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 is the first in a series of episodes featuring public health leaders from the deBeaumont Foundation’s latest group of ’40 Under 40 in Public Health’ honorees.

Anya and Rasika welcome Natalie Kasiborski, deputy health officer at the Health Department of Northwest Michigan and touch on a wide array of public health-related topics including what’s happening in the profession at the local level, mental health, work-life harmony, careers, and burn-out among public health workers.

Learn more about Natalie

Nominate someone for the Class of 2023 ’40 Under 40′ list.

Find our previous episodes on Spotify, Apple Podcasts, and SoundCloud.

Anya Morozov:

Hello, everyone. Before we start the show, do you know someone who is under 40 and working toward the benefit of state or local public health? If so, nominations for the de Beaumont Foundation’s 40 Under 40 in Public Health Class of 2023 are open now until May 17th. The link to nominate is in the description of today’s episode. Now back to the show.

Hello, everyone. Welcome back to From the Front Row. Today we are beginning our series featuring the 2021 Class of the de Beaumont Foundation’s 40 Under 40 in Public Health, a group of leaders who are changing the face of public health in creative and innovative ways. Natalie Kasiborski received a master of social work in 2005 and a master of public health and PhD in social work in 2014. She currently wears many hats. She is a faculty member for Michigan State University, a special projects consultant for multiple public health organizations, and she serves on the board of directors for the Women’s Resource Center of Northern Michigan. Her work touches many sectors including community health, mental and behavioral health, population health, and school health. Today she’s here with us to discuss her career, her experiences with rural health and cross-sector partnerships, as well as her experiences with burnout and change over the course of her career.

I’m Anya Morozov, joined today by Rasika Mukkamala. If it’s your first time with us, welcome. We’re a student-run podcast that talks about major issues in public health and how they’re relevant to anyone, both in and outside the field of public health. Welcome to the show, Natalie.

Natalie Kasiborski:

Thank you so much for having me. I’m so honored to be a guest.

Anya Morozov:

To get us started, can you tell us a little bit about your story and what led you to the roles you have today?

Natalie Kasiborski:

Sure. I feel like I fell into public health. I didn’t know that public health was a career field until I was in it. I initially wanted to be a researcher, so after I finished my undergrad degree in psychology at the University of Michigan, I worked on a National Institute on Drug Abuse study in a methadone clinic in the city of Detroit. That’s where I discovered social work and went back then for my MSW. I focused on interpersonal practice with children and youth, which was a clinical degree because I thought that would be useful. But it was really research that interested me.

From there, then I went to Michigan State University for a PhD in social work, again with the thought of focusing on research and then pursuing a career in academia. In my PhD, I had to have some classes at cognate and a few focus area classes, so I took a public health class. That was really where I started to discover public health and what it was, and really felt my path emerging in front of me. The application of a lot of the social justice principles that I studied in social work and that I felt were important in the work that I was going to do, I saw them in practice in public health. The idea of looking at things at a systems level and being able to work more broadly to make change at a population level and look at population health really interested me. As I started to take a few public health classes, I decided to get a second master’s degree in public health. That’s where I started to pursue the public health aspect.

I moved up north to a small rural community, and I was finishing my PhD. I was working on my dissertation remotely. I was teaching remotely for Michigan State University, and there was a job posted our local public health department that was a grant coordinator position that seemed to merge a lot of my experience. That was really interesting to me. It was an early childhood behavioral health initiative. It was grant funded. It was looking at universal screening and implementing some systems-level work to try to identify infants and toddlers earlier to get them into early intervention services, with a special focus on behavioral challenges and connecting them to resources and creating linkages. I interviewed and got that position, and that was the start of an almost 11-year career with the local public health department. My path was not straight, but I think it took me exactly where I needed to be.

In October of 2021, I resigned from that position at the local public health department. I was serving as deputy health officer. I was definitely a product of COVID burnout. It was a difficult decision. I loved the organization. I loved the team that I worked with. We created the great supportive culture despite some of the challenges that we had working in local public health through COVID. But it was time to move on with some of the politics that had emerged with a mask mandate and some of the other issues that we were facing. So I had an opportunity at Michigan State University as an assistant professor, and made that transition to doing that, and then continuing to work as a practitioner in public health through some consulting projects, through a small consulting business that I started when I left.

Anya Morozov:

I love so many aspects of that story. First of all, I feel like a lot of us fall into public health, so I really identify with that. I don’t know. I feel like you don’t really hear about it in high school, and then, somewhere in college or even afterwards, a lot of us find out that, “Oh, public health is a thing that exists.” Then you start to see the problems that public health works to solve, and you’re like, “That’s where I want to be.” Yeah. I also appreciate your openness with talking about your experiences with burnout and just how you’ve transitioned your role over time.

Natalie Kasiborski:

Yeah. I think we have a marketing issue in public health. We are always onto the next thing. We don’t stop to celebrate or share our success or promote our field. I think there’s many of us who realize late what public health is and that it’s a whole discipline.

Rasika Mukkamala:

Yeah. I was just going to add, after COVID, I think public health has become more popular, per se. I think people are more aware of the impact that public health can have and that public health practitioners can have on the public. I think it was hidden. I know in undergrad, when I took a public health course, we compared and contrasted the H1N1 flu to COVID. Obviously, they were very different, but even just how public health came to light between those two and how we reacted, I think, it’s become more apparent for people to get an MPH or other public health degrees. I know a lot of undergrad institutions are now having public health majors because it’s become such a calling for people. So I think it’s really interesting to hear about your experience and how some of our listeners might be falling into a similar path as well.

Natalie Kasiborski:

It’s such a great field, too, because it’s so diverse. There are so many things that you can do in so many different areas of specialty that you can pursue with a public health degree. I think it really is unique in that it opens lots of different doors and that, along the way, you can always go back to some of the fundamentals if you decide to pursue a different route.

Rasika Mukkamala:

I know you mentioned your background in both public health and social work, so can you talk about the overlaps between those and possibly how being a mental health provider has helped shaped your career?

Natalie Kasiborski:

I think I touched on this a little bit, but I think that so much of public health and social work overlap. So many of the core values, the work that we are striving to do towards health equity and just valuing person, valuing communities, incorporating resident voice into the work that we do, the application of social justice to healthcare was really how I first saw the overlap. Then, as I pursued different areas of my career or different opportunities that fall more into the social work bucket, or more into the public health bucket, there seems to always be overlap. So I’ve appreciated that and being able to lean on either specialty area, depending on what the issue or project is. I think, both my training as a mental health clinician, but also my experience as a mental health clinician, have informed all of the work that I have done.

I was fortunate enough to work as a school-based mental health provider when I first joined the local public health department, and had the privilege to work with so many children and families that were experiencing hardships or difficulties in their life, and trusted me and our services to try to work together to identify some coping strategies or connection to additional resources, and witnessing the increase in access to care and the ability for students to have what they need, where they needed it, and seeing real impact and great outcomes. Looking at that as a systems-level work, I appreciated being able to do that work individually with families, but then really thought every school district should have this access. That was 10 years ago or so. Michigan has really been leading the way with access to school-based mental health. We’ve been fortunate that our leadership and legislature has continued to provide additional funding for new sites. I’ve been really fortunate to be part of that work and to see access expanding across the state, with the goal of hopefully having school-based mental health in every district across the state.

Anya Morozov:

That’s awesome. Can you tell us a little bit more about the work that you’re currently doing to try to increase access to school-based mental health services?

Natalie Kasiborski:

Sure. One of the projects that I work on right now, I serve as the school-based mental health consultant through the School Community Health Alliance of Michigan, which is a state association for school-based health centers or child and adolescent health centers, and work to provide support to sites that are launching best practices, access to training and technical assistance. I work on another project with the local public health department that’s a system-wide regional project looking at increasing access to behavioral health that has some aspect of school mental health services within it. I have my hands in a few different areas that they seem to continually be overlapping, so it feels like I’m in the right space right now.

Rasika Mukkamala:

Can you talk about some of the challenges that are unique to public health efforts in rural areas?

Natalie Kasiborski:

Sure. I think the challenges that we face in rural areas are probably the same challenges that are faced anywhere you’re working in public health. Funding, of course, is an issue. I don’t know if too much is a thing, but there’s either a lot all at once, or there’s not enough. So trying to advocate for appropriate funding and sustainable funding so that, especially at the systems level, when work takes a long time, when your impact has to be measured over years, having those interim data points and that understanding with key stakeholders so that funding is ongoing is really important. I think it’s a strength in rural communities, but I think it’s also a challenge, that sometimes there’s only one of a specific stakeholder. There might be one school district or one hospital or one mental health agency. So having strong relationships and cultivating those relationships to create those cross-sector partnerships, it’s really important to do that work because you might only have one. So if you’re working on an issue where you need that expertise or you need that partnership, having those relationships already in existence is important.

Rasika Mukkamala:

Do you find that working in a rural community that you’re within, does that make it more challenging because you know all of the people? Or does it make it a lot easier for you to work with them since there’s only one agency of each department?

Natalie Kasiborski:

Yeah. I think probably both, just any working relationship. Most of the time, it’s a strength. I think community is really a value that is held closely in a lot of rural communities or rural areas, that residents are proud to be from the communities that they’re from, and to be from small or rural towns. So I think it’s a little bit of both, where it’s nice to have anyone you might need to contact in your phone because you’ve already worked together. If you need a last-minute letter of support or if you’re thinking about applying for a grant application, you can just give them a call or send them a text. I think that partnership in rural communities is really valuable. But at the same time, if that organization doesn’t exist, if there’s a staffing turnover, if you don’t have those relationships, there’s no one else to fall back on.

Anya Morozov:

Yeah. Very true. I also like the part you mentioned about funding because I do think that’s a problem, or not necessarily problem, but that’s a consideration across any health department, especially right now, when I do think we’ve seen an influx of funding from COVID-19, and the next few years are the test of like, “Is that funding going to be sustained, or is it going to be another boom-bust cycle?” Hoping, as Rasika and I move towards graduation, that it’s the former. But we’ll see.

Natalie Kasiborski:

Right. I know. We’re experiencing some of that right now in mental health because there’s been such a push and a focus on mental health, especially children’s mental health. In 2021, the surgeon general had a public health advisory about children and adolescent mental health and the need for services and addressing the issue. So we’ve seen some funding in response to that. But then it goes to, “We have all this funding,” but in that instance now, we don’t have the workforce because it’s such a specialized skill. So we’re always trying to catch up and keep up with the resources, whether it’s people or funding or whatever type of capacity it is, trying to get them in balance so that we can move forward successfully is definitely a challenge.

Anya Morozov:

Along the lines of mental health, we know that burnout is a pressing problem among public health professionals. You talked a little bit about your own experience, and especially just after the pandemic, a lot of organizations are facing high turnover. What are your thoughts on addressing burnout and fostering resiliency just generally among public health professionals?

Natalie Kasiborski:

In my own personal life, I feel so grateful that I’ve been able to stay in the field of public health and to take some of my favorite parts of being an administrator and now be using those same skills in my new role. I think that is really important when we think about burnout and workforce development, that we can’t only be focused on new grads and creating programs to train new people to enter the field. I think we also have to really focus on public health professionals that have been in the field and have experience and expertise. How do we retain them? How do we take their interests and shift them into new projects? How do we keep them in the field, whether they’re transitioning to a new organization? I think it has to be a multi-tiered approach and that we have to look at building the total number of people entering the workforce, but at the same time, we have to look at how do we decrease people who are completely leaving the workforce and maybe shift into different roles or different areas within the field of public health?

I referenced this earlier, that there’s so many different avenues that you can take. You can work in health education. You can work in epidemiology. I think the benefit of having that broad coursework during your education is that you can go back to it and make that shift. Even if you haven’t developed expertise, you have the foundation so that before you get to that place of burnout, you can think back on what are the skills? What’s the work that excites me, and how can I do more of it? So then I think as leaders, it’s our job to be responsive to staff that are looking to make that shift. We can’t just focus on hiring new staff. We have to also be supporting our existing staff.

Rasika Mukkamala:

I totally love what you said. I’m interested in HR, so burnout is super important to me. I think there’s a lot of things that are new ideas that we can approach to help with retention. I think recruitment is its own idea in healthcare, especially when it comes to hospitals. I think it’s a little bit different with recruiting providers and nurses with workforce shortage, but I think there is similarities between public health professionals and providers. I think everyone is experiencing burnout, but I think what you mentioned about when we do our education, it’s almost generalized, so then we can go into different things that we pulled from our education. I think that’s super interesting because I think about that a lot.

Sometimes I’m in my classes and I’m like, “Do I personally see myself using this in the future? No. But it would be nice if I felt like I needed to, I could.” I think that’s what’s important, is that you learn it so that even if you never use it, it’s still in your back pocket. Maybe you can inspire someone. Maybe you find that someone’s really interested in IT, and you, once upon a time, took an IT class, and you can build upon that. Or maybe you yourself suddenly found a project that you’re interested in. So I think that’s really interesting that you bring that up. I think it’s so needed in our everyday lives. I think everyone is really grateful for people who are focusing on burnout because sometimes it’s hard to ask for help, but with professionals like you, I think we’re moving in the right direction.

Natalie Kasiborski:

The common response is looking at self-care and looking at surface-level things like reading a self-help book and taking a yoga class. Really, it’s almost like you apply public health principles to burnout. What is the root cause? Let’s go further upstream. What is it that’s causing the burnout? If your work is not invigorating you, and you don’t feel passionate about the work that you’re doing, and it’s draining you, then how do we change some of the daily tasks and things that are surrounding that work to try to reduce burnout if it’s happening, but even more than that, prevent it?

Anya Morozov:

Yeah. You’re demonstrating how transferable public health skills are. You can even apply public health principles to how we approach thinking about burnout and how to address it.

Natalie Kasiborski:

Yeah. Yeah.

Rasika Mukkamala:

Our next question is about the de Beaumont Foundation. Can you tell us a little bit about your experience as part of the 40 Under 40 Class of 2021?

Natalie Kasiborski:

Sure. Yeah. It’s been such an honor to be named as one of the 2021 40 Under 40. I was so pleasantly surprised. It’s just been such a joy. It’s also very interesting personally because I think we were notified about a week, maybe two weeks, before I submitted my resignation. So it really all was happening at this crossroads in my career. It’s been really nice to participate in some of the training and the networking and to see so much great work that’s happening across the country in public health. My cohort members are specialized in public health in so many different areas, so our trainings have been really helpful. We have been able to develop and practice skills, very specialized, based on things that we’ve requested, like communication or leadership development. There’s an upcoming retreat in a few weeks where they’re bringing together people to meet in person. I unfortunately can’t join. It’s during my kids’ spring break. But I think that will also be really valuable for the cohort. I’m looking forward to hearing about it and still benefiting as those relationships continue to grow, and we continue to meet virtually.

Anya Morozov:

You mentioned spring break and spending time with your kids. You’ve also talked about how many different things you’re doing right now. You’re a faculty member at Michigan State. You’re on the board of directors for the Women’s Resource Center of Northern Michigan. You have kids at home. How do you balance everything?

Natalie Kasiborski:

That is a great question. I’m going to share a story. A few years ago, I had a conversation with a very dear friend and mentor of mine about the idea of balance and how to balance everything, especially as a working mom and wanting to do well and thrive in both of those roles. She shared that she works towards harmony, not balance, and that if you don’t have balance, you are out of balance, so then something is lacking. If you’re focused more on things that are happening at home, your work is going to suffer, and you’re not going to be able to give it what it needs, and vice versa. So this idea of harmony and that, in the time that you’re in, you’re giving your energy where it needs to go.

It might be a little bit towards work efforts one day, and then it might be a little towards home efforts one day. But that ebb and flow that works in synthesis together and in harmony, if that is the mental picture of what you’re working towards, rather than balance, it’s a little bit easier to see how everything fits together, and also not to be so hard on yourself. That conversation has stayed with me. I really use that metaphor to think about my work-life harmony and how to fit everything in and make sure that I’m showing up the way that I want to for my family and three kids, and also for my students and coworkers. So I think just that little shift in language really helps to take away some of the strive for doing all of it all the time, and just recognizing that they flow together in harmony, and that it’s not always going to be 100% in one way and 100% the other.

Rasika Mukkamala:

Yeah. I think that’s really interesting. I think that’s one thing that I have learned after talking to a lot of different people in the workforce. I think a lot of people have changed calling it work-life balance to other iterations of the term. But I think you’re totally right. There might be a day when you have a night class, and you might have to stay late at work. But then the next day you might have something for your family. It’s all about the relative balance rather than like, “Did I spend exactly the same amount of time today at home as I did at work?” I think changing the way that we look at work-life balance and making it more, “Am I giving and getting what I need from both to the best of my ability in a different way?” I think that’s super interesting. I’m glad that you were able to share your experience with us.

Natalie Kasiborski:

Yeah. I think having those conversations, too, with friends or colleagues or people who are in similar positions is important because just having that validation that it’s hard, it’s hard to be an employee. It’s hard to be a mom. It’s hard to be a partner. All of those things come with tasks and stress and use your time. So being able to have that peer support to share strategies and, like I said, just validate that it’s a challenge and that’s okay.

Anya Morozov:

Yeah. Sometimes there’s this desire to put up this front of like, “Oh, everything’s going fine.” But really acknowledging when you’re struggling, when something is challenging, and sharing that with others is more beneficial, I feel like.

Rasika Mukkamala:

We have one final question for you. What is one thing you thought you knew but were later wrong about? We ask all of our guests on the show this question. It can be about healthcare or not healthcare.

Natalie Kasiborski:

Okay. One thing I thought I knew, I think, when I was first starting my career, was that I thought it would be a straight line and that it would be, whatever job one was, job two would be some type of promotion and more, and that it would be promotion and more and promotion and more, and that it would be this linear line, climbing the ladder. I think that I was totally wrong. I learned that it’s much more of a circular, winding path than it is a linear one. That realization has really helped to just bring joy to the work that I do. I’m not necessarily looking for what’s next or that if there’s going to be something greater, that the path is unfolding in front of me. It’s not a destination.

Anya Morozov:

The path is unfolding in front of me. I really like that. As someone who is graduating in a few months, I’ve also had to come to that realization. I had a conversation with someone where I was panicking about, “Oh, my gosh, I have to find the perfect next job or something.” She was like, “You’re not going to be stuck in that job for the rest of your life. Whatever you do next is not going to be the end all, be all of where you end up. You could find out you like it and keep going down that path, or you could decide you don’t and then transition into something else, and that’s okay.” So yeah, it’s really reassuring to hear that similar experience coming from someone who’s gone through the experience as well.

Natalie Kasiborski:

Yeah. I would still say that. It’s still unfolding.

Anya Morozov:

Any last thoughts on anything that we’ve talked about before we wrap up?

Natalie Kasiborski:

No. Just thank you so much. I appreciate you reaching out and being able to share a little bit about my journey and what I do in public health. Everyone that works in public health has a different story, even if you work in the same field, because it’s so unique, the community that you’re in or the organization that you work for. I think it’s great that you’re telling these stories and sharing and giving voice to the work that’s being done. So thank you.

Anya Morozov:

Thank you. It’s been great to learn your story and to hear about the different paths you’ve taken, your experience with burnout, your experience with just the intersections between social work and public health. It’s been a really insightful conversation.

Rasika Mukkamala:

Yeah. Thank you so much for sharing your experience.

Anya Morozov:

That’s it for our episode this week. Big thanks to Natalie Kasiborski for joining us today. This episode was hosted and written by Anya Morozov and Rasika Mukkamala, and edited and produced by Anya Morozov. 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 help support the podcast, please share it with your colleagues, friends, or anyone interested in public health. Have a suggestion for our team? You can reach us at CPH-gradambassador@uiowa.edu. This episode was brought to you by the University of Iowa College of Public Health. Until next week, stay healthy, stay curious, and take care.