We’re excited to introduce you to the always interesting and insightful Nicole Vick, Edd, Mph. We hope you’ll enjoy our conversation with Nicole below.
Nicole, thanks for joining us, excited to have you contributing your stories and insights. Over the course of your career, have you seen or experienced your field completely flip-flop or change course on something?
About 15 years ago, I was very early in my public health career at a large local health department on the West Coast. As a Health Educator I did program and policy development work in a regional area that was quite unique. One part of the region was considered low-income with all sorts of social ills and poor health outcomes and the other part of the region was the complete opposite. I was blessed to be under the leadership of a dynamic and forward-thinking supervisor who happened to be a Black woman and a physician. I was very early in my public health career, so I was bright-eyed and eager to do good work. I wanted to make a difference, especially in the low-income part of the region because that was the community where I was born, raised, and resided. My supervisor saw the drive and passion I had and pushed me professionally in a way I had never experienced before or since. I helped create new programs and initiatives for the office focused on health equity and the social determinants of health, a concept that was new to me. No one else in the department was talking about these things at that time that I was aware of. I also coordinated and facilitated collaborative efforts among private, and non-profit groups and organizations to meet the needs of residents; and I provided technical assistance, advocacy, and coalition building to internal and external partners. It was an amazing time for me both personally and professionally. I learned so much about public health work, leadership development, and my own career aspirations. Those years I spent in that office set the tone for the rest of my public health career and spurred an interest in workforce development as it relates to health equity and the social determinants of health.
What is public health?
Modern American public health is an institution focused on promoting health and preventing disease in communities. At its core, public health is society’s collective effort to make sure that conditions exist that give everyone the opportunity to live healthy lives. Public health is different from the healthcare industry because of its focus on prevention of disease; the health care industry typically focuses on treatment or cure after a person is already sick. The healthcare industry also focuses primarily on individual patients, while public health focuses on entire communities of individuals.
Public health work occurs in various settings such as governmental agencies, community-based organizations, and academic institutions. Governmental public health organizations have the important role of assuring vital public health functions happen and that the mission of public health is appropriately addressed. Governmental public health organizations exist at the federal, state, and local levels across the country.
Local health departments are critical to the institution of public health. A lot of public health work in the United States occurs at local health departments. There are clinical services such as immunizations, treatment for communicable conditions, and maternal and child health services. Population-based programs and services include epidemiology and disease surveillance; primary prevention regulation, inspection, and licensing; and other environmental services such as vector control and land use planning. Local health departments also engage in policy in several areas related to tobacco, emergency preparedness and response, and infectious disease.
The Shift: from Sanitation to Social Determinants of Health
Public health has evolved from its early focus on sanitation and disease prevention, towards health equity by improving the social determinants of health. The social determinants of health are social and behavioral conditions that have a direct influence on disease occurrence, death, and quality of life. Examples of the social determinants of health are healthy and safe environments, housing, access to food, education, employment, transportation, and access to health care.
I was so excited to be a part of the efforts to work on the social determinants of health and health equity in the office I worked in. My supervisor had me develop a health equity scope of work that included goals and objectives that focused on capacity building for the 100 or so staff in the office as well as community-focused endeavors on issues such as housing and violence prevention. I got the chance to research strategies and tools to educate the staff on the impact of institutional and structural racism on population health outcomes and the social determinants of health. I even had the opportunity to conduct research to determine if the workforce was ready to address health equity and the social determinants of health. I won a departmental award for my efforts; from that point on I’ve been very interested in the public health workforce.
As excited as I was about the work, I quickly realized there were some challenges. The research I did made it clear that the public health workforce was unsure about how these concepts related to their everyday work. In other words, it was not clear to a public health nurse, community health worker, or front office staff how their day-to-day work aligned with these very high-level concepts they were learning about.
Second, local health department employees are often given anti-racism trainings or other trainings related to health equity but are not provided sufficient follow up or managerial support to integrate lessons learned into daily practice. I believe this causes tenuous relationships between employees and further exacerbates health inequities in the communities that public health employees are called to serve. I recall sitting in on a couple of trainings at work focused on DEI or health equity and feeling angry and sad because the content affected me directly or non-Black colleagues were oblivious to the issues or shared viewpoints that seemed insensitive and out of touch with the mission and vision of the organization. The workforce had nowhere to express their feelings or get additional support after being trained on such sensitive topics and once training was done, there didn’t seem to be any room for additional learning or support.
Third, although the social determinants of health and health disparity work were becoming more commonplace in public health practice, it was (and still is) often discussed and examined without explicit acknowledgement of the connection to institutional and structural racism, allowing these disparities to continue unabated. In public health, structural racism is implicated in differences in health outcomes by race. The Tuskegee Syphilis Study and the persistently high rates of African American infant and maternal mortality rates are examples of injustices caused by structural racism and what happens when the needs of marginalized populations are ignored.
We’ve come so far, we have so far to go
We’ve come a long way since 2010. In 2020, the murder of George Floyd and the COVID-19 pandemic spurred an overflow of commitments from organizations to adopt DEI principles. In 2019, jurisdictions across the country proclaimed racism as a public health issue and many local health departments hired Diversity, Equity, and Inclusion (DEI) experts or started programs and initiatives focused on health equity. There was lots of public health research done on the impacts of racism on population health outcomes and a significant commitment to addressing the harms so that affected communities had the resources needed to live healthy lives.
Unfortunately, it appears that we will be taking another U-turn and heading in a direction that will likely cause damage that will take generations to repair. The current administration is actively working to eradicate DEI; reduce or eliminate effective strategies for communicable disease control; drastically reduce the public health workforce; attempt to erase trans people by only recognizing two genders; prohibiting the use of terms like “affirming care”, “DEI”, “inclusiveness”, “social justice”, and “LGBTQ”; and halt data collection of marginalized populations, among other things.
So far, my work to eliminate health inequities continues as we wait to see what impact the changes at the federal level will have on local health departments. Much of it will likely depend on individual health department leadership’s desire to continue to do the right thing and secure funding to continue to do work. It will not be easy, but is so very important given all the gains that were made in the last 15-20 years.
Awesome – so before we get into the rest of our questions, can you briefly introduce yourself to our readers.
I am a public health professional, educator, civic leader, podcaster, and author who has spent over twenty years providing tools and strategies to stakeholders, community-based organizations, students, and residents to improve health and prevent disease in some of Southern California’s most underserved communities.
My commitment to community has led to a few prestigious appointments. I serve on the boards of four public health/social service organizations and for two years chaired the Health Commission for the City of Los Angeles.
I have 15 years of teaching experience and enjoys bringing students the “Black Girl Magic” version of public health to students while providing them with a social justice lens to view the world. My last teaching assignment was at Occidental College and I also taught at California State University – Los Angeles, Ashford University, and University of Phoenix.
I have a bachelor’s degree in public policy and management, a master’s degree in public health, and a doctorate degree in Organizational Change and Leadership from the University of Southern California, a place I lived less than 5 minutes away from growing up but felt beyond reach for a young girl from South Central LA.
I have authored two books and have written chapters for two anthologies. In my first book, “Pushing Through: Finding the Light in Every Lesson” I share both the heartbreaking pain and the extraordinary triumphs that led me to advocacy and social justice work.
I also have a weekly video podcast where I discuss critical issues in the Black community from a public health and social justice perspective.
Do you think you’d choose a different profession or specialty if you were starting now?
If I could go back in time, I would absolutely choose the same profession. I love public health and believe that it could be very effective if it actually operated in the way it should. I have been in the field for over 20 years and have seen some of the ways that public health is imperfect. I strongly believe that being an advocate or supporter of public health means I must be open to examining it critically, which I have done since 2014. I even focused my doctoral dissertation on the public health workforce.
I will also say, public health has afforded me an amazing secondary career. For almost 15 years I taught public health to undergraduate students at a few colleges and universities. I thoroughly enjoyed sharing my knowledge and experience with the hopes of inspiring students to consider a career in public health.
Other than training/knowledge, what do you think is most helpful for succeeding in your field?
Training and knowledge is definitely important in succeeding in public health, but I think finding a mentor and being good at networking is also important. Public health is huge, but can also be quite small at the same time. It’s very interesting in that way. It’s really important to talk to folks who have been around a while to get important insight into the work and the back story behind all sorts of important things like job opportunities and trends in the work. You really can’t go into this work and expect to do well by staying closed off. Colleagues and mentors can be important lifelines, especially if you are Black or are part of another marginalized community.
Contact Info:
- Website: https://www.nicoledvick.com
- Linkedin: https://www.linkedin.com/in/nicole-d-vick/
