“Relationships, Relationships, Relationships”: Promoting Population Health Collaboration Across State Government

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Creating population health policy for the states is like the proverbial 3-legged stool: it involves the state health agency, the legislature, and the governor's office. But if the inputs from the 3 legs are not in balance, it can get pretty wobbly for whoever sits there.
Interagency and cross-sector collaboration, which can provide a firmer base, was once commonplace. In the current political environment, it requires more intentional effort. And with federal funding for state population health efforts diminished, state health officials (SHOs) will increasingly need to rely on such collaboration to bring in stakeholders and partners in new and creative ways. Leadership education that lays the groundwork for those collaborations is a promising practice, as the Aspen Institute Justice & Society Program, with support from the Robert Wood Johnson Foundation (RWJF), demonstrated over the period 2013-2017, when it conducted a pilot project in its first cohort called the Excellence in State Public Health Law (ESPHL) program and in its second, TeamWork: Leadership for Healthy States.
In a 2016 valedictory, Paul Jarris, longtime executive director of the Association of State and Territorial Health Officials (ASTHO), wrote about the type of leadership public health officials require to be effective: “Cross-sectoral leadership is essential to transforming the health of the public. Health officials must not only take the time to understand the values of their partners, but also learn to speak their language.”1(p106)* Halverson et al.2 argued that success for SHOs could be measured in terms of internal team building and organizational accomplishments, including the creation or enhancement of formal relationships with the governor, cabinet members, other government agencies, and oversight bodies. Critical success factors for SHOs include “experience in government, experience working with the political apparatus, experience operating in the ‘public eye,' and experience in public health/population health.”2(p193)
Civil dialogue, appreciative understanding of values across the political spectrum, creation of a common vocabulary, and silo busting: these are some of the goals of the curricular materials successfully used by the Aspen Institute in its seminar and leadership programs for the past 40 years. These value-oriented conversations have successfully broken down barriers and tapped into shared understandings and concerns.
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