Interview by Cristi Carman

In addition to having extensive experience as a community health advocate, Dr. Anthony Schlaff, the MPH Program Director at Tufts, is committed to helping Tufts University Medical School students build advocacy skills. For instance, Dr. Schlaff is offering a new course, Public Health Advocacy. The course will provide students with one-on-one guidance in learning the fundamentals of public health advocacy and developing and implementing an independent advocacy activity. The course also includes attendance at the annual Health Education Advocacy Summit in Washington D.C., where Dr. Schlaff will moderate a discussion on incorporating advocacy into professional preparation.

Dr. Schlaff’s research interests include community organizing and outreach methods, physician-community coalition building, and Community-Oriented Primary Care models and methods. Read on to hear how he got started as a Community Health Advocate.

Cristi: Tell us about your connection with public health advocacy.

Tony: Most recently, I have been involved through Association for Prevention Teaching and Research (APTR).  They house the Council of Graduate Programs in Public Health, and as an MPH director in a program not a school, I was a member of that group.  I became involved in the leadership of that group, trying to strengthen it as a place where programs could come together and learn from and support each other.  We became aware of the way the schools of public health were lobbying and using federal rule making to direct funding to themselves at the exclusion of programs, even when such funding was equally appropriate for programs or their students, and we started to advocate to change this.

Cristi: How did you become involved in health advocacy?

Tony: In part, as I described above.  I had early exposure to advocacy as a community health center medical director, where I became involved in a number of issues like the funding of CHCs [Community Health Centers], the relationship between hospitals and CHCs including the ability of CHC doctors to admit and follow their patients in a hospital, and Title X funding (family planning).  In 1997, I had an opportunity to spend time in DC as a primary care policy fellow and this gave me some basic tools and exposure to advocacy at the federal level.

Cristi: What lessons have you drawn from your advocacy experiences?

Tony: It takes staying power…it can be an exhausting game for outsiders, because there is so much to know, and the rules and schedules are complex and, in that way, it favors the insider….but the alternative to outsiders NOT doing this work is for government to become a totally insider game.  The reality is that government officials and their staffs are (for the most part) “corrupt” only to the extent that they tend not to hear outsider perspectives – government does respond to advocacy, but it is usually the organized interests who have the natural ability to have their voices heard.  When knowledgeable individuals who have a community or public perspective take the time to learn enough to engage, they are welcomed and heard.

Cristi: In your experience, what skills are most valuable in advocacy?

Tony: Doggedness – like I describe above.  A willingness to do the research on both the content and the political process.  Ability to be “personally political.”  To be able to create relationships and engage with people as they expect to be engaged and in a way that allows for finding commonalities.

Cristi: Are there any resources you would recommend to students interested in this work?

Tony: You can find some resources at the TUSK site for the MPH advocacy course (a pilot – still in development), MPH 211.  One is the book, Real Clout, which was published by the Access Project.  Congress.org is a good site for getting the basics on congress.  And the Association for Prevention Teaching and Research (APTR) has a nice 20-page resource guide on advocacy, which I have put on the TUSK site.

Cristi: What advice would you give students who are interested in public health advocacy?

Tony: Go meet your congressperson (or at least their health staff) and your state legislator.  A good test of your ability to be an effective advocate:  when your state legislator walks into a room – would they recognize you and know your name?  Also, get involved at the ground level in some sort of national organization.  APTR is one possibility.  American Public Health Association is huge, but has opportunities that are manageable either through student specific activities or through specific sections, SPIGs and caucuses.