About

John Wiesman, DrPH, MPH, is a Professor of the Practice and Associate Dean for Practice at the UNC Gillings School of Global Public Health. He has over 30 years of governmental public health experience, working at local and state health departments in Washington and Connecticut. His career began in Connecticut in 1986, where he was part of the first group trained to provide HIV counseling and testing services. Wiesman has held significant leadership roles, including serving as the Washington state secretary of health, where he led the nation’s response to the first known case of COVID-19, implemented policies such as gender X options on birth certificates, raised the legal age for tobacco and vape sales to 21, and worked to include tribal nations in public health legislation. He was appointed by the Trump administration to co-chair the Presidential Advisory Council on HIV/AIDS (PACHA) and was reappointed by the Biden administration. Wiesman earned his Doctor of Public Health in public health executive leadership from UNC-Chapel Hill and his MPH in chronic disease epidemiology from Yale University. His personal mission emphasizes listening to others, leading with moral courage, and acting with integrity. His research and leadership focus on public health policy, leadership, and emergency preparedness, with notable contributions in pandemic response and health policy development.

Research topics

• Political Science
• Environmental health
• Internal medicine
• Surgery
• Virology
• Medicine
• Family medicine
• Intensive care medicine
• Pathology

Selected publications

• Local Public Health Strategies for Addressing Social Determinants of Health—Analysis of Recent Community Health Improvement Plans

  Journal of Public Health Management and Practice · 2024-09-10 · 2 citations

  article

  CONTEXT: The Public Health 3.0 (PH3.0) framework encourages local health departments (LHDs) to address the social determinants of health (SDOHs) that impact health equity. OBJECTIVE: This study sought to understand how often LHDs are working to address SDOH, which SDOHs are most often being addressed, as well as the mix of strategies that have been proposed to address this work. DESIGN: We reviewed recent Community Health Improvement Plans (CHIPs) to analyze the current involvement of LHDs in addressing SDOH. SETTING: CHIPs published from 2020. PARTICIPANTS: Accredited LHDs from across the United States (n = 80). MAIN OUTCOME MEASURES: We developed a qualitative guidebook to characterize CHIP strategies based on the SDOH domain they addressed and the strategic mechanism they proposed. RESULTS: Across our entire sample, CHIPs were roughly 1.5 times more likely to address Health Care Access than Food Insecurity and Access to Healthy Food (65%), Neighborhood Infrastructure (61%), or Affordable Housing (65%), and they were 3 to 4 times more likely to address Health Care Access than Safe Housing (23%), Education Access and Quality (31%), or Economic Stability (24%). Across all major domains, a few concerned policy changes and a handful focused on improving systems or developing the built environment. Most strategies focused on service provision through events or the education of the public and professionals on health-related topics. CONCLUSIONS: The results of this study demonstrate that not all SDOHs are addressed equally by LHDs within their CHIPs. There is significant variation in how SDOHs are addressed along at 2 dimensions: first, in the likelihood that a CHIP addresses the domain and, second, in the mechanism by which each domain is addressed. Practically, the list of strategies we documented from the 80 CHIPs included in our sample may serve as the basis for strategies that other communities may wish to consider when addressing SDOH.

  PublisherDOI

• Investigating the Role of Local Board of Health Governance on Local Health Department Policymaking Behavior

  Journal of Public Health Management and Practice · 2024-05-14

  article

  OBJECTIVES: This study sought to identify groupings of policymaking behavior among local governmental health departments (LHDs) across the country and assess whether such groupings were associated with the governance activity of their board of health (BOH). DESIGN: We conducted latent class analysis (LCA) to identify possible classes of policymaking behavior among LHDs. Once classes were identified, we used multinomial logistic regression (MLN) to estimate the association between an LHD's policymaking behavior and the governance activity of their BOH. SETTING: 2019 wave of the National Association of City and County Health Officials (NACCHO) Profile Survey. PARTICIPANTS: All LHDs with BOHs in the 2019 NACCHO Profile Survey (n = 1003). OUTCOME MEASURES: Within our MLN, our primary outcome of interest was the association between an LHD's policymaking class (the main dependent variable) and the governance activity of its BOH (the main independent variable). RESULTS: Based on our LCA, we determined our sample to be composed of what we characterized as "Limited Policy-Involvement," "Average Policy Involvement," and "Expanded Policy Involvement" LHDs. Those in the Expanded Class were more likely to be involved across all policy areas compared to the Limited and Average class, especially among social determinants of health (SDOH)-related areas. Our MLN estimated that having a BOH active in legal authority was associated with an 86% increased chance that an LHD would be in the "Average Class" compared to the "Limited Class" and having a BOH active in partnership engagement was associated with an 86% more likely chance that an LHD is in the "Expanded Class" compared to the "Average Class." CONCLUSION: Using nationally representative data on LHD activity, we found distinct groups of policymaking behavior, including a quarter of LHDs that are highly active in traditional and SDOH-related policy areas. We also found that groupings of policymaking behavior, as indicated by class designation, are strongly associated with the BOH's governance activity.

  PublisherDOI

• Local Health Department Values and Organizational Authorities Guiding Cross-Sector Work During COVID-19

  UNC Libraries · 2024-08-03

  articleOpen access

  Objective: The COVID-19 pandemic highlighted the role that local health departments (LHDs) have in cross sector can address alone, including the work of value alignment and the strategic use of organizational authorities. The practices by which LHDs used their authorities to conduct cross-sector work during the pandemic need exploration. Method: We conducted semi-structured interviews with 19 public health leaders from metropolitan LHDs across the United States. Our interview guide assessed the values that LHD leadership prioritized in their cross-sector work as well as the range of organizational authorities they leveraged to influence external decision-making in other sectors. Results: We found that LHDs approached cross-sector work by leaning on diverse values and authorities, each with unique implications for their work. The LHDs emphasized their approach to value alignment on a sector-by-sector basis, strategically using diverse organizational authorities—economic, political, moral, scientific, and logistical. While each authority and value we assessed was present across all interviewees, how each shaped action varied. Internally, LHDs emphasized certain authorities more than others to the degree that they more closely aligned with prioritized core values. Conclusion: Our findings highlight the ongoing need for LHD leadership to improve their ability to effectively communicate public health values and the unique authorities by which health-supporting work can be facilitated, including how this message must be adapted, depending on the specific sectors with which the LHD needs to partner and the governance arrangement in which the LHD is situated.

  PublisherDOI

• Assessing Local Public Health Governance in North Carolina Across Organizational and Governance Configurations

  North Carolina Medical Journal · 2024-08-01

  articleOpen access

  Background: Every county in North Carolina must include a board of health (BOH) with specific prescribed duties and powers. It is unclear how BOHs in North Carolina are currently exercising their governance ability. In 2012, the North Carolina General Assembly provided coun-ties with additional flexibility to select among different configurations for their local health department (LHD). The impact of this flexibility on the governance and service delivery of LHDs is yet to be explored. Methods: We conducted semi-structured interviews with LHD directors and BOH members to assess the strengths and weaknesses of BOHs within different local public health configurations across North Carolina. We employed conventional content analysis to derive themes from the interview transcripts. Results: BOHs were largely described as an underutilized institution, with few BOHs noted to be active beyond satisfying their required legal duties. Strong BOHs were noted to fulfill three identities on behalf of the LHD: an advocate, a bridge, and an advisor. The majority of interviewees desired to work in a standalone county health department (as opposed to a consolidated human services agency) with an appointed (versus elected) board of health. This configuration was preferred because, according to participants, it is more likely to enable a structural focus on public health initiatives. Limitations: Our sample frame did not control for the length of time an interviewee had been in the office nor the professional background of each BOH member. Conclusions: Wide variations exist in the exercise of BOHs across the state, partially due to how different LHD configurations structurally focus resources and attention on public health.

  PublisherOA PDFDOI

• Local Health Department Values and Organizational Authorities Guiding Cross-Sector Work During COVID-19

  Health Promotion Practice · 2023-08-30 · 1 citations

  articleOpen access

  OBJECTIVE: The COVID-19 pandemic highlighted the role that local health departments (LHDs) have in cross sector can address alone, including the work of value alignment and the strategic use of organizational authorities. The practices by which LHDs used their authorities to conduct cross-sector work during the pandemic need exploration. METHOD: We conducted semi-structured interviews with 19 public health leaders from metropolitan LHDs across the United States. Our interview guide assessed the values that LHD leadership prioritized in their cross-sector work as well as the range of organizational authorities they leveraged to influence external decision-making in other sectors. RESULTS: We found that LHDs approached cross-sector work by leaning on diverse values and authorities, each with unique implications for their work. The LHDs emphasized their approach to value alignment on a sector-by-sector basis, strategically using diverse organizational authorities-economic, political, moral, scientific, and logistical. While each authority and value we assessed was present across all interviewees, how each shaped action varied. Internally, LHDs emphasized certain authorities more than others to the degree that they more closely aligned with prioritized core values. CONCLUSION: Our findings highlight the ongoing need for LHD leadership to improve their ability to effectively communicate public health values and the unique authorities by which health-supporting work can be facilitated, including how this message must be adapted, depending on the specific sectors with which the LHD needs to partner and the governance arrangement in which the LHD is situated.

  PublisherDOI

• The Public Health Worker Mental Health Crisis—A Major Leadership Challenge

  Journal of Public Health Management and Practice · 2021-11-19 · 10 citations

  article1st author

  Context As we move into the fall of 2021, public health leaders are faced with a dual crisis. First, responding to the evolving challenges of the COVID-19 pandemic continues to be “job one” for most public health leaders. Now, a parallel crisis is emerging as the public health workforce experiences unprecedented levels of poor mental health as they experience “COVID fatigue,” burnout, and a range of mental health challenges. This workforce mental health crisis has received increasing attention1 as its protean manifestations present leadership challenges that must be addressed if the public health workforce, our most valuable resource, is to be supported, nurtured, and thrive into the future. In this column, we build on a prior Management Moment column on the subject of “COVID fatigue” written 1 year ago,2 which provided initial insights into and suggestions for leader actions, and offer further suggestions based on recent research and shared experience. Dr Cynthia Morrow3 and others4,5 have applied the concept of “moral injury,” a term that refers to “the psychological, behavioral, social, and/or spiritual distress experienced by individuals who are performing or exposed to actions that contradict their moral values,” to characterize this mental health crisis. It is distinct from “burnout.” While the concept of “occupational moral injury” may have originated with combat medicine and treatment of war veterans, the COVID-19 pandemic has brought attention to its applicability to the field of public health in which many workers are under constant stress working in an atmosphere characterized by distrust and threats.1 In this regard, “moral injury” results from systemic forces that compromise the ability of public health professionals to serve their communities. The Scope of the Crisis A recent CDC MMWR article6 provided urgent findings of the scope and scale of this crisis. The article documented rates of depression, anxiety, posttraumatic stress disorder, and suicidal ideation among 26 174 state and local public health workers; 53% of those surveyed reported at least one adverse mental health condition in the preceding 2 weeks. Among other findings, 8.4% reported suicidal ideation. Long work hours and inability to take time off were cited as factors contributing to mental health conditions. Among other suggestions, the authors pointed to the desirability of leaders acting to address the crisis by expanding staff size, addressing need to reduce long work hours, and encouraging use of employee assistance programs. Another study7 of current public health workers revealed that 66% reported burnout when surveyed in August and September 2020. As a result, fewer workers planned to remain in the public health workforce for 3 or more years. The authors concluded that “pandemic-related burnout threatens the US public health workforce's future when many challenges related to the ongoing COVID-19 response remain unaddressed.” The Role of Public Health Leaders Acknowledge that a mental health crisis exists In the case of the public health workforce mental health crisis, leaders must begin by acknowledging that a crisis exists with far-reaching consequences. To begin the process of responding to any crisis, leaders must establish a “sense of urgency”8 by emphatically stating that a crisis exists and demands immediate attention. Along with establishing a sense of urgency, public health leaders must enlist the involvement of those who share this sense of urgency and their governing bodies to form a “guiding coalition” in order to implement a shared vision and immediate action plan. As part of this response, federal agencies should immediately work with ASTHO and NACCHO to aggressively mobilize the public health system to address and support the public health workforce's mental health needs, working synergistically with promising steps now underway.9,10 Forge a collective mindset In addition to acknowledging that a crisis exists, leaders have an opportunity to help others frame the issues that may lead to constructive action. In our view, leaders may be able to forge a mindset within which concerted thought and action can occur. This mindset can focus around (1) restoring routine, (2) fostering recovery, and (3) promoting renewal of spirit and commitment. Restore routine and set limits Among the many challenges faced by the workforce during the pandemic, disruption and elimination of daily routines, both at work and at home, have negatively impacted public health workers' resilience and stamina. Leaders should prioritize the establishment of healthy workplace routines. For example, the length of the “normal workday” can be reexamined. Workers can be asked, “What does your optimal work week look like?” and “What practices should we revisit or reinforce that might work for you (eg, avoiding late night e-mails or extensive weekend ‘catching up’)?” In that regard, leaders must model behaviors that restore healthy work routines that offer a respite from the “always-on” dynamic of the COVID-19 response. Leaders can encourage the creation of institutional norms in which limits are set, monitored, and supported as workers transition into the future of public health work. Foster recovery To foster the recovery process, leaders can encourage individuals to acknowledge their own personal needs and to seek support and assistance. That can start with leaders intentionally sharing their needs and how they are getting support. This is an opportunity to display authentic leadership. As the term “posttraumatic stress disorder” indicates, the prolonged effect of continued stress may persist in various forms long after the initial sources of stress have mitigated or subsided. Now that medical research is focusing on “long COVID” as a persistent syndrome characterized by decreased stamina, “brain fog,” and other symptoms, one may wonder whether the current mental health conditions experienced by public health workers may result in latent negative impacts on functioning within the workplace for months to come. To foster short-term recovery and prevent longer-term functional difficulties, access to professional assistance (eg, mental health professionals, employee assistance programs, beefed up work wellness programs, and other employer-sponsored resources) hold potential benefits. Promote renewal of spirit and commitment As the COVID-19 response has evolved, public health workers have tirelessly and courageously contributed to the daunting tasks of protecting the communities that they serve. As noted in prior Management Moment columns, they have provided situational awareness, made difficult decisions in the face of uncertainty, communicated with the public, struggled to manage their energy, and learned from the lessons of experience.2,11 These stellar contributions to our collective health must be acknowledged and recognized. Thus, meaningful celebrations of the “small victories” to which public health workers have contributed may play a role in building cohesion and improving morale. Furthermore, leaders must model ways in which they themselves seek occasions to restore their own spirit (eg, by finding ways to simply find joy in everyday life) and to reflect on their own commitments to serving the health of the public. Obviously, this step is very difficult, given the continued COVID-19 challenges with ever-increasing quantities of work demands. Nevertheless, despite these unrelenting demands on the leader's time and energy, the quality of work suffers if leaders do not find ways to foster their own renewal of spirit and model these behaviors for others to emulate.3 Implement best practices To assist in this process, we offer a few practical tips for public health leaders committed to addressing the mental health crisis in the public health workforce. Some of these tips may fit into an attempt to recapture fundamental best practices for a healthy workplace culture that served well prior to the COVID-19 pandemic or were lacking before the pandemic but to which we are now committed. Manage time/set limits: Since meetings are often a major time commitment, we refer to our suggestions from an earlier Management Moment column2 to emphasize that meetings should have a clear purpose, an agenda that tracks the purpose (with specific time limits on components of the meeting), and be scheduled for as little time as needed. Rather than the typical 1-hour meeting, leaders should encourage scheduling meetings lasting for 15, 25, or even 42 minutes; meetings should start on time and end early when possible and not run over! And when feasible, have walking meetings. Each day should have time set aside to take stock of daily tasks as well as time to think (a rare commodity). Finally, workers should be encouraged to “uninvite themselves” to meetings that are of low priority without the “fear of missing out [FOMO].” Setting limits on how time is spent is an essential workforce skill that must be cultivated to combat burnout. Set priorities: Each day presents more work opportunities and tasks than can be reasonably accomplished. All too often public health workers fail to distinguish between the “must dos,” “the good to dos,” and the “nice to dos.” As a result, everything seems to be equally important and thus overwhelming. COVID fatigue then results from a sense of being overwhelmed with too much to do and not enough time and energy to “do what needs to be done.” We advocate that public health leaders encourage staff to set aside time regularly to list and then categorize work activities into these 3 categories: “must dos,” “good to dos,” and “nice to dos.”2 Obviously, the criteria for deciding what goes where will vary and the process will be challenging. However, failing to adopt a priority setting routine will further contribute to the mental health challenges faced by public health workers. Finally, cultivating the “power of a positive no”12 should become common practice among overloaded public health workers. Celebrate small successes: Simply stopping to celebrate small successes can be encouraged and orchestrated by leaders. Doing so in an intentional, meaningful, and regular way by leaders can promote a sense of shared pride and shared purpose throughout the organization. Current virtual work arrangements do represent a barrier for celebration and will require creative approaches. As more in-person situations arise, time set aside to celebrate can become a more tangible reality. Seek support: The mental health challenges we describe here are too often faced alone. We strongly advocate that all public health workers (not just those suffering from the mental health challenges noted here) commit to supporting one another as the lingering effects of responding to the pandemic continue to play out. Since each situation is different, we can only suggest that leaders themselves model behaviors needed for their own recovery and restoration and doing so publicly, while fostering an organizational culture that affirms the value of restoration and recovery. Develop a code of conduct: Leaders should communicate consistently, through word and deed, a set of behaviors needed to address the mental health crisis that we describe here. In some instances, a formal code of conduct may be useful as a tool to specify and reinforce those desired workplace practices that can contribute to improved worker mental health. Monitor self and the organization: Leaders might also encourage a more formal approach to self-monitoring by individual workers and, if possible, create aggregate measures that can be monitored over time. As we know, “what gets measured gets done.” So, as in other contexts, public health leaders may wish to create an index or a tool that can be used over time to monitor progress in addressing these mental health challenges. In doing so, organizations might encourage workers to end each day by answering a few questions such as: “What was your toughest activity today?” “What was one thing you did really well?” “What is one thing you will do to take care of yourself?” or “What can you do to support your peers?”9 By aggregating responses to these or other questions, leaders may “take the pulse of the organization” with respect to the organization's collective mental health status. Conclusion/Summary No simple summary or set of suggestions can do justice to the complexities of the moral injuries and mental health crisis being experienced by the public health workforce. Nevertheless, public health leaders can play a very positive role by first acknowledging the nature and significance of this crisis, followed by advocating for and modeling those behaviors that may contribute to restoring routine, fostering recovery, and promoting renewal of spirit and commitment. Clearly, addressing this challenge will be no less daunting than addressing the extraordinary challenges of the COVID-19 response itself. In doing so, however, public health leaders can renew the sense of dedication and commitment to service that has characterized the public health workforce for decades and will be central to success for many decades to come.

  PublisherDOI

• Seroprevalence of Antibodies to SARS-CoV-2 in 10 Sites in the United States, March 23-May 12, 2020

  JAMA Internal Medicine · 2020-07-21 · 743 citations

  articleOpen access

  IMPORTANCE: Reported cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection likely underestimate the prevalence of infection in affected communities. Large-scale seroprevalence studies provide better estimates of the proportion of the population previously infected. OBJECTIVE: To estimate prevalence of SARS-CoV-2 antibodies in convenience samples from several geographic sites in the US. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study performed serologic testing on a convenience sample of residual sera obtained from persons of all ages. The serum was collected from March 23 through May 12, 2020, for routine clinical testing by 2 commercial laboratory companies. Sites of collection were San Francisco Bay area, California; Connecticut; south Florida; Louisiana; Minneapolis-St Paul-St Cloud metro area, Minnesota; Missouri; New York City metro area, New York; Philadelphia metro area, Pennsylvania; Utah; and western Washington State. EXPOSURES: Infection with SARS-CoV-2. MAIN OUTCOMES AND MEASURES: The presence of antibodies to SARS-CoV-2 spike protein was estimated using an enzyme-linked immunosorbent assay, and estimates were standardized to the site populations by age and sex. Estimates were adjusted for test performance characteristics (96.0% sensitivity and 99.3% specificity). The number of infections in each site was estimated by extrapolating seroprevalence to site populations; estimated infections were compared with the number of reported coronavirus disease 2019 (COVID-19) cases as of last specimen collection date. RESULTS: Serum samples were tested from 16 025 persons, 8853 (55.2%) of whom were women; 1205 (7.5%) were 18 years or younger and 5845 (36.2%) were 65 years or older. Most specimens from each site had no evidence of antibodies to SARS-CoV-2. Adjusted estimates of the proportion of persons seroreactive to the SARS-CoV-2 spike protein antibodies ranged from 1.0% in the San Francisco Bay area (collected April 23-27) to 6.9% of persons in New York City (collected March 23-April 1). The estimated number of infections ranged from 6 to 24 times the number of reported cases; for 7 sites (Connecticut, Florida, Louisiana, Missouri, New York City metro area, Utah, and western Washington State), an estimated greater than 10 times more SARS-CoV-2 infections occurred than the number of reported cases. CONCLUSIONS AND RELEVANCE: During March to early May 2020, most persons in 10 diverse geographic sites in the US had not been infected with SARS-CoV-2 virus. The estimated number of infections, however, was much greater than the number of reported cases in all sites. The findings may reflect the number of persons who had mild or no illness or who did not seek medical care or undergo testing but who still may have contributed to ongoing virus transmission in the population.

  PublisherOA PDFDOI

• Seroprevalence of Antibodies to SARS-CoV-2 in Six Sites in the United States, March 23-May 3, 2020

  medRxiv · 2020-06-26 · 72 citations

  preprint

  Abstract Importance Reported cases of SARS-CoV-2 infection likely underestimate the prevalence of infection in affected communities. Large-scale seroprevalence studies provide better estimates of the proportion of the population previously infected. Objective To estimate prevalence of SARS-CoV-2 antibodies in convenience samples from several geographic sites in the United States. Design Serologic testing of convenience samples using residual sera obtained for routine clinical testing by two commercial laboratory companies. Setting Connecticut (CT), south Florida (FL), Missouri (MO), New York City metro region (NYC), Utah (UT), and Washington State’s (WA) Puget Sound region. Participants Persons of all ages with serum collected during intervals from March 23 through May 3, 2020. Exposure SARS-CoV-2 virus infection. Main outcomes and measures We estimated the presence of antibodies to SARS-CoV-2 spike protein using an ELISA assay. We standardized estimates to the site populations by age and sex. Estimates were adjusted for test performance characteristics (96.0% sensitivity and 99.3% specificity). We estimated the number of infections in each site by extrapolating seroprevalence to site populations. We compared estimated infections to number of reported COVID-19 cases as of last specimen collection date. Results We tested sera from 11,933 persons. Adjusted estimates of the proportion of persons seroreactive to the SARS-CoV-2 spike protein ranged from 1.13% (95% confidence interval [CI] 0.70-1.94) in WA to 6.93% (95% CI 5.02-8.92) in NYC (collected March 23-April 1). For sites with later collection dates, estimates ranged from 1.85% (95% CI 1.00-3.23, collected April 6-10) for FL to 4.94% (95% CI 3.61-6.52) for CT (April 26-May 3). The estimated number of infections ranged from 6 to 24 times the number of reported cases in each site. Conclusions and relevance Our seroprevalence estimates suggest that for five of six U.S. sites, from late March to early May 2020, >10 times more SARS-CoV-2 infections occurred than the number of reported cases. Seroprevalence and under-ascertainment varied by site and specimen collection period. Most specimens from each site had no evidence of antibody to SARS-CoV-2. Tracking population seroprevalence serially, in a variety of specific geographic sites, will inform models of transmission dynamics and guide future community-wide public health measures. Key findings Question What proportion of persons in six U.S. sites had detectable antibodies to SARS-CoV-2, March 23-May 3, 2020? Findings We tested 11,933 residual clinical specimens. We estimate that from 1.1% of persons in the Puget Sound to 6.9% in New York City (collected March 23-April 1) had detectable antibodies. Estimates ranged from 1.9% in south Florida to 4.9% in Connecticut with specimens collected during intervals from April 6-May 3. Six to 24 times more infections were estimated per site with seroprevalence than with case report data. Meaning For most sites, evidence suggests >10 times more SARS-CoV-2 infections occurred than reported cases. Most persons in each site likely had no detectable SARS-CoV-2 antibodies.

  PublisherDOI

• First Case of 2019 Novel Coronavirus in the United States

  New England Journal of Medicine · 2020 · 6392 citations

  • Political Science
  • Medicine
  • Intensive care medicine

  An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.

  PublisherOA PDFDOI

• Succession Planning and Management Practice in Washington State Local Public Health Agencies: The Current Situation and Recommendations for Better Practice

  Carolina Digital Repository (University of North Carolina at Chapel Hill) · 2019-08-15 · 1 citations

  articleOpen access1st authorCorresponding

  Strong organizational leaders make it a priority to ensure their organization grows its future leaders and that leaders are ready to lead the challenges of tomorrow, not today or yesterday. This mixed methods study examined succession planning and management practices (SPM) in local public health agencies (LPHAs) in Washington State using a web-administered survey and semi-structured interviews in three exemplary LPHAs. A systematic literature review identified 25 SPM best practices, which formed the basis for the study. The two main impetuses for LPHAs to implement SPM programs were: 1) Discovering the large percentage of employees able to retire in the very near future after profiling their workforce by length of time to retirement, and 2) Requirements for a workforce development plan to achieve national accreditation. It also found that 85% of LPHAs selected high potential-high performers (HP-HP) for development, 76% sent HP-HP to formal technical and management/leadership training, and 70% used cross-functional team projects and 67% used stretch assignments to develop their employees. Many of these SPM programs were informal in nature and lacked transparency, creating a potential environment for bias and inequitable access to opportunities. Barriers to implementing SPM were: too many other competing demands for time, believing the LPHA's workforce was too small for a SPM program, and concerns that there would be union barriers. Semi-structured interviews noted the importance of having a top local public health official that championed the need and modeled its importance. A plan for change to increase the number of LPHAs implementing SP&M programs is included, using Kotter's 8 steps to transforming organizations. The plan recommends creating urgency by focusing on retirement profiles in one's LPHA and emphasizing the need for workforce development plans in accreditation. It advocates using national associations and the public health training centers to assist LPHAs in developing SP&M training programs.

  PublisherDOI

Frequent coauthors

• Edward L. Baker

  Baker Engineering (United States)

  21 shared

• Scott Lindquist

  University of Washington

  18 shared

• Amanda Cohn

  Centers for Disease Control and Prevention

  16 shared

• Susan I. Gerber

  Centers for Disease Control and Prevention

  16 shared

• Keith M. Marzilli Ericson

  Harvard University

  16 shared

• George Diaz

  Providence Regional Medical Center Everett

  16 shared

• Suxiang Tong

  16 shared

• Kathy Lofy

  Snohomish Health District

  16 shared

Awards & honors

• Presidential Advisory Council on HIV/AIDS (PACHA) co-chair
• scientific advisory group of the President’s Emergency Plan…
• Impact in Practice Awards (2024)