Friday, March 31, 2017

Fellowship Stories, Now Recorded

We decided that it was time to switch up the format of the blog this month and record our first-ever podcast-style post! You’ll hear a bit about our experiences from the first-year perspective (Fiona) and the second year (Ashley). Take a listen! 

If you like what you heard, stay tuned for the fellowship’s upcoming podcast – more to come! And if you want to learn more from either Ashley or Fiona, please do get in touch with us - our emails are below!


Thanks for listening!

Ashley and Fiona

Monday, February 27, 2017

PSA: Violence against Women is Still Happening

Leslie Tou, MPH
Population Health Service Fellow, 2nd Year
Wisconsin Department of Health Services
UW-Madison Lifecourse Initiative for Healthy Families
Madison, Wi

I’m angry.  Honestly, we- as public health professionals, as citizens, and as human beings- should all be angry. 

Lately, it seems like we actually need a reminder that women still experience violence at an alarmingly high rate.  Between Russia decriminalizing domestic violence and Trump’s new budget threatening to completely eliminate all Violence Against Women Act (VAWA) grant programs, you could be forgiven for thinking maybe it’s not an issue anymore.

But the numbers don’t lie.  1 in 3 women and girls across the globe experience gender-based violence[*] (1). That is over 30% of our world’s women and girls who will experience sexual, physical and other abuse in their lifetimes.  Here in the United States, more than 1 in 3 women have experienced “rape, physical violence, and/or stalking by an intimate partner in their lifetime” with 1 in 4 experiencing severe intimate partner violence.  And nearly 45% of all American women (almost 1 in 2) have experienced sexual coercion, unwanted sexual contact and other unwanted sexual experiences at some point in their lives (2).  What’s heartbreaking is that this already too-high number goes up for lesbians (46.4%) and bisexual women (a staggering 74.9%) (3).  And keep in mind that rape and sexual violence are some of the most underreported numbers we have (4).

In Wisconsin alone, there were 5,609 injury hospitalizations and ER visits for women 15-44 because of intentional assault in 2014.  In that same year, in one single day, Wisconsin domestic violence programs “provided services to 1,949 victims and had 367 requests for services that went unmet due to lack of resources” (5)

In short: violence against women is not only still an issue but happening to a distressingly large percentage of American women.  (I also want to take a quick moment to recognize that sexual and gender-based violence is not exclusive to women.  This affects men as well and especially affects the LGBT+ and gender nonconforming communities.  The fact that I chose to focus on women in this blog is not meant to detract from the realities of violence to these populations.)

So, how does the fact that almost half of all American women will experience some form of sexual violence victimization in their lifetime lead to the decision to eliminate all VAWA grant funds?  Funds that Kim Gandy (President of the National Network to End Domestic Violence) said “is truly the foundation of our nation’s response to domestic and sexual violence, stalking and dating violence” (6)

But this issue is about more than just numbers, shocking though they may be.  Just volunteer your time at any local domestic violence shelter, sexual assault agency, or any other organizations that work with survivors[†].  Words cannot do justice to the experience of listening to their stories of pain and fear and the lifelong ramifications (higher levels of depression, suicide attempts, anxiety, PTSD, as well as poorer physical health) that come with their experiences of violence, as well as their successes in their personal journeys of healing (7). These women have been through so much and have fought so hard.  They shouldn’t have to do it alone.  They should have spaces like DAIS or the Rape Crisis Center to go to for medical help, legal help, for shelter, and for empathy and support from those who understand.

Then there’s the economics.  The CDC estimates that intimate partner violence costs us $8.3 billion dollars a year (8).  Each rape costs approximately $151,423 (9).  Some of the best research we have identifies rape as our country’s most costly crime, at an annual cost of $127 billion (this is excluding child sexual abuse) (10).  Yet we may be losing one of the only sources of federal funding that works to prevent these crimes- the 25 Office of VAW grants.  These grants provide evidence-based direct services, intervention and assistance for victims of sexual assault as well as training and prevention programs.  They cover everything from training law enforcement agencies to be more effective, trauma-informed responders, assisting with transitional housing for survivors, direct services to marginalized and underserved populations, providing legal assistance to survivors, and specifically supporting children, youth and elders experiencing violence and sexual assault (11).  Without the critical, life-saving work of VAW grants, what is going to happen to the 74 million women who have or will experience some sort of sexual violence in their lifetimes (2)?  We NEED these services. 

Many others have written about this (like this one, this one, or this one or even this one). But I truly believe this is an issue worth elevating at every opportunity.  We need everyone to understand that so many women suffer in the United States but our current government wants to completely eliminate a huge source of federal funding. 

Can we all at least agree that sexual assault and intimate partner violence (as two examples) remain a serious problem in the US?  If the answer is yes, why would we eliminate the funding?  In what world is that good math?  In what world is that the humane choice?  So YES.  I’m angry.  And you should be too.

1.            Ellsberg M, Arango DJ, Morton M, et al. Prevention of violence against women and girls: what does the evidence say? Lancet (London, England). 2015; 385(9977):1555-66. doi:10.1016/s0140-6736(14)61703-7
2.            Black MC, Basile, K.C., Breiding, M.J., Smith, S.G., Walters, M.L., Merrick, M.T., Chen, J., & Stevens, M.R. The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control2011.
3.            Center NSVR. Statistics About Sexual Violence2015.
4.            Thomas E. Rape Is Grossly Underreported in the U.S., Study Finds. In: The Huffington Post. 2013. Accessed February 23 2017.
5.            Violence NCAD. Domestic Violence National Statistics. In: NCADV, editor.2015. p. 2.
6.            Gandy K. Intimate Partner Violence Report Proves VAWA Works. In: Post TH, editor. The Blog. The Huffington Post2012.
7.            Carlson BE, Mcnutt L-A, Choi DY, et al. Intimate Partner Abuse and Mental Health
The Role of Social Support and Other Protective Factors. Violence Against Women. 2002; 8(6):720-45.
8.            Prevention CfDCa. Intimate Partner Violence: Consequences. Atlanta, GA. 2015. Accessed February 23 2017.
9.            DeLisi M, Kosloski A, Sween M, et al. Murder by numbers: monetary costs imposed by a sample of homicide offenders. The Journal of Forensic Psychiatry & Psychology. 2010; 21(4):501-13.
10.          Miller TR, Cohen MA, Wiersema B. Victim Costs and Consequences: A New Look. In: Justice UDo, editor.: Office of Justice Programs; 1996. p. 35.
11.          Justice TUSDo. Grant Programs. United States DOJ. 2017. Accessed Feburary 23 2017.

[*] As defined by the UN: gender-based violence is “physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life”
[†] But really, you should probably look into volunteering because they are going to need all the help they can get if their programs are defunded.

Monday, January 30, 2017

My Observations on Job Applications and Interviewing – What I’ve Learned from the “Other Side” of the Hiring Process

Nick Zupan, MPH
Population Health Service Fellow - 2nd Year
Wisconsin Division of Public Health Western Region Office
Eau Claire City-County Health Department 
Eau Claire, WI

Through my fellowship experience, I have participated in many stages of the hiring process for a variety of public health positions. Experiencing the “other side” as the interviewer has given me a new perspective on approaching the hiring process as a prospective employee. Using this new perspective, I have come up with a few observations that may help you as you apply and interview for your next gig.

1.   Applicants have screened themselves out of an interview process by not answering questions fully. Some applications require you to respond to questions in an essay format. Essays I review are scored based on a rubric related to the job description, so a blank or one-sentence response results in a low score. The applicant who offers very little in their responses will not likely make it to the next round of the process. The same goes for other parts of the application. It may seem like questions on different sections of the application ask for the same information, but be sure to answer each question completely despite any potential redundancy.

2.   The same concept is true for responding to interview questions. One frequent occurrence is that candidates do not say enough in their responses to interview questions. One or two sentence responses are not sufficient.  The interview is a candidate’s chance to really explain their experiences and abilities. The interviewers should have a clear picture of who they are and the skills they bring to the position.

3.   Everyone is (at least a little) nervous during an interview.  What I have found is that nearly every candidate I have interviewed shows signs nervousness. Interviewing can be stressful, but I think that interviewers understand that you may be nervous and it shouldn’t count against you.  Although a candidate may be nervous, it’s not a big deal. The hardest thing to witness is a candidate who stumbles through the interview because they are distracted by their nerves.

4.   Candidates often ask too few questions about the position or about the work environment. Asking questions helps determine if the job is a good fit and shows curiosity about the opportunity. In every interview that I have been a part of, we always ask the candidate if they have any questions, and some people don’t ask anything. I’m left wondering if the person is actually interested in the position. 

5.   Unfortunately, applicants don’t always present themselves professionally (in attire, actions, and the application materials submitted). Spelling errors and formatting issues in a résumé or cover letter can be a serious setback. I have seen a number of different quirks in résumés and cover letters that have impacted an applicant’s chance of being invited for an interview. Attention to detail and professional appearance of application documents can demonstrate interest in the position. 

6.   An applicant’s interactions outside of the interview are important too. We ask our reception staff, who greet and provide tours for candidates, to give their input on their interactions with interviewees. This can be crucial to evaluating how a candidate would fit in our organization. This also presents the applicant an opportunity to connect with other staff and determine their fit in the work environment.

7.   I think that prior to the interview applicants could do more research about the organization they apply to, the community it serves, and the types of programs it offers. This not only helps them figure out if the job is a good fit, it also demonstrates their interest in the position. It would be impressive to have a candidate reference our Community Health Improvement Plan, organizational structure, or information presented on our website.

8.  The old saying “It’s not what you know, it’s who you know” definitely applies to searching and applying for jobs in public health. By working on a regional or statewide committee (e.g. WPHA Annual Conference Committee) or reaching out to others at conferences/meetings, an applicant can establish connections to people in organizations that they’d like to work for. These networks can help identify opportunities, facilitate connections to those in hiring positions, and evaluate fit with an agency.

9.   When an employer makes a job offer, it is appropriate to negotiate benefits. Many times people accept the first offer that is made, but they always have the opportunity to negotiate (not only salary, but vacation, and other benefits). The employer may not have flexibility in negotiations, but it can’t hurt to ask. 

I hope that you find these observations helpful! This is not an exhaustive list, nor is it a strict set of rules. It is simply some advice that I want to share based on my own experiences.

Friday, December 23, 2016

Your Winter Reading List: 9 Books for the Public Health Bookworm

As 2016 winds down and we settle into the cold weather months here in Wisconsin, those of us in the learning community thought now would be a nice time to share some suggestions for your winter reading lists. Whether you find yourself wanting to curl up next to the fire or you’re looking for a good read during those holiday travels, read on for recommendations of books that have inspired, informed, and challenged thoughts on public health issues ranging from housing, to data, to bias.$2.00 a day: Living on Almost Nothing in America
by Kathryn Edin and H. Luke Shaefer                                
Recommended by Fiona Weeks, First Year Fellow 

I wouldn't say I "love" this book because it does inspire some serious discomfort around the realities of poverty in the United States. I also wouldn't say I love it because I don't necessarily agree with all of the interpretations or recommendations of the book. On the other hand, you could say I love it for these very same reasons. It sparks critical thinking and debate about the very essence of poverty and what it would mean to win the war on poverty. You should read this book if you think you know what poverty looks like; if you care about each person having the opportunity to live her life with dignity; or if you have any interaction with or work related to SNAP, WIC, TANF or other anti-poverty programs. This book opened me up to the importance of individual autonomy for family well-being and the real significance of sending the message through public policy that we trust individuals and parents to make smart decisions for their families. Poverty is perhaps THE most important social determinant of health. If you don't believe me, read the book.

Recommended by Stephanie Richards, Fellowship Program Lead

I couldn't put it down-- it was such an engaging read and also incredibly informative. If you're interested in housing policy, you should read this book. It helped me understand more about all that is working against poor, African American, people with disabilities, and other oppressed groups, particularly housing and law enforcement policies. This book was the UW Go Big Read book and I'm pretty sure I gave everyone in the learning community a free copy!

by Nicholas Kristof and Sheryl WuDunn
Recommended by Stevie Burrows, First Year Fellow

This book is phenomenal because it gives the reader a vivid look into the oppression and de-humanization of women in the developing world; however, it does so while simultaneously highlighting the women's intelligence, resilience, and determination to change their communities. In our world today--with constant media coverage-- it is easy to become desensitized to the suffering of others, but this book opened my eyes. It fostered in me a deep respect for these brave women and made me want to effect change in my own community. This book truly transcends a multitude of public health topics, but you should really read this book if you care about women's health, rural health, and global health. It also contains great illustrations of how social and economic factors, such as education, can improve the health of individuals and communities.

by Bryan Stevenson
Recommended by Salma Abadin, Second Year Fellow

This book personalizes the difficulties of inequities through storytelling - both from the perspective of being the one who experiences them and then from the side of the person attempting to dismantle them. While you quickly realize how disheartening this work can be, Stevenson creates hope and resilience in the midst of adversity. The quote from this book, or maybe it's from when I've seen Stevenson speak, that has stuck with me is "Each of us is more than the worst thing we've done." Imagine what that would look like if we all believed this? It's made me think more about respect, dignity, and what a fair and inclusive society actually looks like. Throughout this book, there is a clear call to action that the evolution of our criminal justice system to its present state affects all of us and it will take all of us to overcome it. Public health has the opportunity to provide a framework, lens, or even a goal for what we'd like the criminal justice system to be. It moves away from individual culpability to community action.

by Nate Silver
Recommended by Nick Zupan, Second Year Fellow

This is a book on using data to make decisions and predictions. I think it’s great because it goes into using stats and analytics to make predictions, but also breaks down a number of fallacies in relying too heavily on data. If you’re a data geek like me and want to learn more about modeling, forecasting, and probability, you should check out this book. After reading it, I think I have a better understanding of how to utilize data for public health practice. I also learned some of the pitfalls of over-analyzing data. A data-informed or evidence-based approach is crucial to providing high quality public health programming and services. This book sheds light on how to extract the “story” in the data.

by Anne Fadiman
Recommended by Britt Nigon, First Year Fellow

If you’ve ever wondered about how the US medical system is perceived by those who are not familiar with it, or if you’re interested in thinking about bias in healthcare, this book is worth a read. It got me thinking more about historical trauma, medical anthropology, and the value of culturally-informed practice. It also opened my eyes to the realities of resettled populations and offered different ways of thinking about what happens when two cultures meet. To quote the author, “Our view of reality is only a view, not reality itself.”

by Elizabeth Pisani
Recommended by Leslie Tou, Second Year Fellow

You should read this book if you like reading nonfiction! Because even though it's from an epidemiologist and about public health- it's a fascinating read. It opened me up to how murky data is in reality and what the world is like for a sex worker.

by Daniel Kahneman
Recommended by Geof Swain, Medical Director and Chief Medical Officer, City of Milwaukee Health Department (MHD), site preceptor and MHD liaison

You should read this book if you care about human behavior and decision-making. To quote a review by Larry Swedroe of CBS News: Kahneman “clearly shows that while we like to think of ourselves as rational in our decision making, the truth is we are subject to many biases. At least being aware of them will give you a better chance of avoiding them, or at least making fewer of them.” A colleague of mine characterized it as "the most important book in the last decade, maybe more.”

by Dan Fagin
Recommended by Maria Mora, Preventive Medicine Resident

This book is very engaging and describes a world before the EPA and environmental regulations. You should pick it up if you would like to discover how corporations affect the environment, and how those regulations benefit you even if you don’t know it. It made me care more about risk communication and covered policy implications as well as the role of public health and the government in healthcare. It also contains a lot of history about epidemiology and public health – John Snow and more!

Note: This post is comprised of recommendations based on personal opinions and is not endorsed by any of the authors, publishers, or distributors referenced here. These thoughts are those of our learning community and do not represent the institutions or organizations associated with the fellowship. The views or opinions expressed in this post are not intended to malign any religion, ethnic group, organization, or individual.