Leadership in Public Health: New Competencies for the Future

In Contemporary Public Health, Keck, Scutchfield, and Holsinger call for changes in vision among those leading the evolution of healthcare from individualistic to community-wide approaches to improve health status (1). Having new vision is necessary but not sufficient; new leadership skills are also needed in order to implement and sustain change. This article summarizes our thoughts about new competencies essential to moving our community’s health system to meet the demands of public health in the twenty-first century. Since the start of the New Millenium, “public health”has emerged from a behindthe-scenes discipline to a widely recognized leader of community and global initiatives. Concurrently, the healthcare delivery system has embraced “population health” as fundamental to achieving success in its traditional role of caring for individuals (2). These trends have challenged those leading both sectors and created a context that promotes innovations in collaboration. The County of San Diego is an excellent example of the successes and challenges of such collaboration. Those leading new alliances and partnerships have had to be nimble, courageous, and innovative. They have had to learn new content and develop new leadership skills. San Diego’s health environment has a wealth of proficient leaders and highly skilled managers, as well as strong universities with programs in all clinical professions, public health, and healthcare management and policy. This article combines the insights of three senior leaders on the changes required in our own leadership based on the evolution of the environment, suggests the “competencies” required to deal with those changes, and recommends how these competencies can be taught and/or learned. Our comments are framed in the academic jargon of competencies, include “knowledge, skills, and attitudes,” but recognize that, in the practitioner’s world, these competencies are viewed as practical techniques for orchestrating change and achieving performance. The immediate context of our work is San Diego County, California.