Public Health Leaders Research Articles

The Emerging Leaders in Public Health Initiative: Leadership Development to Advance Public Health Practice.

Effective leadership is essential for governmental public health agencies to promote and protect the health of their communities. The Emerging Leaders in Public Health Initiative, a program of The Kresge Foundation, was implemented to strengthen leadership in governmental public health. We seek to examine lessons from the initiative to contribute to the field a better understanding of leadership development practices. An external evaluator conducted a retrospective analysis of participant responses postinitiative to assess the overall impact of the initiative and explore which components were most valuable. United States. Directors and other staff from governmental public health agencies were recruited in 2-person teams to participate in 3 successive cohorts. Drawn from adaptive leadership principles, a framework was developed to guide the selection and implementation of educational and experiential activities. Participants were challenged to develop a new role for their public health agency, which provided a learning laboratory to practice individual and team leadership skills. The Kresge Foundation provided participants with a resource grant and a National Program Office offered convenings, webinars, coaching, and technical assistance over the 18 months of the developmental experience. Satisfaction, perceived value of components, and future intentions were assessed from participants in cohorts II and III (n = 70). The overall response rate was 93%. One hundred four diverse leaders from 52 agencies, representing 30 states participated in the initiative. Participants were extremely satisfied with the program (94%) and indicated a strong likelihood of recommending it to a colleague (96%). Unrestricted grant funding, peer learning, and in-person learning sessions were the program components rated most highly valuable. This initiative offers insights into principles and processes to be considered for future public health leadership development.

A new precedent in international health cooperation from African public health leaders

A new precedent in international health cooperation from African public health leaders

Developing a management and finance training for future public health leaders.

Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, it is critical that academic content builds capacity in management and finance focused on public health practice. This paper describes the development of a Doctor of Public Health program management and finance course designed to prepare future public health leaders. The course aims to build the knowledge and skills of doctoral-level students to recognize the inherent challenges of public health finance and the importance of cultivating and managing resources to improve public health practice and achieve strategic public health goals.

Strengths, weaknesses, opportunities, and threats for the nation's public health information systems infrastructure: synthesis of discussions from the 2022 ACMI Symposium.

The annual American College of Medical Informatics (ACMI) symposium focused discussion on the national public health information systems (PHIS) infrastructure to support public health goals. The objective of this article is to present the strengths, weaknesses, threats, and opportunities (SWOT) identified by public health and informatics leaders in attendance. The Symposium provided a venue for experts in biomedical informatics and public health to brainstorm, identify, and discuss top PHIS challenges. Two conceptual frameworks, SWOT and the Informatics Stack, guided discussion and were used to organize factors and themes identified through a qualitative approach. A total of 57 unique factors related to the current PHIS were identified, including 9 strengths, 22 weaknesses, 14 opportunities, and 14 threats, which were consolidated into 22 themes according to the Stack. Most themes (68%) clustered at the top of the Stack. Three overarching opportunities were especially prominent: (1) addressing the needs for sustainable funding, (2) leveraging existing infrastructure and processes for information exchange and system development that meets public health goals, and (3) preparing the public health workforce to benefit from available resources. The PHIS is unarguably overdue for a strategically designed, technology-enabled, information infrastructure for delivering day-to-day essential public health services and to respond effectively to public health emergencies. Most of the themes identified concerned context, people, and processes rather than technical elements. We recommend that public health leadership consider the possible actions and leverage informatics expertise as we collectively prepare for the future.

Communication is a Public Health Strategy

At a time when people are losing faith in public institutions, trust in the North Carolina Department of Health and Human Services is high. Using North Carolina’s pandemic journey as a communication case study offers lessons for public health leaders. This article shares communication elements that helped build trust and provides recommendations.

Leading Organizational Change in the Post-COVID Pandemic Era.

Leading Organizational Change in the Post-COVID Pandemic Era.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Strategies to Operationalize Health Equity in Island Area Health Departments.

COVID-19 pandemic on public health systems and practice in 3 districts from the perspective of public health leaders: a qualitative study in Uganda

COVID-19 pandemic on public health systems and practice in 3 districts from the perspective of public health leaders: a qualitative study in Uganda

Building a public health leadership curriculum for future pandemic preparedness

Building a public health leadership curriculum for future pandemic preparedness

The public health leadership coalition: a valuable experience during hard times

The public health leadership coalition: a valuable experience during hard times

Capacity-Building for Complex Crises: Developing public health leadership and meeting decision-makers’ evidence needs

Capacity-Building for Complex Crises: Developing public health leadership and meeting decision-makers’ evidence needs

Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10–19 Years During the COVID-19 Pandemic — United States, 2020–2022

The World Health Organization declared COVID-19 a global pandemic on March 11, 2020 (1). As strategies to mitigate the pandemic were implemented, concerns were raised that the containment efforts through quarantine and social distancing practices were negatively affecting the mental and physical health of children and adolescents (2). Suicide is a growing public health problem in the United States. In 2020, suicide was the second leading cause of death among persons aged 10-14 years and the third leading cause among those aged 15-24 years (3). The National Poison Data System (NPDS) database was used to examine trends in suspected suicide attempts by self-poisoning among persons aged 10-19 years before and during the COVID-19 pandemic. Compared with 2019 (prepandemic), during 2021, the overall rate of suspected suicide attempts by self-poisoning increased by 30.0% (95% CI=28.6%-30.9%), rates among children aged 10-12 years, adolescents aged 13-15 years, and females increased 73.0% (67.4%-80.0%), 48.8% (46.7%-50.9%), and 36.8% (35.4%-38.2%), respectively, and these trends continued into the third quarter of 2022. Substances most frequently involved in overdoses were acetaminophen, ibuprofen, sertraline, fluoxetine, and diphenhydramine. Acetaminophen-involved overdoses increased 71% (67.4%-74.9%) in 2021 and 58.0% (54.5%-61.6%) in 2022. Diphenhydramine-involved overdoses increased 24.2% (19.9%-28.7%) in 2021 and 35.8% (31.2%-40.5%) in 2022. A comprehensive public health approach to suicide prevention, focused on children and adolescents and involving a partnership between families, school teachers, mental health professionals, and public health leadership is needed. The 9-8-8 Suicide and Crisis Lifelineprovides crisis support for persons experiencing mental health-related distress and assists community members who are concerned about persons experiencing a mental health crisis.

Bayanihan E-Konsulta: A volunteer-driven response to the COVID-19 pandemic in the Philippines

COVID-19 stretched health systems worldwide, but its deepest impacts were disproportionately felt across certain population segments. In the Philippines, a low-middle income country with one of the longest pandemic-induced lockdowns, the most marginalised communities suffered the most, and had little agency to afford and access care. Socioeconomic barriers, compounded by the misallocation of limited resources and the militarisation and overall mismanagement of the response, widened inequities, and resulted in poorer health outcomes for these groups. In an attempt to redress this, the Office of the Vice President of the Philippines sought to fill gaps in health delivery and access by launching Bayanihan E-Konsulta (BEK), a free telemedicine platform for indigent Filipinos. Through a Facebook messenger service that ran on free data, patients were given the opportunity to consult with health professionals regarding their medical concerns at no cost. Relevant social services, such as prescription delivery, laboratory assistance, and food and financial aid, were also streamlined in the platform. Recognising limitations in funding, the program banked on the mobilisation of health professionals and volunteers, and relied on capacity building initiatives and the establishment of inter-agency collaborations. Institutional credibility, intersectoral collaboration, and effective management of team dynamics were identified as enabling factors for the program's effectiveness. Transparency attracted partnerships, and trust in leadership inspired solidarity, volunteerism, and continued service. Inclusivity in different project stages improved engagement and encouraged shared participation and accountability, allowing for resilience and sustained action. Overall, BEK stands as a successful example of a low-cost public/private/volunteer health response in a time of crisis. This paper discusses the critical challenges, considerations, and the iterations to the service implemented by the BEK team, providing insights for public health leaders and other low-to-middle income countries when tailoring responses to future public health emergencies.

Assessing climate and health curriculum in graduate public health education in the United States.

Climate change has been identified as both a challenge and an opportunity for public health. The onus to prepare the next generation of public health practitioners lies heavily on schools and programs of public health. This article (i) assesses the status of climate change and health curricula in accredited schools of public health in the United States and (ii) proposes strategies to better train professionals so they are more informed and prepared to mitigate, manage, and respond to the health impacts of climate change. Course offerings and syllabi listed in online course catalogs from 90 nationally accredited schools of public health were evaluated with the purpose of identifying the extent of climate change education in graduate programs. Only 44 public health institutions were found to offer a climate change related course at the graduate level of education. Of the 103 courses identified, approximately 50% (n = 46) are focused on this climate change and health. These courses cover a wide array of topics with an emphasis on conveying fundamental concepts. In-depth assessment revealed a need for integrating learning opportunities that build practical skills useful in a hands-on public health practice environment. This assessment indicates the limited availability of climate-health course offerings available to graduate students in accredited schools. The findings are used to propose an educational framework to integrate climate change into public health curricula. The proposed framework, while rooted in existing directives, adopts a tiered approach that can be readily applied by institutions training the next generation of public health leaders.

Snapshots of ID Week 2022

Snapshots of ID Week 2022

Learning from an equitable, data-informed response to COVID-19: Translating knowledge into future action and preparation.

The COVID-19 pandemic revealed numerous barriers to effectively managing public health crises, including difficulties in using publicly available, community-level data to create learning systems in support of local public health decision responses. Early in the COVID-19 pandemic, a group of health care partners began meeting to learn from their collective experiences. We identified key tools and processes for using data and learning system structures to drive equitable public health decision making throughout different phases of the pandemic. In fall of 2021, the team developed an initial theory of change directed at achieving herd immunity for COVID-19. The theoretical drivers were explored qualitatively through a series of nine 45-min telephonic interviews conducted with 16 public health and community leaders across the United States. Interview responses were analyzed into key themes to inform potential future practices, tools, and systems. In addition to the interviews, partners in Dallas and Cincinnati reflected on their own COVID-19 experiences. Interview responses fell broadly into four themes that contribute to effective, community driven responses to COVID-19: real-time, accessible data that are mindful of the tension between community transparency and individual privacy; a continued fostering of public trust; adaptable infrastructures and systems; and creating cohesive community coalitions with shared alignment and goals. These themes and partner experiences helped us revise our preliminary theory of change around the importance of community collaboration and trust building and also helped refine the development of the Community Protection Dashboard tool. There was broad agreement amongst public health and community leaders about the key elements of the data and learning systems required to manage public health responses to COVID-19. These findings may be informative for guiding the use of data and learning in the management of future public health crises or population health initiatives.

A Review of Social Media Data Utilization for the Prediction of Disease Outbreaks and Understanding Public Perception

Infectious diseases take a large toll on the global population, not only through risks of illness but also through economic burdens and lifestyle changes. With both emerging and re-emerging infectious diseases increasing in number, mitigating the consequences of these diseases is a growing concern. The following review discusses how social media data, with a focus on textual Twitter data, can be collected and processed to perform disease surveillance and understand the public’s attitude toward policies around the control of emerging infectious diseases. In this paper, we review machine learning tools and approaches that were used to determine the correlation between social media activity in disease trends within regions, understand the public’s opinion, or public health leaders’ approaches to disease presentation. While recent models migrated toward popular deep learning methods, neural networks and algorithms that optimized existing models were also explored as new standards for social media data analysis in disease prediction and monitoring. As adherence to public health policies can be improved by understanding and responding to major concerns identified by sentiment analyses, the advancements and challenges in understanding text sentiment are also discussed. Recent sentiment classifiers include more complex classifications and can even recognize epidemiological considerations that affect the spread of outbreaks. The comprehensive integration of locational and epidemiological considerations with advanced modeling capabilities and sentiment analysis will produce robust models and more precision for both disease monitoring and prediction. Accurate real-time disease outbreak prediction models will provide health organizations with the capability to address public concerns and to initiate outbreak responses proactively rather than reactively.

Advancing policies for public health benefit: A collection of policy briefs developed by the Maastricht University students

Where there is no vision, the people perish’ has never been truer than today. We need new models of how to train the future public health leaders in the 21st century to improve and protect people and planet”. The Maastricht University Public Health Leadership course has been described previously (1). The course aims to create leaders with vision, who can see a future different to the status quo, who can influence and drive change, who are able to communicate their vision and win others to embrace and implement it.

Public health prevention in maternity programme: supporting the local system

Too many children in the North East and North Cumbria Integrated Care System do not have the best start in life, and maternity care offers an early opportunity to initiate positive change. In 2018, a new model of regional public health leadership was developed to complement the developing local maternity system with a focus on prevention and reducing health inequalities. With the support of local maternity system partners, the programme set out to improve the quality of preventative intervention available to women and their families in the perinatal period. The programme focused on tobacco, alcohol, breastfeeding, reproductive health, perinatal mental health, healthy weight, immunisations and making every contact count. Through audit and co-production of regional pathways, it increased awareness, enabled greater consistency of service provision and supported quality improvement. As part of a large, evolving health and care system, the programme worked through significant challenges, such as complex leadership and governance models, prioritisation and ensuring that resources supported practice development across all local maternity services in the North East and North Cumbria Integrated Care System. Greater progress was made in areas such as reducing maternal smoking and increasing rates of breastfeeding, reflecting the critical role of local leadership. There is clear evidence of the programme's value to the local system. Ongoing evaluation and work to embed a sustainable model of delivery remain important.

Seroprevalence of COVID-19 infection in a rural district of Tamil Nadu: A population-based seroepidemiological study

Background: Coronavirus disease 2019 (COVID-19) was a recent global pandemic of the era which posed a great challenge for the health care in terms of preventive, diagnostic and treatment dimensions. The seroprevalence rate of COVID IgG antibodies is very crucial in estimating the susceptibility of a particular area to the viral disease. In our study, we estimated the seroprevalence of COVID-19 in a rural area. Aims and Objectives: We aimed to estimate the seroprevalence of COVID-19 in a rural district of Tamil Nadu, 6 months after the index case. Materials and Methods: We conducted a cross-sectional study of 509 adults aged more than 18 years. From all the seven Taluks, two gram panchayats (administrative cluster of 8–10 villages) were randomly selected followed by one village through convenience. The participants were invited for the study to the community-based study kiosk set up in all the eight villages through village health committees. We collected sociodemographic characteristics and symptoms using a mobile application-based questionnaire, and we tested samples for the presence of IgG antibodies for severe acute respiratory syndrome coronavirus 2 using an electro chemiluminescent immunoassay. We calculated age-gender adjusted and test performance adjusted seroprevalence. Results: The age-and gender-adjusted seroprevalence was 8.5% (95% confidence interval [CI] 6.9–10.8%). The unadjusted seroprevalence among participants with hypertension and diabetes was 16.3% (95% CI: 9.2–25.8) and 10.7% (95% CI: 5.5–18.3), respectively. When we adjusted for the test performance, the seroprevalence was 6.1% (95% CI 4.02–8.17). The study estimated 7 (95% CI 1:4.5–1:9) undetected infected individuals for every reverse transcription polymerase chain reaction confirmed case. Infection fatality rate (IFR) was calculated as 12.38/10,000 infections as on October 22, 2020. History of self-reported symptoms and education were significantly associated with positive status (P<0.05). Conclusion: A significant proportion of the rural population in a district of Tamil Nadu remains susceptible to COVID-19. A higher proportion of susceptible, relatively higher IFR, and a poor tertiary health-care network stress the importance of sustaining the public health measures and promoting early access to the vaccine are crucial to preserving the health of this population. Low population density, good housing, adequate ventilation, limited urbanization combined with public, private, and local health leadership are critical components of curbing future respiratory pandemics.