Four Strategies to Help New Health Officials Become Successful Leaders

June 06, 2019|11:03 a.m.| ASTHO Staff

Terry DwelleFollowing the November 2018 midterm elections, ASTHO welcomed more than twenty new state and territorial health officials. To succeed in this key leadership position, new health officials must think early on about ways to inspire and guide the programs, policies, and activities that affect the health of the state’s population. Members of ASTHO’s distinguished alumni society give generously of their own time to serve as advisors and mentors to new and incumbent health officials, often during leadership transitions.

Terry Dwelle (alumnus-ND) served as the state health officer for the North Dakota Department of Health from 2001-2016. A North Dakota native, Dwelle worked previously at the University of North Dakota School of Medicine, CDC, and the Indian Health Service. Looking back on these professional experiences and his 15-year tenure as North Dakota’s top health official, Dwelle reflects on four strategies that helped ensure successful leadership, as well as the support ASTHO offers new state health officials as they develop the skills and competencies necessary to run a public health agency:

Prepare yourself: Becoming a state health official is a big transition. Preparation is critical. “Get to know the position and the agency,” Dwelle says. “Learn about key partners and leaders, meet with agency staff, as well as with colleagues and others (alumni) who have held this role. After you transition into the role, continue to meet with staff to understand their projects and processes, with colleagues and partners to identify priorities and expectations, and with alumni for mentorship and guidance.”

Lead up, down, and across: In order to be a successful state health official, Dwelle believes it is imperative to consider how your leadership style fits within the agency’s culture. “Consider how you will lead ‘up’ with superiors, lead ‘down’ with staff, and ‘lead across’ with colleagues,” Dwelle says. “Public health, population-based problems, and their solutions are commonly complex or adaptive. And adaptive problems require a group process to find an effective solution. These sorts of problems can’t be managed away, no matter how skilled the manager. With this in mind, public health leaders often benefit from a more democratic and consultative leadership style, resulting in a ‘flatter’ organizational structure and often associated with an open door policy.”

Dwelle also emphasizes the importance of coalitions, collaborations, and partnerships, which tap into the incredible wealth of ideas that emerge from various stakeholders. “This leadership approach led to the development of the Healthy North Dakota collaborative,” says Dwelle, “which brought together a variety of stakeholders to network resources to accomplish the common goal of improving the health and wellness of all North Dakotans as defined broadly by the social determinants of health.”

Think strategically: As a leader, one must take a broad, strategic perspective while remaining focused on details. This requires some adjustment. “During my first days as North Dakota’s state health officer, it became clear that the department of health was experiencing severe personnel issues resulting from negative press coverage,” Dwelle recalls. “My deputy and I quickly identified root causes and addressed those issues through reorganization, middle-level management adjustments, and defined a new agency approach to handle personnel problems. That first success, or win, in the eyes of the governor, external stakeholders, legislative leaders, and employees provided the latitude and respect needed to move our vision for population health forward.”

The point being? “Develop an organizational strategy and create your vision and mission to support and motivate staff. Think about early wins, as they will increase credibility with leadership, staff, and partners. Think about coalition building, partnership development, and form alliances that advance the agency’s work.”

Manage yourself: Last, but certainly not least, it is important to manage yourself as a leader. This requires honesty and support. “Think about who you are as a leader and how you can continue to grow and develop,” Dwelle advises. “Establish relationships built on trust with your staff and peers across other state and territorial health agencies to work through challenges and identify opportunities for success. In addition, seek advice and counsel from others. ASTHO can match you with an alumni mentor or peers currently working in other agencies. You might also seek leadership development opportunities, such as the ASTHO Leadership Institute.”

ASTHO members are part of a small network of leaders committed to the public’s health, safety, and well-being. ASTHO, as well as colleagues and partners across the country, offer support in assuming this role and its responsibilities. Agency leadership is critical to improving state and territorial public health, advocating for sustained support, and implementing initiatives that impact health.

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