Date of Defense:
October 5, 2018
My field experience was completed with Washington County Public Health and Environment. Due to the broad scope of public health, implementation of policy, programs, and services are divided between federal, state, and local health departments. Washington County Public Health and Environment focuses on an array of topics that are relevant to residents of Washington County, Minnesota. During my field experience, I was able to work closely on two projects that focused on gaps in health equity among residents and the presence of tick-borne illnesses. In Washington County, there is a growing awareness of gaps in health equity and renewed efforts to reduce or eliminate these gaps among residents. Washington County is also considered a high-risk area (Washington County Public Health and Environment, 2016) for ticks and specific information regarding their prevalence and the disease they carry is a common concern for residents.
During the field experience, I focused primarily on two projects. The first project was creating an info graphic to summarize a recently completed report on health equity among county residents. The report was entitled Health Equity Data Analysis (HEDA) and specifically focused on the impact of income on mental health and physical activity among residents. This report gathered information from 90 residents through 10 focus groups conducted in 2017. The participants identified barriers and positive influences on their mental health and physical activity and discussed what the county could do to further improve these areas. The Minnesota Department of Health (MDH) funded the HEDA project and outlined the steps of the data analysis. When I joined the county, they were focusing on how to reconnect and engage with their stakeholders by bringing the information back to participants. I created three info graphics that summarized the report findings in an easily understandable format. These graphics were created with MDH’s guidance on best practices for communicating information about social determinants of health (Minnesota Department of Health, 2018). Our goal was to create a graphic that was easy to read and understand by our participants, co-workers, policy makers, and the community at large. We selected our words, images, and format with all of these groups in mind (Minnesota Department of Health, 2018). I brought these info graphics to one of the locations where people were recruited for the focus groups and shared the information with the community members present.
The second project I worked on was tick surveillance, specifically by participating in two tick drags. The first tick drag was at two private residences in Cottage Grove. This area was selected because one of the homeowners found several dead rabbits on their property in 2017 that tested positive for tularemia. Tularemia is a disease that can be spread by ticks, is transmittable to humans, and can cause potentially life-threatening symptoms (Centers for Disease Control and Prevention, 2016). This tick drag was done in partnership with the Minnesota Department of Health who wanted to know if the rabbits contracted tularemia from the ticks in the area. The second tick drag location was the Lake Elmo Park Reserve. This is an on-going location for the county’s tick surveillance. The tick drags were an intervention for disease prevention and control that was coordinated by the county epidemiologist, in collaboration with a state health department epidemiologist, and led by a member of the county tick work team. The state epidemiologist set the protocols and procedures for the tick drags, following best practice guidelines (Carroll and Schmidtmann, 1992). Additionally, the tick work group sponsored a booth at the Washington County Fair, offering education and free resources on ticks to the public.
The learning objectives for this field experience were met through these two projects. Both projects offered experience with health promotion within a community and illustrated the framework of various public health programs and services offered at a county level. The health equity project offered experience with needs identification, planning, organizing, and evaluating a county level public health program or service through the analysis of the impact of income on two key determinants of health. Finally, the tick drags also offered experience utilizing disease surveillance, prevention, and control strategies within a specific community.
This field experience was completed with the Public Health and Environment department in Washington County, Minnesota. This is a local, county level public health department in the east metro. Washington County has a total population of 253,128 residents (Washington County, 2018). The Public Health and Environment department employs about 100 people. The vision statement for Washington County is “a great place to live, work, and play…today and tomorrow”, while the mission statement is “providing quality services through responsible leadership, innovation, and the cooperation of dedicated people” (Washington County, 2016). The Public Health and Environment department goals are to “prevent the spread of infectious diseases, promote healthy lifestyles, and build healthy communities” (Washington County, n.d.). My field experience fit well with the vision, mission, and goals of the county and due to the shared focus on health promotion, disease control, and the overall health of the public.
Through my field experience I learned several important lessons. First, I was able to experience the complexities of a county public health department and witness firsthand the variety of projects and services a public health department can offer their community. Through this experience I was able to see how involved public health can be in a community – from organizing health fairs at a local college to rewriting policies in order to promote equity to offering education at a county fair, the public health department works with the community in numerous ways. Second, I learned much more about health equity, including how to identify existing gaps and how to begin reducing the gaps through services, programs, and policies. With the health equity project, I also realized the importance of bringing information from the community back to them in order to maintain healthy partnerships.
I recommend that Washington County Public Health and Environment, or other similar organizations, continue to offer a variety of programs and work groups for interns. The variety of experiences helped capture the diversity of a public health department’s scope. I recommend that health equity analyses continue to be conducted within the community, with a clearer focus on specific topics and an action plan towards reducing identified gaps. Additional efforts to communicate the identified health equity gaps with policy makers and the broader community should be considered. Tick surveillance should also continue in the Lake Elmo Park Reserve control site and other concerning areas, as needed.
Throughout my field experience at Washington County Public Health, I was able to deepen my understanding of a county public health department. My experience illustrated how varied the programs and policies managed by public health can be, and how it takes interdisciplinary teamwork to truly promote and protect the health of the public. This experience underlined the importance of acknowledging and reducing gaps in health equity as well as the multifaceted of disease prevention and control within a community.
- Carroll, J.F. and Schmidtmann, E.T. (1992). Tick sweep: modification of the tick drag-flag method for sampling nymphs of the deer tick. Journal of Medical Entomology, 29 (2), 352-355.
- Centers for Disease Control and Prevention. (2016). Tularemia. Retrieved from: www.cdc.gov/tularemia/index.html
- Minnesota Department of Health. (2018). HEDA: Conducting a health equity data analysis, a guide for local health departments in Minnesota. St. Paul, MN: Minnesota Center for Health Statistics, Minnesota Department of Health.
- Washington County. (2018). 2018 Demographics at-a-glance. Retrieved from: www.co.washington.mn.us/DocumentCenter/View/20145/2018-At-a-Glance?bidId=
- Washington County. (n.d.). Public health services. Retrieved from: www.co.washington.mn.us/582/Public-Health-Services
- Washington County. (2016). Vision, mission, goals, and values. Retrieved from: www.co.washington.mn.us/2016/Vision-Mission-Goals-and-Values
- Washington County Public Health and Environment. (2016). 2014 Washington County Infectious Disease Report. Stillwater, MN: Washington County Public Health and Environment.