Troy, NY
April 24, 2013
Joyce R. Gaufin
President-Elect
American Public Health Association
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Thank you!
Invitations to 28 states
Journey of 100,000 miles
Thousands of smiles
Best part: The People
Highlight “Best Practices” here, around the
country, around the world
Great Basin Public Health Leadership Institute Year 6 Graduates
We need to:
 develop more leaders and improve
leadership ability to advance our work
 engage members in more robust and
effective advocacy for public health
 reach out to new (and different)
partners and build more effective
collaborations
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Lift the spirits of the public health
workforce and champion the work that they
do
Spend as much time as possible learning
about their issues
Translate their stories and experience into
effective advocacy
WWIFM
Where in the
world is
Dammeron
Valley, Utah?
X
Home,
Sweet
Home
Challenges and Opportunities:
Painting a Picture of Today
• Health care costs are still skyrocketing
• Limited amount of money invested in
prevention
• Difficult to find sustainable funding
• Changing U.S. demographics
• Emerging issues in the PH workforce
• And the list goes on…..
IOM Report: U.S. is #17
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Compared U.S. data with statistics from 16 peer
developed countries
Lagging behind other countries in life expectancy
and health; expressed the gravity of the situation
Americans have some advantages:
◦ greater control of blood pressure and cholesterol levels
◦ Lower cancer rates
◦ Americans reaching age 75 can expect
to live longer than people in other
peer countries
 IOM Report, January 2013
America Fared Worse in:
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Infant mortality and low birth weight
Injuries and homicides
Adolescent pregnancy and sexually
transmitted infections
HIV and AIDS
Drug-related deaths
Obesity and diabetes
Heart disease
Chronic lung disease
Disability
Why are Americans so
Unhealthy?
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Unlike peer countries, the U.S. has:
◦ a relatively large uninsured population with limited
access to primary care
◦ People report lapses in the quality and safety of
care outside of hospitals
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While Americans are less likely to smoke and
may drink alcohol less:
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they consume the most calories/person
have higher rates of drug abuse
less likely to use seat belts
involved in more accidents involving alcohol
more likely to use firearms in acts of violence
Social and Economic Conditions
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Americans have higher average income
◦ And they also have higher levels of poverty
(especially for children), more income inequality,
and lower rates for social mobility
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Fewer safety net programs that can buffer the
negative health effects of poverty and other
social disadvantages
Social Change
Chronically Unemployed & UnderEmployed
 Demographic Changes
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 The Hispanic Migration
 The “Graying of America”
The new “Working Poor”
 The widening gap between rich and
poor
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Creating health equity
 Ensuring the right to health and
healthcare
 Building public health infrastructure
and capacity
 Support the principles of evidencebased policies, prevention, and social
justice
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Our most basic common link is that we all
inhabit this planet. We all breathe the same
air; we all cherish our children’s future; and
we are all mortal.
 President John F. Kennedy
"Of all the forms
of inequality,
injustice in
health care is the
most shocking
and inhumane.“
-Dr. Martin L. King, Jr.
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Business speaks a different language (so do
we!)
They think in terms of their customers
(clients, citizens, public, patients, etc.)
They answer to stock holders or invest their
own money (taxpayers, legislators, etc.)
They want to show that they are getting the
“best bang for the buck”
They advertise!
They know VERY LITTLE about what we do
The best way to
predict the future is
to create it.
-Peter F. Drucker
Public Health Accreditation
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It’s the right thing to do (good business
sense)
Demonstrate value to our customers and
stakeholders
Puts the “public” back in public health
Ensures we have a clear vision and strategic
plan to achieve desired outcomes
Brings systems thinking into our
organizations
Addresses the need for workforce
development and succession planning
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“Today, the need for leadership is too
important to leave its emergence to
chance.”
 IOM Report on The Future of Public Health (1988)
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Who are the leaders in Public Health?
How do we identify more leaders?
How will this make a difference?
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We are (finally) losing up to 40% of the most
senior leaders in public health organizations
Differences in generational leadership
Next generation have excellent educational
preparation; limited training and support on
essential skills to succeed and thrive
Need for cadre of coaches and mentors to
support the transition
Leadership is about the ability to
influence others through relationships
– not a title
 Leaders are not born – they are
developed
 Important to “build your bench”
 Effective leaders are evaluated on
their ability to develop
leadership in others
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 Leaders
must inspire a shared
 Leaders
must transform
vision
organizations and communities
 Leaders have to respond to
opportunities and crises
Engage in learning throughout their
career (Ecological Model)
 Take time for reflection and seek
feedback on how they are performing
(the best opportunity for improving
performance)
 Build strong, complex networks for
support
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Leaders need resilience, courage, and
creativity
◦ “Building the stomach for the journey”
◦ Model the Way
◦ Take the “right kind” of risks
◦ Create an environment that encourages
innovation and creativity
◦ Make time to “practice” creative thinking
◦ Change perspective (go to the balcony)
“Leadership is like a relay
race—make sure you pass the
baton to the next person.”
Dr. David Satcher
Former U.S. Surgeon General
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Find ways to support your organization’s
goals without breaking rules or
policies
Join professional public health
associations because they support your
advocacy efforts
Get to know your own elected officials;
contact them outside of the legislative
session and on your own time
Inform to educate and persuade people
by sharing personal stories
We had the right messages
 Delivered in the right way
 To the right people
 At the right time?
 A strong, unified voice can
make an impact!
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Effective collaboration results in multiple
benefits:
• Increases accountability with stakeholders
• Increases community and family engagement
• Increases cost-effectiveness
• Decreases duplication and fragmentation of
effort
• Improves health outcomes
The Public Health System
Police
EMS
Home Health
Community
Centers
MCOs
Churches
Corrections
Health
Department
Parks
Schools
Doctors
Elected
Officials
Hospitals
Philanthropist
Civic Groups
CHCs
Laboratory
Facilities
Nursing
Homes
Environmental
Health
Tribal Health
Drug
Treatment
Mental
Health
Employers
Mass Transit
Fire
Economic
Development
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Maintaining a climate of trust and respect (#1)
Getting the right people to participate
Conflict around defining the problem(s)
Inability to share decision-making
Cultural, ethical, or religious differences
Approach to evidence-based decision-making
Inability to agree on solutions or implementation
plans
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A collaborative leader must have
credibility and respect
Creating a shared vision
Excellent communication
Problem-solving and risk-taking
Group management and conflict
resolution
Change management
Patience and resilience
Special public health partnerships with
medicine, nursing, etc.
 Importance of recruiting new
partners/allies
 Assessing potential for collaboration
 Use tools to determine:
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◦ Shared knowledge base
◦ Shared political will
◦ Strategy for getting things done together
Collaboration is not the traditional practice
within most organizations
 Collaborative skills can be learned and
honed with practice
 Today’s environment requires people to
work together effectively
 Collaboration is a systemic approach to
solving multi-faceted problems
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Part of the 500,000 strong
Best secret that no one has ever heard of
(outside of our world)
We make a difference every day, every
where, all the time
Need to share our stories
Need to celebrate success!
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Please tell me about successes that you and
your colleagues have had
◦ Examples of exceptional leadership
◦ Tales of effective advocacy
◦ Stories of successful and unusual partnerships
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Shout out for your accomplishments
gaufin646@gmail.com
A healthy attitude is
contagious, but don’t wait to
catch it from others. Be a
carrier!
-Tom Stoppard
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Joyce R. Gaufin, President-Elect, APHA
Email: gaufin646@gmail.com
Office phone: 435-574-2015