Leadership Challenges forRural Health Departments

Louis Rowitz, PhDDirector

Mid-America Public Health Training Center

THE CHALLENGES

RURAL HEALTH DEPARTMENTS HAVE TO DO MORE WITH LESS

LESS MONEYLESS STAFFGEOGRAPHIC ISOLATIONLIMITED TECHNICAL RESOURCESPOOR SALARIESFEWER PARTNERS

RURAL HEALTH DISPARITIES

HIGHER SMOKING RATES AMONG TEENAGERS AND ADULTS

FEWER DENTAL CARE VISITSLACK OF HEALTH INSURANCEHIGHEST DEATH RATES FOR

UNINTENTIONAL INJURIES IN GENERAL AND MOTOR VEHICLE INJURIES SPECIFICALLY

HIGH DEATH RATES FOR CHILDREN AND YOUNG ADULTS(AGES1-24)

DIVERSITY OF RURALCOMMUNITIES

DIFFERENCES IN ECONOMIESAGRICULTURETOURISMMANUFACTURINGMININGENERGY

DIVERSITY (CONTINUED)

DEMOGRAPHIC DIFFERENCESMOSTLY CAUCASIANS INCREASE OF MIGRANT STREAM FROM

MEXICO IN SOME AREASAGING POPULATIONSLARGE SEGMENTS OF THE POORLOWER LEVELS OF EDUCATIONAL

ATTAINMENTMANY ON PUBLIC PAYMENT SYSTEMS

IN SOME AREAS

DIVERSITY (CONTINUED)

DIFFERENCES IN POPULATION DENSITY

FRONTIER ISSUESSERVICES ARE OFTEN TIED TO

POPULATION DENSITY

DIVERSITY (CONTINUED)

DIFFERENCES IN TERRAINDISTANCES ACROSS OPEN PLAINS

DIFFERENT THAN MOUNTAIN DISTANCES

ADEQUACY OF ROAD AND TRANSPORTATION DIFFERENCES

REGIONAL WEATHER PATTERNS

DIVERSITY (CONTINUED)

PROXIMITY TO URBAN AREAS INCREASES ACCESS TO SERVICES

DIVERSITY (CONTINUED)

DIFFERENCES IN AVAILABILITY OF RESOURCESLACK OF SOCIAL CAPITALACCESS TO TECHNOLOGYAVAILABILITY OF EDUCATION AND

TRAINING OPPORTUNITIESAFFORDABLE HOUSINGGOOD SCHOOLSTRAINED WORKFORCE

DIVERSITY (CONTINUED)

DIFFERENCES IN PUBLIC HEALTH PRESENCE

THE LEADERSHIP ISSUES

COLLABORATION

LACK OF RESOURCES

DIFFICULITES IN CARRYING OUT THE CORE FUNCTIONS AND ESSENTIAL SERVICES

UNTRAINED STAFF

CREDENTIALING AND ACCREDITATION

PUBLIC HEALTH PREPAREDNESS

TOO FEW STAFF

OLD EQUIPMENT

DIFFICULTIES IN DISTANCE LEARNING

FEAR OF THE BOARD

BILINGUAL AND CULTURAL ISSUES

AGING POPULATIONS

BORDER HEALTH CONCERNS

LACK OF MONEY

HARD TO GET AND PAY CONSULTANTS

MIGRANT ISSUES

SHARING LEADERSHIP CONCERNS

COMMUNITY ASSESSMENT DIFFICULTIES

PERFORMANCE STANDARDS COMPLEX

SYSTEMS THINKING WITHOUT A SYSTEM

LEADERSHIP STRATEGIES

LEADERSHIP

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POLI

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Rowitz, p. 88, Figure 5-3

LEADERSHIP WHEEL

BUILD SOCIAL CAPITAL WITH YOUR BOARD

PARTNERSHIPS UTILIZING A REGIONAL MODEL

ASSETS PLANNING

BUILDING COALITIONS UTILIZING DIFFERENT MEETING MODALITIES

-THE MOVEABLE FEAST

DIFFERENT TRAINING APPROACHES

ADOPT THE SYSTEMS MODEL OF

THINKING WITH PUBLIC HEALTH

SEEN AS A SYSTEMS ISSUE AND

NOT THE SOLE RESPONSIBILITY OF

A LOCAL HEALTH DEPARTMENT

CHANGE IS INEVITABLE

LEADERSHIP IS CRITICAL

MORAL

COLLABORATION IS THE SECRET

TO SOUND LEADERSHIP PRACTICE.

BUILD TRUST AND SHARE POWER