Researchers from the University of Iowa’s Prevention Research Center for Rural Health (PRC‑RH), in partnership with the Iowa Public Health Association, are launching a statewide research effort to better understand how Iowa’s public health workforce perceives the current environment surrounding public health in the United States.

The project uses an innovative mixed‑methods data collection tool, SenseMaker, which helps visualize patterns across stories provided by a wide range of people. Public health professionals are invited to share short stories of their experiences based on the prompt: “Imagine you are trying to explain to someone the current state of public health in the United States right now—what story might you tell?” Follow‑up questions allow participants to expand on their responses, and the results of the analysis will highlight strengths within public health systems as well as areas needing improvement.

According to project lead, Professor Rima Afifi, public health workers across Iowa are invited to participate in this new phase of the project because their insights are essential for shaping policies, strengthening systems, and ensuring that the public health workforce is equipped to respond to current and future needs. This project defines public health workers as all those working in local, regional, state, and national health departments, as well as those working in governmental and non‑governmental public health agencies or community‑based organizations with a public health focus.

“By participating, public health workers can help inform decisions at local and state levels, ensuring that future planning better reflects the realities of those doing the work,” Afifi says. “These stories and perspectives will guide efforts to strengthen Iowa’s public health infrastructure and support the people who sustain it.”

According to Lina Tucker Reinders, Executive Director of the Iowa Public Health Association, the need for this work is clear. “The public health workforce is still struggling with the knock-on effects of the pandemic related to trust and public health authority,” she says. “Across all levels of government and in public spaces, the science and motivation behind public health is being questioned. It can be exhausting, demoralizing, and infuriating.”

She emphasizes that sharing experiences has become essential for the workforce itself. “We all know that the strength and resiliency of a community improves health outcomes. That’s true for the people within public health, as well. Sharing our stories doesn’t change the external factors that we are facing, but it gives us a bigger safety net for the times we feel like we’re going to fall.”

This project is a follow‑up to the PRC‑RH’s Harnessing Knowledge, Elevating Learnings project, which examined Iowa’s response to the COVID‑19 pandemic. That study highlighted the immense strain placed on public health staff, including heavy workloads, emotional exhaustion, and limited recognition for their essential contributions. Many respondents described both the pride they felt in serving their communities and the toll the work took on their mental health and well being. The results also underscored the importance of strong partnerships, clear communication, and evidence‑based decision‑making.

Importantly, collecting stories does more than reflect the workforce’s lived experience; it also illuminates how policy translates into practice. “Local health departments operate where policy meets reality,” says Christine Estle, administrator of Jefferson County Public Health. “Sharing stories highlights how statewide or national policies play out in communities, which helps policymakers, funders, and partners understand what works…and what doesn’t.”

The stories and themes that emerge from this effort will be shared with policymakers and decision makers at both local and state levels to support evidence‑based responses to public health needs and challenges. Ultimately, this narrative‑driven approach complements Iowa’s broader data‑collection efforts.