NACCHO’s Member Spotlight series features interviews with local health department leaders and staff about their careers in public health. This interview features Christopher C. Dobbins, MPH, Director, Gaston County Department of Health and Human Services, in Gastonia, NC. He is also a member of NACCHO’s Board of Directors. Below he shares the challenges of navigating the health landscape during the uncertain future of the Affordable Care Act and the importance of public health awareness.
Tell me about your path into public health.
My path into public health is a bit of a nontraditional one. I grew up here in Gastonia, NC and entered the military right after high school. I served 20 years as a law enforcement officer in the Air Force. When I retired from the Air Force in 2004, I decided to interview for an assistant director position at Gaston County Health Department. At the time, the department was in need of someone with extensive leadership experience, so the health director at the time gave me a shot. I possessed leadership and management experience, but knew very little about public health. Fortunately, the department afforded me the opportunity to study public health at the University of North Carolina in Chapel Hill. I fell in love with the field and acquired my masters in public health. I felt the public health field was easy for me to understand, would give me a greater opportunity to make positive impacts in my community, and it gave me a purpose. So in the end, I got the leadership first, and then learned public health second. I understand that some people would think the way I arrived to where I am, is a bit unconventional but I feel that my job to is to hire those experts, not be the expert.
What would you say are some of the highlights of your career in this field?
Going back to school in my mid-40’s, unlike the traditional out-of-high school or fresh out of college and applying what I was learning to my position was definitely an experience. I never imagined being a director of anything or getting hired to run a health department.
I think my time in law enforcement has helped with overseeing some of the social services functions, because those professionals do a lot of the same things a law enforcement officer does, only without a gun. Visiting with families, dealing with very difficult situations is part of both professions.
In 2017, unbeknownst to me, my staff nominated me for the North Carolina Director of the Year Award, which I received. That was monumental for me because I never would have guessed that I would ever be recognized at that level.
Each year, our adjacent county hosts a large local fair. About five years ago, there was an outbreak at the petting zoo section, and unfortunately, a young person died due to complications caused by the outbreak. In the face of this tragedy, there were a lot lessons learned. In response to that tragic incident, we set out to educate the public and make changes to how animals are showcased during the fair. As a result, fair-goers are no longer allowed to touch the animals. Definitely a lot of lessons learned.
Are there any programs or initiatives that your department has going on right now that you’d like to highlight?
We were awarded a $5 million grant from the Centers for Disease Control and Prevention that allowed us to address the significant teen pregnancy rates in our area. Over the life of the Gaston Youth Connected program, the goal was to reduce teen pregnancy by 10 percent. During that program, we more than met our goal and lowered teen pregnancy in our area by 40 percent. After the success of the program, the department decided to continue the initiative.
In 2016, the department, in collaboration with numerous community stakeholders, launched another initiative called the STAR Program; it’s a substance abuse program for mothers that are pregnant or have recently delivered and addresses babies that are born addicted to drugs. The program provides several services including 24-hour full service care to pregnant women, delivers medication assistance treatment services to women 18 months after delivery, and educates expectant mothers on neonatal abstinence syndrome. The program has significantly influenced the health decisions of the participating mothers.
What makes the work you do worthwhile?
Going back to your home town and being able to help your community be healthier and knowing you’re part of that is very fulfilling. Not wanting to fail is a great motivator. Coming home and being that hometown boy comes back to the community. I really have enjoyed coming back to my community after my military service and giving back. I feel like a part of the community. There’s a lot of buy-in in both ways; I want to see us thrive and I believe the community is happy that I’m the one to lead the charge, and that I’m part of their team, improving their health.
What are some of the issues that you or your local health department are currently facing?
Trying to navigate around the uncertainty of the future of the Affordable Care Act (ACA), or what is healthcare going to look like, is a bit of a challenge. We’re hired and trusted to learn how to sustain programs and decide what programs are needed; so when you don’t know what that looks like, it’s a challenge. It’s hard to forecast what kind of staff, programs, and resources you need if you’re not sure if you’re going to be the one providing that or if those things will even be available. I think the uncertainty is probably the biggest challenge for us. I have a few ACA experts on staff that do their job day in and day out; my job is to give them what they need to do their jobs. The uncertainty of the ACA is kind of scary; my staff are counting on me to know what that looks like. That’s what keeps me up at night, as far as the challenges. Also, the more obvious challenge is limited resources. You never have enough resources for all the things you want to do.
What is the biggest change you’ve seen in this field?
I think, depending on certain parts of the country, public health is moving away from heavy clinical service. I believe public health is becoming more traditional. The clinical services are moving to practices, and that’s probably appropriate, given their ability to deliver affordable and timely services. Reinventing your department and making the community aware of the importance of public health is imperative and something I’ve seen more of over the years. The public oftentimes doesn’t think about the ways we keep them safe and healthy by performing restaurant inspections, providing immunizations, helping to enact no-smoking ordinances for clean breathing air, and implementing safe drinking water measures. I guess you could even lump that into another challenge; making sure that the community is aware and appreciative of those other services that they may not think about.
You previously mentioned that it was a slightly difficult to position your staff or administer certain services because of what may happen with the ACA, but in other roles or other facets, how are you positioning yourself or your health department for the future?
One of the things that we do any time a vacancy comes available is ask questions. Is this a position that we need? Do we need to fill this position immediately? Is this a position that needs to be either reclassified or modified? Is there a need somewhere else in the agency? We’re constantly reviewing the need for any position in the organization during this situation.
Simply filling an empty position doesn’t address a need; it addresses a vacancy and it’s just a cookie-cutter, plug- and-play process. We also take a look at who funds the position. A lot of times, people see positions based on the personality of the person who’s sitting in the job, versus the actual needs and the requirements of that position. Disregarding an employees’ personality and trying to really assess what that position can do or needs to do for the organization is a way of constantly positioning yourself right for what’s next for the organization.
How long have you been a member of NACCHO?
I’ve been an active NACCHO member for about four years now. I’m relatively new, still learning, and it was an amazing experience going to Pittsburgh for NACCHO Annual 2017 and meeting the Board and really seeing NACCHO from the inside for the first time. Watching Umair deal with the effects of Hurricane Harvey in Houston was an eye-opening experience for me. It’s made me appreciate what we have here in small-town Gastonia, North Carolina. I’m not sure I’m ready for the big lights and the big stage of some of those other entities like a Houston or Atlanta. To see what those leaders are doing is quite humbling, to be perfectly honest.
What value do you find in belonging to NACCHO?
Resources! A toolbox of different sorts of resources pertaining to policy, advocacy, and mentorship is an amazing return on my membership investment. I don’t know that there’s a public health question that I have that couldn’t either be answered through the website, or through connectivity with one of those areas. The ability to be plugged in to Capitol Hill, advocacy updates, to know what the challenges are, and what we need to be advocating for. In the absence of having a crystal ball, NACCHO provides an idea of what the landscape looks like and what the challenges are. Going to NACCHO Annual, meeting others, and networking feels more like meeting family; a public health family. You can really take advantage of the resources they provide. From a leadership standpoint, NACCHO Annual is a warehouse of public health assistance. And if you don’t know the answer, they can certainly refer you to the right people to help. I like that NACCHO is not judgmental, very open to new ideas, and they don’t project any kind of political view or party stance on anything.
When you’re away from work, what do you enjoy doing in your free time?
The one thing I enjoy is golf which I call ‘conducting air samples.’ I love getting out and taking advantage of the green grass and the local environment; swinging the club and hitting that little white ball from time to time.
Lastly, I’d like to say one of the great things about NACCHO is after the day was over, is just being able to talk to the other board members at some of the social events about what they’re doing in their state and their county. It’s a great opportunity to learn, and there’s people out there with all kinds of best practice examples, and what a great way to learn from other people’s mistakes and avoid some of those hurdles and pitfalls along the way, so maybe one of these programs can help somebody else.
For more interviews in the series, visit NACCHO Voice Member Spotlight.