Share Public Health Podcast Transcript: Health Should Be a Shared Value. An Interview with Sue Hassmiller.

Season 1 Episode 10

Laurie Walkner Welcome to Share Public Health, the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country, highlighting that we all share in public health. Thank you for tuning into this series of interviews with public health leaders where we learn about different perspectives on current and emerging public health issues.

Suzanne Hawley Thank you for joining us today with our leadership series. I’m Suzanne Holley and I’m from the Midwestern Public Health Training Center, and we’ll be talking about strategic skills in public health from real public health leaders from a personal perspective. So, we’re glad you’re here today, so why don’t you tell us a little bit about yourself and we can get started?

Sue Hassmiller Okay, thanks Suzanne. So, I’m Sue Hassmiller. I am the Senior Advisor for nursing at Robert Wood Johnson Foundation. For the next two years, starting in January, I’ll be at the National Academy of Medicine helping to lead the brand-new Future of Nursing 2030 report, so, very interestingly because, my foundation started all over this you know culture of health stuff four or five years ago. We have really been directed as staff to really engage heavily and I was so excited as a public health nurse. I was the study director for the first Future of Nursing report and that started a national campaign so that nurses and lots of people all over the country could implement those recommendations. Since Robert Wood Johnson, again, started the culture of health work we have been working with our action coalitions all over the country- nurses and others- to engage more around the social determinants and health equity. So, this new report at the National Academy of Medicine has to do with nurses addressing the social determinants and health equity. It will be launched in 2020, in December. We’ll have a big party- balloons and confetti- and we’ll be, you know, working on a new era at the foundation with nurses really more heavily invested in this culture of health work so really exciting stuff.

Hawley Wow, so that sounds really exciting to me, and I was going to ask you what excites you right now the most about public health, so I don’t know if that’s kind of what you’re-

Hassmiller Well, yeah, you know, honestly just- just to go back in a moment like all nurses, we sort of all start out- or we did back when I was a nurse decades ago- we started out in acute care, and I was a coronary care nurse and I saw people- I call it the revolving door- you know, they would come in, they would get their medication, their procedures, and even way back when operations they would go back out they would smoke and eat and do all this kind of stuff, and honestly it was a revolving door, and- and I thought to myself, I didn’t even know there was such a thing as public health to be honest with you. I was a young, acute care nurse, and wanted to save the world but it just wasn’t making sense to me at all. And then I got a master’s- I went on for my bachelor’s and master’s and got more into community health like that, oh, this is like fascinating we can- we can prevent these diseases or we can prevent the complications of these diseases in the first place. We could work more upstream- I didn’t use that word way back then decades ago. So, I think that’s what excites me most- my own career- that has moved from the beginning one of acute care, which is really important when we need nurses and acute care- that’s really important, but to move into public health and to understand prevention, and I love all of this work that we’ve gotten into at the foundation- Robert Wood Johnson Foundation- around social determinants and health equity, it is making connections for nurses today that they have not really been a part of, and it’s so fascinating because Lillian Wald, right? The mother of public health nursing? She would say what’s up with you people, right? This is how I started, this is how public health nursing happened back when I was practicing. I worked with all of these partners. I knew that if kids were sick they couldn’t go to school; people were sick they couldn’t go to work. That is what is addressing the social determinants and social needs means, but we’re getting back to it now and we’re getting back to our roots and that’s what most excites me.

Hawley Wow, so it sounds like we’re coming full circle-

Hassmiller We’re coming full circle.

Hawley But, we have the benefit of new technologies and understanding and we’re just smarter about what we know now and-

Hassmiller I hope so. It takes, you know, even though we know these things, it does take public will and it does take- it does take money, too, but looking at other countries who are so far ahead of us with their with their health indicators, right? They have better quality of life; they- they don’t have as much heart disease and maternal morbidity and mortality. It’s so fascinating that we’re a country that’s so far behind in these indicators. So, we know these things, we know other countries are doing better, but we’re very medicalised… we’re very- it’s going to take, well…

Hawley So, if the field of public health is changing as you said, you know, some of it is coming back to our roots to really address the challenges in public health- the 21st century issues that are facing us today, what do you think are the skills that leaders and public health professionals need to address- change management- I mean all this change?

Hassmiller Yeah, I think there are two things that we need to really focus on: one, we’ve been focused on for a long time- I’ve been in public health for a long time, and we’ve always talked about, you know, what are our messages? They have to be crisper, people have to understand them, we have to really translate our messages so that a normal person and other people that we work with can understand; that we bring value to their equation- whatever their equation is- and I think, again, so it’s communications, and I hope we’ll come back to that again. The other thing is working with other partners. When I came to the Robert Wood Johnson Foundation 20 years ago, or something like that, we were working with physicians and then eventually we started working with nurses and a few other people. But, never before in my life in my time at Robert Wood Johnson Foundation have we, as a foundation, been working with so many sectors. We’re working with business and the faith community and Fire and Rescue and NAACP and the Heart Association- all of these sectors, and it’s because- that we believe health should be a shared value. It’s not enough that a nurse or a doctor believes that health is important. Is- it, it’s not enough if we want to move an entire nation. If we want a healthier country, we want healthier people, then every sector must feel that they’re involved. So, what’s the skill that we need as public health nurses? We need to be very, very comfortable in working with other people. Nurses are great. I mean I love being with my people, my nurses. I love it, you know, but it’s not gonna get us far if we really want to create system change and make our lives healthier and more well.

Hawley So, I guess I want to kind of catch on that word you just used: systems change, systems thinking, so what do you think systems thinking has to do with leadership and addressing these issues?

Hassmiller Well, you know, interestingly so systems thinking- systems thinking means that you’re thinking of the entire system, not just health. What’s fascinating to me, in this country, I believe, is that we have a great separation a divide between health and the economy. There’s all this talk about the economy and investments and- and- and money, and everybody’s going back to work and this is what we got to do. But, but honestly if we ain’t healthy, we can’t go to work. We had- we had the- the senior vice president for human resources of Best Buy on our campaign, or Future of Nursing campaign advisory board, and people would ask him, why are you on a nursing committee to keep people healthy? And he would say at Best Buy we need our people to show up and be healthy and come to work. And so I think the business community gets it. We need to make stronger connections, so really looking at the system that health has to do- has everything- to do with the economy is really important, and if you can get the business community to understand that and they do they want their people to show up healthy, but they need the big picture and they need to know what they can do about it, and we need them to act.

Hawley So, you’re saying, you know, it’s the business community as a critical partner that we need to kind of be a little bit more out there when we look at partners. I’m wondering, are there other partners that you think we need to more fully engage?

Hassmiller Well absolutely, of course. And, and I rattled off the list earlier, but, you know, the faith community, people in- in the volunteer center, in the schools- the schools are really important to get principals, and- and the- the school councils involved, teachers, it’s endless.

Hawley So, you kind of mentioned-

Hassmiller And I say everybody.

Hawley -yes, and, you know, you talked about health equity and that being a really important piece of what you do, and I’m wondering about if you could say a little say again, or- or kind of come back around to health equity and what these partnerships can do.

Hassmiller Yeah, people understand people- need to understand what health equity is. It’s, it’s interesting because my foundation does a lot with research and communications. We want to make sure when we communicate something that everyone understands what we’re talking about and we’re throwing out a lot of buzzwords these days, and buzzwords that some sectors of our country don’t want to hear, you know. They’re in their bubble and they don’t want to hear that other people are having sort of trouble getting along because they’re doing just fine, thank you. Right? You know, so health equity, what does health equity mean? It means that everyone just has a fair and just chance at being healthy, and well, and I always add that word well, because if- if we just say everybody should just be healthy, that’s not realistic. We do want people to be well, so, you know, it’s- it’s just really important that everyone knows that if we’re going to succeed as a nation, and I’m gonna say economically, because that’s like the biggest thing in this country- that we are the strongest, most powerful economic nation in the world, right? Okay, so play on that, so if we want to be the most- that, the strongest country, economically, we really have to make sure that all boats rise in this country; that we all have a fair and just chance- because of just some of us have a fair and just chance, it’s gonna pull down the rest of us. It won’t pull down everyone because there’s a certain sector who will always do well, but we really need to focus on, you know, everyone having a fair and just chance so that we can be this strong economic nation that we so desire to be.

Hawley So, you know, when you talk about kind of raising everybody up together, you’re not doing special interests, you’re really focusing on people you might not even know exists- groups- and I think it might go back to communication, you know. You, you said that was a critical issue and I think persuasive communication is becoming increasingly more important, and I’m wondering what aspects of communication do you think will really further the dialogue, to have a real dialogue, to make this kind of change?

Hassmiller So, I have I have a pretty strong opinion about this because being it in public health we’re really good about talking about, well maybe, you know, if this happened maybe we should consider that, and we’re all about maybes and ifs, right? I think public health and, and some people in public health are really good at this, but we really need to capture the drama of the moment. Look at us as a nation, we- even our cartoons… I have a two- and a five-year-old grandchildren, the cartoons are all about drama, right? Everything on TVs, that our country is about drama. We seem to love it we seem to love it, so why not capitalize on that? We’ve got to jump on when something happens, when a flight attendant is in a coma because of measles, and people are afraid to fly. That affects the economy. We need to jump on the drama when kids are not able to go to school, and other kids, because they haven’t been vaccinated, can’t go to school. That means their parents have to stay home from work, and a lot of people are staying home from work. Don’t you think that affects the economy? So, we need to, you know- the flu, the opioid crisis, we need to jump on the drama of the moment, and that’s where I’m coming from. Yes, I think it’s lovely that we have data and we talk about prevention and we can do all that, but in the heat of the moment, when people’s ears are open, we- we shove things in.

Hawley Yeah, I think you have a great point because I always say, people don’t think public health is sexy, you know? It’s not, you know, the TV, the nightly show, with the McDreamy hair or whatever, you know, so how do we really create that- get the heat going, you know, in terms of these issues? And so we’ve talked – you’ve talked a lot about some important critical ideas in public health and what leaders need to know and just public health professionals in general, and I’m wondering, are there any other things or skills that you think would be helpful to really further prepare professionals for the future of public health?

Hassmiller Well, okay, so I’ve talked about the power of communication, the power of getting out of your comfort zone and working with other people; I think when people are in school, that is such a prime time. Whether it’s in nursing or public health- a health field- I think that just to get your feet wet with- with a lot of different experiences, don’t come out of school and get into one, you know, one thing immediately. I think some of the greatest leaders public health leaders in our country have gotten their feet wet with a lot of different experiences, and that’s what I would really recommend. And in a professional, you know, education is so important. Make sure even in school that you’re working with others. And I think the last thing I would say and sometimes, this is a little bit controversial because I know everyone works really hard- nurses work so, so, so hard, but to get to know your- the community that you’re working in, and sometimes you can best do that through volunteer work. Because sometimes people will say to me, how can I volunteer? I’m already working 12 hours a day, and how dare you ask me? But I will tell you that I’ve learned all of my beginning skills through community volunteer work and getting out in the community and speaking to everyday people in plain language. That is what has brought me my greatest skills.

Hawley Wow, so you know at first I’m thinking this is great advice for someone who is just starting a career in public health, but really I think at any phase of your career, to really think about exposing yourself to new things, especially when you kind of get more and more focused over time, that- that- that lifelong learning and to become more prepared as is what you need to do, is what you said.

Hassmiller Yeah, and I will say one more thing- maybe- unless you ask me another question, but very importantly, nurses need to get themselves on important policy making decision boards, okay? There are a lot of decisions taking place these days around, let’s just say, the social determinants- you know, transportation and housing and food and trauma- there are a lot of decisions being made by people who don’t have this strong health voice or a nursing voice. Sometimes nurses say what would I- what value could I add? But it’s a real dearth. People are trying to make these decisions, and if they could understand, again, big systems thinking, in their decisions about transportation, if they knew that the road they were building was increasing noise, or- or accidents or something, if there was somebody on their committee or board that would talk about health, it just makes so much sense. We have an organization now called Nurses on Boards Coalition to help nurses who want to get on boards so, I would highly recommend that.

Hawley Okay, great, great. And, you know, listening to you makes me think about, I mean really not even a board of- of health where that might be more obvious, but really any policy issue, politics, elected positions where you might not think about, you know, “I’m in clinical care,” or “these things seem so far apart,” but really, maybe you don’t run for office, but you support the candidate who is much more aware and an advocate for health.

Hassmiller Yeah, I think nurses should get involved. That, that is really another key message of it is, you know, through work what you can do? Through work, volunteerism, and being on boards, and- and mentoring the next generation? That is so critical; to be that- that person, that safety net, that promoter of people who are just coming up and- and helping your own in your profession is really so critical.

Hawley Well, I know that you’re a great example of mentoring others and a role model for others, so I really-

Hassmiller Try to be!

Hawley -I thank you for this time today because I think it’ll really help others think about what’s- what are issues today, how can we think about issues tomorrow- be better prepared for them? And it’s just been a real pleasure, Sue, talking with you today. Thank you so much for your time.

Hassmiller Thank you.

Hawley Thank you for tuning in to our leadership series, we hope that you’ll continue to watch other sessions with our leaders and we’ll talk to you soon.

Laurie Walkner Thank you for joining us today. Special thanks to our guests, Shirley Orr, executive director of the Association for Public Health Nurses, Suzanne Hawley, Roger Hileman, Melissa Richlen, Hannah Shultz, and Laurie Walkner.

Funding for this webinar is provided by the Health Resources and Services Administration. Please see the podcast notes for an evaluation and transcript.

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