Contemporary Public Health: Principles, Practice, and Policy

Public health refers to the management and prevention of disease within a population by promoting healthy behaviors and environments in an effort to create a higher standard of living. In this comprehensive volume, editor James W. Holsinger Jr. and an esteemed group of scholars and practitioners offer a concise overview of this burgeoning field, emphasizing that the need for effective services has never been greater. Designed as a supplemental text for introductory courses in public health practice at the undergraduate and graduate levels, Contemporary Public Health provides historical background that contextualizes the current state of the field and explores the major issues practitioners face today. It addresses essential topics such as the social and ecological determinants of health and their impact on practice, marginalized populations, the role of community-oriented primary care, the importance of services and systems research, accreditation, and the organizational landscape of the American public health system. Finally, it examines international public health and explores the potential of systems based on multilevel partnerships of government, academic, and nonprofit organizations. With fresh historical and methodological analyses conducted by an impressive group of distinguished authors, this text is an essential resource for practitioners, health advocates, and students. James W. Holsinger Jr., M.D., Ph.D., is the Charles T. Wethington Jr. Chair in the Health Sciences at the University of Kentucky. He served as secretary of the Kentucky Cabinet for Health and Family Services from 2003 to 2005. “A comprehensive, integrated overview of public health in the early twentieth century, something that few, if any, other works provide students. Well written and clear, with an excellent choice of topics.” -- Max Michael, M.D., Dean, University of Alabama at Birmingham School of Public Health “A compilation of valuable information that provides an overview of contemporary topics. The authors include many leaders in the field of public health.” -- Joel M. Lee, Joel M. Lee, Dr.P.H., Director, Doctor of Public Health Degree Program, and Professor of Health Policy and Management, College of Public Health, The University of Georgia A major contribution to the understanding of this very important field--past, present and future. It brings together a stellar group of authors and their collective work will be a real help to students, practitioners and policy makers alike. In a time of significant change in health, health care and public health, this work will be of great benefit. -- William L. Roper, M.D., MPH, UNC School of Medicine and UNC Health Care System, The University of North Carolina at Chapel Hill Contemporary Public Health offers a unique depth of wisdom based on a comprehensive analysis of the major forces shaping public health in our time. Dedicated to a true public health genius, Doug Scutchfield, this invaluable text will serve as an authoritative guide and a fascinating source of insights to inspire current and future generations as they serve the public\u27s health. -- Edward L. Baker MD, MPH, University of North Carolina at Chapel Hill, Former Assistant Surgeon General, US Public Health Service These well written and succinct essays enrich the thoughts and the visions of the field of public health. -- Dr. Michael W. Popejoy -- Dr. Michael W. Popejoy -- Perspectives in Public Health If you are interested in more than a superficial and sound-bite driven discussion of the U.S.health care system, you really need to read \u27Contemporary Public Health.\u27 This comprehensive and thought-provoking book will definitely enrich your understnading of thhe disparity between where we are and where we potentially need to be on a topic that ultimately affects us all. -- Aaron W. Hughley, Department of Counseling and Student Affairs, Wesrern Kentucky University As services for public health in the US face budget cuts and the field looks forward to opportunities provided by the Affordable Care Act, this edited collection of essays provides welcome historical and disciplinary perspectives on these and other contemporary public health issues. -- Choicehttps://uknowledge.uky.edu/upk_public_health/1001/thumbnail.jp

Undergraduate Public Health Education: Does it Meet Public Health Workforce Needs?

The professional bachelor’s degree [Bachelor of Public Health (BPH) or Bachelor of Science (BS) in Public Health] provides a cadre of trained individuals to fill entry-level positions in American public health agencies. The traditional Bachelors of Arts or Science degrees with majors in public health produce an informed citizenry, but may not provide sufficient public health course content to enable graduates of such programs to effectively enter the public health workforce

Undergraduate Public Health Education: Does it Meet Public Health Workforce Needs?

The professional bachelor’s degree [Bachelor of Public Health (BPH) or Bachelor of Science (BS) in Public Health] provides a cadre of trained individuals to fill entry-level positions in American public health agencies. The traditional Bachelors of Arts or Science degrees with majors in public health produce an informed citizenry, but may not provide sufficient public health course content to enable graduates of such programs to effectively enter the public health workforce

Application of Situational Leadership to the National Voluntary Public Health Accreditation Process

Successful navigation through the accreditation process developed by the Public Health Accreditation Board (PHAB) requires strong and effective leadership. Situational leadership, a contingency theory of leadership, frequently taught in the public health classroom, has utility for leading a public health agency through this process. As a public health agency pursues accreditation, staff members progress from being uncertain and unfamiliar with the process to being knowledgeable and confident in their ability to fulfill the accreditation requirements. Situational leadership provides a framework that allows leaders to match their leadership styles to the needs of agency personnel. In this paper, the application of situational leadership to accreditation is demonstrated by tracking the process at a progressive Kentucky county public health agency that served as a PHAB beta test site

Employing the Precautionary Principle to Evaluate the Use of E-Cigarettes

Electronic cigarettes (e-cigarettes) have emerged onto the public market as an alternative to tobacco cigarettes; however, science is inconclusive as e-cigarettes have not been thoroughly investigated, including their short- and long-term risks and benefits (1, 2). The question arises of whether e-cigarettes will become the future tobacco crisis. This paper connects the precautionary principle to the use of e-cigarettes in an effort to guide decision-makers in the prevention of adverse health outcomes and societal costs

Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

BACKGROUND: During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders\u27 demographic and organizational characteristics and to characterize the underlying relationships. MATERIALS AND METHODS: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ) and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal-Wallis non-parametric tests were used, and to adjust for potential confounding, linear regression analysis was performed. DATA: Local health department leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data were utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders\u27 observable attributes relating to age, gender, race, educational background, leadership experience, and openness to change. RESULTS: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-2013 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply that there are underlying relationships between leader and LHD characteristics based on leader openness to change

Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

BACKGROUND: During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders\u27 demographic and organizational characteristics and to characterize the underlying relationships. MATERIALS AND METHODS: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ) and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal-Wallis non-parametric tests were used, and to adjust for potential confounding, linear regression analysis was performed. DATA: Local health department leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data were utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders\u27 observable attributes relating to age, gender, race, educational background, leadership experience, and openness to change. RESULTS: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-2013 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply that there are underlying relationships between leader and LHD characteristics based on leader openness to change

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership

Effectively leading people engaged in the practice of public health has never been more critical than in the early years of the twenty-first century. Likewise, effectively managing the organizations in which these individuals practice the various professional disciplines of public health has become increasing important and difficult. Taken together, leading the people and managing public health organizations requires well educated and appropriately trained public health leaders and managers. Although leadership is often viewed as one of the key attributes of management, not every great manager will be a great leader and vice versa. While some leaders may be born with the inherent skills to lead, most effective leaders develop the requisite skills through education, additional training, and practice. Our aim is to focus the attention of public health practitioners on the importance of effectively leading public health organizations. Public health managers should recognize that their most valuable resource is the people they lead. The articles comprising the eBook on Leading People – Managing Organizations is composed of articles expressing the opinion of their authors of the need for effective public health leaders; perspective articles establishing their authors’ understanding of how leadership may be applied in various situations; methods articles that demonstrate how public health leadership may be applied, and original research articles that establish the role of public health leadership research studies

Full-Range Public Health Leadership, Part 2: Qualitative Analysis and Synthesis

Public health leadership is an important topic in the era of U.S. health reform, population health innovation, and health system transformation. This study utilized the full-range leadership model in order to examine the public health leadership. We sought to understand local public health leadership from the perspective of local health department leaders and those who work with and for them. Public health leadership was explored through interviews and focus groups with directors (n = 4) and staff (n = 33) from local health departments. Qualitative analytic methods included reflexive journals, code-recode procedures, and member checking, with analysis facilitated by Atlas.ti v.6.0. Qualitative results supported and expanded upon previously reported quantitative findings. Leading by example and providing individual consideration to followers were found to be more important than other leader factors, such as intellectual stimulation, inspirational motivation, or idealized attributes of leaders. Having a clear and competent vision of public health, being able to work collaboratively with other community agencies, and addressing the current challenges to public health with creativity and innovation were also important findings. Idealized leadership behaviors and individual consideration should be the focus of student and professional development. Models that incorporate contextual considerations, such as the situational leadership model, could be utilized to ensure that optimal individual consideration is given to followers

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

Background: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. Materials and methods: The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. Data: Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. Results: The competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement.” The variation between competencies by job category suggests there are distinct underlying relationships between the competencies by job category