What is Regionalization, Anyway?
Eddy Atallah is an MPH candidate at BU SPH and has served as the Activist Fellow focusing on regionalization at the Massachusetts Department of Public Health since the beginning of the 2017/2018 academic year. We sat down with Eddy to learn about his experience.
Eddy Atallah Activist Fellow
Breakfast: I usually wake up to a cup of coffee. Sometimes I indulge in a jalapeno bagel with a veggie tofu spread from Pavement.
Hometown: I was born in Boston but, I lived in Atlanta, Georgia almost the entirety of life.
Extracurriculars: I like being active; going to the gym or kayaking, I’ve been learning how to dance the bachata and merengue, too.
What made you apply to be the Activist Fellow on Regionalization?
I was first exposed to the opportunity in a student senate meeting. My concentrations in public health are epidemiology and health policy/law. I saw this as a great opportunity to get involved in public health at a governmental level, which would be my interest post-graduation. Being a part of this project, I was given the opportunity to learn the structures of public health not only in the state of Massachusetts but around the country. Being a student in public health field, I am equipped with knowledge and understanding on how to do my job post-graduation. However, being the regionalization Activist Fellow, I have learned necessary aspects of public health that can’t be taught in a classroom. For example, I get to see how departments are funded, required processes for reporting data, and how all wings of public health work together for a common goal.
What is regionalization and why is it important?
The goal of regionalization is to minimize the disparities of health across Massachusetts by minimizing inefficiencies within our public health system. But that isn’t as simple or easy as it sounds. Regionalization is very complex and doesn’t really have a specific “formula.” The ambiguity of regionalization stems from the fact that no state or even public health district works similarly to another. Massachusetts is a home rule, decentralized state. In a nutshell, this means that local public health departments have a large authority in delegating public health matters to their constituents (versus Dillon rule and centralized). The challenge here is that Massachusetts has 351 townships or cities that all have their own local public health board. As Ron O’Connor (Director of the Office of Local and Regional Health) says, “Once you’ve seen one public health district, you’ve only seen one.” These boards act autonomously and “should” provide the same services, and quality of services, to their residences.
What we see in Massachusetts is that not everyone is receiving identical care across the state. Many of the local public health boards are poorly funded and serve towns with very few residences. We are addressing these discrepancies through the regionalization board by setting identical standards, workforce credentialing, financing, structure, and utilizing data to show the benefits of regionalization. Our hope is to get our proposal through legislation and passed by the end of the summer. The passage of our recommendations would restructure public health in Massachusetts allowing equal availability to “public health” and everything it entails to every resident of our state.
What have you been doing for the last semester?
As the Activist Fellow, I work with members of the board who make up the subcommittees (finance, structure, workforce credentialing, data, and standards) to gather information they may need to make proper recommendations. Some example of work I am doing is to write up a detailed outline of the structure of public health in other states. This includes the interactions (if any) between local and state public health boards, nonprofit organizations that influence power in their public health, and where they get their funding and how it’s distributed. I also parse through data to see if public health services were adequately provided. Subsequently, I look at other states and how they define the standard by which they deliver care. Often times, states abide by the “10 essential public health services,” a method we are looking into for Massachusetts. Finally, I also look at how other states pick their public health workers, the required credentialing, needed schooling, and work experience for each position so that we can determine what’s best for public health workers in Massachusetts.
What advice would you give the next Activist Fellow who works in regionalization?
My advice is that patience is key. When you work within the government, especially trying to pass recommendations through legislation, it is a long process. You often times won’t see the benefits of you work until months or years later. Regionalization has been talked about for decades in Massachusetts alone. Just keep in mind, we are building a public health landscape from the ground up and it takes time but is very rewarding.