Wisconsin good-byes!

Carly Hood, MPA, MPH

Population Health Service Fellow 2012-2014

Wisconsin Division of Public Health

Health First Wisconsin

Wisconsin Center for Health Equity

Madison, WI

As I wrap up my final week as a Wisconsin Population Health Service Fellow, not only am I dedicating time to ensuring projects are complete and my desk(s) are clean, but I’m making time to reflect on what the last 2 years as a fellow (and 4 as a Wisconsin citizen) have meant to me. I moved here in the summer of 2010 as a reverse-culture-shocked graduate student, ready to apply what I had most recently seen in Vietnam as student of public policy at the Robert M. LaFollette School of Public Affairs. As a “fighting Bob” I took classes in public management, policy analysis, policy-making process and advanced statistics. And ate it up! I can see now, I was most definitely at a point in my life where school sounded right (boy, that ship has sailed!) But it was here that I also began seeing my lens take shape, my interests honed. I observed that the policies I chose to analyze, the experiences I brought to class to discuss, and the data I wanted to play with focused on health and access to what I had always seen as a human right: opportunity to live a healthy life. I quickly learned about the dual program with the UW School of Medicine and Public Health and added on an extra summer of epidemiology, social and behavioral health, and health policy courses to obtain my Master of Public Health and Global Health Certificate alongside my Master of Public Affairs degree.

I was fortunate to have been told about the fellowship program early enough to apply and post-application submission, waited anxiously to hear back from folks at the Population Health Institute. Finally, in late February, I received the call that helped shape my career path and joined the 4 other fellows in my cohort summer of 2012. Since my graduate research was based on food policy, I naturally found dual placement sites at the Division of Public Health in the Chronic Disease Program and at Health First Wisconsin. (I later added my tri-placement at the Wisconsin Center for Health Equity). And then…Poof! 2 years disappeared!

As my fellowship is ending soon, I was recently asked, “What do you think you’ve done as a fellow?” Wellllllllll (insert headscratch). Sometimes I want to say, “What HAVEN’T I done?!” Other times I ask myself, “Have a done ANYthing?” For most fellows, I believe it’s a difficult question to answer when there aren’t particular milestones, expectations or deliverables like those found in many other public health positions descriptions (besides the CALs of course!) The concrete products of my fellowship (which I was interested in hearing 2^nd year fellows talk about as an applicant and incoming fellow so I’ll touch on here) are what I shared in my exit interview last week and include the following: I developed 2 strategic evaluations both aimed at increasing capacity for folks working with homeless, impoverished and/or jobless individuals; I designed and implemented a year-long health equity training at both placement sites; I analyzed socioeconomic data for a chapter in the 2014 Healthiest Wisconsin 2020 Baseline and Health Disparities Report; I published 1 paper (2 in the works yet!), 2 Opinion pieces and 4 Letters to the Editor in various Wisconsin media outlets; I led 2 years of discussion courses for undergraduates interested in public health; I trained local and tribal health departments around the state on the use of national community health tools; I presented on health equity/social policy in public health to community groups, students, state public health employees, and national audiences; and I developed bi-monthly resources on health equity and social policy for national partners.

While most of these have a tangible item attached to them (a pdf report, a powerpoint presentation, a word document newsletter), some of them do not. And in my eyes, the more important outcomes of all of these projects have very little to do with the items one can see and touch. I have found much more value in the relationships I’ve developed, the heightened understanding of how public health & policy works at a State Health Department AND an advocacy organization, and the confidence that my perspective is a valued and impactful one.

I don’t believe in fate. I don’t think my career ‘required’ this 2-year experience or that I couldn’t also have been happy and successful in another position (there are certainly positives and negatives to this position). But I do believe that this experience gave me the flexibility and time to explore the many facets of public health, the plethora of partners who are involved, and the varied organizations that support the field of public health. I believe I was fortunate to be given the opportunity to hone the skills I wanted and dump those I wasn’t interested in. And as an academically funded staff person working in the field, I had access to more resources and training alternatives that helped me sharpen a sort of ‘field of expertise.’

The fellowship was a great opportunity. And—like everything else—it came with a fair share of challenges. I dealt with a loss of preceptors (2 of mine left in the middle of my fellowship). I was conflicted with 2 placement sites and not feeling 100% a part of either. I was challenged to assert the understanding that ‘fellow’ does not mean ‘student’ or ‘administrative assistant’—we are in fact highly trained professionals seeking mentorship and experience early in our careers. And lastly, I struggled with evolving interests, being originally interested in food policy my interests broadened from issues of healthy food access to more upstream equity associated with income, education and housing. That made projects at my particular placement sites hard to find at times…but my preceptors were flexible and encouraging and I was able to develop my own projects that focused on equity and increasing capacity within my placement institutions. I was also able to expand many of my projects to the Wisconsin Center for Health Equity, where I revamped the website and built several partnership that results in facilitation and keynote speaking engagements.

In this way, the fellowship demanded innovativeness and honesty. I had to be cognizant of the skills and abilities I wanted to develop, I had to be honest and open about those, and then look for ways to infuse that work where I & my organizations were. In contrast to many other positions, I had to speak up louder than I might otherwise and was forced to be my own advocate. While this can be challenging at first, it ultimately helped me learn who I was, what I wanted, and encouraged me to think outside of the box. Today I feel lucky to have had the chance to say, “Hey! This is what I want to work on. How do we make that happen?”

In looking back over the last 4 years—and the fellowship in general—Wisconsin has provided a safe space for me to overcome my reverse-culture shock, make new friends and professional connections, and build on the amazing efforts of places like the policy school (3^rd in the country for Social Policy!), the Institute for Research on Poverty, the Population Health Institute, and the School of Medicine & Public Health. Due to its size and approachability (plus people’s lovely Midwestern demeanor!) Wisconsin is a ripe place for networking and building connections. I will miss those that I’ve made as I move on to a new position as Clinic & Public Health Director for a small clinic—in a new country! But I feel more equipped to deal with the challenges I will likely face in the developing world, and look forward to contrasting the public health system in Belize with that of the United States and Wisconsin. Thank you to the fellowship community for the support and learning you’ve provided me!!!! I do hope you’ll keep in touch.