Comments on "important challenges"

We asked a week or two ago about the important challenges facing public health.

In response to your question as to what are the most important public health challenges these days, I would offer the following -- the pressure that the increase in population is putting on our public health systems. These include medical care for different population groups, especially the elderly; increasing amounts of resources for meeting the needs of larger populations, and here I would mention public water supplies , as we are still in a drought; and the effect that development to provide for more people is having on environment, and here I would mention the loss of wildlife habitat, recreational open space, and natural vegetation.

Great point-- as you say, the population pressure comes from the numbers, but also the density and the location of population increases. Note that many of the populations that are increasing are populations that have unmet health needs (immigrants, children, elders, the uninsured).

A friend who attended the Wisconsin Public Health Association Conference added the following:

Youth violence -- it cannot merely be a problem for law enforcement: its causes are broad, and it affects all of us in some way. By the way there was also a talk about the importance of partnerships in public health, which seems right down this book's alley.

Violence is slowly being recognized as a public health issue. I see lots of room for alliances between traditional public health organizations and the many organizations that work on violence prevention specifically. Lots of other groups have a big stake in this issue: law enforcement, health care, economic development, education. A huge challenge but also as you point out a huge opportunity. People who work with the victims of violence are really hungry for solutions on the prevention side.

A central challenge for a violence prevention alliance will be to figure out how to start understanding the issue the same way, and how to start taking useful steps, and how to share the work (and the cost) in a way that is equitable and sustainable.

There are school-based programs and outreach programs that have been rigorously evaluated-- read more about them on thecommunityguide.org.

Americans learned to recycle; most of us quit smoking; a few of us went to the moon; we sent a robot to dig up water from the surface of Mars. The fact that the violence issue is complex could be scary-- or it could keep people interested and motivated!

--Steve Orton

Seeing through the fog

Big day in Chapel Hill today: the twenty-second cohort of the Management Academy started their program at the Rizzo Center.

Jim Johnson talked about civic entrepreneurship this evening. A couple of points hit me as especially relevant right now. First is the notion that most organizations, and most managers and leaders, are in a fog bank right now. It is difficult for most people to clearly see beyond what is right in front them.

Organizations that can find some clarity, that can see ahead instead of focusing right in front of them, will be at a great advantage. Some organizations will be stopping on the side of the road (try not to rear-end them as you go by).

Second is that even in the fog, some things are predictable. To deal with the unexpected, you have to be flexible and lucky. But some things are completely expected. There's no excuse for ignoring the obvious.

Demographics provides a great example. Your workforce is aging. The first baby boomer, Jim said, turned 62 on January 1st this year. That leading edge of the boom generation hits retirement age in three short years, 2011. Are you prepared? Are new leaders and managers being identified and prepared in your organization? Are systems and incentives being put in place to recruit the new workers you will need? Are systems and incentives being developed to retain the baby boomers that you want to stick around a while longer, even though they might be more expensive and less able to read small print and zip around the internet? Or is the organization focused on more immediate concerns?

One team tonight said they wanted to design a business plan to sustain an effort that is currently being maintained by grant funding. They know that grant funding, like an aging cohort of workers, eventually goes away.
The entrepreneur does two things that might seem at odds: one, see clearly what is really happening now , and two, see what could happen, even if it is completely different.

--Steve Orton