Blog Center for Advancing Health Services, Policy & Economics Research

Why policy* is the perfect fit for public health and social work professionals

Written by Susan Stepleton PhD, chair of the policy specialization at the Brown School

When I mention to someone that I work at the Brown School, a typical assumption – voiced or unvoiced – is “Oh, you teach about poverty or epidemiology or child welfare or LGBTQ issues or homelessness.” Well, yes, of course we do. On the occasions when I go further and note that my particular role is to encourage and support students who are interested in policy there is often a puzzled expression. Social workers and public health professionals are interested in policy?

My response then is to say emphatically that they are – over ten percent of Brown School students now declare a specialization in policy.

In my own first role as a social worker I met a five-year old girl named Kim, who determined my professional direction. Kim lived in southern Indiana with her feeble grandmother and three young adult uncles.  She was curled up in a crib when we met and as soon as she saw my male co-worker she turned away and declined to talk or make eye contact or leave the crib. It soon came to light that the uncles were sexually abusing her, grandma was powerless to make them stop, and there was no good alternative for nurturing care other than to hope it happened in an over-burdened and inadequate foster care system.

The small amount of service that I could provide to Kim was in no way adequate to turn her life around. It was blatantly obvious that the profound interventions needed to set her and thousands of children like her on the road to successful child- and adulthood – mental health therapy, case management, legal advocacy, court processes – were to be found not in a local public welfare (1970’s terminology) office, but in the arenas where policy is made and implemented.

Of course there must be public health professionals and social workers (PH/SW) who carry out the one-on-one attention that kids like Kim require, but who better than well-prepared PH/SW individuals to speak to the systems issues impacting her escape from a dark future?

Barbara Mikulski, MSW, now ranking member of the Senate Appropriations Committee, was a community organizer worried about the impact of Interstate 70 wrecking then predominantly immigrant neighborhoods. First priority in helping individual families was finding policy/political solutions to this systems issue. She did it, and from this successful battle she moved to the Baltimore City Council – later to the US House of Representatives and finally to her strategically pivotal position in the Senate.

Lois Capps, RN, never intended to run for Congress, but agreed to do so as she realized that “…my experience as a nurse would make me a great advocate for the health community.”  Her successful experience in the House of Representatives has played that out.

Why do PH/SW professionals move into the public sector? Don’t let the overused words “they want to make a difference” put you off. We choose these professional directions because of a deep desire to make things better and a deep belief that it is possible to do so.

But pie-in-the-sky idealism is not the source of major compassionate and effective systems change.  Nor is effective but compassionate public policy informed strictly by cost benefit analysis or political theory.

A valid theory of change would posit that PH/SW training encompasses just the skills and expertise that can lead to transformative and effective public policy.

Well-trained public health and social work professionals have been exposed to the workings of the political system and its technical components, just as students of public administration and political science have been. But they also operate from a strong sense of social justice. They have practiced transdisciplinary problem-solving. Their curriculum has included environmental concerns, mental health and education issues at all levels, biostatistics, economics, epidemiology, etc. They have research, writing and basic analytical experience. They have honed people skills – relationship building, empathy, communication.

Who better to transform policy than PH/SW community organizers, local government staff, nonprofit advocates, health systems analysts, executive department officials, legislative aides, health/social welfare lobbyists – and yes – elected officials!

Neither Barbara Mikulski, nor Lois Capps, nor I myself intended to be involved in policy-making at any level, but the call to social work/public health led clearly in that direction. It’s a great reason for optimism that public health professionals and social workers, from the early stages of their careers are becoming intentional about careers in policy.*

*And, dare I say politics!