Leadership Challenges for Rural Health Departments

1
Leadership Challenges forRural Health Departments

• Louis Rowitz, PhD
• Director
• Mid-America Public Health Training Center

2
THE CHALLENGES
3
RURAL HEALTH DEPARTMENTS HAVE TO DO MORE WITH LESS

• LESS MONEY
• LESS STAFF
• GEOGRAPHIC ISOLATION
• LIMITED TECHNICAL RESOURCES
• POOR SALARIES
• FEWER PARTNERS

4
RURAL HEALTH DISPARITIES

• HIGHER SMOKING RATES AMONG TEENAGERS AND ADULTS
• FEWER DENTAL CARE VISITS
• LACK OF HEALTH INSURANCE
• HIGHEST DEATH RATES FOR UNINTENTIONAL
  INJURIES IN GENERAL AND MOTOR VEHICLE INJURIES
  SPECIFICALLY
• HIGH DEATH RATES FOR CHILDREN AND YOUNG
  ADULTS(AGES1-24)

5
DIVERSITY OF RURALCOMMUNITIES

• DIFFERENCES IN ECONOMIES
• AGRICULTURE
• TOURISM
• MANUFACTURING
• MINING
• ENERGY

6
DIVERSITY (CONTINUED)

• DEMOGRAPHIC DIFFERENCES
• MOSTLY CAUCASIANS
• INCREASE OF MIGRANT STREAM FROM MEXICO IN SOME
  AREAS
• AGING POPULATIONS
• LARGE SEGMENTS OF THE POOR
• LOWER LEVELS OF EDUCATIONAL ATTAINMENT
• MANY ON PUBLIC PAYMENT SYSTEMS IN SOME AREAS

7
DIVERSITY (CONTINUED)

• DIFFERENCES IN POPULATION DENSITY
• FRONTIER ISSUES
• SERVICES ARE OFTEN TIED TO POPULATION DENSITY

8
DIVERSITY (CONTINUED)

• DIFFERENCES IN TERRAIN
• DISTANCES ACROSS OPEN PLAINS DIFFERENT THAN
  MOUNTAIN DISTANCES
• ADEQUACY OF ROAD AND TRANSPORTATION DIFFERENCES
• REGIONAL WEATHER PATTERNS

9
DIVERSITY (CONTINUED)

• PROXIMITY TO URBAN AREAS INCREASES ACCESS TO
  SERVICES

10
DIVERSITY (CONTINUED)

• DIFFERENCES IN AVAILABILITY OF RESOURCES
• LACK OF SOCIAL CAPITAL
• ACCESS TO TECHNOLOGY
• AVAILABILITY OF EDUCATION AND TRAINING
  OPPORTUNITIES
• AFFORDABLE HOUSING
• GOOD SCHOOLS
• TRAINED WORKFORCE

11
DIVERSITY (CONTINUED)

• DIFFERENCES IN PUBLIC HEALTH PRESENCE

12
THE LEADERSHIP ISSUES

13

• COLLABORATION
• LACK OF RESOURCES
• DIFFICULITES IN CARRYING OUT THE CORE FUNCTIONS
  AND ESSENTIAL SERVICES

14

• UNTRAINED STAFF
• CREDENTIALING AND ACCREDITATION
• PUBLIC HEALTH PREPAREDNESS

15

• TOO FEW STAFF
• OLD EQUIPMENT
• DIFFICULTIES IN DISTANCE LEARNING
• FEAR OF THE BOARD

16

• BILINGUAL AND CULTURAL ISSUES
• AGING POPULATIONS
• BORDER HEALTH CONCERNS
• LACK OF MONEY

17

• HARD TO GET AND PAY CONSULTANTS
• MIGRANT ISSUES
• SHARING LEADERSHIP CONCERNS

18

• COMMUNITY ASSESSMENT DIFFICULTIES
• PERFORMANCE STANDARDS COMPLEX
• SYSTEMS THINKING WITHOUT A SYSTEM

19
LEADERSHIP STRATEGIES
20
LEADERSHIP WHEEL
TEAM BUILDING
VALUES CLARIFICATION
ASSURANCE POLICY DEVELOPMENT
POLICY DEVELOPMENT
EVALUATION
POLICY DEVELOPMENT
ASSURANCE
MISSION
IMPLEMENTATION
POLICY DEVELOPMENT
ASSURANCE
VISION
ASSESSMENT POLICY DEVELOPMENT
ASSURANCE POLICY DEVELOPMENT
ACTION
GOALS OBJECTIVES
Rowitz, p. 88, Figure 5-3
21
BUILD SOCIAL CAPITAL WITH YOUR BOARD
22
PARTNERSHIPS UTILIZING A REGIONAL MODEL
23
ASSETS PLANNING
24
BUILDING COALITIONS UTILIZING DIFFERENT MEETING
MODALITIES-THE MOVEABLE FEAST
25
DIFFERENT TRAINING APPROACHES
26

• ADOPT THE SYSTEMS MODEL OF
• THINKING WITH PUBLIC HEALTH
• SEEN AS A SYSTEMS ISSUE AND
• NOT THE SOLE RESPONSIBILITY OF
• A LOCAL HEALTH DEPARTMENT

27
CHANGE IS INEVITABLELEADERSHIP IS CRITICAL
28
MORAL

• COLLABORATION IS THE SECRET
• TO SOUND LEADERSHIP PRACTICE.
• BUILD TRUST AND SHARE POWER