Wednesday, June 22, 2016

Guest Post by Brandon Baird (Dec '17)

Brandon Baird (Dec '17)

Society likes to compile and categorize occupations to fit a mold. It’s usually a straight path where tasks and activities are clear. Becoming a dual-degree professional is a challenging journey that can lead you down multiple roads because the relative newness of dual-degree programs still carries a uniqueness into the workforce. The combination of the master of public health (MPH) and master of social work (MSW) has grown to become a solid partnership. Public health inevitably creeps into social work as if it were the friend that always was welcome in your home; social work can also lend a hand to public health, even if the reciprocity is not always apparent. Dr. Joseph Telfair, a dual-degree wizard as he has been a piece in starting several MSW/MPH programs around the country, explained that every challenge has multiple factors at play, stressing the importance of understanding the levels of the ecological model from the individual to the environment.
A public health social worker (PHSW) is a professional that can understand and help meet the needs of the individual to support the population’s well-being. By using interpersonal techniques of social work in the framework of public health knowledge, a PHSW can read between the lines to have a greater understanding of an individual’s needs and how to reach those needs. Although this may seem complicated, a clearer picture is painted when you identify the common values between the two disciplines: elimination of health disparities and promotion of social, economic, and environmental justice (Sable et al., 2012). These shared values and ethics between the disciplines show how to accomplish goals from both sides that seem one-sided.
My realization of the integrative nature came when I shadowed a social worker at a low-income health clinic in Atlanta. My usual tasks included calling patients in order to help them schedule appointments from regular check-ups to mammograms to a number of other health services. The people I came in contact with usually did not know how to schedule their own specialty appointments or navigate the Medicare or Medicaid system that was more of a burden on their shoulders than a boost under their feet. I felt good about myself, but I also came to realize the nature of the hierarchy of needs. Most people I helped had some form of income and a house to call home. However, I also helped a mother who did not have a place to stay other than her daughter’s dorm room. This could have built into a bigger situation, but I was able to use my resources with United Way to find some temporary housing for the mother to stay. The spectrum of situations that can arise in the setting I was in was long spanning, and none of these situations could be labeled as simply public health or social work.
Although research is limited, the identity of public health social workers in the workforce is beginning to be evaluated. When comparing dual-degree graduates to MSW-only graduates, Ruth et al. (2006) found that both groups had high employment and career satisfaction. However, the flexibility of the kind of job was apparent as 80% of MSW-only graduates held strictly social work occupations compared to just one-third of dual-degree graduates. A more recent study focused on the kind of education PHSWs would benefit from by analyzing what skills the dual-degree graduates used most. Sixty-three percent of the graduates labeled themselves as PHSW and used both skill sets while only half said they had the ideal integrative job (Ruth et al., 2015). This speaks to the workforce not exactly being prepared for dual-degree professionals, but dual-degree professionals still finding ways to utilize the skill sets that were learned with both degrees.
Even with the skills from both areas being used, Dr. Betty Ruth of Boston University believes that dual-degree professionals have a chance to better integrate more disciplines. She wrote “MSW/MPH programs are not just educational enhancement; they have the potential to become the profession’s building blocks for transdisciplinary and interdisciplinary collaboration” (2015, p. 193).
Similar to interdisciplinary collaboration, transdisciplinary collaboration integrates components such as perspectives, concepts, and theories while also using these components to be creative by generating strategies and techniques to address, and hopefully solve, problems (Stokols, et al., 2013). This kind of collaboration goes through a fluidly sequential set of four phases: development, conceptualization, implementation, and translation. Although collaborative groups would like to flow through these phases in order, there are times where you have to take a step back and make some corrections to your original strategies.
The role of the PHSW in this kind of context is to be able to bring a greater holistic view of the situation at hand. First, the PHSW should go through a collection of steps in order to identify the problem. The three pieces that go into fully understanding the problem is identifying the locus of the problem, identifying key modifiable contributing risk factors, and identifying key issues related to adoption, which leads to an effective solution (Johnson-Reid, et al., 2013). These three pieces are important because it will help the PHSW identify what community partnerships need to be mobilized in order to help advocate for policy changes, provide and increase access to services, educate the community, and evaluate the efficacy of the intervention or program as a whole (Hall & Rounds, 2013).
Consider you are trying to reduce the rate of violence among adolescents. Possible collaborators may include medical personnel, law enforcement, social services, teachers, parents, and coaches. With so many perspectives and ideals that can present themselves in this hodgepodge, leadership is crucial for reaching the intended goal as the separate entities that make up the group have their own agenda and limited power in which to make change. However, dynamic delegation can bring out the best of the group by having each entity do what they can do best in order for the group to strive at full capacity (Dow, et al., 2013). Sometimes polarizing figures will be at the same table with stakeholders that will disagree about plans of action the majority of the time. No one likes to have their toes stepped on, especially when people feel like their way will make a lasting impact. The key is to avoid the crunch and hopefully just give the toes a tap. With leadership, the PHSW can help find the middle ground because understanding how to work through disagreements is critical for the growth and success of the collaboration group.
I am not sure where my journey will take me, but I do know my dual-degree education will mold me into a versatile professional. Of course my attractiveness in the workforce will be boosted, which does matter. By the same token, the multiple perspectives I bring to the table as well as understanding the perspectives of other’s that are at the table will increase the probability for effective and meaningful change. That is what matters most about being a public health social worker.

-Brandon Baird, MSW MPH Student (December 2017)
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References
Dow, A. W., DiazGranados, D., Mazmanian, P. E., & Retchin, S. M. (2013). Applying organizational science to healthcare:  Framework for collaborative practice. Academic Medicine, 88(7), 952-957.
Hall, W. J. & Rounds, K. (2013). Adolescent health. In R. H. Keefe & E. T. Jurkowski (Eds), Handbook for public health social work (pp. 58-80). New York, NY: Springer.
Johnson-Reid, M., Drake, B., Weaver, N., & Constantino, J. (2013). Transdisciplinary approaches to violence and injury prevention and treatment among children and youth (Chapter 10). In D. Haire-Joshu & T.D. McBride (Eds), Transdisciplinary public health:  Research, education, & practice (pp. 217-247). San Francisco, CA: Jossey-Bass.
Ruth, B. J., Marshall, J. W., Velasquez, E. E. M., & Bachman, S. S. (2015). Teaching note: Educating public health social work professionals: Results from an MSW/MPH outcomes study. Journal of Social Work Education, 51, 186-194. 
Ruth, B. J., Wyatt, J., Chiasson, E., Geron, S. M., & Bachman, S. (2006). Teaching notes: Social work and public health: Comparing graduates from a dual degree program. Journal of Social Work Education, 42(2), 429-439. 
Sable, M. R., Schild, D. R., & Hipp, J. A. (2012). Public health and social work. In S. Gehlert & T. Browne (Eds.), Handbook of health social work, (pp. 64-99). Hoboken, NJ: WILEY.
Stokols, D., Hall, K. L., & Vogel, A. L. (2013). Transdisciplinary public health: Definition, core characteristics, and strategies for success (Chapter 1). In D. Haire-Joshu & T.D. McBride (Eds), Transdisciplinary public health:  Research, education, & practice (pp. 3-30). San Francisco, CA: Jossey-Bass.