State Health Officials—Defining Success and Identifying Critical Success Factors

Laws Governing State Health Official Appointments: A Legal and Historical Review

“…The majority of this research occurred prior to the COVID-19 pandemic and primarily comes from the SHO-CASE Study, which involved a 2017 national survey of current and former SHOs. [17][18][19][20][21][22] This body of research found that SHO tenures have decreased over time and that 54% of SHO turnovers (prior to the COVID-19 pandemic) were involuntary. 21 Given the late-19th-and early-20th-century roots of most laws governing the establishment and leadership of state public health agencies, it is not surprising that a frequent statutory requirement to qualify as an SHO has been possession of a medical degree.…”

“…20 Furthermore, current and former SHOs report that the skills they need the most are focused on core public health competencies, managing large organizations and budgets, and navigating the policymaking process. 17,18 The current study presents the legal epidemiological review of the SHO appointment laws, including the evolution of educational and experience requirements of SHOs over time. Findings from this study provide primary empirical evidence that can inform the discussion about state laws and the substantive, multidisciplinary qualifications essential to successfully leading state public health agencies in the 21st century.…”

“…The second category of research is focused on SHOs and their backgrounds, experiences, and tenure. The majority of this research occurred prior to the COVID-19 pandemic and primarily comes from the SHO-CASE Study, which involved a 2017 national survey of current and former SHOs 17–22. This body of research found that SHO tenures have decreased over time and that 54% of SHO turnovers (prior to the COVID-19 pandemic) were involuntary 21…”

“Relationships, Relationships, Relationships”: Promoting Population Health Collaboration Across State Government

“…In a 2016 valedictory, Paul Jarris, longtime executive director of the Association of State and Territorial Health Officials (ASTHO), wrote about the type of leadership public health officials require to be effective: “Cross-sectoral leadership is essential to transforming the health of the public. Health officials must not only take the time to understand the values of their partners, but also learn to speak their language.” 1 (p106) * Halverson et al 2 argued that success for SHOs could be measured in terms of internal team building and organizational accomplishments, including the creation or enhancement of formal relationships with the governor, cabinet members, other government agencies, and oversight bodies. Critical success factors for SHOs include “experience in government, experience working with the political apparatus, experience operating in the ‘public eye,' and experience in public health/population health.” 2 (p193)…”

High Turnover Among State Health Officials/Public Health Directors: Implications for the Public's Health

“…Leadership is important to the success of any organization, especially SHAs; however, the lack of study makes defining, supporting, or improving this position challenging. 9 This study seeks to begin to address this gap by documenting turnover of this important position in state government. This article presents compiled information related to tenure of the 507 individuals who served as an SHO in the 50 states and the District of Columbia from 1980 to 2017.…”