1132: Leading Through the Storm: Carolyn Mullen on Public Health Advocacy, Crisis, and Change

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Friday, May 22, 2026. I’m John Sheehan with news from the Association of State and Territorial Health Officials.

Today, Carolyn Mullen reflects on the defining moments, leadership lessons, and policy battles that shaped her tenure as ASTHO’s senior vice president for government affairs and public relations; she’s moving on to her next chapter.

So Carolyn, I feel like I'm conducting your exit interview. First off, congratulations. And looking back on your nine years at ASTHO, what stands out to you? What's your proudest moment?

CAROLYN MULLEN: 
My proudest moment certainly is my team. When I first started nine years ago, I had a team of seven, and it grew to 35 people. Almost every single member of the team I hired. They are passionate. They come from a place of yes. No problem is insurmountable. They will solve it. And they're really innovative and creative. And I'm so proud of the leadership team, Khalilah, Andy, Jeffrey, and Jane and Jonathan before them. They've just done a stellar job through so many challenges in the public health space. So I'm most proud of my team, and I wish them well after my departure. They're going to be great.

SHEEHAN:
And considering the last nine years, it's been tumultuous, I think it's fair to say. 

MULLEN: 

To say the least.

SHEEHAN:

What stands out to you over these years?

MULLEN: 

What stands out to me is that there are so many challenges in public health and each one we met head-on. Whether it be the Affordable Care Act repeal, replace, Medicaid financing for the U.S. territories, EVALI, that was the vaping illness, the opioid crisis, and the pandemic. And then last year, the year of the Doge, which is what I'm calling it. I hope history books coin it that way. All of the challenges, especially last year. But the team and myself, we met each challenge with tenacity, with a can-do spirit, with our members really supporting us and finding that middle ground in these incredibly politicized times, finding that common thread that binds us all together was really important. And that was the unique space that ASTHO occupied, no matter what came our way.

SHEEHAN: 
And it strikes me that some of the events you listed, they had direct implications either for public health or put public health forward. Certainly, the pandemic. How have you seen the role of public health advocacy and of advocates shift, evolve during this time?

MULLEN: 
It has changed dramatically. When I first started nine years ago, we did a lot of press statements and married that with our advocacy campaign. And at that time, President Trump and his administration really valued organizations that could get in the press. Like, you're important. You're getting in the press. We're going to pay attention to you. And then over time, President Biden really valued sort of that behind-the-scenes conversation. And now with President Trump, the advocacy has really shifted to more behind-the-scenes. Making sure you have governors at the table, having those quiet conversations to members of Congress, particularly in red states, to really say, this is a challenge. And they would go to then talk to the White House. So I call it tunneling advocacy. So it's not flashy, it's not in your face. It's really behind-the-scenes and making those connections. I don't think the rest of the community has really caught up to this new brand. I see a lot of organizations wasting their time with press releases that may actually get them in trouble. And so it's really shifted to meeting members of Congress where they are, understanding the strengths of your organization, the strengths of your members, and being willing to build a bridge with the administration and find that common ground.

SHEEHAN:
Yeah, this might be related to that, but what kind of lessons have you learned about leadership? Specifically, you know, now that your team has grown to the 35?

MULLEN: 

The first lesson is to keep calm. Last year was extremely challenging. We saw things happen we have never seen in our entire careers. There was a lot of stress. Institutions were being dismantled right before our eyes, oftentimes illegally. And we had to figure things out and help our members understand what was happening. So it was fast and furious. But my job was really to be that calm voice saying, look,
I don't know what's happening here, but we're going to figure it out, and we are going to do the best that we can every day. So first of all, to keep calm. A lot of people in my field of government affairs, I saw them spiraling out, getting too stressed out in the moment, and not being able to see the field and understand that each action they took could actually impact them directly and their organization. So, remaining calm. Being that voice of reason in the midst of chaos was really a top priority for me.

The other leadership lesson that I learned was to be vulnerable, that people look to you to help validate how they're feeling in the moment. So when I talk to staff, I would say, look, I'm really scared right now, and I'm not sure if you're feeling the same way, but I know we will get through this. There is a light at the end of the tunnel. You squint really hard, you can see it, and we will get through this time together. I oftentimes would tell them, I get paid to worry, so you don't have to, so send your worries my way. But being a leader and being authentic, it really resonated with people. And I didn't understand that as much very early on in my career, that it's okay to bring your authentic self to work. And those are the two key things that really helped me, especially last year during unprecedented times.

SHEEHAN:
Yeah. And during those unprecedented times, what was one of the harder times to stay calm?

MULLEN: 
I would say when the funding freeze memo hit in January, so this was a memo that the administration released and said we are freezing all federal funds. I never expected I would see that in my entire life. And it was very scary because I knew, know, ASTO is 95% federally funded. I know we could go under. I knew the impact it would have on our members. It wouldn't be able to make payroll. So it was significant. So that day, I actually didn't sleep that night when that funding freeze memo hit. I woke up, actually, I didn't sleep. I started my morning, I said, when is the person that I know at the White House gonna be on their commute in? I said, I think 7:30 feels about right. I called their cell, and I said, 'This is going to have a significant impact on our members, on the states, on nonprofit organizations. We need you to resend the memo.' And so he asked me to send him some information and he actually picked up his cell phone and we sent him some information that day. Then you saw the news pick up over the day and kind of put pressure on, the administration ultimatley rescinded that memo, but it was very stressful. Because again, it could have had catastrophic consequences moving forward for not only public health, but all of U.S. government.

SHEEHAN: 
Yeah, absolutely. Boy, it's, there have been so many ups and downs. What kind of message do you have for the next generation of public health advocates, of communicators?

MULLEN: 
Sure, retire the old talking points for public health, please. A lot of public health advocates will say public health is underfunded and under-resourced. Like that's just not true. We got billions and billions of dollars during the pandemic, and we need to own that. We need to say we got billions and billions of dollars during the pandemic. Here's what we did. Here's the work that still needs to be done. Here's the impact it had on our workforce. People are kind of lazy and use that old talking point. I was like, that's just not authentic. It's just not true. And then the other talking point is the boom and bust cycle of public health funding. It is what it is. If anything was going to change after the pandemic, that would have been the moment to change the way it's funded. And it didn't. So it's just the cycle that we're in. So states
and organizations need to be ready for the boom, and they need to be ready for the bust. And that's it.

The other piece is for communicators. The world is changing. We know AI is there. Written issue briefs and blogs are going to go by the wayside and we really need to think about how we need to meet people where they're at. We can learn a lot from the MAHA movement. The MAGA Minute, the video that the administration releases on a weekly basis, is brilliant. They're very good at it. We also need to really think about how to make sure people who feel a certain way are heard and providing those forms for them. So communicating differently. The administration talks about promises made, promises kept. It's really effective. And you think some people in public health kind of shun that line of thinking, but you need to be curious and learn from what the administration is doing because they're very good at messaging and very good at communicating.

And finally, for public health advocates, think about the future and think about where we need to be going. There's a lot of stuff that advocates do that just aren't effective. Need to be meeting with members of Congress in their districts, need to be talking to the public. You need to really rally and again, meet people where they are in their communities. We spend a lot of time doing sign-out letters, doing statements. Those line the bottom of trash cans. Why are we doing that? We need to innovate and push the needle forward so that we remain at the table moving forward for the next decade. Because there will be a rebuilding phase for public health, and we want to be present for that moment.

SHEEHAN:

Lastly, Carolyn, what would you, what can we leave your colleagues and partners?

MULLEN:
Just to keep on keeping on, the work is so important. The mission is critical to protect the health of all Americans and people globally. I know that the days can be long, but at the end of the day, you can be proud of the work that you all do and I'll be cheering at you from the sidelines and wishing you well from afar.

SHEEHAN:
Well, Carolyn Mullen, thanks again, and best of luck.

MULLEN:
Thank you so much.

SHEEHAN:

Carolyn Mullen is ASTHO's outgoing Senior Vice President of Government Affairs and Public Relations. 

Congratulations to ASTHO President-Elect Dan Edney, state health officer and executive director of the Mississippi State Department of Health. Magnolia Tribune named Edney to the 2026 class of Mississippi’s Top 100. This annual recognition honors leaders across business, government, education, culture, and community who are making a meaningful impact throughout the state.

May is Mental Health Awareness Month, and a reminder that prevention, connection, and support can save lives. At ASTHO, we’re highlighting resources to help public health leaders strengthen mental health well-being in communities nationwide, like preventing Adverse Childhood Experiences ACE’s, suicide prevention efforts, addressing overdose, and preventing suicide. Visit the links in the show notes to learn more.

This has been Public Health Review Morning Edition. I’m John Sheehan for the Association of State and Territorial Health Officials.