New York State Public Health Association Annual Meeting

New York StatePublic Health Association

Annual MeetingTroy, NY

April 24, 2013

Public Health in Transition: Embracing and Preparing

for the Future

Joyce R. GaufinPresident-Elect

American Public Health Association

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

Greetings

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

Supporting State Affiliates

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

Also, serve by helping to:

WWIFM

X

Where in the world is Dammeron Valley, Utah?

Home,SweetHome

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 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:

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? 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

While Americans are less likely to smoke and may drink alcohol less:◦ 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 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

Fewer safety net programs that can buffer the negative health effects of poverty and other social disadvantages

Social Change

Chronically Unemployed & Under-Employed

Demographic Changes The Hispanic Migration The “Graying of America”

The new “Working Poor” The widening gap between rich and poor

Creating health equity Ensuring the right to health and healthcare

Building public health infrastructure and capacity

Support the principles of evidence-based policies, prevention, and social justice

APHA’s Overarching Prioritiesfor 2013

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

Equity

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane.“

-Dr. Martin L. King, Jr.

Social Injustice

Building the Public Health Infrastructure and Capacity: A System

in Crisis

Where do you fit in?

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

Gaining a New Perspective- ROI

The best way to predict the future is to create it.

-Peter F. Drucker

Creating a Shared Vision

Public Health Accreditation 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

“Today, the need for leadership is too important to leave its emergence to chance.”

IOM Report on The Future of Public Health (1988)

Who are the leaders in Public Health? How do we identify more leaders? How will this make a difference?

Leaders and Leadership

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

Passing the Torch

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

Anyone can be a leader

Leaders must inspire a shared vision

Leaders must transform organizations and communities

Leaders have to respond to opportunities and crises

Leadership Makes a Difference

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

Characteristics ofSuccessful Leaders

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)

Additional Leadership Characteristics

“Leadership is like a relay race—make sure you pass the baton to the next person.”

Dr. David SatcherFormer U.S. Surgeon General

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

Personal and Organizational Advocacy

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!

What would be possible if:

People don’t fall in lovewith a population!

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

Collaborating with Others

MCOs

Home Health

Parks

Economic Development

Mass Transit

Employers

Nursing Homes

Mental Health

Drug Treatment

Civic GroupsCHCs

Laboratory Facilities

Hospitals

EMS Community Centers

Doctors

Health Department

Churches

Philanthropist

Elected Officials

Tribal Health

Schools

Police

Fire

Corrections

Environmental Health

The Public Health System

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

Potential Risks and Issues

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

Collaborative LeadershipRequires Multiple Skills

Special public health partnerships with medicine, nursing, etc.

Importance of recruiting new partners/allies

Assessing potential for collaboration Use tools to determine:

◦Shared knowledge base◦Shared political will◦Strategy for getting things done together

Getting Things Started

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

Collaboration is an Essential Skill

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!

Public Health Champions

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

Shout out for your accomplishments [email protected]

“The Nation’s Health”

A healthy attitude is contagious, but don’t wait to catch it from others. Be a carrier!

-Tom Stoppard

A good epidemic to have…

We Are the Ones We’ve Been Waiting For

Joyce R. Gaufin, President-Elect, APHA

Email: [email protected] Office phone: 435-574-2015