What State Health Officials Wish They Had Known and How They Learned Best

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In a prior Management Moment column,1 which introduced our study of state and territorial health official success and critical success factors, we summarized a few important themes derived from informal group interviews with state health officials (SHOs) and senior deputies. They identified 2 aspects of success: (1) specific policy or program achievements, and (2) team building within the state health agency. A range of critical success factors including individual attributes and skills and on-the-job behaviors was perceived to contribute to these successes. Organizational structure and culture also were perceived to impact the ability of SHOs to achieve success.
Most SHOs function as the chief executive officers (CEOs) of their health departments. However, unlike most CEOs, many SHOs come to the position not having had extensive managerial experience and, likewise, lack experience in a governmental setting, in public health, or both. This presents unique challenges for new SHOs. Given the importance of this role in achieving effective departmental operation as well as the optimal health of the public, we have been conducting interviews to better understand what SHOs know and don't know before taking the job and how they learned best once in the position.
In this column, we begin the process of sharing insights from our ongoing research project on SHO success. In doing so, we explore perceptions of current and past SHOs whom we formally interviewed about those things SHOs wish they had known before taking the position and also steps they took during their first several months on the job to enhance their effectiveness and impact.
Although our research relates specifically to the experiences of SHOs, some of our findings are relevant to other public health leadership positions. In that regard, a prior Management Moment column relating to actions needed during the first 6 months on the job may be of interest to readers.
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