Author: mnabavi

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“What keeps you coming in?” Dr. Lisa McCormick asked the room of officials and directors at the Mississippi State Department of Health (MSDH). We, the students, fell silent, leaning in to understand why. Why continue fighting against health disparities in Mississippi? Why continue fighting against the conflicting values of culture and politics and religion and community? Why keep taking on additional roles amid an ever-shrinking budget? Why?

“We want to make a difference for the folks in Mississippi,” said Kathy G. Burk, Director of Health Services.

“The need,” said Dr. Paul Byers, the State Epidemiologist. “The role we fill is unique.”

“The diversity,” said Meg Pearson, Pharm. D., Director of Public Health Pharmacy, referring to the group of people working together with different strengths and experiences towards the same goal of a healthier state.

            Many youth and adults in the Bible Belt take trips around the world each year – mission trips with their churches or youth groups designed to create an experience for Americans to minister to people in different countries. However, the United States contains places and communities that are in just as desperate need of support and care as a developing nation. According to Mitchell Adcock, CPA, CIA, CFE, CPM and Chief Administrative Officer, this state is one of those places. You don’t have to look far to see poverty and suffering. The people of Mississippi are in great need of additional health services. And the people that were in the room before us on this Monday are tasked with planning, implementing, and evaluating programs to deliver these services. 

  The atmosphere in the room was heavy with equal parts humidity and the weight of the responsibility of improving public health in one of the states with the most drastic health disparities. Public health services are not valued by the public until there’s a disaster. Additionally, ongoing disparities don’t often affect the most powerful and influential politicians or their constituents. After a series of budget cuts and administrative reorganization, the MSDH is trying to spread their resources over competing demands, including maternal and child healthcare, disaster preparedness, preventing and treating HIV infections, preventing and treating tuberculosis, and providing education to promote healthier behaviors.

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            While accomplishing this, officials must sashay through bureaucratic red tape, pirouette around cultural barriers, and glide in step with community organizations. Toes get stepped on. Sometimes they stumble. But fighting against the powers that be won’t create better health outcomes. And so they dance, working with partners in federal, state, and local government, places of worship, non-profits, community leaders, and rural areas. Their mission doesn’t belong to a political party or affiliation. All they want is for the people of Mississippi to thrive and prosper in health and well-being.

The social, environmental, and economic factors that influence both individual and population health outcomes (social determinants of health) for Mississippi residents are many. In the shadow of the Antebellum South, Jim Crow law, and systemic racism, Mississippi has the highest percentage of black residents than any other state in our nation. While schools teach abstinence as the only method of sexual education, teen pregnancy rates soar. While communities enjoy cultural southern delicacies, Type 2 Diabetes, and Hypertension claim lives. While stigma effects those living with HIV, rates of new infections in Jackson, MS rival those of underdeveloped nations. Competing values clash, and the most vulnerable residents are left in the wake.

            To address health, the MSDH can’t merely address prevention and disease treatment. Instead, they must waltz with Washington, cha-cha with community non-profits, tango with hospital systems, foxtrot with public education, and tap dance with religious organizations. They wake up and put on their figurative dancing shoes daily on behalf of Mississippians.

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We left the building with a newfound appreciation of the complexity and balance required for statewide public health practice. It’s certainly not an easy task but a worthwhile and necessary one. While Mississippi has a long way to go to reach health equity, it has a team of dedicated and passionate professionals fighting or dancing in its corner.

Team C³ – Claire, Courtney, and Catherine

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Today we loaded the bus and left for Jackson, Mississippi. But before we get to our first stop, we wanted to share what we’ve been doing to prepare for the trip.

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We started on Monday, May 7^th learning about principles of effective teamwork.  We did a couple of team building exercises, the most memorable being around team communication.  Students were broken into teams of three and each team member was assigned a specific role:  Looker, Runner, or Builder.  The Looker was responsible for looking at a simple structure built of tinker toys and relaying instructions to the Runner on how to begin recreating it in another room.  The Runner, who was not allowed to see the structure personally, then relayed instructions between the Looker and the Builder who were separate rooms.  This exercise demonstrated how hard it can be to communicate simple instructions and how easily a message can be misinterpreted!  One student, Tessa Graham, stated that this was one of the best team building exercises she had ever participated in and that it really drove home the point of how hard it can be to communicate between stakeholders who have different viewpoints or come from different backgrounds.   

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Next, we had the opportunity to visit the UAB Archives and talk with Tim Pennycuff, Associate Professor and University Archivist.  Mr. Pennycuff brought out many historical documents that related to the themes and topics that we will be discussing in this course and sites that we will be visiting.  He highlighted historical events and discussed how these events have shaped the health disparities we see today.  “It was exciting to see our very own Dr. Michael Saag in newspaper clippings from the 1980’s at the forefront of the battle of HIV/AIDS” said student and UAB employee, Claire Auriemma.  Especially knowing that he is still working just as hard today through the UAB Center for AIDS Research and the 1917 Clinic to reach the goal of zero new HIV infections in Alabama.

And finally, students collaborated on drafting working definitions of key themes we will see when on the road: population health, health inequities, and social determinants of health.  Each stop along the way was researched by student groups and introductory information was presented to the rest of the class before we set off on our journey.

All of this to say, we are excited, prepared and ready for what we will see and learn over the next two weeks!

Stay tuned for more blog posts from the UAB SOPH Explorers!

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Fifteen students will travel from Birmingham to Mississippi, Louisiana and Georgia to study population health and how social determinants of health and inequities are affecting health outcomes. The trip is led by Lisa McCormick, DrPH, associate dean for Public Health Practice and associate professor of environmental health science in the School of Public Health and Ms. Meena Nabavi, MPH, program manager for the Office of Public Health Practice.  

A nuclear test site, a tuberculosis sanitarium, and a quarantine station designated in the late 1800’s are just a few of the stops students will make on a two-week long journey that looks at both historical and contemporary public health issues across the deep south. Students will explore issues around poverty, pollution, infectious disease outbreaks and biosafety, chronic diseases, natural disasters and mass casualty disaster response. Officials from local, state, tribal and federal public health agencies will meet with students to discuss programs and infrastructure in place to advance health equity and address the social determinants of health impacting the populations they serve.  

The sum of this experience will illustrate the interdisciplinary nature of public health practice and introduce students to the value of working in rural, medically underserved communities and/or on behalf of medically underserved populations.  

The sites we will be visiting include Baxterville, Mississippi (population 7,343), where nuclear weapons were tested in 1964 and 1966 as part of a governmental project at the Salmon Test Site, Ft. Massachusetts on Ship Island, Mississippi, where one of the nation’s first quarantine stations was located, the lower ninth ward in New Orleans where effects from Hurricane Katrina can still be seen today, Tuskegee, Alabama to learn about the legacy of the Tuskegee Syphilis Study, and the Carter Center in Atlanta to learn about President Carter’s initiative to eradicate Guinea Worm across the world.  

Students will also visit the Mississippi State Department of Health, the New Orleans Health Department, the Poarch Band of Creek Indians Tribal Health Department, the Southwest District of the Alabama Department of Public Health, and the Centers for Disease Control and Prevention.  The Alabama Department of Agriculture and Industries will open the doors of the Thompson Bishop Sparks State Diagnostic Laboratory in Auburn, AL to teach students about the surveillance and monitoring of animal populations.  Auburn University School of Veterinary Medicine will meet with students to discuss the intersection of human and animal medicine. 

The students will leave Birmingham on May 13^th and return on May 25^th and will be blogging every day!  So make sure you bookmark our blog and follow our adventures daily!