Tag Archives: APHA

Public Health in Action – The Secret Life of Males

man mountain.jpeg

 

It was in fifth grade when I first read a handful of James Thurber’s “The Secret Life of Walter Mitty.”  My teacher, Mrs. Dalton, used Thurber as an example of descriptive writing, what she referred to as “Show, not tell” or SNT for short.  I vividly remember writing a story similar to Thurber’s Walter Mitty, where I would drift back and forth from real life to daydreaming and back again – racing a car in my daydream, only to be scolded by the grocery store manager for barreling the shopping cart into an innocent pyramid of watermelons.

Now more than two decades later, I still chuckle at Thurber’s humorous tales; humbled by his seamless transitions between fantasy and reality.  But on a deeper level, the life of Walter Mitty illustrates distinct social norms and narratives.  Walter’s fantasies transport him into a life that’s far more exciting, full of adventure and intrigue, and completely different from his normal life.  He’s the stoic commander of a helicopter flying into a snowstorm or the Air Force captain taking a few drinks of brandy before jumping behind the machine gun turret.  He becomes his own hero; a figure of admiration by those around him.  But the story beneath reveals a few underlying messages to males, in particular: take risks, be heroic and be brave.  And those messages are absorbed, accepted and passed from generation to generation.  These “rites of passage” have a profound effect on personality, lifestyle and behavior. Moreover, they may also explain the following:

Males are:
*less likely to have health insurance
*half as likely to visit a healthcare provider
*employed in the most dangerous of professions – fishing, mining, fire fighting, construction
*more likely to take risks at younger ages

As a result, males aren’t as healthy as their female counterparts.  And for a group of this size, roughly 150 million, the impact on society is a staggering thought.

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I had a chance to catch up with Dr. Michael Rovito, assistant professor at UCF about his passion and interest in men’s health.  Let’s check out his story.

 

Me: How did you end up doing the work that you’re currently doing?  Describe your journey to your current role as assistant professor and researcher at UCF.  Describe why you’re passionate about making men healthy…why others should care about the health disparities between genders.

Michael Rovito: I had an unorthodox path to practicing public health, actually. I obtained a BA in Geography and a MA in Urban Studies. I was a bit aimless with life goals and no real idea of what I wanted to do with my career. During my graduate studies, I had a class called ‘Medical Geography’. An epidemiologist taught the course and it opened my eyes to the idea of public health and what I can do, not just with my own career, but for other people. I don’t think we really reflect on how we can assist others with our profession and that was my ‘eureka’ moment with public health.

After I realized I wanted to get into public health, I reflected back on my life and the health behaviors I made when I was younger and I focused in on men’s health. The notion of life course perspective was brand new to me so I dove in head first, borderline psychoanalyzing my past habits and trying to predict my future health outcomes. I chuckle now at my naiveté at the whole process, but it’s what we all do when we discover a new toy or gadget, right? We kind of go overboard a bit. But, I am thankful for my rather intense puzzling of the past with present outcomes as I remembered a time when I was 16 and I discovered a lump on my testicles. I thought it was cancer. Being the mid-90’s, there wasn’t the internet that we know today. No WebMD. No Google. So, I just kept quiet and suffered silently. Eventually I broke down and told my parents. That anxiety is some serious stuff. Worrying about the possibility of having cancer at 16 with no information…it was pretty rough.

Eventually I saw a urologist and fortunately it was not cancer. I went through the cancer scare right around the time of my introduction to public health so I thought to myself that I needed to help other guys who were in the same situation as I was. I wanted to help them feel less confused, more comfortable, and empowered. So, after obtaining my PhD in Public Health from Temple University in Philadelphia, I decided to devote my professional life to, again, helping males get healthier in any way possible – from learning new information to practicing new preventive behaviors. Whatever it took, if I can help even in the slightest sense, I wanted to do that. It seems like a simplistic mantra to explain why I do what I do, but deep down, I think most of us who practice public health have similar ambitions.

Me: What inspires you on a daily basis, especially when things get hard?

MR: I guess I should say “who” inspires me now is my wife and my daughter, and my little Shiba Inu, Lola. What currently inspires me? Making sure they have the best life possible. Having this new family of mine has REALLY changed my perspective on life. I had always heard while growing up how kids and family life changes you, but I shrugged that off and rolled my eyes at it. I mean, how would I know just how much that would alter my view on life if I never had them? It’s understandable, I guess. But, now, I can’t let them down. That’s what drives me everyday.

But, before my family, my inspiration was to succeed where most of the people I grew up with didn’t. The odds of leaving the little Appalachian town in the hinterlands of Pennsylvania were certainly not in my favor growing up. There’s certainly nothing against not leaving, but I needed to leave. I wanted to leave. So, finding the means possible to leave, to grow, and mature in ways that weren’t readily available to me was my primary motivator. If anyone reading this ever grew up in small town America, they can relate. They can relate to the entirety of John Cougar Mellencamp’s discography serving as the official soundtrack to their lives. My inspiration then was to make a new soundtrack.

Me: Describe your research interests and/or current research projects.

MR: I have two primary research interests: testicular self-examination (TSE) promotion and intervention/instrument design within young adult and adolescent male populations. In terms of the TSE work, I am currently focused in on the health policy side of it all. I am embroiled in a push to directly challenge the USPSTF review of the TSE and its “usefulness”.  In terms of the intervention and instrument design, I developed a series of tools and assessments that can be used in outreach programs that can capture great data on current outcomes and indicators of future outcomes.

Me: What made you decide to be involved in the men’s health movement and the American Public Health Association Men’s Health Caucus (MHC)?

MR: Advocacy is very important to me, as is disseminating my work to a broader body of my peers. MHC does that for me. APHA/MHC provides a pathway, not only to share my work, but also provides a means to collaborate. That’s very important. I can’t stand the thought of being a professor if I can’t profess to people. I can’t stand the thought of having a degree in public health and not actually getting my work into the public. So many of academics don’t actually practice what they preach, which frustrates and angers me. What’s the point? But, MHC is one way that I can get my ideas to others and perhaps implement them in the field.

Me: What are the current needs in central Florida (or focus in on the city you live in) as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

MR: Central Florida has the same needs as pretty much the rest of the country, but it’s just amplified due to the huge population growth and the diversity here, which makes it a bit different than some other areas of the US. But, overall, the needs are the same: we need to inform, we need to empower, we need to advocate.

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Engaged in Thought

cenrAugust 23

I was fortunate enough to attend the “Engaging Patients, Families and Communities in all Phases of Translational Research to Improve Health” Conference this past Thursday and Friday because it stimulated some serious thought and discussion amongst attendees, but most importantly myself.  Conferences are usually worthwhile because attendees are typically doing similar work.  An added feature is the sharing of ideas, best practices and stories – the dreaded “networking” – can actually be broken down into genuine conversations about helping each other perform their respective careers better.  Most conferences meet this basic expectation.  But this one was different.  It went above and beyond my expectations for several reasons, which I will describe below.

First, the size of this conference was extremely manageable.  Roughly 200 attendees registered to attend and all but a dozen or so made it to Bethesda to hear keynote speaker Dr. Chris Austin kick off Thursday with laughter and thought-provoking questions.  Out of the 180+ that attended, I can safely and confidently say that I was able to engage with 20 of them in meaningful conversation regarding potential opportunities to collaborate in the near future.  Contrast that with a larger conference, say APHA’s annual conference of a massive 30,000+ attendees, and it’s no wonder why attendees stay within their subsections and specialties.  This conference provided me with ample opportunities to engage with and learn from professionals doing completely different work.  And that to me was particularly valuable.

I touched on it earlier, but I was very impressed with the wide range of experts in the field of public health and community-based research.  One group showcased their work to improve health outcomes in Amish communities and another described relaying crucial health communication messages via text messages in rural health clinics at various sites in Kenya.  Talk about learning opportunities!  And this is my favorite way to learn – seeing problems being solved in the field as they relate to the realities of life and then interacting with the investigators to learn how these interventions could be replicated to improve health in other populations.

Lastly, the agenda was designed to introduce ideas via speaker presentations then move into smaller breakout groups to tackle more specific questions.  One specific breakout session that I attended dealt with the ethical implications of community-based research.  Here were a few questions that were left in my mind to sort out post-conference as I continue working at the community level:

*As researchers, what value can we provide back to communities in exchange for critical research data?  

*How can we make the relationship more mutually beneficial?

*What if the research results did not shed the community in a particularly positive way – think of the negative implications that could arise if the media reported on those same results

*The idea of research and the value of official academic research compared to “findings” or “observations” seen in communities…is one necessarily better than the other?

For the reasons aforementioned, I personally thought this conference was very valuable to my work as a public health professional.  But, similarly, it also leads me to think that much more work needs to be done outside of our own “public health bubble.”  Dr. Austin of the National Center for Advancing Translational Sciences at the National Institutes of Health illustrated this with a simple, yet extremely profound anecdote.  He described meeting with members of Congress recently and one of the members asked him about his work in linguistics.  Apparently that member read translational sciences in the title of his division and assumed it was translating language rather than public health science.  Viewing this from a public health lens, I would shake my head and laugh.  But viewing this outside our “public health bubble,” I probably would have said the same thing or asked, what does this really mean?  Even in my own experiences when trying to explain what public health is to people from all walks of life, to put it simply, it is a complex conversation to have.  Which is why I strongly believe that we as public health professionals need to do a better job at relating to and forgiving others for not understanding ideas and concepts from our perspective.  One example of this is public health funding.  Public health funding was increased under the support of President Obama and written into the Affordable Care Act back in 2010.  Shortly thereafter, resulting from the many tumultuous battles to reduce federal debt and annual federal budgets, public health funding was the first on the chopping block.  Many members chose to redistribute funds previously appropriated for public health work to budgets of the Department of Health and Human Services.  The same funds which were originally set aside to boost prevention efforts in communities nationwide.  This left public health professionals – including myself – outraged.  Why can’t the appropriations for the Department of Defense be on the chopping block instead?

But now it all makes sense.  The dots are finally connecting because of that anecdote Dr. Austin shared.  One of the main reasons that the field public health has trouble getting traction with funding streams is that the greater public – whose health we ironically serve to improve – doesn’t really know what we do.  And when a member of Congress sees a significant budget devoted to what appeared to them as “translating language,” then our efforts will always be reactive in nature – why are you taking from our much needed annual appropriation?  Therefore we must strive to espouse one of the basic principles of public health: take action for a proactive solution to funding – “Dear members of Congress, this is why we need what we are asking for.”

Until we get to that point, we’re still downstream on that river asking why there are so many people falling in.

I know we can do better and I am confident that we will.

“Anybody can become angry – that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way – that is not within everybody’s power and is not easy.” — Aristotle