After graduating from the University of Wisconsin–Madison in December 2012 with bachelor’s degrees in biology and Spanish, plus a certificate in global health, Elizabeth Hovel embarked on a new learning adventure earlier this year—an internship in northern Spain, with the health department of Asturias, one of 17 Spanish autonomous communities.
The Asturias Consejería de Sanidad—comparable to a state health department—has been collaborating with UW–Madison’s Population Health Institute to implement the Health Observatory of Asturias—the first application outside of the United States of the County Health Rankings methodology pioneered by the PHI.
Dr. Rafael Cofiño, chief of population health in Asturias, has been a visiting scholar at UW–Madison, working with Dr. Patrick Remington, Dr. Javier Nieto, and Marion Ceraso.
Dr. Cofiño and Lori DiPrete Brown, associate director for education and engagement of UW–Madison’s Global Health Institute, assisted Hovel in planning her internship. To help with funding, Hovel received an internship grant from the Latin American, Caribbean and Iberian Studies (LACIS) Program.
During her internship, Hovel:
- Participated in a community health rotation with family medicine residents, which consisted of learning about public health programs and spending time with various associations working to improve social determinants of health;
- Took courses in community health, qualitative investigation, and web 2.0 strategies;
- Spent a week at a clinic with a primary care pediatrician;
- Helped to review and organize the Health Observatory’s online health asset database to make it more searchable for citizens;
- Translated some materials from Spanish to English to increase the Health Observatory’s potential for outreach.
Hovel, of Sun Prairie, Wisconsin, talks about her experiences in an interview:
Question: What is your background in public health?
Hovel: I completed the Undergraduate Certificate in Global Health, which included classes in global and public health and cross-disciplinary electives. I’ve been very involved in volunteer work in the Madison area and was able to integrate that into a public health honors project.
I also participated in “Linking Agriculture and Nutrition,” a weeklong field course at the International Maize and Wheat Improvement Center in Mexico, led by Drs. Sherry Tanumihardjo and Natalia de Leon. The sum of my experiences with the certificate allowed me a deep understanding of its focus on a local to global connection.
Q: What previous international experiences have you had?
Hovel: I have always loved to travel and learn about other cultures. At the UW I was able to thoroughly integrate this passion with my studies. In addition to my field course in Mexico, I spent a semester abroad in Seville, Spain.
Q: What experiences during your internship did you find to be most meaningful and/or rewarding? What sorts of insights did you gain?
Hovel: One especially meaningful experience for me was the opportunity to be involved in the different stages of the Observatory’s work. During my rotation, we met with the researchers who compile findings to create a “picture of health” for each zone: health factors and outcomes are presented as rankings with the purpose of inspiring action.
I was able to sit in on several meetings with local government leaders who approached the Consejería wanting to develop a project that could improve their community’s situation of health. Seeing this motivation sparked by the rankings was particularly rewarding and I was able to learn about different approaches to collaboration; we definitely have opportunities to do more of it in the United States.
The Consejería has a great video about this process, titled From Information to Action. (Click on captions for English subtitles)
Q: How did this experience strengthen your belief that important work in the health field is not always clinical?
Hovel: I learned quite a bit about social determinants of health, which include factors such as socioeconomic status, education, and physical environment. These and others greatly influence people’s health status—they are the “causes of the causes” of health problems.
For example, children who live in neighborhoods without access to safe parks may be more sedentary, which can lead to obesity, which can lead to many chronic health issues.
Great community health assets can be primary care clinics, but they can also be bike paths or organizations that work towards better social integration. Community health is inherently interdisciplinary and the opportunities for meaningful work are endless.
Q: How did this experience affect your views on universal health care?
Hovel: I was able to see first-hand the advantages of the Spanish National Health System, such as more direct collaboration between public health departments and clinics and quality primary care for all. Something that caught my attention is that it’s written into Spain’s General Health Law that every resident has the right to health services.
While every country is different, I think health as a basic human right is an attitude that we need to adopt and I’ve become even more passionate about increasing access to care here in the United States.
Q: What impact did your internship have on your future plans?
Hovel: I will be serving with Americorps in the coming year at Sixteenth Street Community Health Center in Milwaukee, and I hope to pursue degrees in both medicine and public health.
The internship really solidified my professional interest in working to improve community health, and I feel more adept to do so. My time in Asturias was a fantastic learning experience—I hope we are able to create more opportunities for exchange in the future.