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Public Health Laboratories Can Play Important Health Equity Role

By Melanie Padgett Powers, writer

Public health laboratories can play an important role in improving the health equity of their communities, experts said during a May 10 APHL 2021 Annual Conference session, “The Public Health Laboratory’s Role in Promoting Health Equity.”

“Public health and health in general should be about community — and that’s no different for laboratories across the country,” said Umair Shah, MD, MPH, secretary of health, Washington State Department of Health. “It can’t be about what’s happening in the laboratory, but it has to be about what’s happening outside and how we impact what’s happening in those communities.”

Promoting equity in a community starts by hiring and training a diverse public health workforce. Focusing on diversity, equity and inclusion (DEI) of the workforce improves relationships with communities, decreases inequities and can lead to better health outcomes in communities, Shah said. The Washington State Department of Health promotes cultural humility, provides on-the-job training, implemented non-discrimination and anti-harassment policies, increased accessibility and accommodations, and implemented equitable recruitment, hiring, promotion and retention practices.

For example, Shah directed the public health laboratory to ensure that any educational requirement for a job position is truly necessary and that a person’s lived experience will be considered in lieu of those requirements in some cases. “We can’t always be thinking about the degrees, but [we need to] think very carefully about what are the biases that we are putting in place when we ignore lived experience,” Shah said. “That is absolutely critical in our recruitment processes.”

The department of health has also invested in training that celebrates diversity, promotes equity and encourages employees to be allies. In 2020, the department created safe spaces for employees to process racial trauma. Employee resource groups were created for employees who share common characteristics and interests to gather. There are required trainings on diversity and inclusion, sexual harassment prevention and “outward mindset,” which is when employees acknowledge that others matter and focus on collective results. Leadership teams are encouraged to read and discuss the book How to Be an Antiracist by Ibram X. Kendi.

DEI in Milwaukee

In Wisconsin, the City of Milwaukee has adopted a city-wide racial equity action plan that recognizes that racism is a serious threat to public health. That commitment certainly extends to the city’s health department and public health laboratory, said Sanjib Bhattacharyya, PhD, laboratory director and special deputy health commissioner of the City of Milwaukee Health Department.

“We are constantly working toward increasing diversity in our workforce, retention and career advancement, and diversifying engagement within the health care organization,” Bhattacharyya said.

Currently, city laboratory staff is 56% white, 18% Black, 15% Asian American and 11% Hispanic. Staff is 70% female and 30% male.

In the staff interview process, candidates are given a diversity, equity and inclusion questionnaire and are interviewed by a diverse panel.

Recruitment efforts start early with a focus on promoting public health careers among middle school, high school and college students, focusing on students in underrepresented groups. The health department has created affiliation agreements with about 15 universities and colleges for internship opportunities, again focusing on underrepresented groups.

Workforce retention is a critical component as well. The health department offers tuition reimbursement and has established employee resource groups for both racial and ethnic groups and common interests, such as community service and career development.

The department also has a strong global health equity focus. This includes providing learning opportunities for international students including multiple Fulbright scholars. “We are very fortunate to have those students and have their learning and understanding,” Bhattacharyya said.

Public health has long had an invisibility crisis, but the COVID-19 pandemic has raised the visibility and need for a strong public health workforce, Shah said.

DEI also received a lot of attention this past year, said session moderator Marilyn Bibbs Freeman, PhD, M(ASCP), deputy director of the Division of Consolidated Laboratory Services, Richmond, Virginia.

While a lack of DEI has created long-term obstacles that have resulted in poor health outcomes, Bibbs Freeman said, the public health workforce “is uniquely qualified to take action to address such inequalities and to promote diversity, equity and inclusion. … Public health departments can address DE&I for the betterment of the communities that we serve.”

APHL 2021 Annual Conference is being held online May 4-20, 2021. View the final program and follow #APHL to join the conversation.

Melanie Padgett Powers is a freelance writer and editor specializing in health care and public health.

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