders trusting that process and so for those of us that receive federal funding it’s often very clear that we want you to reach X number of people or reduce this disease by this disease by X percent and you need to do it by tomorrow and here’s how we want you to do it and we’ll tell you whether it’s successful or not. Um, where as what you’re describing is more of a collective impact sort of approach where you are remaining open to the opportunities that exist and seeing what solutions might emerge from that. And what solutions a community might propose. And it’s uncomfortable going in because you don’t know what’s going to be a success or not. Um, I can assure you something, either way, will be learned. I hope that in the future funders will be a little more flexible in you know what they’re requiring of us in terms of programs and delivery. I was reminded of many years ago I worked on a program with the CDC called the National Public Health Performance Standards, I’m not sure if you’ve heard of these standards. So the National Public Health Performance Standards program [inaudible] the standards were intended to help a community assess how well it’s public health system was functioning. What actually happened is as people came together to assess their public health system they developed relationships and they developed partnerships and they learned about what this organization is doing and that organization is doing and so the result was that they were better equipped to assure the public’s health together than they were before they had come together. Whether or not this actual tool truly assessed the capacity of that system is another question. This coming together was sort of an unintended consequence but truly beneficial in those communities and so we have to be open and flexible to sometimes there’s a result that we didn’t anticipate but sometimes it’s better than what we anticipated.
Hawley So I’m thinking about the work that you do in supporting all of the public health training centers, work you have done with all of the different centers as well as the public health institutes across um the country and when I say systems thinking I’m wondering what are ways that systems thinking has helped you in your role.
McKeever Right. So for me I think the idea of systems thinking really plays into what we were just talking about about partnerships. And understanding that there are more factors and more people involved in any solution. And instead of saying I was to accomplish X with my new public health program you really have to do more observing and more listening to how the people and the pieces and the policies are working together to try to identify those lever where you can actually identify and impact some change by, um, just identifying a small opportunity in a greater system. I think often the tendency I would have had is to sort of forge ahead with a strong belief and you know an idea for a program and you know we need to make this happen, but it might not be the right time it might not be the right environment you might not have the right people engaged, but by keeping your ears open and your eyes open and just really watching you can find that opportunity and say oh now is when we can take our step forward.
Hawley So, um diagnosing, really, is, is a good, kind of piece where you know you’re really nicely describing this and I’m thinking about your role with the PHLN. Do you think that the PHLN or you have a sense of what might the opportunities for PHTC’s to kind of further the work of Public Health?
McKeever Yeah so I think right now we have been working collectively as the Public Health Learning Network for about 5 years and I think there’s sort of the concrete things that we do. We provide training to people working in public health, we now have this resource that is the Public Health learning navigator where people can access training. We are making sure that people who are working in public health are able to have the education and training they need to do their jobs effectively. But there’s also an undercurrent to the work we do, um, the sub-motivation, if you will, and that is really about raising the bar on quality learning in public health. Um, we in public health get the short shrift of education. Um, so we have a lot of instances where health departments are struggling with limited or no resources to develop and provide training for their staff. We have instances where we have multiple training on a single topic that are being developed across the country and, um, so if somebody goes to look for training they don’t know what training is there and if it’s any good if they find it. And so what we’re really trying to do is say that the public health workforce is public health. The value of public health is only as good as we value the public health workforce, and we can value the public health workforce by saying they deserve his quality education opportunities because they are protecting the public’s health and this is pretty important. And so we want to raise the value of the public health workforce in the communities’ eyes and we want to raise the value of public health education in the communities’ eyes. So we’re really trying to sort of raise the bar across the field on what is quality public health practice and what is the quality that we need for that practice.
Hawley And I guess I’m indirectly hearing raising the expectation of the audience of that they can expect it, they should ask for it.
McKeever Demand it.
Hawley Demand it. And that we also need to advocate that they need that and what that looks like because, you know, um it’s a privilege to even have the resources to have a training center. And um, but we’re all kind of still within our regions but there’s, you know, to share across that court of the nation can be really challenging. When we’re trying to address those local needs, but ultimately we have these system kind of skills that are cross-cutting and um giving a good story, making that, um argument I’m thinking about, you know persuasive communication is another skill and um, I’m just wondering what you think the pieces of persuasive communication are important in advocating.
McKeever Yeah, um I mean I think in, in short, I don’t know if this actually directly answers your question but what I’ve been hearing for years and what I believe is we just have to do a better job in communicating the value of our work. And I think we approach that by saying well let’s tell people this is important. Let’s tell people about what we do. When really, I think there’s more of a, you know, there’s the why of what we do, I don’t know if you’ve heard this… There’s somebody called Simon…
McKeever Yes, thank you. And he talks about…
Hawley Yes, the golden circle.
McKeever Exactly, so, instead of telling people what you do, you start with the why. And I don’t think we’re doing a great job of starting with the why. I know that’s something I’m practicing in my own life in my own work. I tend to want to start of by saying well I do XYZ and you know here’s the result of that without kind of getting at the why. Sometimes that involves having to be a little more personal about ourselves. Like a lot of us got into public health, myself included, for really personal reasons, and really personal motivations.
Hawley Well, your story of Honduras, I’m thinking wow. You know I love that I know that about you because, I’m there. I can imagine myself being there as you’re describing it, you know, this is where your passion comes from.
McKeever Yeah and I see us often at these conferences, stand behind our podiums and talk about the science and there’s a real story there. You know there are, I heard somebody speaking recently about having lost a child in childbirth, you know, and that’s what brought her to public health. When I think of persuasive communication I think that we need to do a better job of embracing the why we’re in this field in the first place and communicating about that. Because that’s what will get people to pay attention. Not specifically standing behind a podium and talking about the science with a million powerpoint slides.
Hawley So, when I think about you talking about the importance of connecting with all of these sectors, you know, ultimately we have data. That’s what we’re trained to do. We’re not trained to show up, as people, with our stories that embed the passion, the purpose, you know, what is vocation about social justice or bringing communities together and, ultimately, I’m going to get emotional, that’s what it’s about. And, um, yeah. I think, I think, um you just being able to say that idea of we need to bring ourselves to the table. And, um, I think about authentic leadership you know, being a piece of, of connecting with others and communicating in a more deeper way to actually have a conversation outside of just, you know here, and kind of connecting the below the neck conversations, um, that we don’t know how to do. Um, so I’m wondering you know, I’m saying a lot of things but, um, in terms of how do our own stories help reduce stigma, help bring to the center of the stage where most people in that large auditorium could say either someone in their family or somebody very close to them has cancer. Or they’ve been interfaced with cancer. Um, I’m sure many more people could tell much more difficult stories about mental illness and addiction and things that they’re not just going to be able to stand up in a room and say this is why we need to do this. And only talking about it and to be in a position in a leadership role and say this is what happens regardless of where you are in life and that we need to protect our workforce, we need to have a healthy community and when the number one reason for absenteeism at work is mental health related it’s this silent issue that is a public health epidemic. So, I think ok you’ve really kind of push my hot button with this issue because it’s very difficult, I think, to be the person to have that courageous conversation and say you know what I have this issue and I’ve had many public health leaders come to me at the end of their talk because they know that uh I’m in the mental health field that they have a mental health condition, but it’s after the talk and um they want those resources for their community they want those resources for themselves, but they feel very reluctant, and in very indirect ways to just kind of um it’s too risky. And we think about what’s too risky in public health but, what’s at risk if we don’t.
McKeever Right. But, I do feel like that like that honesty about our own lives and what brought us to public health is really crucial for us to not just acknowledge but embrace if we really want to demonstrate the value of this work. I think we need to talk about it more honestly and why we’re doing it more honestly.
Hawley Well, you know in terms of like a- a skill thing. You know, someone I just talked to talked about Steven Covey’s book that talked about trust and building trust and really trust is about someone’s character and someone’s competency. So real, kind of clean definitions, but really when you, uh, I think about authentic courage and vulnerability is the trust level just changes it completely within a minute what you couldn’t do even within a year kind of with that, that podium, cocktail level discussion. So, you know, when I think back to persuasive communication I think about where can I build trust in real ways to do the difficult work in public health.
McKeever Yeah, and I, so you know, that’s in being authentic and that’s as a leader being willing to say: I don’t know all of the answers, can you help me? Let’s figure this out together, you know we tend to put a real focus on, in our society, is the leader in the leadership role is responsible for everything so if something happens within the organization it’s the leader who gets fired. You’re sort of, you’re a group of people working together, you’re a collective, right, each leader is only as good as the folks that are co-leading, if you will. So we have kind of this individualistic view of leadership when it’s really a collaborative effort that everybody plays a different role in.
Hawley Yeah. And I like what you’re saying about really kind of practicing your ability say I don’t have the answer, and let me find it out. Or just, you know, not being so prescriptive or, um you know and…
McKeever I’ve had people tell me, you know that… I, uh, for people that I work with always offer opportunities for them to give me feedback so I can continually be improving and you know I’ve been told that that’s one of the things that folks that work with me appreciate the most is that I often say I don’t know, let’s go figure it out together, and that that’s okay. And so I really, I appreciate that in others, as well.
Hawley So, what I’m hearing is kind of building trust with your partners but really within your own organization and within your staff, that that’s really, you know you’re kind of needing to model integrity all the way through, ultimately, in a good scenario. Is there um, anything else that you think would be helpful in terms of what would help prepare a future public health leader or someone just getting into the field or just in this work now.
McKeeverYeah I think, um, I would encourage emerging leaders, folks that are just getting into the field to push us. It feels a little like public health is sort of opening itself up to the world in a way saying we need new partners, we need help, we need to communicate better, we need to understand systems, and I think, you know, having a generation of young leaders coming into the field I hope they would continue to push us in that direction.
Hawley Great. Well, thank you for joining us today, sharing your thoughts, sharing your insights, it’s just a real pleasure to get to talk with you and to meet you.
McKeever Thank you so much.
Hawley Thank you for joining us for this leadership series and we hope that you will come again to listen to a future leadership session. Thank you.
Laurie Walkner Thank you for joining us today. Special thanks to our guests, Shirley Orr, executive director of the Association for Public Health Nurses, Suzanne Hawley, Roger Hileman, Melissa Richlen, Hannah Shultz, and Laurie Walkner.
Funding for this webinar is provided by the Health Resources and Services Administration. Please see the podcast notes for an evaluation and transcript.