The following is a transcript of an episode of From the Front Row: Student Voices in Public Health, the University of Iowa College of Public Health’s student podcast. This episode features a discussion between College of Public Health student Steve Sonnier and Iowa Public Health Association Executive Director Lina Tucker Reinders. This episode was published on Aug. 7, 2020.

Steve Sonnier:
Hello from all of us From the Front Row. My name is Steve Sonnier. Today. We’ll be chatting with Lina Tucker Reinders the executive director of the Iowa Public Health Association. Following her graduate education. Lina was the legislative liaison for tobacco control at the Minnesota Department of Health that worked opened doors for her to move to Geneva, Switzerland, where she spent seven years at the World Health Organization, focusing on strategic planning, communication and health equity. Upon her return to the United States, Lina has spent time consulting on various public health projects ranging from social protection, global health system development, and maternal child health with a focus on health equity. Here is our interview with Lina.

Steve Sonnier:
Reading your biography, we saw that you had moved around a lot, and you had a lot of experiences in different sectors within public health. What made you settle down here in Iowa?

Lina Tucker Reinders:
I have moved around a lot and I’ve worked in several different settings from a local public health county, state government, and then of course I spent some time at the World Health Organization. M family moved back to Iowa or to Iowa, I’m not from here originally, essentially because my husband’s work. So I was what we call a trailing spouse. And so I also had that experience of trying to build a brand new network in a new location. So, yep, it was my husband’s work that brought us here and we’ve been here for seven years now. People have heard me say in the past that when I moved to Iowa, I really didn’t know anybody but I knew that I wanted to work in public health. And so I knew I needed to build a network to do that. And IPHA is the first place I turned to. I signed up as a member and wrote to the then executive director, Jeneane Moody, and said, “I’m here. This is what I’m interested in and how can I get involved?”

Steve Sonnier:
That’s awesome. Jeneane’s a fantastic resource and a wonderful way to start things off. Shifting gears to IPHA, what is IPHA and how is it different from APHA? If you can go into a little bit of differentiation between those two organizations and what they stand for.

Lina Tucker Reinders:
Sure, it’s a good question. So IPHA is of course Iowa Public Health Association, and we are the statewide professional membership organization for public health professionals in this state. And when I say public health professionals, it’s really anybody who’s studying, is working in, has an interest in public health. We know that public health is so broad and it captures so many fields of work. When we look at social determinants of health, we have allies in education, in transportation, in workforce development, in rural development, and we have, our membership reflects that. And so we are the, like I said, the statewide public health association for Iowa and our relationship with APHA or the American Public Health Association is that we are the state affiliate for them, but we are an independent organization. So we are our own 501C3.

Lina Tucker Reinders:
We don’t have any, there’s no supervisory relationship with APHA or anything like that. As a state affiliate, we are part of that broader network. And so, whereas IPHA is a great network for working professionals and students in Iowa, the APHA is a network for all of the affiliates. And so for example, every month I get on a call with other state affiliates around the country and we discuss what’s going on in our states. And if we have an issue that we’re dealing with here in Iowa, I can talk with other state affiliates and say, “How are you guys handling this,” and get ideas. So we do pay some membership dues to APJ and that’s just so that we, it supports how they support us as state affiliates, but we have a special day at the annual conference that APHA puts on that, where we highlight work of the affiliates, but it really is more of a network.

Steve Sonnier:
That’s fantastic. No, and it’s a very good overview of the two relationships between the organizations and what they stand for. When you’re talking about what the successes are, what you’re presenting as a goal within the context of the current pandemic, what really has been IPHA’s role in battling the current pandemic?

Lina Tucker Reinders:
When we first started talking about the pandemic was and it reached us, it reached Iowa, and when we first started having community spread, I really thought about that question a lot, because as a professional network, we are here to support our members, support public health professionals and students, but we’re not the frontline workers. So we’re not county health departments that are doing contact tracing. So what was our lane? And it was a little bit of a challenging question to start off the pandemic with. But what I have found is that really our role is to support local public health, to raise their voice, to amplify their words and voice. Of course, our mission is to unit and strengthen the voice for public health in Iowa. And I feel that the pandemic has really empowered us to do, or it’s so important for us to do that even more now because our local public health teams, they are on the frontline and they’re exhausted.

Lina Tucker Reinders:
I’m worried that with so many conflicting viewpoints and the bickering that goes back and forth on social media, that our public health professionals aren’t getting the respect that they deserve and not just in Iowa, but across the board. We see people questioning science at overall. We see people questioning CDC and Dr. Fauci, and there’s different guidelines and sometimes contradictory guidelines. And that all is presenting or resulting in an erosion of trust of public health. And so we want to build that back up and we want to make sure our local public health professionals and state public health professionals are the trusted source of information, of credible information, of epidemiological information. And so we have really been a voice for them and backing their work. We have been also providing information via our social messaging platforms about different evidence-based research and guidelines.

Lina Tucker Reinders:
And trying to explain that, that just because the guidance and guidance is shifting, that doesn’t mean we’re waffling. It means we’re learning and that it’s did novel virus, which by definition means that we don’t know exactly how it’s going to play out. But we have learned from past pandemics, from past infectious disease outbreaks, and we know what the best practices are. And so we’ve really been trying to reinforce those. Most recently, we have taken a stronger advocacy position because as the evidence points us more and more towards wearing masks in public, universal masking, and we have yet to see a mask mandate in Iowa, we have taken a stronger advocacy position on that. And calling on the governor to issue a mask mandate or at the minimum of not preempting local control. We have several counties and cities that are wanting to take that matter into their own hands and say, “We’ve read the evidence. We understand the spread in our communities. And we want to issue a mass mandate for our municipality.” And we feel that they should be able to do that. Iowa’s a big state and we have different rates of spread across the counties.

Steve Sonnier:
Communications aspect of public health has always been, I feel, a very difficult point to navigate, where we’re trying to figure out, how do we communicate that science is this process that we have to go through? It’s not something that we have an immediate correct answer. When we’re talking about the idea of presenting this to the public and I feel like there is that general tenacity for folks to jump down your throat if you don’t get it exactly right the first time. What do you do in terms of public health messaging? What, in your experience, has shown to be effective in dealing with it in the appropriate manner, especially when it comes to something as simple as wearing a mask in public?

Lina Tucker Reinders:
It’s a really good question. And I think we’re still learning about health communication and how we do that. We used to take a very simplistic approach, just say no, without looking at the bigger context. And even since then, our society has become ever more an instant gratification society. You click on a link and you get the video, you don’t have to go to the library to research things anymore, you just click on Google or Wiki and there the information is. Likewise, we’re used to having quick fixes for diseases. And so I have an infection, so I take a pill and it clears up. And none of this matches that, and people are scared. They’re anxious, they’re frustrated, they’re tired. We’re not used to problem solving in this way.

Lina Tucker Reinders:
And I think the best thing we can do for communicating is back to the basics and transparency, and we have to be competent with what we say, but on the flip side of that is if, I think, we’re for overconfident and then, and we don’t admit that we’re still learning. That’s when we, then we can cut ourself off at the knees, because we are so confident in that what we say week, two weeks, a month later, we have to change it, we have to say something else because we’ve learned that initial overconfidence can come back to harm us. And so I think really transparency and humility are important. And it’s also important to understand what motivates people and how people make their decisions. I attended a presentation last year at the APHA annual meeting, it was on communication.

Lina Tucker Reinders:
It’s called the Moral Foundations Theory. It really was talking about how do we communicate messages? How do we sell public health? And how do we tailor our messages based upon where people are coming from? And the example they used was immunizations. And we can’t make a blanket assumption of somebody, if they are against immunizations, they fall into this box. If they vote this way, then they fall into that box. And it’s really about looking at what motivates people to make the decisions that they make. And so is somebody who’s resistant to wearing a mask, is it because they, the quick answer is because they’re obstinate or because they don’t trust science or because they’re whatever, or is it because they have anxiety about, they have asthma, they have something else that is motivating and fueling their resistance, or have they had a negative experience with something similar in the past? We look at racial disparities in our community and we wonder sometimes why the Black community especially has differential rates of use of a healthcare system.

Lina Tucker Reinders:
And of course we know there’s wide disparities in health outcomes, but let’s look at the full picture of that. And where’s the trust issue. And we know that very negative history in terms of the treatment of Black people and people of color in our country in terms of medical research and science. And so when we look at the full picture and we understand what motivates trust, what motivates decision-making, then we can be more intentional in our communication. And so that’s true for anything. And then I think with the pandemic, again, you throw into the fact that it is heightened anxiety. It is heightened fear. We’re worried about whether to send our kids back to school, and what’s going to happen to our teachers and our elderly parents at home or grandparents at home. And science messaging, even though we find it cut and dry, it’s perhaps sometimes too sterile. And we need to make sure that we are addressing the whole person in our communication and not jumping to conclusions, and being judgmental in how we communicate and how people receive that communication.

Steve Sonnier:
And I think that you’re right on the nose with that and the addressing the whole person concept, and also being respectful. I think that’s ultimately what it really boils down to, is you want to approach it from a field of respect and not this top down situation that can sometimes be the appearance of it, but really honoring the person and honoring the conversation.

Lina Tucker Reinders:
Right. And remember that public health, our role is to look at populations, but people come to us as individuals and with their individual experience. And so just because I can read the population data and say that this is what the data are telling me, we know that there’s always outliers. And there’s the individual experience doesn’t always match the population data. There’s that tension between population and individual experiences. And our job in public health is to represent population based evidence and promote policies that are going to do the most [inaudible 00:13:32], do the most good for the most people, of course, with an equity lens in place as well.

Steve Sonnier:
And within that, doing the most good for the most amount of folks, I know that a lot of people have their eye on what’s coming up in the next few weeks, such as the big school year for folks and starting that off IPHA’s recently provided some recommendations about this. Can you talk a little bit more about the points that IPHA is making with that population and with that health equity lens in place?

Lina Tucker Reinders:
To the mask mandate calling for masks to be worn and if the governor is not going to issue a statewide mandate, we’d like to see the ability for local control. I feel the same is true for schools that school districts need to be able to read their communities, again, working from their relationship with local public health, working with their school nurses who are inside their district that can help make these health policy decisions. They need to be able to respond quickly and appropriately for their districts. And they’ve been working hard at doing that. It would be helpful to have reasonable statewide guidelines and guidance on things like when case rates, and when do we shut schools? What is recommended? It would be nice if those were consistent with CDC policy, with WHO policy.

Lina Tucker Reinders:
But we saw the governor issue guidelines that, in my opinion, in the opinion of many health professionals and epidemiologists around the country, are too high. So now schools are again at this place where they want to do what’s right for their students. And they’ve been looking at different guidelines and different evidence. And now we have a mandate that says, “You must continue in school until you reach 15% positivity or higher and 10% absenteeism.” And so, whereas it’s on one hand, it’s nice to have, it’s helpful to have state guidelines because many of our school districts cross counties, those guidelines need to be reasonable, and schools within those guidelines need to have flexibility to react and respond appropriately. We don’t dictate to superintendents when they close schools for weather, for snow or anything like that. We trust them to understand what’s coming to their community and what’s best for the students and staff of their districts.

Lina Tucker Reinders:
I think the same is true for the pandemic, but the difference of being is that this is a very long process. This is not an acute snowstorm, blizzard, tornado. And so it’s difficult for the school districts to be able to plan if everything that they do is on a 14 day window. If they have to continue to get, to ask for exceptions to the rule, exceptions to the rule, exceptions to the rule. And again, you bring back the heightened anxiety that we’re living in, the exhaustion, our school districts, have been working all summer on the return to learn plans. And now they’ve recently learned that maybe their return to learn does plan doesn’t fit. And so what would be nice is to have, and what would be really helpful and beneficial to public health, not just nice, would be to have guidelines that are consistent with CDC best practices, WHO best practices that are really evidence-based, that provide yet still flexibility for the school districts to respond to the needs of their communities.

Steve Sonnier:
And it’s an incredible weight for the teachers who are coming back into the situation for parents, for students, and within these upcoming situations here, what do you think IPHA’s goal is within the next several coming months? Where are you hoping to best serve in the context of [inaudible 00:17:19]?

Lina Tucker Reinders:
Well we’re going to continue to do what we’ve been doing and being an advocate for evidence based policy making and evidence based decisions. We’re going to continue to be a resource in terms of health education, information that’s going out via our networks. And then also another important thing that I haven’t mentioned yet is just being a supporting network for each other. Every week I send out an email to members basically saying, “I got your back and I believe in you and you’re doing great work.” And it’s so important to hear those messages for all of us, because that’s not always what we’re perceiving when we’re out in public and we’re the only one wearing a mask. And we also provide opportunities for people to, to connect otherwise. Every once a week we host a zoom happy hour that people come and they just relax and we can download on what’s going on.

Lina Tucker Reinders:
We are working with a student, a University of Iowa student, undergrad studying public health. She’s an AmeriCorps Vista with us this summer. And she’s working on a project where she’s collecting the lived experiences, the stories of local public health through the pandemic. And so she’ll be interviewing public health directors around the state. And so just letting them tell their story, and then we’ll share those stories either through social media or when we develop our advocacy campaign for the next legislative session saying that these are your local public health professionals, and they need your support, they need your trust, they need your leadership and they need your funding and your commitment. So we’ll be using their lived experiences that they may not have time to be writing up every day what’s going on. But yet, if they can share those messages with us, then we were happy to amplify those.

Steve Sonnier:
And you mentioned some of the benefits along the way. And then for our audiences, as an incoming and returning public health student, what are some of the other benefits that you can get from IPHA? I know you had mentioned the opportunity to take part of some of these initiatives, like you talk about interviewing public health officials across the state of Iowa. How can students get more involved with IPHA and what goes into being an IPHA member as a student?

Lina Tucker Reinders:
Well, first and foremost, I think that the benefit is just being part of a network, being part of a professional network. As you advance in your education and then get into the job market, you quickly realize, no matter what field you’re in that, and it sounds cliche, but it’s not always what you know, it’s who you know. And so the more you can engage in your network of professionals, the more connections that you make. And so we have opportunities in IPHA for students to get involved, for anybody to get involve. We have several standing committees that help us do our work. So we have an advocacy committee that helps us set our legislative agenda and helps us get action alerts out, and we’ll send those out and, and people can talk to their elected officials and whatnot.

Lina Tucker Reinders:
We have a communications committee that really helps us focus on what messages we’re sending out and how do we set the tone of those. Our education committee sets our programming schedule for the year, including things like our third Thursday lunch and learns where we talk to different members about what they’re doing in their work. And so it helps to shine a light on the breadth of public health that’s happening across Iowa and then our membership committee. And that one is all about how do we enhance the membership experience and how do we bring new people into IPHA?

Lina Tucker Reinders:
And so for students, it’s a great opportunity for you to get involved, do some volunteer work that is particularly relevant to your career field. If you think about it now, you have your cohort of students and you have group projects together, you work together, you may maybe compete a little bit for grades here and there for standing, but in a year or two, when you all graduate, you’re going to each other’s real competition on the job market. And so whatever you can do to set yourself apart from one another is going to give you an edge as well. And so we feel that IPHA not only is your network for how do you meet people, and how do you learn what other professionals are doing, and get exposure to different career possibilities for you. But it’s also a way for you to set yourself apart and say, “These are the leadership experiences that I’ve had in my field already.”

Steve Sonnier:
Within those experiences, too, that you’re talking about and especially the volunteer concept, I know that there’s a lot of interest right now in online volunteering opportunities or something to that extent, not necessarily a face to face, given the situation with the pandemic, do those opportunities exist for incoming or returning students in that capacity?

Lina Tucker Reinders:
Most of our meetings, they are and always have been virtual. And that’s because we’re a statewide organization and Iowa’s a big state. And so when we have our monthly meetings of our advocacy committee or our communications or education committee, those all happen online, they used to happen over the phone, over a call in conference line. Now there are more and more happening over Zoom and all of those planning meetings happen over Zoom. And so there’s no reason just because you’re an Iowa City, or maybe you’re a student at UNI or you’re elsewhere, ISU. We have people across the state that come together monthly on these calls that do the planning for our team. In fact, even our board, our board of directors, which students have opportunity to serve as a director on the board, the only qualifications to be a member of the board is that you’ve been an IPHA member for at least a year. Our board members are, they come from our membership and they are voted on by our membership. So I would love to, at some point, to see a student on the board of directors. But anyways, even our board of directors, they meet virtually. So there’s really no limitation in how someone can participate.

Steve Sonnier:
The last point I want to touch on while we’ve got time here is within the context across you’re working within the field of public health, what is one thing that you thought you knew, but were later wrong about?

Lina Tucker Reinders:
I think this is a great question. You could have so much fun with this one. But really, when I thought, and this is the question, I probably thought about the most. The more experiences that I have and that I have had in my career and the older I get, the more I realize how much lived experiences really matter. We talked a little bit about it in our communication, how we communicate with people. But what I realize when I look back, the things that I’ve been wrong about are usually I’ve been wrong factually, I’ve misquoted something before, but really the things that get me at the heart, that when I realize I’ve been wrong or when I’ve judged someone or something incorrectly. And when I’ve done that, it’s always because I haven’t had a similar lived experience and I haven’t been in their shoes before.

Lina Tucker Reinders:
And so it can be simple things like, I think before.. So I have three kids and they range in age from nine to 15. And so we’re a family of five, which means we have five different schedules. And as they get busier and our family dinners are more rare, I realize that I used to, even though I wouldn’t have admitted at the time, I used to judge people who didn’t have family dinners, because I know from my growing up, from evidence and nutrition, and such that family meal mealtime is so important for relationship building, for nutrition, everything else.

Lina Tucker Reinders:
And I know I used to think, “Well, why wouldn’t you have a family dinner?” And some of the academic things like, well, if you’re a single mom and you’re working [inaudible 00:25:31], but what I realize is just how hard things are. And so that’s a very simple example from a personal example, but there’s other times too, when I’ve been working with coworkers and thought, “Well, why are you doing it that way when the evidence points to it this way?” And being hard and fast in how I approach something more scientifically without that, the whole picture realization that you have to put into context. And so I think that’s where I would say my mistakes have [inaudible 00:26:09], in not giving the grace of what experience brings.

Steve Sonnier:
I think [inaudible 00:26:15] that’s an incredibly important point is the idea of we do so much research and we do so much reading and all this higher level stuff and a very much so that’s the other part of public health, is the implementation side of things. What are the realistic ways that I’m actually going to go about doing this and how is this going to affect boots on the ground, affect the everyday person, how is this actually going to translate into an experience? So that’s a fantastic point to hit on. I really do appreciate you mentioning that. I do want to thank you for coming on to our podcast today, and getting a chance to chat with you about IPHA. And we do with you the best of success in this upcoming year, and we look forward to hearing more about you and your organization’s progress.

Lina Tucker Reinders:
Well, thank you. Thanks for the opportunity. I love talking with students, with groups of people and sharing my public health experience. So anytime I can do that, it’s always a joy for me.

Steve Sonnier:
That was our interview with Lina Tucker Reinders of IPHA. Thank you for tuning into From the Front Row. Please share this episode with your colleagues and network if you enjoyed it. This week’s episode was hosted, edited and, produced by Steve Sonnier. You can find us on Facebook at the University of Iowa College of Public Health. We’re also on iTunes and Spotify as the University of Iowa College of Public Health. Let us know your thoughts, or if you’re interested in being interviewed our email cph-gradambassador@uiowa.edu. Thanks for tuning in this week and stay safe and stay healthy.