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 TEAM BUILDING LEADERSHIP WHEEL VALUES CLARIFICATION ASSURANCE POLICY DEVELOPMENT POLICY DEVELOPMENT EVALUATION POLICY DEVELOPMENT ASSURANCE MISSION IMPLEMENTATION POLICY DEVELOPMENT ASSURANCE VISION ASSURANCE POLICY DEVELOPMENT ASSESSMENT 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