1. Leadership Challenges for Rural Health Departments Louis Rowitz, PhD Director Mid-America Public Health Training Center

2. THE CHALLENGES

3. RURAL HEALTH DEPARTMENTS HAVE TO DO MORE WITH LESS  LESS MONEY  LESS STAFF  GEOGRAPHIC ISOLATION  LIMITED TECHNICAL RESOURCES  POOR SALARIES  FEWER PARTNERS

4. RURAL HEALTH DISPARITIES  HIGHER SMOKING RATES AMONG TEENAGERS AND ADULTS  FEWER DENTAL CARE VISITS  LACK OF HEALTH INSURANCE  HIGHEST DEATH RATES FOR UNINTENTIONAL INJURIES IN GENERAL AND MOTOR VEHICLE INJURIES SPECIFICALLY  HIGH DEATH RATES FOR CHILDREN AND YOUNG ADULTS(AGES1-24)

5. DIVERSITY OF RURAL COMMUNITIES  DIFFERENCES IN ECONOMIES  AGRICULTURE  TOURISM  MANUFACTURING  MINING  ENERGY

6. DIVERSITY (CONTINUED)  DEMOGRAPHIC DIFFERENCES  MOSTLY CAUCASIANS  INCREASE OF MIGRANT STREAM FROM MEXICO IN SOME AREAS  AGING POPULATIONS  LARGE SEGMENTS OF THE POOR  LOWER LEVELS OF EDUCATIONAL ATTAINMENT  MANY ON PUBLIC PAYMENT SYSTEMS IN SOME AREAS

7. DIVERSITY (CONTINUED)  DIFFERENCES IN POPULATION DENSITY  FRONTIER ISSUES  SERVICES ARE OFTEN TIED TO POPULATION DENSITY

8. DIVERSITY (CONTINUED)  DIFFERENCES IN TERRAIN  DISTANCES ACROSS OPEN PLAINS DIFFERENT THAN MOUNTAIN DISTANCES  ADEQUACY OF ROAD AND TRANSPORTATION DIFFERENCES  REGIONAL WEATHER PATTERNS

9. DIVERSITY (CONTINUED)  PROXIMITY TO URBAN AREAS INCREASES ACCESS TO SERVICES

10. DIVERSITY (CONTINUED)  DIFFERENCES IN AVAILABILITY OF RESOURCES  LACK OF SOCIAL CAPITAL  ACCESS TO TECHNOLOGY  AVAILABILITY OF EDUCATION AND TRAINING OPPORTUNITIES  AFFORDABLE HOUSING  GOOD SCHOOLS  TRAINED WORKFORCE

11. DIVERSITY (CONTINUED)  DIFFERENCES IN PUBLIC HEALTH PRESENCE

12. THE LEADERSHIP ISSUES

13.  COLLABORATION  LACK OF RESOURCES  DIFFICULITES IN CARRYING OUT THE CORE FUNCTIONS AND ESSENTIAL SERVICES

14.  UNTRAINED STAFF  CREDENTIALING AND ACCREDITATION  PUBLIC HEALTH PREPAREDNESS

15.  TOO FEW STAFF  OLD EQUIPMENT  DIFFICULTIES IN DISTANCE LEARNING  FEAR OF THE BOARD

16.  BILINGUAL AND CULTURAL ISSUES  AGING POPULATIONS  BORDER HEALTH CONCERNS  LACK OF MONEY

17.  HARD TO GET AND PAY CONSULTANTS  MIGRANT ISSUES  SHARING LEADERSHIP CONCERNS

18.  COMMUNITY ASSESSMENT DIFFICULTIES  PERFORMANCE STANDARDS COMPLEX  SYSTEMS THINKING WITHOUT A SYSTEM

19. LEADERSHIP STRATEGIES

20. LEADERSHIP TEAM BUILDING VALUES CLARIFICATION MISSION VISION GOALS & OBJECTIVES ACTION IMPLEMENTATION EVALUATION POLICY DEVELOPMENT ASSESSMENT POLICY DEVELOPMENT ASSURANCE POLICY DEVELOPMENT ASSURANCE POLICY DEVELOPMENT Rowitz, p. 88, Figure 5-3 LEADERSHIP WHEEL

21. BUILD SOCIAL CAPITAL WITH YOUR BOARD

22. PARTNERSHIPS UTILIZING A REGIONAL MODEL

23. ASSETS PLANNING

24. BUILDING COALITIONS UTILIZING DIFFERENT MEETING MODALITIES -THE MOVEABLE FEAST

25. DIFFERENT TRAINING APPROACHES

26. ADOPT THE SYSTEMS MODEL OF THINKING WITH PUBLIC HEALTH SEEN AS A SYSTEMS ISSUE AND NOT THE SOLE RESPONSIBILITY OF A LOCAL HEALTH DEPARTMENT

27. CHANGE IS INEVITABLE LEADERSHIP IS CRITICAL

28. MORAL COLLABORATION IS THE SECRET TO SOUND LEADERSHIP PRACTICE. BUILD TRUST AND SHARE POWER