Political Savvy

Big Decisions at Small Tables

When Regina Royan, MPH '12, first learned of Detroit's plans to tear down roughly 40,000 abandoned houses—part of the city's long-term redevelopment plans—she saw a "powerful opportunity" for public health to take on an advisory role. "In early conversations, there were experts in land use and environmental concerns weighing in, but no voice to bring those factors together in the context of health," she says.

Having spent three years as a research associate for Matthew Davis, professor of medicine and public policy at U-M and chief medical executive for the state of Michigan, Royan knew something about persuading policymakers to take an interest in health issues. She got in touch with city officials, secured seed money to write a health impact assessment, and convinced the Detroit Building Authority to create a new advisory position for her in Detroit's Department of Health and Wellness Promotion.

Royan's chief task—critical in a city with an above-average chronic-disease burden—is to produce a health impact assessment and advise officials on health issues associated with blight removal, from lead exposure and pest management to clean fill and public notification. "It took a lot of pitching to get people to start thinking about health in this process," says Royan, who is continuing her Detroit work while starting medical school at U-M this fall. "But the fact that they established—and are utilizing—this new position speaks to their desire to make a long-term positive impact."

Royan's advice to those who want to make a difference is to "first get yourself to the table. Sometimes these are very small tables—but more often than not, big decisions get made at small tables." Good communication skills are indispensable. "Most of my job is synthesizing health concerns for people with no public health background—so writing well and knowing your audience are key."

Just as Davis taught her how to use the political system to advance public health, Royan is now passing those lessons on to second-year SPH epidemiology student Doug Strane, who interned with Royan at the Department of Health and Wellness in 2014. Royan says he's been a tremendous asset. "When you establish a strong voice for health, you have to teach others how to fill that role after you."