Internship Focus: Perinatal, Reproductive and Sexual Health with the State Health Department
ALBANY, N.Y. (May 11, 2023) – Master of Public Health (MPH) students at the UAlbany School of Public Health complete 720 internship hours in two different settings during their academic program, with many students hosted by the New York State Department of Health, which co-founded the school in 1985. This semester, Samantha Van Buren and Abbi Zalucky are interning at the health department’s Bureau of Perinatal, Reproductive and Sexual Health, and we sat down with them to learn more about their experiences.
Screening for Postpartum Depression
According to the CDC, it is common for women to have postpartum depression, with about 1 in 8 women experiencing symptoms after having a baby. Healthcare professionals can screen for postpartum depression— using tools like surveys and questionnaires— to administer treatment and help avoid negative health outcomes for the birthing person, the baby, and other family members.
“With undiagnosed postpartum depression, there is an increased risk of the birthing individual harming themselves or their baby and there is also a risk for developmental issues for the baby. Postpartum depression may lead to the inability for the child to self-regulate and develop healthy coping mechanisms as well as increase the risk for behavioral problems,” explains MPH student Samantha Van Buren.
There are two widely accepted and validated screening tools for postpartum depression—the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EDPS). Which tool is used following childbirth is up to the healthcare provider, which Van Buren explains can pose a challenge based on the advantages and disadvantages of each screening. For example, the PHQ-9 does not ask about anxiety, which is a common symptom of postpartum depression, and both tools may not diagnose someone with postpartum depression if they score slightly too low to meet the criteria.
“We also know that there are health disparities when it comes to racial/ethnic minorities receiving postpartum diagnosis and treatment,” Van Buren says. “Therefore, screening for social determinants of health should be incorporated into screening for postpartum depression so that we can better help those who are not currently captured using the current screening methods.”
Van Buren is assisting with a report on racial disparities and health inequities related to postpartum depression screening. The report, which includes information on factors related to social determinants of health that contribute to postpartum depression, will be provided to the governor and the legislature in summer 2023.
As a part of her work, Van Buren is collecting information and data on various determinants of health that contribute to disparities, including food insecurity, financial stress, substance use, stressors, various family structures, and a lack of social support.
“It’s been very rewarding to know that the work we are doing will hopefully be used to improve screening tools and the process of postpartum depression screening. I’ve also really enjoyed being able to collaborate with a variety of different people with varying backgrounds/positions at the New York State Department of Health,” Van Buren says.
Van Buren is graduating this May and plans to take the Certified Health Education Specialist (CHES) exam while she pursues a career in health education or health communication.
Advancing Social Justice and Health Equity Through Policy Building in Rape Crisis Response Services
Currently, there are over 2,300 rape crisis counselors in New York State who are trained to support Rape Crisis Programs that provide confidential, free and accessible services to victims/survivors of sexual violence.
“Some services available include 24/7 crisis intervention via telephone hotlines, short-term group and individual counseling, and accompaniment to medical facilities or law enforcement,” says MPH student Abbi Zalucky. “Other services include information and referrals regarding medical needs, legal options, and law enforcement reporting options, availability of compensation to survivors of crime, and civil and criminal court proceedings and accompaniment.”
Zalucky is interning with the Rape Crisis Program, helping to identify national program best practices with a specific lens on cultural competency, social justice, health equity, and intersectionality as they relate to secondary prevention of sexual violence, in which proper care and treatment can help prevent negative long term health outcomes.
“Intersectionality is really important because those experiencing violence often face multiple forms of harm and oppression, yet service providers often focus on domestic violence, sexual violence, child abuse, human trafficking, gang violence, and many other forms of harm as separate entities,” explains Zalucky. “We need to look at how these various factors co-exist and how they impact our community members as a whole, particularly to help reduce sexual violence.”
After identifying best practices, Zalucky will help to create an updated standards document for the Rape Crisis Programs.
“Throughout this internship, I’ve worked closely with the Rape Crisis Program Manager along with meeting with the Program Coordinator and sitting in on meetings with the BPRASH staff. I have learned so much about what the bureau does and the complex roles within the state health department. It has been great working alongside people that care so deeply about their work,” she says.
Zalucky is continuing to internship with the Bureau of Perinatal, Reproductive and Sexual Health this summer, and plans to graduate in August 2023.