Delivery of Care

Beyond fear and loathing in public health

The director of the master’s program in Public Health at New England Tech offers her views on the public health enterprise

Photo courtesy of Magali Angeloni

Magali Angeloni, DrPH, MBA, the director of the Master of Public Health Program at the College of Graduate and Professional Studies at the New England Institute of Technology.

By Richard Asinof
Posted 8/17/20
With public health in the spotlight, it requires a better understanding of what public health actually is and the kinds of work and career opportunities it can provide.
What would be the best way to ferret out misinformation about public health concerns and the coronavirus pandemic? Why is it so difficult for people to properly wear a mask in public? Are there possibilities for greater collaboration between nursing schools and public health schools in Rhode Island? When will there be a unified database that brings together information on the diseases of despair – alcohol, drugs, suicide, gun violence and domestic violence?
Ana Novais, the deputy director at the R.I. Department of Health, has accepted a new position in state government, working as the Assistant Secretary of Health for the R.I. Executive Office of Health and Human Services, under Secretary Womazetta Jones. She will be slowly transitioning to her new job, beginning on Monday, Aug. 17.

PROVIDENCE – It can be confusing to talk about public health during this traumatic time of the coronavirus pandemic, when all of the nation’s networks and systems for health care delivery have become stressed out from the overwhelming demands of testing, diagnosing, treating and caring for millions of patients.

Worse, the definition of “recovery” has become equally blurred, because many “survivors” continue to be hobbled by lingering health consequences caused by the virus – including damage done to the kidneys, to the lungs, to the heart, and to the brain. The novel nature of the virus means that health professionals do not know all the long-term ramifications of what recovery from the coronavirus will entail.

Public health is different from health care delivery; understanding the differences becomes an important component of fighting back against the virus and halting its spread. As Dr. Peter Simon, a retired pediatrician, said in a recent tweet: “Our health care system was designed to maximize return on capital. Why would anyone expect it to be ready to respond to a public health crisis?”

Equally problematic, the conversation around the public health concerns of the coronavirus pandemic have become politicized, with the President, among others, purposely spreading false information: wrongly comparing it to the flu, falsely claiming that children are immune, falsely claiming that wearing a mask does not matter, arguing the illogical syllogism that more testing creates more cases, and hyping unproven drug treatments as beneficial.

The virus does not discriminate; it is apolitical; and it is an equal opportunity ambusher.

In an attempt to put public health in its proper context in Rhode Island, ConvergenceRI reached out to Magali Angeloni, DrPH, MBA, the director of the Master of Public Health Program at the College of Graduate and Professional Studies at the New England Institute of Technology. Here are her responses to a series of questions:

ConvergenceRI: So much has been written about “public health” during the current coronavirus pandemic. Could you provide a "reframe" in terms of defining “public health” and what it entails, and where it comes from?
ANGELONI: Public health professionals work to keep communities healthy. While health care professionals focus on caring for one patient at a time, public health takes action to protect entire communities. Public health practitioners develop policies, inspect facilities and set regulations to help prevent people from getting sick.

When we promote safe practices such as breast cancer screening, consuming fruits and vegetables, wearing seat belts, getting an annual flu shot and keeping public housing and restaurants smoke-free, we are doing the work of public health professionals. We also track diseases and health issues, so we have large databases for immunizations, lead screenings, cancer, communicable diseases, etc.

Public health touches everyone’s life, every day, wherever you are. If you have safe drinking water, buy groceries from inspected establishments, dine at a smoke-free restaurant or swim in clean beach water, you are receiving the benefits of public health.

ConvergenceRI: What kinds of new careers are emerging in public health? How has the coronavirus changed the perception of public health?
ANGELONI: The COVID-19 pandemic is the largest single event of our time that has made public health the topic of conversation at families’ dinner tables. Most people understand that in a pandemic, public health professionals are a valuable resource. They are witnessing the work of their respective health departments to keep communities safe.

This is accomplished by informing the community, providing resources and collaborating with other entities. We have witnessed this happening every day during the past several months, and for the first-time public health in action has become widely visible.

Public health workers have expertise in many areas such as epidemiology, policy, communications, data analysis, environmental health, informatics, law, financing, management, occupational health, infectious disease and more. There is always a need for new expertise.

For example, after the 9/11 tragedy, health departments developed a nationwide infrastructure of emergency preparedness, which we now use for events like hurricanes and epidemics. The nature of our profession is the constant challenge to develop expertise in areas of which we were unfamiliar such as SARS, Ebola and now COVID-19.

ConvergenceRI: What kinds of investments are needed, from your perspective, in public health infrastructure in Rhode Island, beyond a new state health lab?
ANGELONI: I’d leave that question to be answered by health department authorities, but given my more than 20 years of experience as a public health practitioner, I’d say that investments are needed in building improvements, some of which lack large meeting rooms and state-of-the-art equipment, and streamlining government processes.

Procedures to hire staff with updated job descriptions, promptly contract services, acquire new technology, train the workforce, exchange resources and foster innovation need to be further developed. Of course, this is easy to say but difficult to do.

ConvergenceRI: Why do you think there appears to be such antipathy and anger directed at public health officials doing their jobs?
ANGELONI: It may be because public health officials are employed by government entities, and the government can be an easy target for criticism. I tell my students that public health agencies may not always have sufficient funding; therefore, an important skill to develop is the ability to properly prioritize available resources and work in partnership with public, private and academic institutions.

ConvergenceRI: What are the promises and what are the concerns regarding digital health platforms and wearable devices? What kinds of data should we be paying attention?
ANGELONI: We all know technology can help us to work smarter not harder, so government should have access to state-of-the-art technology to work more efficiently. It takes additional funding, streamlined processes and trained staff to replace unnecessary steps with more digitalized functions.

There is already a great deal of health-related data in the state. We need to combine datasets and examine those results in depth to learn more. But analyses require skilled data analysts and epidemiologists and these resources are rather sparse for the sizable datasets we have. As a result, we are not able to fully utilize the current data that policymakers need to consider policy improvements.

ConvergenceRI: What opportunities are there for greater collaboration in public health education between New England Tech and Brown University, for instance?
ANGELONI: NEIT and Brown University share common as well as different characteristics, which presents a wide array of possibilities. NEIT offers associate, bachelor, masters and doctoral degree programs in areas such as architecture, engineering, information technology, digital media production and criminal justice in addition to several health sciences programs. In addition, NEIT offers online programs that have been nationally recognized.

The one common program NEIT and Brown University share is the Master of Public Health [MPH]. NEIT trains practitioners with management skills via its online program [www.neit.edu/mph] while Brown University trains researchers on campus.

Opportunities for collaboration abound especially when we consider interprofessional education. Imagine the results of a collaboration between students in NEIT’s master’s degree programs in Engineering Management, Public Health and Nursing or Post-Professional Occupational Therapy Doctoral program, paired with students from Brown Medical School and supported by a research grant.

We could also include students from NEIT’s Graphics, Multimedia and Web Design bachelor’s degree program. Collaboration requires a great deal of work, but the potential benefits for all students and communities are worth the investment.

ConvergenceRI: What haven’t I asked should I have asked, that you would like to talk about?
ANGELONI: The public health profession is diverse. Individuals with a Master of Public Health degree can find employment in a variety of areas such as program management, health education, wellness, research, communicable diseases or data analysis.

There are job opportunities in financial services, non-profit agencies, community-based organizations, government, policy, consulting, media firms and more. The possibilities are endless, so I urge young people to consider a Master in Public Health degree.

Presently, the public health workforce is comprised of approximately 75 percent women and 25 percent men, so we need to encourage more men to consider a public health career.

For working professionals who wish to earn a Master of Public Health degree, NEIT’s online program is a great choice to consider. I’m always available to speak about the public health profession, and I’m just an email away at mangeloni@neit.edu.

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