In this episode, we celebrate National Public Health Week with a conversation about partnerships, resiliency, and community and what it’s been like to work in local, community-based public health during the COVID-19 pandemic. Our guest is Danielle Pettit-Majewski, director of Johnson County (Iowa) Public Health and MPH alumna of the University of Iowa.

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Anya Morozov:

Hello, everyone. Welcome back to From the Front Row, brought to you by the University of Iowa College of Public Health. My name is Anya Morozov. And if this is your first time with us, welcome. We’re a student-run podcast that talks about major issues in public health and how they are relevant to anyone, both in and out of the field of public health. Today, I am excited to be talking with the University of Iowa College of Public Health alumna, Danielle Pettit-Majewski. Danielle is the director of Johnson County Public Health. She is also a member of the Iowa Public Health Association’s Advocacy Committee, and she is a former public health director and city council member in Washington County. Today, she is on the show to talk with us about her journey and about collaborating with the community to promote resiliency. Welcome to the show, Danielle.

Danielle Pettit-Majewski:

Thanks, Anya.

Anya Morozov:

To start off, can you walk me through your background and what led you to become the director of Johnson County Public Health?

Danielle Pettit-Majewski:

Sure. Well, I graduated from the University of Iowa College of Public Health in 2010. And at that time, I had taken a job in private practice, managing family practice clinics in Waverly, Iowa. And did that for about three years when I had the opportunity to be the director in Washington County. And so my husband and I moved to Southern Iowa. And that was a really wonderful experience, getting to be the director in a community of about 22,000 people, getting to build really close relationships within the community, and really getting to learn the ins and outs of what it’s like to work on the ground in local public health. And they say that if you’ve seen one health department, you’ve seen one health department. And so it’s really been an interesting experience to take what I’ve learned from serving in Washington County for eight and a half years, and then being able to apply it when I applied last spring for the director position in Johnson County.

Anya Morozov:

Yeah. That’s awesome. I can imagine that like probably going from 22,000 people to, I believe it’s like 90,000 here has been a bit of-

Danielle Pettit-Majewski:

It’s 152,000. Yeah. Yeah. It’s quite a leap, but public health is public health. And so a lot of our grants are the same. We have different levels of capacity. We have different programs, but the mentality behind how we implement public health on the ground is still about meeting the community where they’re at. So it’s not as much of a leap if you’re thinking of the philosophy of how you’re going to interact with a community and how you’re going to assure that their needs are met. It’s just the needs might be different. And so it’s getting to know the community and really trying to fill the need.

Anya Morozov:

Yeah, that’s a really good perspective. So in your last decade of working in public health, what have you learned about promoting community partnerships?

Danielle Pettit-Majewski:

That they are the key to everything. Public health, local public health does not have capacity to make the changes on their own. We just don’t. But that’s why we call ourselves a convener. Public health is a convener and we are often at the center of moving public health processes forward, but it’s really about getting to know our partners, being able to leverage capacity, being able to leverage funds because we won’t have the money to do things, to fix all of the problems. So we have to be able to braid funding, whether it’s through grants that we might get or talking with our communities as they’re putting together their five year plan, maybe to improve workability. And if we’re on a wellness coalition, maybe we can find a grant that can also help supplement plans that they were already going to do, but then enhance them. So it’s really about figuring out where the community is at, what their needs are, what resources each community part can bring to the table and trying to utilize them as effectively as possible.

Anya Morozov:

Can you talk a little bit about what public health collaborations currently exist in Johnson County?

Danielle Pettit-Majewski:

There are so many. It’s really interesting because I’ve only been here for about seven months. And so a lot of the collaborations, we were able to strengthen during COVID because that required so much communication between our community partners, between the schools, between the University of Iowa hospitals, between the college. There are so many partnerships that we worked on through COVID and there’s so many more that we want to help strengthen and enhance as we move beyond COVID. And I will say, because I came in and was really trying to focus on the internal workings of this department, I have not had the opportunity to make as many connections in the community as I would like to yet, but it’s something I’m looking forward to doing, to getting to know the community outside these walls a little bit better and gaining more partnerships. But my staff have been really collaborative and working with the community and making those connections, which is how we are going to be able to make progress.

Anya Morozov:

Can you talk kind of like day to day about how you go about getting to know the communities that you or your staff collaborate with?

Danielle Pettit-Majewski:

Sure. So it’s about building trust, right? And it’s about, like, if you don’t have a pathway, you don’t have a path. Sometimes it might be because you’re doing a direct service and then it might be making connections about, okay, so how else can we help this community partner? We’re seeing maybe a trend where we’re getting a lot of referrals from one particular community partner. Okay. So how can we have conversations with them to see what else can we be collaborating with? How else can we be working together to make sure that we are kind of a reinforcing cycle to say like, we’re going to assist these folks, but they’re also going to send them to us, we have these other resources?

Danielle Pettit-Majewski:

So it comes down to things like providing WIC clinics at mobile food pantries, how can we maybe provide immunizations in schools? It’s having conversations about meeting people where they are, and really trying to figure out the best way to utilize our partnerships, because there’s a lot of barriers to care, but if we can provide services and make connections with folks when they’re already utilizing other services in our community and working with our partners, that’s the best route for us to go.

Anya Morozov:

Yeah. So it sounds like there’s like not a one-size-fits-all approach to developing partnerships. In fact, quite the opposite. It’s kind of like how one health department is. If you’ve seen one health department, you’ve seen one health department, if you’ve seen one partnership, you’ve seen one partnership.

Danielle Pettit-Majewski:

Yeah. That’s absolutely it. And sometimes it’s such an amazing thing because you stumble upon partnerships sometimes by accident and you realize how many additional resources that folks can have. And so we really want to do some more work on kind of broadcasting what we have available in the health department. We’ve been talking to people for the last two years about COVID, but that’s not all we do. There’s a lot of services we provide and we have a lot of benefit to share. And so we have some positions that have been funded through ARPA funding, from the American Rescue Plan that we are hoping to really get out into the community more, build those relationships, connect folks to care, and make sure that we are trying to fill some of the gaps and those health disparities that we saw during the pandemic.

Anya Morozov:

So moving on to talking about resiliency, when I think of resiliency in public health, I think mostly about like emergency preparedness or planning for the next disaster or pandemic. I’d love to know what you think promoting resiliency in public health practices and what it means to you.

Danielle Pettit-Majewski:

Two years ago, it would’ve meant that to me. It doesn’t mean that to me anymore. When I think about the last two years, and I think about my colleagues from across the state and across the country, how difficult this pandemic has been on folks, on their mental health, on their families, on their feelings of being safe in their jobs. One out of eight Americans lost their public health director during the pandemic. They were either fired or they left. And I’ve seen a lot of good people in Iowa resign from their position because of the impact that the pandemic had on the public health workforce. And so this is something that is really important to me and something that we’ve been talking a lot about in my department, something we’ve been talking a lot about with my peers across the state, something I’ve been talking about with my colleagues at the College of Public Health about how, and my colleagues with IPHA, how do we improve the resiliency of the workforce?

Danielle Pettit-Majewski:

Because the people in public health are the capital. You know what I mean? We don’t buy like half a million dollar pieces of equipment to build growth. Like, we hire people, capable people to do this work, but we’re all human. And so that kind of, when you think about like emergency preparedness and all of the planning that we did, usually it’s a disaster, it’s a recovery, it’s a disaster response and recovery. But it was like disaster, disaster, disaster, disaster, disaster, disaster. Like, that was so prolonged that that produced a lot of trauma and a lot of turmoil and mental health and the field of public health. And then WR came out in July of last year saying about 56% of those total… About 26,000 respondents said they either had depression, anxiety, PTSD, or suicidal ideation. That’s a problem and we can’t just kind of wipe our hands and say, “Well, cases are low. We’re moving out of the pandemic. Let’s just go start talking about tobacco.”

Danielle Pettit-Majewski:

We need to put investment into our public health workforce because there are folks who are still struggling and there’s also people who are saying like, “I just can’t do this anymore.” So how do we put that emphasis on our public health workforce? How do we help people like you, Anya, coming in as the next generation of public health workforce to be ready for just the state of public health as it is right now in 2022? I think that has to be our biggest investment, our most important investment for the resiliency of the profession, because it’s the people who build up the profession and who make the work happen.

Anya Morozov:

Yeah. That is very true. And that is not how I thought of it, but really yeah, you can’t do any of this work without the people. And it takes a long time to make a public health worker as I’m learning myself.

Danielle Pettit-Majewski:

Yes. And it’s interesting that you say that because I think too, like I was still in college, I was in graduate school during H1N1, but there were my colleagues at the start of the pandemic that we’re relating COVID to how it was in H1N1. And so it was helpful for me who was not involved in that epidemic to be able to learn from them. And so what I don’t want is to lose all of this institutional knowledge that we’ve gained from COVID-19 and our response, because I don’t think that this will be the last epidemic or pandemic that I deal with in my career. It probably won’t be the last one that you learn about in your career as it kind of stretches out in front of you. We need to make sure that the people who are going to be able to say, “We’ve seen this before. We know what to do. We’ve learned from this experience, Anya, let me help you because I’ve been here before.”

Danielle Pettit-Majewski:

We want to make sure that those people who with this institutional knowledge are staying in the field, staying resilient, feeling like they can be safe in their workplace so that they can help be ready for when it happens again, so that we don’t have to make the same mistakes the next time around.

Anya Morozov:

Yeah. Yeah, I agree. Keeping a good record of what we’re learning from this and making sure we hold onto the people who have learned from this experience is going to be really important going forward. So I think we’ve already kind of talked about how the COVID-19 pandemic has changed the way you think about resiliency. Are there any other ways you think that the COVID-19 pandemic has changed the way you think about collaborating with the community to promote resiliency?

Danielle Pettit-Majewski:

Oh yeah, absolutely. I think we saw obvious disparities in the pandemic, right? For the majority of the pandemic, I was director in Washington County. Our Hispanic population in Washington County is about 7%, but when I think about the disproportionate impact that COVID had on our Hispanic community, I mean, it was way more than 7% of our cases. So we saw a disproportionate impact impacting our minority populations, our vulnerable populations. We saw across the country, more people of color were dying of COVID-19 than folks who were white. And that’s for a number of reasons, right? Whether they had the ability to stay home and work from home, whether they had to be a frontline worker, whether they were working in large groups and close together, whether they were given PPE.

Danielle Pettit-Majewski:

And so to me, when we think about resiliency and we think about the impact that like systemic racism has on our resiliency, systemic racism makes us less resilient as a community because it puts our marginalized populations at greater risk, because maybe they have less access to care or because they have been redlined into a community that has more industrial businesses that make them sicker or make them predisposed to asthma or cardiac disease. It makes us less resilient as a community. And so to me, I hope that we take this opportunity to see, we need to do this differently because it kills people. And so how can we kind of unbreak the system that we have right now and rebuild it in a way that makes our community’s more resilient, that doesn’t target those marginalized populations, that kind of is the rising tide that lifts all ships?

Danielle Pettit-Majewski:

So we all have an equal opportunity to have good health outcomes. And that’s where the hard work really happens because a lot of people don’t want to have that conversation and it takes a lot of policy change, big P policy change at the federal level, but also small P policy change at the local level, at the state level. And it really makes us need to think very hard and very critically about our system and about how they can improve, because we can do better. We don’t have to accept that there are just going to be populations that are sicker, that there are going to be populations that die. We can say no, we can create a more resilient, healthier population, which literally helps everything.

Danielle Pettit-Majewski:

It improves our economy. It improves our years of productive life. If somebody isn’t sick, they might start that business, they might get that degree, they might do something amazing, but if they are ill or they don’t have access to healthy food, or they’re constantly fighting a battle just to survive, it’s really hard to thrive. So we need to be looking at those systemic issues, like systemic racism and say, “How can we disrupt that, break that system to make our communities more resilient?”

Anya Morozov:

That was very well said. And I think it leads us right into the next question. So the latest version of the 10 Essential Services of Public Health, which is basically this list of services that public health professionals and departments should provide to the community, the latest version of these 10 essential services of places equity at the center. So as someone at the local public health level, what are some ways to center health equity in work to promote community resiliency?

Danielle Pettit-Majewski:

Well, I think that’s an opportunity where we really have to get diverse opinions at the table. So even in public health, even in Johnson County, the majority of public health professionals are Cis white women. Like, that’s our demographic here in Iowa. But it’s really important that we get diverse voices at the table as we’re centering health equity in our policies. Because I think even people who are good-intentioned may inadvertently put together a policy that’s actually harmful. So we have to listen to different voices. It’s kind of like the no policies about us without us. We need to be thinking about, how are they going to impact marginalized populations? How are they going to impact people who are differently abled? How are they going to impact people of color? How are they going to impact the LGBTQ community? If we’re going to center equity, we have to be centering those voices as well.

Anya Morozov:

Yeah, that’s so true. And I think like that has to happen, first of all, at all levels, including education, like we need to be educating a more diverse population and make sure that everybody has the opportunity to get an education and then get roles like working in a health department. And then even beyond that, just making sure that you’re listening to community voices, I think is really important. We talk a lot about community-based participatory research, where community members kind of get a say in the direction the research is going, but you could almost think about community based participatory policy as well, and making sure that the people who need to be there get a seat at the table when it comes to making policy.

Danielle Pettit-Majewski:

And I think you’re right, Anya. And it’s one thing too, it’s like trying to remove our ego, right? So if I’m thinking like, okay, I have this idea, I have this plan, and I’m totally thinking about equity. And then I get a group of different voices at the table. And they’re like, “This is actually harmful.” Being okay with being okay. And making sure that we are asking for that feedback with genuine intent and being okay with being uncomfortable, because like you said, having the opportunity to learn. Learning about perspectives that are different from ours. And it’s really concerning to me right now to see some of the trends of like banning books and learning about things.

Danielle Pettit-Majewski:

And when we don’t understand how we got here, it’s really hard to understand how we get it better. And everybody keeps saying like, “I just want things to go back to normal.” And I’m like, “No, normal got us here. We can’t go back to normal.” Like you talked about in disasters. After the tornado hit that hospital in Missouri, I forget exactly where. It’ll come to me. Probably when we’re done with this conversation, but when they rebuilt that hospital, they built it with a lot of additional like green space and solar energy. And that green space was to help prevent flooding so that you reduce the amount of concrete in that space. And so you have the ability to absorb water in the event of a flood and solar panels to help with renewable electricity. They didn’t go back and build the hospital just exactly as it had been, they were thinking about how can we do this better? Let’s not go back to normal, let’s go to better.

Anya Morozov:

Yeah. That’s a really good way to think about it. So going forward, are there any new collaborations that you would like to develop in Johnson County or statewide to promote community resiliency?

Danielle Pettit-Majewski:

Like I said, we have 99 counties, we have 99 different responses to the pandemic, and we have 99 different needs. But honestly, when we think about community health needs, right? So many people in our state are struggling with obesity, right? So many people in our state are struggling with mental health. There are things that we should be focusing on as a state to try to help move that needle. When we did our community health needs assessment in 2015, the top two priorities were mental health and obesity. And it was like 77 counties were working on each one. And I’m like thinking to myself, you have all of this energy and all of this capacity so narrowly focused, how could we be partnering together to move some of these issues in terms of policy change? How can we be collaborating so that we are talking in a collective voice?

Danielle Pettit-Majewski:

So often we look at local public health as really focusing on our community and we are, but when so many of our needs are the same, we really need to be thinking about how can we use the collective voice of 99 public health departments? Actually, I think we have 101, because there’s some city health departments. How can we use that collective voice to say, “These are the policies that are causing 17% obesity in children in Johnson County. It’s these same policy that are impacting kids statewide, countrywide. How can we change this?” We did it with the Smoke-Free Air Act. You got to go to college and not have to worry about going out into a restaurant on a Friday night and coming back and having your hair and your coat smell like smoke, whereas I left my coat in my apartment because I, in January, because I didn’t want it to get disgusting.

Danielle Pettit-Majewski:

But that policy, like, we didn’t even think about that now. But that took policy change and the impact that that had on our health. So if we could be saying like, “We need to invest in mental health. We need to invest in trying to prevent obesity. We need to be looking at our food systems.” We live in Iowa, we live in an ag state and there are food deserts everywhere. And that’s a decision. That’s a political decision that is made. That doesn’t just happen. So we need to be having these conversations collectively to try to be advocates for the people of our state, because a lot of us have very similar concerns. And I think too, I think people are people. They want to be healthy, they want to be happy, they want to make sure that their kids have a good education and have access to care. Like, no matter if we are living in like urban Johnson or rural Winneshiek County, there’s still a lot of the same things that we want. And so how can we use our collective voice to get them?

Anya Morozov:

Yeah, I think that’s so important. And we talk a lot about the social ecological model in classes as well. And like the outer layer of that that kind of shapes the environment that we all live in is policy. So changing that is of course going to change all of the internal layers of like community and organization and interpersonal and individual. So relating to that, you are a member of the Iowa Public Health Association, or IPHA’s advocacy committee. So as a member of that committee, what role can advocacy play in promoting community resiliency?

Danielle Pettit-Majewski:

Well, the first thing I always tell everybody around like, how do we improve our communities? Is you vote in every single election, every single one. Whether it’s school board, your city council, you board of supervisors. I mean, don’t just vote every four years with the president because it is these local elections that are really going to make sure that you know whether your kids are going to get like maybe free school lunch, whether they’re going to pass policies that are going to allow CAFOs to be spread really closely together to where your home is and what kind of impact that has on your air and water. Those decisions make the biggest impact on our health. Like they say, your zip code has more to do with your health outcomes than your genetic code. And these decisions are made at every level of government. I’m reading the Political Determinants of Health right now by Daniel E. Dawes, D-A-W-E-S.

Danielle Pettit-Majewski:

And it’s amazing, where they talk about how we got things like Medicare and Medicaid was really about trying to promote health so that we would be ready to go to war. Like, we wanted to make sure we had a healthy population for war. Like, it was a readiness issue. But being an advocate, paying attention to elections, paying attention to policies, people say, “I don’t care about politics.” Politics cares about you. And I didn’t know how political public health was until I was out of school and working in the field. But having these conversations, get to know who’s on your city council because they’re going to determine whether or not you have playgrounds, whether or not your community has good sidewalks, whether they’re well lit, get to know your Economic Development Board, are they going to be bringing in investments and businesses and childcare and good housing that is going to really improve a community’s health? Get to know who’s on your county board of supervisors, because they’re going to appoint your board health.

Danielle Pettit-Majewski:

Like, what are their priorities? Get to know your state, senate and legislators, because they’re going to be passing policies about how, where tax money is spent and what they allocate to education and what they allocate to local public health departments. The board of supervisors will do that too. Get to know them, tell them what’s important to you. I mean, I can contact the folks in Congress. Absolutely. And I do, but also getting to know and have conversations with those people at all levels of government or your school boards, they will be making decisions that will impact the health of yourself, your community, your children, your parents. This is really important because, and it’s hard because it takes time. It takes time and having to understand how funnel works and the different issues that they’re talking about and honest to God, a lot of it is very boring.

Danielle Pettit-Majewski:

And I say that as somebody who sat on city council. I’m like, some of the stuff that we do is really fun and it’s really exciting and I wanted to promote like water fluoridation and good sidewalks and parks and all of those things. But also it was replacing water main line, which is important because you do not want to have lead in your water pipes. You also don’t want your water main lines to break. Investing in those types of things, investing in our infrastructure is what is going to keep us healthy. So it’s getting to know these issues, paying attention, making sure you’re voting. And if you’re unhappy with how things are going, run for office yourself.

Anya Morozov:

As someone who’s relatively new to the world of advocacy, I think the most overwhelming part is finding information about everything. Do you have any advice on where to go for information?

Danielle Pettit-Majewski:

Everywhere. I mean, look around your community. I think that’s the most important thing. You know what’s happening in your community. If you see an injustice, bring that up. There doesn’t need to be a bill to be voted on for you to go and say, “This is important to me. I need you to do something about this.” Like, I tell you what, as a city council person, there would be things that were not on my radar and people would call me and they’re like, “Danielle, this needs to be fixed.” “Thank you for bringing that to my attention. I will bring it up with the next council meeting and we’ll do something about it.” So you know what’s important to you. If you’re seeing that there are people struggling or that there are things that are unjust, bring them to the attention of people who need to care about that.

Danielle Pettit-Majewski:

And if they don’t, bring it to their attention again. And if they still like… Go to a meeting. There’s an opportunity for you to have like a public comment, bring it up because it’s important. And I tell you, if the squeaky wheel gets the grease, we need to have people who are passionate about how we can improve public health for a community to be those squeaky wheels. And absolutely, you can go to like your Day on the Hill, like we have here in Iowa every year and talk to your legislators. I mean, there’s so many bills and I tell you what, by 8:00 AM versus 5:00 PM, they might be different, the numbers have changed, they’ve taken pieces of one and put it into another, and that could be really confusing, but going to them and making those conversations and saying, “Hey, I’m Anya. I care about this. I want to talk to you about the importance of this.” Because it might not be a bill that they’re considering, but they’re going to know that you are an expert.

Danielle Pettit-Majewski:

That was something that we saw when Medicaid privatized in Iowa in 2016. I had my Senator, Kevin Kinney, reaching out to me to say, “Danielle, I have questions about this.” Let people know that you are available to answer their questions. Like, “Hey, I know that you have to know a lot of things about a lot of things and you can’t be an expert in everything, but I am an expert in this. I want to make myself available to answer any questions that you might have about this particular issue, about how raw milk can impact pregnant women, about how changing policies around vaccination can really impact the health outcomes of our kiddos. Let me have a conversation with you about that.”

Danielle Pettit-Majewski:

So I think the best thing to do is just to start and be there and be passionate and bring things to their attention because there’s a number of issues that they’re dealing with and your issue is probably not a front and center. So be kind of a pain and bring it up in the nicest way possible. But I mean, like, I would stand up during legislative forums and they’d be like, “And here she is again,” because they got used to seeing my face. They got used to hearing that. I was like, “All right, we need to talk about this. This is important. I want you to fund this.” I want you to understand… You can’t actually tell them how to vote. That’s lobbying, but I want you to understand the impact of this bill. I want you to understand how this is going to impact your constituents.

Danielle Pettit-Majewski:

And the most important thing that you can do is to take other people with you, because that was one thing unfortunately that with the Medicaid privatization, a lot of our clients, our elderly clients were like, “Danielle, I can’t call him. I don’t feel right. I don’t feel like I should. You call him for me.” “I will. And I will share your concerns.” But me sharing concerns of 20 people is not the same as those 20 people standing up and saying, “This is going to impact my life. And this is how, and your vote will matter.” So be the squeaky wheel.

Anya Morozov:

Yeah. I think it’s interesting because it feels like there’s a lot of new terms to learn and things to learn about bills, but ultimately it’s about what’s behind the bill, like what it’s going to impact. So if you at least know about that and can talk about that, that’s a good first step. And then the rest kind of comes along with it as you go.

Danielle Pettit-Majewski:

Absolutely. Absolutely.

Anya Morozov:

So that might about cover it, but do you have any other advice for students or really anyone wanting to get involved in public health advocacy work?

Danielle Pettit-Majewski:

No, but thank you. We need your voices. Bring a friend.

Anya Morozov:

I just wanted to make sure we got everything.

Danielle Pettit-Majewski:

I think that’s about it, but yeah, bring a friend. And stories make a big difference. That’s one thing like in data… Data doesn’t really matter. I mean, it does. To us, it totally matters. Like, we love data, we’re nerds, we geek out on it, we want to follow trends. But to politicians, lawmakers, people making decisions, data is irrelevant. A story, a story makes a difference. Talk about the impact to people, talk about the impact to their constituents. That really makes a difference. I mean, yes, data is good and you can have that on a sheet that you give them to look at, you give their aid to look at, but having a story about the impact that these things have, that’s really where we get them.

Anya Morozov:

Yeah. That makes a lot of sense. And as someone’s studying epidemiology, I definitely-

Danielle Pettit-Majewski:

You’re like, no, but data. That’s the thing, Anya, like, we need you. We need people looking at epidemiology, but then what we need to be able to do is say, “Let me find this data and let me explain it.” Because like we just saw during the pandemic, data is real hard. And especially when things are changing and big terms and people just zone out, right? We need short… We need to be able to explain it to people. We can talk about the data and what that means amongst ourselves, but we need to figure out a way to make it consumable to people who are not experts in epidemiology, to people who are not experts in public health. So we need you getting all that data. And then we to be able to figure out how to tell a story with it.

Anya Morozov:

Yeah. Even though like I’m thinking, you mentioned the 56% of professionals in the healthcare or in the public health workforce are facing mental health issues now. And like, you can say that, but at the same time telling the story of someone in public health who is facing a mental health issue is going to probably be a lot more powerful.

Danielle Pettit-Majewski:

Well, and I will tell you, because I filled out that survey when the CDC sent it and I was diagnosed with chronic PTSD and I also had suicidal ideations during that. And so when I got that data, on one hand, I thought to myself, oh, thank God. It’s not just me. Like, I thought there was something wrong with me. And then on the other hand, I thought, oh my God, my poor profession, these poor people. Everybody is feeling this. And I had people telling me like, “It’s not just, you don’t worry.” I’m like, “I would rather it be just me. I don’t want my people, my colleagues, my peers, the people who I think are fricking superheroes to be feeling this way.” And so that’s why I have tried to talk very openly about out my experience because I mean, if you can say like, “Yes, I have chronic PTSD. Yes, there were moments when I had suicidal ideations dealing with the pandemic. Like, yes, I had anxiety and I am still a competent, capable individual who can still lead this health department.”

Danielle Pettit-Majewski:

And I said that and I shared that. And then I said, “And I got help,” because I wanted somebody to see, somebody in my position, in my profession to be able to say like, “It’s okay to not be okay,” this has been terrible. You are worth talking to somebody. Your health is worth investing in because to me, mental health is public health. And to me, I’m like, I can’t serve my community if I am not well. And that’s why I go back to resiliency of our workforce. We’ve got amazing people in this field who can do phenomenal things sometimes with nothing, but if they do not have their cup filled, if they are not well, we’re not going to be able to serve the public in the way that we need to. And there are so much need right now.

Danielle Pettit-Majewski:

So I think it’s really important that you say like, “Yeah, we talk about the data, but then we also be brave and we tell our stories.” And so much of advocacy requires that we be brave, because these are hard conversations to have. Saying systemic racism is a public health issue is not going to get some communities to stand up and applaud. They’re going to be like, “Why are you talking to me?” That’s a hard conversation to have. It’s also a true statement. We need to make sure that our workforce is ready for the hard work that’s going to come now. Yes, that was hard. This is also going to be hard, a different kind of hard. And hopefully we’ll see some better outcomes on the other end of it.

Anya Morozov:

Thank you so much for sharing that. In our last few minutes here, I do want to make sure we get to the last question that we tried to ask of everyone who comes on the show. What is one thing you thought you knew, but were later wrong about?

Danielle Pettit-Majewski:

Oh my God. So many things. I thought I knew how people would react to COVID because it made so much sense to me. Like, we’re making small, inconvenient changes like wearing a mask and getting a vaccine to save lives. I don’t think anywhere in my brain that I ever imagine that we would be dealing with fights about wearing masks. I never thought there would be so much hate and vitriol spread to my public health colleagues for talking about vaccination, for talking about staying home when people were sick, for putting quarantine and isolation orders on people who were ill to protect the public. I thought people would do their part to protect the lives of others. That was really hard for me to see how people were more like, “No, I don’t want to have to be told what to do.” And that kind of like… Well, they’re old anyway or they can just stay home.

Danielle Pettit-Majewski:

Like, I didn’t expect some of the countless things that we saw around trying to do what we could to save lives. That did not enter my brain. It’s not something I anticipated. And it’s very hard because these are happening in your communities. And it’s hard to think about… These are people you know.

Anya Morozov:

Yeah. I do think even on the like educational side, going through classes and kind of thinking about how the pandemic has progressed and how people have reacted to it is a big thing that we all have to consider and are still kind of learning how to go about having conversations with people who have very different views from you and how to navigate how the pandemic has kind of affected the climate around public health, I guess. And it’s not something we have the answer to yet, but it was definitely unexpected.

Danielle Pettit-Majewski:

Yeah. Because you think about like polio when people are lining up to get that vaccine because they wanted to keep their children safe. And I think too, part of that, we do not have the institutional knowledge of what it’s like to live in a world where we have all of these illnesses that are now vaccine preventable killing children. Because from some of my elderly neighbors, my 80 some year old neighbors, when I said, “When I have a vaccine for you, I will call you. Don’t worry. Like, I will make sure you get in to get an appointment.” And I said, “Do you have any questions? Are you concerned that…? “Nope, nope, nope, nope. Like, you just call me, we’ll be there.” Because they had lived through that. They knew what it was like when their friends got polio or they were in an iron lung and they were disabled.

Danielle Pettit-Majewski:

And so it’s easy to have kind of this false sense of security that this is more dangerous than the potential consequences. And also, like not knowing what the long-term consequences will be for all of these millions of people who’ve gotten COVID and what the impact is on long COVID, even littles who had really mild cases, how did that impact their bodies? How did that impact their selves? And we may not find out for a long time.

Anya Morozov:

Thank you so much for coming on the show. I’ve learned so much from our conversation and thank you.

Danielle Pettit-Majewski:

Oh my gosh, Anya, I really enjoy chatting with you. I really appreciate you inviting me to speak with you today and thank you. I’m so grateful for people like you, who are going to join us in the fight for what comes next.

Alexis Clark:

That’s it for episode this week. Big thanks to Danielle Pettit-Majewski for coming on with us. This episode was hosted and written by Anya Morozov, edited and produced by Alexis Clark. You can learn more about the University of Iowa College of Public Health on Facebook. Our podcast is available on Spotify, Apple Podcasts, and SoundCloud. If you enjoyed this episode and would like to support the podcast, please share it with your colleagues. Our team can be reached at cph-gradambassador@uiowa.edu. This episode was brought to you by the University of Iowa College of Public Health. Stay happy, stay healthy, and keep learning.