Profile

Julie Rovner: Shining a Light on Healthcare Policy

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                    [post_content] => Julie Rovner has been covering health on Capitol Hill for over three decades. Her voice and expert reporting will be familiar to anyone who listens to NPR, where she served as health policy correspondent for 16 years. She is the author of the popular reference guide Health Policy A to Z,  now in its third edition, and she continues to cover major health policy issues like the looming repeal of the Affordable Care Act. Rovner sat down with PHP’s Jonathan Gang for a chat about her career and the big stories she sees on the horizon in 2017.

JG: How did you get your start reporting on the healthcare beat?

JR: I was hired at Congressional Quarterly in 1986. I think at the time the beat was health, welfare, and government operations. It was that or transportation and commerce. They chose for me, and I have not looked back since.

When you were first getting started in the field, can you point to any story that you did that you really felt like you had made it?

Yeah! I think it was in 1988 or 1989 after I covered my fourth budget reconciliation bill, I did a big story about how the reconciliation process twists the health policy process because it makes health policy back-fit to meet budget goals, rather than doing health policy for health policy’s sake. It’s a story that has stuck with me through my entire career because it hasn’t changed.

What are some favorite stories you’ve worked on over the years? 

I wrote, I think, one of the first big stories about pro-life Democrats. I was covering reproductive health, and it dawned on me that none of these things could ever pass. Why is that when the Democrats control – at this point it was both houses of Congress? It was because a third of the Democrats wouldn’t vote with them on reproductive health! That was 1992. Other than that, there so many, so many stories over the years.

I’m not an investigative reporter. I’m sort of an explanatory kind of reporter. So, my stories aren’t big flashy news, for the most part. They’re mostly helping people understand what’s going on.

What’s your strategy for taking a piece of health care legislation or policy that might be really complicated and putting that into terms that a general audience can understand?

In some ways, it helps that I have a broad institutional memory. So, one of the things I like to do is put it in the context of “has this happened before?” The answer is usually “yes,” or something similar. A lot of the same issues keep coming back.

You have some facility having written about it 150 times. That’s my favorite kind of writing though. Taking complicated things and breaking them down so that people can understand them. It helps that I’ve been doing this for thirty years, so I understand them.
...there’s an art to writing a good abstract about a study. You know, it’s the old “you never get a second chance to make a first impression.” Make your first impression a good one, and then I might go in and dig deeper.  
  What are your primary sources for what’s going on in health and health policy? I don’t know if I have primary sources. I read blogs, I read press releases, I read website. I get press releases from lawmakers, from the Department, from the White House, and from interest groups. I go to events. I do read a lot. When I was leaving the health beat at CQ and talking to my successor, I said “if you’re not inherently interested in this topic, it will kill you. But if you are interested, it will be endlessly fascinating.” I’ll find myself sitting around at home sometimes reading Health Affairs articles. After all these years, I still find it interesting. What can public health researchers or other academics do to make your job easier? Try to put things in English. I’m pretty skilled in reading academic research but if it’s badly written and I have to slog through it… Please, don’t. I read a press release yesterday that I found interesting but I didn’t end up linking to the study because I was so frustrated. It raised all of these questions that it didn’t answer. There’s an art to writing a good press release about a study and there’s an art to writing a good abstract about a study. You know, it’s the old “you never get a second chance to make a first impression.” Make your first impression a good one, and then I might go in and dig deeper. Or at least don’t make your first impression a bad one. With the incoming administration, what are some of the issues and stories that you are focusing on? The repeal of the Affordable Care Act. And the repeal of the Affordable Care Act. And the repeal of the Affordable Care Act. And also, reproductive health. But everything right now is playing a back seat to the repeal of the Affordable Care Act. Do you have any insight into how you see that story developing or where you think things are going? I have no idea! I would guess at this point that things are more fluid than some people are saying. There are a lot of potential hurdles for Republicans. It will not be as easy as they think. I think I tweeted last week that they’re juggling with lit sticks of dynamite here. Can they do it? Maybe. If not, big boom. What do you think some of the challenges are going to be in reporting on healthcare over the next four to eight years? I’m a little concerned, particularly that the administration, and perhaps Republicans on Capitol Hill, might just stop talking to the media, or that they’ll only talk to “friendly” media. I’ve covered lots of changes of administration from party to party and I will say that on a bipartisan basis it’s kind of harder to get information out of the department. Every administration seems to try to centralize more and say less. From Bush one to Clinton, Clinton to Bush two, Bush two to Obama, it’s gotten harder every time regardless of party. But I think this particular group of Republicans really, really, really hates media. I’m really concerned about media access. Feature image courtesy of Julie Rovner.  [post_title] => Julie Rovner: Shining a Light on Healthcare Policy [post_excerpt] => Julie Rovner, Kaiser Health News, talks with PHP’s Jonathan Gang about her career and the big stories she sees on the horizon in 2017. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => julie-rovner-shining-light-healthcare-policy [to_ping] => [pinged] => [post_modified] => 2017-08-24 23:15:56 [post_modified_gmt] => 2017-08-25 03:15:56 [post_content_filtered] => [post_parent] => 0 [guid] => http://www.publichealthpost.org/?post_type=bu_profile&p=1016 [menu_order] => 0 [post_type] => bu_profile [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Julie Rovner, Kaiser Health News, talks with PHP’s Jonathan Gang about her career and the big stories she sees on the horizon in 2017.

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Profile

Ron Sims: How Where You Live Affects Your Health

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                    [post_content] => Over his long career in public service, Ron Sims has always fought for healthy communities. From 2009 to 2011 Sims was the Deputy Secretary of the Department of Housing and Urban Development. Before that, he served as the County Executive of King Country, Washington for 12 years, working on policies that prioritized affordable housing, climate change, and social justice.

Now happily retired, Sims has served as the volunteer chair of the Washington Health Benefit Exchange Board, the group responsible for implementing the Affordable Care Act in Washington State, since 2014. Sims sat down with PHP’s Jonathan Gang to discuss his career, the future of the ACA and the role that public health will play in fighting for people’s access to healthcare over the next four years.

PHP: You’ve had a long and distinguished career in public service, from King County to the Department of Housing and Urban Development to the Washington Health Exchange. In broad terms, what role has public health played in your career?

Sims: I can’t think of a year when public health did not play a role in my career. When I was first elected as a county council member, public health reported to my committee. Then, when I became executive of King County, public health was going through a significant transformation, a merger of two governments at one time. We were looking at how we would be able to sustain public health and the new roles that we wanted it to play in our rapidly growing region. When I got Housing and Urban Development, I brought a lot of the work that had been done in public health with me. Particularly, a study that I had asked public health to do.

When I was the county executive I had a report from a group called the Joint Center that had identified that 36% percent of African Americans under the age of 30 would have nothing in common with America but their death. So, I brought that back to one of my staff who was a demographer, a young man named Chandler Felt. I had a rule, which is that if I gave you information, I wanted you to think it through. It wasn’t that I would be in a hurry to get it, but I was going to give it time to grow and mature. I call that “Smart people be smart.”

So, several months later, I asked about whether they were close to being finished with their analysis and they asked for two more months, which I gave them. They came back with a report that disturbed them, which was our ability to determine life outcomes such as lifetime earning of children and cause of death by zip code with incredible precision.

When I went to the US Department of Urban Development, I brought that with me. We continued to use that tool and applied it on a national basis by reminding jurisdictions that [ictt-tweet-inline]a zip code is not just an address. It is a life determinant[/ictt-tweet-inline]. We needed to refocus our attention on why that happens and try to figure out whether we could make these life determinants positive.

PHP: And what are some of the ways that you’ve worked to address that issue?

Sims: I think there are several. One thing is that we noticed that neighborhoods that have wide sidewalks, community gathering points, many parks, that are well-lighted, and well vegetated, that’s really important. Canopy cover is very important. We always do better in what’s called the grasslands than we do in concrete. And the data screams out loud that we need to do more of that.

Neighborhoods that were considered to be “nice” had all of that. Neighborhoods that were poor lacked an organized system of parks and playgrounds. They had narrower sidewalks. They were not well lighted. They did not have places for people to sit and watch the neighborhood or for people to walk around safely.

We realized that the built environment had significant epigenetic consequences for people. A neighborhood could either soothe them or it could bring a sense of wanting to escape or flee. If you look at cortisol levels, we see that flight response. If you have that flight response when you go to the classroom of a school, you can’t learn because the information you’re getting is being packaged differently than a student that comes in and is very relaxed.

Interestingly enough, if you take a person who is in those neighborhoods and you move them to a neighborhood that’s considered to be a better neighborhood, one that’s well vegetated, has wider sidewalks, has good lighting, that has a capacity for people to relax and feel safe, they do better. Now we know that for people who have moved, their lives change. [ictt-tweet-inline]We realized that the built environment has significant consequence.[/ictt-tweet-inline]

PHP: So, what’s the way forward to address this problem?

Well, let me talk about public health and its role.

If you go into public health, your voice has legitimacy. But the issue is not to make it a traditional health issue, like how do you treat diabetes or how do we deal with obesity or immunizations? All of which are really important. It’s about working with the other schools. For instance, if you talk about a community design, you’ve got to talk about planners. You’ve got to talk about people who are in urban agriculture, or landscape architects. Transportation planners. Our assumptions are that those schools are easy to communicate with, and they’re not. So, public health has to be the driver at getting people out of their lanes. Break down the silos so that we can say “all of these other elements are really, really important.” We’re never going to have a discussion unless public health people see themselves as being catalytic and being able to communicate with other disciplines about how we resolve complex issues in those neighborhoods.

There’s a lot of work to be done, but it requires new skills. You’re going to be in a room full of bright, skilled people and you have to understand where they’re coming from and the language that they use. The one thing you do when you come out of any graduate school I know of is you develop an art form: the use of a particular language to describe something. But a landscape architect might have a whole different vocabulary than you in looking at the same problem.

The key is to listen and learn. Public health people have to be, in my opinion, the catalyst. The people who are going to break those walls and invite other people to be a part of the solution. And to listen to them so that we can see “here’s our public health issue that we are looking at, and here are the roles that you can play to ensure that we have a healthier population.”
Public health people have to be, in my opinion, the catalyst. The people who are going to break those walls and invite other people to be a part of the solution.  
PHP: We are entering an uncertain time for the country and especially the ACA and public health in general with the results of the last election. So what do you think are some of the biggest challenges that we’re going to face over the next four years in terms of public health? I think that the changes will not be as dramatic on the public health side as we think, because it’s not the target. What is disturbing is that there are people who believe that people should not have healthcare, which stuns me in a modern age. I think some of the early rhetoric is now dissipating over how much of the ACA can be rejected. For instance, in my state of Washington, a columnist came out and said here are the percentage of people who have either had Medicaid or lower cost insurance. All of those were counties that President-elect Trump won. The blue counties were not the ones that had the highest percentage of people who were in the ACA either by number or percentage. I think what’s going to happen is that as this discussion goes on is we’re going to see the areas that President-elect Trump won are the areas that are most dependent on the ACA. And I think that most people want to strengthen their base, they don’t want to weaken it. Taking away health insurance will do that. PHP: As someone in public service, what is your plan for the next four years? What are you hoping to fight for? Since those meetings have already started, I think many of us now are trying to figure out what are the next steps for insuring that people will continue to have full health coverage. That’s going to be really, really critical, because that can’t fail. It creates too many problems. I want to continue to be an advocate for extensive research into things like pandemics, because we’re going to have one. The issue is how quickly we can mobilize, but we’re going to have one. There’s just too many people on the planet, and viruses love hosts. We’re going to get viruses that do what viruses do, which is move very, very quickly from one human being to another. What we’re not doing well is looking at some underlying causal factors. You know, and a lot of those are based upon diet, mobility issues. We’re still going to have to deal with obesity issues, diabetes issues, heart attack issues. We’re still going to have to look at what is a healthy child. How do we increase the learning capacity of children by making changes to the built environment in particular? What constitutes really good health? That will be our biggest challenge. Photo: Ron Sims at Boston University School of Public Health Dean's Symposia: How Does Where You Live Affect Your Health?, December 1, 2016, courtesy of Boston University School of Public Health Communications Office.  [post_title] => Ron Sims: How Where You Live Affects Your Health [post_excerpt] => Sims sat down with PHP’s Jonathan Gang to discuss his career, the future of the ACA and the role that public health will play in fighting for people’s access to healthcare over the next four years. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => ron-sims [to_ping] => [pinged] => [post_modified] => 2017-08-24 23:17:06 [post_modified_gmt] => 2017-08-25 03:17:06 [post_content_filtered] => [post_parent] => 0 [guid] => http://www.publichealthpost.org/?post_type=bu_profile&p=799 [menu_order] => 0 [post_type] => bu_profile [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Sims sat down with PHP’s Jonathan Gang to discuss his career, the future of the ACA and the role that public health will play in fighting for people’s access to healthcare over the next four years.

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Sarah Verbiest: Maternal & Child Health Leader

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                    [post_content] => Sarah Verbiest is a public health social worker. What does that mean? She joins dedication to disenfranchised populations with commitment to systems change, interweaving health policy and community practice to improve maternal and child health. She was drawn to this hybrid profession as a systems thinker and emphasizes public health social workers also “do a lot of work with people in systems.” Her conceptual attention to links, interconnections, and structure complements her focus on the experiences of people whose lives are entwined in public systems.

Sarah “never thought [she] would get a doctorate degree or that [she] would be an academic, ever” but in UNC’s DrPH program she found a doctoral program built on lived work experience which integrated her practice experience, research interests, and facility and desire to educate and train public health social workers.

[caption id="attachment_723" align="alignright" width="243"]Sarah Verbiest Sarah Verbiest[/caption]

Preparing for Policymaking

Sarah’s students and the public health social work community are fortunate she found this path given her passionate, informed, and engaging approaches to teaching, research, and policy making. Her own work in policy and public engagement with organizations like the March of Dimes convinced Sarah [ictt-tweet-inline]effective policy work relies on extensive training and support as well as experiential learning[/ictt-tweet-inline]. She got hooked on policy as a path to improved public health and wellbeing through the exhilarating experience of seeing a policy succeed from inception to implementation. With the dedicated time, support, and training of her formal position with March of Dimes, Sarah was involved in drafting a bill, lobbying for its passage, and eventually seeing funding for her effort to ensure women had access to folic acid before pregnancy in North Carolina. That experience drove home for her that "when the process works well, and you’re working to build policy across difference, it’s great, and you really come up with good policy.”

Sarah underscores two key points about preparing and inspiring new policy influencers: big national policy is not the only way to bring about change, and comfort and skill in policy advocacy come with extensive training and support. When you frame policy as Sarah does, seeing its important place in state-level systems, local PTA organizations, and even organizational policies like hiring practices or responses to clients’ missed appointments, it’s that much more urgent to understand and encourage strong policymaking knowledge in public health practitioners. Sarah describes the impact of employer-supported training, experiential learning, and encouragement in reducing intimidation and clarifying how the policymaking process works: “it’s intimidating [but] I had support, people approving my content before it went out…people need training in order to feel comfortable engaging in policy arenas.”

Policy training and preparation through employers may be essential, but universities can play a role in preparing public health social workers to be policy influencers as well. Sarah’s students in classes on health policy and equity and non-profit management engage in in-depth policy learning through a day spent in the North Carolina assembly meeting with lobbyists, observing elected officials’ meetings, and familiarizing themselves with the state policy process. In true keeping with her commitment to seeing policy on many levels, Sarah has another class participate in a real local meeting with policy implications, like a city council, city planning, or school board meeting.

These learning experiences help students understand the context in which “these decisions [are] made, who is elected and what does that mean” and gives them concrete knowledge of local policymaking which can reduce the intimidation they might feel as new practitioners seeking to make policy change. Sarah described these learning experiences as sometimes “flipping the switch” for students who might not have pictured themselves as having a role in policy change, noting “you have to get in and try it, you can’t learn about it just from sitting at your desk.”
As her leadership of the Center for Maternal and Infant Health suggests, Sarah has clear and ardent policy dreams for women and children which remain rooted in a fundamental commitment to health equity for all women.  
Policy for Women, Infants, and Families True to the shared core commitments of social work and public health to working with and for vulnerable populations, Sarah’s reflection on her own work is focused outward, on her opportunities to improve the lives of women and children and support the success of new practitioners. She roots her focus on women and children’s health and wellbeing in a lifelong feminist perspective. As a young person, Sarah was passionate about women’s equal opportunities, from access to sports to pay equity to reproductive justice, and which she has always seen as issues to address through policy. As her leadership of the Center for Maternal and Infant Health suggests, Sarah has clear and ardent policy dreams for women and children which remain rooted in a fundamental commitment to health equity for all women. If she could wish into being a single policy, Sarah would address post-partum health for women, encompassing 12 weeks of guaranteed paid family leave for every worker and providing significantly more support for new mothers and families, including “the best possible access to everything you would ever need as a new parent, seamlessly available, behavioral health, physical therapy, whatever you need, without copayments, for the first 6 months.” Such policy would provide concrete supports to improve women and children’s health and wellbeing outcomes, but Sarah emphasizes the additional significance of the intangible impact of enacting such policy: “it shows our society’s commitment and respect for new parenting and for parenthood and for women: what policy says about what we care about really matters.” As Sarah tells it, influencing public health social work policy is often about exactly this kind of “communicating what we care about.” If students and new practitioners have training and supported practice in engaging meaningfully with policy processes, they can communicate critical policy commitments to those making policy at the agency, local, state, and national level. Sarah described the inspiring experience of this kind of communication in discussing her attendance at the 2016 European Congress on Preconception Health and Care in Sweden. Her long-term investment in and preparation to discuss policy in the areas she’s passionate about let her engage with new people and ideas from countries with very different and invigorating approaches to a shared policy topic. The Congress – which took place in an actual, snowy, fairyland-esque castle – might be the epitome of unfamiliar for many new practitioners, but armed with training and encouragement, public health social work can be a force to influence policy at every level and, as Sarah says, to communicate what the field cares about. [caption id="attachment_729" align="aligncenter" width="600"] One of Sarah's many cool accomplishments - running the marathon on its original course this summer in Greece![/caption]   Photos: courtesy of Sarah Verbiest [post_title] => Sarah Verbiest: Maternal & Child Health Leader [post_excerpt] => Sarah Verbiest has clear and ardent policy dreams for women and children which remain rooted in a fundamental commitment to health equity for all women. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => sarah-verbiest [to_ping] => [pinged] => [post_modified] => 2017-08-24 23:17:39 [post_modified_gmt] => 2017-08-25 03:17:39 [post_content_filtered] => [post_parent] => 0 [guid] => http://www.publichealthpost.org/?post_type=bu_profile&p=720 [menu_order] => 0 [post_type] => bu_profile [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Sarah Verbiest has clear and ardent policy dreams for women and children which remain rooted in a fundamental commitment to health equity for all women.

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Renée Spencer: Military Student Mentoring

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                    [post_content] => [ictt-tweet-inline]Today we reflect on the service and honor the sacrifice of members of the military[/ictt-tweet-inline]. Many of them have families whose service and sacrifice at home should be acknowledged and honored as well. Dr. Renée Spencer is a professor at the Boston University School of Social Work involved in a project focused on helping all members of military families. Along with a team of colleagues (Timothy Cavell, PhD (PI), University of Arkansas; Amy Slep, PhD, New York University; Janet Heubach, PhD, Mentoring Works Washington; Carla Herrera, PhD, Independent Researcher), and in partnership with the North Thurston Public Schools and Big Brothers Big Sisters of Southwest Washington, Dr. Spencer is developing a model for programs to link military students with mentors.

Dr. Spencer’s work, which is funded by the Institute of Education Sciences, grew out of the recognition that when a parent serves in the military, the whole family also serves. Across the United States, nearly 2 million children live in military families, and the Military Student Mentoring project is working to assess how best to support those children.

Reducing Predictable Stress

Dr. Spencer is very clear that the goal of Military Student Mentoring is to increase the supports available to all children and families experiencing the predictable stress accompanying parental deployment and military service rather than targeting struggling students. Her team of researchers has developed a model to provide weekly in-school mentoring to military students in a pilot school district in Washington State. They are assessing both whether the model works to connect military students with mentors and ultimately what the impact on military students is of having a mentor. The project’s approach includes a core commitment to understanding and incorporating military culture into the service model. Military families tend to be resilient and fiercely independent in meeting their own needs, despite the challenges of frequent moves, extended episodes of parenting without a partner, and supporting children’s experiences of parental deployment. The Military Student Mentoring project acknowledges and respects these military family strengths and therefore focuses on providing additional support aimed at reducing the widespread, normative stress military students experience related to parental deployment. The positive reception of Military Student Mentoring may be rooted in precisely this attention to the particular needs, preferences, and experiences of military families. Locating the core mentoring intervention in schools is one example. Dr. Spencer noted military families themselves identified schools as a critical source of community knowledge and resources. “With the frequent moves that they make, they don’t have a ready-made network to inquire about what are the safe, good, supportive services in the community… We learned…that the schools were a pretty good place to do this because that’s a place that the families are already connected to, there’s a level of trust in schools, because adults are screened and supervised…services offered through schools are pretty safe bets.”

Respecting Families’ Narratives

Military Student Mentoring has tapped into critically important perspectives provided by military families themselves about their openness to and interest in additional, safe, supportive adults in their children’s lives and, importantly, disinterest in outside rescuers or “fixers” of their daily reality. And in addition to these key elements of the program’s model, the importance of shared and family-specific culture is incorporated into training provided to the mentors. Dr. Spencer offered a compelling example of this sensitization to the particular needs of military families: “One of the big factors these families shared with us was, they have stories that they tell their young kids about what a deployment is, and they don’t want adults coming in and disrupting that story. So it might be, ‘daddy’s working building schools overseas, and he’ll be home in a few months.’ And when an adult who doesn’t understand this hears the word deployment, they might start saying, ‘well are you afraid, are you worried about your dad,’ and that’s not what these families want."
With the frequent moves that they make, they don’t have a ready-made network to inquire about what are the safe, good, supportive services in the community… We learned…that the schools were a pretty good place to do this because that’s a place that the families are already connected to, there’s a level of trust in schools, because adults are screened and supervised…services offered through schools are pretty safe bets.  
The Project draws on the family and deployment narratives which military parents identified to the researchers to tailor how mentors are trained. Mentors are educated about military culture generally and families’ particular choices in helping their children understand their unique context. As Dr. Spencer explains, “it really is that sense of trying to heighten mentors’ awareness they need to tread lightly and try to understand how this family has framed a deployment experience, or how they’re framing a move, and follow that family’s lead.”

Impacting Stress and Support

While Military Student Mentoring is still very much an ongoing project, it’s had early, anecdotal success, such as the positive experiences some students have shared and which you can see here. Over the longer term, the project is hoping to see specific, positive impacts on children and families. For instance, military students may feel more connected to their schools – an important outcome for children who move on average between six and nine times while school age. They may also experience a higher sense of social support particularly related to school, as their mentor can represent someone who is reliably supportive of and present for them in the school context. Beyond these child-level impacts, Military Student Mentoring is assessing whether engagement in the program could reduce stress more broadly for the whole military family. Anecdotal evidence from other programs serving military families suggests military parents can feel relief and support when they know and trust that there is another reliable adult who is committed to and aware and supportive of their child.

Creating a Model to Support Families

If Military Student Mentoring can accomplish some of these hopeful outcomes, the program model it is testing could be broadly applied and have beneficial impacts on military families across the country – and the world. As Dr. Spencer noted in closing, “[ictt-tweet-inline]It’s both humbling and incredibly inspirational to do this work.[/ictt-tweet-inline] You see up close the sacrifices that everybody in the family is making when somebody is serving our country in this way, and…it’s a real honor and privilege to be a part of a project that’s trying to offer supports to those folks.” Feature image: DVIDSHUBFather, Daughter Reunite. Navy Visual News Service. Photo by Kaylee LaRocque, used under CC BY 2.0. Electronics technician Petty Officer 2nd Class Sam HerediaPerez greets his 7-year-old daughter during a special reunion at Dinsmore Elementary School. HerediaPerez, assigned to the naval Air Station Jacksonville Air Operations Ground Electronic Maintenance Division, has been deployed to Afghanistan as an individual augmentee for the past nine months. [post_title] => Renée Spencer: Military Student Mentoring [post_excerpt] => Today we honor the service and sacrifice of members of the military and their families. We profile a program focused on supporting children whose parents are deployed through school-based mentoring. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => renee-spencer [to_ping] => [pinged] => [post_modified] => 2018-05-25 05:40:30 [post_modified_gmt] => 2018-05-25 09:40:30 [post_content_filtered] => [post_parent] => 0 [guid] => http://www.publichealthpost.org/?post_type=bu_profile&p=548 [menu_order] => 0 [post_type] => bu_profile [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Today we honor the service and sacrifice of members of the military and their families. We profile a program focused on supporting children whose parents are deployed through school-based mentoring.

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Profile

Djamil Bangoura

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                    [post_content] => When Djamil Bangoura speaks, the Senegalese LGBT community listens. Article 319 of the Penal Code, which prohibits and penalizes homosexuality in Senegal, mutes LGBT voices. Bangoura unifies a community marginalized in a country known for its hospitality, and he has over 10 years of experience organizing sexual minorities in francophone West Africa. In 2003, he established Association Prudence, a LGBT health and human rights advocacy group based in Dakar.

Since its establishment as a grassroots organization, [ictt-tweet-inline]Prudence has grown to serve 500 Senegalese in the local LGBT community[/ictt-tweet-inline]. The group primarily targets men who have sex with men (MSM), focusing on HIV/AIDS sensitization, education, and testing. Bangoura envisioned an organization that engages the community, providing home visits, group discussions, prevention education, and HIV/AIDS testing. The HIV/AIDS prevalence is 0.5% in Senegal, but the prevalence ranges between 38.4-44% among Senegalese MSM.

Prudence improves the community’s health by reducing poverty, unemployment, homelessness, violence, stigma, and discrimination. Bangoura’s work, which is recognized by international LGBT advocates, is not often acknowledged in a society that silences its gay brothers and sisters.

Coming Out

Bangoura grew up in Pikine, one of Dakar’s suburbs, and he accepted his sexuality at the age of 22 after friends pushed him to discover the LGBT community. Like most LGBT Senegalese, Bangoura never came out to his family because others labeled him as goorjigéen, the Wolof translation for homosexual.

“I lived quietly, but unhappily,” Bangoura said. “I was like someone who was imprisoned by himself. I was scared to express myself.”

He understood the consequences of identifying as LGBT in Senegal.

“Physical, moral, and verbal aggressions,” Bangoura said. “Someone will label you as something. They’ll call you homosexual. They’ll label you while insulting your families, treating you like animals.”

While producing music with Senegalese rappers in Dakar, Bangoura entered a romantic relationship with a German friend who financially supported the studio. Once the group discovered their relationship, Bangoura’s partner left the country, and the studio closed. After working with his partner for 10 years, Bangoura lost his job at the studio. He tried to find work for three years.

“I didn’t have any more money, so I found myself in real poverty,” Bangoura said. “I had absolutely nothing. I couldn’t support myself. After three years of unemployment, I couldn’t pay for my apartment."

Homeless and unemployed in Dakar, Bangoura connected with Serigne, a friend who introduced him to other gay Senegalese. An informal LGBT organization invited Bangoura to a five-day workshop, and it changed his role in the community. He was inspired to turn from music to advocacy.

“I’m unemployed, but I know how to create something,” Bangoura said. “We’re going to see what we can do.”

 
“Young men have shown me a lot of light,” Bangoura said. “It’s because of this [organization] that I’ve discovered I’m not alone, but there are others, too."  
  Reaching Out In the early 2000s, there were no formal LGBT organizations registered with Senegal’s Ministry of the Interior. “We need to take preventative action for this community,” Bangoura said. “It’s hard. We need to try to support this organization that is the only of its kind, and finally I realized this is an opportunity.” Bangoura understood he would need to initially frame Prudence as an HIV/AIDS prevention service rather than an LGBT advocacy group in order to gain approval from the government. Although same-sex acts are illegal in Senegal, the Ministry considered Prudence as an HIV/AIDS organization, not an LGBT organization, at a time when the government made strides in prevention efforts. “And what they told us in response was that they would give us the approval, but not because we’re gay, but because of the objectives they saw in our application,” Bangoura said. “That’s why they would sign, and finally they signed the approval, and [ictt-tweet-inline]Association Prudence became the first organization of gay Senegalese to be officially recognized[/ictt-tweet-inline].” Established in 2003, the Ministry officially recognized Prudence in 2005. “Finally we have an association that is solely comprised of the LGBT community whose objective is to fight against HIV/AIDS, which is too high in our community, and to fight against injustice,” Bangoura said. “We promote justice, fight poverty. It’s all part of our primary objectives. Help those infected with HIV to have better treatments and follow-up care. That’s our objective.” Today, there are 14 organizations improving health outcomes among Senegalese key populations, which include MSM, sex workers, and people who inject drugs. Not only is Bangoura the president of Prudence, but he also leads RENAPOC, the National Network of Key Population Associations. RENAPOC, collaborating with the National Alliance Against AIDS, streamlines the objectives of all 14 organizations. “Young men have shown me a lot of light,” Bangoura said. “[ictt-tweet-inline]It’s because of this [organization] that I’ve discovered I’m not alone, but there are others, too.[/ictt-tweet-inline]” Speaking Out Bangoura has experienced stigma and discrimination and witnessed violence against his community because of Article 319. “There are certain actors and certain politicians who say that homosexuality is not prohibited by Senegalese law, but, to me, that’s false,” Bangoura said. “This article in the Senegalese constitution condemns homosexuality. That’s what I see. Nobody can say anything else.” After the police arrested members of Prudence in 2008, Bangoura sought refuge in France for six months before returning to rebuild Prudence. “I prefer our partners to support our organizations on the ground so that we can continue what we already started,” Bangoura said. “If everyone leaves, then nothing will change. [Prudence] is founded, and they support us. We stayed, and we’re here.” A letter sent from the Ministry of Health in April 2016 signaled the government’s evolution on LGBT issues. Awa Marie Coll Seck, Senegal’s Minister of Health, invited Bangoura to represent key populations at the United Nations. The invitation confirmed his decision to work with young and vulnerable Senegalese identifying as LGBT. “When we start to talk, it's like they're retelling my story," Bangoura said. “So I see that we all have the same story.” Editor's Note: This is part two in a Public Health Post series about LGBT health in Senegal. Click here to read parts onethree, and four. Interviews were conducted in French and translated to English. 

Version française : Profil : Djamil Banjoura

La communauté LGBT sénégalaise écoute quand Djamil Banjoura parle. L’article 319 du Code pénal, qui interdit et pénalise l’homosexualité au Sénégal, réduit au silence les voix de la communauté LGBT. Bangoura unifie une communauté marginalisée dans un pays reconnu pour son hospitalité. Il a plus de 10 ans d'expérience organisant des minorités sexuelles en Afrique francophone. En 2003, il a établi l'Association Prudence, un groupe de défense des droits de l’Homme et de la santé LGBT à Dakar. Depuis l'établissement en tant qu’ organisation communautaire, Prudence s’est développée pour desservir 500 sénégalais chez la communauté LGBT locale. Le groupe cible principalement les hommes ayant des relations sexuelles avec d’autres hommes (HSH), se concentrant sur la sensibilisation, l'éducation et le dépistage du VIH. Bangoura a envisagé une organisation qui engage/implique la communauté en fournissant des visites à domicile, des discussions de groupe et l’éducation sexuel pour prévenir le VIH. La prévalence du VIH/SIDA est de 0,5% au Sénégal, mais entre 38,4 et 44% chez les HSH sénégalais. Prudence améliore la santé de la communauté en réduisant la pauvreté, le chômage, l’itinérance, la violence, la stigmatisation et la discrimination. Le travail de Bangoura, qui est reconnu par les défenseurs des droits de l’homme LGBT, n’est pas souvent reconnu dans une société qui réduit au silence ses frères et ses sœurs homosexuels. Faire son coming-out Bangoura a grandi à Pikine, l'une des banlieues de Dakar, et il a accepté sa sexualité à l'âge de 22 ans, après que ses amis l'ont encouragé à découvrir la communauté LGBT. Comme la plupart des sénégalais LGBT, Bangoura n’a jamais révélé son orientation sexuelle à sa famille parce que d’autres l’ont étiqueté en tant que goorjigéen, la traduction Wolof pour homosexuel. « Je vivais tranquillement mais malheureusement » Bangoura a dit. « J'étais comme quelqu’un qui était emprisonné tout seul. J’avais peur de m'exprimer. » Il a compris les conséquences d’être LGBT au Sénégal. « Agressions physiques, morales et verbales » a dit Bangoura. « Quelqu'un vous donnera toujours une étiquette. Ils vous appelleront homosexuel. Ils vous étiquettent tout en insultant vos familles, vous traitant comme des animaux. » Bangoura est tombé amoureux d’un ami allemand qui soutient financièrement un studio qui produit de la musique avec des rappeurs sénégalais à Dakar. Le partenaire de Bangoura a quitté le pays et le studio a fermé lorsque le groupe a découvert leur relation. Après avoir travaillé avec son partenaire pendant 10 ans, Bangoura a perdu son emploi au studio. Il a essayé de trouver du travail pendant trois ans. « Je n’avais plus d’argent, alors je me suis trouvé dans la vraie pauvreté » a dit Bangoura. « Je n'avais absolument rien. Je ne pouvais pas subvenir à mes besoins. Après trois ans de chômage, je ne pouvais pas payer mon appartement. » Sans-abri et sans emploi à Dakar, Bangoura a communiqué avec Serigne, un ami qui l'a présenté aux autres homosexuels sénégalais. Une organisation LGBT a invité Bangoura à un atelier de cinq jours qui a changé son rôle dans la communauté. Il a été inspiré pour quitter la musique et plaidoyer. « Je suis au chômage mais je sais comment créer quelque chose » a dit Bangoura.« Nous allons voir ce que nous pouvons faire. » « Les jeunes hommes m'ont montré la lumière » a dit Bangoura. « C’est à cause de cette [organisation] que j’ai découvert que je ne suis pas seul mais qu’il y a d’autres personnes aussi. » Tendre la main Au début des années 2000, il n’y avait pas d’organisation LGBT formelle selon le Ministère de l’intérieur du Sénégal. « Nous devons prendre des mesures préventives pour cette communauté » a dit Bangoura. « C'est difficile. Nous devons essayer de soutenir cette organisation qui est unique en son genre et finalement je me suis rendu compte que c'était une opportunité. » Bangoura a compris qu'il aurait besoin de d’abord présenter Prudence comme un service de prévention du VIH plutôt qu’un groupe de défense des droits des LGBT afin d'obtenir l'approbation du gouvernement. Bien que les actes sexuels de même-sexe soient illégaux au Sénégal, le ministère a considéré Prudence comme une organisation pour prévenir le VIH et pas comme une organisation LGBT pendant que le gouvernement a fait des progrès dans les efforts de prévention. « Et ce qu’ils nous ont dit en réponse était qu’ils nous donneraient l’approbation, pas parce que nous sommes gais mais à cause des objectifs qu’ils ont vu dans notre demande » a dit Bangoura. « C’est la raison pour laquelle ils ont signé et finalement ils ont signé l’approbation, et L'Association Prudence est devenue la première organisation de sénégalais gais à être officiellement reconnue. » Établie en 2003, le ministre a officiellement reconnu Prudence en 2005. « Finalement nous avons une association qui est composée uniquement de la communauté LGBT à qui lutte contre le VIH qui est trop élevé dans notre communauté et lutte contre l’injustice » a dit Bangoura. « Nous promouvons la justice, luttons contre la pauvreté. Cela fait partie de nos objectifs principaux. Aider ceux infectés par le VIH à recevoir de meilleurs traitements et des soins de suivi. C’est notre objectif. » Aujourd’hui il y a quatorze organisations qui améliorent la santé des populations clées sénégalaises, qui inclut les HSH, les travailleurs du sexe et les gens qui se droguent. Non seulement Bangoura est le président de Prudence, mais il dirige également le RENAPOC, le Réseau National des Associations des Populations Clées. Le RENAPOC collabore avec l’Alliance nationale contre le SIDA pour rationaliser les objectifs des 14 organisations. « Les jeunes hommes m'ont montré la lumière » a dit Bangoura. « C’est à cause de cette [organisation] que j’ai découvert que je ne suis pas seul mais il y a d’autres personnes aussi. » Avoir une voix Bangoura a été victime de préjugés et de discrimination et il est témoin de la violence contre sa communauté à cause de l'article 319. « Il y a certains acteurs et certains politiciens qui disent que l'homosexualité n'est pas interdite par la loi sénégalaise mais pour moi c'est faux » a dit Bangoura. « Cet article de la constitution sénégalaise condamne l'homosexualité. C'est ce que je vois. Personne ne peut rien dire d'autre. » Bangoura a cherché refuge en France pendant six mois avant de revenir pour reconstruire Prudence après que la police a arrêté des membres de l’association en 2008. « Je préfère que nos partenaires soutiennent nos organisations sur le terrain afin que nous puissions continuer ce que nous avons déjà commencé » a dit Bangoura. « Si tout le monde part, rien ne changera. [Prudence] est fondée et ils nous soutiennent. Nous sommes restés et nous sommes ici. » Une lettre envoyée par le ministère de la Santé en avril 2016 signalait l’évolution du gouvernement en ce qui concerne la communauté LGBT. Awa Marie Coll Seck, ministre de la Santé, a invité Bangoura à représenter les populations clés aux Nations Unies. L’invitation confirmait sa décision de travailler avec les jeunes et les vulnérables LGBT au Sénégal. « C’est comme s’ils racontaient mon histoire quand ils commencent à parler » a dit Bangoura. « Alors je vois que nous avons tous la même histoire. » Note de l’éditeur: Cela est la partie deux d’une série sur la santé des LGBT au Sénégal. Cliquez ici pour lire les parties un, trois, et quatre. Des entretiens ont été menés en français et traduits en anglais. Image: Djamil Bangoura, courtesy of Association Prudence Facebook [post_title] => Djamil Bangoura [post_excerpt] => In part two of PHP's four-part series on LGBT health in Senegal, Nick interviews Djamil Bangoura, founder of Association Prudence, a LGBT health and human rights advocacy group based in Dakar. 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In part two of PHP’s four-part series on LGBT health in Senegal, Nick interviews Djamil Bangoura, founder of Association Prudence, a LGBT health and human rights advocacy group based in Dakar.

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Profile

Chrysula Winegar

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                    [post_content] => Both motherhood and technology shaped Winegar’s 20-year marketing and communications career. She identified her own space online to raise the profile of mothers around the world. “This digital revolution and motherhood hit, and I fell in love with digital communications as the next iteration,” Winegar said. “In my career, I have been very lucky to have the progression of digital media map the growth of my career. When I started having my children, at the same time I was discovering all these women out there talking about their lives online.”

She not only professionally witnessed a revolution in ways to approach digital communications, but she also personally observed how mothers share stories online. Winegar’s blog, When You Wake Up a Mother…You Wake up the World, uses motherhood to connect with women around the world. She tackles issues diverse topics like pregnancy, race in America, family, and travel to Mozambique. Those early mom bloggers inspired her to take part in the conversation online.

“They didn’t know each other and would build these relationships that seem so normal now, but back then, it was really radical and in many ways quite a feminist act to dialogue about contemporary motherhood in such an open and transparent way.” She finds motherhood to be an experience that connects communities 10,000 miles apart. “This one experience that is pretty universal across cultures and socioeconomics, but you find that some of those cultural and socioeconomic factors make it that much harder for many women around the world, and so your heart and your head are really switched on to this idea of global motherhood and what it’s like to be a mother in different parts of the world,” Winegar said.

But Above All She Was a Communicator

Growing up in Australia, one of Winegar’s early inspirations was her aunt, a teacher in immigrant communities who was the first person in the family to receive a college degree. Winegar’s aunt taught English as a second language to the children of Vietnamese families migrating by boat to Australia in the 1980s. “I got to watch her with these communities and how she formed relationships with the children who had trauma or difficult experiences and were processing those experiences while they were trying to go to school after moving to a new country,” Winegar said.

This aunt taught Winegar the importance of using communication to engage with communities, especially mothers and children. “The entire Vietnamese community in Brisbane just fell in love with her and wrapped her up as she just loved on their kids and embraced their culture and learned to love their food,” Winegar said. “She was a teacher by profession, but above all she was a communicator.”

[caption id="attachment_405" align="alignright" width="200"]Chrysula Winegar Chrysula Winegar[/caption]

Using lessons learned from her aunt, Winegar landed her first communications job at a headhunting agency in Sydney and London. “That began my love for figuring out how to take a message and get it out there,” Winegar said. “But then I also have always been really interested in how the message resonates, how to tweak it, how to make it better, how to make it more compelling.”

The United Nation’s Best Friend

In July 2016, Winegar became the Senior Director for Communications & Special Initiatives and the Community Manager for Global Moms Challenge at the UN Foundation, which she calls “a private organization that operates like the UN’s best friend.” Her day-to-day activities are diverse: she interacts with partners including UN agencies, watches social media channels, works on the communications strategy, manages an editorial calendar, writes, makes phone calls, and meets colleagues at other UN agencies.

“Every day, I think about how the stories I tell lift up the work of the UN,” Winegar said. Her favorite part of the job is the people she works with at the UN Foundation and partners like UNICEF, UNFPA, Save the Children, 1,000 Days, and UNHCR. She sees how every colleague is motivated to make the world a better place. She also enjoys the opportunity to moderate panels and interview impressive people, such as Connie Britton, Dr. Nina Ansary, and Lonny Ali at the Social Good Summit 2016 (as seen in the featured image).

[caption id="attachment_407" align="aligncenter" width="640"]Winegar (left) with Erika Nicole Kendall and Rosie Pope. This, and the featured image, courtesy of the UN Foundation. Winegar (left) with Erika Nicole Kendall and Rosie Pope. This, and the featured image, courtesy of the UN Foundation.[/caption]

“I am incredibly excited to be living in a time where something like the Sustainable Development Goals exists,” Winegar said. “The fact that the United Nations has the wherewithal and energy and excitement to rally all 193 countries around a list of 17 goals that will solve for poverty and mitigate climate change and really, truly leave no one behind: that to me is why I get up every day and what gives me enormous joy and hope and excitement.”
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                    [post_excerpt] => Nick Diamond profiles Chrysula Winegar, Senior Director, Communications & Special Initiatives, at the United Nations Foundation. 
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Nick Diamond profiles Chrysula Winegar, Senior Director, Communications & Special Initiatives, at the United Nations Foundation.

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