Public Health Profile: Dr. Christina Welter

“We’re the champions of change and the warriors of the future.”Dr. Christina Welter

Earlier this year, the Public Health Learning Network (PHLN) convened more than 250 public health professionals in New Orleans, La. to discuss the current and future needs of the public health workforce. The daylong Public Health Workforce Forum featured an array of voices from the public health sphere, including researchers, practitioners, and funders.

Dr. Christina Welter, clinical assistant professor of community health sciences of the UIC School of Public Health, director of the MidAmerica Center for Public Health Practice, and co-author of the recently released PHLN Strategic Workforce Action Agenda, sat down with us to discuss her thoughts on the current state of the public health workforce and the opportunities for growth and improvement. Welter served as Deputy Director of the Cook County Department of Health Prevention Services unit and more recently, led the Region 5 Public Health Training Center, which gives her a unique view of the workforce from entry-level to expert. This conversation has been lightly edited for length and clarity.

What are your thoughts on public health workforce development from an academic perspective?

Welter: I know there has been a decreased emphasis both in terms of money going to the practitioners and money going to academia to support workforce development, so it’s become increasingly difficult. We’ve had to become even more creative in terms of how we support the most important resource of our system — our public health workers.

If our workers aren’t prepared and ready to prevent disease and, more importantly, promote healthy living, then that’s difficult. So, that’s just one trend. Alternatively, though, I think one of the good things is that we’ve had to work more collaboratively and be more strategic. In our work with the Public Health Training Center (PHTC) through the National Network for Public Health Institutes (NNPHI) and Health Resources and Services Administration (HRSA), we’ve been trying to see how we can leverage our resources, collaborate, align better, and be more focused.

What are schools doing to prepare public health workforce professionals?

Welter: Academic centers and universities are trying to keep their fingers on the pulse of what’s needed in the field. Schools are adapting their curriculum to help workers, future workers, and students become more prepared with skills that are relevant for the 21st century.

We work to help students not to think in silos but to think of how policy and programming go together and how you can use biostatistics and epidemiology and environmental health to more deeply understand social determinants of health. We’re trying to be more responsive to the real needs of the workforce.

What did you learn from your work to develop the Action Agenda?

Welter: One big thing that came out the action agenda is that the respondents in this particular process spoke very loudly about the need  for more integrative learning approaches in order to address complex problems.

What I mean by that is we have a real opportunity in public health, I think, to be the facilitators of change, to be the real leaders of change, to bring people together at all levels in the system, not just the public health system. The way we’re delivering training needs to be more integrative, more diverse, and more connected to a focal point so that people can take a project or an issue from A to Z.

Right now, we’re doing OK. We might do a webinar series here, a webinar there, an in-person meeting here, but it’s not connected to how you create change. So, if we’re going to make systems change, we need to think about a variety of skill sets, not just one skill set across really complex challenges. So, that’s one thing, the practitioners want that kind of workforce development. I call it capacity building. They want leadership development and not just knowledge. They want to be able to apply and really test those skills.

The second thing I would say is that it [Workforce Action Agenda] emphasized the need to focus on workforce development, and what I mean by that is there has really never been a national coordinating, convening entity or body that can focus on: “What does quality workforce development mean?” And I think we’ve started that with the Public Health Learning Network (PHLN).

I think we’re in the beginnings of that, but just like other disciplines, like evaluation or planning, they have entire associations committed to how to measure, how to evaluate, how to define their discipline. We haven’t really had that. And I think it ties to my first point, which is that there is so much more that we could do or that we could be doing even better with higher quality, so we need greater emphasis on workforce. So in the action agenda, for example, it calls for a conceptual framework on how learning occurs in the field. There’s never really been a focus on how to measure it, and if you can’t measure it, we don’t know if we’re doing a good job. I think there is real opportunity to amplify what we’ve already started.

Related to that is money. I’ve been a part of several different research projects that all have training attached. What if all of money attached to those projects were connected together and we could talk about what quality training looked like together? It would be great if we had a common language for what good training looks like.

What would you name as the top priority to establish a better system for training?

Welter: We need leadership at the national level, so I would create some type of leadership or advisory committee on workforce development to help shape and set the vision for what workforce development might look like. I know without vision or coordination or communication or leadership, it won’t be sustained.

What are your hopes for the future of public health?

Welter: I would say that there is some sort of organization or collaborative that exists and that we have systems in place across the United States that are advancing health equity. My passion is about building leadership capacity across local, state, and national levels to address health equity, and one of the ways you do that is teaching people how to deal with issues like racism, issues like precarious work, the really hard stuff.

It would be great if a system of training were in place and occurring in a grassroots way to help in robust capacity building.

Any additional comments?

Welter: There are so many public health workers that are doing amazing work, and I feel like we don’t get highlighted. It is hard, and we’re always in the shadows. So, the more things that there are that raise us up and build our confidence, the better. We’re the champions of change and the warriors of the future. I just want there to be a support system for that.

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