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 conversation between College of Public Health students Steve Sonnier and Emma Meador and 2020 Outstanding Alumni Award winners Kari Harland and Ty Borders. They discuss Kari and Ty’s lives and careers as influenced by their time at the College of Public Health.

Steve Sonnier:
Hello all. Welcome back to From The Front Row. My name is Steve Sonnier, and this week, Emma Meador and I had the opportunity to interview the two recipients for the University of Iowa College of Public Health, 2020 Outstanding Alumni Awards. Our two recipients were Ty Borders who earned a master of arts degree and a doctoral degree in hospital and health administration, a master of science degree in epidemiology, and now works as a professor in the College of Nursing and director of the Rural and Underserved Health Research Center at the University of Kentucky; and Kari Harland, who earned a master of public health degree and a doctoral degree in epidemiology and is now director of research operations in the department of emergency medicine at the University of Iowa Carver College of Medicine and adjunct assistant professor with the department of epidemiology at the University of Iowa College of Public Health. This award recognizes College of Public Health alumni who have made distinguished contributions to the field of public health and demonstrated a strong interest and commitment to the mission, vision, and values of the college. Please, enjoy this interview with them.

Emma Meador:
To start off. Could you each talk a little bit about your time as a student? What advice do you have for today’s students?

Kari Harland:
We didn’t talk about who would go first. I’ll take this one first. I think some of the things I talked about earlier, I think for today’s student, it’s really important when you come into the job market, the expectation is that you will have applied those skills that you learned in the classroom. I think that’s one big takeaway and the other is to build your mentorship team to be what you want your career to be. If academia is not what you want, then that’s… Find mentors outside of academia. If you think you want to have a family, have mentors that have a family, all of those sorts of things. I think those are the two big take-homes that I would have for students today.

Ty Borders:
Yeah. I think my comments would be similar. When I think about students I’ve worked with who graduated or recently and been successful in pursuing careers, whether those are in research or academia or the private sector. I think that what’s really important is that persons have skills because I think employers are looking for graduates who are good writers, who have strong analytical skills. Those may be quantitative or statistics oriented, or that could be [inaudible 00:02:46] they oriented in terms of thinking about complex problems. To the extent that persons have skills and they have experience with those skills, I think that really is what sets persons apart. That’s what I look for in my own work when I’m thinking about hiring somebody to be part of our team.

Kari Harland:
Ty, continuing on that thread of skills needed. What made you want to pursue that master’s in epidemiology after you got your master’s and doctoral degrees in hospital and health administration? Was there something that stuck out to you that made you think I need epidemiology to succeed in this area or define myself for there?

Ty Borders:
Usually when a person receives or pursues a PhD in health administration, or really at that level is health services research, and a person would minor or sort of concentrate in economics, health economics, or epidemiology or organizational behavior. I decided to have my methods concentration in epidemiology. Then I learned a lot about the substance of health management and policy from my courses in the health administration. I think that having just the added methods skills and I took more courses than needed to graduate. I forget how many hours I had, but there was like 20 or 30 hours more than I needed to get my doctorate. I decided, why not just go ahead and tack on the MS? I think those combination of skills is beneficial. If individuals can bring together skills from different areas, I think it helps to set them apart.

Emma Meador:
Then going on to our next question, how did you find out about finding your first job? Many students here will be going through that process this year or next year. Do you have any suggestions for them to make that process easier or more robust?

Ty Borders:
Well, my first, I guess, job, real career type position was after I got my master’s degree in health administration and worked in De Moines at Blue Cross and Blue Shield of Iowa for their consulting division. Iowa’s had really strong alumni connections and that works, which is a real benefit to graduates of the programs. As I spoke about during my brief words, clearly, a lot of the positions I’ve taken over the years and the positions that I’ve been offered are really because of the connections I’ve built up in the field. Some of them through contacts and connections to other Iowa alumni, but also in terms of just getting to know people in the field. I suppose that’s something that the persons in any area might say is, continue to try to get to know people and so forth.

Kari Harland:
I would echo those words as well. I have found it’ll be a little bit different in the next couple of years, but also reach out to those people who are experts in the field and ask to meet with them at conferences. It’s been amazing to me how many of the big names that you know in your field, would love to have breakfast with you and talk with you about your future plans. It can feel like a big risk that I think it’s one that’s definitely worth taking to reach out to those people.

Ty Borders:
Yeah, that’s a good point. I tell my students all the time that I’m happy if they come to my office. I think people are sort of scared to come in my office for some reason. Maybe they just think I’m too busy or, but people are generally pretty happy to talk with others. Don’t be shy about reaching out or emailing somebody or giving up person a call.

Steve Sonnier:
In addition to that opportunity to reach out and talk to further connections, when you’re talking about finding your first job or your second job, aside from the connections piece, what did each of you do to position yourselves to be successful in the workforce? What were kind of the do’s and don’ts of building up your career initially?

Ty Borders:
In academia as is not necessarily how it works in other sectors, but in academia, I think one of the things I did was I began by doing analysis, publishing many papers to try to get my work out in publication. I think that’s important before people start applying for grants. In medicine and public health and pharmacy and nursing, we know the health wider fields, we’re applying for grants. That’s very important too. You need to build up your skills in terms of writing and also analysis and being successful in getting grant funding to be in many fields in academia. Now, that’s not necessarily the case, I wouldn’t think, for persons that may go into the private sector or may go work for a health department or so forth. Some of my students from the past few years have gone on to work for the federal government and sort of research related positions or health policy positions.

Ty Borders:
I think that what they have found that has been important is to really stay up to date on what the current issues are in health management and policy, and just to be, I guess, very well versed on those issues.

Kari Harland:
I think from my standpoint, what I was able to do that set me apart, particularly between when I was getting my master’s degree is actually coordinating research studies. I was actively developing questionnaires, writing angles of procedures, a lot of those things that will apply in a lot of different workspaces. It wasn’t until I got my PhD was able to do more of those analysis sort of things. I think a lot of what we weren’t learning data collection, once you’re good at analysis, it makes data collection easier because you think about how you’re going to analyze that data later. I think, again, it’s more of that practical experience that you can get writing papers like Ty was saying that really can set you apart.

Steve Sonnier:
Yeah. It seems like it’s definitely a big part of that issue is wanting to have a strong foundation coming to any of the roles or any job that you’re going to be experiencing.

Emma Meador:
Going off about what we just talked about, about building up your career. For the both of you, has there been a really big moment in your career in which you could go in one direction or the other? If so, how did you decide how to proceed?

Kari Harland:
I spoke to it briefly in my comments, but there was a point after I graduated, where I was working with the injury center at the College of Public Health three days a week, and then emergency medicine two days a week. The injury prevention people are my people. That’s my passionate area. It took a lot of thought and decision-making to think about what I wanted for my career. That’s when I decided to move over to emergency medicine. It was at that time, there was one other research staff person in the whole department, Dr. Dream Denning. She mentored me on some of those clinical things that I hadn’t experienced in some of my training.

Kari Harland:
The reason I made that decision is I saw opportunity for growth. I knew at the injury center, I would be able to publish papers and I would be able to help manage studies. At emergency medicine, I thought there was an opportunity to build a research infrastructure, which I’ve been able to do with Dr. Moore. We now have 24/7 research coverage in our emergency department. We have a whole three analysts, including some graduate research assistants. We have two research coordinators and all of that’s happened in the last 10 years. It’s something I’m really proud to have been a part of. Emergency medicine as an academic field is fairly new. Our departments, I’m going to say 15 years old, maybe, which is not very old in the grand scheme of things. For me, that big decision was, what did I want for my career and did I want to be part of building something new? Again, it’s about taking a risk that might seem scary, but so far so good.

Ty Borders:
Yes. I agree with Kari, that sometimes you have to kind of just take a chance or take a risk. For me, in academia, as a health services researcher, many of us are more interested in more general health care, accessing quality issues, but a lot of the funding is more condition or disease specific. I decided really to dive in to the area of addiction and health services research, to try to compete for funding from the National Institute of Drug Abuse and the National Institute of Alcoholism, Alcohol Abuse. That was, I think, a pretty pivotal moment for me to really like take a shot at getting NIH funding. Also, over the years, I went to Texas Tech to help start a new department out in West Texas. It was pretty far out there.

Ty Borders:
I didn’t even know where Lubbock, Texas was until I looked on the map. That was a little risky. Then I met my wife there who went to law school at Texas Tech, and then I went to UAMS and now I’m at Kentucky. I think that sometimes you kind of have to move around in academia. Unfortunately, that means you may have to move to a different university to have a new experience or a new opportunity. Recently as Dean Parker [inaudible 00:12:10] and I transferred to the college of nursing here at Kentucky after being in public health for maybe 15 years. Having a little bit of a change of pace and work more with clinically oriented faculty members opened up some other doors in terms of doing research for the Market Cancer Center here at UK. I guess the thing I would, I would mention again is, take a chance. It’s a little, probably easier to do if we’re not in academia, if somebody has an attorney or works in banking, that a person can maybe go across town across the street to a different place to work.

Ty Borders:
I think, I have one colleague, Glenn Maze. I think he would not my mind if I shared this. He sort of has in his mind that persons to move every seven years or so just to have a different experience. I think it’s important to kind of take a risk once in a while.
Steve Sonnier:
I think that’s an incredibly valuable message because I think a lot of folks end up in public health, but they don’t expect to be doing what they’re doing along the way. It’s kind of a very common thread to see all walks of life come together here. When you’re talking about opening these doors are pulling on these different threads and seeing where they’re leading, how did you guys decide to focus on your areas of research, whether it’s rural health or injury prevention. What was kind of the thread that you pulled on to see where you should focus your interests?
Ty Borders:
Well, for my research, a lot of my work does involve the conduct of population-based surveys. I’m really interested in the consumer perspective and the patient perspective of health and health care access. This probably dates back even farther to my undergraduate days as a psychology student at the University of Kansas, but I’m really interested again, in individual’s perceptions and behaviors. I kind of just applied that to rural health. I think in part, because I went to Iowa and there were persons faculty members there working in the area of rural health research. Then in part, because of where I went I graduated from Iowa to Texas Tech and then to Arkansas, and now here at Kentucky, these are places where rural health problems are more substantial than in some other areas of the US.

Ty Borders:
I think it’s sort of a mixture of my interests, but also it’s been affected by where I’ve worked and who I’ve been able to work with. You can’t plan everything out, I suppose. Sometimes it kind of just happens.

Kari Harland:
It’s interesting now that I did not know this, but Ty and I both have undergrads in psychology, so it’s a good place to start. My area of focus, like I said, is intimate partner violence, gender violence. It really comes from my belief that what happens in our homes really has an effect on who we, the opportunities we get and the privilege that we have. I have personally been affected by, with family members who have experienced this sort of violence. I have seen how it can change people and how strong it can make people. Like I said, a lot of the work that I did early on was more in identifying risk factors and interventions for people experiencing this type of violence, but really in the last five years or so, I’m trying to take that public health model and move up the rung to kind of that primary prevention.

Kari Harland:
I think, and Ty’s alluded to this, it’s really important that you have something you’re passionate about, but at times you will work on things that you might not be as passionate about, but that are really important because that’s where the funding is. It’s really important to have those skills that can apply across these different topics. I remember when Dr. Moore called me about the covered COVID project that we’re doing, and my response was, “I know really nothing about infectious diseases, but I’m passionate about helping the people I work with.” I think it’s really important to have people that you work with that you’re passionate about as well as a topic, an interest area that you’re passionate about.

Emma Meador:
Throughout your career from your time as a student to where you are now, how valuable has mentorship been to you?

Ty Borders:
As I mentioned earlier, it has been very important. I kind of think about different persons who have served as mentors. I mentioned my colleague and friend, Peter [Helzerot 00:16:44], Who I’ve bounced ideas off of, and he’s kind of mentored me in terms of thinking about positions I’ve considered over the years. Then I mentioned Brenda Booth, who was very instrumental in really helping me get into the field of addiction and health services research, and engaging me in her projects and giving me the opportunity to work with her and published from her data and so forth. It has been really important now today, I still call people and say, “Hey. What do you think about this? Do you think this is a good idea, or this is kind of a crazy idea?” It still plays. It’s a little different now. I think my mentorship is more in terms of colleagues, but you need somebody who I think who can really kind of reflect on what you’re thinking.

Kari Harland:
Yep. I agree wholeheartedly. I think I mentioned, my first mentor who I haven’t had a lot of connection with over the years, but Dr. Bill Fields was the one who said, “Give it a shot.” Dr. Aubrey Saftlas and Corinee Peek-Asa, as well as Anne Wallace were really instrumental. During my graduate degree, not just from training in epidemiology and data collection, but also in work-life management and those sorts of things. It’s really important to have mentors who are willing to give you critical feedback and push you to be the best that you can be. Sometimes others can see in you what you can’t see in yourself. Sometimes you just have to believe them when they tell you that you’re capable of some things. I think as a woman in science, it’s really important to have other women in science as your mentors, as well as have mentors that are hashtag, he for she. They understand some of the challenges that come to us as women in science. They’re willing to advocate for us, but mentorship, as you can tell, is really important to obviously.

Steve Sonnier:
Yeah, I think that you hit on all of those, both you hit on all those key points that a mentor gives you that critical feedback, that they are there to understand your academic life, but then also your personal life. At the end of the day, you want that integration there because then you can understand how to be successful. I really enjoyed the idea of, they can see what in you that you haven’t been able to see yet, or what you can see being your potential and wanting to that be realized. Within this context of everything that you’ve been able to accomplish so far in both of your ends, what has been the highlight of your career thus far, and why is that the highlight of your career?

Ty Borders:
That’s kind of a tough question. I kind of think about, well, here’s one of them. Receiving this award, because we don’t receive a lot of feedback in academia, at least very immediate feedback. Certainly when I ended up being successful in getting in I spending, that was a pretty pivotal moment for me. I’ve also, as Dean Parker mentioned, been editor of the journal of rural health for I guess, 11 years. That’s been very beneficial for my career in terms of giving me more recognition in the field, but also forcing me to understand that the field of rural health research and policy. I kind of think about those really big events in terms of when I’ve done something that’s been pretty hard in terms of getting the grant, successfully being chosen as editor and so forth.

Kari Harland:
I think for me, the thing that I’m most proud of besides this award, as Ty said, would be the work that I’m doing with the department of public health and the sexual violence prevention. It’s really important to me that we try to translate what we’re learning in academia to the community. It’s also by far the hardest thing I’ve ever done, trying to measure things outside of a research infrastructure, doing true program evaluation, where I’ve learned so much from graduate students, even in our own college who have expertise that I don’t. I really think trying to make that community impact in the realm of gender violence and sexual violence is probably what I’m most proud of.

Ty Borders:
The other thing I might add is, maybe I was going to throw this in for a question later. The other thing that I think is really fulfilling is for me, is teaching. I spend most of my time, these days doing research, but I like teaching students, undergraduates as well as graduate students, because when I see that a student gets it, it’s rewarding for me. I figure “Well, I must understand what I’m doing. Maybe I’ll have a small impact on the way a student may think about things.” Or if I’m walking across campus and somebody says, “Hey, Dr. Borders.” That to me really matters because I may write an article and so forth. Some people may read it or cite it, but it’s not as, I guess, it’s not the same impact as I think I have sometimes in teaching.

Steve Sonnier:
Yeah. It’s really phenomenal to have those touchstones throughout the interaction of talking with folks, especially in the mentorship side of things like both of you have played in your roles, teaching students and encouraging their professional and personal growth along the way. We do want to thank you for your contributions to Iowa, and then also congratulate you on receiving this excellent award. We’d like to turn it over to our Q&A now. We’ve got a couple of questions along the way. Emma, if you want to lead off with our first question from the audience.

Emma Meador:
Our first question from the audience is, do you have examples when perseverance played a critical role in your career success?

Kari Harland:
I think perseverance is probably the number one characteristic that someone in academics has to have. I think, gosh, I’m trying to think of a specific example. I guess the biggest one would be applying for that grant again or in the current cohort study we’re doing is trying, we get that cohort study up in about four weeks from the notice of funding to recruiting 1600 physicians, nurses across the US. Perseverance is what did it like our, and not just my own, but the team’s perseverance that we were going to do this, this had to be done now because COVID is now. We want to support those who are taking care of those. I really think, I mean, perseverance is by far, I think the best characteristic that maybe someone in academia can have.

Ty Borders:
Yeah. The example I was thinking of, and maybe it’s because I’m working on like ran up application right now. I was at UAMS, I submitted an RO1, and this has been, we could submit applications three times. The first reviews that other professors provided, they were good, but I didn’t get a score. You want to get a score on these things. We reapplied. The second time we got a pretty good score, but it wasn’t funded. A little disappointing, I suppose. Then on the final stage, the final application, we actually got a perfect score somehow. I’m like, you have to keep trying. You can’t just give up. Unfortunately, in academia, some of these things take months or years, so you really have to kind of stick with it.

Steve Sonnier:
Within that thread of things, you’re talking about perseverance and having to reapply or doing things as a team, you both have indicated how versatile epidemiology is and the importance of teams overall. What is it that you want to focus on with balancing teams out? When you’re coming together and bringing together different skill sets, what are things that students should be thinking of in that interprofessional environment?

Ty Borders:
I work with people from many different areas, and especially with the rural research center. I have colleagues who are from political science, epidemiology, bioinformatics, communication and journalism, public health, medicine, and people have different knowledge and also different skills. I’m the first one to acknowledge, I have some skills and there are some skills that other people have that I don’t. People who were graduating now know things that I don’t know too. We’re really dealing with complex issues and it’s important to work in teams. I also think it’s intellectually challenging. To really pull this off though, I think it also requires that persons having an understanding, at least some understanding of different disciplines in the language. Sometimes we’re studying the same, we’re trying to address the same things, but maybe do it in a slightly different way or with different language.

Ty Borders:
I’m thinking about people I’ve worked with in economics that are trying to address the same types of things as epidemiologists, where they’re using different techniques and different languages. I think there’s important and students in public health like Sutherland and Emma and others are, I’m sure, getting a really good education on this, is that you do have an understanding of health behavior, bio stats, health management and policy, et cetera, so that you can successfully communicate with others.

Kari Harland:
Yeah. When I think about balancing a team, I think about what the project involves and when that project comes to an end, who is going to be the end user of that research project and what sort of information I’m going to need to communicate that to participants? I think a lot of in public health, we’re realizing we don’t maybe communicate as well as we should. In developing the team, I think about what skills people have. I also think it’s really important to make that we had diversity to our teams. Just as Ty was talking, not only discipline, but focusing on pulling in people that we haven’t worked with before across different colleges, different universities, as Ty’s spoken before. I think one of my favorite things about working with students is I’m always learning from them also because as he said, epidemiology is changing every day. I think in building that team, I want to have someone who knows more than I do always on some sort of other topics for whatever that end user product’s going to be.

Emma Meador:
Great. Thank you. I think those are wonderful points you both brought up. Based on the last six months, how do you think that the current events are playing into your research? How do you think it may change your research and specifically, has your research changed based with rural public and rural emergency systems?

Ty Borders:
Well, when COVID-19 really started to take off in the USA, I started to get some calls from media about how is this affecting rural areas. I, like most people, didn’t have many answers because it was so new. I spent a lot of time trying to really read up and what we didn’t know about this issue and potentially treatments and how it may be affecting the healthcare system. Of course, because last semester, I was teaching a class on healthcare organizational policy for undergraduate students. I quickly added a session on COVID-19, but there’s just so much that we don’t know. We’re learning more, but there’s a lot that we don’t know. I think it’s important though, that we try to change our research and teaching pretty rapidly to respond to this crisis. As an example, I submitted a grant proposal in May.

Ty Borders:
Actually, I submitted several grant proposals in May, either as the PI or a Co-I with some other colleagues to try to get more information about how COVID is affecting the healthcare system, including primary care physicians, family physicians, as well as some more specific topics like how our primary care physicians being able to treat persons with opiod use disorder via Tele-health. COVID has really forced all these changes in the healthcare system, such as relaxation of these regulations pertaining to Tele-health, which I think could have some really long lasting positive effects in terms of improving access. We just need more information, but it is important in public health in general, to really, I think, address topics that are of a timely nature.

Kari Harland:
I spoke a little bit already about Project Covered, which is a project that we have in the emergency department looking at the risk to emergency physicians. Although I’ve found that work really fulfilling, I think what COVID-19 has given to me is even more energy to understand societal inequities, particularly gender inequities. We see that women who are working from home having to balance, even though I don’t like to use the word work-life balance. Even more the sort of inequities and how this pandemic may affect women’s careers differentially than it has some of our male colleagues. I think it’s just even maybe more passionate about learning more about gender inequities, how kids being at home has affected the violence that those children are seeing and everyone being in the home. Things that we currently don’t understand, but with kids not being in school and not being with mandatory reporters and those sorts of things, it really has made me just more passionate about what I already cared about.

Steve Sonnier:
I think that’s one of the silver linings out of the pandemic. We were finding out these really intricate areas that we are all wanting to explore further and seeing potential. Then areas of concern too, that are evolving with that. We are seeing an unprecedented situation on our hands that we can devote our public health interest to for current students. Then for current career professionals, as well to this. One of the last points that we want to touch on today too is, we’ve talked a lot about different skills along the way. One of the things outside of the academic setting is the soft skills. The thing that we want to touch on really quick is what are some soft skills that you would encourage students to develop that will help in their success beyond their education?

Ty Borders:
One thing that comes to mind, I guess this is sort of a soft skill, is being able to convey your work and what you do succinctly to others who are not in these rather specific fields that we sometimes get into. As an example, I’ve had the opportunity to travel with our university’s federal liaison to DC a couple of times to meet with our congressional delegation, staff persons. Typically, I have five minutes tops to tell them our story and what we’re doing for Kentucky and kind of put it in, ask for what they can maybe try to do to help out the university to continue our work. This takes, so you had to be a good communicator. You have to do it quickly. You also have to be sure that you kind of put politics aside because you’re not there for political reasons. You’re there for the university. I think persons can think about this in terms of their own positions and their private sector or government, et cetera, being able to communicate effectively, but also to represent your organization in a way that helps the organization out.

Kari Harland:
The two that kind of come to mind is developing your emotional intelligence, as well as understanding who your staff are and the type of feedback that they need are the students that you’re working with, those that you mentoring. One of my strengths is not being a direct communicator. I’m a Midwestern girl. There are people who respond better to more direct communication. Sometimes my ways of communication are confusing. Developing those sort of soft skills to know how to work with the people, you’re mentoring your staff, your emotional intelligence, to be able to understand without maybe any words being said, if someone is experiencing something that maybe they don’t even want to talk about, like giving them the space, the safe space to be able to discuss those things.

Steve Sonnier:
Yeah. I think that’s a good, important emphasis is saying more with less. Tailoring your audience accordingly. Making sure that you are recognizing where people are at. I think those are really common themes that we see in public health and it is a continual thing to want to improve our communication skills. I do want to thank you both for coming on today and chatting with us more and hearing about all of your answers to our various questions. I’d like to turn it over to Dean Parker, to deliver our closing remarks.

Emma Meador:
Thank you.

Dean Parker:
Thank you all. Thank you particularly to Ty and Kari, and also I think Steve and Emma, you did a fantastic job with that. I really thank you for your time and efforts today and for everyone else, it’s good to be together again and look forward to seeing you in our next event. Again, congratulations to Ty and Kari, on the very well-deserved honor.

Steve Sonnier:
Thank you for tuning into this week’s episode. You can find us on iTunes, SoundCloud, and Spotify. If you enjoyed this episode, please share it with your colleagues. If you had feedback for our team or suggestions for contact. We can be reached at cph-gradambassador@uiowa.edu. Thanks to our guests, Ty Borders and Kari Harland for chatting with us today and a warm congratulations on their achievements. This episode was hosted by Emma Meador and Steve Sonnier. This episode was edited and produced by Steve Sonnier. Thanks for listening in and have a great week.