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Healthy Maine Talks
Stories from people across Maine working to make their communities healthier and safer. Hosted by Maine Public Health Association.
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Healthy Maine Talks
Shelley Hearne, DrPH: Engaging in Public Health Advocacy
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For this month's episode, Matt speaks to Shelley Hearne, DrPH, the Deans Sommer and Klag Professor of the Practice in Public Health at the Johns Hopkins Bloomberg School of Public Health and Director of the Lerner Center for Public Health Advocacy. Shelley shares why it's critically important for public health professionals to engage in policy-making right now, and simple ways you can make your voice heard and serve as a resource for policymakers.
Check out the recent book that Shelley co-authored, Policy Engagement - a field guide for public health practitioners, from government workers to nonprofit leaders, on engaging with policymakers to create a healthier, more equitable world.
*This Healthy Maine Talks episode is supported by the New England Public Health Training Center*
Hey everybody, welcome to another episode of Healthy Maine Talks. This is Matt Wellington, your host and associate director of Maine Public Health Association. I thought it was only fitting after the uh end to the legislative session in Maine to have a leader in public health advocacy join our podcast uh this month. And that is why I was really excited to sit down with Dr. Shelly Hearn, the Dean Summer and CLAG Professor of the Practice in Public Health at the Johns Hopkins Bloomberg School of Public Health, as well as director of the Learner Center for Public Health Advocacy. And Shelly and I talked about why it is so critical now, perhaps more than ever before, for public health professionals to be engaged in the policymaking process. And I certainly know from my work with health professionals in advocacy that, you know, there are some common questions like, is it appropriate for me to jump in and do this? How do I best share fact-based information with legislators while still, you know, making sure that I'm telling compelling stories and not just sharing data? I also have a lot of folks ask me, what's the difference between advocacy and lobbying? Because I have certain restrictions on lobbying. Uh, and if you're asking yourself those questions, then this episode is definitely for you. Um, and we also cover uh a book that Shelly helped to co-author uh called Policy Engagement through the APHA Press. Uh and so there will be some links to that in the show notes. I encourage folks to check it out. It's a great resource. And please stay tuned for my conversation with Shelly. Thanks. Hey everybody, thanks for tuning in to another episode of Healthy Main Talks. As I said in my introduction, I am here with Shelly Hearn, and I'm excited to see you again, uh, Shelly. Thanks for doing this.
SPEAKER_00It's a pleasure, Matt.
SPEAKER_01Yeah. So last time we talked, I was trying to think, probably was a couple years ago at this point, and uh we spoke about some of the national work I was doing and how I could engage with the learner center. And that's when I found out you went to Bowden. So you have some some main routes.
SPEAKER_00Yes, go you bears. Uh I I it's part where I'm so thrilled to be talking with you, Mac, because it's just how I kind of vicariously feel like I'm in Maine. Miss it every day. Uh, those of you who are there, uh you are you are the lucky ones.
SPEAKER_01I consider myself very lucky. We just got a canoe as well. So we took a canoe trip out on Sunday when it was really beautiful out to Sabbath Day Lake in New Gloucester. And I did find myself thinking, this is the way life should be. This is definitely the way life should be. Well, you're you're welcome back anytime, Shelly, if you want to take a break from are you in Baltimore right now?
SPEAKER_00I'm I'm actually down in South Carolina, which is a little further. Um, but but there are actually quite a few uh uh polar bears down here. So I I I feel feel better having some main connections all the way south.
SPEAKER_01Gotcha. And I find that whenever I see somebody from Maine, it just happened to me when we went to a wedding in Texas, somebody stopped me on the street because I had a t-shirt on from one of the main breweries and they said, Oh, you like that brewery? I'm I'm from Maine. We talked for a long time. It's always nice to find that that kinship.
SPEAKER_00Yeah, well, I I I'm not to do advertising here, but I have three, I have three flight deck shirts. Uh, my favorite brewery, and I get stopped all the time. No one, no one knows um uh the brewery, but they recognize the outline of the main state and they love the the Orion plain that's on the front. So, you know, it just one more thing going for Maine.
SPEAKER_01Yeah, exactly. And I will say Flight Deck is the destination for us because they have the big grassy section where our two and a half year old can go absolutely wild. So that's the stop, mostly for the pizza and the grassy section. We do get a beer every now and then, but mostly for the pizza and the big area where she can run around. Um, well, yeah, so let's dive in. I wanted to touch base with you for a couple of reasons. One is that, of course, you're a leader nationally on public health in general and especially public health policy and advocacy. And so before we get into some specific questions about a book that you've co-authored on that front, uh, can you just share a bit more of your background with our listeners? So, how did you end up as, you know, in this position as the director of the Learner Center for Public Health Advocacy? How did you end up here? What was your trajectory like?
SPEAKER_00I am part of the the journey started actually in Maine. I I grew up in New Jersey, which uh at that time was land of the hazardous waste sites, uh, terrible pollution problems, air, water, you you name it. And I always identified it as something that had to do uh with a lot of the poor health outcomes that uh I was seeing right and left as I was growing up, that you you knew there was something that was wrong with our environment that must be why we were seeing so many rates of cancer and asthma and many things that back, I hate to say how long ago, but in the 60s and 70s, you you knew it. I wanted to be an environmental activist. And I also wanted to be as far away from New Jersey as possible. Um, and Maine, Maine was the place. And little did I know, fast forward today, that Maine is also now a hub of really some of the nation's leading thinking on how do you connect the dots with environmental issues, what's happening to people's health, and most importantly, what are some of the smart policies that you can bridge together to really engage and fix our environment a healthier planet and healthier people? So, my my getting going in this field, um, my my training in chemistry and actually environmental policy up at Bowdoin led me on a long journey in many different places in government, in philanthropy, um, in the academic side, uh, putting together programs and policies that were really designed to how do you go upstream? How do you not deal with trying to clean up pollution, but really a basic health concept of prevention? How do you prevent the disease? How do you prevent the pollution? How do you encourage industries to think smarter, a little bit differently about the chemicals they're using to make materials so that it's safer for those workers, it's safer for the environment, and they're not creating products that have hazardous materials in there. And again, to make the link to Maine, it's one of the places where we're seeing some of the leading front-edge policies on things like PFAS, the forever chemicals, uh, whether it's with um soil levels or actual production issues, you're seeing some of those smart innovative policies coming out from the state that the rest of the country is going to catch up and follow Maine's lead. It's kind of the way California did it back in the 70s with cigarette smoke and other air pollution. Um, just really exciting to see what's happening there.
SPEAKER_01Yeah, as you were talking, I was thinking of PFAS. I was also thinking about how long the tail is on some of the environmental pollution and the kind of ripple effects it has. So we just had a story about a community garden here that unfortunately I think they were doing some construction or something in the area and they found contamination in the soil, like significant contamination, and the garden was also contaminated. So this stuff sticks around, you know, and it can have ripple effects. Absolutely. Yeah. So and and and can you share how did that background, academic background, training in chemistry, looking upstream and thinking about prevention, how did that then get you into the advocacy world? When did you start to think, ah, I really, in order to make an impact, I need to jump in on the policy front?
SPEAKER_00Yeah, I you know, I I'm not sure I can tell you that that definitive moment, but I got really fortunate that both my first job out of college, I worked for the Natural Resources Defense Council uh down in New York City. And I was involved in some of the very early work on pesticide exposures and looking at how could we stop using some of the most dangerous, long-lasting chemicals. Uh, I I got to have a number of really early experiences, including testifying in front of Congress. You know, when you're 22 years old, it's not how it normally happens, but it was an eye-opening experience to understand how do you really use data and evidence to help drive good decision making? Because so many times there's so many other pressures that are on those decision makers, whether they're state lawmakers or agency rule uh regulators, um they need people who either have experienced those problems, they have uh expertise in those issues, or they have direct data evidence that can help shape the laws, the rules. So they're really practical, they they make a difference, and they're ones that can be used and implemented by others. And that it it part was that very early experience that if you didn't bring the data to those decision makers, then all those other pressures, the political donations, the the noise from uh other regulated parties, uh, a lot of misinformation about, oh, it's gonna force me to close my business or we're gonna lose jobs, which was kind of the go-to, but not necessarily real and evidence-driven. It was just kind of the crying wolf. And so it really impressed upon me right from the beginning that you had to find the ways to get people in front of those decision makers to really engage and tell them what you know, what you've experienced, what you've seen out in the field, and those real life stories and real factual data can uh tip the balance and can actually, you know, when there is all this uh difficult political pressure out there, if you have enough people showing up who care and have data and are are willing to do that translation, it's amazing how much of a difference you can get in really good policies being put into place. So that was my lessons, but fast forward to where we are in public health today, and I you know, where that was the standard operating practice in the environmental field, it just wasn't what people were comfortable doing in the public health field. And I I kind of consider those two worlds synonymous, but we're actually trained really differently and we've had different career experiences as fields. And so where public health used to be extraordinarily good at advocacy, I mean it it was one tough muscled, you know, entity of a field that could just just make a difference. We've we've atrophied, we've we that muscle hasn't been used, in fact, it's been discouraged, and we've got to rebuild it. So that's why I've been involved in this work, and that's why I'm now teaching this skill to our field, um, not just to Hopkins students. We are really determined to bring this as an accessible, readily um used skill by everyone in the public health field. And that's what that book we wrote, uh Policy Engagement, is all about.
SPEAKER_01That's a great segue. So I I do want to jump into the book and some of the skills that are in there because when you shared your background and and my mind just went to the how do we give the how to public health people? You know, my background, as you know, is advocacy. And so that is what I hope to do in MPHA and in our network here in Maine, is pass some of those skills on. And so what is the what's the how to, right? So what is included in the book? What are some of the things that folks would be able to access there?
SPEAKER_00Yeah, we we we wrote it to be one really accessible. It's it's not a, I mean, okay, let's just be honest. That title, policy engagement, is about as dull and boring as it can be. It's just, it just ain't sexy. But we kind of did that because if you've called it advocacy, a how-to, it's gonna spook a lot of us. Because we've been told for years and years and decades that no, no, no, we can't do that. That's lobbying. Well, that's not the truth. And in fact, the National Academies of Science has been calling for the public health field to become more skilled on this. And I can go on this long list, the Council of Linkages between academy and practice has specifically spelled out advocacy as a critical skill. And then when the De Beaumont Foundation and ASTO, the Association of State and Territorial Health Officials, um, have done those series of surveys of the public health workforce, what's been identified over and over is that a critical skill that the field wants is that policy engagement skill, but they're not trained, they're not taught it, and they're not encouraged. So this book was put together as part of the Essential Skills series that APHA Press, that Astow and De Beaumont combine forces, and this is the second book of the series of essential skills. And it's again, it's I mean, yes, I'm biased, but it's a decent read. It's kind of fun, it's made to be accessible. How-to what is efficacy? How is it different from lobbying? How can you decide what is appropriate for you? Because engaging in the policy arena is absolutely a personal choice, and there's a wide, wide spectrum of ways you can do it, all of them important. Not everybody has to go out and be public and standing on the mountaintop. In fact, a lot of help and a lot of advocacy is behind the scenes, working with local groups, helping uh coalitions form, being a resource that translates your information to those who could use it, whether those are community groups, nonprofits, maybe it's the main public health association, maybe it's actually getting relationships with those regulators who are struggling with a decision on how to set a standard, and you've got data that could help them, or they're trying to figure out how to write a rule, or even if a rule is necessary, you can be that expert, or you can take your expertise and experiences from working in hospitals or working in an agency, talking to your counterparts in different places, uh, to explain why health matters in the decisions they're making. It could be a decision about education, transportation, housing. Those all have something to do with health. And the more that we are having those relationships, being engaged, uh being a resource, being visible to help others, we can make a big difference. And that's what this book goes through of the different ways to both decide how to focus and how to collaborate with others to move policies forward.
SPEAKER_01This is great. And I it I'll just really emphasize here in Maine, we have a part-time legislature. So these are regular people who have other jobs. They're not, they don't have a ton of staff capacity, very little staff capacity to be able to comb through pieces of legislation and understand them and how it impacts. And so I'll just say this is, I've worked all across the country. It is even more important for public health folks to engage here in Maine because those legislators just don't know how these policies could affect public health, what kinds of proactive policies to put in place. There's just not that level of expertise, but all mostly just not that level of capacity. It's just them, right? And they have a thousand things on their plate. And so the more you can be a resource for them talking to our listeners now, the more you can be a resource for your legislators as a public health professional, the better. And they will appreciate that. So I often say the first step is just reach out to your legislator and say, hey, I just wanted to introduce myself. Uh here's my background. If anything comes up in my you know areas of expertise that you have questions on, please feel free to reach out to me or just grab coffee with them and have that kind of introductory meeting and present yourself as a resource for those legislators because they will appreciate that. So yeah.
SPEAKER_00It's it's really good advice, Matt. And let me just add a few things to it. And given the dynamic in Maine, one, you're pointing out they're part-time. So yeah, they really could use your staffing in a certain way, your expertise. But two, they also by you engaging and talking to them, not yelling at them, but it's helping them, you're letting them know that you care about public health, you're a constituent, you are a voice that public health matters. And that's going back to that National Academy of Sciences series of reports that was saying that public health has got to be more engaged in the policy making world. That is a signal that public health is something that those rule makers, lawmakers, whatever kind of policymaker they are, that that there's a constituency out there that cares. So that's that's two, that's really important. And three, just talking to them as you're uh speaking about more and more that we can have those relationships that they know who to go to when they have questions down the road. If they're part-time in their in their roles, well, they're also out in the community talking to people. Talk to them in the grocery store, go to their town halls, ask questions, be a resource. It's it's it's a it is a relationship. And the more that they know you and trust you and uh hear from you, the better it is for public health.
SPEAKER_01It's one of the things I love the most about working in Maine is it's so accessible. The lawmakers are so accessible, and I I think it's so it's important to engage at the national level. I did it for a long time. Obviously, you and your colleagues do it. We have to do that work, but there's just a difference advocating in DC versus advocating in Augusta. The level of access you get to the lawmakers is unparalleled. So we are really lucky here, is what I'm saying.
SPEAKER_00You are on there's just one more way that you're lucky, but I I'll also add that third element. Look, Maine, people are real. You know, they just it it just they are. There's not the pretension. There's not the there's you you you get what you get, you see what you get. They are what they are, and and there's um, I don't know, there's a beauty in it that you can have real conversations. And in a day and age when there's so much of this polarized world, I mean, of course, people are in different parties, but I still come down to, and I don't don't say this as a Pollyanna, but people are are that are we have common values regardless of your party. And I have seen it routinely in Maine, that those labels are almost irrelevant. And it's a state where you can still roll up your sleeves and let's solve problems together, not get into this political theater of I'm this party, that party. It's really, no, I'm a problem solver, and let's just figure out how to get things done. And take advantage of that public health. It's not this is not a democratic issue, it's not a Republican, it's not an individual. Independent issue, public health is everyone's issue, but it's often forgotten. And that's part of our job. By re-engaging, we make public health a priority for those who are elected or in agency positions who are supposed to be problem solvers who need some help to get it over the finish line.
SPEAKER_01Yeah. One thing I really appreciate too about switching from DC to being focused in Maine is the difference in dress code. Uh, very much appreciate the more relaxed dress code of Augusta. Um you mentioned, well, I'm not sure if you specifically said the election, but that is obviously on my mind and lots of people's minds. And so I know what we're talking about isn't exactly about electoral politics, but how do you think that public health professionals can engage in some of the election type, you know, not advocating for a particular candidate to win or lose, but having the same kind of interactions that we just spoke about, just reaching out and letting candidates know, hey, here's who I am, here's what I care about. What would you recommend for public health professionals to do to engage in the elections?
SPEAKER_00Well, you can approach it in many different ways, but every public health professional is also an independent voter. You you are allowed to engage in electoral politics as long as there is a separation from you and your identity in your work professions. And I make that distinction, obviously, if you're a state or federal, federally funded worker. Um, or even with philanthropic dollars, there are often those those restrictions. But you can and should show up at town halls or any kind of meeting and engagement. If someone invites you to a house to meet a candidate, go and ask them I I said him, but I the ask her or him or they something that's about public health and what you care about. Make sure that they're thinking about those public issues, public health issues, and you're helping them shape their platform and their positions. The more you ask, the more they have to start thinking about, well, what is what is my position? How do I go? And you can have those exchanges that are extraordinarily influential. So be out there, ask questions, uh, volunteer. Uh if there are candidates that you really like, and I I I have always been a again a firm believer, and I'm going to be redundant here, but don't assume that because of someone's party affiliation, they don't care about public health. In fact, um they could end up being some of the strongest, most important champions. And so be open-minded, hear everyone, ask everyone those public health questions.
SPEAKER_01And I'll say this legislative session, we had Republicans and Democrats as champions on our priorities, kind of in a surprising mix from my perspective. So definitely don't assume. And I'll say too, that I think this election obviously is critically important, and so is the next election, the gubernatorial election in Maine. And I think it's really key that we have conversations with folks across the political parties and lay the groundwork for the importance of public health in communities so that regardless of who comes into office, they understand what it actually means to them. Um, and that is another question I have for you, and how, you know, what kind of advice you would give to public health professionals? Because I think often we focus on data, which we should. It always has to start from the data and the research and the facts. But that's winning the minds. We also have to win the hearts if we're trying to pass policy. So, how would you recommend public health professionals get that right balance of leading with the fact-based information, but not forgetting and really emphasizing what are the stories to back up the thing? You know, you're gonna share the statistics, but how does that actually filter down into someone's everyday life? So, what would your advice be for people on that front?
SPEAKER_00I I appreciate the question, Matt, because I I actually love it. A dear colleague, um, the fellow who heads up the De Beaumont Foundation, Brian Castrucci, was uh at a session with me recently, and someone he he asked, he he asked this rhetorical question to the crowd, which is um when you when you want your kid to do something, what do you do? And you know, everyone was like, Well, you tell them, you ask them what what you know what what it is. And he said, Yep, that's true, but in public health, we say no, we have to go off and do more research. We get very caught up in our data, which is important, but what we have to remember is we're asking a person, a human being, to do something that that matters. And we have to one, be very specific on what we're asking them to do. Don't just talk we have a problem and in generalities, but rather here's my you know, here's here's the problem. Make it relevant to them. And routinely, a story is a great way to connect the dots of why this problem matters to them. You can tell it as a constituent, you can tell it as someone who's just a put the real human side of why this is a problem. We we tend to go off into data and forget the reason we're in public health is because of people, about trying to keep people healthy and well. And we often don't make those connections as directly. Stories are a great way, they're not always the the best answer. And and I'm gonna do one little professor moment of you know, there are research studies that show Democrats respond better to stories and Republicans better to financial data. This is taken from an analysis of state legislators. You know, is that right? Is it true? You'll know. This is about going in and it's not a conversation you're having with your policymaker. You're on a mission. There's something you want them to do. Let them know what it is and why it matters. But you got to know who you're talking to. And I know I just said that, but we tend to just kind of scream our facts versus the person you're talking to. What is it that they care about the most? What are they most, what's the pressure they're under? This is something that's spelled out in the book of really know your audience so that you don't just come in with a hundred facts, but rather you relate to who they are and what how they see the world and what their values are and their issues and care and connect that. Make it something so that they're gonna want to ask you the follow-up questions. That's that's really the key. It's it's um the key to engagement is knowing who it is you're engaging and what you're asking for.
SPEAKER_01Yeah, the same message is not going to work for every legislator. And I've had enough experiences to show that that I am now very conscious of who are the folks I'm talking to, what should the message be? And the Republicans, I'd be interested to see that research you cited because I've definitely felt this, but it would be great to see what the survey said. Um, but we don't, I think, talk about return on investment enough in public health because it feels a little bit icky, right? Like we're in this for people, but that's part of it. It is about the return on investment. Investing in prevention, whatever that's saying is an ounce of prevention is worth a gold, whatever that do you know what I'm talking about?
SPEAKER_00Yes, I do. An ounce of prevention is worth a pound of cure, right?
SPEAKER_01There you go.
SPEAKER_00Okay, well, yeah, it's it's a Ben Franklin line, but you know, we'll we'll go back and look up our facts.
SPEAKER_01People will get it, people will understand. Um, but I do think we need to focus more on return on investment for public health. And I'll just say you mentioned before advocacy versus lobbying. Can you say a little bit more about that and and you know, illustrate there's a lot that folks can do before they cross that quote unquote lobbying line. So, what do you see as that difference between advocacy and lobbying? Because it's a question I get all the time from our members.
SPEAKER_00Yeah. I, you know, I've been doing this work for three decades, and it has been extremely rare that any of my actual activities would fall under the definition of lobbying. And lobbying is technically defined um through the IRS with specific rules on um what kind of what you say and what's out there in terms of existing laws to make it qualify as lobbying and how you do that outreach. And every state is different, but in general, you know, advocacy is a big umbrella of different ways to engage policymakers to inform and influence them, and a very, very small subset of activities which falls under that would be considered lobbying. So well, I don't know the specific rules in Maine. But typically it's if you're talking about very specific existing legislation or you're organizing groups to go and speak to a lawmaker, a policymaker to take a specific action, that that starts to get you a little closer to the lobbying line. But if you're testifying, especially if you've been invited to testify, that's not lobbying. You're you're in the education business. They again back to that point of this they're not full-time public health people, they need public health to come and engage. Um, having those conversations about here are the issues, here are different ways that you could approach it and solve it, here are the different kinds of laws you can consider, here's the implication of different rules and regulations. Um, here's what my experience shows. Um, if you did the rule this way, you'd have this outcome. But if you did wrote it this way, again, you can be in conversation with them, you could be testifying, you could be submitting comments. Um I have produced reports that analyze specific bills and give implications for different provisions of them. But if I mailed it or emailed it or delivered it to all members of that legislature, that's not lobbying. That's education. So one, know the rules of lobbying in your jurisdiction. That's most important. Um, and that's something that we highlight in this book. But two, they're generally um very specific, very limited on what is lobbying, and there's a huge range of activities that you could do that will be really helpful and don't even get you close to that line if people think they can't lobby. But the flip is you can lobby in a lot of places. A lot of nonprofits absolutely are allowed to lobby. You just have to know the rules and how to report that. And it's something that we should be doing a lot more of, but we think often that we can't do any and just want to avoid it. Where in fact it's better to know what is allowed and take full advantage of that.
SPEAKER_01Take full advantage of it. That's a good place to end. I'll just emphasize, please, to our listeners who are thinking, should I, how can I engage in advocacy, do it. And this is a great resource, the book that I'll uh I'll share a bit more of in the introduction that uh Shelly co-authored. Great resource. We also have some skills trainings through MPHA that I'd encourage folks to check out. And um, I'll just end by saying thank you so much for doing this. It was good to touch base with you again. Uh, next time you're in Maine, let me know. We should get together.
SPEAKER_00Matt, it's wonderful to just even feel like I'm a little bit in Maine. So keep doing what you're doing and uh public health. Um be inspired, be engaged, and thank you for everything you do.
SPEAKER_01Of course. Thanks again.