Share Public Health podcast transcript: Leah Casanave, Every Hero is a Person

Season 1 Episode 6

Ian Buchta Welcome to a collaborative episode of From the Front Row and Share Public Health, two podcasts produced from the University of Iowa College of Public Health. I am Ian Buchta, a host and producer for From the Front Row, a podcast produced by University of Iowa College of Public Health students, to share public health, to provide conversations in public health with established and emerging leaders in public health. I am thrilled to be partnering with the Midwestern Public Health Training Center’s podcast, Share Public Health, which connects 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 in to this series of interviews with young public health leaders in our region.

Thank you so much for coming on the pod today, Leah. Can you state your name, organization, and position within that organization?

Leah Casanave My name is Leah Casanave and I supervise the STD prevention and control program at the Douglas County Health Department, which is a local health department in Omaha, Nebraska.

Ian Buchta Thank you so much for coming on the pod today. Congratulations, again, on this prestigious honor of being named the de Beaumont 40 Under 40. Can you talk a little bit about the project that got you on this list? The take-home kit project?

Leah Casanave Yeah, so that was one of the big ones that we kind of started to do and we’re still attempting to roll that out, trying it in different avenues, and seeing what’s going to work the best. To be 100% honest, I started in this position three years ago. When I started, they had had some testing events already occurring. We had been testing in our public libraries and community centers for the last eight years. I think we are over now, I think we are at ten years, so this is something that’s been going on in our community. We’re a recognized entity and I don’t want to take credit for stuff that I didn’t do, but I’m here. I think of my job as bragging about my group and the work that they do. I’m kind of their way to push that forward so that they can get recognized. So that’s been going on. What we thought was, for sustainability reasons, how can we make this project and STD testing accessible to everyone any day, any time, and anything along those reasons? If we can’t be there, how can we make sure that those items are available for people? We started working with one of our community colleges. It’s got three different campuses in Omaha, one on the north side, one on the south side, and then one out west. We worked with them and we partnered with some other organizations to try and see what was feasible. That project is still kind of in the pilot-phase. We’re still working through that, but word has gotten out that we’ve done that. Now we are trying to have other college campuses have that same project. We’re working with two other local colleges that are here and are willing to work with us, so we can kind of push this forward.

Ian Buchta Have you had any preliminary results with this so far that you can share?

Leah Casanave At this moment, I don’t have the results with me, but once we get some stuff, I’m more than happy to share where we’re going with that and what we end up finding out.

Ian Buchta Awesome. If you don’t mind me changing directions a bit, as you’ve gone about this project, how has systems-thinking informed your work? Why is systems-thinking important?

https://www.train.org/cdctrain/course/1064819/Leah Casanave We really need to as a health department. We have to know what’s going on around us, how can we be sustainable, what organizations are out there, and how we can collaborate in order to basically save money or find out how to do these projects that we haven’t had the funding to do. I think that’s one of the big things of recognizing what’s going on, learning about your community, and learning what potential opportunities are out there that you can collaborate with.

Ian Buchta Great, thank you so much. Change management is an essential skill for public health and in most fields, so do you think about change management in your role?

Leah Casanave Yeah, there’s been several different areas. In my group we’ve got, just to give you some background on what my program consists of, two STD HIV prevention specialists, one community health educator, four disease investigators, and two and a half secretaries, essentially. We kind of joke that they touch every STD in our county. So, with them, we got our outreach program that’s going and we’ve also got our disease investigation, which takes a lot of time and effort. These people are the hidden gems, I think, of STD prevention because they’re not seen all the time, but they do a lot of the background work. They are the ones really preventing that disease from spreading further. When it comes to looking at change and how stuff can be done, at least in my role, don’t make big changes right away. Get to understand the program, understand what’s going on, what works, and what doesn’t in your area. Then, once we kind of figured that out and saw where the trends were going and our rate, I said something’s got to happen. We’ve got things that are increasing and rates that are going up. We need to get a handle on what’s going on behind the scenes. Is there particular age groups, is their locations, I don’t know, it was something that we weren’t quite sure what was going on. One of the big changes we made when I – I wouldn’t say first started, but within maybe eight to nine months – was having my disease investigators interview all the gonorrhea cases that came into our county. That was because we were seeing the rates increase, so how can we determine what’s going on and get some information. It was not taken well at first, but we realized what was going on and I started to show them the data that was coming back as to why this group might be going up, or this group might be going down. It was good in the sense of we were able to monitor those changes and eventually we got a handle on what was going on. Now, we’ve started to cut back on some of those interviewing cases because other things are taking precedence at this point. Knowing how to recognize what changes are needed and when, and then knowing that that may not be something that is a permanent change or something that is going to stick around forever, I would say is one of the key points.

Ian Buchta So it sounds like you and your team have been able to be pretty fluid with the different changes that have come up in your field of work. How can professionals develop skills to manage change more effectively in the way that your team’s been able to adapt?

Leah Casanave I think recognizing who’s on your team, and that’s a skill that you can only really get once your knowing them, and they’re in-person and talking to the people. Get to know who you’re working with. This is my team and I rely on them for a lot. I know one person is extremely good at entering stuff, like they are a computer guru. She is my go-to when it comes to computer items and helping me fix this programming. Then I’ve got people that are very detail-oriented and know how to get from A to B in a very detailed, procedural way, which we also need. You need every piece of this. Recognizing who’s on your team and how they may take change, and preparing them differently for how they plan to attack it, in sense. So, how might professionals learn, right? I would say I’ve had some really great mentors along the way and that’s been incredibly helpful. Having people that you can turn to and say hey, look, I’m having a problem with this, can you help me? Don’t ever be afraid to ask for help. That’s one thing I’m known for. I don’t know if that’s a good or bad thing, but if I don’t know something, I’m not going to pretend to know it. I’m going to ask the folks that know what’s going on.

Ian Buchta In previous episodes of From the Front Row, we’ve talked to different people about mentoring. One question that I think a lot of people had from those earlier episodes was how do you find a mentor?

Leah Casanave Oh man, that’s a great question. So, I think I was lucky. I was very fortunate. I went to the University of Kentucky for my master’s and my doctorate, and just fell into some really great mentors that were there. When working through that program, some of the teachers that I had there, even teachers that weren’t necessarily in my area, I became very close with and I still talk to them to this day. Referring back to them and saying, hey, do you know who I could contact here? I tend to talk a lot in general, so I try to keep those connections open in making sure that I am still in contact with them. I’m willing to hit up anyone if I need something and I know that this person is really good at what they’re doing. I’m not afraid to contact them and just say hey, so and so referred me, can you help me with this problem I’m having? In order to find a mentor, I started with someone that I admired and worked with at Kentucky. I asked him, can you help me? Here’s what I’m looking for in a mentor, here’s where I’m at in my career, and this is kind of what I’m looking to get into and where I want to see myself grow. He gave me three different people to talk to and I talked with them. They all had great backgrounds and were very helpful and willing to help. So it’s pretty easy if you find one person and then ask them who might they refer as a mentor based on here’s where I want to go, this is what I want to do.

Ian Buchta That’s great advice. If you don’t mind me broadening it a little bit, what advice to you have for students considering public health and students embarking on their public health careers? I guess that’s two questions, so let’s just start with what advice do you have for students considering public health?

Leah Casanave So, I’ll kind of give my background story a little bit in this piece. I went to Creighton University for undergrad and I swore I was going to go to medical school, which I feel like a lot of us end up in that realm. At Creighton, we have to take theology or philosophy classes. It’s one of the Jesuit values that we have to focus on one of those two. I ended up taking more philosophy classes and ended up being a philosophy minor. From there, I realize, it was the classes that I took in that was bioethics and all of this, and really learning about public health in general, epidemiology, and learning that this field existed. Beforehand, I just thought I wanted to be this cool doctor that investigates diseases and goes out in the Sahara Desert and lots of these stupid movies, to be quite honest. But, I was fascinated by them, so that’s how I ended up in this world. A lot of us tend to think medical field, but now that public health is a new and up-and-coming path, I think it’s fantastic. I work with a lot of the undergrads here and try to get them to see what areas of public health are there. I show them all the different programs that we have in our health department alone. Even in the classes I’ve taught I remind folks that whatever you’re interested in, be it, you know, from Iowa. I had a professor that was interested in farm safety, but he did a ton of epidemiological research that was based on tractor rollover bars, which stuff like that people don’t think of, but depending on where you’re at, there’s always something related to public health wherever you are or whatever interest you might have. I think finding what you enjoy, like find something that you’re interested in and that you can talk about for hours, and find out how public health has a role in that. Then, once you get that piece down, talk to your local health department. I think we’re all pretty friendly here and we’re happy to meet with students or folks that are coming back and want to go back into public health. We’re always happy to talk and share our experiences. So I guess that’s the one piece of what I would recommend. There was a second question there I believe, wasn’t there?

Ian Buchta Yeah, so the second question is for people, young professionals, or students who know they want to go into public health, and maybe they’re in their last year of college or grad school. What can they do to better set themselves up or to accelerate their careers?

Leah Casanave One of my dearest friends worked at the CDC for a while and now she works at Centers for Medicaid, and I was talking with her the other day. We both have differing ideas on how this happens. It more or less depends on the person, but as I mentioned earlier, I’m all up for just emailing and calling people, saying hey I got your name, how can I get involved with this? I put myself out there without really doing a whole lot of background research, which sometimes comes back to bite me, I get that, but it’s just how I operate. I’m happy to go talk to anyone that I know exists in that area, just give me a way to contact them and I’ll talk to them. Where my friend, on the other hand, researches and finds out what this person has done, does all the background research, and knows what she’s stepping into a little bit more than I do, but may be more hesitant to reaching out to people right away. I don’t think there’s harm in either way, I’m not really giving an answer to that question, but I think looking at both directions, they’re both really good. It just depends on your personality I think. But, really creating connections when you can and how you can in whatever way you feel comfortable.

Ian Buchta It’s so interesting – I’ve been able to over the last year that we’ve been doing this podcast – to talk to all of these different public health professionals, and all of them when I asked them what is the most important thing, they always tell me go build relationships. I think that’s really an interesting testament to our field.

Leah Casanave Yeah, I would say that that’s really the connections that you create in our field. It is small, when you think about it. Public health has been around for forever, but it’s now growing popularity. It’s becoming, we always joke, the sexy topics. They’re coming around and people are realizing that that’s what public health is. Like, oh, they do that? So having those connections will help you build programs and help you get through stuff easily. We typically never really have enough funding to do what we want. We have big ideas, but we can’t push them forward because we don’t have the dollars. If you can find those relationships and connections with community partners, or even state and federal partners, you might have more opportunities to try and push stuff forward, and say listen to my idea, I think this is worthwhile.

Ian Buchta Yeah, so kind of going off that last point, in how to convince community partners and lawmakers to get involved, what tips do you have for persuasive communication and getting people to buy into the important of public health and public health programs?

Leah Casanave Oh man. So, as you are aware, I work in the STD prevention office. I also live in Nebraska. So, it’s a little bit tough here to get some of the things that we want through because we are typically more a conservative state, so really trying to get the buy-in on some of these things . . . There is a college here that is a very conservative school and we are actually working – the stars aligned – and we are actually now going to start pushing to do STD testing on campus. Granted, there are some things that we can’t talk about, but they’re actually letting us come in there, which has never been done before. So we’re excited because all of this happened. Know who your partners are. As I mentioned with this university, they’re conservative, but they’re willing to work with us as long as we state we’re not going to talk about this, we’re going to respect you, and know that’s not your values, but we’re here to really just protect the health of students. We’re here for that disease prevention piece. I think that’s really beneficial. Right now I can really speak to the STD world. I’ve done some work with chronic disease, but my passion is in what I’m doing now. I think that persuasive conversation is just knowing and listening to your partners and collaborators and hearing what they might be interested in and how you can work together.

Ian Buchta I really like the point that you made about really knowing your partner and building that relationship with that community partner in order to make an incremental change that might not have been the huge glorious public health change the world at every single step, all at once, but it is still a huge step.

Leah Casanave Yeah, I think a lot of our work is dealt like that. We do these baby steps. In our community, we’ve changed so much even since I’ve been in this position. The stuff that’s been allowed has changed so much. More and more things and ideas are opening up. People are more willing to let us come in and we do have more opportunities. We’ve got condom boxes throughout town at bars, barber shops, and pharmacies. All of these folks are willing to let us in because I think we are a reliable source, but we don’t push what we know. We don’t push the limits to the sense of making folks uncomfortable. We’re only there to say hey, when you’re ready, let us know and we’re happy to come in and provide this information. Or if it’s just being there as a support to say yeah, we can help with that, just let us know when.

Ian Buchta Yeah, that’s a really interesting perspective on this. If you don’t mind, I’m going to change directions a little bit here again. So, we’ve been talking about how you get to funding and how you get people to buy-in. Let’s talk about if you had the ability to change one thing in public health, and time and money weren’t factors. If you got a magical wand with one use and you could change one thing in the world of public health or in the work that we do, what would it be?

Leah Casanave Oh man, that’s a really tough question. I have a thousand things spinning in my head. Looking at where public health is today, and I even think like I said, in my program – I don’t want to speak to other things – but even here we’ve seen how social determinants of health and all of these things play such a role in every aspect of public health. Every inch of it is covered by this. So if I had unlimited time and money and could do whatever I wanted, it would somehow – I don’t even know how this would happen but – work on those inequalities that exist and work in creating equitable situations for folks. Somehow being able to make that happen, like I said, I have no idea. It would take a lot to make all of this happen because there’s just so many differences. Anyways, I guess that’s where I would probably focus my magic wand.

Ian Buchta Alright, thank you. Just two last questions. The first is what is one thing that you thought you knew but later realized that you were wrong about?

Leah Casanave I make sure that any time I get students that come in and they’re either coming to visit and shadow for a day or are doing their internships with us . . . When you see all of these zombie shows and hospital shows that talk about disease outbreaks and that kind of stuff, which is like I said, that’s the sexy public health stuff right now, I think a lot of people get tainted by those, thinking that’s what public health is. Well, there’s so much more on the backend. Such a small piece of public health is that piece. I wish I would have known one, how much paperwork is required of me to do anything and I’ve gotten used to it now, but that’s one of the things. I guess another thing that I learned when I worked at the state – and hopefully this doesn’t come off as a bash to anyone – but I used to think that folks at federal level organizations were these end-all be-all’s, but they’re just like us. I think that was the one thing that I took to myself and now have a fun time with it. Just realizing that these are folks that I may have gone to school with or that I met at a conference. I just have to remember that things may happen, stuff may get messed up, but they’re just like us. So, I guess those are my two things, I don’t know.

Ian Buchta I like that second point a lot that every hero is a person. The last question is a little different. What’s one thing outside of the world of public health that’s really caught your attention or amazed you?

Leah Casanave Oh, outside of public health. Let’s see. One, this is just a funny comment I think to myself, but I’ve been in the public health realm and now when I got outside and look at other things, that’s all I notice. Maybe seeing the change of how media and technology and all of that has become so different and has such a different effect than when I was younger. Even, for example, seeing how much stuff has changed, like I think the MTV VMAs were on the other day and I didn’t know a single person on there. These are just some of the things that keep me up at night, I don’t know.

Ian Buchta Well, Leah, thank you so much for your time to come on the podcast today.

Ian Buchta Thank you for joining us today. Special thanks to our guests and to members of our planning committee Sonja Armbruster, Hailey Boudreau, Katie Brandert, Ian Buchta, Maya Chilese, Stacey Coleman, Brandon Grimm, Suzanne Hawley, Abigail Menke, Melissa Richlen, Hannah Shultz, Laurie Walkner, and Kristin Wilson for guidance in creating this series, and to the de Beaumont Foundation for creating the 40 Under 40 list and connecting us to the impressive honorees. Funding for this podcast is provided by the Health Resources and Services administration. Please see the podcast notes for an evaluation and transcript. This podcast is brought to you by the University of Iowa College of Public Health. If you want to hear more of either of the two podcasts that are collaborating today, you can find links to our shows in the show notes. Don’t forget to subscribe. Alright, have a wonderful week everybody.

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