#UMNMCH student Kaitlyn Traub (MPH 2022) wrote this reflection on how her deployment with the Title V Maternal and Child Health Block Grant Team at the Minnesota Department of Health has contributed to her career in MCH. Her work with briefs at MDH highlighted the importance of describing systems impacting the health of Minnesotans. In this piece, Kaitlyn shares how intentional, equity-based reporting practices can change the way populations are described in Minnesota and the impacts such reporting can have on health.
It took me many years to finally pinpoint public health as the career I wanted to settle on. I have always wanted to use my knowledge to do something. Public health offers many opportunities for direct applications of knowledge to address the needs of communities and make an impact on the lives of people. My time working with Augusta Victoria Hospital (AVH) through The Lutheran World Federation deeply impacted my understanding of public health. I knew I wanted to find a role where interventions now would have impacts in future generations, which led me to apply for the Maternal and Child Health MPH Program here at the University of Minnesota. While the populations I am interested in working with have shifted since the start of the program, I am constantly reminded that this is where I want my work to be.
TITLE V MATERNAL AND CHILD HEALTH BLOCK GRANT
I have been very fortunate to be working with the Title V Maternal and Child Health Block Grant team within the Division of Child and Family Health at the Minnesota Department of Health. This team is currently focused on reporting the work of the 2021-2025 funded Block Grant Program. Eleven priority areas were identified through a community needs assessment and are the focus of programming efforts. The bulk of my work has centered around creating Priority Briefs, public-facing documents reporting the status of the priority areas in Minnesota and the State’s plan to address these areas.
WHAT’S IN A BRIEF?
These priority briefs are intended to give an overview of each priority area for the general public and provide current data that could be used by colleagues in MDH for their own work. I focused on the briefs for Infant Mortality and Boys and Young Men. As a team, we wanted the briefs to highlight success stories and to emphasize the systemic factors contributing to persistent and extreme disparities in Minnesota. For example, the infant mortality rate in Minnesota is lower than the national average and has been declining in the past three decades (Minnesota Department of Health, 2021). But there are huge disparities within our population. The gap between American Indian and White infant mortality rates in Minnesota is one of the top five in the nation (Hirai et al., 2021). Infants born to American Indian birthing parents in Minnesota are about three times more likely to die than infants born to White birthing parents. This disparity is not because American Indian families do not know how to care for their children. It is because there are numerous, systemic factors that contribute to poor birth outcomes.
Some of these factors can be more easily measurable, such as a lack of transportation infrastructure or insufficient funding for education. Other systemic factors can be much harder to measure or quantify. For example: the impact of historic, biased policies, particularly if not explicitly codified; the effects of historical trauma on the body; and the negative and racist interactions with healthcare facilities that lead to mistrust of medical institutions. These are all very influential factors in the infant mortality disparity we have in Minnesota. Too often, these factors have not been explicitly identified in data reports. In reality, we rarely collect data to describe these factors. Components of systemic factors may be collected, but the process of creating comprehensive variables can be time-consuming and still not fully capture the factor. State health departments generally have not started the process of identifying methods of measuring systemic factors. For some small populations, data are suppressed for identity protection. While data suppression is ethically needed, this practice can in effect, erase the stories and experiences of historically oppressed communities. We need data to be representative and we need to represent the implications of the data responsibly.
SHIFTING THE FOCUS FROM POPULATIONS TO SYSTEMS
A lot of public health work has focused on highlighting and enumerating disparities in populations. Data describing populations have historically been presented in ways that place blame on communities. Unfortunately, this can still happen. When writing these priority briefs, our team worked hard to highlight the systemic factors out of the control of individuals which deeply impact communities. These briefs have been an improvement, but there is still much work to be done. Creating standards of inclusive language within organizations, including MDH, is needed. Engaging communities and including them in decision-making not only when conducting needs assessments and developing programs, but also when reporting data outcomes is crucial to narrowing disparities. Working with communities, instead of on communities, can also help drive a fundamental shift in public health. Rather than only focusing on deficits and needs, communities and public health practitioners can highlight the strengths of communities and build upon those foundations. As a new practitioner entering the field, I have learned skills to report data responsibly and equitably. My work with MDH has helped me identify areas of improvement and challenged me to have a strengths-based mindset. I look forward to incorporating these lessons into my work in the future.
Kaitlyn is a second-year MCH MPH student with minors in Epidemiology and Sexual Health. She has a varied background from international non-profit work to microbiology laboratory work (sometimes she really misses being in the lab). She received a Bachelor of Arts in Biology from Wartburg College in Waverly, Iowa where she found a need to use her interest in science to serve communities, both locally and globally. In her free time, Kaitlyn is an avid knitter, loves to bake and cook, and enjoys hiking and running. After graduation, she intends to stay in the Twin Cities area and work within programs focused on adolescent health.
Minnesota Department of Health. (2021, March). Infant Mortality. Retrieved from https://www.health.state.mn.us/docs/communities/titlev/infantmortality2021.pdf
Hirai, A.H., Sppenfield, O., & Uesugi, K. (2021). Region 5 Infant Mortality Data Disparity Report. Health Resources and Services Administration.
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