First published on May 14, 2015 in observance of the COPH’s 30^th anniversary celebration.

Long before the deluge of online learning became a given of modern education replete with a glut of overnight “universities,” USF’s College of Public Health launched a distance-learning presence that was formidable before online classes even existed.

From 1990-93, 45 state health department employees in Tallahassee earned master of public health degrees from USF via the old-fashioned method of distance learning.  Every Tuesday, a COPH professor would journey to Tallahassee to teach a three-hour course that evening, said Dr. Charles Mahan, at that time state health officer, and later COPH dean.

Dr. Charles Mahan

“We gave them Tuesday afternoon off, and they gave up their evening,” Mahan explained.  “One professor would come up for a month and do the whole core segment of epidemiology and biostatistics, and then somebody else would come up and do the whole core of community and family health.

“When people in practice throughout the state at the health departments saw what we were doing up there, they came to the college and said, ‘Please, do that for our staff.’  That’s when we began the distance-learning program.”

Technology offered a more efficient means by 1994, when COPH began beaming public health courses via satellite to 33 host sites at state and local health departments across Florida.

Answering a mandate

“USF College of Public Health had a very good partnership with the Florida Department of Health,” recalled Sandhya Srinivasan, COPH director of educational technology and assessment, “and through this partnership, we were able to deliver public health education while utilizing health department meeting space and satellite equipment that was already part of the Florida Department of Health satellite network.  We were able to piggyback on that and beam our classes to busy health professionals.”

Sandhya Srinivasan, MPH, MEd

WUSF-TV had an uplink facility, Srinivasan explained, which enabled COPH to buy satellite time at the discounted educational rate.  The telecasts were cabled to the uplink facility in Clearwater, then beamed to the satellite from there.

As part of the founding of the college a decade earlier, USF and COPH had a legislative mandate to train public health employees statewide, Srinivasan said.  A needs assessment at the time signaled the need when it found that very few public health workers had had any formal public health training.

“They had come to public health through medicine or nursing or sociology, but they were not trained in public health,” she said, “and so the college had a huge challenge in front of it.”

Two evening courses were initiated to meet that challenge, she said.  Each met once a week for three hours, and each had an on-site technical point person should the satellite or any link in the technology fail.  Technical and material needs were communicated via phone or fax in those days before the advent of personal computers and e-mail.

Given those limitations, early growth was slow, but within a few years, the need for more courses and faster, easier means of delivery coincided well with the PC age.  In 2001, Srinivasan said, technical advances and growing interest in the program sparked its rapid expansion.

“We started incrementally,” she said, “moving our classes from satellite to a blended online-and-satellite format.”

The Department of Education weighed in with a $3-million grant for instruction in technology.  That IIT grant, as it was known (standing for Innovations in Technology and Training), enabled the college to hire instructional designers who brought in multi-media components that completed the transition from satellite-online hybrid to a fully online operation.

From online courses to online degrees

With all classes delivered entirely via Internet, geographic limitations were gone.  Anyone, anywhere could take courses on the World Wide Web, and host sites were things of the past.  It wouldn’t be long before the state’s first public health college conferred the state’s first fully online public health degrees.

According to figures supplied by David Hogeboom, statistical data analyst for COPH, the online degree program has conferred 383 MPH degrees in various concentrations since spring 2001.  The total represents more than one-fifth of all MPH degrees and more than one-eighth of all degrees awarded by COPH in that timeframe.  Srinivasan said nine students graduating on Dec. 13, 1998, from the Public Health Practice program were the first to earn their degrees via satellite.

COPH distance learning’s first nine MPH graduates made headlines in 1998.

“Today, in addition to public health practice, we have five other master’s concentrations online and 11 online graduate certificates,” Srinivasan said.

Unlike other classrooms, the virtual variety requires technical design specifically geared to disseminating educational materials.  Accordingly, full-time instructional designers are a big part of the picture at COPH online.

“Our office consists of six full-time instructional designers and a graphics designer,” Srinivasan said.  “The designers are assigned to particular courses and work hand-in-hand with faculty in preparing course materials and assessments.  They are able to parse down a lesson to bare essentials and match the right technology that can deliver that content efficiently to the students.”

Today’s COPH online learning team.  Back row, from left: Thomas Reilly, James Taylor, Andres Abril, Carlos Montoya, Samantha Lopez.  Front row, from left: Ana Vizcaino, Jung Lim, Sandhya Srinivasan, Trudian Trail-Constant.

Srinivasan said one of the concerns the designers address is interaction.

“It is less than ideal to listen to a talking head for three hours, so we use different types of interactive technologies that enable and even encourage student interaction,” she said.

Much of that interaction involves typed responses, she said, but even that is rapidly changing.

“As part of Canvas, the learning management system at USF, we now have access to an interactive virtual tool called Blackboard Collaborate.  Students and instructor log in at a given time and date, and the tools within that virtual classroom allow for interaction.  Students and faculty are able to interact via audio, video and whiteboard tools to do everything they could do in a traditional classroom.”

Alison Oberne, MA, MPH, CPH, an instructor in the USF College of Public Health, narrates a lecture for an undergraduate public health course using the recording space in COPH used for recording content for the lectures and modules of most of the college’s online degree programs.

It doesn’t take an instructional designer to appreciate the brightness of COPH’s online future.

When the college launched its online master’s program, Mahan said, deans at other colleges of public health told him it would never work.  In fact, he said, deans from the older schools of public health at revered institutions like Harvard and Johns Hopkins flat-out swore they would never do it.

“Now, of course, they all do it,” he said.  “Absolutely, we were the first to do it.  We were a couple of years ahead of everybody else in offering the full MPH by distance.”

“The tools from the beginning to now have undergone tremendous change,” Srinivasan said.  “We are committed to remaining on the cutting edge, so the future of our program will be wherever virtual classroom technology will allow us to go.”

Story by David Brothers, College of Public Health.

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First published on December 9, 2019 in observance of the COPH’s 35^th anniversary celebration.

In 2018, the USF College of Public Health (COPH) resurrected its Public Health Executive Leadership Program, which had been dormant for 10 years.

The program aims to bring rising leaders in the Florida Department of Health (FDOH) together to “collaborate and improve upon their own as well as their agency’s effectiveness,” said Dr. Marissa Levine, a COPH professor and co-director of the program along with Dr. Anthony Masys, an associate professor and director of global disaster management, humanitarian assistance and homeland security. “We revived the program not to teach public health skills, but to bring out leadership skills.”

Last year’s program brought 28 FDOH professionals—everyone from bureau chiefs to doctors and nurses to lab executives—to the USF Tampa campus several times over the course of nine months to attend workshops and presentations. In between the sessions, the group performed online work and discussions.

“The students evaluated their own leadership skill growth at the beginning and end of the program,” explained Levine. “Based on this, we saw a significant increase in self-assessed leadership skills. In addition, each student completed a capstone project relevant to their work at their base of operations. Each project was impactful and some had the potential for state- or national-level effectiveness.”

As an added bonus, many students in the program who did not initially know each other created professional relationships. “That will not only help them personally, but it will also enhance the work and impact of the department,” noted Levine.

Hurricane season pushed back the start of this year’s program, but in November 30 FDOH workers came to campus to open the 2019 program and begin fine-tuning their leadership skills. 

“This is another dynamic group who we will meet again in person four more times between now and May. Next month we will be exploring leadership in a political context and will convene in Tallahassee where we will view committee meetings and learn about all levels of government budget and policy making,” said Levine.

The Center for Leadership in Public Health Practice, the COPH group that puts on the program, has an annual contract with the FDOH. According to Levine, the group is looking to expand its offerings to engage other public health professionals. “We’re disseminating information to our graduates and others interested in leadership so that we can create a robust resource for leaders working to collaboratively improve health and well-being,” said Levine

.Story by Donna Campisano, USF College of Public Health

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In the aftermath of Hurricane Ian, the USF College of Public Health’s (COPH) Community Emergency Response Team (USF CERT) played a crucial role in supporting response efforts in collaboration with the Florida Department of Health and the Hillsborough County Office of Emergency Management.

The volunteer organization is dedicated to promoting, training and providing education on emergency preparedness within USF and its surrounding communities.

The team’s efforts involved setting up and managing 16 site locations – general population shelters, special needs shelters and emergency pet shelters. Over a four-day period, they deployed 53 volunteers who contributed more than 800 hours of service.

Volunteer Florida, the state’s lead agency for mobilizing volunteers and coordinating donations before, during and after disasters, took notice of USF CERT’s accomplishments and dedication during Hurricane Ian. The recognition led to an invitation for Elizabeth Dunn, instructor I and director of USF CERT, and her team to speak on a panel at the Annual Emergency Management Convening in Orlando on Feb. 28 and March 1, 2023, to shed light on the CERT program and its capabilities.

On the last day of the annual meeting, Dunn and her team were surprised to be honored with Volunteer Florida’s Excellence in Volunteerism Award for their response efforts and contributions during and after Hurricane Ian.

“It was a nice surprise and special having some of my students there to accept the award as well,” Dunn said. “I think one of the biggest highlights is knowing the state and our local government recognize the hard work and dedication that we’re doing for our local community.”

Additionally, the Hillsborough County Board of County Commissioners honored the team with a proclamation designating June 22 as CERT Day.

Reflecting on the team’s recognitions, Dunn said, “As the team celebrates its 10th anniversary this year, their contributions to hurricane responses, pandemic efforts and other emergencies have solidified their position as an essential resource for the county. The success stories of CERT program alumni, some of whom now hold prominent positions in emergency management, further highlight the program’s impact and the valuable experience it provides to students. We’ve given our students an opportunity to practice what they’re passionate about. This award serves as a reminder of the value of building relationships and continually striving to improve emergency preparedness and response efforts.”

Story by Caitlin Keough, USF College of Public Health

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Ana Scuteri felt compelled to make a difference in the health of the public after she watched two of her sisters die of a heart condition.

“I knew working in this field would provide an opportunity to help improve people’s quality of life,” said Scuteri, a native of Peru who is fluent in Spanish. “My professional goals were driven by the desire to serve, teach, inform and work in a team, and public health was the perfect fit. Public health has given me everything I have hoped for. I enjoy being a public health professional, doing community service and sharing the knowledge and experience I have gained throughout the years.”

Scuteri is the assistant county health department director at the Florida Department of Health (FDOH) in Seminole County. She is a trained epidemiologist who has worked in the field of public health for over 20 years and held leadership positions with the FDOH for more than 15 years. Scuteri, who earned both her bachelor’s and MPH from Florida International University, is responsible for managing the community health operations, services and programs of Seminole County.

In her current role at the FDOH-Seminole, Scuteri oversees the Community and Population Health Division, making sure the department’s mission is achieved and that it promotes wellness, disease prevention, access to care and emergency response related to health and medical services. Under her leadership, Seminole County ranked as the third healthiest county in health outcomes in Florida in 2022.

“I love that I get to do something different every day,” she said. “And it’s exciting to see that our work has such a positive effect.”

Scuteri was nominated for the award by her coworkers and community leaders, who called her “passionate,” “inspirational” and “determined.”

“The characteristic of Ms. Scuteri’s that amazes me is her determination to make ideas come to life through her energetic optimism, consensus-building skills and keen understanding of what makes sense, yet always within the bounds of regulations and guidelines,” said Monica Araujo, program director of Catholic Charities of Central Florida. “I have personally seen the result of her work: Our community is a much better place to live because of her.”

Scuteri said it’s the community she serves that feeds her public health passion.

“It’s incredibly satisfying to make an impact on someone’s life,” she said. “Whether it’s helping a mom not to give up on breastfeeding, teaching a lesson to kindergarteners about nutrition, educating college students about STIs, promoting bicycle safety, assisting older adults with a fall-prevention program, helping a refugee learn about our health care system—the list goes on. Public health professionals touch people’s lives in so many ways.”

Scuteri said she’s “deeply honored and humbled” to receive the Outstanding Woman in Public Health Award, presented by the college each year to a woman whose career accomplishments and leadership contribute significantly to the field of public health in Florida.

“Public health professionals usually work behind the scenes, and sometimes people don’t really know the extent of the work we do. I am very grateful the University of South Florida has such a great recognition for the work many of us do, especially for women working in this field. I believe those of us who have chosen public health as a career do it because we care, we want to make a difference.”

To view the awards ceremony, click here.

Story by Donna Campisano, USF College of Public Health

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The USF College of Public Health (COPH) is partnering with the Florida Department of Health, Hillsborough County, on programs designed to help build, reinforce and retain the public health workforce in the county.

Funding for the county’s programs, totaling more than $15 million over five years, is coming from the Centers for Disease Control and Prevention’s (CDC’s) Public Health Infrastructure Grant Program. The COPH itself will receive more than $5 million of that amount.

The goal of the grant program, which overall will award more than $4 billion over five years to public health departments around the country, is to “help ensure that every U.S. community has the people, services and systems needed to promote and protect health,” according to the program’s website.

The college got involved when the county health department reached out to COPH Dean Donna Petersen, saying that they had met a population eligibility requirement set forth by the grant.

“They said, ‘We meet the eligibility requirement of having a population of 1 million or more, but we need the college’s help writing the proposal and developing programs,’ ” said Petersen, who is the principal investigator on the grant. “So we worked together with the county to develop public health workforce skills development, leadership training and programs intended to refresh, revive and retain public health professionals. We’ll also be adding wellness programs that address burnout and stress. And all these things will be available not only to the county’s health department staff but also to its partners, including the school district, Healthy Start and others.”

In addition to specially developed programs, the grant will also focus on creating a more streamlined process whereby public health personnel and partners can gain early access to both undergraduate and graduate COPH courses and certificates (with grant money covering tuition). Eligible employees can also complete a CPH exam prep course and sit for the exam.

“The COPH is excited to have the opportunity to work closely with the Hillsborough County Health Department and its partners to build a stronger, more effective public health workforce and system in this community,” said Petersen. “These programs will have a robust audience.”

Programs are expected to start in the next fiscal year.

Story by Donna Campisano, USF College of Public Health

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USF College of Public Health alum Charles Ford was recently selected as a 2022-2023 Gilman Scholarship alumni ambassador. He will serve as an official representative of the U.S. Department of State’s Benjamin A. Gilman International Scholarship Program.

The scholarship enables students of limited financial means to study or intern abroad, providing them with skills critical to our national security and economic prosperity.

As alumni ambassadors, these representatives provide testimonials about their Gilman Scholarship experiences at campus presentations and offer application tips via written articles, videos, webinars and special events.

Ford, a Tampa native, earned his BS from Florida State University in 2018 and his MPH from the COPH in 2020. In addition to receiving his graduate degree from the COPH, Ford also completed a graduate certificate in infection control.

“I chose to attend the COPH because of the preeminence and history of the public health program for educating and training world-class public health professionals,” Ford said.

During his time in the program, Ford focused his studies on the dual epidemiology and global communicable disease concentrations and is most proud of serving as treasurer for the Epidemiology and Biostatistics Student Association.

In 2019, in his second year at USF, Ford began his first public health career experience at the Florida Department of Health (FDOH) in Hillsborough County as a human services program consultant in the HIV Surveillance Program. In this role, he worked to conduct and coordinate public health surveys for people living with HIV/AIDS with the CDC Medical Monitoring Project.

“Maintaining a healthy work-life balance can be difficult for graduate students and this is one obstacle I overcame while simultaneous working and studying full-time,” Ford said, “Supportive classmates and peers who are willing to grab food after stressful exams can make all the difference in graduate school. The skills and principles I gained while at the COPH were foundational in my success as a public health professional, and the connections I have made during this time have greatly influenced my career path.”

In May 2020, Ford graduated from the COPH and transferred to the epidemiology department of the FDOH where he began work as a long-term care facility co-lead in the COVID-19 pandemic response efforts.

In this role, he directly applied the skills he learned at the COPH to assist contact tracing, case investigations, outbreak management and so much more.

“The opportunity to work as an epidemiologist on an emerging disease in my home community was both exciting and nerve-racking due to the novelty and severity of the virus,” he said.

In October 2020, Ford moved to Miami and began working as an applied epidemiologist at the FDOH in Miami-Dade County and most recently started his career as an infection preventionist (IP) with HCA Florida Aventura Hospital.

There, he promotes and delivers high quality, patient-centered care by assisting with the administration of infection prevention policies, procedures and programs.

“The most exciting part of my job is the application of the knowledge and skills I learned during the infection control graduate certificate,” he said.

As an infection preventionist, he identifies, investigates, reports and monitors the incidence of nosocomial infections among patients and personnel, and implements policies and procedures to prevent cross-contamination.

In June 2020, Ford was selected as a Gilman alumni ambassador after completing a nine-week medical service internship with the NGO Humanity and Community Development Projects in Ghana. Following his service internship, he completed a follow-up service project where he spoke to first-generational college students about his experiences abroad at organizations in Tallahassee, such as the Southern Scholarship Foundation.

“I am incredibly honored and excited to be selected as a Gilman alumni ambassador and to get the word out about the Gilman Scholarship to as many eligible students as possible,” he said.

As for future plans, Ford wants to continue growing in his career as an IP by obtaining certification in infection control and becoming a certified professional in health care quality.

COPH Alumni Fast Five:

What did you dream of becoming when you were young?

As a child and young adult, I dreamt about becoming a famous saxophonist and world-renowned jazz musician.

Where would we find you on the weekend?

On a weekend you would find me lounging by the pool with an adult beverage and a good book.

What is the last book you read?

“The Immortal Life of Henrietta Lacks,” by Rebecca Skloot.

What superpower would you like to have?

My all-time desired superpower is elemental control (i.e., control of the elements—earth, water, fire, air).

What’s your all-time favorite movie?

All-time favorite movie is Pixar’s “Ratatouille.”

Story by Caitlin Keough, USF College of Public Health

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University of South Florida College of Public Health associate professor Dr. Jennifer Marshall, an expert in maternal-child health, is a co-principal investigator with USF OB-GYN Dr. Kimberly Fryer of a “secret shopper” survey to evaluate access to prenatal care for women in Florida with opioid use disorder (OUD).

The study was prompted by a similar secret shopper study conducted by researchers at Vanderbilt University who hired a company to conduct calls in 10 states to measure access to medication-assisted treatment (MAT) for pregnant women with OUD.

Colleagues of the COPH at the Florida Department of Health and the Department of Children and Families asked if a COPH team could replicate the study in Florida. Marshall and her colleagues also collaborated with Dr. Stephen Patrick’s Vanderbilt team to examine opioid addiction treatment for pregnant and nonpregnant women in Florida.

Callers, armed with a specially designed protocol, posed as pregnant women with Medicaid receiving methadone treatment and made 1,755 calls to over one thousand OB-GYNs throughout the state.

“It was surprising that in both the access to treatment and access to prenatal care studies, over 50 percent of providers were unreachable, even after five attempts were made.”— Dr. Jennifer Marshall

And the results were sobering.

“It was surprising that in both the access to treatment and access to prenatal care studies, over 50 percent of providers were unreachable, even after five attempts were made. It’s hard to know why it was so difficult for callers to reach providers or receive a callback,” Marshall said.

Opioid Use on the Rise

Opioid use in general—and among pregnant women in particular—is a serious and growing problem, in the nation and in Florida. 

From 1999 to 2014, OUD increased from 0.5 to 5.6 per 1,000 delivery hospitalizations in the state. In addition to a greater risk of having their babies born with neonatal abstinence syndrome (a group of serious conditions that can occur when a baby is exposed to opioids in the womb), pregnant women with OUD have a greater likelihood of giving birth to babies who have a low birth weight, are small for their gestational age and/or have cognitive, psychomotor and behavioral issues.

Appointments Hard to Get

 As for the findings, even when the shoppers could reach a provider, care was far from guaranteed.

“When a woman was seeking treatment to stop using opioids, regardless of pregnancy or insurance status, only 25 percent of over 1,000 buprenorphine prescribers … and 64 percent of all 139 opioid treatment programs … offered appointments. Over half of these treatment providers required cash payment and would not take Medicaid or private insurance.”—Dr. Jennifer Marshall

Only 20 percent of prenatal care providers were willing to see the caller for an appointment. And when they were denied care, only a third were referred somewhere else. 

Things weren’t much better for those looking for OUD treatment. 

“When a woman was seeking treatment to stop using opioids, regardless of pregnancy or insurance status, only 25 percent of over 1,000 buprenorphine prescribers [buprenorphine is the preferred drug to treat OUD because of its convenience, better adherence profile and reduced stigmatization] and 64 percent of all 139 opioid treatment programs [using methadone] offered appointments. Over half of these treatment providers required cash payment and would not take Medicaid or private insurance,” Marshall reported.

Callers were also often met with judgment and made to feel stigmatized, Marshall said, either because they were using methadone or had delayed prenatal care or both.

What Needs Improvement

According to Marshall and her team, training clinicians and their staff to be more responsive to patients is critical. So is working with insurance companies, including Medicaid, to increase the availability of providers.

“The reimbursement rates for Medicaid are much lower than for private insurance,” Marshall explained. “And many providers were not taking new patients or accepting new Medicaid patients; they cap the number of Medicaid insured patients that they accept.”

“Women who are seeking [treatment] or are in recovery should be applauded and supported, not stigmatized.”—Dr. Jennifer Marshall

But perhaps most important, Marshall said, is compiling a publicly available, comprehensive and accurate list of prenatal care and OUD treatment providers, including those who accept Medicaid. Making quality ratings available to the public would also be beneficial.

“We need to ensure that treatment is available the moment an individual is seeking recovery,” Marshall said, “and most certainly that prenatal care is available for every woman the moment she discovers she is pregnant. Women who are seeking [treatment] or are in recovery should be applauded and supported, not stigmatized.” 

To access more information about the project, visit the Florida Department of Health’s website.

Story by Donna Campisano, USF College of Public Health

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Suicide is a leading cause of death among 10- to 14-year-olds in Florida. That’s one of several areas of focus in a study led by the University of South Florida (USF).

The USF College of Public Health is contracted by the Florida Department of Health to help collect and analyze specific data for the Florida Violent Death Reporting System (FLVDRS). The FLVDRS keeps track of deaths caused by suicide, homicide, deaths likely caused by violence, legal intervention (with the exception of executions) and unintentional firearm-related deaths.

Karen Liller, professor and principal investigator for the state contract, and her team reviewed 5,017 victims’ cases from 2019 that showed that 69 percent of violent deaths in Florida were caused by suicide. The remainder are primarily attributed to homicide. While most suicide victims tend to be middle-aged or older-white males, Liller and her team are also studying the increasing number of suicides among Black males, especially younger Black males between the ages of 10 and 24.

“Suicides increasing in the younger age groups is critical to study,” Liller said. “Not enough study has been done especially among underrepresented youth, so we are using what we discovered in the FLVDRS to delve deeper into the suicide data of these individuals.”

Liller’s team combed through thousands of death certificates and reports provided by 16 medical examiners district offices and 24 law enforcement agencies, representing more than 40 percent of the state, and sent the data to the Centers for Disease Control and Prevention (CDC) through a secure portal.

The team wrote narratives from the law enforcement and medical examiner reports. Codes developed from the narratives describe recent life events, known history of psychiatric diagnosis, such as depression and ADHD, known history of self-injurious behavior, engagement with law enforcement, suicide method and scene information. While death certificates provide statewide information, some results are based on data submissions from the participating medical examiner districts and law enforcement agencies. Therefore, not all information represents statewide estimates for violent deaths.

“What is especially important about the FLVDRS is the fact we can learn so much more by reviewing the information from the death certificates, medical examiner reports and law enforcement records for each case,” Liller said. “We are humanizing the victims, rather than focusing solely on statistics, which allows for more effective intervention strategies to prevent deaths.”

In 2019, there were 25 suicides among 10- to 14-year-olds in Florida – the age group’s second leading cause of death behind unintentional injuries. There were 102 suicides among those ages 15 to 19 and 190 were ages 20 to 24.

The FLVDRS was launched in 2018 and joins other states in contributing data to the CDC’s National Violent Death and Reporting System (NVDRS). According to the National Center for Health Statistics, Florida had the third-highest number of violent deaths in 2019, behind California and Texas, and a slightly higher rate than the national average (22.47 vs. 20.5 per 100,000 respectively).

Liller’s team is working with the Florida Department of Health to continue expanding FLVDRS data collection throughout the state to ensure Florida is appropriately represented on a federal level.

The USF research team includes Nicholas Thomas, Jennifer Ramirez, Elizabeth Amoros, Alexis Diblanda, Dr. Abraham Salinas, Rolando Trejos and Kelli Agrawal.

Story reposted from USF Newsroom

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Combining forces to take action

The Florida Department of Health (FDOH) Hillsborough County Office of Minority Health has chosen the USF College of Public Health (USF COPH) to co-facilitate their health equity coalition and task force with the goal to create a “health equity plan” this spring. USF COPH’s Dr. Alicia Best, assistant professor and principal investigator of this contract, said the goal is to raise awareness about health inequities and develop an action plan to move toward health equity.

“Health equity can be described as ‘a state of being’ in which everyone within a given population has a fair opportunity to be healthy. As such, health equity is dependent upon the equitable distribution of resources and removal of barriers to health within that population,” Best said. “Addressing the social determinants of health is essential to achieving health equity because they include conditions and environments where people are live, learn, work, play, etc.”

According to Best, it is well established in public health that only a small proportion of health is determined by individual-level factors like behavior.

“Most of health is determined by social and environmental conditions that largely influence behavior, such as access to care, etc.,” she said.

Addressing the upstream factors of health

Allison Nguyen, program manager for the Office of Health Equity at FDOH-Hillsborough and co-facilitator of this initiative, said that inequities impact health in Hillsborough County by causing preventable, avoidable differences in health outcomes.

She says under this initiative, they will be developing a health equity plan with a focus on “upstream factors” that impact two health disparities: severe maternal morbidity and initiation of PrEP (medications used to prevent HIV infection in people who have not contracted the virus).

“In the Office of Health Equity, we believe that good health should be an option for everyone,” Nguyen said. “We believe this new initiative will help address the social, political and environmental factors that are driving the disparities in health outcomes for severe maternal morbidity and initiation of PrEP through improving options for good health.”

But to get there, Nguyen said they are looking forward to the academic perspective offered by the USF COPH.

“[USF COPH] compliments the need for this work to be data-driven and evidence-based,” she said. “It’s the same approach we take for our work as a county health department, and we are excited to work with faculty from the USF COPH for this effort.”

Disparities in health locally and nationally

According to Best, the health of communities in Hillsborough County is similar to what is seen throughout the entire state and nationally.

“We see glaring differences in health between various segments of the population. Those racialized as Black, indigenous or people of color have worse health outcomes than non-Hispanic White populations. For example, Black Hillsborough County residents have less access to quality health care, and Black women in particular experience delays in initiating prenatal care, contributing to higher rates of severe maternal morbidity and infant mortality among Black residents compared to White Hillsborough County residents,” she said.  

This new initiative will involve internal DOH staff and external community partners from many different sectors, including health, transportation, education, social services, non-profit and others, according to Best. The end goal of this initial phase will be the development of a county-wide health equity plan to address the social determinants of health that impact health disparities prioritized in the county.

She said they also plan to host an event in April to educate and raise community awareness about health inequity and the social determinants of health.

“The key to this initiative and to addressing health inequity in general is working together with communities, building community capacity and collaborating across systems,” Best said.

A growing team

COPH’s Dr. Mahmooda Khaliq Pasha, assistant professor, is also involved in the health equity task force, and, Best says, many others have expressed interest in supporting this initiative.

“My interest in joining this task force stems from my work, which centers on working with community partners and engaging and empowering them to address public health concerns in their communities. This work involves capacity building and the use and application of social marketing,” Khaliq Pasha said. “Equity plays a fundamental role in public health outcomes, therefore, my hope is that through this collaboration we can start working at the environmental and policy level to start influencing change.”

Best said the newly established USF Faculty Senate Council on Racial Justice is also offering support, especially as it relates to educating and raising awareness about issues of racism and inequity. 

The kick-off meeting was held on in late January 2022 with the goal to have the health equity plan completed by the end of this May.

“A huge part of my life’s purpose is to chip away at structural racism and make meaningful progress toward achieving health equity,” Best said.

Story by Anna Mayor, USF College of Public Health

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Eight recent graduates of the USF College of Public Health (COPH) Public Health Executive Leadership Program (PHELP) have been promoted to health officer/administrator positions at health departments across the state.

Health officers within the Florida Department of Health (FDOH) are the lead public health officials for the counties in which they serve. They are responsible for their department’s operations and any response to community public health events, concerns or disasters.

After a hiatus of several years, the COPH revived PHELP with the aim of teaching and reinforcing leadership skills among early-to-mid career FDOH managers and supervisors who have demonstrated leadership potential. Since its resurrection four years ago, 75 FDOH employees have graduated from the program.

“The program provides those who enroll with new skills and knowledge, but maybe, most importantly, the opportunity for personal leadership development,” Dr. Marissa Levine, a professor of public health practice and director of the Center for Leadership in Public Health Practice, said. “That includes enhancement of the mindset necessary to be a successful leader.” 

The eight PHELP grads recently promoted to health officer include:

“I wanted to take part to learn how to be a better leader, to network and ultimately to advance in the field of public health,” said Kimberly Kossler, who served as a disease intervention specialist, an epidemiologist, a program manager and in other capacities before being named health officer of Collier County in Dec. 2020. 

“I serve as the local lead public health official to provide direction, management, leadership and evaluation of a wide variety of complex and multi-faceted community public health programs,” she added. “This role is an essential part of the Florida public health system and is responsible for assessing, maintaining and improving the health and safety of the entire community.”

Kossler said taking part in the program was essential to advancing her career. 

“The program provided an opportunity to meet other colleagues who had similar ambitions, exchange experiences and share knowledge,” she said. “It gave me a chance to demonstrate my interest and desire to continue to advance my career in public health while learning valuable ways to improve my leadership skills.”

Meaghan Crowley, who at the time she was enrolled in the program served as director of community health in Marion County, agrees. 

“PHELP was an invaluable experience in my leadership journey, which still serves me on a daily basis, even today,” said Crowley, now health officer/administrator in Baker County. “Drs. Levine and Masys [a former COPH associate professor involved in the program] set the foundation by including a myriad of advanced leadership topics such as adaptive leadership, systems thinking, change management, appreciative inquiry, complexity in public health, communication and partnership, to name a few. Rather than merely ‘teaching’ us leadership, they acted as our champions in our leadership journey. I was able to implement many of these lessons while at DOH-Marion and feel they have served me even more in my current role as the DOH-Baker health officer/administrator.”

Crowley said she was so impressed by her PHELP experience, she decided to enroll in the COPH DrPH program with a concentration in Advanced Practice Leadership in Public Health. 

“I have felt supported, encouraged and inspired by all the COPH faculty in my continued leadership journey,” she stated. “I can say without a doubt that [the program] has unquestionably helped me not only in my journey to become a health officer, but to create a culture of quality and excellence at DOH-Baker, where staff are encouraged to be leaders themselves, no matter their position, and to create positive change to better serve our community and one another.”

Story by Donna Campisano, USF College of Public Health

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