What's Changing in the Practice of Public Health: A NewPublicHealth Q&A with Lillian Shirley

Jul 21, 2011, 12:04 PM, Posted by NewPublicHealth

Do you work in a local health department? Please share stories from your departments here with the Robert Wood Johnson Foundation.

NACCHO President Lillian Shirley, M.P.H., M.P.A., was a featured speaker at the Town Hall meeting that kicked off the NACCHO Annual 2011 on Wednesday. NewPublicHealth spoke with Shirley about her work as the director of the Multnomah County Health Department in Oregon and the NACCHO conference and her goals for the meeting.

NewPublicHealth: How has the job of a health director changed since the time that you’ve been the director?

Lillian Shirley: I think it has changed in a couple of ways. One is we used to be the people who were the super managers of programs in a variety of areas--maternal and child health, environmental programs, disease programs--now we understand that our job is much more geared toward looking at systems and integration of systems of care rather than just program by program. I also think the other thing that’s a big emphasis in the last ten to fifteen years has been real collaborations with communities--not just as recipients of our services but as full partners in having those communities participate with us in defining what our vision will be and what our goals will be. And then also, I think that we have, through pushing public health as health in all policies and getting people to understand the social determinants of health, that we’ve really expanded our partnerships and our sense of who our peers are in our communities in creating health beyond hospitals and health systems to transportation systems to planning departments, working with them around built environments and zoning and housing codes and expanding our whole understanding of what public health actually means.

NPH: Can you tell us about Multnomah County’s new Healthy Eating program?

Lillian Shirley: It’s a very broad coalition. We’ve looked at it as kind of a healthy active living with healthy eating choices and the part of the campaign that’s focused on foods and food choices has been really multi-sectored. So we’ve partnered with our local media outlets for our media campaign that will be presented during the conference. And we’ve also looked at the policies that these kinds of issues raise. So we’re working closely with our school systems, with providers of large institutional food services, as well as the individual choices that you can make every day. We’ve looked at it as a holistic approach--it’s not just about me getting off the couch and eating an apple everyday, but it’s about working with the reasons that it might be hard for someone to get off the couch or to find an apple in the fridge, as well as changing the social norms of what is offered and what are the kinds of conditions that people think about when they think about making healthier choices.

>> Watch a video about Lillian Shirley’s work as health director of Multnomah County

NPH: What are your chief goals for the NACCHO Annual?

Lillian Shirley: The most important thing at the conference is for people to get together to really understand what is out there, what is new, what is changing in our practice of public health. Attendees should make sure that they are able to meet with other people--their colleagues--to share their stories with them, to see how people are implementing some of these important new changes, both through the Patient Protection and Affordable Care Act and in the recently announced National Prevention Strategy.

NPH: Do you have a networking story of your own from an earlier meeting that benefited you in your work as a health director?

Lillian Shirley: I actually do. When I was promoted to Director of the Public Health Department in Boston--I had worked there in different capacities and different areas for a number of years--but there I was, I was the director of the department and that kind of changes the work that you do and changes your responsibilities. And one of the main things I think is that you are then the person who’s responsible for looking down the road and being able to figure out what it is that you should be focusing on and what does your department need to learn for the future. And I remember going to a meeting that first year and there were two health department directors there who were both a bit older than I. One was from Fulton County, Georgia and the other from Columbus, Ohio. They really were very generous with their time and made me feel more comfortable and confident about my own skills and they were encouraging me to really bounce off of them things that I had questions about so that I could raise certain issues and get some opinions outside my own work environment. And I will be forever indebted to them because they were so generous with their time and they were very supportive and very encouraging.

NPH:What tips do you have for attendees of the conference on how to get the most out of the meeting?

Lillian Shirley: Take some time to review the program. Really stretch yourself to go to something that you might not know a lot about, something that you might not understand. But probably the most important thing is to take absolutely every opportunity to meet with colleagues from around different parts of the country, different states, different areas, and hear their stories and share and discuss what is being presented from national leaders and policy leaders. What does this mean to us? Knock that around a little bit from different perspectives.

>> Read full NACCHO 2011 coverage here

This commentary originally appeared on the RWJF New Public Health blog.