Student Voices
Jan. 21 2020

A Tale of Two Master's Degrees

How one Mailman student is using social work skills to enhance the practice of public health

I’m not a heartless person, but I’ve gotten used to people crying in front of me. It isn’t taught in school, or asked about on your application, but just about every social work student I know has the remarkable ability to sit with someone in a dark time and hold space without becoming overwhelmed by emotion themselves. As a dual MSW/MPH student, I had no idea that skills like this one would become just as vital to me as a public health practitioner as they are to me as a social worker. Throughout my practicum experience with Dr. Marni Sommer and the GATE program at Columbia Public Health, as I collected firsthand stories about how New Yorkers experiencing homelessness were managing their periods, my social work side and public health side supported one other – and sometimes conflicted – to produce work that expanded our understanding of an often-overlooked dimension of life in one of our community’s most vulnerable groups.

Rachel Clark Smith, Columbia University Mailman School of Public Health, Columbia University School of Social WorkMy graduate studies have affirmed that social work and public health are beautifully complementary disciplines. Social work’s unit of measurement is the individual. From clinical providers to those shaping policy on the macro-level, social workers are interested in an individual’s strengths and challenges, nested within the ecology of their family, community, and society. Public health, of course, is focused on populations, harnessing commonalities in environment and behavior to move toward the best possible state of health and well-being. When the individual and population-level perspectives come together, it creates a unique, multi-faceted view of social problems, each bringing to light dimensions that the other might miss. As my program nears its end, I know that I’ve learned more from studying both fields together than I ever could have by approaching them separately.

A social work education is intensely practical. Fieldwork begins the same time classes do, so you can spend more than three times the hours in the field as you do in the classroom. The clients I’ve worked with face numerous serious, intersecting challenges, and many have been the victims of appalling injustice. A lesson I quickly learned was that I was not powerful enough to eliminate most of their problems, but that my presence and affirmation, validating their experiences, reminding them of their strengths, and partnering with them to navigate complicated systems, could sometimes make the season they were walking through a little easier. Conducting qualitative interviews as part of my practicum brought this lesson to bear in a public health setting, as well.

Our goal was to learn more about the menstrual hygiene experiences of people in New York City who live in shelters or on the street. What happened when they got their period? Where did they find products, toilets, places to wash up? What made these experiences easier or harder, and how did they feel about them? Participants were actively homeless, and the power and privilege difference between us stood out in sharp relief. They shared honestly and in painstaking detail about the realities of managing one’s period with little stability or privacy, as well as the myriad other challenges that accompany homelessness in New York City. I felt intense gratitude for the people who shared their stories with us, as well as some unavoidable guilt, especially knowing that I could go home at the end of each day to a safe, comfortable space.

My social worker’s impulse to problem-solve was strong, and sometimes conflicted with my role as a researcher. One woman, over the course of telling her story, shared about being in the middle of a particularly tough situation I had dealt with numerous times in the field. I began to depart from the interview guide, asking for more details and whether she had accessed this or that resource when Dr. Sommer gently stopped me and refocused the interview. Throughout the summer, I leaned on this reminder that I could not solve every problem, but that research, like direct services, was another imperfect but important way to try and serve my neighbors.

I wasn’t prepared for how emotional these interviews would be at times, but it was a privilege to be part of bringing such powerful, often untold narratives to light. It confirmed to me that my decision to center my career at the intersection of social work and public health was the right one, that it has the potential to do real good and bring about real change. It also challenged me to be self-reflective, ensuring I bring the most effective skillset to every role. I don’t know if the next step on my professional path will include people crying in front of me, but if it does I know I’ll be ready.


Rachel Smith is a 2020 dual MSW/MPH degree candidate at the Mailman School of Public Health and the Columbia University School of Social Work. She received a BFA in Drama from New York University. 

If you're interested in submitting to Mailman Student Voices, please send a three-to-five sentence pitch outlining your topic to mailmancomm@columbia.edu