A Study In Health Equity

Partnership with Oregon Health Authority Provides School of Public Health Students with Hands-On Experience Managing COVID-19 Outbreak

By Katy Swordfisk, PSU Communications

Once it became clear that coronavirus had spread to Oregon — and the United States — public health students and officials alike began to mobilize. By mid-March, the Oregon Health & Science University-Portland State University School of Public Health had formed a partnership with Oregon Health Authority to manage the growing outbreak.

The partnership has proven to be a wealth of real-world experience for students, providing a pathway to potential careers after graduation while also giving them hands-on experience with health equity.

Student employees were assigned to support the Center for Disease Control and Prevention’s emerging infection program, help with contact tracing and conduct case investigations for people confirmed to have COVID-19. For many students — about 25 students have participated in the partnership program to date since March 2020 — providing support to more rural communities was most needed.

Jon Snowden, an epidemiologist and associate professor at the OHSU-PSU School of Public Health, said students were tasked with connecting people with “wraparound services” to help ensure their needs were being met as they recovered from COVID-19. These services include things like housing assistance, food assistance or securing a safe place to isolate.

The conversations could be sensitive ones.

“If we fail to connect or build rapport with some communities it could affect some people disproportionately and make things worse in terms of health equity,” Snowden says.

COVID-19, like many health conditions, disproportionately impacts people of color, those with lower incomes and with public-facing jobs. That knowledge and the need to emphasize health equity has guided the SPH/OHA partnership.

The challenge for students has been to take that understanding and put it into practice.

“It’s been an ongoing process to figure out how we take this commitment, and we turn it into a concrete action and concrete principle,” Snowden says.

Jennifer Ku, a PhD candidate in epidemiology, has served as the student lead for case investigation and contact tracers since the partnership launched.

“A general commitment to health equity may not be sufficient for our work here,” Ku says. “We have to take concrete actions to realize these commitments.”

In her role as liaison, Ku acts as the first point of contact for student workers and the leadership teams at both SPH and OHA. The team continues to evolve but she tries to ensure an open conversation in their regular meetings to encourage students to think about health equity and how they can continue to address ongoing issues. Faculty leads continue to be acutely aware of the importance of health equity as they support students in navigating those conversations, Ku adds.

Those conversations include new ways to present information in multiple languages or techniques to facilitate community engagement. It can also mean reminding students that as they talk with patients their own biases and tone should be considered.

“We try to make sure we’re committed to centering health equity in all of our work,” she says.

Abigail Newby-Kew, also a PhD student in epidemiology, previously worked in Alaska as an epidemiologist but as a PSU student, this is her first foray into infectious diseases.

She works on the case investigation team and is now helping coordinate the team. When Newby-Kew first joined the program, she worked with Umatilla County where a vast majority of cases were among non-native English speakers.

“From an equity and disparity point, that was the most difficult thing: making sure that we are reaching these communities and getting that message out,” she says, “and making sure that we ask all the same questions and produce the same education that we would a native English speaker.”

Student workers often bring in a translator to the call to help communicate with the patient, but Snowden says they’re hoping to continue recruiting new employees who speak additional languages to reduce that barrier to communication.

“It’s really exciting to see this huge focus on public health right now, and it’s a shame that the focus is really on how broken the system is at the moment,” Newby-Kew says. “But I feel like there is a real propensity for change if we are recognizing how chronically underfunded our agencies are and if that inspires action.”

She adds that OHA has been welcoming and supportive to SPH students who’ve joined its collaborative efforts. Students are treated as equals, she says, and are privy to the same information and training as the public health employees as protocol changes and the epidemic continues. At least two students have been offered internships or jobs with OHA since the program began and more students have been able to join the program as a result.

“Even beyond our specific work on COVID-19, I think it’s a great opportunity for us to build more partnership between the state public health organization and our academic institution,” Ku says. “And it’s really giving our students a great opportunity to learn public health in action.”