1028: Leading Through Change: Adaptive Leadership in Public Health

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This is Public Health Review
Morning Edition for Monday,

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November 17th, 2025.
I'm John Sheehan with news from

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the Association of State and
Territorial Health Officials.

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Today we'll be discussing
adaptive leadership in public

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health and how it can help build
trust, strengthen community

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partnerships, and Dr. meaningful
change across systems.

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We have two guests from the
Public Consulting Group.

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A founding member of Asto's
Innovation Advisory Council, Ida

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Johnson is an associate manager.
A part of the solution to

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today's problems, I think,
though, isn't going to be just

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around the newest tool or the
newest technology or the shiny

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thing, right?
Really, it's going to be around

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the approach to leadership.
And Lillian Shirley is a senior

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public health advisor.
So adaptive leadership moves

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away from the top down
leadership style and instead it

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gets guidance from those who are
doing the work and experiencing

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the problem.
It helps our science based data

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land in a way that communities
can see how it relates to what

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they're experiencing.
Drawing from real world

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initiatives, they'll share
practical insights on adaptive

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leadership as well as leading
with empathy, collaboration and

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purpose in today's complex
public health landscape.

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I think that in public health,
we often truly believe that

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leading all solutions with the
science and the evidence is the

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the most prominent thing.
And while yes, I agree that is

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important, maybe instead of
solely relying just on that,

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when you can bring in an
adaptive leadership mindset, it

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pushes leaders to think also
about how that wisdom is really

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sourced from our communities.
So if we start with the platform

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of our science clients, but then
go into more of a curiosity and

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inquiry mindset, understanding
how the communities actually

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interpret and relate to it, this
is going to be more beneficial

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and advantageous.
So of course, that doesn't mean

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that we're just asking
communities how they want us to

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fix the problem, rather asking
about their perspective on how

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the problem or the challenge is
really understood and how they

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feel it, right?
How do they relate to the

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solutions that we can provide
them?

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Does it make sense for their
daily lives?

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This should really be able to
help tailor your decision making

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and then move forward with the
programmatic or the technical

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issues, right?
So in looking at the landscape,

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our community engagement
practices have absolutely

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improved over the past five
years, right?

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But there really needs to be
that follow up step to the

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collection of input and drawing
out from our communities and

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really making sure that the
priorities and the practices to

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help their families are relevant
to them so that we can get the

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best outcomes and that adaptive
leadership will allow us to flex

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in a way that is more
responsive.

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Adaptive leadership moves away
from relying solely on the

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science as the reason to adopt
health practices, but rather

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present the science and then ask
how could this work in your

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life?
What's missing?

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And I don't think we can say
this too often or repeated

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enough.
Kind of go into inquiry as

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opposed to didactic.
Understand what that guidance

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means to the community and how
they would apply it.

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Being honest and transparent
with humility and working to

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achieve a solution together with
those constraints.

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These are not new ideas, but
these are ideas I think we have

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to remember there isn't
something new maybe going back

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to that basics.
It's important to be honest

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about resource deficits,
limitations, and challenges that

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public health agencies face.
But also being forthright about

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what you can do allows people to
manage expectations on how

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programs can deliver and also
how they may find solutions and

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offer it to us on how to
deliver.

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Ida says that public health
leaders can begin applying

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adaptive leadership into their
communication strategies.

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I actually worked in hospital
administration for nearly a

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decade.
And what I've seen working in

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that operations world is that
traditionally communication has

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fallen on the shoulders of the
community health workers, the

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navigators, right, those on the
frontline.

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However, as I mentioned earlier,
everything rises and falls based

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on leadership.
So this task should really be

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shared by everyone within the
agency.

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And it's the leadership
responsibility to really be able

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to relate, be among the
community in a different we

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can't continue to delegate it
solely to the community health

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workers and those delivering
those services.

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And collaboration with other
public health agencies can

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definitely improve messaging to
communities.

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To start, we really need to, you
know, get to the balcony, so to

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speak, get the bird's eye view
of the problem.

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And once we do that, the public
health leaders really can

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continue to build those
partnerships with other agencies

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like the social services, child
welfare and aging and disability

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services, those Human Services,
right, to address common complex

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problems like homelessness,
substance abuse, the chronic

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disease, working together.
If we do that, then we're

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breaking out of the silos of
funding in programs.

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And that's something that's
needed in these times.

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Learning from these agencies
about how they're approaching

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some of the same issues and
problems from their purview, and

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then build on that where our
knowledge and expertise can

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really, really help.
I do think that this is

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especially relevant with the
emergency and incident response

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strategies that oftentimes
require resources from multiple

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parts of our safety net.
And it doesn't just start with

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going to the meeting.
We've all been to the meeting,

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right?
You have to be informed with the

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strategic plans of other
agencies so that we can pull

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those best ideas.
And so when we're understanding

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their goals and priorities, we
can align with our shared values

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and determine where everyone's
capabilities and strengths can

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really complement theirs.
I just wanted to share just this

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week Oregon announced an
initiative called Move Oregon

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Health Forward Pledge and it's
an initiative that has a

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concrete and accountable basic
health and all policies approach

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has a plan across the various
sectors in the state, including

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importantly not just Human
Services, but business partners

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for how to reach public health
goals in that state.

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In addition, in Maine, Maine
Health has a system wide

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initiative that forwards public
health community outcomes, again

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working across sectors with a
common goal.

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These are not things that we
don't know and understand.

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For instance, health and all
policies is something that has

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been part and parcel of our
public health practice, both

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academically and as we've done
our community health improvement

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plans, et cetera.
But this really puts a

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discipline around it and a
shared commitment to focus on

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this, for leadership to have
that as a priority.

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I totally agree wholeheartedly
and these are excellent

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examples.
I would also say that PCG has

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done many cross sector
initiatives to facilitate this

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type of shared problem solving
with representatives from

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behavioral health, substance
use, and health plans.

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I've seen this and supported
work in Maine, in California,

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Oregon, and in other states
nationally.

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And what this looked like was
getting the frontline providers

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together, the managers, the
directors in mapping out the

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barriers, yes, with the sticky
notes from, you know, pre 2020

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and brainstorming possible
solutions to their thorniest

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problems.
Using a quality improvement

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process to really govern those
conversations and have them

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centered around things that are
as complex, from data sharing

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and data sharing agreements to
the more common ones, such as

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just the resources that are
limited and our coordination and

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care.
Here are some of Ida and

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Lillian's final thoughts.
I think one of the things that

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we heard loud and clear at NATO
this past summer is that we

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really do need to start working
with our Human Services agencies

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because our public health work
comes out of the Human Services

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practice area.
Here at Public Consulting Group,

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we are very familiar with that
and have seen time and time

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again that we are all working on
the same problems.

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And if we come to the table with
our mindset of that health and

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all policies and saying how do
you all work towards this

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problem, I think that we really,
really can get far, especially

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in these times and build up a
resilience in relationships that

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can be sustained over the next
several decades.

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Yeah.
And I would just add to that,

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you know, language changes and
it comes to different ideas and

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different, you know, things come
and go, you know, as time goes

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on.
But I think one of the things we

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need to remember in public
health as a profession, public

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health has always been about
social justice.

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And it's our discipline and our
work and our commitment to our

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communities that has helped make
many, many outcomes for healthy

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communities.
And we know, we know there's the

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little programmatic work that
makes a big difference.

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And then there's also the
overall system work that has

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made a difference.
But we should stay optimistic

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because we know that we're
connected to the communities

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that we face, and we know that
everyone wants health for their

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families, their children and
their communities, and that's

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our job.
Lillian Shirley is a senior

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public health advisor and Ida
Johnson is an associate manager,

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both of the Public Consulting
Group, a founding member of

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Asto's Innovation Advisory
Council.

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You can learn more about them at
publicconsultinggroup.com or

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find the link in our show notes.
I'm John Sheehan, and this has

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been another edition of Public
Health Review Morning Edition

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from the Association of State
and Territorial Health

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Officials.