Linnea Warren May and Jennifer Sloan

commentary

(The RAND Blog)

November 17, 2016

What If Being a Leader in Public Health Is About More Than Just Health?

Jennifer Sloan and Linnea Warren May

by Linnea Warren May and Jennifer Sloan

As recent graduates of master's in public health programs and first-time attendees at this year's American Public Health Association (APHA) annual meeting, we were initially overwhelmed and ultimately impressed by the size and breadth of the conference in Denver and the diversity of attendees. We flew home to Pittsburgh inspired and proud to be part of APHA's “Generation Public Health” and pondering what we believe is needed to shape the future of public health. And as the results of the presidential election became clear, we continued to think about some of the skills and tools that emerging public health leaders ought to possess in an uncertain future.

1. Public health leaders should be able to articulate the business case for their work

At APHA, we participated in a roundtable discussion about innovative nursing care models. When the inevitable conversation about funding woes began, the discussion got stuck on how to make “the business case” for health promotion. At a table of seven, almost evenly split between young and middle-age professionals all with similar training but different experience, no one felt they had the skills to make the necessary pitch.

In our training, we had learned how to write proposals using data to argue for interventions that improve health, but not how to frame the benefits of health promotion from a “business” perspective. In fact, some in our school scoffed at this “business” perspective. The attitude seemed to be, “We're in public health to help people, not to care about money.” As public health officials make their case for funding, especially given the multiple claims on scarce public dollars, they have to be prepared to show the return on investment.

2. Public health leaders should have the skills to work with others outside the health sector

Most of the presentations at APHA described lessons about the value of partnerships between health organizations and entities from other sectors. Reflecting on our own education again, we felt the majority of our implementation training took place in a health-centered sphere. We both had classes in grad school where we partnered with external organizations to do work with “real world” benefit. But all of the partners were health-focused: in Pittsburgh, a health communications class worked with a pediatric clinic, an HIV/AIDS service organization and Planned Parenthood. And in North Carolina, for example, masters of public health students partnered with the health department, aging services, and an organization managing community gardens.

Training public health practitioners in this silo is comfortable, but also risky. It emboldens a mindset that health is always (or ought to be) the ultimate goal of work in communities rather than spurring development of shared goals that other sectors may see their missions represented in, such as creating vibrant neighborhoods that are economically strong as well as walkable, safe, and healthy. So it shouldn't come as a surprise that public health leaders find it difficult to engage diverse partners.

Perhaps health professionals can be trained to start fostering these cross-sector collaborations during their public health education so they can enter the workforce with the skills and knowledge to help them happen. In particular, learning about social, economic and political forces outside the health sphere that influence health would help public health professionals understand what drives partners in other sectors, including government and the private sector. Training on the social determinants of health takes us partway, but building the skills needed to work with those who have influence over those determinants is a requisite next step.

Our main takeaway from APHA's annual meeting: There is vast potential in the field of public health to create the “healthiest generation,” as APHA sets out to do, and we're thrilled to be a part of it. We just hope that in the future public health schools can effectively prepare public health professionals to think beyond the traditional boundaries of public health, starting with the way our field trains its leaders of the future.


Linnea Warren May and Jennifer Sloan are project associates at the nonprofit, nonpartisan RAND Corporation.

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