Arnell Hinkle, MA, RD, MPH, CHES

AH photoArnell Hinkle’s experiences as a restaurant chef and organic farmer led her to pursue a degree in nutrition.  She quickly realized that environmental changes were needed to facilitate individual-level behavior change, and decided to focus on public health nutrition.  She worked on anti-hunger and chronic disease initiatives for several years before founding Communities Adolescents Nutrition and Fitness (CANFIT).  The non-profit, which celebrates its 20 anniversary this year, is dedicated to increasing healthy eating and physical activity opportunities for low-income youth of color and the communities they’re in, with a focus on afterschool and community-based settings.  Her deep commitment to collaborating with communities to improve nutrition and physical activity make her a public health hero.

Career in Profile

  • 1990-1991 – Senior Health Education Specialist, Contra Costa Health Services Department, Martinez, California
  • 1991 – 1993 – Project Coordinator, Contra Costa Health Services Department, Martinez, California
  • 1993 – 1995 – Program Director, CANFIT
  • 1995 – 1998 – Director, CANFIT
  • 1999 – Present – Executive Director, CANFIT
  • 2003 – Robert Wood Johnson Community Health Leader Award
  • 2007 – Mary C. Eagan Award, Public Health Nutrition, American Public Health Association
  • 2008 – Kellogg Food and Society Policy Fellowship
  • 2010 – Ian Axford (New Zealand) Public Policy Fellowship

What inspires you and the work that you do?

There’s a real dichotomy between what we’re fed and what’s possible.  Many people have very little choice available to them.  Economics and other social determinants limit their choices to “which fast food should I eat?” instead of “the breadth of wonderful foods available.”  We try to make sure that people have both the skill and education they need to make healthy choices, and also the availability of healthy choices and safe places to be active.

On a personal level, my life changed when I participated in an afterschool program in St. Louis that brought kids from all over the city to participate in afterschool and summer activities.  I was surrounded by so many people with different ways of being – I remember one of my friends eating a cucumber sandwich.  I had never seen anything like it!  They shared it and it was good, and I thought, “Wow, you don’t have to have bologna on sandwiches?”  It was a radical moment for me.  So I’m aware of the importance of exposing adolescents to other ways of being, and this is one reason our work at CANFIT focuses on afterschool programs.  Especially in communities with challenged school systems, afterschool programs become a place where adolescents can form positive youth-adult interactions, do project-based activities, and just be themselves.  CANFIT makes sure that those are also healthy environments, and uses them as a place to work with young people.

Your career has taken several turns along the way, but is there a particular success or highlight that you are proud of?

We’ve been performing trainings with high school kids around sugar sweetened beverages, and as part of the training we show a video that we co-developed with youth, called PHAT (Promoting Healthy Activities Together).  PHAT uses hip hop culture to talk about healthy eating and fitness.  PHAT showcases youth talking about the importance of eating well and being active, what’s available in their neighborhood, and ends with a dance video.  To create the dance video, we worked with DJs to get clean hip hop beats, some young people came up with the rhymes, and a hip hop choreographer worked with after school programs to develop a dance routine into a dance video.  It’s youth speaking to youth, and 6 years later, young people can still relate to it.  I’m proud of the work and products that we’ve developed over the years because they speak to youth and youth culture, and are still relevant to youth.

Now we use the video in our trainings as a “hook” or conversation starter.  Youth see the film and get ideas, and then we work with them to develop action plans around decreasing sugar sweetened beverages in their communities or for themselves or their families.

Switching gears, what are the challenges you’ve faced or continue to face?

CANFIT also works in the policy arena, and I find that I have to be bilingual, bicultural.  I’m always aware of how to frame things to appeal to which audiences.  So, if I’m with a group of teenagers I might say it one way, and if I’m with a group of funders or policymakers I have to say it another way, and you constantly have to go back and forth between those two vocabularies in order to function in both of those worlds.  I think that grassroots-grounded experience versus academia is always a challenge. People come up with these great ideas that aren’t always necessarily grounded in community and so you constantly have to be the conduit, the reality check. That’s a challenge.  You want to strike that balance, so that research is not just on the community, but for the community, and also works within the community – not just doing research because its convenient to do the research.

The funding is always a challenge.  Because of the way foundation dollars work, you have to shift from project to project, because most places don’t fund general operating costs.  We’re often a training ground for staff; after a couple years with us, they get scooped up by state health department or the county health department.  Because we maintain a network of former colleagues and can bring them in for specific projects, we’ve added a strong “consultation and training” component to our organization. So we try to maintain a lean operating machine and make it work that way.

Is there a persistent public health problem that still concerns you today?

I’m concerned about all of the social determinants of health, like whether people have a livable wage and safe places and education, income.  So much of what we do in public health could be solved if people had higher wages and more education – well, a better quality of education.

In terms of the work that CANFIT deals with, I think we need to take a look at the cost of things – especially the hidden cost of things.  For example, it drives me crazy that the food industry gets tax breaks for donating unhealthy foods to food banks.  If our health values were more aligned with our economic practices, our practices might be in better shape.

Jim Bloyd, MPH

JB 1As an undergraduate at San Francisco State University, Jim discovered public health through a Sociology of Medicine course.  His interest further blossomed as a volunteer in San Francisco General Hospital’s Emergency Room, where he observed that the health problems he witnessed were not rooted in biomedicine, but in social factors like hunger and malnutrition.  He switched career paths from medicine to public health.  Currently with the Cook County Department of Public Health in Chicago, Jim has been heavily involved in Place Matters, a national initiative to address the social, economic and environmental factors that influence health inequities.  Jim’s experiences highlight the challenges and opportunities of working within a local health department, as well as the need to maintain social justice as a central tenet of public health.

Career in Profile:

  • 1988 :  Studied Spanish and Health at San Francisco State University, California
  • 1990:  Studied Behavioral Sciences and Health Education at University of California Los Angeles, School of Public Health
  • 1990-1991: Implemented tobacco use prevention programs in East Los Angeles as a Health Educator for the County Department of Public Health, California
  • 1991-1993:  Worked as a Health Educator at the Lake County Health Department, Illinois
  • 1993- NOW Leads community health improvement planning activities and assists in fulfillment of agency strategic goals as the Regional Health Officer for the Cook County Department of Public Health, Illinois
  • 2007- NOW:  Studying at the University of Illinois at Chicago, School of Public Health as a DrPH Candidate

What is a career highlight for you?

In Chicago, we recently hosted a Place Matters action lab that succeeded in several ways.  Our Place Matters for Health -report in Cook County showed that folks who live in Census tracts where the median household income is $55,000 lived 14 years longer than people who lived where the median income was $12,000 or less.  This underlines the point that the solution is not just to educate people from poorer neighborhoods. There is a whole constellation of living conditions and stresses that follow income lines.  That’s the real issue.

Related to that, in the metropolitan Chicago area, structural racism shows up as patterns of residential segregation. We found that quality of education and educational attainment are stratified by race.  We found that opportunities are also segregated, so that 80-90% of Blacks and Latinos live in low opportunity neighborhoods in metro Chicago.  Public health relates to life expectancy inequities, chronic illness inequities, and we need to work with individuals to increase their collective power.  We need to find ways for individuals and communities to change policies, which will create healthier places for them to live.  Ultimately, we need to wrestle with privilege and segregation and unfair distribution of resources of all kinds.

The report is an example of issues I hold dear, and it was given a very strong vote of approval by our agency’s leadership.  It was a team effort.  There were many people, locally and nationwide, who were working on this national initiative.  It was fun, exciting moment at the end of a lot of hard work.

What’s a challenge that you’ve experienced in your career so far?

Trying to see the work in public health as process. Trying to be patient.  Trying to listen to other people more, and trying to understand that other people are coming from other perspectives, and to feel okay about challenging perspectives that I need to disagree with, and find a way to disagree that is still effective.  I think a challenge is to try and understand my personal responsibility for challenging racism and privilege, especially in the area of race, but in other areas as well.  I may not have played a role creating these systems of privilege, but I can feel good about taking responsibility for challenging and opposing these systems of privilege.

Especially in large, local health departments, it’s a challenge to work in a bureaucracy. You may have more resources, but I can’t say that we’re as flexible, or that we operate as quickly, as I would like.  However, many community leaders and residents welcome discussions on the social determinants and injustices as a way to explain their daily experiences.  They want to know what we, as a health department, can offer them beyond behavior change trainings and education.  Folks have setbacks in their careers, but I’m learning to say, “OK, this is just one day or one battle.  Or maybe there’s a battle I choose not to fight, and I’m gonna choose to work on this.   I’m learning to avoid burnout by not spreading myself to thin.”  This is a time of diminishing resources, so it’s a challenge to keep that perspective in order to keep being effective, keep generating resources for social justice and public health.

When it comes to public health what matters to you and why?

It’s important to make social justice more apparent in the work that we do, and it’s always a challenge.  When it comes to the big picture, health inequities are the most important part of public health.  I try to take an explicitly anti-racist, community engagement, social determinants approach to addressing health inequities.

What is a persistent public health problem that concerns you?

On a practical level, I’m concerned with cutbacks to public health infrastructure, staff and budgets.  It hampers our ability to do our job and to inform the public about the data we collect.  It’s even a challenge to inform the public about health inequities!  Despite the fact that the U.S. ranks among the wealthiest countries in the world, our political priorities mean that that public health is not highly valued.  Building a public constituency is challenging.  People fought for the creation of local health departments, and the public health workforce should not be afraid to take on the politics of informing folks. We don’t have a profit motive, we are accountable to the taxpayers, and I think that’s a very valuable thing.

If we don’t exist … people are paying for that now!  You see it in the widening inequities, premature deaths, chronic diseases, and this is especially true for people of color and low income folks.  We’re still approaching epidemiology through a biomedical risk factor lens.  We need to be evidence- or science-based, which requires a theory of change that can be tested and researched.  For those of us in the practice world, we need to reflect on our theories of change.  Nancy Krieger’s Epidemiology and the Peoples’ Health outlines non-biomedical risk factor-oriented theories.  These theories should guide our work.  Rudolph Virchow recommended that people need freedom from homelessness, illness and poverty.  Awareness of theories can – and should – affect our practice.  It challenges us to question our status quo positions, like our focus on individual behavior change that tends to blame the victim. This puts us in difficult positions, and I think that’s why people don’t think too hard about these alternatives.

What’s your ideal solution to this public health problem?

We have a lot to learn from community organizing and political analysis to understand power.  Who has power and who does not?  I would hire community organizers to challenge unequal or balancing relationships of power, which is called for by the World Health Organization.  A successful community organizer challenges the status quo.

At a practical level, community-based organizations like the Restaurant Opportunity Center (ROC) build power among marginalized people, low-wage earners and communities of color. They address racism and unearned white privilege. We need to build strong relationships with the ROCs and other labor-organizing efforts.  Local health departments can – and are – getting involved with foreclosure and anti-eviction movements, big box retail store and labor, even the 99% movement, equity, and Wall Street.  Public health can make connections to movements that move us towards social justice.  Social justice will lead to health equity, which allows everyone’s health potential to be fully realized.

Joe Zanoni, PhD

imageFolio_jz_final - for websiteDr. Joe Zanoni, like many others, considers himself an accidental public health practitioner.  He started his career as an early childhood/special education teacher in the 1980s.  After he was laid off he returned to school, and entered a labor relations program in hopes that it would prepare him to provide training and education for businesses.  This led him to work with labor unions, which in turn prepared him to work with various populations, from teaching health care workers about blood protections at dawn of the HIV/AIDS crisis, to his current focus on the safety and health of immigrant day laborers.  Dr. Zanoni has drawn upon these experiences and the educational philosophy of Paolo Frèire and others, to promote the importance of peer-led education.  He is particularly proud of his research with workers’ centers.  This work has shown how empowering immigrant workers – whose voices are often unheard and whose labor is markedly unregulated – can reduce their rates of death and injury on the job.  We are pleased to profile Dr. Zanoni as one of our public health heroes.

Career in Profile:

  • 1980: Completed his Bachelors of Science in Education, Disabilities at the University of Wisconsin
  • 1980 – 1983: Special Education Teacher at the Madison Metropolitan School District, Madison, WI
  • 1984 – 1986: Infant Care Provider at the Kunkle Center, University of Wisconsin-Milwaukee
  • 1986: Completed his Master of Industrial and Labor Relations at the University of Wisconsin
  • 1987 – 1991: Research and Legislative Coordinator, Service Employees International Union, Local 150, Milwaukee, WI
  • 1991 – 1997: International Senior Representative for Health and Safety, Service Employees International Union (SEIU) in Chicago
  • 1998: Program Manager, Great Lakes Center for Occupational and Environmental Safety and Health, University of Illinois at Chicago, School of Public Health, Chicago, IL
  • 1998 – 2010: Associate Director of Continuing Education and Outreach, Illinois Occupational and Environmental Education and Research Center (IOEERC), University of Illinois at Chicago, School of Public Health, Chicago, IL
  • 2007 – 2010: Instructor at the Division of Environmental and Occupational Health Sciences (EOHS), SPH-UIC
  • 2010 – Completed his PhD in Education: Curriculum Studies at the University of Illinois at Chicago
  • 2010 – NOW: Research Assistant Professor, EOHS, University of Illinois at Chicago, School of Public Health
  • 2011 – NOW: Director of Continuing Education and Outreach at the IOEERC, preparing masters and doctoral graduates to serve as occupational and environmental health professionals in the areas of industrial hygiene, nursing, medicine, safety and epidemiology

Can you tell us about a career highlight?

I’m really proud of the work that I’m doing with workers’ centers because there are so many things that are part of it. I’m most proud of my dissertation, and also the Charla work.  Charla means “to converse, talk or chat” in Spanish.  It’s a social learning process.  I worked on a pilot study through the University of Illinois School of Public Health, where I learned about workers centers.  These centers are community-based groups, and this brought our focus from unions to immigrant groups.  We went to workers’ centers in Chicago and asked, “How do you like to learn?”  Instead of offering them training, we wanted to know, “How can this be part of what you are doing?”

They said, “We don’t really want to come to a training session, we don’t want to be lectured at, we’d like to learn in some kind of informal chat…like a charla!”  “What would that be like?” “Like sitting around doing different things, and then all of sudden we start talking about something.”

I thought “Wow, why don’t we delve into this?”  So I worked with three different workers’ centers to create a team of people that set up Charlas that invite people to talk about health and safety on the job.  The twist is that we’d do it in a communal setting.  I found a Spanish-speaking, culturally relevant colleague and trained him to facilitate three sessions at each workers’ center.

We’ve since continued this work with another research project. We trained peer educators to lead trainings at worker centers.  We had to have authorized trainers in the room, but they co-lead with the peer educators in a small group workshop format.  We have lots of workers employed in these types of jobs, where many immigrant workers die on the job for a variety of different reasons.

We started in Chicago, and when we heard about other Midwest workers centers we created a train-the-trainer program.  In our third year, we expanded to the Southwest.  We’ve also performed assessments to see how we were doing.  We want to know, “What did they learn?  What is the social context of the training? How are the workers’ centers and the peer relationships? How did they develop and how can they extend practices in the job to protect them?”  That work has been very satisfying.

What’s a career challenge that you’ve faced?

The funding aspect is always a challenge.  How do you sustain an effort? We can create a good idea or a great intervention, but especially if you work with community partners how do we keep it going?

When it comes to public health, what matters to you and why?

The glaring inequities in the U.S.!  So often we are told that we are the richest and smartest country in the world.  We are the top!  We’re the model for the rest of the world!  That’s not necessarily true.  Those of us in occupational health go crazy over the debate about jobs … because it’s not just jobs!  What kind of job are we talking about?  What’s the quality of the job?  What’s the health of the people in their job?  All of that links together.  Yes, some people are healthy but other people are not.  How did we get that way, and what do we need to address in society to fix it?

What is a persistent public health problem that concerns you?

Injury, illness and death on the job.  Overall, if you look at the statistics of death on the job, the trend is decreasing.  But that trend is not true for all subgroups.  For example, Latino immigrants have a much higher “death on the job rate” than white males.  Why is that? It’s the kind of work that they are doing.

It’s almost like we are coming back around to what Jane Addams and her colleagues at Hull House worked on.  We need to improve workplace conditions for specific groups of people who are on the margins, or those who are trying to integrate into society and don’t get enough support.  Liberty Mutual estimates that we lose $50 billion a year due to injury, illness and death on the job.  It’s important to look at where work happens, who knows about it, and who can create the structure and support.  A lot of effort went into creating OSHA but that’s for traditional work places. What about other work places?  What about day laborers, construction, family businesses?  We should place greater effort into addressing and enforcing non-traditional work.

What’s your ideal solution to this problem?

We should support the education of community health workers and peer educators. What kind of curriculum do they want?  There are some groups doing incredible grass roots work with communities to determine what those communities want and need. They collaborate to develop training and curricula that meets people where they are. How can we support workers to learn and share with each other, and put more energy into their organizations? How can public health teach them how to work in collaborative ways? How can we teach them to teach each other about being healthy and safe, and how can that expand and make their work more secure?  We have very vulnerable workers who are day laborers, or people that have just come in the country trying to find work, they are trying to survive.  We need to explore these issues in public health, and we should do it through workers’ centers, community health workers and peer communities. All these people need to be encouraged and supported.