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A Perspective on Public Health

May 21, 2020

DR. LASHAUNE JOHNSON SPEAKS TO THE IMPORTANCE OF PUBLIC HEALTH DURING A PANDEMIC

Dr. LaShaune Johnson Image
Dr. LaShaune Johnson

What is Public Health?  According to the American Public Health Association, “public health promotes and protects the health of people and the communities where they live, learn, work and play.” Individuals who work in public health aim to prevent illness, promote wellness and encourage healthy behaviors.

In a time of unprecedented uncertainty, particularly as it relates to the health and well-being of some of the world’s most vulnerable, how does Public Health adapt and fulfill its aim of preventing illness? We had the pleasure of asking LaShaune Johnson, PhD for her perspective.

LaShaune Johnson, PhD is an associate professor of public health in the Department of Interdisciplinary Studies at Creighton University. Dr. Johnson received her bachelor’s degree from Wellesley College. She earned her PhD from University of California, Santa Barbara in Sociology, with doctoral certificates in Human Development and Feminist Studies. She has also completed two postdoctoral fellowships. One from the University of Connecticut Health Center, Ethel Donaghue Center for Translation Research into Practice and Policy (TRIPP) Center and the other from the University of Missouri, Columbia, School of Health Professions. Dr. Johnson’s research interests include the African American experience across the breast cancer continuum, faith-based maternal and child health education, culturally responsive program evaluation and community-based mental health interventions.

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CAN YOU TELL US HOW YOU FIRST BECOME INTERESTED IN THE PUBLIC HEALTH FIELD?

I have been interested in some elements of public health—maternal and child health, interpersonal violence, food deserts, and health inequities--since my adolescence in Oklahoma, but I’d say I officially became interested in public health as a postdoctoral researcher at the University of Connecticut TRIPP Center (now part of the Health Disparities Institute). There, I co-created a Photovoice project with weight-loss surgery patients. During this project, I was working with patients who were struggling with Emergency Department admissions and unexpected complications. In the process of the project, I began to learn that it was more than a lack of willpower making their wellness journey tough. I learned that there were policies that made it tougher for publicly insured persons to afford the supplements they needed post-surgery; that many lived in “food deserts” that made it hard to regularly afford healthy food; that some had experienced ACEs, or adverse childhood experiences, which are often linked to later health struggles; and that many were juggling chronic comorbidities (like diabetes, hypertension, joint pain). After this project, I understood that their experiences were multilayered, and that a clinical intervention would fall short of meeting their needs. Public health efforts can complement clinical interventions for patients with complex social and economic needs.

HOW HAS THE PUBLIC HEALTH ARENA CHANGED SINCE THE ONSET OF COVID-19?

In some ways, the core principles and functions of public health have not changed at all. What has changed is that more community members are aware of all of the ways that public health touches our lives. There’s a sense of urgency for public health workers to publicly address COVID-19, but the public health community is always working on addressing communicable (contagious) disease, and non-communicable ones as well!  

In public health, we divide our work into ten essential services, and all of them are coming into the forefront now. These services fall broadly into three core functions—Assurance, Policy Development, and Assessment.

Assessment includes collecting and analyzing the major causes of illness and death in the community, and what factors might be causing them. In the case of COVID-19, this would be all of those maps you have seen that tell you where the coronavirus “hot spots” are, and also the information we have seen about who seems to be at higher risk for developing the disease.

Policy Development happens when we take that data and work as a community to develop the rules that will help people live their healthiest lives. In the COVID case, this is the decision of federal, state, and local governments to enact “stay at home” orders to prevent the spread.

Finally, assurance means that we are making sure that needed services are available, and ongoing monitoring the quality of these services. In COVID, this is the ongoing conversation about PPE for providers, workers able to provide testing for community members, and the availability of providers to take care of non-COVID care, such as routine vaccinations, broken bones, and delivering babies. In your state, and possibly also your county, you have a Board of Health made up of public health officials, and regular community members, that keep track of the local health concerns in your community. Often these meetings are open to the public, so if you’re interested in hearing about public health in your community you can sit in on them.

HOW ARE PUBLIC HEALTH LEADERS COPING WITH NEW WORK CHALLENGES DURING THE PANDEMIC?

While emergency management and disaster preparedness are an integral part of public health, no one feels fully prepared for a pandemic. Fortunately, in the US, we have a number of crisis management lessons we have learned from public health responses to Ebola, the “Spanish flu”, and HIV. Although with trying to maintain their normal (non-COVID-19) health promotion work, most public health departments are calling on all of their staff to use their skills and experiences to help ramp up the epidemiological work—this includes counting cases, offering testing and helping to craft the re-opening directions.  Public health teams are also coordinating with health systems and community organizations to get out the word about the risks, educate about prevention and start contact tracing programs.

WHAT WOULD YOU SAY TO SOMEONE WHO HAS AN EMERGING INTEREST IN THE FIELD?

The possibilities of public health are boundless. Public health covers a myriad of issues—from chronic disease, to violence, to housing, to substance abuse, to climate change. Public health touches citizens throughout the life course, in big cities to small towns. Public health happens in hospitals, schools, health departments, community organizations, faith-based organizations, and beyond. I would tell them that if they have a passion for helping community members be the best version of themselves, then there is likely a place for them in public health

WHERE CAN PEOPLE GET THE BEST INFORMATION ABOUT COMMUNITY HEALTH/PUBLIC HEALTH (SERVICES, FACILITIES, OPPORTUNITIES?)

Every state in the United States has a public health department; most counties, and some cities do as well. I would suggest looking at those websites—they can offer some information about the pressing issues near them. Many counties regularly conduct a Community Health Needs Assessment that gives a useful snapshot of the community’s health, and often the most important governmental and non-governmental players are co-authors or partners in the data collection and writing of this assessment. You can even look up the health outcomes for your zip code! Nationally, the National Institutes of Health and the Centers for Disease Control and Prevention will give you the overview of the nation’s health, along with information sheets about health issues, written in an easy-to-read format. Internationally, the World Health Organization will offer similar overviews for locations around the world.  

WHAT IS THE MOST IMPORTANT THING FOR ALL OF US TO UNDERSTAND ABOUT PUBLIC HEALTH TODAY?

The pandemic has unfortunately highlighted some of the areas of growth in our local, national, and international public health infrastructure. We will get through this, and the silver lining of this—if there can be—is that citizens understand more deeply the value of the public health infrastructure, and there are likely to be more organizations seeking workers who are able to be nimble in the face of health crises, so any public health-related skills/knowledge you acquire will be advantageous. In seeing how the pandemic has impacted income, education, housing, and health care, this crisis has also highlighted the value in a “health in all policies” approach to life. I anticipate that more organizations—whether they are explicitly health-related or not—will be taking into account the lessons learned from the pandemic in their planning for the future. Understanding the interconnectedness to health and all other parts of life will be an immeasurably useful skill for any graduate to have.

Read more about the Master of Public Health Program at Creighton University.