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Investing in public health leaders is crucial to create healthier and more equitable communities


Verbal abuse. Vandalism. Physical threats. Political pressure. This is what many public health professionals around the country face today as they try to do their jobs and keep us safe from COVID-19.

During this time of uncertainty and fear, public health officials need to be valued as sources of reliable information. In a rational world, they would be routinely recognized as essential front-line responders and we would honor their work just like we do with doctors, nurses and paramedics.

Instead, and unfortunately, frustration over the pandemic and a highly polarized political environment has resulted in hostility towards science and the resistance to efforts to protect the public’s health. Since April, dozens of state and local health leaders have resigned, retired or been fired.

It’s appalling that dedicated public health leaders across the country face an ethical dilemma of: “Do I stay in my job and continue to risk threats to myself and my family, or do I leave because it’s not worth it?”

But all around the country, despite these impossible conditions, they continue to do the work. Staff around the country are weathering this stress and trauma around the clock and battling burnout. In addition to the harm it is causing to current public health staff, these events will certainly have an impact on growing a strong pipeline of reinforcements and recruiting new staff when we need them the most.

This is particularly troubling because local health departments have already eliminated more than 56,000 jobs since 2008 due to funding cuts. And according to the 2017 Public Health Workforce Interests and Needs Survey, nearly half the workforce indicated they could leave their organizations within the next five years, including people who will retire and many who said they may leave the public health field altogether. As we can now see all too clearly, a decline in the public health workforce can threaten the health and safety of communities,

There is hope, though, in light of the current environment. In a July 2020 national poll, 7 in 10 voters said public health departments are important to create a healthy community, compared to 5 in10 voters in 2018. The majority of respondents also said that they’d be willing to pay more in state and local taxes to increase funding for local health departments. How can public health departments capitalize on this moment of being in the spotlight and no longer in the shadows?

Shaping the road for new leaders and preparing them for the challenges they’ll face in the communities they serve is now more important than ever before.

Since 2015, The Kresge Foundation has equipped more than 100 visionary leaders from local health departments around the country with the knowledge and skills to strengthen and transform the role of their organizations and improve the health and well-being of people in their communities through the Emerging Leaders in Public Health initiative.

Over the course of 18 months, participants collaborate with national and local experts and their staff to position themselves as chief health strategists and health equity leaders.

By participating in ELPH during my time as executive director of the Boston Public Health Commission, I gained valuable leadership skills and an expanded network of public health peers. By having resources that allowed us to advance our racial justice and health equity agenda with other city departments and connect to executive leadership development opportunities, we were better positioned to move ahead with our efforts in Boston.

The ELPH initiative provided public health leaders like me with a foundation built on adaptive leadership and resilience. ELPH colleagues have echoed that these two dimensions have provided a support system that helps boost their energy as they continue to lead response and recovery efforts in their respective communities.

But as we know all too well, their, and our, work is nowhere near done. Although, we’ve invested in more than 100 leaders to date, we recognize it is small, yet significant investment, given the increasing challenges that they have been confronting on three fronts: the pandemic, racism and economic instability.

With new grant funding to ELPH partners, Kresge is investing in efforts that support local health departments’ COVID-19 response and recovery activities and continue to reinforce the ELPH teams’ efforts to as chief health strategists to boldly tackle issues of racial injustice and health inequities in communities. We’re also working to better understand the infrastructure challenges facing our nation’s local health departments and identify different ways that we can build on the initiative.

Public health experts bring together everyone who has a role to play in their community’s health—schools, businesses, government agencies, and others— to stop health threats before they start.

While we’re in a moment we could have never imagined, we have the opportunity to reimagine how public health can be transformed and create healthier and more equitable communities for all of us.