Jane Carpenter is a Community Data Manager for the HEALing Communities Study at Boston Medical Center. In this role she works with communities to implement evidence-based practices to reduce opioid-related overdose deaths focusing on three specific areas: overdose education and naloxone distribution, medication for opioid use disorder, and safer opioid prescribing and dispensing practices.
As a Health and Social Behavior MPH-65 student, you completed your coursework in December of 2019 and started working at BMC immediately. What was that transition like?
I negotiated to delay my start date from December 2019 to early January so that I would have a couple of weeks off after classes ended. I used some of that time to travel to Thailand with a couple of my closest friends from Harvard Chan. I was so grateful to be able to travel (to somewhere warm!) and spend time with friends before starting my job. I had only been working for about a month and a half before the Governor of Massachusetts declared a state of emergency in response to the pandemic, and the study shifted to be entirely remote. I felt really fortunate to have been able to get to know my colleagues in person briefly before we shifted to remote work. It was such a scary and stressful time for everyone, and I was glad that my colleagues and I could support each other. Our work hinged on community engagement, which, because of the pandemic, we suddenly had to do entirely remotely. It was challenging to balance the need to move forward with the study while honoring our community partners’ obligations; many of them worked in healthcare, public health, or human services, and had to respond to the immediate needs of the populations they served. At the same time, the pandemic exacerbated the opioid overdose epidemic, making our work all the more urgent, and we all quickly adapted to doing the work virtually.
In what other ways has your work on the HEALing Communities Study shifted or changed?
The intended role of the Community Data Manager was to help communities use data to make decisions about how to allocate resources to reduce opioid overdose deaths. At the start of the study, this mostly involved using community-specific data from places like the Department of Public Health, however the measures we had access to were somewhat limited. Over time, my work became more focused on monitoring the progress of the strategies that community partners were implementing. This was not part of the original intent of the study; the study was designed to evaluate the impact of a community coalition process on the reduction of opioid overdose deaths, so we weren’t evaluating the effect of any evidence-based strategies themselves. It took a while for the four states involved in the study (Massachusetts, Kentucky, New York, and Ohio) to come to a consensus, rather than just focus on the community-level outcomes. The Community Data Managers play a large part in monitoring both the quantitative and qualitative data to track the progress of the programs, as well as the community-level data on opioid overdose deaths, medication uptake, naloxone distribution, and so on. We communicate that information back to the coalition members to support decision making.
What has the data shown over the past two and a half years?
The results of the study have not been published yet, but what we have seen in Massachusetts and across the country through publicly available data is an increase in opioid-related overdose deaths in the past three and a half years. The reasons are multifold, but we have seen a dramatic increase in the number of fatalities involving synthetic opioids, particularly fentanyl. The pandemic disrupted global supply chains, and the drug supply chain was no exception, and as a result the drug supply has become more dangerous and unpredictable. Fentanyl has become ubiquitous, and it is far more potent and deadly than heroin, but cheaper to produce and thus more readily available. Increased contamination is also a risk factor. For example, there have been many cases of people thinking they are using stimulants like cocaine but it turns out to be contaminated with fentanyl, and so people can overdose without even realizing they are using opioids. This makes it more challenging to address opioid overdose, because a lot of strategies don’t work for all people at risk of fatal overdose. Someone who primarily uses stimulants might not have naloxone (or Narcan, a medication that can reverse an opioid overdose) on hand because they don’t realize they are at risk of an overdose. Additionally, we have seen that there are many social and structural determinants of health – such as housing and access to transportation – that we can’t directly address through the study but that profoundly impact people’s ability to access healthcare and harm reduction services.
Looking back at your time in the Department of Social & Behavioral Sciences, were there particular courses that prepared you to enter this work?
Bekka Lee’s Program Planning (SBS 203) and Program Implementation and Evaluation (SBS 204) provided me with a strong framework for community involvement in public health programs, and reaffirmed my interest in community-engaged work. In my last semester at Harvard Chan, I took a course on health literacy with Rima Rudd. That class really shaped how I think about the communication of health information and data. She framed health literacy as a social justice issue, and emphasized the idea that conveying information in plain language benefits everyone. A large part of my work at BMC involves translating data and communicating complex information to diverse audiences, and I often draw on what I learned in Dr. Rudd’s class.
What career advice would you give to our continuing MPH students heading into their final semester?
I would recommend exploring different potential career paths you are interested in by talking to people who work in those fields. Informational interviewing can be incredibly helpful for giving a real sense of the day-to-day experience beyond a job description. Talking to Harvard Chan graduates, or other members of your network, can be a great way to learn more about different career paths and help you gauge your interests. The practicum can be a great way to explore a particular field or organization, but if there are skills you want to build that you didn’t get a chance to apply in your practicum, think about how you can build that experience into your coursework – through a class project or an extracurricular role, for example. All of that can provide great experience to draw on during interviews and in cover letters.
And for our incoming MPH students, what should they keep in mind as they begin their studies?
While I loved my SBS coursework, I would recommend also taking courses that interest you in other departments. I really enjoyed the Health Policy & Management courses I completed in survey research methods, qualitative research, and organizational behavior. Take advantage of opportunities to socialize and get to know your classmates and professors. The people I met were the best part of my time at Harvard! It was such a wonderful experience to meet so many people with similar values but different backgrounds. The time at Harvard Chan is limited, so make the most of those opportunities to connect with people while you’re there.
Thank you, Jane!
Connect with Jane Carpenter on LinkedIn.