I’m an International Public Health Social Worker…Seriously!

Say what now?

No it really is a thing! I promise! It’s called international public health social work. It’s really important to know about.

Well why?

That’s a loaded question. It’s focused on prevention. But in a unique way and brings a set of skills which require thinking on a clinical and population level at the same time and being able to understand that empowerment is not simply a tag line you put into a grant application. It’s about understanding the importance of balancing process with outcomes. It’s focused on the social environment as a significant contributing factor to health statuses. After all, it is not an accident that African Americans tend to be at a higher risk of obesity, diabetes, violence, and lower birth weight. Mostly, it’s about being able to approach a problem from two different and valuable perspectives.

Being an international public health social worker, or at least being in this field, requires me to have an elevator speech ready to go in order for someone to understand what I am doing and bringing to the table. A doctor is more or less universally understood, no matter if it is in a tent in a refugee camp in Kakuma, a health clinic in Lima, or the emergency room on Friday night at Boston Medical Center. We understand doctors and what they do – they diagnose and treat people. Simple enough. The same works for nurses and increasingly for community health workers.

Doctors_Nurse_Residents_Interns

But a public health social worker? What is that? Why not just get training in public health?

Funny thing about public health and sometimes we forget this – it’s made up of a lot of individuals. The concept of the “public health” is merely a collected aggregate of individual people’s health statuses. As service providers, we will always have to interact with the people who we are serving.

But still why not just get the MPH?

Well the answer is quite obvious, but it requires a bit of humility on our part as service providers. We recognize the power and privilege we have, and that people skills and trust come before any program implementation anywhere.  We as international public health social workers focus on the social environment as being a significant contributing factor to a person’s health status. Social workers are trained to deal with different systems on an individual, macro, and ecological manner. Social workers tend to hold a unique view on how the world operates and how it got as wacky as it is. They can examine power and historical racism. This is really important for understanding the system in which global health operates – a post-colonial historical context. When it comes to global aid, we are talking about mainly Western Liberal Democracies giving aid to poorer countries which have experienced a long history of violence, oppression, and exploitation at the hands of the donor countries.

Read Paul Farmer’s Infections and Inequalities to understand. Social inequities manifest themselves as infectious and chronic diseases in poorer populations. Sickness is a function of the social pressures and inequities which people face in societies.

Why is diabetes such a problem in the United States? It’s about lifestyle and adherence. Both of these are driven by social forces. Why does an urban African American woman have a significantly higher risk of getting diabetes than her white counterpart? Well, it has something to do with the food she can afford to buy. And what about the fact that there aren’t any safe parks nearby that aren’t hotspots for drug or gang activity? The answer to this social inequity is that there are different social stressors. Public health social workers recognize the social determinants of health.

Sad and unhappy nurse

Public health social work can create the understanding and trust between service providers and clients that can accelerate a program’s implementation or expand its coverage simply by recognizing that people are agents of change and work together to better their lives. Social workers are trained how to deal with the individual.

Public health social work is necessary in a fast paced dollar-driven world of global aid and health. Social workers create the necessary rapport and trust between service providers and the clients. Being a refugee or an internally displaced person is one of the most disempowering things that can happen to someone.  The distribution of resources for global health decides who lives and who dies. As global health workers, we must recognize this power and treat it carefully.

Power, health equity, racism, and structural oppression are all very real things that negatively impact the daily lives of hundreds of millions of people worldwide. Public health social work plays a vital and unique role in the global aid field.

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jon-labrecque

Jon LaBrecque, "Almost" MSW, MPH

I am a dual degree student at Boston University’s social work and public health program. I am in my third year and getting ready to change the world.