Growing the Grassroots Power of Public Health

Eric Coles, Heather Krasna, and Tameir Holder describe the work they're doing to increase awareness and funding for public health activities.

The post Growing the Grassroots Power of Public Health first appeared on JPHMP Direct.

In earlier installments of this column, I have called for more visibility for public health, and emphasized the role of advocacy and lobbying activities to raise much-needed funding. In my Would-be Manifesto and other articles, I have suggested priorities for long-overdue action to raise the profile of public health and reimagine the capacities of our long-neglected sector. In today’s installment, I’m passing the mic to colleagues who are working towards exactly that goal. 

This guest blog by Dr Eric Coles and Dr Heather Krasna, co-founders of the National Alliance for Public Health Students & Alums (NAPHSA), together with Tameir Holder, MPH, doctoral student in Epidemiology at Columbia University’s Mailman School of Public Health, explains the work that they are doing to organize towards increased awareness and funding for public health activities.

Is lobbying part of your job description? Are you tasked with contacting your member of Congress in support of a bill? Or holding a briefing meeting with congressional staff? As public health professionals, we rarely see these tasks prioritized in our field.

Yet, we believe that public health needs more lobbying — for our workforce, our departments, our schools, and our futures. For decades, research has shown the huge return on investment on public health projects, leaders have written op–eds advocating for more resources, and national committees have raised the banner for public health. But the tragic losses of the COVID-19 pandemic show that vastly more needs to be done. As the COVID-19 public health emergency in the US ended on May 11, a policy window for major change is now rapidly closing. 

An untapped power in public health is the growing number of public health students and graduates, a group which has grown 1000% in 19 years. Yet, despite the growth in numbers, we don’t hear the grassroots voices of public health students and graduates being represented in lobbying and advocacy efforts. We recently founded and now lead the National Alliance for Public Health Students and Alums (NAPHSA) to meet this need. If you are a student or alum of a public health degree program, we invite you to join our listserv here and become part of a community dedicated to public health advocacy and health equity.

Public health professionals dedicated to improving the public’s health through use of evidence-based programs and strategies may question the relevance of diving into the political realm. However, we emphasize that public health is innately political: from 19th century urban sanitation initiatives, to advocating for vaccines and taxes on cigarettes in the 1950s and 1960s, to continuing the push for racial and social justice today, the history of public health has always been entwined in politics. 

And we have latent power to leverage. There are approximately 140,000 current public health students with approximately 40,000 graduates every year, which is more than dental and medical degrees combined.

Meanwhile, we observe other health-related professions substantially more engaged in lobbying efforts. The American Medical Student Association (AMSA), for instance, was established nearly 70 years ago with advocacy as a central part of its mission. Annually, AMSA organizes “Weeks of Action” every year when their members walk the halls of Congress in their white coats, voicing support for issues including public health, environmental health, LGBT and reproductive rights, gun safety, global health, getting out the vote, and more. 

It is our hope that NAPHSA will offer similar opportunities for public health students and graduates to become involved in advocacy work. As an incorporated 501c4 nonprofit organization, we are not restricted from lobbying, unlike 501c3 nonprofit organizations which are more common in the public health field. 

Our early efforts are already starting to show success. Our first campaign is supporting a loan repayment program for those with a public health degree working in state, local, or Tribal health departments. While public health students are eligible for the Public Service Loan Forgiveness program, which cancels student loans after 10 years of payments for those working in any nonprofit or government agency, they are not eligible for several other specific programs aimed at supporting health professionals. For example, the National Health Service Corps (NHSC) pays back up to $150,000 over 3 years to those with clinical degrees (doctors, nurses, dentists etc.) for working in certain organizations, including public health departments. Even though public health is the only degree specifically designed for trained work in health departments, holders of public health degrees do not qualify for NHSC repayments. 

In the summer of 2022, we shared a petition letter with over 2,500 signatures supporting a loan repayment program for public health graduates with congressional representatives. We organized the first-ever Public Health Students & Grads Hill Week in September 2022, in which the Association of Schools and Programs of Public Health (ASPPH) trained nearly 100 public health degree students and alumni on how to effectively speak to, and persuade, members of Congress. This led to over 20 meetings with members of both the House and the Senate throughout the fall. These efforts started to pay off in December 2022, when the Omnibus Appropriations Bill included language authorizing a public health loan repayment program; however, the program is currently stuck in political limbo until funds are appropriated. 

Our efforts have continued in 2023 with another sign-on letter for appropriations for the program, this time with over 4,100 signatures from every state in the union and another round of meetings with congressional staff. We are also very excited about the recent report by the President’s Council of Advisors on Science and Technology about the public health workforce, which specifically highlights the need for loan repayment for public health students. We plan to continue advocating for student loan repayment opportunities for public health degrees and those working in public health. 

Our work is just getting started. Over the next few months, we hope to build a presence in more states around the country, host trainings in advocacy, communications, and lobbying, and empower new and current public health professionals. We have support from institutions and from students. We have already partnered with ASPPH, one of the leading public health advocacy organizations, and we hope to partner with other leaders in the field in the coming months.

We imagine a future where every candidate for office has a public health scorecard, every public health school and program has a NAPHSA chapter, public health professionals see advocacy and/or lobbying as a key part of their work, and all public health students are prepared to speak to their elected officials. We must form a new generation of public health leaders that confronts political issues head-on. The voice of public health degree holders must be loud and clear to prevent the further dismantling of our nation’s public health system. If you are a public health degree student or alum, please join us. 

Whether lobbying is in our job descriptions or not, it is time for public health students and graduates to take center stage, speak up, and be as loud as we can be.

Questions (join us for discussion in the comments or on LinkedIn) 

• How can we get more public health students and professionals to recognize the importance of lobbying? 

• What is the best way to do grassroots organizing of public health students and alums for political campaigns?

• What policies or programs should be the lobbying priorities for NAPHSA?