Name: David Cotton, PhD, MPH
Location: Atlanta, GA
Place of Employ and Position: NORC at the University of Chicago, Vice President, Public Health Research
Degrees, including Institutions:
PhD (Clinical Psychology) – University of Alabama
MPH – University of Alabama at Birmingham (UAB)
BA (Psychology/Linguistics) – University of Alabama
What attracted you to the field?
When I was a junior or senior in college (in the early ‘80s), I had a professor in the psychology department who had been working in suicide prevention for a long time. He and a colleague saw that prevention was the foundational principle of public health, and they went back to school for a Masters in Public Health after decades in academia and clinical work. He came back proselytizing the value of integrating psychology and public health; I took a couple seminars with him and was intrigued. They were then starting a joint PhD in Clinical Psychology and MPH program and I jumped at the chance to participate.
I thought initially that I would apply the prevention approach of public health to mental health issues, but after finishing my PhD realized that the exciting work was in applying behavioral and social science principles to public health. In 1990, I took a job with CDC developing and evaluating social science-based HIV prevention interventions. That was a life-changing experience; I realized that public health intervention development, evaluation, and other aspects of what is now known as implementation science were where my passions were.
In 1994, I moved to my first professional services firm to do similar work for CDC from that vantage point. While many of my CDC colleagues joked about me having to “worry about billable hours,” I soon realized that the incentives in the private sector made for better process and product for public health. We were – and are – expected to 1) have high quality products – every time, 2) have a reasonably priced budget and be committed to it, and 3) get the work done on the timeframe that was promised. Unlike in some others, our clients hold our feet to the fire on these aspects, and that is good stewardship of public and non-profit funds. So, we stay motivated on every engagement to do our best work in both technical aspects and the management of that technical work. And the public wins in that equation.
You are in a particularly important position, given the COVID-19 pandemic. Can you tell us a bit more about how you are coordinating two states’ contract tracing programs?
Contact tracing is a decades old, fundamental public health practice for helping control infectious diseases that have the potential to spread quickly from person to person. It is typically used for sexually transmitted infections, tuberculosis, and rarer or less frequent situations like Ebola or Zika. Given the more constrained populations in which those diseases travel, contact tracing can be done by a few people, often in-person, and rapidly reach all affected people. What is different about the current situation with COVID is how widespread it is and, thus, how many people need to be reached, and reached quickly. Traditional methods are proving inadequate – in particular, the exclusive reliance on small cadre of highly trained professional tracers and data management systems designed for small numbers of cases.
The Maryland Department of Health was an early innovator in addressing the latter part and initiated the development of an integrated case management system and data collection/calling solution in early April. NORC was chosen in a competitive process to be the workforce provider because of our long history with data collection in the survey context. We were able to build on that experience of collecting highly sensitive health data in secure systems, managing call flow and providing rigorous quality control, and hiring and managing a large workforce of callers (contact tracers). That pivot from research to public health service is all based on the marriage of technical expertise, technological expertise, and strong management of high-volume, time-sensitive, public health endeavors.
We’re all getting acquainted with the perspective of working from home, or teleworking, could you touch on the pros and cons of telework for management and for professional development, from your perspective?
I have a bias – I like to be with my colleagues both for the effectiveness of getting work done (for me, at least) and for the social value in interacting and getting to know people that you spend one-third of your life with. I think it’s important to differentiate the productivity of day-to-day task accomplishment from the value to one’s career development. I realize that others may find that draining. However, from a management or leadership perspective, I think it’s important to differentiate how we optimize productivity on day-to-day task accomplishment from the way we value and enhance others’ career development in the long-term. I believe that it is a significant struggle to stay tied in to your employer, your colleagues, and the culture of the workplace when working remotely. The culture of a workplace is defined in large part by the nature of relationships one develops, the informal communication that occurs in the interstitial times between tasks, and the sense of community that comes with sharing a space (think kitchens and common areas). In my experience, a significant part of taking on more responsibility in your career is about “corporate citizenship”, not task management. Whether it’s a newer employee helping plan the holiday party or a mid-level person helping organize management resources to make everyone’s job easier – those are rarely in the job description, but they’re the glue that helps determine whether you want to stay with an organization for 2 years or for a career. I have found that getting people interested in doing those things, or even being aware of the need, has been much harder since more and more people have started working from home full- or part-time.
COVID has created an unfortunate national experiment in how to make remote working as productive as possible, because there is no other option. We have figured out how set up offices, use the technology, and organize our work-days. And the work continues to get done. But I believe for every person who now says, “I am just as happy working from home,” there’s another person saying, “I need my colleagues around, I feel isolated, I can’t separate work from home (so I work all day and night), and I can’t focus with children, pets, and others demanding my attention.” So, an individual’s satisfaction is going to depend on the type of work they’re doing, their career aspirations at a particular point in their developmental cycle, and their own interpersonal needs. A manager needs to decide what she needs from each of those employees and whether working remotely meets those needs or what can be done to enhance the match.
I know a lot of people are burned out on videoconferencing, but there has been one unexpected silver lining for me. There is a humanizing function of seeing my colleagues in their “native habitat” with cats walking across keyboards, kids darting in to ask a question, and interesting artwork in the background. People are dressed for comfort, have literally let their hair down, and don’t stand on formalities in what they wear or the way they groom. While in “normal times” we may know a few of our colleagues this way, we now see a much wider range of co-workers this way – as people with lives, families, life challenges. Each person is not just someone who either does or doesn’t get the job done or have a winning personality or a difficult one. They’re a complex person with a multifaceted life. This is work-life balance in its rawest form. I think we’ll all come out of this situation more compassionate and grounded about one another, whether we’re in an office together or miles apart. It can be a pivotal understanding for how manage and lead the evolving workforce.
Can you tell us about what drew you to working for NORC?
The mission orientation. Most people who work in public health are doing it because they value population-wide health and well-being as a core part of who they are. With NORC, I found a smart group of people who share that passion – whether it’s public health or education or justice issues – they’re in it for the importance of the work to the world. When I was interviewing for my job I had a discussion with the CEO, Dan Gaylin. I thought I was going to impress him with my insights about the company finances and questions that would demonstrate that. I asked him about margin targets and growth, and similar bottom-line issues. His response was that profit was not really the driver; he wanted to make sure that staff had a full and growing portfolio of work that was important to the sectors in which we worked and that allowed us to flex our technical muscles. Any surpluses were beneficial because they allowed NORC to make strategic investments in people with new skills and in tools and skill-building to let us do more of that work. I knew then that if the highest levels of leadership were focused that way, so would the rest of the company.
Advice for students pursuing their dream job
Dream big, and act realistically. Choosing your field of interest and the kind of work you want to do in it are important choices. You need the passion for them, because you need to put in the time at each stage in your career to get to the “dream job.” Time figuring out what you need to learn, honing your skills, performing and then leading with increasing responsibility and authority. “Dream job” skills are cumulative; to do the dream job, you have to have mastered many component skills that you get by doing things that are not always “dreamy”. But within a given job, you need to master that one before you’re ready to take on new responsibilities at the next level. I love to have colleagues who are eager and ambitious, but I caution them that their rush to do more can also undermine their career progress. Stretching is good, but repeatedly falling short because you’re not prepared earns you a reputation that doesn’t further your ambitious goals. Look for mentors within those jobs who can help you identify the steps and what skills and experience you need to solidify to move steadily – as rapidly as your capability dictates – to the dream.
What do you do for fun?
Because I sit for hours each day in front of a computer or on a phone, my off hours are often spent sweaty, dirty, and tired. My wife and I do a lot of gardening and landscaping; as the Sherpa of our family, I dig a lot of holes, move dirt and rocks, and build things. I’m teaching myself woodworking (I’m not very accomplished yet), so I also like to spend time in the shop surrounded by sawdust, tools and random pieces of wood. I’m always surprised how much TV I’m able to watch, but I enjoy popular culture and try to keep up. And I try to read a book every week or two.