Gail Brandt Interview; Region X (7/11/16)
1.
Identification:
-What
is your name? Gail Brandt
-Where
were you born? Mount Vernon, New York
-Where
did you grow up? Yonkers New York and moved to Pelham New York
-Profession
currently: Health Equity Manager for the Washington State Department of Health
and also the lead for the cross health equity work group; represents the
department on the Governor’s Interagency Council on Health Disparities.
-Region
working in right now: Washington State
-State
living in right now: Washington State
2.
Why
are you interested in public health and how did you get into the field of
public health?
Right after I got out of
college I did an internship at Boston City Hospital, a public hospital. This
hospital serves patients with no insurance and limited ability to pay for
health care. During that time (2 years). With this experience, I knew that this
job was not for me after working there for 1 year. I noticed that when patients
left, they would come back 3-4 months later and would have the same type of health
conditions when they initially came in with the first time. And the reason why is
because they would live and work in the same environment that took them to
hospital to begin with! These environments were hazardous, apartments contained
mold, were tough neighborhoods with poor work conditions, etc. Knowing this, I
knew that working at the hospital was not the place for me, but rather wanted
to dedicate my life in figuring out why people where coming back so frequently.
3.
What
is health equity to you?
Assurance
that we all have access to the resources to make healthy choices. An element
beyond that is that I, myself personally might have access to all the resources;
but let’s say I might be somebody who experiences discrimination or bias then I
am living with that constant tension and anxiety which will essentially affect
my health. I want to see us treat each other emotionally and civically with
respect and without any discrimination.
4.
What
are some challenges (that still persist) within the field of health equity in
public health?
I
will speak from my other experience. Historically, leadership within public
health departments has not always embraced health equity as our foundation. We
have a new head of our department who started 3 years ago who is very proactive;
it really takes that person at the top to take action in order to know how to
make business the business case for equity. With new secretary, we are finally
starting to see action. Once you move down to mid-level management, they are
caught in the middle of leadership and programs. Unfortunately they don’t
always fully understand what health equity looks like. Overall, challenges
within public health is the continuation of racism and how it affects the
receivers.
One
more note, we need to do a better job with the affordable care act. People were
given access to insurance, but not necessarily health care. People also believe
that health equity only involves health care, but there is a lot more to that.
5.
Why
do you think those challenges still persist?
When
we have people like yourself understand this type of work (health equity) and
hopefully move into leadership positions, we will make these challenges better.
We have to start thinking about how do we make some substantial changes? How do
we move away from individual intervention? I believe we are working more
effectively in the political arena. Therefore, moving towards the political
system is more ideal than the previous individual intervention focus.
Also,
funding within public health comes in discreet packages. Research support is
very politically driven. This gets us stuck from moving forward; funding
influenced from political interest creating limitations to what we can do.
6.
What
models within your workforce have worked to encourage health equity?
I
have two models that I like and those are the social determinants of health (SDOH)
model and the socio-ecological model. The SDOH model can be found in Healthy People
2020 (found as an illustration and graphic form). Using these models, I like to
help people understand how these models can fit into their work. I have no
problem with that because they work in my world since I interact with
communities, but this might be tricky with others to accomplish because some
might not work with communities at all.
Again,
health care is just 1 of 5 areas. We want good health care when we are sick but
that is a small fraction of what contributes to population health overall.
7.
At
the beginning of your career, what were some root causes for health inequities
and health disparities? How has those changed (or not at all) following the end
of your career?
People
are living longer, having better birth outcomes and lower infant mortality.
Overall, there has been improvements as a country, but disparities still persist.
Ex: Washington state. Great job with reducing smoking and initiation of
smoking. Therefore, smoking rates are going down, but not for the people who
are in the lower 25% income bracket.
Overall
improvements are masked within some subpopulations; not sure if we have done
enough for those who experience bad health outcomes.
My
last reflection is that when my career started, we were all focused on
individual and small groups. But I have changed and we should all change and
move towards how we can establish polices that will help people be healthy;
focus more on policy type of changes that would really contribute to health.
Resources:
· A Public Health Perspective on
Health Care Reform by Micah L. Berman
· Hope Dies Last by Studs Terkel
