Janie, a Program Supervisor at the Kent County Health Department in Grand Rapids, Michigan, is applying her global public health training on slowing the spread of HIV, to her hometown health department where she works to slow the spread of COVID-19.
After graduating from Brown, you worked in Rhode Island at the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals as a project director, but you’ve recently moved back to your home state of Michigan where you work at the Kent County Department of Health in Grand Rapids. Tell us about your position.
I work as a Public Health Program Supervisor at the Kent County Health Department (KCHD) in Grand Rapids. I work in an area called the Center for Community Health Strategy, which focuses on working with communities to address and improve upstream social determinants of health. I also oversee our Academic Health Department, which (pre-COVID) hosted an average of 10-12 student interns each semester. Students come to us from both undergraduate and graduate programs across Michigan (and occasionally outside of Michigan!) to work in a variety of hands-on public health practicums. Much of our work in the Academic Health Department has transitioned to virtual learning for the time being.
I also supervise three staff that do a range of work, including running coalitions, designing and implementing the Community Health Needs Assessment, working with community members to develop messaging for emerging health issues, and facilitating Health Equity, Social Justice workshops. Finally, I oversee our Public Health Accreditation Board accreditation process, which gives me a comprehensive understanding of the inner workings of the health department. My favorite thing about my role is that my workday varies week-to-week and there is always something new and interesting to dive into!
Cases of COVID-19 and test positivity rates are currently rising in Michigan. How has your role at the health department been impacted by the pandemic?
In early April, my job duties shifted to responding to COVID in our community. Initially, I served as a COVID investigator, calling people who recently tested positive for COVID and asked them about their symptoms, other people they may have been in contact with, places they had recently traveled, whether they worked during their contagious period, etc. I provided information about how to isolate and for how long. We made sure people understood we were a resource to answer their questions.
If a positive case was in contact with other people while contagious, we would call those people and let them know they may have been exposed to COVID and they should quarantine. We followed up with patients throughout their isolation or quarantine period, and I would often work with people far beyond that point as well.
In the early days, a significant portion of my role was trying to stay current as information and guidelines changed. There were frequent meetings and communications and I am lucky that the staff at KCHD are so incredibly dedicated to their work. Anytime I spoke to a community member and had questions, I always knew who to call. It was really hard work, but I always felt supported.
I served as a COVID Investigator for about four months. I now serve with other COVID Leads and we each manage teams of investigators. In my role as a Team Lead, I have more capacity to be involved in the administrative and management aspects of our COVID response.
With the State Supreme Court striking down Governor Whitmer’s emergency orders requiring face coverings, limiting gatherings, and closing bars, it is now falling on county health departments, like yours, to enforce restrictions. How effective are regional orders compared to state-wide mandates?
Thankfully, the Michigan Department of Health and Human Services stepped in shortly after the Michigan Supreme Court struck down Governor Whitmer’s COVID-19 Executive Orders. They are using their authority to issue Epidemic Orders, some of which overlap with mandates originally in the Governor’s Orders. It is extremely helpful as we navigate our work for there to be state-wide mandates in place.
Cases of COVID-19 are increasing throughout the country and Michigan is no different. There are a number of factors that are contributing to this increase. Cooler weather is causing more people to spend time indoors with non-household members, and people are unfortunately growing tired of safety measures and are complying less. We sit on the cusp of the holiday season, which likely means people will be traveling more and spending time with people they don’t live with. I have concerns this will all contribute to even higher numbers of positive cases.
I encourage everyone to continue taking necessary precautions; wearing a mask, washing their hands often, staying 6 feet away from people they do not live with, and working from home if/when possible. We’re all in this together. We have to try and stay positive while we keep doing the right thing.
How did you first become interested in public health?
I first became interested in public health while working at a children’s nutrition clinic in the Dominican Republic. The organization offered a mobile medical clinic once a month to neighboring towns and settlements, in addition to their work in the nutrition clinic. I participated in several mobile medical clinics and saw an overwhelming number of people with serious health needs seeking care. Despite the tireless work of the physician and nurse that were attending these folks, they didn’t have enough resources or staff to sustainably address all their health needs.
It was one of the first times I really considered the fact that some solutions need to be systems-based. Even if I went on to become a doctor, I would still only be one person with 24-hours in my day. That experience made me realize the commitment of good people to providing quality care isn’t always enough to address huge health inequities. I returned home and started to learn more about public health and the social determinants of health, which ultimately led me to seek a Master of Public Health.
What brought you to Brown University?
It goes without saying that Brown University has an outstanding reputation. I learned that Brown had a Global Health Concentration in their Master of Public Health program. I also saw stories featured on the Brown MPH website of students who had traveled to South Africa to participate in research focused on HIV/AIDS. I was interested in infectious disease and I knew I wanted to get involved in similar work. It was an easy decision to apply!
What was your experience in the MPH program like? How does your training impact your current role?
I had a great experience in the Brown MPH program. The staff and faculty were accessible, and I felt supported throughout my time at Brown.
My area of study was Global Health. I was interested in infectious disease, particularly tuberculosis and HIV/AIDS. I learned so much at my internship in the township of Gugulethu in Cape Town, South Africa where I worked with Professor Mark Lurie to perform a rapid ethnographic assessment of a men’s sexual health clinic.
For my thesis project, I used data collected in a community-based clinic in Cape Town to examine partner notification methods in resource limited settings. Partner notification strategies are designed to control the spread of sexually transmitted infections (STIs), but in places were providers do not have enough capacity to contact the partners of patients who test positive for STIs, they must depend on patients to alert partners themselves. I looked at which partner notification approaches—face-to-face, phone, text—were preferred by patients. Improving patient-delivered partner notification may increase the likelihood of partner’s actually being notified about their exposure to an STI, such as HIV.
These experiences, in my coursework, internship, and thesis project, developed my critical thinking skills, my understanding of data, and my knowledge of important topics like health equity and social determinants of health. I also gained experience juggling competing deadlines; something I contend with every day in my professional life!
My MPH also gave me a network of public health professionals to bounce ideas off and discuss important topics with. I benefit immensely from conversations with my classmates who I still talk to often. This year has not been easy, but it has been made easier by talking to people with shared experiences.
Do you have advice for current public health students, especially at this extraordinary moment?
My advice to current public health students is this: The world needs you now more than ever! At no time in recent memory has it been clearer that public health is a necessary— and interesting—field of study. There is so much variety in what it means to be a public health professional. We need dedicated folks with a mind for innovation to step up and help shape the post-COVID public health landscape.