The magazine of the UW School of Public Health

From the Dean: Meta-Leadership

By Howard Frumkin, Dean, UW School of Public Health


It seems that the only constant in contemporary public health is change. The recently released Global Burden of Disease study, from UW’s Institute of Health Metrics and Evaluation, documents that risk factors, such as obesity, and chronic conditions, such as heart disease, have supplanted infectious disease as leading threats for much of the world. Infant mortality is down and we are living longer, but our later years are plagued by a constellation of age-related disabilities and illnesses. Short-term trends shift rapidly, too. In January 2013, weeks after the tragic shootings in Newtown, Connecticut, a Pew Research Center poll showed that a majority of Americans supported a range of gun control measures—a dramatic shift of public opinion on this pressing public health issue. 

“Upstream” determinants of health—social circumstances, neighborhood environment, food access and quality, housing and transportation infrastructure, and global environmental change—have never been more important. Barry Commoner’s first Law of Ecology—that “everything is connected to everything else”—could also be the first law of contemporary public health. 

Public health leadership in these changing times must reflect that reality. We need to embrace, and lead through, change. We need to lead outside the public health silo, in arenas ranging from community development to energy policy. Our prototypical organizational setting needs to be the multi-stakeholder coalition rather than the specialized public health team. We need to “lead up” to senior policymakers. We need to lead through persuasion rather than the exercise of power. We will often be in crisis situations and outside our comfort zones; we need self-knowledge and insight to perform well in these situations.

The concept of “meta-leadership,” developed in the context of emergency preparedness and response, offers a fruitful approach to meeting these challenges. This concept emerged from the National Preparedness Leadership Initiative (NPLI), a joint venture of Harvard’s School of Public Health and Kennedy School of Government. 

Among the hallmarks of meta-leadership is an emphasis on collaborative activity and connectivity of effort. It requires leaders to step out of their silos and in turn persuade others that it is in their best interest to do the same to accomplish an overall mission. Meta-leadership builds relationships between people, transforming cultures that may have traditionally championed independent decision-making into cultures that value cooperation. The impact lies not just in the outcome, but also in the collaborative process needed to get there. 

Meta-leadership can work especially well when the goal is a form of social good, aligning people who work in different sectors (public, private, community-based, for example) and/or on different levels of a hierarchy. It has been used within the Centers for Disease Control and Prevention and by emergency preparedness and response agencies. 

As you read this issue of Northwest Public Health, I hope you enjoy reflecting on the theme of public health leadership in changing times and learn from the stories presented about models of leadership appropriate to your work. Lead on!