- I am so, like, hopeful and excited about the next 20 years. But really the next five is what is gonna happen in the public health world because it's almost like a completely new, like, a whole new world that, you know, we're embarking on because of all these things that have happened. And it's just such an amazing time to be in public health right now. - [Host] You're listening to "Further Together: The ORAU Podcast". Join Michael Holtz and his guests for conversations about all things ORAU. They'll talk about ORAU storied history, our impact on an ever-changing world, our innovative, scientific, and technical solutions for our customers and our commitment to the communities where we do business. Welcome to "Further Together: The ORAU Podcast". - Welcome to "Further Together: The ORAU Podcast". As ever, I'm your host, Michael Holtz in the communications and marketing department at ORAU. And today, I am really excited to be talking to two folks that I know fairly well from the world of public health. Julie Crumley, Dr. Julie Crumley, our own senior researcher here at ORAU. And Dr. Paul Erwin, who is the dean of the School of Public Health at the University of Alabama Birmingham. And you may be wondering why are we talking to Dr. Paul Erwin, the dean of the School of Public Health at the University of Alabama Birmingham. And it's because these two people are connected 'cause Julie's an alum of UAB and recently received an award as an alum from UAB. She received the alumni award for practice. And we're gonna talk about all of that. We're gonna talk about the state of public health in general and whatever the heck other ground we might cover in the next few minutes. So first, let me welcome Julie and Dr. Erwin. Welcome to "Further Together: The ORAU Podcast". - Thank you. - Thank you, Michael. Pleased to be here. - Glad to have you. So Julie, let's start with you. So you received this award, the alumni award for practice from the School of Public Health at UAB. What does this award mean to you as a public health practitioner? - Oh, wow. You know, really it's a tremendous honor and privilege to have graduated from the School of Public Health at UAB and I mean, that pretty much sums it all up. It's an honor and a privilege to even be in the same sentence or list of other awardees that were awards that were given out this year. So just complete honor and being back there was just like being at home, you know, seeing some of the same faces and new faces and just fantastic culture and environment there in the School of Public Health. They really set the bar high. So quite a truly an honor and privilege. - Awesome. Well, congratulations, first of all. And of course, and Dr. Erwin, Julie Crumley was the recipient of this year's alumni award for practice. Why? - Well, I'm really, really pleased that Julie received the award and that it's an acknowledgement of her accomplishments at ORAU and the work that she's been doing there. Again, the particular award that she received was the alumni award for practice. And those of us who know something about the work of ORAU know that that work impacts the practice of public health far and wide. And it was because of that impact to the practice world of Julie's work that she received this award. And so she has brought great visibility to UAB in her work and through her work. And we hope that other alumni who come from UAB will see this work as being both representative of the kinds of alumni that we produce but also impactful in the practice world. - Excellent. And Dr. Erwin, you talked about ORAU having an impact on the practice of public health, you know, far and wide, as you said. Can we unpack that a little bit? I mean, yes, I know we've, you know, public health is, you know, certainly part of our capabilities. We are not per se, you know, a public health agency, but we work very closely with the Centers for Disease Control and Prevention and the National Institutes of Health and, you know, other organizations that do have a, you know, impact on public health. So we are kind of right there in the trenches. And of course we have folks like Julie who are, and many other folks on our public health team that are our public health practitioners. So, you know, we're sort of touching a little bit of everything. - You are. And the, you know, work that ORAU does, particularly in the areas of evaluation and assessment has huge impact in the public health practice field. You know, we often, at least in my experience when I was in public health practice working with the Tennessee Department of Health, evaluation and assessment was, and I would say especially evaluation was one of our weakest areas in public health practice. And I think there were a number of reasons for this but it's an important, an incredibly valuable arena that ORAU finds itself in when it's conducting large scale evaluation projects and activities, whether it's for CDC or the NIH or other level of public health organizations within both federal and state agencies. - And just for the sake of honesty, you and I worked together briefly when I believe you were at the Tennessee Department of Public Health and I was at the Knox County Health Department. So our paths crossed... - Yes. - And we did some work together. And actually one of my favorite time periods when I was at the Knox County Health Department was the course that you led on, basically, I think it was public health evaluation, basically understanding how that process works and why it's important to measure what we do. - I'll make note of one other connection that we have, Michael. While I was, I think, your time at the Knox County Health Department also coincided with me leaving the Tennessee Department of Health and going to establish the Department of Public Health at the University of Tennessee. - Right. - And while I was there as department head, a person by the name of Jeff Miller came through and got his PhD while I was there and I was on Jeff's dissertation committee and actually ended up being a co-author on at least two of his publications that came from his dissertation. And I know that Jeff is on your leadership team there at ORAU. And so... - He certainly is. - Again, very pleased for that. Freddie Gray is another graduate from the University of Tennessee in Knoxville, well before my time there. But I know that there are other graduates from UT up and down the hallways of ORAU. So there are multiple points of interface. - Absolutely. - But Julie is our UAB graduate. - Right, yes, absolutely. Let's make that clear. - Small world, very small world. - Yes. - That's right. We are all connected. It's true. So, you know, in the last few years, we've been going through kind of a major public health crisis, right? And on some levels, public health has taken a beating, but public health is so critical. I mean, what public health practitioners do in terms of disease prevention and education and as you said, Paul, you know, evaluation of understanding you know, basically, what gets measured you know, gets evaluated, what gets counted, gets evaluated and determines the success of, you know, a campaign whether it's education or, you know, vaccine uptake, whatever it is. Where are we in the world of public health today? And I know that's a big question but I know practitioners are still doing their thing. You know, despite all of this stuff of the last few years, there's still work to do. There's lots of work to do. - You know, Michael, I think that, first of all, that many people have discovered public health, the cause of the pandemic. You know, the joke around the school is that many people now realize that an epidemiologist is not a skin doctor. And that interest, actually, was reflected in a huge surge in enrollment, not only in our school, but in public health schools and programs, like the one at UT, across the nation in the fall of 2020. We haven't maintained that huge tidal wave, but our enrollment numbers are still above pre-COVID levels. So that's one reflection, I think, of the pandemic. Right. You know, while I understand that, probably in many ways, CDC, as the lead public health agency in the nation, got a lot of black eyes on its management and response to the pandemic. I think that there were some things that were attributed to the CDC that were unfair and out of bounds because in many ways, the CDC was sidelined by the previous administration in a way that we had never seen CDC managed in previous large outbreaks or epidemics such as Ebola or even SARS-1. - Right. - But my own experience here at UAB during the pandemic was to just be amazed and thankful and so appreciative of the work of our local, the Jefferson County Department of Health and the Alabama Department of Public Health of the commitment and the incredible courage that so many in public health practice exhibited and just the incredible investment of time and energy in trying to do the best that they could to make the best situation possible for the public. And so my hat remains off to those public health practitioners, some of whom we know, in many places, became the objects of workplace threats and violence. - Sure. - Simply by doing their job. - And left practice in many cases, right? - Yes, yes. Many left practice. But I think we're certainly hoping that with the WHOs ending of the public health emergency of international concern statement on COVID and the CDCs on lifting of the public health emergency, I'm hoping that we can truly say that it is in our rear view mirror, even though we know that it's still here - Right. - And people are still contracting COVID and people are still dying from COVID. But it has become, in many ways, literally and figuratively endemic and we'll continue to see COVID for years and years to come. No doubt. - Sure. - But I think that, I think we're, in many ways, have come out of the pandemic, in many ways, with a stronger sense of what public health can do, both governmental public health agencies as well as public health writ and large. And I include ORAU under that large umbrella of public health related organizations. - Well, that's a good segue actually to the work that Julie does because I know Julie and the whole team at ORAU do yeoman's work. And Julie, I know your expertise is in things like non-medical interventions and, you know, in preparedness and evaluating response. You know, one of the large projects that you have been working on, I'm not sure if it's complete or not, so you can answer that question, but was for the Office of Inspector General, you know, at HHS to measure and evaluate, to evaluate the response to the pandemic and how to basically be better prepared when the next one comes, because there will be a next time. - Absolutely. And I think, you know, in public health, the threats are constant, for sure, but certainly, there were still hurricanes and other natural disasters that went on during COVID and you know, they just don't stop just because there's an outbreak. So, you know, that really stresses a system in ways that, you know, you don't ever want to stress it, but you learn where the flexibilities are and where the areas are that could be a little bit more elastic. And hopefully, we don't get into the situations of I guess what I'm gonna call learning lessons. 'Cause I think it's one of those things that you learn something, but then what are you doing about it, right? So you take that one moment in time and you learn, but how are we correcting some of those things? And I think we see that at the national level right now with certain offices being, having been recently created at CDC and some White House initiatives focusing on new areas like well, renewed emphasis or new areas for public health is like big data, modernization, surveillance, things that needed adjustments or could use some enhancements to be better prepared for the next fill in the blank that happens. - Right. - And so, you know, preparedness and response is just this fascinating area to me because it's just so dynamic and you never stop learning. - Right. - And so it's where we go from there. I'm so, like, hopeful and excited about the next 20 years but really, the next five is what is gonna happen in the public health world because it's almost like a completely new, like a whole new world that, you know, we're embarking on because of all these things that have happened. And it's just such an amazing time to be in public health right now. - Well, that's exciting to hear that we're sort of in exciting almost rebirth, so to speak, of a practice and a profession because we've learned so much and there's so much more now to emphasize and put our focus on. Paul, do you see that as well? - I absolutely do, and we will definitely want to stay connected to Julie because of the work that she's done in evaluating the response to the pandemic because we will be standing up a new DRPH, a doctorate in public health, in leadership in public health preparedness. - Okay. - And we'll reach out to Julie for help in our curriculum development. - Well, that's exciting. - The state of UAB and the School of Public Health is tremendous and getting that overview and listening, getting to listen to where things were in the last couple years and where they're going and what's happened. And it's just, I'm so excited for the school. - That's great news to hear. You know, and Julie, we've talked about preparedness, you know, and sort of lessons learned from the pandemic and other, you know, natural disasters and other, you know, incidents that require sort of large scale response. But at the same time, there's always, right, ongoing disease surveillance, right? We're always, you know, as my heart lives in all things cancer, so, you know, tracking cancer incidents and mortality and watching those improve because we're doing a better job of educating people about early detection and prevention and, you know, so there's the big stuff, right? There's the, like, disaster preparedness, which is hugely important. And, you know, we have a very large group of folks who are expert in that, but we also have a group of experts who are, you know, involved in sort of that day to day, the education, the ongoing here's what you can do about this and here's how prevention works. And, you know, all of those to, there's literally room for anybody in public health, right, depending on sort of what your focus is and where you want to, you put your skills, I guess. So, you know, I was not a public health practitioner working at the Knox County Health Department. I'm a marketing guy by a background. But running those programs was amazing. And the people I got to work with, still to this day, and knowing what they've been through, you know, during the pandemic, Dr. Erwin, like you, my hats are off and remain off to like, holy cow, those people know their stuff and you all know your stuff. So I don't know, I don't know where that's going except to say there's still a lot to do in the wide world of public health. - There certainly is, Michael. One of the things that the pandemic did was make visible what many of us in public health were well aware of, but I would say the general public was not and that's health inequities. - Absolutely. - And I think what became very apparent with the pandemic were the very extensive health inequities experienced by people of color and low income Americans as well, regardless of color, significant health inequities that continue to call for our attention. - Absolutely. - And in addition to laying bear the health inequities, I think, the challenges of mental health - Oh yes. - And how pervasive those challenges are. And I have to imagine there's great intersection in, you know, all of those in the health equity issues, the mental health issues that exist, et cetera. I mean, just access to all of that is, I feel like just from the conversations I've had, not only in our organization, but in some of the cancer groups that I work with, we're sort of at this inflection point where we really need to figure this out and we need to figure it out now. Does that sort of feel like the next great public health emergency, if there is such a thing? - It's certainly one of them. Wouldn't you say, Julie? - I absolutely agree. Those are not simple problems and... - Yeah. - They took... - Right. - Some time to develop. - Right. - Yeah. Absolutely, yeah, they didn't happen overnight so they're not gonna be solved overnight either. - Mistrust, I think being one of those areas that's sort of, like, quickly shot to the top of the list for many people in public health as a, oh, well, we didn't really cover a whole lot of this but it is certainly something that we have to address and how to best address it and... - Right. - What are those best strategies? - Right, and how do you reach people who don't trust the healthcare system? They don't trust public health. They don't trust the messaging. And they've never been taken seriously. You know, if you live in an area of town that doesn't have access, you know, and it's not like suddenly you're gonna wake up and have access and then, oh, trust the system and everything's gonna be great, right? So it feels like, from my perspective as a layperson, there's a lot of groundwork that needs to be covered to rebuild that trust. And it's not just about sort of throwing the doors open and access for everybody. You know, yes, that's important, but people aren't just gonna walk in the door because the door is open. - It takes time to correct the problems that it took time to develop. - Absolutely, absolutely. - Well said. - For both of you, anything I haven't asked that you want to make sure we talk about in the time that we have left? And it's okay if there is nothing. - Well, I hope that we can continue this connection with ORAU and that, Julie, I hope that you'll be able to serve as a place for potential internships for our students. I know that when I was at UT, a number of our students did their MPH internships at ORAU and those turned into jobs, full-time jobs for many people. So I'm hoping that the same can continue to take place with you, Julie, because we certainly admire the work that you're doing. - I'm so excited. - Awesome. - I should've brought a jacket 'cause I have goosebumps. - I'm hearing that as a yes, Dr. Erwin. - No, that's good. That's good. - All right, well, thank you both so much for your time today. I really appreciate it. Oh, one more question for both of you. This is a question I ask everybody and I almost forgot. What brings you joy? - Children. Happy children. - Happy children. I like it. All right. - Yeah. I'll take that to a healthy next generation. - Ooh, I like that. - Yeah. - Good on both of you. I like that a lot. Well, thank you both for joining me for this conversation. I hope we can do it again and talk more about how we're working together to solve some of those big problems we talked about. - Great. - Thank you so much. - Thank you, Dr. Erwin. - Thank you. Thank you, Michael, and thank you, Julie. - Thank you both. Have a great day. - All right, y'all too. Bye-bye. - [Host] Thank you for listening to "Further Together: The ORAU Podcast". To learn more about any of the topics discussed by our experts, visit www.orau.org. You can also find us on Facebook, Twitter, and LinkedIn at ORAU and on Instagram at ORAUTogether. If you like "Further Together: The ORAU Podcast", we would appreciate you giving us a review on your favorite podcast platform. Your reviews will help more people find the podcast.