Stan and Clarence chat with Jan Malcolm - an experienced public health practitioner - about public health leadership. Jan Malcolm has an extensive 40 year career in public health leadership across public, for-profit, and not-for profit sectors. Additionally, the former Commissioner of Health has served across 3 different governors - Ventura, Dayton, and Walz - representing both political parties. Malcolm was also one of the first health care leaders to highlight health disparities and the impact of the social determinants of health. She laid the foundation for health legislation aimed at reducing health disparities in the state. Listen along as Jan Malcolm sharers her experiences and exemplifies what it means to be a public health leader.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at http://huemanpartnership.org/
Hello, everybody. Welcome to Health Chatter. Today's show is going to be a really great show. Actually, all our shows are great, but this takes it to another level. On public health leadership, past, present, and future, we have an illustrious guest with us today, Jan Malcolm. I'll get into her logistics in a minute. I want to thank our crew. As I always do without them, we would not
Be as successful as we have been. I believe this is our 66, 65, 66 show. So it's going going strong. Maddie Levine, Wolf, Aaron Collins, Deandra Howard. and Sheridan Nygaard all do are responsible for getting some background research together and great talking points for both Clarence and I. So thank you to you two. Sheridan also helps us with our marketing.
And then Matthew Campbell is our tech guru who takes care of everything technical to make sure that these shows get out to you, the listening public. So many, many thanks to you. You're the best team ever. And then, of course, Clarence Jones is my great colleague in this endeavor. We've been having a lot of fun doing this.
He comes with a really good breadth of background in community health, and I greatly appreciate your insights and perspectives. It's a wonderful partnership, and I really appreciate it. And then, of course, there's H-U-E-M-A-N Partnership, which is a community endeavor focusing on health-related issues for all of us, actually, and we hope that All of us can listen to their insights.
You can check out their website at humanpartnership.com.org. I always say com, don't I?
Yeah, you do. .org.
.org, okay. But they're a great, great organization, and many thanks to them. So today, everybody, Jan Malcolm. Jan and I go back a long ways. I remember, Jan, when you were at Health Partners. So that really goes back a way. But it's been a great collegial relationship these years. We've seen a lot of things come and go in public health and in medicine. Jan's had over 40 years of public service
and continues to have a great positive influence. She's gonna be leading up or maybe in the midst of leading up an initiative to address the issues of health sciences at the University of Minnesota. And I think that group has got kind of a deadline of what January to get your decisions made. So Jan, Jan is leading that effort, so thank you for that.
She served under three governors in the state of Minnesota, for those of you who do not live in Minnesota, Governor Ventura, Governor Dayton, and most recently, Governor Tim Walz. And it's also interesting representing two different political parties over that course of time. Wonderful health
policy expert that comes with great background, not only in the true government arena, but also she was involved with health partners here in the state of Minnesota, Alina Health. She was the CEO of the Courage Center here in the Twin City area. So, wow. Wow. Great, great career, great career. And recently retired, and I see a smile. So that's great.
So Jan, thank you so much for being part of Health Chatter. And really, this is a chat. And we're going to be focusing on the concept of leadership. And it's probably easier, I'm hoping it's easier, to reflect on it than to talk about it when you're in the midst of it, okay? If you get my drift. I do. You understand. So, all right. So, let's start out this way. Health leadership overall.
So, you know, with all the different things that you've been involved with, give us your perspective on it. What, as, you know, as somebody who's led a lot of different things, but Truly, what is your perspective on leadership and health from all the different things you've been involved with?
Well, first of all, thank you for inviting me to join you and Clarence in this conversation. I think it's a critically important topic, leadership in general, but leadership in health, leadership in public health, particularly now, given what we've just been through and the time that we're in, there is so much we need to learn.
from what we've just been through and figure out how to take those very hard won lessons through the COVID-19 pandemic and apply them not only to being more ready for the next health emergency, but how do we improve what we do every day to serve the people that we serve, which is everybody.
And I think too, that, you know, the one thing I know for sure is that it is not true that leaders are born and not made. I think there needs to be intentionality to to thinking about what is leadership? How do you get better at it? Nobody just, you know, kind of comes fully formed as a leader, no matter your training or your experience. I think there are always ways to get better.
I do think that there are certain characteristics that help one to be a better leader, but the characteristics alone don't make you a good leader. And by characteristics, I guess I mean things like, I think actually there are values and there are personality traits, if you will, or styles, and then there are skills. And I think those are three different things.
But how you marry them together, how you take advantage of any, how you, first of all, I think it's a lot easier to lead and to lead authentically, which is a key word, I think, authentic leadership. People can sense it if it's there and if it's not. But what makes an authentic leader, I think, is somebody whose work is aligned with their values.
And who who kind of is intentional about how you how you use the traits that you either naturally have or that you learn over time and then being being really attentive to where, you know, where your skills are the strongest and where they're not. So I think, you know, kind of on that front of values to me and I feel so lucky to have had a career in health policy and public health.
because that is just an exceptionally well aligned with my personal values, especially the field of public health, what we're all about really just resonates with me and makes it easy to love this field and the people in it because we do share this deep values connection about social justice, about thinking at a very kind of ethically driven
equity-driven look at how society is either helping or harming people's ability to be healthy. I just have always felt so at home, actually, in this field and with these incredible colleagues that I've had. I think some of the traits that are important, again, I think top of my list is authenticity
and empathy, really genuinely caring about the work that you're doing and the people that you're doing it for and the people you're doing it with. And I think another trait that I would call out, probably especially from the last few years, is persistence. Because nothing that we do in public health is necessarily easy.
And nothing, I think we've learned this the hard way, even when we make great progress, that progress isn't, it's not a given that that's always going to last. You sort of have to keep remaking the progress and building on it. So I could go on and on about values and about traits, and we can go any way you want on that.
I'm not going to try to make a comprehensive list, but just wanted to kind of get across the point that I think it's helpful to be cognizant of You know what are the values are they aligned, what are some of the traits that you can draw on which might be different in different circumstances, and then the skills question and maybe we'll we'll go into that you know, through this conversation.
you know, but certainly communication, coalition building, kind of political acumen. I think, you know, we could go on and on. I think skills around emergency preparedness, oh my heaven, have we just learned, you know, how important that is, not just to read the book, but to, you know, practice that, I think, in a much more robust way than we've ever done before. So,
You asked me a really open-ended question, and I could go on the whole novel with that, but let me stop there.
I'll tell you, when you said authenticity, that really rings a bell. It really, really does. You really have to embrace that in order for you to move ahead properly in the healthcare field. I will tell you this now. I'll let Clarence chime in. I saw you speak many, many times in many, many different situations.
And it always struck me, you as a leader, I always had this sense that you were listening ever so carefully, even in an open forum, listening ever so carefully. And getting that sense of appreciating the other point of view, which I think is an incredible leadership attribute. You don't have to agree with it.
Mm-hmm.
but you can appreciate at least their perspective. And then hopefully from that go forward. The one thing I can say is that I don't care what side of the aisle you're on or whether or not you agree or you disagree with people. The bottom line is we all want to be healthy. And so that's something that we all carry. Clarence, go ahead.
Yeah. So, Jan, let me first thank you for your comments. You know, you asked all my questions all in that opening statement. But I think one of the things that I really wanted to know was this. What type of skill should be demonstrated by a leader? during a crisis? I mean, what do you think are the top maybe three or four skills that should be demonstrated by a leader during a crisis?
I mean, we just came to this COVID piece, this pandemic, and it seemed like people were all over the place. And so for me as a community member, what are the skills that I should be looking for from my leader going through a crisis or just in general?
Well, yeah, thanks, Clarence. You know, I think in a crisis in particular, communication is essential. That was probably the main job that I, as the leader of the state health department, had was to try to keep the lines of communication flowing between the scientists and the policymakers, between the quote-unquote experts and the public, with the media, with the legislators.
And to Stan's point, being able to not just say, here's my speech, I have to deliver these facts, to listen to people, to listen to the community. As I know you know, Clarence, this has been a devastating pandemic in many ways, but it absolutely further kind of illuminated and exacerbated, I would say, all the flaws in the system.
And so that people who've been disadvantaged and experienced inequities for so long on so many different fronts, it happened again with COVID. And so, understanding and listening to the community about what about our response? As hard as we were working and trying, what about it wasn't working for the communities that were at some of the greatest risk?
And to be not in denial about that and to really seek out honest conversations
with communities who were disproportionately affected, and then to Stan's point, on the other end of the continuum perhaps, the folks who really were having a hard time believing that COVID was as big a deal as we were saying, whether those were folks in the business community or folks who were just very concerned about the role of government in all of this, hearing that incredible,
variety of experiences and perspectives and being able to try to navigate your way through how do you effectively communicate with folks who are in such different places in terms of how this is affecting them, what the reality is of their point of view and their circumstances. So You know, there's many more things, obviously, about kind of keeping a cool head and trying to help keep people going.
You know, so many people worked their hearts out for so long and how to support them, how to encourage them. But I would say, you know, kind of that trying to help people keep it together from an organizational health perspective. And then... this multifaceted communication challenge, those would be probably the two things I'd call out.
Thank you. No, it's interesting. During COVID, you know, I'll be honest, I was considering, you know, retiring before that hit. And then when it hit, you know, as a public health professional, and by the way, I can probably say that this is true for a lot of people, certainly at the health department. they put off retiring or they put off this or that so that they knew that they could help.
Because that's what it was all about. I mean, if you're not there for that, I mean, what was your public health career all about? Right. But it was intense. You know, none of us at our age ever lived through something like that before. All we could do is go based on history of what happened like in 1918 with the flu. So here's a couple of other questions I have. How do you balance?
And this has always been a kind of an issue. How do you balance the avenues of medicine? with the avenues of public health as a leader on the public health side of the equation. Because there's always that integration that needs to be done and that collaboration that needs to be done. But oftentimes they're in their own ways. How did you deal with that?
Well, you know, when I said there are so many lessons we need to learn or we must learn, I think, from what we've just been through, there's a lot to unpack in that question of how does the medical care system and public health
um best interact um you know and i think there's a lot of specific experiences we had through covid that uh that can help us um deepen that understanding i you know quite honestly i think when it came to particular things about the pandemic response our respective roles were not clear Who should do what? Who is in the best position to stand up all that testing and do the mass vacs?
And, you know, are those the things we typically lean on healthcare for? But healthcare didn't have the capacity to do it, nor, you know, in some respects, did they have the incentives to do it? Crazy as that sounds. So, but we haven't built a public health system to be that safety net when it comes to the delivery of some of those services. So should we?
You know, and how do we kind of put some surge capacity back into the public health system and into the healthcare system when that's systematically been squeezed out over years and years and years of... of resource constraints and short workforce and all the rest. I think we absolutely learned how interdependent we are on each other.
I mean, healthcare could not succeed unless public health could succeed in trying to keep as many people from getting sick as possible and to get the the preventive measures in place. Politically, we absolutely needed the healthcare system's support to say, we have got to do some of these things at the community level to try to restrict the spread because we can't handle
this surge in volume if we just let this thing rip through the society. Certainly, we couldn't succeed in keeping the public healthy if healthcare didn't have the capacity to take care of the people that inevitably were going to end up needing Needing acute care.
So I mean, to me, this was a wake up call that we better have some deep conversations about what our respective roles are, how we can best support each other. where we need to beef up the resources, because I think we'd be naive at best to think that this was only a once-in-a-hundred-year thing. Correct. No way. We know.
I mean, the virologists know how much is sort of out there, able to do what COVID did at any given time, just given the globalization of of the economy, of the world. It's a much smaller world than it was in 1918. And climate change is absolutely a driver of what we're seeing with viruses. So we got to be more ready. And I think that takes a deeper conversation about
what went well, what didn't go well, where did we kind of spend time and lose time trying to negotiate who should do what and figure that out and then support each other. Healthcare needs to show up for public health.
to say, you know, we need public health to be strong and we need them to have resources and we need them to have authority and we need, you know, they need to see the degree to which our capacity in public health is necessary for them and vice versa. I mean, I think we should be like seriously kind of really pretty concerned about what we've just seen about the fragility of the healthcare system
um in terms of surge capacity or lack of surge capacity um you know and and the workforce shortages that are popping up all over the place that's a shared problem right but we don't we don't typically you know we typically you know kind of public health's over here and health care's over here and we're looking out for ourselves we gotta look out for each other to a greater you know um
As you think about it going forward, it seems to me that what COVID provided us, maybe there's a silver lining in it, is a quick opportunity for lessons learned. But we have to act on those lessons learned. We have to somehow or other coalesce those lessons so that, frankly, quickly, so that we can take advantage of them before we forget what they are.
And then another thing happens, and then, oh, my God, then we're in the same ballpark again.
Yeah, no, I think that's exactly right, and that's one of my biggest worries, actually.
Right, yeah.
This was so disruptive, you know, so bad. Everybody just wants... Nobody wants to talk about this except the three of us, maybe. It's like, don't say COVID anymore. And I think... we, we do have a, you know, a window here to try to, I agree while things are still fresh to have some candid conversations, but it's, you know, and I understand why people aren't so very eager to, to go there.
Cause it's, it is, it's hard. Yeah. We're recovering from it. It's, you know, it brings back some pretty, pretty bad feelings to, to reflect back on it. But, but boy, I sure hope we do.
Yeah. Clarence, and then I want to talk about chronic disease. Go ahead.
So as a community member, I agree with you 100%. I'm out in the community doing work, and I see this gap between what I call biomedical and public health. And it's like nobody wants to really talk about it. Everybody wants their own silo. What I want to know from you is what tips –
do you have going through this crisis for both the community and public health leaders to discuss in order for us, as you just said, to not have to repeat all of these lessons over again?
Yeah, you know, I really do think that we can use some of the specific things that we saw in COVID to illustrate things we've been talking about for quite some time about, you know, the fundamental need to work on the community conditions that support health or that don't support health, that it isn't all about the biomedical, you know, end of the continuum.
It's about what really determines health. It's not just can you get to the doctor when you need to, essential as that is. It's about the conditions in your community, about people's economic security, their physical security, housing, the environment, the access to resources.
And I think we saw that in who was disproportionately exposed to COVID and who was disproportionately affected by the severity of it. And so taking some of those just really, you know, practical lessons learned about the importance of the housing conditions, the working conditions. Could you get access to tests or not?
Did, you know, how did we do at getting, you know, testing, vaccination and therapeutics into the communities that were the hardest hit? You know, I think we've got some really tangible examples, you know, when we kind of talk about the the social and economic determinants of health in a theoretical way, people just don't really quite get what we're talking about. But when we say,
look at the patterns of how COVID moved and how much that was influenced by things like housing conditions and working conditions and multi-generational families and the lack of good quality ventilation in buildings and all of that stuff. I think we just reflect on, okay, what did we see and how do we talk about that in ways that policymakers and other influencers
can can see the need to really invest in those community conditions and not just you know as important as it is to say boy we need more nurses and doctors yeah we do and that's not enough right you know we need we need to to pay attention to these community conditions way differently than we have so ask a question let me let me ask you a question because i'm i'm intrigued now by the fact of how you've been responding uh
Who was your inspiration? What was your epiphany with the way that you're thinking? Because I think that it's important for me to know, and I think it's important for people to hear that, because I think the things that you're saying, we need to hear more of.
Wow. So many inspirations along the way. But, uh, you know, I, I go back to, I mean, many years ago, I was a much younger person, you know, somebody who really inspired me a lot was Dr. David Satcher, former surgeon general of the United States.
I mean, I can remember him, you know, talking about this, you know, kind of the social determinants of health before very many people were using that terminology. Um, You know, and he would talk about I can remember vividly a speech that he gave. He was talking about how this was in the in the 1990s, talking about how unacceptable infant and maternal mortality rates were back then.
Yeah.
And he said, you know what the most important factor is for infant and maternal mortality? Maternal income security. I was like, whoa, you know, light bulb just kind of went off. It's not just prenatal care or not. It's that more fundamental, do people have what they need to be safe and healthy? And so he really was, he sort of put that spark in me, you know, early, early on.
And since then, it's really been, you know, leaders in the community, many of whom were were rightly kind of critical of kind of what we were doing with the response. And this is a dilemma, I'll just call it right out, between focusing on the largest number of people versus focusing on the biggest degree of harm, if you will.
So the whole tension between how do you deploy the resources from an equity perspective
Um, you know, whether we're talking about testing or vaccination, you know, how do we, how do we prioritize the populations that, that are at the greatest risk while the, the other side of the coin is saying, but you got to get the countermeasures and, you know, as broadly spread as possible, as fast as possible. And that kind of makes you do these sort of more, more untargeted mass events.
And, and so that, you know, I, and I, you know, I kept being challenged appropriately. So by leaders in the community saying, this isn't working, you need to do more to get the resources deeper into the community. You know, and, and I mean, the, the, the, I will just call out, you know, kind of the black religious leaders, you know, the, the, the, the churches, the pastors, the,
You know, and the folks in service organizations like yours, you know, working with communities to try to get communities access to the resources and to get the resources deeper into communities.
I think we got better as we went, but it was always a challenge to, you know, to get that balance between the big, you know, the big P population and the more targeted communities where the needs were particularly great.
You know, it's interesting. I remember, you know, one that inspired me was C. Everett Koop. He was another, you know, a Surgeon General. And I remember distinctly, I was at a presentation that he gave and somebody asked him, and we were dealing with smoking and all that kind of stuff. And somebody asked him straight out, what should we be doing? And his answer was,
I thought really just, I don't know. That's up for you guys to decide now. Take this torch and run with it. So, you know, it was really inspirational, you know, from somebody who had that much clout to be able to kind of give the work off to you and be, you know, be creative and be good risk takers. So these were good people. Okay, so I want to talk a little bit about chronic disease.
Let's get away from COVID because, you know, while all of this COVID stuff was going on, the pandemic, guess what? We were being affected by the stuff that affects us every day, okay? You know, we still had people, you know, having strokes and people having heart attacks and people suffering from diabetes, et cetera, et cetera, et cetera, cancer, et cetera, asthma,
Yet it appeared to me that certainly at that time, everything was kind of put into a holding pattern for everything else. I mean, we even saw indications of that in the hospitals where people were presenting themselves who were apparently having a stroke or a heart attack. And how did we find out about them?
From the funeral homes because they didn't get the care they needed and they eventually died. So this is what's always struck me. And this is maybe a question that you can address for us. It's what should a state health department really be responsible for?
So in the scheme of things here, it's just like, you know, much of the funding for many of the chronic diseases, frankly, doesn't come from the state. It comes from the federal level through grants that we receive there.
But if those grants never were, if we never got them, frankly, I could tell you from experience, we would have been in trouble as far as dealing with cardiovascular disease for the citizens of the state. So what, literally, how is it, you know, from a leadership standpoint, should... what should we be doing to assure the health of our citizens?
How should the state be responsible for it financially, et cetera? And the bottom line is what should be the core responsibilities of public health?
Well, I think that is, you know, that's a question, that too is a question that really needs a lot deeper discussion. I mean, we've, to your point, public health is hugely underfunded. No matter what part of the public health Absolutely. Infectious disease is underfunded. Emergency preparedness is underfunded. Chronic disease is certainly underfunded.
You know, analysis and planning is certainly underfunded. So it's it's kind of I think where we in public health are kind of expected to do all of it. But but really without any appreciation of of. what it takes to do it, to do it robustly and well. I can remember you raised tobacco as a great kind of lesson, if you will, of how this works.
I can remember in my first term at the health department with Governor Ventura, it was right after the tobacco settlement. And, you know, so we had this boatload of money coming from the tobacco settlement with kind of lots of differences of opinion about how that money should be spent. But very little support for spending it on prevention. Oh, let's spend it on cancer treatment.
Intervention.
Yeah. Let's, yes, exactly. Let's, you know, let's help people stop smoking. Well, yes, let's, but let's. try to work on the prevention side as well. And I think we had some real successes there because with that money and with, frankly, Governor Ventura's support, we were able to get more money put into the prevention side than we ever had before. We went from funding our
our anti-tobacco efforts at a couple million dollars a year, which was like, if that's all you're going to spend, frankly, why don't you save it? Because it's not going to make a difference. It's not going to move the needle at all if you're battling against all these bigger forces that are much more
successful in uh in getting people to smoke on the marketing side or use tobacco commercial tobacco but but when we could really appropriately resource it we actually produced some pretty good results it wasn't just the money but it was this multi-layered strategy of understanding oh you got to work at the individual level you got to work at the family the community the policy level
And we had all these things kind of working in synergy. And we dropped youth smoking by 30 percent in about five years. It was like, wow. And it was a combination of lots of different strategies. So to me, that just sort of says we and I think we did it again in the pandemic with a lot of resources. We moved mountains in a hurry. We can do it.
But it takes it takes resources that we don't typically have in public health. So in chronic disease, I kind of went off a little bit there on a tangent, other than the point being our role is prevention of chronic disease.
And that's where, again, I think we need our healthcare colleagues to say, we have to be working at the population level to try to reduce these risk factors overall, because just trying to remediate or treat or cure at the other end is going to overwhelm us.
And because, you know, people just like, well, you know, if I get diabetes, I'll take the drug, you know, or if I have a heart attack, the hospital will save me. You know, I mean, that's sort of how we think about, you know, kind of our individual perceptions of risk.
And, you know, and I think a lot of folks in the legislature, for example, think, well, the chronic disease, you know, managing that, that's healthcare's job. We want you public health people to, you know, you do this emergency stuff because we just saw that we really need you to do that. You stop the outbreaks. And healthcare should deal with chronic disease.
But I don't think healthcare is set up to do that. Not the way healthcare is paid for. So I think a lot of this, I know this is kind of wonky, but so much of this comes back to financial incentives and how the healthcare system is paid and how the public health system is funded or isn't, that we just really need to, you know,
to have a much more specific question about, and I think we've got good roadmaps from CDC and others about what would it take to fund things at a robust enough level population-wise to to make a difference. There are recommendations about what should public health funding per capita be? No state is close. If we really wanted to intervene on the upstream end, how much more should we
Should we invest upstream? You know, I mean, it's still, what is, maybe you guys know the current data better than I do, but it's, you know, what is it still like 97, 98% of all the dollars are going into the intervention and a pittance is going into prevention. Well, you know, guess what? Part of the reason that other countries spend less money and get better results than we do.
They put more money into it.
They put more money, not only into kind of classic, you know, classic, if you will, public health, but also into what we were talking about earlier, the social determinants of health, the social net is stronger in places that invest more in housing and economic development and, you know, on and on.
And so I think the economics are actually on our side, but we got to really sharpen our arguments around that and broaden the coalition of people who can see that picture and see how all these things really are so interconnected and start to move more of that money upstream, because we will all suffer from it.
You know, it's interesting. When I was teaching in this arena for a long, long time, um we often discussed you know with with students you know the avenues of medicine the avenues of public health and how how poorly funded public health has been um and and it can and then i can't tell you that was you know 30 years ago we were we were we were talking about there were more um
And it's still, and I often said, I remember speaking to students and saying, you know what, public health isn't as sexy as medicine. You know, when somebody goes in and they're sick, and they're really sick, and somebody fixes them.
Yeah.
That's pretty sexy. You know, that's pretty cool. You know, okay. But what, okay, now what do you do in public health? Well, we never could communicate it very clearly exactly what we were doing. Prevention is two kind of big picture stuff that people can't get their heads around as well. And that's still with us. That concept is still with us. Clarence, go ahead.
So I'm gonna ask you this from a community perspective, okay? A community is often pointing fingers at medicine and at public health about its issues. My question to you is, what should the expectations of public health be for the community?
Great question. Well, I think we need to be partners. And the critiques are a part of that. You know, like to help us understand what isn't working from the community's perspective. But then we also need...
for community organizations, community leaders, community members to kind of embrace their role in changing some of the conditions so that it's not all like, you know, you out there, you government people, you need to fix this. It's like, how do we fix it together? You know, how do we
how do we get the community the resources and the support, but also look to the community to lead and to learn how to Let me take that back. It's not about learning how to take responsibility, because I think community knows that a lot, but how to exercise some of the The muscles, if you will.
Yeah, okay. This is one of the biggest issues for me in terms of this whole idea about having healthier communities is that I think sometimes the expectation on communities from healthcare leaders is not enough. I think that people are afraid of being critical and saying that this is not working or people are afraid of being, of hurting people's feelings when we have these diseases.
And yet by not being, by not having higher expectations, people are dying. Okay. So the question I'm really trying to see is that I know that many times people have their favorites. It's easy to go to these organizations and give them money because you are accustomed to them.
But I'm wondering about the the increase in the accountability and the responsibility of organizations in order for us to really address these issues. Because I think, you know, one of the one of the concerns I always have is that, you know, the state has put 50, 60 million dollars in a certain zip code for the last 40 to 50 years. And people are sick of how they've ever been.
That makes no sense to me. That makes no sense to me. And so I'm not getting on the soapbox. I'm just saying, I just want to kind of figure out how then do we have this, this honest conversation, talk about authenticity. We have this authentic conversation about what is really needed and what is really expected as we start talking about these healthcare chronic diseases and illnesses.
So I just want to put that out there. So I don't, I want your response.
I am so glad you did. I think you said it way better than I did. I was kind of trying to get at the same point, I think, that We have to support communities to be able to be more responsible and to create those expectations. Absolutely. You know, you're right about that. I think we need to be more explicit.
The expectations shouldn't be lowered for, you know, investing in the capacity of more community-based organizations to take more charge. But they also need to then, you know, be able to to deliver, as you say, and that's not a one way street.
So I love what you said about, you know, let's let's set the expectations higher and then let's have a dialogue about, you know, what is needed to be able to fulfill those expectations and get, you know, get the get the outside in, you know, perspective switched to the other way.
You know, it's interesting, you know, we're I think today or tomorrow the state is going to be publicly getting out their, their plan for cardiovascular disease and diabetes, their state plan. And one of the things that kind of slowed up the process was this whole idea of community engagement. Okay. So it, it turned out it was easy for communities to identify what they wanted. On the other hand,
getting them engaged in working with the strategy, ownership of the strategy. It's not just identifying what it is, it's like how it is, can we accomplish it together? And if you own it as a community and a good leaders in the communities understand that, then more action can come from that and hopefully better results.
One thing, Jan, I wanted to reflect on for you is, as we're talking about plans, is, and I'm sure you're aware of it, healthy people, the objectives for the nation, 2030. Okay, so one of our dear colleagues, Nico Prank, was one of the co-chairs in developing the national objectives for the nation. How was it leading the health departments Were we engaged in that or are we engaged in it?
Or is it just a function of being aware that these objectives exist and hopefully whatever work that we do at the state can complement that? So how is it that we embraced the objectives for the nation?
You know, I'm not sure I'm in a great position to answer that just because the last three years, as you said earlier, were hijacked by everything. So I don't have a great answer to that question, but I do think. that we need to do a better job of lining up our state priorities with the national.
And we've spent a lot of time writing plans, and I'm not always sure that we're using the plans that already exist well enough to save the resources. I did want to, if it's okay, Stan, I know Clarence was trying to make another point there before. I know we're getting close on time, but I just wanted to turn it back to Clarence and see if he had another comment that he wanted to make.
I did, but at my age, I forgot. You're entitled.
You're entitled. Okay. Okay.
Sorry about that, Clarence.
So Jan, all right. So, all right. So now you've retired from, from the health department. Let's talk about just for, you know, maybe the final thoughts here. Knowledge transferred. How do you transfer your knowledge as a leader to a new leader? Or maybe not. Is it just an assumption that, okay, somebody else is going to be appointed, you know, in this case, commissioner. And thank you very much.
Knowledge transfer.
Yeah.
Well, I think there's often not a lot of time for that. And I'm so proud of Commissioner Cunningham and the work that she has been doing and will be doing on equity and so many other things. The job is like you're in the deep end of the pool right away and having to juggle a million things and there's not as much time for that sort of
reflection and bigger picture conversation that things tend to be more like, how do I handle this thing? And anything a former colleague can do to help their successor. I think there certainly is a willingness. I know I'm part a member of the Alumni Society of the Association of State and Territorial Health Officers. And we talk about that a lot.
It's like, how do we make this easier for the folks who've been around the block a few times to be helpful to the people who are in the hot seat now? Because it's just The pace of the work doesn't really allow that as much as you would wish. How do we build more time into the jobs of leaders at any level for this kind of continual learning and reflection and improvement?
We don't do a very good job of saying how much of the leader's job is that.
Yeah. You know, I, I'm sure she knows that, you know, you're, you're as close as a phone call away. Oh yeah.
We talk. Right.
Right. It's just like, help, help me out here, Jan. It's kind of like final thoughts, Clarence.
Thank you. I think there's a lot I'm going to be chewing on as we listen to this program. But thank you very much. And I think that it's a pleasure. And now I'll reinstate what Stan said. He was talking about what a pleasure it was to listen to you. It was a pleasure for me to listen to you. And thank you for your insight.
Thank you. Nice to be with you this morning.
You know, Jan, it feels as though in many ways, we've shared a lot of history together. You know, we've gone down, you know, perhaps different public health paths, but it's always been complimentary. You know, like you were president of the Minnesota Public Health Association, as was I. And those are dear, dear colleagues that you can always count on for insight and encouragement.
One thing I can say from my perspective to you is you always provided, whether or not you realized it or not, either directly or even indirectly encouragement to me as a colleague. And I greatly, greatly appreciate that. I I've come to realize that perhaps that is the ultimate form of leadership, is providing constant encouragement, trust with one another.
Like I always knew that if I'd get in contact with you, I'd hear from you at one point or another, I'd hear back from you or vice versa. Or if I needed insight from you or vice versa, we could get it from one another. And to me, that supersedes everything. And I want to really, really thank you as a colleague in the healthcare area for that.
That's very kind of you, Stan. And I think that that is, again, kind of what I love about public health, the people in public health.
Yeah, yeah.
We don't always do it perfectly, but we get it that, you know, this is a team effort. It's not just individuals working really hard. It's the collective impact of people knowing how to work together and how to support each other. So I think that's a great note to end on. Thank you.
Yeah. We all know how to give each other a good hug when we need it. And so thank you. So thank you for a perspective on leadership today for our listening audience. We've got many, many great shows coming up.
Our next show that we'll be doing ironically is on the new state plan for cardiovascular disease and diabetes, which will lend itself very, very nicely and compliment this show very nicely going forward. So for all of you out in listening land, Keep health chatting away.
Hi, everyone. It's Matthew from Behind the Scenes. And I wanted to let everyone know that we have a new website up and running, healthchatterpodcast.com. You can go on there. You can interact with us. You can communicate with us, send us a message. You can comment on each episode. You can rate us. And it's just another way for everyone to communicate with each
Stan and Clarence and all of us at the Health Chatter team. So definitely check it out. Again, that's healthchatterpodcast.com.