October 15, 2017

Claudia S. Plaisted Fernandez, DrPH
Clinical associate professor of maternal and child health

There is no more pressing crisis in America full potential and keep our country at the bottom of today than the fact that the zip code of a child’s birthplace largely determines the course of his or her life. (The University of Washington’s Institute for Health Metrics and Evaluation published the first study about this, in the Journal of the American Medical Association, in 2013.)

Poverty or wealth, food insecurity or nourishment, ineffective or engaging education, neighborhood violence or safety, and absence of or access to basic health care – all can be predicted by zip code, as a number of researchers have studied. These aspects of daily life make up the fabric of our communities, and how we address them in the future largely will determine whether we build a true culture of health in the United States.

The fact that a child’s zip code of birth strongly predisposes how his or her life will unfold raises complex, cross-cutting issues that we call the “wicked problems” facing our society. These wicked problems will not respond to simple, technical solutions, even though those solutions represent our very best science.

The wicked problems are public health issues that require exceptional leadership – the type of boundary- spanning leadership that brings together individuals, teams, organizations and communities to address the core challenges that plague our country. These are the challenges that prevent our children from reaching their international health rankings for developed nations.

Q: How does your work address these ‘wicked problems’?

A: At the Gillings School, we address these complex issues, in part, through our award-winning national and global leadership development institutes. Through these programs, mid- to senior-level public health leaders learn how to implement solutions more effectively by developing healthy organizational cultures that nurture high- performing teams.

Each year, we teach about 250 leaders how to foster thought diversity, employ effective communication skills, negotiate for win-win outcomes and promote innovation. Through our programs, leaders tackle projects that stretch their experience as they apply new skills to real public health issues affecting their home institutions and communities.

For more than 15 years, the Gillings School has provided this multifaceted and individually customized approach to maximizing leadership impact.

Participants in these programs have used their leadership skills to address a variety of public health concerns. One participant in the Maternal and Child Health Public Health Leadership Institute used her training to effect a change in Utah’s state legislation that gave teen mothers who had been abandoned the right to consent for their own vaccines. Prior to the change, these young women did not have the ability to make decisions about their health care – no one did, because they had no guardians and were themselves not of age.

Currently, a team of participants with the Clinical Scholars National Leadership Institute is addressing the fact that children with special needs in Minnesota can seek dental care from only one provider in the entire state, resulting in months of waiting for routine and complex problems alike. Supported by the Robert Wood Johnson Foundation and co-led by the Gillings School and the UNC School of Medicine, the Clinical Scholars program expands our ongoing work to improve the culture of health in the United States.

Q: How will alumni of your programs create healthier communities in the future?

A: Now more than ever, public health leaders must guide their teams in collaborating with communities, garnering diverse expertise and approaches to address the deep problems of society. It takes outstanding leadership to ensure that many voices are heard, competing concerns are considered and multiple needs are met.

The leaders we train come from health care, public health and higher education. In the upcoming year alone, they will address a variety of issues, including the opiate crisis, native health, mental health, teen violence, transgender health, access to higher education, child health, access to women’s reproductive health care, the “One Health” initiative and food insecurity.

Through the Gillings School, many of these leaders also make global connections. They carry their expertise abroad and bring back new perspectives when they return. By 2020, cross-cultural learning opportunities will have taken leaders in our programs to South Africa, Cuba, Vietnam, France and Costa Rica.

Locally and globally, the goal is the same – for all to lead healthier, more productive lives, regardless of where they were born.

Fernandez also is director of the ACOG National Leadership Institute, director of the leadership core of the Food Systems Leadership Institute, co-director and executive coach of the Clinical Scholars National Leadership Institute.

The Gillings School has received national recognition for several of its leadership programs. The Maternal and Child Health Public Health Leadership Institute, sponsored by the U.S. Maternal and Child Health Bureau, was named a ‘Top 15’ program in 2015. The Food Systems Leadership Institute received second- and third-place nods in a national competition in 2016, and the American Congress of Obstetricians and Gynecologists’ Robert C. Cefalo Leadership Institute was named a “Top 10” leadership program in 2017.

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