On the Nature of Leadership

At 2011 RWJF Community Health Leaders annual meeting, local health heroes discuss what makes a leader.

    • December 7, 2011

Barely 12 hours after a joyous and tear-filled celebration of the 2011 Robert Wood Johnson Foundation (RWJF) Community Health Leaders Award recipients, the new awardees and their colleagues from previous years were back at work, trading ideas, making plans and building their networks.

Much of the discussion at the Community Health Leaders annual meeting on November 10 and 11 focused on the nature and origins of community leadership—how leaders are forged, what inspires them, what qualities they have in common, and how best to nurture their leadership qualities.

Of course, the group was no stranger to the topic, since each of the attendees had long demonstrated extraordinary leadership qualities themselves. For many in the group, personal tragedy or crisis served both as a catalyst to action and as a way to take something constructive from an otherwise painful experience. For instance, when newly named Community Health Leader Andrea Ivory was diagnosed and treated for breast cancer, she was reminded of the importance of early detection. So she created an organization in her hometown of Miami Lakes, Fla., that sends volunteers door to door, educating women about breast cancer and early detection, and connecting them to low-cost or free mammograms.

Ivory’s fellow award recipient, Zane Gates, MD, also found commitment from a personal struggle. After living in a public housing project in Altoona, Pa., as a child, he overcame daunting odds to get a medical degree. Rather than leaving his hometown behind, he returned to Altoona, opened a free clinic for the working poor and then founded Partnering for Health Services. Relying on volunteer doctors and a small paid staff, the organization makes health care accessible to about 3,500 people a year, most of whom make just enough money to be ineligible for Medicaid, but not enough to afford health insurance.

Mapping the Pathways to Leadership

Such connections to the community were one of several common “pathways” to leadership identified in a study presented at the annual meeting by Alberto J.F. Cardelle, PhD, chair of the department of health studies at East Stroudsburg University in Pennsylvania. With funding from the RWJF New Connections program, Cardelle surveyed 23 Community Health Leaders Award recipients working in rural communities across the United States, and conducted follow-up interviews with 12 leaders. His objective was to analyze the pathways and factors common to the group, seeking to discover what was most significant to their taking on leadership roles in their communities.

As Ivory’s and Gates’ cases illustrate, an early life experience was a typical catalyst. Writes Cardelle, “The rural Community Health Leaders participants’ pathways to leadership show a strong tendency to have been influenced by early life experiences, either though exposure to social injustice and/or an activist family member; then followed by an iterative period of networking, skill-building, success, crisis and vision.”

In addition to such broad life experiences, Cardelle also identified common traits among the RWJF Community Health Leaders, including “passion for an ideal”; experience with networks of people and organizations, particularly those that exposed them to government entities and other leaders in the community; problem-solving skills; and a history of seeking positions of leadership.

Cardelle’s findings were echoed in another New Connections-funded study by Hanh Cao Yu, PhD, of Social Policy Research Associates in Oakland, Calif. She interviewed Community Health Leaders one-on-one and in groups, and reviewed background documents related to the individual leaders. Her focus was on the influential forces and defining events that shaped the Community Health Leaders.

The research pinpointed a number of specific life experiences that Yu deemed formative. For example, many of the Community Health Leaders trace their commitment to their current work back to their youthful devotion to community service. For many, living abroad or immigrating to the United States served not only to equip them with linguistic, social and cultural tools that proved useful, but also “increased their commitment to diverse communities in need.” Other common experiences included powerful youth programs and inspiring mentors in higher education, and many reported that growing up during the Civil Rights Movement was critical to their development as leaders.

The Community Health Leaders in Yu’s research also reported that the awards themselves played an important role in their work. Yu writes, “For many of these ‘unsung heroes,’ receiving this prominent award by a distinguished national foundation gave them a new lease on life and a credibility and financial boost to their work on the ground. While these leaders would have continued with their remarkable work regardless, they describe the award as impacting their leadership trajectory in many different ways, including personal impact on them as leaders, skill-building, networking, organizational impacts and leveraging of the award in organizational development and programmatic work.”

In a question-and-answer session following their respective presentations, Yu and Cardelle noted a handful of other common qualities. Yu noted the importance of being leaders rather than managers, pointing toward the importance of identifying, clearly articulating and remaining focused on a vision. She also took note of leaders’ willingness to make mistakes and learn from them. Cardelle identified another quality, which he described as the ability to construct and follow “mental maps” that allow leaders to navigate complex social and political networks, finding and following paths that allow leaders to maneuver their way toward their objectives over time.

Inspiration, Perspiration, Insanity

Later in the conference, Martin Iguchi, PhD, dean of the Georgetown University School of Nursing and Health Studies and a member of the RWJF Community Health Leaders National Advisory Committee, returned to the question of what makes a leader. He told the group that in his experience, Community Health Leaders had often experienced some moment of inspiration, either flowing from a single event or an accumulation of events that “brought you to a place where your role was made evident to you.” That, he said, was followed by equal measures of perspiration and persistence. He noted also that Community Health Leaders were also unusually “mission-focused.” “You’ve had the values embedded,” he continued, “and a real sense of the importance of what you’re doing. It’s a guidance that tells you, ‘this is the right thing to do,’ and you’re going to keep on doing it…. This is a quality that we can’t always train.”

Iguchi also observed that Community Health Leaders usually combined a sense of social justice, “articulated as the right to affordable health care, the right to have a say in that care, and the right and responsibility to advocate for that care,” with an understanding “that even though it feels wonderful to give, it doesn’t always feel that good to get. So you have to allow the people you’re serving to give, and to respect them for that. Only in that reciprocal relationship, where you value them as equals, will the activity continue because, in the end, they’re the ones who carry the torch.”

Finally, Iguchi joked that a small dose of “insanity” might also be a common trait. He told the group, “You’re all a little bit crazy, because every one of you set off on a path that people kept telling you wouldn’t work…. But you had that clear vision.”


Now in its 18th year, the RWJF Community Health Leaders Award elevates the work of the leaders by raising awareness of their extraordinary contributions through national visibility, a $125,000 award, and networking opportunities.