What I’m Learning About Public Health Leadership From My Sons’ Youth Football Program

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What I'm Learning About Public Health Leadership From My Sons' Youth Football Program

Transforming Public Health for the 21st Century: Bridging Theory to Practice is a blog series that will explore the challenges and opportunities faced by the public health sector and will introduce innovative ideas and unique voices to support transformation. Sign up here to receive these summaries and more, and also follow KHI on Facebook, Twitter, LinkedIn, and Instagram. Learn more about the series on our archive page. Please feel free to share your feedback or suggestions with us by emailing [email protected].

At the Kansas Health Institute, our Transforming Public Health blog series is designed to cultivate a space for innovative ideas and voices that can create the conditions conducive to change in public health. We believe this approach supports change because it helps "unfreeze" peoples' perceptions about what public health is and what is possible. Kurt Lewin, the founding expert on systems change says this "unfreezing' is a requirement for change.​¹​Other experts in change have referred to this state as "readiness for change​²​" or "a sense of urgency.​³​"

To foster innovation, many of the ideas in this blog series stem from disciplines outside of public health, such as business or public administration. However, recently I found inspiration from an unexpected place - the football field. I've enrolled my nine-year-old twins in their school district's youth football program this season. Watching my sons during their first week of football practice, I saw a model of success in this program that holds valuable lessons for public health leaders seeking to build a better public health system. This school district has built a reputation as a Kansas high school football powerhouse, boasting multiple state championships and a consistent track record of players advancing to collegiate careers. This program's success is a testament to its strong foundation, disciplined coaching and a culture that emphasizes excellence at every level - principles that resonate well beyond the gridiron. These principles offer valuable insights for public health leaders striving to build a more robust and effective public health system. I want to share four key lessons that stood out to me.

A Winning Aspiration

In their book, Playing to Win - How Strategy Really Works, authors A.G. Lafley and Roger L. Martin say that a winning aspiration is the cornerstone of any successful strategy.​<_sup3d_22_22_>4​The winning aspiration goes beyond a mission or vision statement by defining what success looks like and setting a clear, ambitious target that inspires and drives the organization. In my son's football program, the high school coaches were clear when talking with parents about their winning aspiration - they want to compete for state championships every year. This is a much more ambitious goal than having a winning season, or even winning a state championship this year. To compete for championships every year requires them to look far into the future and make it a strategic priority to work closely with players who haven't even reached double digits in age yet, like my sons.

In public health, we often frame our mission around disease prevention, health promotion and protecting communities. We also tend to set realistic, but modest, goals for improvement; for example, we might strive for a three percent improvement in smoking or diabetes rates over five years. While these types of mission statements and goals may be useful for framing services or program planning, they seem to lack the excitement needed to galvanize enough people needed to create significant change. When addressing big public health challenges, like reversing Kansas' declining health statuscompared to the U.S., more exciting goals that can galvanize the people needed to create change are necessary.

So how might we create a true winning aspiration for public health in Kansas? The Kansas Health Foundation's strategic priorityto empower Kansas to lead the nation in health is the closest thing I've seen to a winning aspiration for public health in my 20-plus years in the field. This is something that personally excites me and that I can get behind. How could we use this aspiration as a call to action for public health transformation in Kansas?

Mastering the Fundamentals

My sons' football coaches emphasize the importance of mastering the fundamentals, such as the proper technique for tackling, how to block without holding, how to hold the ball to avoid fumbling and how to throw a perfect spiral. Every athlete practices each position on both sides of the ball. Across all the positions on the field, the coaches have set high standards for their athletes and are diligently measuring their progress in these essential skills. This approach allows the coaches to identify each player's optimal role and track their development over time.

The fundamentals of public health are embodied in the 10 Essential Public Health Services. Just as youth football players must master blocking and tackling, it is crucial for public health professionals and organizations to excel in assessment, policy development, assurance and equity. PHAB Accreditationis the gold standard for evaluating these fundamentals. However, there are alternative paths toward aligning the work of health departments with the 10 Essential Public Health Services. Just as my sons aren't able to do the same things as the high school football players, some health departments may begin their journey toward the 10 Essential Public Health Services through PHAB's Pathways Programor the Operational Definition of a Functional Local Health Department. These tools can help health departments integrate the fundamentals - the "blocking and tackling" of public health - into their work. Finding ways to move existing programs just a little more upstream is something any health department can accomplish.

Figure 1: The 10 Essential Public Health Services - The Fundamentals of Public Health

Teamwork

Perhaps more than in any other sport, teamwork is essential to success on the football field. This is evident in how the coaches work with the youth athletes on running routes and blocking assignments. For the football team to be successful, they must be coordinated and act in unison. It only takes one player to miss a block or run the wrong route for an entire play to go sideways.

Similarly, public health professionals and organizations must work in unison. While the adage, "If you've seen one health department, you've only seen one health department," is often celebrated in public health, these differences can create confusion among stakeholders about what to expect from their health departments and reduce coordination in addressing outbreaks or chronic disease epidemics that cross jurisdictional boundaries. When some health departments lack the resources or economies of scale to provide essential public health services effectively, collaboration and teamwork are required to advance the ball. Just as every football player must perform at their best for the team's success, it is crucial to have a high-functioning network of public health organizations in every part of the state.

Preparing for the Future

It's evident that the football program in my community is serious about its winning aspiration - to compete for championships every year. To bring this aspiration to life, they have intentionally connected current high school players and coaches with the youth athletes. By attending these youth practices, the high school coaches are able to provide the vision for the entire program. As the high school players work alongside the youth athletes, they offer mentorship and help to build a winning culture for the long term. Additionally, all the youth teams practice on the same field, fostering a sense of community and connection to the program's culture.

We can learn a lot from this in public health. While we have our conferences and associations, how are we preparing the next generation of public health leaders? How far ahead are we planning? How could we be more intentional about this? Across the country, the typical tenure of a state health department director is only three years, and for a local health department director, it's only six years.​^5,6​That means we need more than 170 public health leaders in Kansas every decade, and that doesn't count the various other leadership positions. Moreover, younger public health professionals are more prone to avoid or leave governmental public health.​⁷​The lack of advancement opportunities has been cited as a major reason for this.

Public health could learn much from this football program. Dynasties aren't built one year at a time. They last over generations. If we are to build a public health system for the ages, how might we be more intentional about connecting past, present and future public health professionals to create pathways to leadership?

Conclusion - Leadership and Embracing the Vision

While I may not know the full story behind how this football program rose to prominence, one thing is clear: the coaches had a vision for success and demonstrated the leadership needed to bring that vision to life. During my doctoral training in public health leadership, I became a strong advocate for the power of visionary leadership. A clear and ambitious vision is essential to align the efforts of all stakeholders and to inspire them to take on the challenging work required to achieve it.

Just as this football program united coaches and players across the entire school district, public health in Kansas needs a unifying vision that brings us all together. Momentum for this unifying vision is building. The Kansas Department of Health and Environment's Healthy Kansans 2030kicked off this work by identifyingpriorities for the State Health Improvement Plan. The Kansas Health Foundation and Kansas Public Health Association are leading a winning drive to bring attention to Kansas leading the nation in healthand reimagining the public health system for Kansas, respectively. To build on this momentum and move the conversation forward, KHI is collaborating with its partners across the public health system to develop a clear process for shaping and implementing this vision and actionable strategies for the future of public health in Kansas.

In public health, as in football, success requires not just a vision, but a collective buy-in to that vision that leads to every team member excelling in their role. Together, we hope to create a stronger, more cohesive public health system for Kansas - one that is equipped to meet the challenges of today and tomorrow.

References

1. ​​Schein EH. Kurt Lewin's Change Theory in the Field and in the Classroom: Notes Toward a Model of Managed Learning. Systems Practice. 1996;9(1):27-47. doi:10.1007/BF02173417
2. ​Weiner BJ. A theory of Organizational Readiness for Change. Implementation science. 2009;4:67-75. doi:10.1186/1748-5908-4-67
3. ​Kotter JP. A Sense of Urgency. Harvard Business Review Press; 2008.
4. ​Lafley AG, Martin RL. Playing to Win - How Strategy Really Works. Harvard Business Review Press; 2013.
5. ​Halverson PK, Lumpkin JR, Yeager VA, Castrucci BC, Moffatt S, Tilson H. High Turnover among State Health Officials/Public Health Directors: Implications for the Public's Health. Journal of Public Health Management and Practice. 2017;23(5):537-542. doi:10.1097/PHH.0000000000000639
6. ​Cunningham M, Patel K, McCall T. 2022 National Profile of Local Health Departments.; 2024. Accessed April 8, 2024. https://www.naccho.org/resources/lhd-research/ national-profile-of-local-health-departments
7. ​Leider JP, Castrucci BC, Robins M, et al. The Exodus Of State And Local Public Health Employees: Separations Started Before And Continued Throughout COVID-19. Health Aff (Millwood). 2023;42(3):338-348. doi:10.1377/hlthaff.2022.01251