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A Conversation With ... Beverly Triana-Tremain

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Tell us about your company.
I do grant writing, qualitative and quantitative research and data analysis. I work with mostly government organizations (such as) the U.S. Department of Health and Human Services (and) the Centers for Disease Control and Prevention ... and the Missouri (DHSS) and the University of Missouri system. My clients are all over the nation.

How do you define public health?
Many people think of public health as medicine, and it is. We're all players in the same system. But I always say, "You may or may not need your doctor, but you always need public health." Public health has always been behind the scenes ... fluoridating the water, making sure people are immunized (and) looking at policies to improve health in the community and looking at things from a population perspective rather than individual health.

What are some examples of how public health advocates function?
We can teach people to quit smoking, or we can go to companies and say, "Your employees will be healthier if you had a no-smoking policy." Or we can help build better roads, or better water systems or better foods available to you. A lot of public health is educating people about healthy choices (and making) healthy choices available.

What are some key public health challenges in the U.S.?
Nationally, we've come a long way since the 1900s ... in disease prevention, healthy waters, healthy communities and educating children about how you can prevent disease. ... But we still have a long way to go as far as policies (are concerned). You can tell people to do certain behaviors, but unless we have a policy in place (there aren't results). We're starting to understand more about how the environment plays such a role in peoples' health, so if they don't live in a healthy community, it's hard for them to be healthy. I think one of the biggest challenges is getting entire communities to get involved in community health. ... It's more than just shots and individual behaviors.

What about challenges in the Ozarks?
The teen pregnancy rate ... smoking, obesity, cardiovascular health and strokes are some of the biggest areas of concern. These individual health problems will only get better in healthy (community) systems.

How does your consulting work come into play?
One of the biggest services I provide (is) process evaluation and quality improvement, looking at how a service is implemented. For example, (I've been working with) Missouri Institute for Community Health for five years ... to plan and implement a voluntary accreditation program for local health departments (in) 115 counties. We wrote work-force, infrastructure and physical facilities standards. And we wrote standards for local health departments to do self-analyses on how they plan and implement their approach to public health. ... It's totally voluntary, but (the effort) is now being supported by (CDC) as a national model for local health departments. ... We've got about 20 health departments accredited right now, and we're hoping to get more.

What about the challenges of public-health funding?
We need more funding for public health. You tend to get what you invest in public health. Many organizations have to respond to request for proposals, and 80 percent to 90 percent - if not more - is grant-driven. ... One of the most frustrating things about public health is that it is so grant-driven. You tend to do something for a grant ... and then when the grant's over, if you can't sustain the grant, you have to look for funding elsewhere. (Programs) start and stop, and that's frustrating.

Tell us about your family. My husband, Jack, and I will be married for 20 years in August. He is a fabulous math teacher in Nixa. I would say he puts up with me (and is) a wonderful father. We have three kids, all boys: Hunter, 14; Hayden, 8; and Holden, 4.

Interview by Features Editor Maria Hoover.

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