Leadership Viewpoint: Confidence and Responsiveness

Carol Moehrle, RN, has been the Director for the North Central District Health Department in Lewiston, Idaho, since 1992. She is currently Chair of the Public Health Accreditation Board (PHAB) Board of Directors and served as President of NACCHO* in 2010–11. 

How would you describe the current opportunities in public health? 
We live in an exciting time for local public health. Here are a few opportunities that I see: 

• We have the mysterious Affordable Care Act on our horizons. We have the opportunity to redefine ourselves and choose a new strategy for influencing prevention and improving population health in our country, but first we need to decide where we fit in this new plan. 
• We have strong CDC leadership. We have a like-mindedness of federal, state, and local public health officials and organizations. If all of us work together, we will have the leverage we need to improve population health. 
• We have a nationally recognized set of standards and measures for tribal, state, and local public health to be held accountable to. With the launch of PHAB, all of public health has the opportunity to demonstrate the outstanding work being done and to show our populations that we meet the nationally recognized standards.

What do we in public health need to do differently to take advantage of these opportunities?
We need to tell our story. We need every citizen to know and understand what public health is and what we do for communities. Even after decades of great public health work, it’s frustrating to think that much of our population does not know or value what public health does with them and for them. 

Do you have concerns about the field of public health today?
Having been in the director position for many years, I have witnessed the ebbs and flows of our public health workforce. Our public health workforce is smaller than it has been in my entire career. I worry about the future of our current employees and sometimes find it difficult to match a new vision of public health with the current staffing. 

Do you have concerns about the health of the population?
I know our population is very resilient, and we find ways to support each other to maintain our health. But yes, I have concerns about the health of the population. We all know that health outcomes take years to change, and we have done a great job documenting much progress in certain areas, like high blood pressure. But when you look at the historical trend data, we still have not made a measurable impact on improving the overall health of our population. 

How might public health become more relevant and effective in communities?
We need to be confident in the role we play. The importance of what we do is linked to economic development as well as health outcomes. Public health can become more relevant in communities if we continue to use data to tell our story. We need to help our communities align their policies around health, and data is a great anchor for this discussion. Public health can no longer tell people what to do. We must listen and be responsive to understanding the public’s expectation of health and help them implement change.

*National Association of County and City Health Officials (NACCHO)