189: Encouraging the Public Health Workforce

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Tuesday, May 31st, 2022. I'm Robert Johnson.

Now, a special conversation with Dr. Karyl Rattay, director of the Delaware Division of Public Health. We caught up with her at last week's COVID-19 Summit hosted by ASTHO. She's leaving her job after 13 years. Here's what she had to say about her time in office.

You have been in this position for 13 years, and now you're going to pursue other things in your career. How does that feel—moving on?

KARYL RATTAY:

You know, there's some very mixed feelings. I am so proud of the public health team in Delaware. And, you know, we have just such a rock star team, people who have sacrificed so much for public health. And we have seen that in the last couple of years, more than any time in our lifetimes. It makes me sad to walk away from this incredible team at this time.

But personally, I feel a little less stressed. I'm excited for something new. So, while it's hard to make a change in some ways, it's also a good time. It just feels like it is clearly the right time for me to make a change.

JOHNSON:

Well, and you have worked with—led—the department, the people of Delaware through a rough time in history with this pandemic. What reflections do you have regarding that part of your service?

RATTAY:

Yeah, I mean, it's interesting, 'cause I started my role in Delaware's Division of Public Health right as H1N1 hit. So, I started at a pandemic—the beginning of a pandemic—which was incredibly stressful at that time as well.

What was so different about this COVID pandemic is how long the response has been. And quite frankly, I don't think that humans are intended to work this intensely for this long of a period of time. I mean, it just—it's really taken a toll on our team. I think that a lot of members of our team certainly took a lot of hits from the public—received threats—and just overall are exhausted. Sacrifices made have been incredible.

But on the other hand, some of the relationships that we have developed together—there's a lot of funny times, too. A lot of humorous experiences that we had, the unexpected moments that, frankly, I'm hoping sometime I can find the time to write a book about because it really has been the most incredible experience in so many ways. And while it has been so incredibly hard, I guess I say I'm glad that I've, you know, had this experience in my life to work with other humans, other professionals, in this way.

JOHNSON:

We just talked to Dr. Piercey from Tennessee, who also is leaving her position, and she reminded us that there was a time before COVID and there will be time after.

You worked at the department a long time before the pandemic came around the corner and hit us over the head. What about some of the other accomplishments you're most proud of?

RATTAY:

Yeah, I mean there's a lot. And again, I'm just so proud of this public health team.

Public health accreditation was one of the best things we've done in my time. When I got to the division, we didn't really have a strategic plan. We would have never done a state health improvement planning process. Took us several years to build the infrastructure, but we were the 16th state to become accredited. And that's really helped us, I think, lift the work that we do in public health. But we've decreased infant mortality by 30%, we've decreased cancer mortality by 15%.

Two initiatives that have just been so exhilarating to me where we've seen some great strides. One is called the Delaware Can Initiative, focusing on increasing access to effective contraception—all forms of contraception—for women. And we've seen a 25% decrease in unintended pregnancies and just significant uptake in effective contraception for women in our state.

The project that's hardest for me to leave is one that, although I've worked on kind of getting it going for about 13 years, the last five years or so we've really been able to stand up a place-based health equity initiative, a community-driven initiative to address social determinants of health. And so, we've been able to leverage investments into the community and really help communities, community leaders, identify and address their most important social determinants of health.

So, a lot of exciting work that we've been able to do in my time at public health, and certainly I hope it all continues.

JOHNSON:

We caught up with you here at the COVID Summit that ASTHO held recently in Washington D.C. So, some of your colleagues maybe are having these conversations with you about your time coming to a close here; but for those who are not in the room or around, what would you say to them? Any words of wisdom or encouragement that you would offer as they continue to fight the good fight here?

RATTAY:

You know, I think it takes a combination of factors to keep going and, you know, can be an exhausting journey in many ways. But it takes time for the rewards, but it's so worth it. But again, it takes persistence. It also takes knowing what your values are and sticking with them.

I've had, you know, a number of times to really stand up for what feels right to me, and luckily I've had great support to be able to do that in my environment—I know not everybody's so lucky. But you know, I think it's those combination of things that can really matter.

But I will tell you, I think what's most important is we all in these roles have to do work and spend parts of our day doing things that maybe we're not super excited about or that we just have to work on. But always having work that you're involved in that you really care about, work that makes you feel like you're making a difference, work that matters to you, keeps you going. And that's what I found.

I can't always, you know, spend all my time on it, but at least I know if I can continue—even through the pandemic, this Healthy Communities Delaware initiative, this place-based initiative, I never missed a meeting. I kept working on that work and it made me happy. And I think that's really important to find that work that matters to you.

JOHNSON:

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.