Episode #3 | Season 2: Building Communities for Health with Allison Myers, PhD

Funding Rural | Episode #3| Season 2: Building Communities for Health with Allison Myers, PhD

Allison Myers, PhD leads the community health program at Oregon State University Extension based in Corvallis, but her work takes her across the state. Allison has a Masters in Public Health and a PhD in Health Behavior – and is passionate about serving people and bringing health knowledge to rural, underserved communities. This episode delves into mental health topics and suicide prevention. If you or someone you know are experiencing thoughts of suicide, call or text the national helpline at 988. Folks in agriculture or forestry who need help, can call the Agristress Helpline at 833-897-2474.

“I believe with every fiber of my being that communities can collectively work together to change conditions for health and to create conditions for health. ” —Allison Myers, PhD

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More about Allison Myers, PhD

 

Allison is the Associate Dean for Extension and Engagement within the College of Health (2022-present), and in that role also serves as program leader for Extension Family and Community Health (FCH) (2021-present).

As FCH program leader, Allison oversees statewide health extension programming including SNAP-Ed nutrition, physical activity and gardening; Coast to Forest behavioral health promotion; food systems, security and safety efforts; disaster preparedness interventions and more. During the Oregon 2023 legislative session, Allison partnered with a broad coalition towards the successful passage of Senate Bill 955, and implementation of the free and confidential crisis line for the agriculture and natural resource communities, AgriStress Helpline© for Oregon (available 24/7 at 833 897 2474).

Allison began work at Oregon State University in Fall 2018 as the first full time director of the Oregon State University Center for Health Innovation (OCHI) which connects external organizations and Oregon State University faculty in the discovery of innovative solutions to pressing health and wellness issues, and builds workforce capacity in public health and human sciences. Prior to her work at Oregon State, in 2017-2018, Allison served as Health Policy Fellow to U.S. Senator Sheldon Whitehouse (D-RI), a member of the Senate Finance Committee, with support from the Robert Wood Johnson Foundation and the National Academies of Science, Engineering, and Medicine. From 2011-2017, Allison co-founded and led Counter Tools, a non-profit technology startup dedicated to advancing place-based public health through Citizen Science, data visualization, and policy advocacy. Early in her career (2005-2011) she led market research and strategy development for health and health care organizations at Innovation Management, LLC.

Allison earned her BS in environmental resource management from The Pennsylvania State University, and her MPH and PhD in health behavior from the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She was a Peace Corps volunteer in Gabon from 2000-2002.

“There are folks who will tell you that in rural areas, you have independent people, maybe a little stubborn who are very self-sufficient, and feel like they can handle whatever comes at them. And that’s actually true. That’s a strength, right? We have incredible resilience. At the same time, we get tired of being resilient. And I think that’s okay, as well.”  —Dr Allison Myers

Discussion Questions

• What are the intersections of community health that your organization works with?
• How can you help develop trusted messengers within your programming in community?

Resources

• • Native American Center of Excellence
  • https://health.oregonstate.edu/directory/allison-myers
  • https://c2f.oregonstate.edu/
  • https://health.oregonstate.edu/ochi
  • https://extension.oregonstate.edu/agristress-helpline-toolkit
  • Online Podcast/Facebook Interview with Oregon Cattleman’s Assocication: https://fb.watch/sIlYYpBCGb/

“When both of us are willing partners, acknowledging ‘you’ve got expertise, I’ve got expertise. You’ve got areas that you’re blind to, right, we all do, and how do we sort of approach one another with a good sense of humor, and a willingness to just just be ourselves and not worry too much about the rest, you know? When you all care about an issue, how do we mobilize around that issue? ” —Dr Allison Myers

Transcript:  Episode #3 | Season 2: Building Communities for Health with Allison Myers, PhD

Erin Borla: 0:13
Hi I’m Erin Borla, and you’re listening to Funding Rural. My secret dream as a kid was to be an extension agent. For folks who don’t know Cooperative Extension is 100 years old, and works as a partner to land grant universities in every state. They began as a way to help farmers showcase what they learned, how they solve problems and over the last 100 plus years, they’ve grown to support and share best practices and things like agriculture, forestry, fisheries, food preservation, youth development, and even community health. Alison Myers and I connected by happenstance, and knew instantly that we would have so much in common. She leads the community health program at Oregon State University based in Corvallis. But she works across the entire state. Allison has a master’s in public health and a PhD in health behavior. And she’s passionate about serving people and bringing health knowledge to rural and underserved communities. A heads up here, we’re gonna be talking about mental health and suicide in this episode, if you or someone you know, is experiencing thoughts of suicide, call or text the national Helpline at 988. And for folks in the agricultural world who need help, you can call the Agra stress helpline, and we’ll talk more about that with Allison. But that number is 833-897-2474. We’ll share this information and lots more in our show notes at FundingRural.com. It was such an honor and a pleasure to hear Allison talk about her work with so much passion here she is

Dr. Allison Myers: 1:32
I believe with every fiber of my being that communities can collectively work together to change conditions for health and to create conditions for health. But you know, I think it’s a saying maybe your listeners will tell us from the disability community about, nothing about us without us. It’s it’s never appropriate, in my humble opinion, for the folks from the university to sort of show up in community and say, look, we brought you a cardiovascular disease intervention, isn’t it wonderful, you know, and the community is like, actually, can you help our kids graduate from high school, and it would be really awesome if you could help us with the overdose issue. And so, I tend to approach work differently. And that’s really the point and is the point of the Center for Health Innovation work. And quite frankly, all of that now is part of extension. And that that is the work of extension, nobody in the university does it better than our extension professionals who live and work and play and worship and serve in communities and are able to bring the very best of the science that we generate, at the university level into community and to bring the very best of community expertise and skill back into the university for this collective benefit.

Erin Borla: 2:48
Talk a little bit about the coast to forest project, because I think that is such an interesting project, and how it really ties in with the work that you’re doing, really, in that mental health space.

Dr. Allison Myers: 3:00
Coast to forest is the overarching name for some mental health promotion and substance use prevention work that we do at the Extension Service. I said before that I’m a health educator by training. I think folks can think of Cooperative Extension in the health space, really as a health education unit. That’s what we do. Health Educators, though we’re not you know, just folks in front of the room with flip chart paper or an overhead projector like we’re also conveners. We build community for health. So we’re community organizers, which I hope it’s safe to use to use that phrase I’ve been known to teach about, you know, the model of community organizing and community building for health is exactly what we do when we bring people together to make decisions and plan, plan for change. But Coast to forest got started. Because in 2018, when I arrived here, my dean at the time and the extension leadership at the time, you know, it’s very clear that Oregon is not doing terribly well in the metrics that matter with regard to mental health or behavioral health, which includes substance use. And we felt quite strongly as the land grant university were the only one as the Cooperative Extension Service. What are we going to do, to show up to contribute to add value, and we’re not treatment people, right? We are never going to be we are not therapists. We are not drug and alcohol counselors. We’re educators at heart and we’re conveners and people trust us for a lot of stuff, dating back, you know, 100 years with our expertise in Agriculture and Food Security and Nutrition work. So it’s been a dance but the very first thing we did was bring dollars to Oregon from the federal agencies that were only eligible like only available to the extension service for doing work in behavioral health, that was the first thing because if I felt like, you know, I, it wouldn’t be okay for me to start to maybe go after funds that were for others, it was like wait, if these are going to be on, on the table for extension, to get involved in behavioral health work, and all we need to do is apply to the Feds and then bring them to Oregon. Let’s do that first. Right, the first part, we know that the stigma is so strong internally and externally and the perception of stigma is so strong, that folks don’t want to get help. What do we do that can undo that? How can we start to tell real life stories? What do we know works to undo the stigma? And how do we do that in Oregon? And that was one of the first steps, right? What are the evidence-based trainings that we can offer to people to recognize the signs and symptoms of someone in distress, and to know how they can actually tangibly help a fellow human that they know is struggling? Not to ignore it, not to turn away, but to say, Erin, how are you? Listen to the answer, ask the right questions if a person is struggling, and then a lot of what we’ve done is compile resources. Right, we’ve built these are very simple, we call them resource guides, but it really is a it’s a handout, it’s a piece of paper, and it’s on a website that lists all the places where you can go for various supports in your county, and we keep them updated, and we make them in Spanish. And you know, they’re never perfect, but they’re always better than googling frantically and can provide. So you know, things like that. That’s what Coast to Forest has become. Bringing people together, undoing the stigma, making folks aware that mental health challenges and substance use challenges happen to a lot of people. They’re not a moral failing, we can gather around and collectively improve.

Erin Borla: 6:51
No, and I think you touched on it a little bit about some of the differences in rural spaces. And some of those additional challenges. And that’s been a lot of the focus of your work is how do we support those folks in more rural and remote places? And how is that different? Or what are the things that you think are you’re seeing are extensions supporting to support some of those folks?

Dr. Allison Myers: 7:12
Well, rural places are different from access to health care . We know that if we’re just thinking about, you know, the number of physicians providers or specialty providers, right, there are fewer the access to get there, you know, it takes longer. So that I think is one sort of simple layer. When we think about health, health care and mental health. We have shortage, shortage areas, provider shortage areas. I think culturally too, I hesitate to make any broad generalizations about you know, rural versus urban differences. But there are folks who will tell you that that in rural areas, you have independent people, maybe a little stubborn, you know, who are very self self sufficient, and feel like they can handle whatever comes at them. And that’s actually true. That’s a strength, right? We have incredible resilience. At the same time, we get tired of being resilient. And I think that’s, that’s okay, as well. There are stressors in terms of finances for many of our agricultural and natural resource communities, farming, ranching, timber, forestry, fishing in our coastal areas, that put those folks in particular at risk. And we know that we’ve gotten more of our Ag and Natural Resource folks in rural and remote areas. So that’s an issue as well. And then I think, at least with the folks that I work with a lot in Eastern Oregon, is that there really is a felt sense of being othered. And I don’t know if you know, if my buddies would say they feel othered. But that’s language that I would use. I think a lot of communities and groups in the United States feel “othered” and that makes me really sad, particularly as a human who often is a connector, bringing people together across disparate backgrounds. But, you know, you add that sort of constellation of factors together, and particularly in the ag a natural resource community, you know, you get to a place where folks are really at risk for things like suicide, and that that’s part of why we started the agri stress helpline was to respond to those to those challenges.

Erin Borla: 9:26
Well, and I think that’s a great opportunity to talk a little bit about that, because that’s another project that we’ve supported, working alongside you. And it’s one of those it’s a solution. It’s not the solution. It’s a piece of the solution. It’s a it’s a piece of a resource. Why don’t you share a little bit about what that is and how that came about? I mean, that was like an odd bedfellow kind of partnership that came together.

Dr. Allison Myers: 9:48
It’s one of the most beautiful things I’ve ever worked on. In my in my career. I’ve I’ve had a reputation as being a builder and a doer for a long time. but this one was a was a miracle that would have not been possible without folks like you. And folks like Todd Nash at the Oregon Cattlemen Association and some of our elected officials. The Agra stress helpline for Oregon is a 24/7 crisis and referral line. It’s like a 988 and a 211. Put together specifically for the Ag and Natural Resource community. And I discovered as part of our Coast to Forest work, that we had such high, high suicide rates among this population. Now they’re, they’re high generally in Oregon, they have been for the last 20 years, they’re increasing. I didn’t realize I wasn’t aware. And then I was aware and I couldn’t unsee it. And I knew too at the time that if you dial 988, the national number, you can get a tailored approach tailored supports for veteran status, which we need for Spanish speakers for LGBTQ plus folks, which really important in crisis lines for that tailoring for it to be effective. And I knew that we were missing something for rural or for ag and natural resource. And then I learned about the helpline that it existed in six other states, but not here in Oregon. And I called I called my new friend at the time. Todd Nash, who was the President of the Oregon Cattlemen Association, we barely knew each other. But I, I would say I was brave. I made a phone call, and said, You’re gonna have to tell me if you think this is a terrible idea. But but here’s the thing. It exists. It’s an evidence based solution. You know, we know that phone lines work, we know there’s a need. And he said, I think it’s a great idea. Let’s talk to Senator Hansel. And I swallowed hard and thought, wow, okay. And sure enough, we did. We met with Senator Hansel, who’s a state senator in the Northeast region of the state. He introduced a bill to offer some money to start the helpline during the 2023 legislative session, which is also when our Republican friends walked out for six weeks. But sure enough, they came back and the bill passed, it passed. It was the last one to go through the legislature before the gavel came down. It got all yes votes, there was a bipartisan coalition to provide what amounts to seed funding in an endowment for the helpline. And then and then we got to work. We didn’t actually have enough cash to start to start the line. But that didn’t stop us. I started calling people that I love. You were one of them to say, Erin, how do we get this going? And sure enough, we launched on September 1 of 2023. It’s been in existence now nine or 10 months, we’ve been getting the word out. We’ve received calls from more than half of Oregon’s counties. One of them in February, late January, early February was almost an hour long. From a person who was in crisis. We’re doing it and it it’s not easy, but we’re, we’re doing it we got calls last month Erin from from some older men in agriculture, and that felt like okay, right, we’re very gently softly starting a conversation that they’re the health behavior of calling a number, a trusted, anonymous human who can offer you a connection quickly, is an okay thing to do. And nobody even has to know. That’s the helpline. That’s the story of the helpline so far. There’s a funny story. I would love to hear Todd tell it but when we first met, he invited me to come be on his podcast, the Oregon Cattlemen Association podcast when he was president to talk about mental health. And I just said, Todd, I don’t know. I don’t know anything about ranching that I actually use the S word. I don’t know shit about ranching. And he immediately said, that’s okay. You don’t need to know anything about ranching. And anyway, he told that story to Governor Kotek at the at the signing, and he said, it’s, it’s proven to be she’s proven it to be true over time.

Erin Borla 14:29
Oh, what a compliment

Dr. Allison Myers: 14:32
That she doesn’t know anything about ranching, I’m learning. I learned a lot I’ve been reading. I’ve been trying to not be so you know, so naive, but but the truth is, is that I know a lot about community health. And, you know, when both of us are willing partners, acknowledging like you’ve got expertise, I’ve got expertise. You’ve got areas that you’re blind, right? Like, it’s like we all do, and how do we sort of approach one another with with a good sense of humor, and a willingness to just just be ourselves and not worry too much about the rest, you know, when you all sort of care about an issue, how do we mobilize around that, around that issue. And the last thing I’ll say, I, I believe strongly to that health means something to everyone. And that it’s, it’s my job as the health lady at the Cooperative Extension Service, right? We use federal, state and county dollars, lots of people make investments in us, they, they trust us to do great work in community. And I know that health means something to everyone. And it’s our job to understand what that is what that looks like, and how we can be partners in creating it. And that that’s what keeps me going that and meeting new people is fun. You know, I, I had dinner in a wheat field in Hermiston, a couple of weeks ago, you know, that’s my actual life. Like, how special is that? Never in my wildest dreams did I think a girl, you know, born to a navy family in Norfolk, Virginia would find herself in Ione Oregon, underneath those wind turbine things, you know, eating with folks at an economic summit. It’s just incredible. I get to do this.

Erin Borla: 16:12
And you get to see these really remarkable places that oftentimes we just don’t even get to see we don’t get to put boots on the ground. Well, you’ve talked a little bit about substance use and, and opioids as part of the mental health crisis. But it’d be interesting to hear sort of where that sits right now. And what what extension is working on what other things are happening around around opioid specifically and fentanyl and other issues that are just prevalent?

Dr. Allison Myers: 16:40
Yeah, I’d be happy to one of the things we one of the ways that I spent my June, January to June actually was working on compiling a project for a new federal mechanism called Heroes, which is from the Advanced Research Projects Agency for Health ARPA H. It was a new federal agency that launched in 2022, and has funding for moonshots. And one of the really special opportunities is around a pay for outcomes model towards reducing opioid overdose rates, as measured by EMS calls for fatal and non fatal overdoses which imperfect proxy measure for sure, but when that can be used nationally to compare county by county across the more than 3000 counties. And that particular opportunity, it was Oregon Health Authority that called to say, you know, are you interested, we think extension could really do something here for opioid overdose rates, particularly in rural and remote or frontier communities in Oregon, where you’ve got a trusted voice. You’re a trusted educator, you’re a trusted convener, and could really be a backbone and a collective impact model. So that’s what we did over a series of months, I worked with Oregon Health Authority and Oregon Health Leadership Council and got some feedback from you and Rebecca, folks on your team, some county commissioners, some elected officials who all said, Sure, you know, how do we be really clear about plussing up some interventions that we know work in a really targeted way, in counties where the the current rates are highest, to be able to see what we can do, because the bottom line is we will have to gather investors for the project to get started. But if we meet the metric and reduce overdose rates by 10%, over three years, the federal agency will will offer us a return of 15 million. And that would nearly reimburse us for the effort, maybe. But the bigger point is, is that it’s a really beautiful thing when your state public health authority looks to your health extension partners to be able to offer additional support, you know, like, everybody’s busy, we’re strapped, we’ve all said that we’re nobody’s having an easy time in 2024. And so how can we how can we partner together, and this project would bring medication assisted treatment in jails and prisons with our Medicaid partners, Eastern Oregon CCO who we love and partner with regularly, we’d be working in emergency departments. We’d be bringing, expanding the use of software systems that we know are effective in wraparound services and making sure you know, providers have the right alerts. There’s never any substitute for harm reduction and education, you know, having people understand the dangers of fentanyl. So it that was a real joy to put to put together. It was hard and it’s certainly a draft but conversations are continuing about about what we could do together. If we’re able to secure additional resources for the state which would be really helpful our overdose rates are above the national average. And we’ve not yet seen what the East Coast is seeing in terms of very recent reductions. Yeah.

Erin Borla: 20:10
Well, lastly, that, you know, this show talks a lot about it’s about philanthropy, how funders can do a better job communicating in in rural and indigenous communities, wherever they are, whether they’re here in the Northwest, or are in another state, what has been your work? Or what do you love about working with philanthropy? What do you wish they would do differently? What would make your dreams come true?

Dr. Allison Myers: 20:31
Wow, I think you’re the first philanthropist that I’ve ever really gotten to know as a, as a, as a friend. I that was the beauty of it is that I saw you in the very beginning as a, as a connector. And I think you saw me as a connector, and you knew different people that I knew. And we started to sort of merge those networks in, in a like sisterhood of progress. And that meant a ton, I think, to just to see you as a as a partner, not as like the the gift giver, grantor on high, it’s a very different like you to have mud on your boots. And that that is, is wonderful. I think another thing that’s really useful from funders is to be able to have them be with me and to see what I see. The strongest relationships I have with funders are ones where we’re, we’re actively doing it together. I think of Eastern Oregon Coordinated Care Organization who’s given generously to our team at OSU. And there we trained community health workers, and we train healthcare interpreters. And the reason we do all of that is because they saw a need, we could fill it. And we were willing to crawl, walk, run, as our dear friend at EOCCO would say, and it wasn’t easy, the crawling involves bruises, sometimes the running involves a broken leg. But if you can, if you can do it together and feel safe doing it together, walking through the struggles, I think that that’s really helpful, so that there isn’t maybe a power imbalance, maybe you get rid of any power imbalance. Recognizing everybody’s strengths at the table. And just knowing that we that we need each other is another is another thing I’d recommend. I also think you are making dreams come true, that might be useful to hear. I’m trained in health behavior, I care about health policy, and John Kingdon is a political theorist. And he talks about windows of opportunity, that policy changes when you can bring together a clear articulation of the problem from the point of view of the people most affected, an actual tangible solution, and the political will to bring it all together, right. And we teach that in courses in theory, to have it all come together and practice. To start the helpline in Oregon, for example, literally is a dream come true. That is a community health educators dream come true, to see a policy work for the people and then to start to see change. Now I won’t be satisfied until suicide rates are, are down. But I think hopefully for now we’re crawling forward.

Erin Borla: 23:23
It’s a step in the right direction. And I think just so folks know, too, there is a toolkit online, where there’s information, and there’s flyers and posters, and all the different things. So we’ll make sure that we link that. So books have access to that there’s a social media toolkit so things can be shared. I think that’s the most important piece. It’s one thing to have a line, it’s another thing to tell people about it. So it’s been really great. Thanks for spending time today.

Dr. Allison Myers: 23:48
Yeah, thanks, Erin. So good to talk with you.

Erin Borla: 23:58
I wanted to touch on the things that Allison shared so much about her comment about being brave, right. And that struck me so differently about how she felt brave to reach out to Todd Nash, to talk about the line and to talk about mental health. And I think that’s such an interesting way to think about how we do this work, how to be brave, and how to be courageous by reaching out to those that you don’t know, or maybe those that, that you don’t think exactly the same on every single issue and being able to recognize the commonalities between folks from all different walks of life. I think we hear a lot, especially right now about folks feeling alone and isolated. And how do we support one another and as philanthropists, we have that opportunity to really convene and bring people together, but then also add action at the end. And really building relationships on the ground. I think what’s really interesting that she talked about is how to how extensions sort of showed up in those spaces and how they have been showing up. And there’s this opportunity for philanthropists especially those of us that have a huge footprint to find in that we really need to look at intermediaries. And perhaps we can look at extension as one of those intermediaries, because they are showing up in those communities in a way that maybe our organizations cannot. And we’re actively doing that together. So how do we how do we build those relationships? How do we find those folks that have relationships on the ground? struggles with mental health have a lot of stigma, and we’ve covered a lot of things in this episode. So we all know somebody that’s been impacted by scares in their mental health or feelings of suicide and thoughts of not being enough. I want to share this important information one more time. If you or someone you know are experiencing thoughts of suicide, please call or text the national Helpline at 988. And for folks in the agricultural forestry fisheries ranching world who need help, you can also call the Agra stress helpline that number 833-897-2474 one more time 833-897-2474 Links to all of their information, social media toolkits, all sorts of show notes and transcripts will be available at FundingRural.com. Thanks so much for listening.

Transcribed by AI