Category: Community Health

VINCE LARA: Hi, and welcome to another edition of A Few Minutes With, the podcast that showcases Illinois’ College of Applied Health Sciences. I’m Vince Lara and today I’m speaking with KCH Assistant Professor Rachel Hoopsick about her research inspiration, dealing with the pandemic, and her current projects.

Rachel, so commonly when I do these interviews, I ask people what inspired them to choose their path. And so I’d like to start off with that. How did you decide you wanted to be a teacher? Did you always want to teach and go down this line?

RACHEL HOOPSICK: Oh, gosh. Yes and no. So I was always interested in health and health care. But I think that the idea of being a University professor was completely out of the realm of possibilities for me as far as what I would be doing when I grew up. So I was the first person in my family to go to college. So I didn’t grow up with role models around me in this type of a career. So as a young child, my dad worked in a factory that manufactured vehicle engines, and my mom worked in an administrative support role at a chemical manufacturing plant. So as a first-gen student, I ended up finding myself working as a tutor a lot. And partly, it was out of interest in teaching, but it was mostly out of necessity to support myself. So once I finished my master’s degree in public health, a colleague of mine took a chance on me and hired me as an adjunct instructor to teach health courses. And I continued to adjunct while earning my PhD. And here I am nine years later with a wealth of different teaching experiences that I have wholeheartedly enjoyed. And I eventually became a health education specialist and also briefly worked as a health educator in a program that served pregnant women with substance use disorders. So collectively, all of those experiences made me realize that I enjoyed all of the different aspects of public health, including research, practice, and teaching.

VINCE LARA: Now, why did you pick your line of research? I’m always interested in that. Was there something in your past, was there something in your history that made you decide, this is what I want to study, and this is what I want to look at?

RACHEL HOOPSICK: Sure. So I grew up in a fairly low-income neighborhood in New York State that was just absolutely decimated by the opioid overdose crisis. And those communities were just riddled with social and environmental justice problems. And looking back, that’s probably how I ended up in public health and researching substance use in mental health specifically.

Most of the research on substance use and mental health tends to focus on individual-level risk factors, so meaning the characteristics or attributes of the person that put them at risk for problematic substance use or poor mental health. But we don’t live in bubbles. People don’t live in bubbles. So in my research, I try to consider other factors, so how our relationships with other people affect our health, the communities that we live in and the resources and social norms within those communities, policy-level factors and how that shapes our outcomes, including the war on drugs, and organizational-level factors. So what are the practices, programs, and policies in workplaces that affect our risk and resilience to psychiatric problems? And I think to that end, my work has focused primarily on populations with high-stress occupations and life circumstances.

So military-connected families obviously deal with a lot of stress. And serving in the military is a stressful occupation. As a PhD student, I was fortunate enough to be able to start working on my mentors cohort study that followed military-connected families over time, focusing on their mental health and substance use across the lifespan. And that experience really solidified for me my interest in working with populations with high-stress occupations, because I think that there are a lot of practical things that we could and should be doing in workplaces to protect the health and well-being of workers beyond just addressing hazards to physical health.

VINCE LARA: I gotcha. Now, you said you’re from Upstate New York. You’re from Buffalo, if I can say that. So why the University of Illinois? You lived in a cold place. You came to another cold place. So you weren’t looking for a lifestyle change, necessarily. But what about UIUC drew you here?

RACHEL HOOPSICK: I will say this– that we do get much more snow in Buffalo, so this is actually a step up in climate for me. So this is great. All joking aside, the University of Illinois, and I think the Department of Kinesiology and Community Health in particular, made it really easy for me to know that I was accepting the right position when I was looking for a faculty position in public health. So I interviewed for multiple positions across the country and was really struck by U of I and how different they were from most of those other institutions, and particularly with respect to both diversity and the role of public health within those institutions.

So now, when you think about the time that we’re living in, we’re really going through a reckoning with the legacy of systemic inequity, racial injustice amidst a global pandemic. So it was really imperative for me to be a part of an institution that shares my values. And in my interactions with faculty, staff, and students in the College of Applied Health Sciences, it became really apparent to me that by accepting a position in kinesiology and community health, I would be stepping into a role where kindness and compassion are valued and public health is paramount. So I absolutely love the U of I community.

VINCE LARA: That’s great. Speaking of COVID and speaking of– yeah, I mean you–

RACHEL HOOPSICK: How could we not go there?

VINCE LARA: Exactly you almost cannot bring it up, right? So as an epidemiologist what has surprised you most about COVID and how people have dealt with it?

RACHEL HOOPSICK: I have many thoughts about COVID as an epidemiologist. So I think the most surprising thing about this pandemic is the way in which we, collectively as a country, are continuing to rely on a vaccine-only approach to the pandemic, which places the burden on the individual to protect themselves when there are a lot of other non-pharmaceutical interventions that we could also be leveraging in addition to vaccines. So in essence, we’re attempting to solve a collective public health crisis with individual-level measures only. And I think that strategy was a bit doomed from the start. So I’ll preface this by saying that my perspective here is shaped not only by my experience and training as an epidemiologist, but also as a parent of an immunocompromised child with complex medical needs who’s too young to be vaccinated. So from my perspective, we have many other tools in our public health toolkit to address this pandemic and do a better job at protecting our most vulnerable community members, but they’re severely underutilized, including mask mandates– although we’re fortunate here in the state of Illinois to have a state mask mandate, that is certainly not the case across the country. We could be leveraging vaccine mandates, expanding access to free masks and testing, and also thinking about socioeconomic measures like a temporary paid shutdown, hazard pay for frontline workers, temporary moratoriums on evictions and student loans. I think the list goes on and on. There are many other things that we could be doing to address issues around the pandemic that we’re not leveraging at least at this point. So I think what’s most surprising is not anything related to the virus itself. It’s doing exactly what viruses do. But for me, I think the surprising piece is more how our elected officials have chosen to address the problem, prioritizing economic factors over human factors.

VINCE LARA: Interesting. Speaking of that, speaking of our elected officials– so recently, there have been reports that the Biden administration has thought about at least advising a way for us to live with COVID rather than eradicating it. It doesn’t appear the virus is going anywhere. So are you of the opinion that we have to deal with living with COVID for probably years?

RACHEL HOOPSICK: So I think that, yes, we’re going to have to continue to deal with COVID-19 for an extended period of time. But I also really dislike the framing of this being the, quote unquote, “new normal.” So I don’t think that, as a society, that we should be normalizing our hospitals being overflowed and being stretched beyond their functional capacity. We shouldn’t be normalizing poor access F to testing and quality masks. And we certainly shouldn’t be normalizing mass death to the tune of thousands of people per day dying from coronavirus.

So learning to live with the virus, I think, requires you to ignore all of these things that collectively are very traumatic. We are nowhere near reaching a level of endemicity or– that is, COVID-19 is not an endemic state or at being at an ongoing low level. We are very much in a surge right now. And it’s actually the worst point of the pandemic so far as far as cases per day.

So I think instead of learning to live with things the way that they are, we also need to be thinking about implementing policies that shape a better normal from where we are right now. A lot of the folks shaping policy that frames the acceptance of this ongoing mass infection, disability, and death are also the same folks who have the luxury of being fully vaccinated, having easy access to masks and testing, and who are able to safely work from home.

We need to demand a public health response that considers some of our most vulnerable people in our communities, so thinking about front-line workers who are working in unsafe conditions, thinking about disabled and immunocompromised people, and also thinking about our children, most of whom are not fully vaccinated. So I think that in this framing of the pandemic, we need to be lifting up the voices of those people instead of normalizing the pandemic itself.

VINCE LARA: I think there’s been a big question about how to reach the people who are vaccine-hesitant, let’s say, who are maybe subject to misinformation or just don’t have the ability to get the information they need. And I’m wondering how– and I’m sure you get questions, given what you do, about vaccines. How do you reach those people, and what do you tell them?

RACHEL HOOPSICK: Sure. Number one, I would say that if you are waiting for the science before you get vaccinated, we have it. It’s here. More than 9 billion doses of the COVID-19 vaccines have been administered globally, and it is the best individual action that you can take to protect yourself against severe illness, hospitalization, and death. But unfortunately, many people do remain unvaccinated, including all children under age five who are currently ineligible for COVID-19 vaccination at this point. So those trials are still ongoing.

But I do want to point out that throughout the pandemic, not all of the people who are unvaccinated are truly vaccine-hesitant. So we’ve had some real problems with vaccine equity and reaching populations in underserved communities, particularly when you think about front-line workers who might be unable to take time off of work to receive a vaccine or who are unable to get time off of work to rest after the vaccine. So we know that many people feel a little under the weather after their first or second dose or even the booster. And more importantly, many of the people who are working in front-line jobs also can’t afford to take unpaid time off of work to either get the vaccine or recover from it.

So there’s a lot more that we can do to reach these populations. And there are a number of different policies that we could put into place to make vaccination less burdensome. And on a global level, we have even worse issues related to vaccine distribution. Much of the Global South remains unvaccinated or only partially vaccinated. So here we have a real need to address patent issues around the manufacturing of the vaccines to create better vaccine equity on a global level, which will be absolutely critical to eventually, hopefully, ending the pandemic and the ongoing new variants of concern. We have to think about this issue on a global scale.

VINCE LARA: Illinois is an R1 university, as you know. And so the projects that you’re working on are always top of mind for researchers. So what projects are you currently working on that you’re excited about? I’m sure you’re all excited about all of them, but–

RACHEL HOOPSICK: Yeah. So I’ll briefly tell you about– there are three major projects that I’m working on at the moment, two of which I carried over with me from the university at Buffalo. So right now, I’m currently a co-investigator on a study called Operation SAFETY, which stands for Soldiers And Families Excelling Through the Years. So this is a longitudinal study of the health and well-being of US Army Reserve and National Guard soldiers and their partners. And that study is primarily focused on substance-related outcomes and is funded by the National Institute on Drug Abuse.

A second study that I’m a co-investigator on is a longitudinal study that compares the outcomes of people who use opioids, who are participating in the nation’s first opioid intervention court, to people who are participating in a traditional drug treatment court program. So when you think about drug treatment court programs, oftentimes they can be seen as coercive. And there are some punitive measures that are involved. So for example, in traditional drug treatment court, if an individual who uses opioids tests positive for opioids during the course of their participation in that program, the judge may sanction them and send them to jail.

So in Buffalo, New York, they have implemented an opioid intervention court which takes a little bit more of a public health approach to addressing the opioid overdose crisis in that region. So the court system there recognized that traditional drug treatment court was not working because they had so many court participants who would die, fatally overdose between their visits with the court judge. So they implemented a new program that puts rapid access to evidence-based treatment at the forefront and really gets rid of those punitive measures like sending someone to jail for continuing to use that substance. So that’s the second project that I’m working on from the University of Buffalo. Something brand new that I’m working on here at the University of Illinois with some lovely undergraduate research assistants from our department here in Kinesiology and Community Health is a pilot study focused on health care worker stress. So working in the health care industry was, I think, a stressful occupation even prior to the COVID-19 pandemic. But now it is just– the stress working in the health care industry has exponentially increased.

So our team is working on a pilot study that will examine the social and environmental influences on substance use, mental health, and suicidality of people who are working in health care settings, particularly as it relates to all of those workplace policies, programs, and practices that are implemented or not implemented during the ongoing COVID-19 pandemic. A bit of what we know about health care workers already with respect to substance use and mental health has really focused on physicians.

So we know that burnout is really high among physicians, and physicians are at risk for suicide and addiction and other psychiatric problems. But I would also argue that physicians are also in a very high-wage occupation. They have much more social capital, more resources and support and autonomy over their positions than many other people who are also working in health care settings.

So through this pilot study, I’m hoping to gather data from a range of health care occupations, including those low-wage health care occupations, so thinking about perhaps certified nurses’ aides, LPNs, dietary staff, housekeeping and maintenance staff. So these are other people who are also collectively experiencing this very stressful pandemic working in a high-risk, high-stress occupation but who don’t have as many systems and support in place, perhaps, as physicians might. So this is my next new, exciting project. And I have a really great team of folks who are working with me to make this happen.

VINCE LARA: That’s great, Rachel. Thanks so much for taking the time to talk with us today.

RACHEL HOOPSICK: It was wonderful. Thanks for chatting with me as well, Vince.

VINCE LARA: My thanks to Rachel Hoopsick. For more podcasts on Illinois College of Applied Health Sciences, search A Few Minutes With on iTunes, Spotify, iHeartRadio, radio.com, and other places you get your podcast fix. Thanks for listening, and see you next time.